WorldWideScience

Sample records for policy service delivery

  1. Inclusive Service Delivery : Yemen Policy Note 4

    OpenAIRE

    World Bank Group

    2017-01-01

    The ongoing conflict in Yemen has led to substantial destruction of physical infrastructure and significant disruptions in public services, livelihoods, income and well-being of individuals and households throughout the country. With little signs of the conflict abating,innovative options are now being explored to rehabilitate infrastructure and restore services during and immediately afte...

  2. Point of Care Testing Services Delivery: Policy Analysis using a ...

    African Journals Online (AJOL)

    Annals of Biomedical Sciences ... The service providers (hospital management) and the testing personnel are faced with the task of trying to explain these problems. Objective of the study: To critically do a policy analysis of the problems of point of care testing with the aim of identifying the causes of these problems and ...

  3. Human Trafficking in Ethiopia: A Scoping Review to Identify Gaps in Service Delivery, Research, and Policy.

    Science.gov (United States)

    Beck, Dana C; Choi, Kristen R; Munro-Kramer, Michelle L; Lori, Jody R

    2017-12-01

    The purpose of this review is to integrate evidence on human trafficking in Ethiopia and identify gaps and recommendations for service delivery, research and training, and policy. A scoping literature review approach was used to systematically search nursing, medical, psychological, law, and international databases and synthesize information on a complex, understudied topic. The search yielded 826 articles, and 39 met the predetermined criteria for inclusion in the review. Trafficking in Ethiopia has occurred internally and externally in the form of adult and child labor and sex trafficking. There were also some reports of organ trafficking and other closely related human rights violations, such as child marriage, child soldiering, and exploitative intercountry adoption. Risk factors for trafficking included push factors (poverty, political instability, economic problems, and gender discrimination) and pull factors (demand for cheap labor). Trafficking was associated with poor health and economic outcomes for victims. Key recommendations for service delivery, research and training, and policy are identified, including establishing comprehensive services for survivor rehabilitation and reintegration, conducting quantitative health outcomes research, and reforming policy around migration and trafficking. Implementing the recommendations identified by this review will allow policy makers, researchers, and practitioners to take meaningful steps toward confronting human trafficking in Ethiopia.

  4. A Critical Discourse Analysis of Provincial Policies Impacting Shelter Service Delivery to Women Exposed to Violence.

    Science.gov (United States)

    Burnett, Camille; Ford-Gilboe, Marilyn; Berman, Helene; Ward-Griffin, Cathy; Wathen, Nadine

    2015-01-01

    Shelters for abused women function within a broad context that includes intersecting social structures, policies, and resources, which may constrain and limit the options available to abused women and tacitly reinforce the cycle of abuse. This feminist, qualitative study combined in-depth interviews and focus groups conducted with 37 staff and four executive directors from four shelters in Ontario, Canada, along with a critical discourse analysis of salient policy texts. Together, the interviews and critical discourse analysis formed an integrated analysis of the dialectic between policy as written and enacted. The study findings illuminate the complexity of the system and its impact on women, shelters, and the community and highlight how specific types of social policies and various social system subsystems and structures, and system configuration, shape the day to day reality of shelter service delivery and impact outcomes for abused women and their children. Collectively, these findings offer direction regarding where these policies could be improved and provide a basis for shelters, policy makers, advocates, and the community to strengthen current services and policies, potentially enhancing outcomes for women. © The Author(s) 2015.

  5. Emergence of a rehabilitation medicine model for low vision service delivery, policy, and funding.

    Science.gov (United States)

    Stelmack, Joan

    2005-05-01

    A rehabilitation medicine model for low vision rehabilitation is emerging. There have been many challenges to reaching consensus on the roles of each discipline (optometry, ophthalmology, occupational therapy, and vision rehabilitation professionals) in the service delivery model and finding a place in the reimbursement system for all the providers. The history of low vision, legislation associated with Centers for Medicare and Medicaid Services coverage for vision rehabilitation, and research on the effectiveness of low vision service delivery are reviewed. Vision rehabilitation is now covered by Medicare under Physical Medicine and Rehabilitation codes by some Medicare carriers, yet reimbursement is not available for low vision devices or refraction. Also, the role of vision rehabilitation professionals (rehabilitation teachers, orientation and mobility specialists, and low vision therapists) in the model needs to be determined. In a recent systematic review of the scientific literature on the effectiveness of low vision services contracted by the Agency for Health Care Quality Research, no clinical trials were found. The literature consists primarily of longitudinal case studies, which provide weak support for third-party funding for vision rehabilitative services. Providers need to reach consensus on medical necessity, treatment plans, and protocols. Research on low vision outcomes is needed to develop an evidence base to guide clinical practice, policy, and funding decisions.

  6. Impact of free delivery policy on utilization of maternal health services in county referral hospitals in Kenya.

    Science.gov (United States)

    Njuguna, John; Kamau, Njoroge; Muruka, Charles

    2017-06-21

    Kenya has a high maternal mortality rate. Provision of skilled delivery plays a major role in reducing maternal mortality. Cost is a hindrance to the utilization of skilled delivery. The Government of Kenya introduced a policy of free delivery services in government facilities beginning June 2013. We sought to determine the impact of this intervention on facility based deliveries in Kenya. We compared deliveries and antenatal attendance in 47 county referral hospitals and 30 low cost private hospitals not participating in the free delivery policy for 2013 and 2014 respectively. The data was extracted from the Kenya Health Information System. Multiple regression was done to assess factors influencing increase in number of deliveries among the county referral hospitals. The number of deliveries and antenatal attendance increased by 26.8% and 16.2% in county referral hospitals and decreased by 11.9% and 5.4% respectively in low cost private hospitals. Increase in deliveries among county referral hospitals was influenced by population size of county and type of county referral hospital. Counties with level 5 hospitals recorded more deliveries compared to those with level 4 hospitals. This intervention increased the number of facility based deliveries. Policy makers may consider incorporating low cost private hospitals so as to increase the coverage of this intervention.

  7. Relationship between tobacco control policies and the delivery of smoking cessation services in nonprofit HMOs.

    Science.gov (United States)

    Stevens, Victor J; Solberg, Leif I; Quinn, Virginia P; Rigotti, Nancy A; Hollis, Jack A; Smith, K Sabina; Zapka, Jane G; France, Eric; Vogt, Thomas; Gordon, Nancy; Fishman, Paul; Boyle, Raymond G

    2005-01-01

    This project examined tobacco policies and delivery of cessation services in nonprofit HMOs that collectively provide comprehensive medical care to more than 8 million members. Three annual surveys with health plan managers showed that all of these health plans had written tobacco control guidelines that became more comprehensive over the span of this study. We also surveyed a random sample of 4207 current smokers who had attended a primary care visit in the past year (399-528 at each of nine health plans). Of these smokers, 71% reported advice to quit, 56% were asked about their willingness to quit, 49% were provided some assistance in quitting (mostly self-help material or information about classes or counseling), and 9% were offered some kind of follow-up. Smokers receiving assistance in quitting reported higher satisfaction with their care. In general, health plans with the most comprehensive policies also showed higher rates of implementing tobacco treatment programs in primary care. Compared with tobacco control efforts of a decade or more ago, considerable progress has been made. However, there is still room for improvement in the proportion of smokers who receive the most effective forms of assistance in quitting.

  8. Health services financing and delivery: analysis of policy options for Dubai, United Arab Emirates

    Directory of Open Access Journals (Sweden)

    Hamidi S

    2015-02-01

    Full Text Available Samer Hamidi School of Health and Environmental Studies, Hamdan Bin Mohammed Smart University, Dubai, United Arab Emirates Introduction: A national health account (NHA provides a systematic approach to mapping the flow of health sector funds within a specified health system over a defined time period. This article attempts to present a profile of health system financing in Dubai, United Arab Emirates using data from NHAs, and to compare the functional structures of financing schemes in Dubai with schemes in Qatar and selected member countries of the Organization for Economic Cooperation and Development (OECD. Methods: The author analyzed secondary data published in NHAs of Dubai and Qatar and data collected by the OECD countries and publicly available from Eurostat (Statistical Office of the European Union of 25 OECD countries for comparative analysis. All health financing indicators used were as defined in the international System of Health Accounts (SHA. Results: In Dubai, spending on inpatient care was the highest-costing component, with 30% of current health expenditures (CHE. Spending on outpatient care was the second highest-costing component and accounted for about 23% of the CHE. Household spending accounted for about 22% of CHE (equivalent to US$187 per capita, compared to an average of 20% of CHE of OECD countries. Dubai spent 0.02% of CHE on long-term care, compared to an average of 11% of CHE of OECD countries. Dubai spent about 6% of CHE on prevention and public health services, compared to an average of 3.2% of CHE of OECD countries. Conclusion: The findings point to potential opportunities for growth and improvement in several health policy issues in Dubai, including increasing focus and funding of preventive services; shifting from inpatient care to day surgery, outpatient, and home-based services and strengthening long-term care; and introducing cost-containment measures for pharmaceuticals. More investment in the translation of

  9. Health policies and federative gaps in Brazil: an analysis of regional capacity of services delivery.

    Science.gov (United States)

    Ribeiro, José Mendes; Moreira, Marcelo Rasga; Ouverney, Assis Mafort; Silva, Cosme Marcelo Furtado Passos da

    2017-04-01

    This paper analyzes Brazilian health regions according to their service delivery capacity from the debate on the crisis of cooperative federalism in the SUS that resulted from decentralizing process established in the 1988 Constitution. Service delivery capacity tracer indicators were selected by regions and statistical analyses evidenced greater regional capacity in hospital care and large asymmetries with regard to the availability of physicians, high complexity equipment and private insurance coverage. In conclusion,we argue that further solutions are required to strengthen governmental capacity to reduce regional inequalities throughincreased central coordination.

  10. Forest biodiversity and the delivery of ecosystem goods and services: translating science into policy

    Science.gov (United States)

    Ian Thompson; Kimiko Okabe; Jason Tylianakis; Pushpam Kumar; Eckehard G. Brockerhoff; Nancy Schellhorn; John A. Parrotta; Robert Nasi

    2011-01-01

    Biodiversity is integral to almost all ecosystem processes, with some species playing key functional roles that are essential for maintaining the value of ecosystems to humans. However, many ecosystem services remain nonvalued, and decisionmakers rarely consider biodiversity in policy development, in part because the relationships between biodiversity and the provision...

  11. Globalisation, rural restructuring and health service delivery in Australia: policy failure and the role of social work?

    Science.gov (United States)

    Alston, Margaret

    2007-05-01

    The impacts of globalisation and rural restructuring on health service delivery in rural Australia have been significant. In the present paper, it is argued that declining health service access represents a failure of policy. Rural communities across the world are in a state of flux, and Australia is no different: rural communities are ageing at faster rates than urban communities and young people are out-migrating in large numbers. During the past 5 years, rural Australia has also experienced a severe and widespread drought that has exacerbated rural poverty, and impacted on the health and well-being of rural Australians. Australian governments have responded to globalising forces by introducing neoliberal policy initiatives favouring market solutions and championing the need for self-reliance among citizens. The result for rural Australia has been a withdrawal of services at a time of increased need. This paper addresses the social work response to these changes.

  12. Human factors that derail extension services delivery in developing countries: implications for policy

    Directory of Open Access Journals (Sweden)

    E.N. Ajani

    2012-12-01

    Full Text Available The paper examines human factors derailing extension services delivery in developing countries. Poor management of rewards and incentives; quality of work life; poor assessment system; limited quality of human resource; inadequate extension support training materials; inconsistencies of government programmes; inadequate staff training and poor extension programme evaluation were viewed as major constraints. Considering the role of extension to agricultural development, the paper recommends that efforts should be made by the various stakeholders in agricultural extension services to improve the capability of human resources involved in extension services and highlights the need for government agricultural programmes to be consistent to enable the beneficiaries of such programmes derive the benefits that will boost productivity in agriculture.

  13. The Development of Statewide Policies and Procedures to Implement Telehealth for Part C Service Delivery

    Directory of Open Access Journals (Sweden)

    Beth Cole

    2016-12-01

    Full Text Available The use of telehealth has been discussed nationally as an option to address provider shortages for children, birth through two, enrolled in Part C of the Individuals with Disabilities Education Act (IDEA Early Intervention (EI programs. Telehealth is an evidence-based service delivery model which can be used to remove barriers in providing EI services to children and their families. In 2016, Colorado’s Part C Early Intervention (EI program began allowing the use of telehealth as an option for providers to conduct sessions with children and their caregivers. This article outlines the process taken to develop the necessary requirements and supports for telehealth to be incorporated into EI current practice.

  14. Domestic water service delivery indicators and frameworks for monitoring, evaluation, policy and planning: a review.

    Science.gov (United States)

    Kayser, Georgia L; Moriarty, Patrick; Fonseca, Catarina; Bartram, Jamie

    2013-10-11

    Monitoring of water services informs policy and planning for national governments and the international community. Currently, the international monitoring system measures the type of drinking water source that households use. There have been calls for improved monitoring systems over several decades, some advocating use of multiple indicators. We review the literature on water service indicators and frameworks with a view to informing debate on their relevance to national and international monitoring. We describe the evidence concerning the relevance of each identified indicator to public health, economic development and human rights. We analyze the benefits and challenges of using these indicators separately and combined in an index as tools for planning, monitoring, and evaluating water services. We find substantial evidence on the importance of each commonly recommended indicator--service type, safety, quantity, accessibility, reliability or continuity of service, equity, and affordability. Several frameworks have been proposed that give structure to the relationships among individual indicators and some combine multiple indicator scores into a single index but few have been rigorously tested. More research is needed to understand if employing a composite metric of indicators is advantageous and how each indicator might be scored and scaled.

  15. Domestic Water Service Delivery Indicators and Frameworks for Monitoring, Evaluation, Policy and Planning: A Review

    Directory of Open Access Journals (Sweden)

    Jamie Bartram

    2013-10-01

    Full Text Available Monitoring of water services informs policy and planning for national governments and the international community. Currently, the international monitoring system measures the type of drinking water source that households use. There have been calls for improved monitoring systems over several decades, some advocating use of multiple indicators. We review the literature on water service indicators and frameworks with a view to informing debate on their relevance to national and international monitoring. We describe the evidence concerning the relevance of each identified indicator to public health, economic development and human rights. We analyze the benefits and challenges of using these indicators separately and combined in an index as tools for planning, monitoring, and evaluating water services. We find substantial evidence on the importance of each commonly recommended indicator—service type, safety, quantity, accessibility, reliability or continuity of service, equity, and affordability. Several frameworks have been proposed that give structure to the relationships among individual indicators and some combine multiple indicator scores into a single index but few have been rigorously tested. More research is needed to understand if employing a composite metric of indicators is advantageous and how each indicator might be scored and scaled.

  16. Health services financing and delivery: analysis of policy options for Dubai, United Arab Emirates

    Science.gov (United States)

    Hamidi, Samer

    2015-01-01

    Introduction A national health account (NHA) provides a systematic approach to mapping the flow of health sector funds within a specified health system over a defined time period. This article attempts to present a profile of health system financing in Dubai, United Arab Emirates using data from NHAs, and to compare the functional structures of financing schemes in Dubai with schemes in Qatar and selected member countries of the Organization for Economic Cooperation and Development (OECD). Methods The author analyzed secondary data published in NHAs of Dubai and Qatar and data collected by the OECD countries and publicly available from Eurostat (Statistical Office of the European Union) of 25 OECD countries for comparative analysis. All health financing indicators used were as defined in the international System of Health Accounts (SHA). Results In Dubai, spending on inpatient care was the highest-costing component, with 30% of current health expenditures (CHE). Spending on outpatient care was the second highest-costing component and accounted for about 23% of the CHE. Household spending accounted for about 22% of CHE (equivalent to US$187 per capita), compared to an average of 20% of CHE of OECD countries. Dubai spent 0.02% of CHE on long-term care, compared to an average of 11% of CHE of OECD countries. Dubai spent about 6% of CHE on prevention and public health services, compared to an average of 3.2% of CHE of OECD countries. Conclusion The findings point to potential opportunities for growth and improvement in several health policy issues in Dubai, including increasing focus and funding of preventive services; shifting from inpatient care to day surgery, outpatient, and home-based services and strengthening long-term care; and introducing cost-containment measures for pharmaceuticals. More investment in the translation of NHA data into policy is suggested for future researchers. PMID:25750545

  17. Health services financing and delivery: analysis of policy options for Dubai, United Arab Emirates.

    Science.gov (United States)

    Hamidi, Samer

    2015-01-01

    A national health account (NHA) provides a systematic approach to mapping the flow of health sector funds within a specified health system over a defined time period. This article attempts to present a profile of health system financing in Dubai, United Arab Emirates using data from NHAs, and to compare the functional structures of financing schemes in Dubai with schemes in Qatar and selected member countries of the Organization for Economic Cooperation and Development (OECD). The author analyzed secondary data published in NHAs of Dubai and Qatar and data collected by the OECD countries and publicly available from Eurostat (Statistical Office of the European Union) of 25 OECD countries for comparative analysis. All health financing indicators used were as defined in the international System of Health Accounts (SHA). In Dubai, spending on inpatient care was the highest-costing component, with 30% of current health expenditures (CHE). Spending on outpatient care was the second highest-costing component and accounted for about 23% of the CHE. Household spending accounted for about 22% of CHE (equivalent to US$187 per capita), compared to an average of 20% of CHE of OECD countries. Dubai spent 0.02% of CHE on long-term care, compared to an average of 11% of CHE of OECD countries. Dubai spent about 6% of CHE on prevention and public health services, compared to an average of 3.2% of CHE of OECD countries. The findings point to potential opportunities for growth and improvement in several health policy issues in Dubai, including increasing focus and funding of preventive services; shifting from inpatient care to day surgery, outpatient, and home-based services and strengthening long-term care; and introducing cost-containment measures for pharmaceuticals. More investment in the translation of NHA data into policy is suggested for future researchers.

  18. Why the Critics of Poor Health Service Delivery Are the Causes of Poor Service Delivery: A Need to Train the Policy-makers

    Science.gov (United States)

    Harding, Nancy

    2015-01-01

    This comment on Professor Fotaki’s Editorial agrees with her arguments that training health professionals in more compassionate, caring and ethically sound care will have little value unless the system in which they work changes. It argues that for system change to occur, senior management, government members and civil servants themselves need training so that they learn to understand the effects that their policies have on health professionals. It argues that these people are complicit in the delivery of unethical care, because they impose requirements that contradict health professionals’ desire to deliver compassionate and ethical forms of care. PMID:26340498

  19. Toward a New Era of Policy: Health Care Service Delivery to First Nations

    Directory of Open Access Journals (Sweden)

    Miranda D. Kelly

    2011-05-01

    Full Text Available The disproportionate burdens of ill health experienced by First Nations have been attributed to an uncoordinated, fragmented health care system. This system is rooted in public policies that have created jurisdictional gaps and a long-standing debate between federal, provincial and First Nations governments as to who is responsible for First Nations health care. This article examines: (1 the policies that shape First Nations health care in Canada and in the province of British Columbia (BC specifically; (2 the interests of the actors involved in First Nations health policy; and (3 recent developments in BC that present an opportunity for change to First Nations health policy development and have broader implications for Indigenous health policy across Canada and worldwide.

  20. Issues affecting therapist workforce and service delivery in the disability sector in rural and remote New South Wales, Australia: perspectives of policy-makers, managers and senior therapists.

    Science.gov (United States)

    Veitch, Craig; Dew, Angela; Bulkeley, Kim; Lincoln, Michelle; Bundy, Anita; Gallego, Gisselle; Griffiths, Scott

    2012-01-01

    The disability sector encompasses a broad range of conditions and needs, including children and adults with intellectual and developmental disabilities, people with acquired disabilities, and irreversible physical injuries. Allied health professionals (therapists), in the disability sector, work within government and funded or charitable non-government agencies, schools, communities, and private practice. This article reports the findings of a qualitative study of therapist workforce and service delivery in the disability sector in rural and remote New South Wales (NSW), Australia. The aim was to investigate issues of importance to policy-makers, managers and therapists providing services to people with disabilities in rural and remote areas. The project gathered information via semi-structured interviews with individuals and small groups. Head office and regional office policy-makers, along with managers and senior therapists in western NSW were invited to participate. Participants included 12 policy-makers, 28 managers and 10 senior therapists from NSW government agencies and non-government organisations (NGOs) involved in providing services and support to people with disabilities in the region. Information was synthesised prior to using constant comparative analysis within and across data sets to identify issues. Five broad themes resonated across participants' roles, locations and service settings: (1) challenges to implementing policy in rural and remote NSW; (2) the impact of geographic distribution of workforce and clients; (3) workforce issues - recruitment, support, workloads, retention; (4) equity and access issues for rural clients; and (5) the important role of the NGO sector in rural service delivery and support. Although commitment to providing best practice services was universal, policy-related information transfer between organisations and employees was inconsistent. Participants raised some workforce and service delivery issues that are similar to

  1. Law, policy and the use of non-physicians in family planning service delivery.

    Science.gov (United States)

    Paxman, J M

    1979-04-01

    A great deal of attention is being devoted to the use of nonphysicians to provide such fertility control services as contraception, sterilization, and abortion. Legal obstacles exist, however, which must be overcome before the role of nonphysicians can be expanded. Such obstacles include medical practice statutes, nursing and midwifery legislation, and laws and regulations directly related to such fertility control measures as the provision of contraceptions and the performance of sterilizations. On the other hand, the following 3 main approaches have been used to permit increased participation of nonphysicians: delegation of tasks by physicians, liberal interpretation of existing laws, and authorization. Thus, the important elements in expanding the roles of nonphysicians are 1) authorization; 2) training; 3) qualification; 4) supervision; and 5) opportunities for referrals to physicians. The ultimate role of paramedicals will depend upon the continued simplification of technology, the results of research on the quality of care which they can provide, the attitudes of the medical profession, and the elimination of the legal ambiguities and obstacles which exist.

  2. Integrating evidence into policy and sustainable disability services delivery in western New South Wales, Australia: the 'wobbly hub and double spokes' project.

    Science.gov (United States)

    Veitch, Craig; Lincoln, Michelle; Bundy, Anita; Gallego, Gisselle; Dew, Angela; Bulkeley, Kim; Brentnall, Jennie; Griffiths, Scott

    2012-03-21

    Policy that supports rural allied health service delivery is important given the shortage of services outside of Australian metropolitan centres. The shortage of allied health professionals means that rural clinicians work long hours and have little peer or service support. Service delivery to rural and remote communities is further complicated because relatively small numbers of clients are dispersed over large geographic areas. The aim of this five-year multi-stage project is to generate evidence to confirm and develop evidence-based policies and to evaluate their implementation in procedures that allow a regional allied health workforce to more expeditiously respond to disability service need in regional New South Wales, Australia. The project consists of four inter-related stages that together constitute a full policy cycle. It uses mixed quantitative and qualitative methods, guided by key policy concerns such as: access, complexity, cost, distribution of benefits, timeliness, effectiveness, equity, policy consistency, and community and political acceptability. Stage 1 adopts a policy analysis approach in which existing relevant policies and related documentation will be collected and reviewed. Policy-makers and senior managers within the region and in central offices will be interviewed about issues that influence policy development and implementation. Stage 2 uses a mixed methods approach to collecting information from allied health professionals, clients, and carers. Focus groups and interviews will explore issues related to providing and receiving allied health services. Discrete Choice Experiments will elicit staff and client/carer preferences. Stage 3 synthesises Stage 1 and 2 findings with reference to the key policy issues to develop and implement policies and procedures to establish several innovative regional workforce and service provision projects. Stage 4 uses mixed methods to monitor and evaluate the implementation and impact of new or adapted

  3. Controlling service delivery in service triads

    NARCIS (Netherlands)

    Iwaarden, van J.; Valk, van der W.; Aalders, L.; Virolainen, V.-M.

    2010-01-01

    Organizations are increasingly sourcing services that are directly delivered to their (end) customers by external providers. Buying organization, supplier and (end) customer operate in a triadic service relationship. In these triads, the buying organization lacks direct control over service delivery

  4. Situation Analysis of Healthcare Service Delivery using ...

    African Journals Online (AJOL)

    ISML5

    7. No. 1, AARSE 2017 Special Edition, January 2017. 75. Situation Analysis of ... then becomes a major bottleneck to proper planning and policy formulation in healthcare delivery. ... Uganda Annual Health Sector Performance Report for Financial Year 2014/15 ... government's strategy of taking services closer to the people.

  5. planning for gender equitable services delivery in a decentralised ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Sarah Ssali

    Services Delivery in Uganda. – Services offered. – Participation. – Decision making process. – Actors. – Issues. • Post-Conflict Situations in Uganda. – Challenges from Conflict. – Decentralisation in Post conflict settings. – Planning for gender equitable services delivery. • Recommendations (Policy). • Research Gaps ...

  6. Clinical leadership development in postgraduate medical education and training: policy, strategy, and delivery in the UK National Health Service

    Directory of Open Access Journals (Sweden)

    Aggarwal R

    2015-11-01

    Full Text Available Reena Aggarwal,1,2 Tim Swanwick2 1Women's Health, Whittington Health, London, UK; 2Health Education England, North Central and East London, London, UK Abstract: Achieving high quality health care against a background of continual change, increasing demand, and shrinking financial resource is a major challenge. However, there is significant international evidence that when clinicians use their voices and values to engage with system delivery, operational efficiency and care outcomes are improved. In the UK National Health Service, the traditional divide between doctors and managers is being bridged, as clinical leadership is now foregrounded as an important organizational priority. There are 60,000 doctors in postgraduate training (junior doctors in the UK who provide the majority of front-line patient care and form an "operating core" of most health care organizations. This group of doctors is therefore seen as an important resource in initiating, championing, and delivering improvement in the quality of patient care. This paper provides a brief overview of leadership theories and constructs that have been used to develop a raft of interventions to develop leadership capability among junior doctors. We explore some of the approaches used, including competency frameworks, talent management, shared learning, clinical fellowships, and quality improvement. A new paradigm is identified as necessary to make a difference at a local level, which moves learning and leadership away from developing "leaders", to a more inclusive model of developing relationships between individuals within organizations. This shifts the emphasis from the development of a "heroic" individual leader to a more distributed model, where organizations are "leader-ful" and not just "well led" and leadership is centered on a shared vision owned by whole teams working on the frontline. Keywords: National Health Service, junior doctors, quality improvement, management, health care

  7. Clinical leadership development in postgraduate medical education and training: policy, strategy, and delivery in the UK National Health Service.

    Science.gov (United States)

    Aggarwal, Reena; Swanwick, Tim

    2015-01-01

    Achieving high quality health care against a background of continual change, increasing demand, and shrinking financial resource is a major challenge. However, there is significant international evidence that when clinicians use their voices and values to engage with system delivery, operational efficiency and care outcomes are improved. In the UK National Health Service, the traditional divide between doctors and managers is being bridged, as clinical leadership is now foregrounded as an important organizational priority. There are 60,000 doctors in postgraduate training (junior doctors) in the UK who provide the majority of front-line patient care and form an "operating core" of most health care organizations. This group of doctors is therefore seen as an important resource in initiating, championing, and delivering improvement in the quality of patient care. This paper provides a brief overview of leadership theories and constructs that have been used to develop a raft of interventions to develop leadership capability among junior doctors. We explore some of the approaches used, including competency frameworks, talent management, shared learning, clinical fellowships, and quality improvement. A new paradigm is identified as necessary to make a difference at a local level, which moves learning and leadership away from developing "leaders", to a more inclusive model of developing relationships between individuals within organizations. This shifts the emphasis from the development of a "heroic" individual leader to a more distributed model, where organizations are "leader-ful" and not just "well led" and leadership is centered on a shared vision owned by whole teams working on the frontline.

  8. Clinical leadership development in postgraduate medical education and training: policy, strategy, and delivery in the UK National Health Service

    Science.gov (United States)

    Aggarwal, Reena; Swanwick, Tim

    2015-01-01

    Achieving high quality health care against a background of continual change, increasing demand, and shrinking financial resource is a major challenge. However, there is significant international evidence that when clinicians use their voices and values to engage with system delivery, operational efficiency and care outcomes are improved. In the UK National Health Service, the traditional divide between doctors and managers is being bridged, as clinical leadership is now foregrounded as an important organizational priority. There are 60,000 doctors in postgraduate training (junior doctors) in the UK who provide the majority of front-line patient care and form an “operating core” of most health care organizations. This group of doctors is therefore seen as an important resource in initiating, championing, and delivering improvement in the quality of patient care. This paper provides a brief overview of leadership theories and constructs that have been used to develop a raft of interventions to develop leadership capability among junior doctors. We explore some of the approaches used, including competency frameworks, talent management, shared learning, clinical fellowships, and quality improvement. A new paradigm is identified as necessary to make a difference at a local level, which moves learning and leadership away from developing “leaders”, to a more inclusive model of developing relationships between individuals within organizations. This shifts the emphasis from the development of a “heroic” individual leader to a more distributed model, where organizations are “leader-ful” and not just “well led” and leadership is centered on a shared vision owned by whole teams working on the frontline. PMID:29355184

  9. Project management: a new service delivery paradigm

    Directory of Open Access Journals (Sweden)

    G. van der Walt

    2007-07-01

    Full Text Available In line with international trends in governance, the South African Government’s initial focus on the development of policy frameworks, structures and systems in order to give effect to the values and principles of the Constitution, shifted to the most critical issue, namely service delivery. The Government became increasingly aware that a significant expansion in the scope and quality of service provision was not possible with traditional delivery settings and approaches. There is growing evidence that there is a need for a significant departure from conventional approaches and that a leap into a new service delivery paradigm is necessary. Increasingly this new paradigm highlights the need to further develop the government’s project management skills and applications with a view to achieving improved delivery capability. In this article the focus will be placed on the changing service delivery paradigm – from an “old” traditional model through the transition to a “new” paradigm. This paradigm is shaped by international and national trends and events in government. The contribution and advantages of project management applications for effective governance are highlighted and the article concludes with an explanation of project management organisational arrangements necessary to support the new paradigm.

  10. Why the Critics of Poor Health Service Delivery Are the Causes of Poor Service Delivery: A Need to Train the Policy-makers; Comment on “Why and How Is Compassion Necessary to Provide Good Quality Healthcare?”

    Directory of Open Access Journals (Sweden)

    Nancy Harding

    2015-09-01

    Full Text Available This comment on Professor Fotaki’s Editorial agrees with her arguments that training health professionals in more compassionate, caring and ethically sound care will have little value unless the system in which they work changes. It argues that for system change to occur, senior management, government members and civil servants themselves need training so that they learn to understand the effects that their policies have on health professionals. It argues that these people are complicit in the delivery of unethical care, because they impose requirements that contradict health professionals’ desire to deliver compassionate and ethical forms of care.

  11. 77 FR 44306 - Service Delivery Plan

    Science.gov (United States)

    2012-07-27

    ... SOCIAL SECURITY ADMINISTRATION [Docket No. SSA-2012-0048] Service Delivery Plan AGENCY: Social... input as we develop our Service Delivery Plan (SDP). We recently completed our Agency Strategic Plan... how we plan to provide our services over the next four years and beyond. DATES: To ensure that we...

  12. Implementation of Fee-Free Maternal Health-Care Policy in Ghana: Perspectives of Users of Antenatal and Delivery Care Services From Public Health-Care Facilities in Accra.

    Science.gov (United States)

    Anafi, Patricia; Mprah, Wisdom K; Jackson, Allen M; Jacobson, Janelle J; Torres, Christopher M; Crow, Brent M; O'Rourke, Kathleen M

    2018-01-01

    In 2008, the government of Ghana implemented a national user fee maternal care exemption policy through the National Health Insurance Scheme to improve financial access to maternal health services and reduce maternal as well as perinatal deaths. Although evidence shows that there has been some success with this initiative, there are still issues relating to cost of care to beneficiaries of the initiative. A qualitative study, comprising 12 focus group discussions and 6 interviews, was conducted with 90 women in six selected urban neighborhoods in Accra, Ghana, to examine users' perspectives regarding the implementation of this policy initiative. Findings showed that direct cost of delivery care services was entirely free, but costs related to antenatal care services and indirect costs related to delivery care still limit the use of hospital-based midwifery and obstetric care. There was also misunderstanding about the initiative due to misinformation created by the government through the media.We recommend that issues related to both direct and indirect costs of antenatal and delivery care provided in public health-care facilities must be addressed to eliminate some of the lingering barriers relating to cost hindering the smooth operation and sustainability of the maternal care fee exemption policy.

  13. 78 FR 15797 - Service Delivery Plan

    Science.gov (United States)

    2013-03-12

    ... SOCIAL SECURITY ADMINISTRATION [Docket No. SSA-2012-0048] Service Delivery Plan AGENCY: Social... input as we finalize our Service Delivery Plan (SDP). We designed our SDP as a roadmap for how we will... Plan. DATES: To ensure that we consider your comments, we must receive them no later than April 11...

  14. Universal service policy in Vietnam

    DEFF Research Database (Denmark)

    Do Manh, Thai; Falch, Morten; Von Salakpi, Simeon

    2016-01-01

    Universal service provision is a key to bridge the digital divide. This paper provides an empirical examination of the Vietnamese universal policy introduced in 2015 for implementation up to 2020. Using the framework of King et al. (1994) the paper analyses the universal services policy in Vietna...

  15. The delivery of primary care services.

    NARCIS (Netherlands)

    Wilson, A.; Windak, A.; Oleszczyk, M.; Wilm, S.; Hasvold, T.; Kringos, D.

    2015-01-01

    This chapter will be devoted to the dimensions which have been grouped in the framework as “process” and that focus on essential features of service delivery in primary care. In addition to the breadth of services delivered, a comparative overview will be provided of variation in access to services,

  16. 42 CFR 460.98 - Service delivery.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Service delivery. 460.98 Section 460.98 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED..., national origin, religion, sex, age, sexual orientation, mental or physical disability, or source of...

  17. Municipal service delivery SET for success

    CSIR Research Space (South Africa)

    Naidoo, S

    2015-10-01

    Full Text Available The application of scientific, engineering and technological solutions by the CSIR to support local government environmental management and service delivery has the potential for significant impact. A case study illustrates the application...

  18. 78 FR 16753 - Service Delivery Plan; Correction

    Science.gov (United States)

    2013-03-18

    ... the first sentence after the words, ``Service Delivery Plan (SDP) insert http://www.ssa.gov/open/SDP... http://ssa.gov/asp/plan-2013-2016.pdf . Paul Kryglik, Director, Office of Regulations, Social Security...

  19. Effect of delivery care user fee exemption policy on institutional ...

    African Journals Online (AJOL)

    Background: To improve access to skilled attendance at delivery and thereby reduce maternal mortality, the Government of Ghana introduced a policy exempting all women attending health facilities from paying delivery care fees. Objective: To examine the effect of the exemption policy on delivery-related maternal mortality.

  20. EPISTEMIC COMMUNITIES AND SERVICE DELIVERY CHOICES IN SPANISH MUNICIPAL ADMINISTRATIONS

    Directory of Open Access Journals (Sweden)

    Miquel SALVADOR

    2015-12-01

    Full Text Available This article contributes to the debate on the use of alternative formulas for public service provision with arguments related to epistemic communities’ influence. Drawing on the literature on models of local public service delivery, the role of internal epistemic communities is discussed and tested through the consideration of two different communities related to specific municipal areas such as personal and urban services. The results demonstrate that the association of urban services’ epistemic communities with alternative formulas for direct provision to deliver services is greater than in the case of personal services’ epistemic community. Those findings contribute to the academic debate not only with arguments and evidence that reinforces the role of variables included in previous research but also by introducing the role of epistemic communities in determining some policy options (as the use of local public-service delivery formulas.

  1. Manual on service business for policy research

    International Nuclear Information System (INIS)

    1999-01-01

    The contents of this book are summary of service business for policy research : conception classification and ways of service business for policy research, propel procedure of service business for policy research on system of committee, management, choice, contract, evaluation and post management, related regulation on service business for policy research : management regulation on service business for policy research, guide of evaluation for service business for policy research, estimation standard of policy research cost, law arrangement of national contract, required document on service business for policy research, and application manual for PRISM.

  2. 20 CFR 628.405 - Service delivery areas.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Service delivery areas. 628.405 Section 628... TITLE II OF THE JOB TRAINING PARTNERSHIP ACT Local Service Delivery System § 628.405 Service delivery... evaluate the degree to which a proposed service delivery area meets criteria established by the Governor...

  3. Personalizing knowledge delivery services: a conceptual framework

    Science.gov (United States)

    Majchrzak, Ann; Chelleppa, Ramnath K.; Cooper, Lynne P.; Hars, Alexander

    2003-01-01

    Consistent with the call of the Minnesota Symposium for new theory in knowledge management, we offer a new conceptualization of Knowledge Management Systems (KMS) as a portfolio of personalized knowledge delivery services. Borrowing from research on online consumer behavior, we describe the challenges imposed by personalized knowledge delivery services, and suggest design parameters that can help to overcome these challenges. We develop our design constructs through a set of hypotheses and discuss the research implications of our new conceptualization. Finally, we describe practical implications suggested by our conceptualization - practical suggestions that we hope to gain some experience with as part of an ongoing action research project at our partner organization.

  4. A review of technology and trends in document delivery services

    Energy Technology Data Exchange (ETDEWEB)

    Bourne, C P [DIALOG Information Services, Inc., Palo Alto, CA (United States)

    1990-05-01

    This paper reviews the major lines of technical development being pursued to extend or replace traditional inter-library loan and photocopy service and to facilitate the delivery of source documents to individual end users. Examples of technical approaches discussed are: (1) the inclusion of full text and image data in central online systems; (2) image workstations such as the ADONIS and UMI systems; and (3) the use of electronic networks for document ordering and delivery. Some consideration is given to the policy implications for libraries and information systems. (author). 11 tabs.

  5. A review of technology and trends in document delivery services

    International Nuclear Information System (INIS)

    Bourne, C.P.

    1990-05-01

    This paper reviews the major lines of technical development being pursued to extend or replace traditional inter-library loan and photocopy service and to facilitate the delivery of source documents to individual end users. Examples of technical approaches discussed are: 1) the inclusion of full text and image data in central online systems; 2) image workstations such as the ADONIS and UMI systems; and 3) the use of electronic networks for document ordering and delivery. Some consideration is given to the policy implications for libraries and information systems. (author). 11 tabs

  6. ELECTRONIC BANKING ADVANTAGES FOR FINANCIAL SERVICES DELIVERY

    Directory of Open Access Journals (Sweden)

    Paun Dragos

    2010-12-01

    Full Text Available E-banking is a fully automatic service for traditionally banking customers products based on information technology platforms. E-banking services provide customer access to accounts, the ability to move their money between different accounts or making payments via e-channels. The advantages generated by this services have determined an accelerate developing of this industry over the entire world. This paper examines some of the advantages of electronic banking products together with the characteristic management issues generated by the implementation of this new channel for financial services delivery.

  7. Quality & timely delivery of products and services

    Energy Technology Data Exchange (ETDEWEB)

    Scott, K.; Shabbir, K. [WorleyParsons, Toronto, ON (Canada)

    2015-07-01

    This paper discusses quality and timely delivery of services. The approach is to support our customers, to ensure quality, schedule and cost predictability with no compromise to safety, to avoid optimistic project schedules and conservative cost estimates. It is important to maintain a strategic focus in helping to improve the customer's assets and improve the methodology to improve assets.

  8. Strategic Promotion And Bank Services Delivery: Operational ...

    African Journals Online (AJOL)

    Chi-square (x2) non-parametric statistical technique was applied in analyzing the primary data so harnessed. The results indicated that Banks services delivery systems are not critically determined by available operational finance. This strategically necessitates budgetary enhancement and focal human capital development ...

  9. Quality & timely delivery of products and services

    International Nuclear Information System (INIS)

    Scott, K.; Shabbir, K.

    2015-01-01

    This paper discusses quality and timely delivery of services. The approach is to support our customers, to ensure quality, schedule and cost predictability with no compromise to safety, to avoid optimistic project schedules and conservative cost estimates. It is important to maintain a strategic focus in helping to improve the customer's assets and improve the methodology to improve assets.

  10. Key Informant Views of a Free Delivery and Caesarean Policy in ...

    African Journals Online (AJOL)

    This article presents the findings of one component of an evaluation of the national policy for free deliveries and caesareans in Senegal. The policy was introduced in 2005 in five more deprived regions of the country. It aimed to reduce the financial barriers to using maternity services and to increase the number of ...

  11. Improving the delivery of preventive care services.

    Science.gov (United States)

    Hung, Dorothy Y

    2007-05-01

    Performance of preventive services is an important indicator of high-quality health care, but many recommended services are not regularly offered in primary care practices. Health risk assessments, counseling, and referral to community-based programs help address risk behaviors, many of which are leading causes of preventable death and disability in the United States. This study examined various influences on the delivery of preventive services designed to address smoking, excessive consumption of alcohol, unhealthy diets, and sedentary lifestyles. More than 300 health care providers in 52 practices nationwide have contributed data to this study. Staff participation in quality improvement enhanced work relationships and also diminished the effect of practice size on the performance of preventive care. The use of nurse practitioners, allied health professionals, clinician reminders, and patient registries were positively associated with care delivery.

  12. Service delivery, community development, and disability.

    Science.gov (United States)

    Murphy, John W

    2010-01-01

    Service delivery has traditionally been based on market forces. When this is the case, the community becomes a silent partner in this process. Services, accordingly, are directed mostly to correcting personal ills and have little to do with community uplift. Another model, based on the work of Amartya Sen, is available that conceptualizes interventions in a very different way. If understood in the context of community development, the focus of services is social change, rather than merely personal rehabilitation. This reorientation is discussed in this article.

  13. Efficient Web Services Policy Combination

    Science.gov (United States)

    Vatan, Farrokh; Harman, Joseph G.

    2010-01-01

    Large-scale Web security systems usually involve cooperation between domains with non-identical policies. The network management and Web communication software used by the different organizations presents a stumbling block. Many of the tools used by the various divisions do not have the ability to communicate network management data with each other. At best, this means that manual human intervention into the communication protocols used at various network routers and endpoints is required. Developing practical, sound, and automated ways to compose policies to bridge these differences is a long-standing problem. One of the key subtleties is the need to deal with inconsistencies and defaults where one organization proposes a rule on a particular feature, and another has a different rule or expresses no rule. A general approach is to assign priorities to rules and observe the rules with the highest priorities when there are conflicts. The present methods have inherent inefficiency, which heavily restrict their practical applications. A new, efficient algorithm combines policies utilized for Web services. The method is based on an algorithm that allows an automatic and scalable composition of security policies between multiple organizations. It is based on defeasible policy composition, a promising approach for finding conflicts and resolving priorities between rules. In the general case, policy negotiation is an intractable problem. A promising method, suggested in the literature, is when policies are represented in defeasible logic, and composition is based on rules for non-monotonic inference. In this system, policy writers construct metapolicies describing both the policy that they wish to enforce and annotations describing their composition preferences. These annotations can indicate whether certain policy assertions are required by the policy writer or, if not, under what circumstances the policy writer is willing to compromise and allow other assertions to take

  14. 42 CFR 136a.15 - Health Service Delivery Areas.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Health Service Delivery Areas. 136a.15 Section 136a... Receive Care? § 136a.15 Health Service Delivery Areas. (a) The Indian Health Service will designate and... Federal Indian reservations and areas surrounding those reservations as Health Service Delivery Areas. (b...

  15. Older adults and the emerging digital service delivery

    DEFF Research Database (Denmark)

    Siren, Anu; Knudsen, Sine Grønborg

    2017-01-01

    Based on data from a survey (n = 3291) and 14 qualitative interviews among Danish older adults, this study investigated the use of, and attitudes toward, information communications technology (ICT) and the digital delivery of public services. While age, gender, and socioeconomic status were...... associated with use of ICT, these determinants lost their explanatory power when we controlled for attitudes and experiences. We identified three segments that differed in their use of ICT and attitudes toward digital service delivery. As nonuse of ICT often results from the lack of willingness to use...... it rather than from material or cognitive deficiencies, policy measures for bridging the digital divide should focus on skills and confidence rather than on access or ability....

  16. Improving Service Delivery of the Finance and Budget Section ...

    African Journals Online (AJOL)

    dell

    Action research was conducted in May and June 2004 aimed at improving service delivery of ... improve service delivery. (Quinby,1985). Furthermore, the intervention stage in which the development of ..... Educational leadership,. 42, 17-21.

  17. 'Wagging the dog': supply chain management and service delivery

    CSIR Research Space (South Africa)

    Wall, K

    2013-09-01

    Full Text Available in the appointment of contractors, leading to delays in the delivery of services. The SCM “tail” would appear on those occasions to be “wagging the dog”, namely service delivery....

  18. original article predictors of safe delivery service utilization in arsi

    African Journals Online (AJOL)

    Abrham

    There is limited information on the mothers' use of skilled delivery services in the ... edited, cleaned, and entered into a computer and analyzed using SPSS for ... education and communication on safe delivery service utilization, expansion of ...

  19. 78 FR 773 - Hartford Financial Services Group, Inc., Commercial/Actuarial/Information Delivery Services (IDS...

    Science.gov (United States)

    2013-01-04

    ... Services Group, Inc., Commercial/Actuarial/ Information Delivery Services (IDS)/Corporate & Financial... Assistance (TAA) applicable to workers and former workers of Hartford Financial Services Group, Inc., Commercial/ Actuarial/Information Delivery Services (IDS)/Corporate & Financial Reporting group, Hartford...

  20. Geographic delivery models for radiotherapy services

    International Nuclear Information System (INIS)

    Roberts, G.H.; Dunscombe, P.B.; Samant, R.S.

    2002-01-01

    The study described here was undertaken to quantify the societal cost of radiotherapy in idealized urban and rural populations and, hence, to generate a measure of impediment to access. The costs of centralized, distributed comprehensive and satellite radiotherapy delivery formats were examined by decomposing them into institutional, productivity and geographical components. Our results indicate that centralized radiotherapy imposes the greatest financial burden on the patient population in both urban and rural scenarios. The financial burden faced by patients who must travel for radiotherapy can be interpreted as one component of the overall impediment to access. With advances in remote-monitoring systems, it is possible to maintain technical quality while enhancing patient access. However, the maintenance of professional competence will remain a challenge with a distributed service-delivery format. Copyright (2002) Blackwell Science Pty Ltd

  1. Quality policy at nuclear medicine services

    International Nuclear Information System (INIS)

    Gil Martinez, Eduardo Manuel; Jimenez, Tomas

    2007-01-01

    In the present text we comment about a Quality Policy model to establish in a Nuclear Medicine Service. The need for a strict control in every process that take place in a Nuclear Medicine Service, requires of an exact planification in terms of Quality Policy, specific to the real needs of every Service. Quality Policy must be a live Policy, with capability of changes and must be known for every workers in a Nuclear Medicine Service. Although the 'model' showed in this text is concret for a specific Service type, it must be extrapolated to any Nuclear Medicine Service with the necessary changes (au)

  2. Steering healthcare service delivery: a regulatory perspective.

    Science.gov (United States)

    Prakash, Gyan

    2015-01-01

    The purpose of this paper is to explore regulation in India's healthcare sector and makes recommendations needed for enhancing the healthcare service. The literature was reviewed to understand healthcare's regulatory context. To understand the current healthcare system, qualitative data were collected from state-level officials, public and private hospital staff. A patient survey was performed to assess service quality (QoS). Regulation plays a central role in driving healthcare QoS. India needs to strengthen market and institutional co-production based approaches for steering its healthcare in which delivery processes are complex and pose different challenges. This study assesses current healthcare regulation in an Indian state and presents a framework for studying and strengthening regulation. Agile regulation should be based on service delivery issues (pull approach) rather than monitoring and sanctions based regulatory environment (push approach). Healthcare pitfalls across the world seem to follow similar follies. India's complexity and experience is useful for emerging and developed economies. The author reviewed around 70 publications and synthesised them in healthcare regulatory contexts. Patient's perception of private providers could be a key input towards steering regulation. Identifying gaps across QoS dimensions would be useful in taking corrective measures.

  3. Mental health service delivery following health system reform in Colombia.

    Science.gov (United States)

    Romero-González, Mauricio; González, Gerardo; Rosenheck, Robert A

    2003-12-01

    change in the pattern of mental health service delivery from a reliance on costly inpatient care to more efficient outpatient services. Health reform in Colombia improved access to health services for the general medical services, but not for specialized mental health services. Although the primary goal of the health reform was to provide universal medical coverage, by not including mental health services in the standardized benefits package, inequities in the delivery of mental health services appear to have been perpetuated or even exacerbated. IMPLICATIONS FOR HEALTH CARE AND POLICY FORMULATION: If health reform in Colombia and elsewhere is to provide universal coverage and adequate access to comprehensive health care, mental health services must be added to the standardized package of health benefits and efforts to develop accessible and effective mental health treatment at the primary care level should continue. Mental health services research in Colombia should focus future studies on the differential impact of health reform on access to mental health services across regions, and between urban and rural areas.

  4. Engaging children and parents in service design and delivery.

    Science.gov (United States)

    Bedford Russell, A R; Passant, M; Kitt, H

    2014-12-01

    The involvement of all user groups, including children, young people (CYP) and their parents, encourages people to take responsibility for healthier lifestyle behaviours, improves treatment compliance and leads to more appropriate use of healthcare resources. Initiatives to engage CYP in the UK are gathering momentum, but significant improvements are still needed. There is a national drive from the department of health (DH) and NHS England, strategic clinical networks, operational delivery networks (including newborn networks), charities, parent groups and a number of other bodies to embed CYP involvement in service design and delivery. User engagement and patient choice, is underpinned by the NHS outcomes framework, and a myriad of other DH and NHS England policies and practice frameworks. It is now everybody's business. 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.

  5. Controlling the delivery of outsourced services in asymmetrical supply chains

    NARCIS (Netherlands)

    Iwaarden, van J.; Valk, van der W.; Aalders, L.; Brown, S.W.

    2009-01-01

    Services are increasingly outsourced. When outsourced services are directly delivered to the final customer by the supplier, the buying company lacks direct control over the delivery of the service. The purpose of this study is to expand theory on control over service delivery in supply chains. A

  6. Rethinking the delivery of public services to citizens

    National Research Council Canada - National Science Library

    Seidle, F. Leslie

    1995-01-01

    ... Sector Reform and Service Delivery in the Antipodes New Zealand: Transforming the State Australia: a Concerted Program of Management Reform Conclusion Notes 75 Chapter Four The Canadian Federal Government and Service Delivery Issues Perceptions of Service from the Federal Government The Mulroney Government and Public Service 2000 Special Operati...

  7. Towards a project-based service delivery approach : Uncovering organisational tensions

    OpenAIRE

    12330841 - Van der Waldt, Gerrit

    2009-01-01

    In line with the modernizing, re-inventing and alternative service delivery paradigm, governments increasingly utilise project-based methodologies to improve service delivery. There is general agreement that projects are becoming increasingly important for government institutions to operationalise strategic objectives and policy programmes. This approach is commonly known as ‗Management-by-Projects‘. To adopt this approach requires of public institutions to adjust their existing structures...

  8. NASA policy on pricing shuttle launch services

    Science.gov (United States)

    Smith, J. M.

    1977-01-01

    The paper explains the rationale behind key elements of the pricing policy for STS, the major features of the non-government user policy, and some of the stimulating features of the policy which will open space to a wide range of new users. Attention is given to such major policy features as payment schedule, cost and standard services, the two phase pricing structure, optional services, shared flights, cancellation and postponement, and earnest money.

  9. Institutional arrangements for decentralized water and health services delivery in rural Tanzania: differences and constraints

    NARCIS (Netherlands)

    Masanyiwa, Z.S.; Niehof, A.; Termeer, C.J.A.M.

    2013-01-01

    In recent years, decentralization has been upheld by governments, donors and policy makers in many developing countries as a means of improving public services although opinion is divided on the link between decentralization and service delivery. This article reviews recent literature and research

  10. Relational Analysis for Delivery of Services

    DEFF Research Database (Denmark)

    Nielson, Flemming; Nielson, Hanne Riis; Bauer, Jörg

    2008-01-01

    substantially improves the precision of the results obtained while being able to deal with the full generality of the syntax of processes. The analysis reveals a feasible complexity for practical examples and gives rise to a fast prototype. We use this prototype to automatically prove the correct delivery......Many techniques exist for statically computing properties of the evolution of processes expressed in process algebras. Static analysis has shown how to obtain useful results that can both be checked and computed in polynomial time. In this paper we develop a static analysis in relational form which...... of messages for the implementation of an accident service, which is based on multiplexed communication, a crucial feature of global computing applications....

  11. Graduate Student Services: A Study of the Delivery of Services at the Location Where Students Matriculate

    Science.gov (United States)

    Burlison, John G.

    2010-01-01

    This dissertation investigates and explores the best method for the delivery of graduate student services. Essentially, there are two methods for delivery of these services. They can be delivered by virtue of centralization or decentralization. Decentralized delivery, for the purpose of this dissertation is the delivery of graduate student…

  12. 76 FR 4726 - Avaya Global Services, AOS Service Delivery, Worldwide Services Group, Including Workers Whose...

    Science.gov (United States)

    2011-01-26

    ... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-74,411] Avaya Global Services, AOS Service Delivery, Worldwide Services Group, Including Workers Whose Unemployment Insurance (UI) Wages Are Reported Through Diamondware, Ltd and Nortel Networks, Inc., Including Workers Working at...

  13. Menu-based service access and delivery pattern: Towards achieving equatable access to digital services

    CSIR Research Space (South Africa)

    Makitla, I

    2014-11-01

    Full Text Available . This capability is used in basic service such as Short Message Service (SMS) as well as Unstructured Supplementary Service Data (USSD). There is a need for a service access and delivery pattern that can facilitate the delivery of services using common...

  14. Assessment of Extension Service Delivery on Improved Cassava ...

    African Journals Online (AJOL)

    Extension service delivery is too often merely seen as a vehicle for spreading scientific and technical progress and technology transfer. In the real sense, however, dissemination of knowledge is not a one way affair from scientists to producers. The study was conducted to assess extension service delivery on improved ...

  15. Invigorating Library Service Delivery through the Adoption of M ...

    African Journals Online (AJOL)

    Invigorating Library Service Delivery through the Adoption of M-Learning by Library Users in Nigeria. ... Nigerian School Library Journal ... so as to be at par with the libraries in the developed nations and to keep abreast Nigerian library users with the recent mobile technologies in the library services delivery in the world.

  16. Innovations in health service delivery: the corporatization of public hospitals

    National Research Council Canada - National Science Library

    Harding, April; Preker, Alexander S

    2003-01-01

    ... hospitals play a critical role in ensuring delivery of health services, less is known about how to improve the efficiency and quality of care provided. Much can be learned in this respect from the experiences of hospital reforms initiated during the 1990s. Innovations in Health Service Delivery: The Corporatization of Public Hospitals is an a...

  17. Good governance, service delivery and records: the African tragedy ...

    African Journals Online (AJOL)

    A paper tasked to establish the relationship between records, good governance and service delivery, especially in Africa, runs into immediate definitional ambiguities. This is because good governance and service delivery mean different things to different African leaders. Moreover, even the most criminal and tyrannical ...

  18. Contributing factors to poor service delivery by administrative ...

    African Journals Online (AJOL)

    This article reports on a study that was conducted among non-managerial administrative employees in the public sector in Gauteng. The researchers attempted to determine the effect of specified job factors on the wellbeing and service delivery of these employees. Poor service delivery in the country triggered the research.

  19. Service Coordination Policies and Models: National Status.

    Science.gov (United States)

    Harbin, Gloria L.; Bruder, M.; Mazzarella, C.; Gabbard, G.; Reynolds, C.

    This report discusses the findings of a study that investigated state coordination of early intervention services for infants, toddlers, and young children with disabilities. State Part C coordinators participated in a survey that sought their perceptions of values under girding service coordination, approach to service coordination, policies,…

  20. Application of social media to library service delivery: Perception of ...

    African Journals Online (AJOL)

    The study revealed that few of the social media identified are rarely relevant to library service delivery. Reference services, current awareness services, and library news postings were the types of library services that social media are applied. Results also indicated that there were benefits derived from using social media in ...

  1. Interplay Wellbeing Framework: Community Perspectives on Working Together for Effective Service Delivery in Remote Aboriginal Communities

    Directory of Open Access Journals (Sweden)

    Eva McRae-Williams

    2018-02-01

    Full Text Available Access to effective services and programs is necessary to improve wellbeing for Aboriginal and Torres Strait Islander people living in remote Australia. Without genuine participation of Aboriginal community members in the design, governance, and delivery of services, desired service delivery outcomes are rarely achieved. Using a "shared space" model, Aboriginal communities, governments, and scientists came together to design and develop the Interplay Wellbeing Framework. This Framework brings together stories and numbers (or qualitative and quantitative data to represent community values for the purpose of informing program and policy agendas. This article unpacks what community members saw as making a service work well and why. The domains of empowerment and community functioning are discussed and their relationship to effective service delivery demonstrated.

  2. 78 FR 8596 - Hartford Financial Services Group, Inc., Commercial/Actuarial/ Information Delivery Services (IDS...

    Science.gov (United States)

    2013-02-06

    ... Services Group, Inc., Commercial/Actuarial/ Information Delivery Services (IDS)/Corporate & Financial... workers and former workers of Hartford Financial Services Group, Inc., Commercial/Actuarial/Information Delivery Services (IDS)/Corporate & Financial Reporting group, Hartford, Connecticut (The Hartford-IDS...

  3. Decision making under the tree: gender perspectives on decentralization reforms in service delivery in rural Tanzania

    NARCIS (Netherlands)

    Masanyiwa, Z.S.

    2014-01-01

    In recent decades, decentralization has been upheld by governments, donors and policy makers in many developing countries as a means of improving people’s participation and public services delivery. In 1996, the government of Tanzania embarked on major local government reforms reflecting the

  4. Impact of Affirmative Action on Quality of Service Delivery in the Public Service Sector of Kenya: A Comparative Case Study of the Ministry of State in the Office of the President and Ministry of Higher Education

    Science.gov (United States)

    Kilonzo, Evans Mbuthi; Ikamari, Lawrence

    2015-01-01

    This study was carried out to determine the impact of affirmative action policy on the quality service delivery in the public service sector of Kenya. The study was carried out on the premise that there is a relationship between affirmative Action implementation and the quality of service delivery in the public service sector of Kenya. A lot of…

  5. Safe delivery, Service utilization, Metekel Zone

    African Journals Online (AJOL)

    decision making power of subjects were found to have a statistically significant association with preference of safe delivery ... Studies that focused on maternal mortality and proportion of ...... Anna M, Hannekee M, Frank Odhiambo et.al. Use.

  6. The democratisation of meal delivery service in France

    OpenAIRE

    Chen, Szu-Pu

    2017-01-01

    Master's thesis in International hotel and tourism management : Culinary leadership and innovation The purpose of this study was to explore the meal delivery service in French market and the customer’s opinion in the future meal delivery business. In addition, I first did the research basically on the evolution of history and the existing of delivery business in France. Then, I examined the dining habits and behaviours during the weekday of French citizen and their opinions in the futur...

  7. Assistive Technology: Use and Service Delivery

    Directory of Open Access Journals (Sweden)

    Roya Ghasemzadeh

    2010-04-01

    Full Text Available As individuals with long-term disabilities and other older adults face declines in health and function, there is a greater need for assistive technology (AT or assistive devices and environmental interventions (EI to help them maintain their independence and community participation. These aids can help older adults and individuals with disabilities function in work, home, recreational, and other community settings as they encounter age related or disability related changes. Assistive Technology refers to products, devices or equipment that are used to maintain, increase or improve the functional capabilities of people with disabilities. A thorough assessment of the individual’s preferences and needs must be conducted before an assistive device is obtained. If one type of device is inadequate to meet an individual’s needs, it should not be assumed that there are no viable alternatives. Individuals’ use of AT and the type of technology used may change over time or as they age. Low-tech aids, such as canes or walkers, or high-tech aids, such as manual or power wheelchairs or scooters, are used to help individuals achieve mobility. Assistive Technologies to aid in communication currently range from low-tech devices such as books to high-tech, augmentative communication devices, which are computers. Computer technology can help individuals become more independent and can enhance their ability to overcome a wide range of limitations. Accessibility can involve more than architectural structure. AT for use in the environment can also increase individuals’ ability to function within their environment. Advancements in AT will occur in the technology itself, the services associated with the technology, and in the government policies and programs relative to AT. There will more widespread use of universal design, with less special-purpose AT required.

  8. Human Resources Management and Service Delivery in Nigeria ...

    African Journals Online (AJOL)

    The paper represents essentially an attempt to analyse and comprehend the role of Human Resource Management (HRM) in effective service delivery in Nigeria. The paper advocates that the revamping and transformation of the Nigerian Civil Service to render effective service to the public lies not in the continuous ...

  9. Alternative Public Service Delivery Models in Health, Water and ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    The literature on public service delivery alternatives has to date been highly localized, sector specific and lacking in methodological consistency. This project seeks to analyze health, water and electricity delivery models in Africa, Asia and Latin America in order to identify and document successful alternatives to ...

  10. Challenges in immunisation service delivery for refugees in Australia: A health system perspective.

    Science.gov (United States)

    Mahimbo, A; Seale, H; Smith, M; Heywood, A

    2017-09-12

    Refugees are at risk of being under-immunised in their countries of origin, in transit and post-resettlement in Australia. Whilst studies have focused on identifying barriers to accessibility of health services among refugees, few focus on providers' perspectives on immunisation service delivery to this group. Health service providers are well placed to provide insights into the pragmatic challenges associated with refugee health service delivery, which can be useful in identifying strategies aimed at improving immunisation coverage among this group. A qualitative study involving 30 semi-structured interviews was undertaken with key stakeholders in immunisation service delivery across all States and Territories in Australia between December 2014 and December 2015. Thematic analysis was undertaken. Variability in accessing program funding and vaccines, lack of a national policy for catch-up vaccination, unclear roles and responsibilities for catch-up, a lack of a central immunisation register and insufficient training among general practitioners were seen as the main challenges impacting on immunisation service delivery for refugees. This study provides insight into the challenges that impact on effective immunisation service delivery for refugees. Deliberate strategies such as national funding for relevant vaccines, improved data collection nationally and increased guidance for general practitioners on catch-up immunisation for refugees would help to ensure equitable access across all age groups. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. original article predictors of safe delivery service utilization in arsi

    African Journals Online (AJOL)

    Abrham

    There is limited information on the mothers' use of skilled delivery services in the ... to conditions related to pregnancy and child birth. 99% of .... having favourable attitude towards utilization of ... two injections of Tetanus Toxoid vaccine during.

  12. Contributing Factors to Poor Service Delivery by Administrative ...

    African Journals Online (AJOL)

    Poor service delivery by local government is crippling South African businesses .... main categories: one focuses on an employee's internal attributes (content ... admitted that their attitude to work was adversely affected by the poor quality.

  13. Prospects for Mainstreaming Ecosystem Goods and Services in International Policies

    International Nuclear Information System (INIS)

    Kok, M.T.J.; Prins, A.G.; Tyler, S.R.; Pinter, L.; Baumuller, H.; Bernstein, J.; Tsioumani, E.; Venema, H.D.; Grosshans, R.

    2010-08-01

    Degradation of ecosystems worldwide threatens local and regional supplies of food, forest products and fresh water, and also biodiversity. Although most decisions that directly affect ecosystem management are made locally, these decisions are influenced by national and international policies. This study shows how local delivery of ecosystem goods and services (EGS) is closely linked to international policies on development cooperation, trade, climate change and reform of international financial institutions. Integrating or mainstreaming EGS considerations into these policies provides significant opportunities for reducing poverty, while simultaneously improving the quality of local EGS. Furthermore, mainstreaming EGS in international policies can contribute significantly to achieving policy objectives on biodiversity and sustainable management of natural resources. However, mainstreaming EGS requires careful consideration because many of the opportunities identified as reducing poverty, may have the opposite effect if poorly managed or implemented. A major challenge is, therefore, to ensure consistent policies across scales and policy domains based on analysis of the local situation. In order to support poverty reduction it matters how the mainstreaming is done and who benefits locally. Tools to mainstream EGS into non-environmental policy domains are available, but there are few examples of their systematic application. Examples of tools that could play a constructive role in this process are the monitoring and reporting mechanisms developed by the Convention on Biological Diversity (CBD)

  14. Conscientious Objection and Reproductive Health Service Delivery ...

    African Journals Online (AJOL)

    HP

    Lack of access to quality reproductive health services is the main contributor to the high maternal mortality and morbidity in ... such services to clients/patients on moral and/or religious grounds. While the ..... The internal morality of medicine:.

  15. The design & delivery of quality services: A paradigm shift

    Directory of Open Access Journals (Sweden)

    D. B.H. Smith

    2002-12-01

    Full Text Available As result of the increasingly important role information technology (IT is playing in service provision, less person-to-person contact will in future be made during service provision. Highly skilled specialists will make the remaining contact. Emphasis will shift to speed of delivery, with logistics playing an important role. The designers of services must take these factors into account if they wish to design quality services.

  16. Auditing Information System : Delivery Product Service

    Directory of Open Access Journals (Sweden)

    Purwoko Purwoko

    2011-05-01

    Full Text Available Purpose of the research is to ensure the securities of information system asset and to ensure if informa-tion system support the operational and data collected was valid. Research method that used in this research were library studies and field studies. Field studies such an observation, questioner, and inter-view. the expected result are founding the weakness of security management control, operational man-agement control, input control, and output control of risk happened in the company. Conclusion of this research are the system on the company work good and there’s no potential risk happened and make an impact to the delivery process of information system.Index Terms - Auditing Information system, Delivery product process.

  17. Operations and quality management for public service delivery improvement.

    Directory of Open Access Journals (Sweden)

    Paulin Mbecke

    2014-10-01

    Full Text Available Public service management reforms have not yet contributed to poverty eradication and generally socio-economic development of many African countries. The reforms suggested and implemented to date still prove to be weak in addressing the many challenges faced by the public service in delivering goods and services to the population. The failure of the current public service management calls for a consideration of business-driven approaches and practices that facilitate effectiveness, efficiency, competitiveness and flexibility in goods and services provision. The critical social theory methodology and the literature review technique described and raised awareness on service delivery chaos in South Africa. A public service reform that focuses on operations and quality management is one of the ways of improving and sustaining service delivery in South Africa. Operations management is an essential tool for the planning, execution, control, monitoring and evaluation of production processes. Quality management, in the other hand, is essential to ensure best quality of goods and services produced by the public service within acceptable time and available resources to meet or exceed people’s expectations. The operations and quality management framework proposed in this article is a potential alternative to the current service delivery crisis in South Africa.

  18. Assistive Technology Service Delivery in Rural School Districts

    Science.gov (United States)

    Ault, Melinda Jones; Bausch, Margaret E.; Mclaren, Elizabeth M.

    2013-01-01

    Little is known about the implementation of assistive technology (AT) services for students in rural areas. This study investigated the AT service delivery in 10 rural districts across six states. The results indicated that students use AT across functional areas, but considerably fewer number of devices than do those not living in rural areas. AT…

  19. Records management and service delivery: the case of Department ...

    African Journals Online (AJOL)

    This article explores the role of records management in the delivery of public service in ... to the Corporate Services Division at the Ministry of Health headquarters. ... delays in access and use of records; lack of a elaborate electronic records ...

  20. Innovative Mobile Platform Developments for Electronic Services Design and Delivery

    DEFF Research Database (Denmark)

    Scupola, Ada

    In the ever-growing world of technology, it is becoming more important to understand the developments of new electronic services and mobile applications. Innovative Mobile Platform Developments for Electronic Services Design, and Delivery is a comprehensive look at all aspects of production manag...

  1. Situation Analysis of Healthcare Service Delivery using ...

    African Journals Online (AJOL)

    ISML5

    Geography plays an important role in planning and allocation of healthcare resources for an effective and efficient ... utilization and gaps in resource allocation, and to develop propositions to support the health policy. Facility survey and .... Figure 2. Location of health centres against population density in Sironko district ...

  2. Decision policy scenarios for just-in-sequence (JIS) deliveries

    International Nuclear Information System (INIS)

    Cedillo-Campos, Miguel Gaston; Ruelas, Dario Morones; Lizarraga-Lizarraga, Giovanni; Gonzalez-Feliu, Jesus; Garza-Reyes, Jose Arturo

    2017-01-01

    The Just-in-Sequence (JIS) approach is evidencing advantages in efficiently managing variety-driven costs, and reducing the risk of disruption in sourcing, manufacturing companies and third-party logistics. This has increased its implementation in the manufacturing industry, especially in highly customized manufacturing sectors such as the automotive industry. However, despite its growing interest by manufacturers, scholarly research focused on JIS still remains limited. In this context, little has been done to study the effect of JIS on the fluidity of supply chains and processes of logistics suppliers as well as providing them with a decision making tool to optimise the sequencing of their deliveries. Therefore, the aim of this paper is to propose a genetic algorithm to evaluate different decision policy scenarios to reduce risks of supply disruptions at the final assembly line. Consequently, an algorithm considering a periodic review of the inventory that assumes a steady demand and short response times is developed and applied. Design/methodology/approach: Based on a literature review and real-life information, an abductive reasoning was performed and a case study application of the proposed algorithm conducted in the auto-industry. Findings: The results obtained from the case study indicate that the proposed genetic algorithm offers a reliable solution when facing variability in safety stocks that operate under assumptions such as: i) fixed costs; ii) high inventory turnover; iii) scarce previous information available concerning material requirements; and iv) replenishment services as core business value. Although the results are based on an auto-industry case study, they are equally applicable to other global supply chains. Originality/value: This paper is of interest to practitioners and academics alike as it complements and supports the very limited scholarly research on JIS by providing manufacturers and 3PL suppliers competing in mass customized

  3. Decision policy scenarios for just-in-sequence (JIS deliveries

    Directory of Open Access Journals (Sweden)

    Miguel Gaston Cedillo-Campos

    2017-10-01

    Full Text Available Purpose: The Just-in-Sequence (JIS approach is evidencing advantages in efficiently managing variety-driven costs, and reducing the risk of disruption in sourcing, manufacturing companies and third-party logistics. This has increased its implementation in the manufacturing industry, especially in highly customized manufacturing sectors such as the automotive industry. However, despite its growing interest by manufacturers, scholarly research focused on JIS still remains limited. In this context, little has been done to study the effect of JIS on the fluidity of supply chains and processes of logistics suppliers as well as providing them with a decision making tool to optimise the sequencing of their deliveries. Therefore, the aim of this paper is to propose a genetic algorithm to evaluate different decision policy scenarios to reduce risks of supply disruptions at the final assembly line. Consequently, an algorithm considering a periodic review of the inventory that assumes a steady demand and short response times is developed and applied. Design/methodology/approach: Based on a literature review and real-life information, an abductive reasoning was performed and a case study application of the proposed algorithm conducted in the auto-industry. Findings: The results obtained from the case study indicate that the proposed genetic algorithm offers a reliable solution when facing variability in safety stocks that operate under assumptions such as: i fixed costs; ii high inventory turnover; iii scarce previous information available concerning material requirements; and iv replenishment services as core business value. Although the results are based on an auto-industry case study, they are equally applicable to other global supply chains. Originality/value: This paper is of interest to practitioners and academics alike as it complements and supports the very limited scholarly research on JIS by providing manufacturers and 3PL suppliers competing in

  4. Decision policy scenarios for just-in-sequence (JIS) deliveries

    Energy Technology Data Exchange (ETDEWEB)

    Cedillo-Campos, Miguel Gaston; Ruelas, Dario Morones; Lizarraga-Lizarraga, Giovanni; Gonzalez-Feliu, Jesus; Garza-Reyes, Jose Arturo

    2017-07-01

    The Just-in-Sequence (JIS) approach is evidencing advantages in efficiently managing variety-driven costs, and reducing the risk of disruption in sourcing, manufacturing companies and third-party logistics. This has increased its implementation in the manufacturing industry, especially in highly customized manufacturing sectors such as the automotive industry. However, despite its growing interest by manufacturers, scholarly research focused on JIS still remains limited. In this context, little has been done to study the effect of JIS on the fluidity of supply chains and processes of logistics suppliers as well as providing them with a decision making tool to optimise the sequencing of their deliveries. Therefore, the aim of this paper is to propose a genetic algorithm to evaluate different decision policy scenarios to reduce risks of supply disruptions at the final assembly line. Consequently, an algorithm considering a periodic review of the inventory that assumes a steady demand and short response times is developed and applied. Design/methodology/approach: Based on a literature review and real-life information, an abductive reasoning was performed and a case study application of the proposed algorithm conducted in the auto-industry. Findings: The results obtained from the case study indicate that the proposed genetic algorithm offers a reliable solution when facing variability in safety stocks that operate under assumptions such as: i) fixed costs; ii) high inventory turnover; iii) scarce previous information available concerning material requirements; and iv) replenishment services as core business value. Although the results are based on an auto-industry case study, they are equally applicable to other global supply chains. Originality/value: This paper is of interest to practitioners and academics alike as it complements and supports the very limited scholarly research on JIS by providing manufacturers and 3PL suppliers competing in mass customized

  5. Our natural capital: Ecosystem service delivery

    CSIR Research Space (South Africa)

    Dziba, L

    2012-10-01

    Full Text Available new technologies in Earth observation that target relevant ecosystem attributes for monitoring ecosystem service changes, tools for spatial development planning in multifunctional landscapes such as ecological infrastructure mapping for disaster...

  6. Abortion law, policy and services in India: a critical review.

    Science.gov (United States)

    Hirve, Siddhivinayak S

    2004-11-01

    Despite 30 years of liberal legislation, the majority of women in India still lack access to safe abortion care. This paper critically reviews the history of abortion law and policy in India since the 1960s and research on abortion service delivery. Amendments in 2002 and 2003 to the 1971 Medical Termination of Pregnancy Act, including devolution of regulation of abortion services to the district level, punitive measures to deter provision of unsafe abortions, rationalisation of physical requirements for facilities to provide early abortion, and approval of medical abortion, have all aimed to expand safe services. Proposed amendments to the MTP Act to prevent sex-selective abortions would have been unethical and violated confidentiality, and were not taken forward. Continuing problems include poor regulation of both public and private sector services, a physician-only policy that excludes mid-level providers and low registration of rural compared to urban clinics; all restrict access. Poor awareness of the law, unnecessary spousal consent requirements, contraceptive targets linked to abortion, and informal and high fees also serve as barriers. Training more providers, simplifying registration procedures, de-linking clinic and provider approval, and linking policy with up-to-date technology, research and good clinical practice are some immediate measures needed to improve women's access to safe abortion care.

  7. Knowledge and perceptions of antenatal services need and delivery ...

    African Journals Online (AJOL)

    Conclusion: While client demand for services depends on volume, cost/price and quality of services supplied, lack of knowledge of what one deserves also influences one's care seeking behavior. Therefore, it is imperative to do periodic evaluations of population knowledge, perceptions of the introduced policy, and service ...

  8. Policy-Making in Unemployment Services:

    DEFF Research Database (Denmark)

    Caswell, Dorte; Høybye-Mortensen, Matilde

    The development of paternalist policies, such as the increase of punitive methods in welfare services, has been identified and analysed internationally (Mead, 1998; Soss et al., 2011a). The combination of these with an emphasis on instruments such as competition and performance measurement has be...... are categorised as having problems besides unemployment (Caswell et al., 2011)....

  9. Advanced content delivery, streaming, and cloud services

    CERN Document Server

    Sitaraman, Ramesh Kumar; Robinson, Dom

    2014-01-01

    While other books on the market provide limited coverage of advanced CDNs and streaming technologies, concentrating solely on the fundamentals, this book provides an up-to-date comprehensive coverage of the state-of-the-art advancements in CDNs, with a special focus on Cloud-based CDNs. The book includes CDN and media streaming basics, performance models, practical applications, and business analysis. It features industry case studies, CDN applications, and open research issues to aid practitioners and researchers, and a market analysis to provide a reference point for commercial entities. The book covers Adaptive Bitrate Streaming (ABR), Content Delivery Cloud (CDC), Web Acceleration, Front End Optimization (FEO), Transparent Caching, Next Generation CDNs, CDN Business Intelligence and more.

  10. IT enabled service delivery innovation from quality perspective

    Directory of Open Access Journals (Sweden)

    Yao-Chin Lin

    2014-03-01

    Full Text Available The objective is to understand how information and service quality to influence of IT enabled service (ITeS, then to enhance service delivery innovation (SDI. This study bases ITeS to elaborate two research questions by adopting Rodosek’s business reference model. Consequently, we conduct a case study approach, by deriving proposals concerning the relationships among two quality perspectives, ITeS, and SDI in a Taiwanese publishing company. In the end, we concluded three related findings. Firstly, the company based on service orientated to provide basic service functions to encourage more users to enjoy their services, as well as facilitating collaborative work via the online discussion area. Secondly, the company adopted advanced service functions to extend their service scopes to end-users, such as download the news into handheld devices. Finally, the company utilized the supporting service functions to assist customers integrating the ideas and plans.

  11. Nursing Services Delivery Theory: an open system approach.

    Science.gov (United States)

    Meyer, Raquel M; O'Brien-Pallas, Linda L

    2010-12-01

    This paper is a discussion of the derivation of the Nursing Services Delivery Theory from the application of open system theory to large-scale organizations. The underlying mechanisms by which staffing indicators influence outcomes remain under-theorized and unmeasured, resulting in a 'black box' that masks the nature and organization of nursing work. Theory linking nursing work, staffing, work environments, and outcomes in different settings is urgently needed to inform management decisions about the allocation of nurse staffing resources in organizations. A search of CINAHL and Business Source Premier for the years 1980-2008 was conducted using the following terms: theory, models, organization, organizational structure, management, administration, nursing units, and nursing. Seminal works were included. The healthcare organization is conceptualized as an open system characterized by energy transformation, a dynamic steady state, negative entropy, event cycles, negative feedback, differentiation, integration and coordination, and equifinality. The Nursing Services Delivery Theory proposes that input, throughput, and output factors interact dynamically to influence the global work demands placed on nursing work groups at the point of care in production subsystems. THE Nursing Services Delivery Theory can be applied to varied settings, cultures, and countries and supports the study of multi-level phenomena and cross-level effects. The Nursing Services Delivery Theory gives a relational structure for reconciling disparate streams of research related to nursing work, staffing, and work environments. The theory can guide future research and the management of nursing services in large-scale healthcare organizations. © 2010 Blackwell Publishing Ltd.

  12. A century of infrastructure service delivery

    CSIR Research Space (South Africa)

    Wall, K

    2011-01-01

    Full Text Available , climb into our cars, switch on the radio or a CD, and head through sets of traffic lights, on a tarred road via a multi-level interchange giving access to the freeway to the airport, to catch an aircraft flight that we had booked on the Internet... proportion of commuters that use either bus or commuter rail in those cities with such services. Growth in commuter traffic has to all intents and purposes been entirely absorbed by taxis ? commuter rail patronage has increased only marginally over...

  13. Water service delivery - the weakest link

    CSIR Research Space (South Africa)

    Wall, K

    2009-05-01

    Full Text Available as strong as its weakest link at the time. • An integrated system …. Water and the poverty trap Poor level of water services Disease and sickness Spread of HIV/AIDS High cost for provision of household water and sanitation Limited employment... opportunities Education problems Skills deficiencies Loss of dignity POVERTY POOR WATER SUPPLY POOR SANITATION The poverty trap The poverty trap – Eastern Cape Eastern Cape Provincial “End of Term” Report (2009): • 7 out of 10 people in Eastern...

  14. 76 FR 24339 - Streamlining Service Delivery and Improving Customer Service

    Science.gov (United States)

    2011-05-02

    ... accessed by the Internet or mobile phone and improved processes that deliver services faster and more... ``Conversations with America'' to Further Improve Customer Service). However, with advances in technology and... major initiative (signature initiative) that will use technology to improve the customer experience; (b...

  15. Simulation of robotic courier deliveries in hospital distribution services.

    Science.gov (United States)

    Rossetti, M D; Felder, R A; Kumar, A

    2000-06-01

    Flexible automation in the form of robotic couriers holds the potential for decreasing operating costs while improving delivery performance in hospital delivery systems. This paper discusses the use of simulation modeling to analyze the costs, benefits, and performance tradeoffs related to the installation and use of a fleet of robotic couriers within hospital facilities. The results of this study enable a better understanding of the delivery and transportation requirements of hospitals. Specifically, we examine how a fleet of robotic couriers can meet the performance requirements of the system while maintaining cost efficiency. We show that for clinical laboratory and pharmaceutical deliveries a fleet of six robotic couriers can achieve significant performance gains in terms of turn-around time and delivery variability over the current system of three human couriers per shift or 13 FTEs. Specifically, the simulation results indicate that using robotic couriers to perform both clinical laboratory and pharmaceutical deliveries would result in a 34% decrease in turn-around time, and a 38% decrease in delivery variability. In addition, a break-even analysis indicated that a positive net present value occurs if nine or more FTEs are eliminated with a resulting ROI of 12%. This analysis demonstrates that simulation can be a valuable tool for examining health care distribution services and indicates that a robotic courier system may yield significant benefits over a traditional courier system in this application.

  16. Techno-Bureaucratic Governance and Public Service Delivery: Indonesia and Nigeria in Perspectives

    Directory of Open Access Journals (Sweden)

    Jacob Olufemi Fatile

    2015-09-01

    Full Text Available Techno-bureaucratic governance is fundamental to contemporary public service. This is because the roles of the bureaucrats and technocrats become more relevant in policy formulation and implementation when the government had to (reinvent its institutions to move from routine administration to that of development planning and management. Utilizing a qualitative approach, the paper notes that techno-bureaucratic ideology values technical expertise itself and its technical experts, efficiency, economic development and effective public service delivery. Adopting comparative perspective, the paper examines techno-bureaucratic governance and public service delivery in Indonesia and Nigeria. The paper takes a cursory look at the similarities and differences between the two countries. The paper notes that the technocracy nurtured by the New Order in Indonesia was cohesive and effective because of its technical expertise and has helped Indonesia to turn oil income into productive investments,whereas in Nigeria the oil income was used for prestigious projects to the detriment of productive investments. The paper therefore recommend among others that developing societies need a new strategy in delivery services in their public service, and this can be achieved through skilled professionals, technocrats and knowledge based actors. It concludes that for public service to deliver effective services, an efficient bureaucracy and technocracy remain invaluable.

  17. Nursing Services Delivery Theory: an open system approach

    Science.gov (United States)

    Meyer, Raquel M; O’Brien-Pallas, Linda L

    2010-01-01

    meyer r.m. & o’brien-pallas l.l. (2010)Nursing services delivery theory: an open system approach. Journal of Advanced Nursing66(12), 2828–2838. Aim This paper is a discussion of the derivation of the Nursing Services Delivery Theory from the application of open system theory to large-scale organizations. Background The underlying mechanisms by which staffing indicators influence outcomes remain under-theorized and unmeasured, resulting in a ‘black box’ that masks the nature and organization of nursing work. Theory linking nursing work, staffing, work environments, and outcomes in different settings is urgently needed to inform management decisions about the allocation of nurse staffing resources in organizations. Data sources A search of CINAHL and Business Source Premier for the years 1980–2008 was conducted using the following terms: theory, models, organization, organizational structure, management, administration, nursing units, and nursing. Seminal works were included. Discussion The healthcare organization is conceptualized as an open system characterized by energy transformation, a dynamic steady state, negative entropy, event cycles, negative feedback, differentiation, integration and coordination, and equifinality. The Nursing Services Delivery Theory proposes that input, throughput, and output factors interact dynamically to influence the global work demands placed on nursing work groups at the point of care in production subsystems. Implications for nursing The Nursing Services Delivery Theory can be applied to varied settings, cultures, and countries and supports the study of multi-level phenomena and cross-level effects. Conclusion The Nursing Services Delivery Theory gives a relational structure for reconciling disparate streams of research related to nursing work, staffing, and work environments. The theory can guide future research and the management of nursing services in large-scale healthcare organizations. PMID:20831573

  18. Transforming Health Care Service Delivery and Provider Selection

    OpenAIRE

    Reiner, Bruce I.

    2011-01-01

    Commoditization pressures in medicine have risked transforming service provider selection from “survival of the fittest” to “survival of the cheapest.” Quality- and safety-oriented mandates by the Institute of Medicine have led to the creation of a number of data-driven quality-centric initiatives including Pay for Performance and Evidence-Based Medicine. A synergistic approach to creating quantitative accountability in medical service delivery is through the creation of consumer-oriented per...

  19. Factors associated with institutional delivery service utilization in Ethiopia

    Directory of Open Access Journals (Sweden)

    Kebede A

    2016-09-01

    Full Text Available Alemi Kebede,1 Kalkidan Hassen,2 Aderajew Nigussie Teklehaymanot1 1Department of Population and Family Health, 2College of Health Sciences, Jimma University, Ethiopia Background: Most obstetric complications occur unpredictably during the time of delivery, but they can be prevented with proper medical care in the health facilities. Despite the Ethiopian government’s efforts to expand health service facilities and promote health institution-based delivery service in the country, an estimated 85% of births still take place at home.Objective: The review was conducted with the aim of generating the best evidence on the determinants of institutional delivery service utilization in Ethiopia.Methods: The reviewed studies were accessed through electronic web-based search strategy from PubMed, HINARI, Mendeley reference manager, Cochrane Library for Systematic Reviews, and Google Scholar. Review Manager V5.3 software was used for meta-analysis. Mantel–Haenszel odds ratios (ORs and their 95% confidence intervals (CIs were calculated. Heterogeneity of the study was assessed using I2 test.Results: People living in urban areas (OR =13.16, CI =1.24, 3.68, with primary and above educational level of the mother and husband (OR =4.95, CI =2.3, 4. 8, and OR =4.43, CI =1.14, 3.36, respectively, who encountered problems during pregnancy (OR =2.83, CI =4.54, 7.39, and living at a distance <5 km from nearby health facility (OR =2.6, CI =3.33, 6.57 showed significant association with institutional delivery service utilization. Women’s autonomy was not significantly associated with institutional delivery service utilization.Conclusion and recommendation: Distance to health facility and problems during pregnancy were factors positively and significantly associated with institutional delivery service utilization. Promoting couples education beyond primary education regarding the danger signs of pregnancy and benefits of institutional delivery through available

  20. Addressing Trauma in Schools: Multitiered Service Delivery Options for Practitioners

    Science.gov (United States)

    Reinbergs, Erik J.; Fefer, Sarah A.

    2018-01-01

    Hundreds of thousands of children are confronted with traumatic experiences each year in the United States. As trauma-informed care begins to take hold in schools, school mental health providers (e.g., school psychologists, counselors, and social workers) desire concrete service-delivery options for students affected by trauma. This article…

  1. Improving Financial Service Delivery to Communities through Micro ...

    African Journals Online (AJOL)

    ... through Micro-finance Institutions in Uganda; the case of Pride Micro-finance ... This data was analysed qualitatively and the results of the analysis indicated that ... a number of challenges in financial service delivery; like inability to reach out ...

  2. Quality Service Delivery as a Competitive Weapon in Corporate ...

    African Journals Online (AJOL)

    The study assessed quality service delivery of Zenith Bank of Nigeria to determine whether it confers competitive advantage on the Bank. A survey research method was adopted. A sample of the Bank's branches in 4 towns in Anambra State was selected. Data were generated from questionnaires, interviews and internet as ...

  3. Decentralisation in Uganda: Prospects for Improved Service Delivery

    African Journals Online (AJOL)

    Financial decentralisation, on the other hand, attempted to assign responsibilities and taxes between the centre and local governments, to enable the transfer of grants and other resources to different parts of the country, and to improve service delivery. This paper will review different government, public and academic ...

  4. Assessment of the administration of healthcare service delivery in ...

    African Journals Online (AJOL)

    The study examined the structure and mode of administration in Obafemi Awolowo University Teaching Hospitals Complex Ile-Ife Nigeria; and also assessed the impact of the structure and mode of administration on the service delivery in the hospital. These were with a view to assessing the administration of healthcare ...

  5. Library service delivery, information literacy knowledge: a modelling ...

    African Journals Online (AJOL)

    Knowledge preservation, access to information and dissemination has rapidly changed the way people seek and use information. The study concluded that the application of IT will encourage self sufficiency in food production, good health and rapid development among the citizenry. Keywords: Library service delivery, ...

  6. Understanding the queuing theory for improved service delivery: an ...

    African Journals Online (AJOL)

    The methodology adopted in this paper, therefore is to describe queuing theory and its associated terminologies in relation to service delivery. In view of this, the paper presented a simplified exposition of queuing theory and management of waiting lines as it affects entrepreneurial drive for more business growth and ...

  7. Delivery of public services in ethnic minority states: Gender equality ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Delivery of public services in ethnic minority states: Gender equality and decentralization in Myanmar. In 2017, to sustain Myanmar's democratic transition, IDRC and Global Affairs Canada ... and staff from the University of Toronto's Munk School of Global Affairs (Asia ... Ideas from the global climate change hotspot research.

  8. Changing public service delivery: Learning in co-creation

    NARCIS (Netherlands)

    W.H. Voorberg (William); V.J.J.M. Bekkers (Victor); Timeus, K. (Krista); Tonurist, P. (Piret); L.G. Tummers (Lars)

    2017-01-01

    textabstractCo-creation – where citizens and public organizations work together to deal with societal issues – is increasingly considered as a fertile solution for various public service delivery problems. During cocreation, citizens are not mere consumers, but are actively engaged in building

  9. Buying results? Contracting for health service delivery in developing countries.

    Science.gov (United States)

    Loevinsohn, Benjamin; Harding, April

    To achieve the health-related Millennium Development Goals, the delivery of health services will need to improve. Contracting with non-state entities, including non-governmental organisations (NGOs), has been proposed as a means for improving health care delivery, and the global experience with such contracts is reviewed here. The ten investigated examples indicate that contracting for the delivery of primary care can be very effective and that improvements can be rapid. These results were achieved in various settings and services. Many of the anticipated difficulties with contracting were either not observed in practice or did not compromise contracting's effectiveness. Seven of the nine cases with sufficient experience (greater than 3 years' elapsed experience) have been sustained and expanded. Provision of a package of basic services by contractors costs between roughly US3 dollars and US6 dollars per head per year in low-income countries. Contracting for health service delivery should be expanded and future efforts must include rigorous evaluations.

  10. Changing public service delivery: learning in co-creation

    NARCIS (Netherlands)

    Voorberg, William; Bekkers, Victor; Timeus, Krista; Tonurist, Piret; Tummers, L.G.

    2017-01-01

    Co-creation – where citizens and public organizations work together to deal with societal issues – is increasingly considered as a fertile solution for various public service delivery problems. During co-creation, citizens are not mere consumers, but are actively engaged in building resilient

  11. California Integrated Service Delivery Evaluation Report. Phase I

    Science.gov (United States)

    Moore, Richard W.; Rossy, Gerard; Roberts, William; Chapman, Kenneth; Sanchez, Urte; Hanley, Chris

    2010-01-01

    This study is a formative evaluation of the OneStop Career Center Integrated Service Delivery (ISD) Model within the California Workforce System. The study was sponsored by the California Workforce Investment Board. The study completed four in-depth case studies of California OneStops to describe how they implemented the ISD model which brings…

  12. Knowledge and perceptions of antenatal services need and delivery ...

    African Journals Online (AJOL)

    treatment during pregnancy (IPTp) against malaria in Mkuranga and Mufindi districts, Tanzania. Methodology: ... when it comes to utilization of specific health services or interventions .... decision to visit a clinic was the need to be vaccinated .... Health information provided about how to prepare for the delivery. 68 (47.6%).

  13. Good governance, service delivery and records: the African tragedy

    African Journals Online (AJOL)

    mpho ngoepe

    A transparent and accountable government conducts its business openly ... party to boast about its service delivery record but also to allow international ... members of public and private bodies need strong and explicit ethics to prevent bribery, ... have actually carried out the actions and transactions that they had to execute,.

  14. How to move towards community based service delivery?

    NARCIS (Netherlands)

    Meuwissen, L.; Voorham, T.; Bakker, D. de

    2007-01-01

    Aim: Community based primary health care offers in potential the opportunity to tailor health service delivery to the needs and demands of the local population. Up to now, there is no clear cut method to do this. In a pilot benchmark for general practices, data were collected on demand and

  15. Industrial Perspectives of Work Place Basics and Training Delivery Services.

    Science.gov (United States)

    Logan, Joyce; Byers, Charles

    1991-01-01

    Kentucky employers (249 of 800 surveyed) identified adaptability, teamwork, communication, and problem solving as entry-level and advancement skills. Over 50 percent did no preemployment testing. Responses indicated areas needing change: training focused on workplace basics, accessible training delivery, and preemployment assessment services. (SK)

  16. Consumer Cooperatives for Delivery of Urban Water and Sanitation Services

    OpenAIRE

    Ruiz-Mier, Fernando; Ginneken, Meike van

    2008-01-01

    To find the optimal delivery model for urban water supply and sanitation (WSS) services, one must look beyond ownership structures to the practices and designs that support good performance. Consumer cooperatives are often attractive institutional models. This note focuses on a Bolivian cooperative that is one of the most successful water cooperatives in Latin America. Successful cooperatives ...

  17. A Multi-organisational Approach to Service Delivery

    Science.gov (United States)

    Purchase, Valerie; Mills, John; Parry, Glenn

    Who is involved in delivering a service? There has been growing recognition in a wide variety of contexts that service is increasingly being delivered by multi-rather than single-organisational entities. Such recognition is evident not only in our experience but in a number of areas of literature including strategy development, core competence analysis, operations and supply chain management, and is reflected in and further facilitated by ICT developments. Customers have always been involved in some degree in the process of value delivery and such involvement is increasing to include complex co-creation of value. Such interactions are challenging when they involve individual customers, however, this becomes ever more challenging when the 'customer' is another organisation or when there are multiple 'customers'. Within this chapter we will consider some of the key drivers for a multi-organisational approach to service delivery; examine the ways in which the parties involved in service co-creation have expanded to include multiple service providers and customers; and finally, identify some of the challenges created by a multi-organisational approach to service delivery.

  18. The health maintenance organization strategy: a corporate takeover of health services delivery.

    Science.gov (United States)

    Salmon, J W

    1975-01-01

    This paper presents a political economic framework for viewing the social organization of the delivery of health care servies and predicting a qualitatively different institutional configuration involving the health maintenance organization. The principal forces impacting American capitalism today are leading to a fundamental restructuring for increased social efficiency of the entire social welfare sector, including the health services industry. The method to achieve this restructuring involves health policy directed at raising the contribution to the social surplus from the delivery of health care services and eventual corporate domination. The health maintenance organization conceptualization is examined with suggestions as to how the HMO strategy promoted by the state leads to this corporate takeover. The mechanism and extent of the present corporate involvement are examined and implications of health services as a social control mechanism are presented.

  19. The Effects of Medicaid Policy Changes on Adults Service...

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Effects of Medicaid Policy Changes on Adults Service Use Patterns in Kentucky and Idaho According to findings reported in The Effects of Medicaid Policy Changes...

  20. Assessing family planning service-delivery skills in Kenya.

    Science.gov (United States)

    Valadez, J J; Transgrud, R; Mbugua, M; Smith, T

    1997-06-01

    This report demonstrates the use of Lot Quality Assurance Sampling (LQAS) to evaluate the technical competence of two cohorts of family planning service providers in Kenya trained with a new curriculum. One cohort had just finished training within two months of the study. The other cohort was the first group trained with the new curriculum about one year before the study. LQAS was adapted from industrial and other public health applications to assess both the individual competence of 30 service providers and the competence of each cohort. Results show that Cohorts One and Two did not differ markedly in the number of tasks needing improvement. However, both cohorts exhibited more tasks needing improvement in counseling skills as compared with physical examination skills or with all other skills. Care-givers who were not currently providing services accounted for most service-delivery problems. This result suggests that providers' use of their skills explains their ability to retain service-delivery skills learned in training to a greater degree than does the amount of time elapsed since they were trained. LQAS proved to be a rapid, easy-to-use empirical method for management decisionmaking for improvement of a family planning training curriculum and services.

  1. Urban governance and spatial inequality in service delivery: a case study of solid waste management in Abuja, Nigeria.

    Science.gov (United States)

    Adama, Onyanta

    2012-09-01

    Spatial inequality in service delivery is a common feature in African cities. Several factors account for the phenomenon but there is growing attention towards urban governance and the role of the state. Urban governance policies such as privatization serve as key strategies through which the state regulates and (re)produces spatial inequality in service delivery. This study examined how governance practices related to privatization and the regulatory role of the state reinforce spatial inequalities in the delivery of solid waste services in Abuja, Nigeria. It focused primarily on the issue of cost recovery. Privatization became a major focus in Abuja in 2003 when the government launched a pilot scheme. Although it has brought improvements in service delivery, privatization has also increased the gap in the quality of services delivered in different parts of the city. Drawing on empirical data, the study revealed that little sensitivity to income and affordability, and to income differentials between neighbourhoods in the fixing of user charges and in the choice of the billing method is contributing to spatial inequalities in service delivery. Furthermore, the study suggests that these practices are linked to a broader issue, a failure of the government to see the people as partners. It therefore calls for more inclusive governance especially in decision-making processes. The study also emphasizes the need for a policy document on solid waste management, as this would encourage a critical assessment of vital issues including how privatization is to be funded, especially in low-income areas.

  2. Family-centred care delivery: comparing models of primary care service delivery in Ontario.

    Science.gov (United States)

    Mayo-Bruinsma, Liesha; Hogg, William; Taljaard, Monica; Dahrouge, Simone

    2013-11-01

    To determine whether models of primary care service delivery differ in their provision of family-centred care (FCC) and to identify practice characteristics associated with FCC. Cross-sectional study. Primary care practices in Ontario (ie, 35 salaried community health centres, 35 fee-for-service practices, 32 capitation-based health service organizations, and 35 blended remuneration family health networks) that belong to 4 models of primary care service delivery. A total of 137 practices, 363 providers, and 5144 patients. Measures of FCC in patient and provider surveys were based on the Primary Care Assessment Tool. Statistical analyses were conducted using linear mixed regression models and generalized estimating equations. Patient-reported FCC scores were high and did not vary significantly by primary care model. Larger panel size in a practice was associated with lower odds of patients reporting FCC. Provider-reported FCC scores were significantly higher in community health centres than in family health networks (P = .035). A larger number of nurse practitioners and clinical services on-site were both associated with higher FCC scores, while scores decreased as the number of family physicians in a practice increased and if practices were more rural. Based on provider and patient reports, primary care reform strategies that encourage larger practices and more patients per family physician might compromise the provision of FCC, while strategies that encourage multidisciplinary practices and a range of services might increase FCC.

  3. Local Governance, Urban Poverty and Service Delivery in Namibia

    OpenAIRE

    Fjeldstad, Odd-Helge; Geisler, Gisela; Nangulah, Selma; Nygaard, Knut; Pomuti, Akiser; Shifotoka, Albertina; Van Rooy, Gert

    2005-01-01

    The urbanisation of poverty is one of the most dramatic developments on the African continent, yielding contrasting images of affluent residential and business districts and utter misery in sprawling shantytowns or slums. Namibia has one of Africa’s highest urban growth rates, taking thousands of women, men and children to towns in search of a better life. The large majority of these end up in poverty-stricken informal settlements in urban areas. The current service delivery approach of the g...

  4. Improving Government service delivery with private sector intermediaries

    OpenAIRE

    Klievink, B.; Janssen, M.

    2008-01-01

    Government organizations operate a variety of channels to interact with citizens and businesses. Advances in information and communication technology enabled an online presence and more direct interactions. A focus on efficiency makes organizations encourage the use of electronic channels over traditional channels. Also, intermediaries in the service delivery chain are cut out in favor of direct interactions. This strategy of disintermediation finds its rationale in the transaction costs theo...

  5. Local government energy action in the UK: from service delivery to community leadership. Volume 1

    Energy Technology Data Exchange (ETDEWEB)

    Wade, Joanne; Pearson, Amanda; Knowland, Rachael [Impetus Consulting (United Kingdom); Flanagan, Brooke [Energy Saving Trust (United Kingdom)

    2007-07-01

    In October 2006 the UK government published a new Local Government White Paper. This policy statement set the framework for the role of local government in the coming years.The White Paper is one stage in the latest wave of local government reform in the UK. This reform has aimed to refocus attention away from delivery of specific services and towards community leadership, particularly with reference to sustainable development. Climate change is given some emphasis within the White Paper, and should become one of the indicators against which local government performance is measured.This paper examines energy action in local authorities in the past few years, in a situation where most, but not all, were still strongly focused on service delivery. By contrasting this with the results achieved in authorities that have taken a community leadership role, the paper examines the potential of the White Paper. It addresses the following questions: does local government have the capacity to deliver increased local action on climate change? Does the UK policy framework support and encourage development and deployment of this capacity? And do the national and regional bodies that provide support for local authorities need to change the services they offer in light of recent policy developments?.

  6. Local government energy action in the UK: from service delivery to community leadership

    Energy Technology Data Exchange (ETDEWEB)

    Wade, Joanne; Pearson, Amanda; Knowland, Rachael [Impetus Consulting (United Kingdom); Flanagan, Brooke [Energy Saving Trust (United Kingdom)

    2007-07-01

    In October 2006 the UK government published a new Local Government White Paper. This policy statement set the framework for the role of local government in the coming years.The White Paper is one stage in the latest wave of local government reform in the UK. This reform has aimed to refocus attention away from delivery of specific services and towards community leadership, particularly with reference to sustainable development. Climate change is given some emphasis within the White Paper, and should become one of the indicators against which local government performance is measured.This paper examines energy action in local authorities in the past few years, in a situation where most, but not all, were still strongly focused on service delivery. By contrasting this with the results achieved in authorities that have taken a community leadership role, the paper examines the potential of the White Paper. It addresses the following questions: does local government have the capacity to deliver increased local action on climate change? Does the UK policy framework support and encourage development and deployment of this capacity? And do the national and regional bodies that provide support for local authorities need to change the services they offer in light of recent policy developments?.

  7. Local government energy action in the UK: from service delivery to community leadership. Volume 1

    International Nuclear Information System (INIS)

    Wade, Joanne; Pearson, Amanda; Knowland, Rachael; Flanagan, Brooke

    2007-01-01

    In October 2006 the UK government published a new Local Government White Paper. This policy statement set the framework for the role of local government in the coming years.The White Paper is one stage in the latest wave of local government reform in the UK. This reform has aimed to refocus attention away from delivery of specific services and towards community leadership, particularly with reference to sustainable development. Climate change is given some emphasis within the White Paper, and should become one of the indicators against which local government performance is measured.This paper examines energy action in local authorities in the past few years, in a situation where most, but not all, were still strongly focused on service delivery. By contrasting this with the results achieved in authorities that have taken a community leadership role, the paper examines the potential of the White Paper. It addresses the following questions: does local government have the capacity to deliver increased local action on climate change? Does the UK policy framework support and encourage development and deployment of this capacity? And do the national and regional bodies that provide support for local authorities need to change the services they offer in light of recent policy developments?

  8. Complaints and compliments assessment in developing service delivery measurement

    Directory of Open Access Journals (Sweden)

    Norshahrizan Nordin

    2018-05-01

    Full Text Available Excellent healthcare services delivered to patients would not necessarily entail an excellent patient service fulfillment, fulfill patient expectations, and attain high satisfaction levels. Hence, patient satisfaction is multifactorial and difficult to measure. Appliance of satisfaction model, service dissatisfaction and satisfaction feedback are able to translate the nonlinear attributes for a more accurate service dissatisfaction and satisfaction feedback assessment. Service recipients of experienced Inpatient and Outpatient (IOPs can be translated into levels of compliments and complaints to describe degrees of patient satisfaction and dissatisfaction, respectively. Compliments and complaints voiced by patients should be taken seriously. As a result, the translation of service satisfaction and service dissatisfaction based on compliments and complaints from patients in the form of satisfaction index SCi and dissatisfaction index SCa introduced a new theoretical concept of concurrent and balance measurement in evaluating customer (VOC or VOPs feedback. In normal practice, the service improvement is usually based on complaints or dissatisfaction aspect, but the compliments or satisfaction aspect on the same service delivery was always neglected. In this study, the formulation which was based on a non-linear assessment, not only amplified the effectiveness in communicating patients’ compliments and complaints in a more receptive manner but also corresponded with Kano model.

  9. [Provide comprehensive service for state policy].

    Science.gov (United States)

    Wu, X

    1991-04-01

    In recent years, Chinese insurance companies introduced family planning (FP) insurance series. These schemes originated from the "one child" and life insurance and accident insurance of the early 1980s, which were established in response to the need that came with the "one child" policy. In order to help relieve the difficulties of rural FP work, the People's Insurance Corporation extended these programs to a series of schemes. These schemes included e.g., and old age security program for the families with 1 daughter only, old age security for families with an only child, and the program for FP workers' personal safety. The purpose of these schemes was to guarantee security in old age for families with few children, to ensure compensation if accident occurs during delivery or as a result of birth control operations; and compensation for FP workers for physical assaults they encountered. As FP organizations have been directly involved in advertising the insurance programs, there has been support from local governments with human and financial resources, and these insurance programs have been expanding every year. The payment of the policy has been either entirely or partially borne by the employers of the insured. In the process of the development of the insurance program, some problems have occurred. 1st, competition between FP organizations and insurance companies have evolved in sponsoring the program for its profit. 2nd, some media reports have confused the payment of premiums with the compulsory levy of undue fees, which in a way, hindered the expansion of program enrollment. 3rd, some local administrations are short of funds to pay for the insurance premiums. 4th, the accrued income from the premiums is lower than the expected sum of the principle and interest if the same funds were deposited in a bank at current interest rate. Therefore, some schemes lack appeal. FP series insurance is a longer term program which will have an important impact on the

  10. 20 CFR 652.208 - How are core services and intensive services related to the methods of service delivery described...

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false How are core services and intensive services related to the methods of service delivery described in § 652.207(b)(2)? 652.208 Section 652.208 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR ESTABLISHMENT AND...

  11. The challenges of government use of cloud services for public service delivery

    NARCIS (Netherlands)

    Irion, K.

    2014-01-01

    Cloud services hold the promise of rendering public service delivery and back-office operations more effective and efficient, by providing ubiquitous, on-demand access to computing resources. Beyond the compelling cost economies, cloud technology is also a promising platform for open government,

  12. How does outcome-based funding affect service delivery? An analysis of consequences within employment services for people living with serious mental illness.

    Science.gov (United States)

    Gewurtz, Rebecca E; Cott, Cheryl; Rush, Brian; Kirsh, Bonnie

    2015-01-01

    This paper explores the impact of outcome-based funding on service delivery within employment services for people with serious mental illness. It draws on a case study of a policy change in the provincial disability support program in Ontario, Canada where funding for employment programs and services was changed from a fee-for-service to an outcome-based model. The findings highlight that the financial imperative for programs to meet employment targets in order to secure their funding has shifted the focus away from the provision of pre-employment supports to job development and job placements. However, there remains little attention to job matching and career development, and there is concern about access to services among those with complex barriers to employment. There is a need to reconcile tensions between the goals of outcome-based funding and on-the-ground service delivery to promote ongoing innovation in employment services for people with serious mental illness.

  13. THE WEB SERVICE PROTOTYPE ON DELIVERY SYSTEM IN THE IMPLEMENTATION OF ENTERPRISE SERVICE BUS

    Directory of Open Access Journals (Sweden)

    Ghifari Munawar

    2017-04-01

    Full Text Available The main component of the logistics system is a delivery goods system. It has an enormous role in managing the entire historical shipment data from the start point (origin to the end of delivery (destination. This research aims to implement the Enterprise Service Bus (ESB on delivery systems as a middleware in the integration data process. ESB technology used in this research is NServiceBus. The stages of research using a prototype model to develop a web service that suits with theirs needs. Testing is done by tested two aspects of the exchange messages; the performance aspect and the aspect of independence. The test results show that the performance of the web service with the ESB application is better than the non-ESB user and Web services developed to have a good level of independence (loosely coupling.

  14. Global fund financing of tuberculosis services delivery in prisons.

    Science.gov (United States)

    Lee, Donna; Lal, S S; Komatsu, Ryuichi; Zumla, Alimuddin; Atun, Rifat

    2012-05-15

    Despite concerted efforts to scale up tuberculosis control with large amounts of international financing in the last 2 decades, tuberculosis continues to be a social issue affecting the world's most marginalized and disadvantaged communities. This includes prisoners, estimated at about 10 million globally, for whom tuberculosis is a leading cause of mortality and morbidity. The Global Fund to Fight AIDS, Tuberculosis and Malaria has emerged as the single largest international donor for tuberculosis control, including funding support in delivering tuberculosis treatment for the confined population. The Global Fund grants database, with an aggregate approved investment of $21.7 billion in 150 countries by the end of 2010, was reviewed to identify tuberculosis and human immunodeficiency virus/tuberculosis grants and activities that monitored the delivery of tuberculosis treatment and support activities in penitentiary settings. The distribution and trend of number of countries with tuberculosis prison support was mapped by year, geographic region, tuberculosis or multidrug-resistant tuberculosis burden, and prison population rate. We examined the types of grant recipients managing program delivery, their performance, and the nature and range of services provided. Fifty-three of the 105 countries (50%) with Global Fund-supported tuberculosis programs delivered services within prison settings. Thirty-two percent (73 of 228) of tuberculosis grants, representing $558 million of all disbursements of Global Fund tuberculosis support by the end of 2010, included output indicators related to tuberculosis services delivered in prisons. Nearly two-thirds (64%) of these grants were implemented by governments, with the remaining by civil society and other partners. In terms of services, half (36 of 73) of grants provided diagnosis and treatment and an additional 27% provided screening and monitoring of tuberculosis for prisoners. The range of services tracked was limited in scope

  15. The effect of service delivery in public ‘community service centres’: A case of an emerging economy

    OpenAIRE

    Ndabazinhle Ngobese; Roger B. Mason; Mandusha Maharaj

    2017-01-01

    This study investigated public perceptions of the service delivery provided by the Community Service Centres (CSC) of the South African Police Service (SAPS) Durban, South Africa. The study focuses on measuring service quality and service delivery. SERVQUAL was used to compare clients’ perceptions against expectations of service quality. Four hundred respondents were surveyed at three community service centres (previously known as ‘police stations’), with expectations and perceptions being as...

  16. Cost effectiveness and efficiency in assistive technology service delivery.

    Science.gov (United States)

    Warren, C G

    1993-01-01

    In order to develop and maintain a viable service delivery program, the realities of cost effectiveness and cost efficiency in providing assistive technology must be addressed. Cost effectiveness relates to value of the outcome compared to the expenditures. Cost efficiency analyzes how a provider uses available resources to supply goods and services. This paper describes how basic business principles of benefit/cost analysis can be used to determine cost effectiveness. In addition, basic accounting principles are used to illustrate methods of evaluating a program's cost efficiency. Service providers are encouraged to measure their own program's effectiveness and efficiency (and potential viability) in light of current trends. This paper is meant to serve as a catalyst for continued dialogue on this topic.

  17. Trends in Rural Water Supply: Towards a Service Delivery Approach

    Directory of Open Access Journals (Sweden)

    Patrick Moriarty

    2013-10-01

    The papers in this special issue argue that tackling these challenges requires a shift in emphasis in rural water supply in developing countries: away from a de-facto focus on the provision of hardware for first-time access towards the proper use of installed hardware as the basis for universal access to rural water services. The outline of the main actions required to achieve this shift are becoming clearer. Chief amongst these are the professionalisation of community management and/or provision of direct support to community service providers; adoption of a wider range of service delivery models than community management alone; and addressing the sustainable financing of all costs with a particular focus on financing capital maintenance (asset management and direct support costs. This introductory paper provides an overview of these issues and a guide to the other articles, which demonstrate these points.

  18. Influence of Students’ Feedback on the Quality of Adult Higher Distance Education Service Delivery

    Directory of Open Access Journals (Sweden)

    Akpovire ODUARAN

    2017-10-01

    Full Text Available The evaluation of a program’s compliance with service delivery and features necessary for the attainment of the programs educational objectives, student outcomes and continuous improvement is an important element in program accreditation and continuous improvement process. The study reported in this paper investigated the possible effects of students’ feedback on the improvement of adult higher education distance learning service quality in a South African rural-based university. The study interrogated the service provision factors that seemingly helped in improving the delivery of the program. Such information are vital for planning, good governance, policy formulation, monitoring and evaluation, and for decision-making. The study used a quantitative descriptive statistics analysis of data generated ranging from 2013-2014. It comprised of overall student satisfaction as the dependent variable and the explanatory variables were given by program management, facilitation, assessment, learner support, systems, resources, program outcomes and subject matter. Analytical results were obtained from the Mann Whitney Test. The population consisted of students enrolled in the Advanced Certificate in Education (ACE program by distance mode. The 313 respondents sampled were randomly selected from a total population of 916 students. Data were collected using a semi-structured questionnaire. The results revealed that service qualities linked to effective management, facilitation, academic support and subject matter delivery were the main qualities that the students recommended for the improvement of the program. It is therefore recommended that adult higher education programs must have a documented systematically utilized and effective process involving program service delivery constituencies like assessment, academic support and resources provided, for the periodic review of the program educational objectives to ensure that the program remains consistent

  19. Bespoke program design for school-aged therapy disability service delivery.

    Science.gov (United States)

    Weatherill, Pamela; Bahn, Susanne; Cooper, Trudi

    2012-01-01

    This article uses the evaluation of a school-aged therapy service for children with disabilities in Western Australia to investigate models of service delivery. The current literature on family-centered practice, multidisciplinary and transdisciplinary approaches, and 4 models of service are reviewed. The models include the life needs model, the relational goal-orientated model of optimal service delivery to children and families, the quality of life model, and the collaborative model of service delivery. Analysis of the data is presented together with a bespoke model of service delivery for children with disabilities, arguing that local contexts benefit from custom-made service design.

  20. Performance Analyses in an Assistive Technology Service Delivery Process

    DEFF Research Database (Denmark)

    Petersen, Anne Karin

    Performance Analyses in an Assistive Technology Service Delivery Process.Keywords: process model, occupational performance, assistive technologiesThe Poster is about teaching students, using models and theory in education and practice. It is related to Occupational therapy process and professional...... af top-til-bund, klientcentreret og aktivitetsbaseret interventioner, ERGO/MunksgaardFisher, A. &, Griswold, L. A., 2014. Performance Skills. I: B.Schell red.2014 Occupational Therapy. Willard &Spackman’s occupational therapy. -12th ed., p.249-264Cook A.M., Polgar J.M. (2015) Assistive Technologies...

  1. Overview of States' Use of Telehealth for the Delivery of Early Intervention (IDEA Part C Services

    Directory of Open Access Journals (Sweden)

    Jana Cason

    2012-12-01

    the implementation of telehealth as a delivery model within Part C programming included security issues (40%; n=11; privacy issues (44%; n=12; concerns about quality of services delivered via telehealth (40%; n=11; and lack of evidence to support the effectiveness of a telehealth service delivery model within IDEA Part C programming (3%; n=1.  Reimbursement policy and billing processes and technology infrastructure were also identified as barriers impacting the implementation of telehealth programming.  Conclusions:  Provider shortages impact the quantity and quality of services available for children with disabilities and developmental delay, particularly in rural areas.  While many states are incorporating telehealth within their Early Intervention (IDEA Part C services in order to improve access and overcome personnel shortages, barriers persist. Policy development, education of stakeholders, research, utilization of secure and private delivery platforms, and advocacy may facilitate more widespread adoption of telehealth within IDEA Part C programs across the country.

  2. Systems modelling and simulation in health service design, delivery and decision making.

    Science.gov (United States)

    Pitt, Martin; Monks, Thomas; Crowe, Sonya; Vasilakis, Christos

    2016-01-01

    The ever increasing pressures to ensure the most efficient and effective use of limited health service resources will, over time, encourage policy makers to turn to system modelling solutions. Such techniques have been available for decades, but despite ample research which demonstrates potential, their application in health services to date is limited. This article surveys the breadth of approaches available to support delivery and design across many areas and levels of healthcare planning. A case study in emergency stroke care is presented as an exemplar of an impactful application of health system modelling. This is followed by a discussion of the key issues surrounding the application of these methods in health, what barriers need to be overcome to ensure more effective implementation, as well as likely developments in the future. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  3. An information technology framework for strengthening telehealthcare service delivery.

    Science.gov (United States)

    Chen, Li-Chin; Chen, Chi-Wen; Weng, Yung-Ching; Shang, Rung-Ji; Yu, Hui-Chu; Chung, Yufang; Lai, Feipei

    2012-10-01

    Telehealthcare has been used to provide healthcare service, and information technology infrastructure appears to be essential while providing telehealthcare service. Insufficiencies have been identified, such as lack of integration, need of accommodation of diverse biometric sensors, and accessing diverse networks as different houses have varying facilities, which challenge the promotion of telehealthcare. This study designs an information technology framework to strengthen telehealthcare delivery. The proposed framework consists of a system architecture design and a network transmission design. The aim of the framework is to integrate data from existing information systems, to adopt medical informatics standards, to integrate diverse biometric sensors, and to provide different data transmission networks to support a patient's house network despite the facilities. The proposed framework has been evaluated with a case study of two telehealthcare programs, with and without the adoption of the framework. The proposed framework facilitates the functionality of the program and enables steady patient enrollments. The overall patient participations are increased, and the patient outcomes appear positive. The attitudes toward the service and self-improvement also are positive. The findings of this study add up to the construction of a telehealthcare system. Implementing the proposed framework further assists the functionality of the service and enhances the availability of the service and patient acceptances.

  4. Spatial service delivery system for smart licensing & enforcement management

    Science.gov (United States)

    Wahap, N. A.; Ismail, N. M.; Nor, N. M.; Ahmad, N.; Omar, M. F.; Termizi, A. A. A.; Zainal, D.; Noordin, N. M.; Mansor, S.

    2016-06-01

    Spatial information has introduced a new sense of urgency for a better understanding of the public needs in term of what, when and where they need services and through which devices, platform or physical locations they need them. The objective of this project is to value- add existing license management process for business premises which comes under the responsibility of Local Authority (PBT). Manipulation of geospatial and tracing technology via mobile platform allows enforcement officers to work in real-time, use a standardized system, improve service delivery, and optimize operation management. This paper will augment the scope and capabilities of proposed concept namely, Smart Licensing/Enforcement Management (SLEm). It will review the current licensing and enforcement practice of selected PBT in comparison to the enhanced method. As a result, the new enhanced system is expected to offer a total solution for licensing/enforcement management whilst increasing efficiency and transparency for smart city management and governance.

  5. Rationale and design: telepsychology service delivery for depressed elderly veterans

    Directory of Open Access Journals (Sweden)

    Richardson Lisa K

    2009-04-01

    Full Text Available Abstract Background Older adults who live in rural areas experience significant disparities in health status and access to mental health care. "Telepsychology," (also referred to as "telepsychiatry," or "telemental health" represents a potential strategy towards addressing this longstanding problem. Older adults may benefit from telepsychology due to its: (1 utility to address existing problematic access to care for rural residents; (2 capacity to reduce stigma associated with traditional mental health care; and (3 utility to overcome significant age-related problems in ambulation and transportation. Moreover, preliminary evidence indicates that telepsychiatry programs are often less expensive for patients, and reduce travel time, travel costs, and time off from work. Thus, telepsychology may provide a cost-efficient solution to access-to-care problems in rural areas. Methods We describe an ongoing four-year prospective, randomized clinical trial comparing the effectiveness of an empirically supported treatment for major depressive disorder, Behavioral Activation, delivered either via in-home videoconferencing technology ("Telepsychology" or traditional face-to-face services ("Same-Room". Our hypothesis is that in-homeTelepsychology service delivery will be equally effective as the traditional mode (Same-Room. Two-hundred twenty-four (224 male and female elderly participants will be administered protocol-driven individual Behavioral Activation therapy for depression over an 8-week period; and subjects will be followed for 12-months to ascertain longer-term effects of the treatment on three outcomes domains: (1 clinical outcomes (symptom severity, social functioning; (2 process variables (patient satisfaction, treatment credibility, attendance, adherence, dropout; and (3 economic outcomes (cost and resource use. Discussion Results from the proposed study will provide important insight into whether telepsychology service delivery is as effective

  6. Can a Unified Service Delivery Philosophy Be Identified in Aging and Disability Organizations? Exploring Competing Service Delivery Models Through the Voices of the Workforce in These Organizations.

    Science.gov (United States)

    Keefe, Bronwyn

    2018-01-01

    Services for older adults and younger people with disabilities are increasingly merging, as reflected in the creation of Aging and Disability Resource Centers (ADRCs). Using ADRCs to coordinate services is challenging, primarily because these fields have different service delivery philosophies. Independent Living Centers, which serve people with disabilities, have a philosophy that emphasizes consumer control and peer mentoring. However, the aging service delivery philosophy is based in a case management or medical model in which the role of consumers directing their services is less pronounced. Using institutional logics theory and a qualitative research design, this study explored whether a unified service delivery philosophy for ADRCs was emerging. Based on focus groups and questionnaires with staff from ADRCs, findings revealed that competing service delivery models continue to operate in the aging and disability fields.

  7. Legislated Policy as the Basis for Effective Extension Delivery ...

    African Journals Online (AJOL)

    The paper compares the extension policies and programmes of Britain and Nigeria. Extension policy in Nigeria is characterized as stemming from ad hoc arrangements which are compounded by political instability and external locus of control. The United Kingdom in contrast has had focused extension policies supported ...

  8. Policy challenges for the pediatric rheumatology workforce: Part II. Health care system delivery and workforce supply.

    Science.gov (United States)

    Henrickson, Michael

    2011-01-01

    The United States pediatric population with chronic health conditions is expanding. Currently, this demographic comprises 12-18% of the American child and youth population. Affected children often receive fragmented, uncoordinated care. Overall, the American health care delivery system produces modest outcomes for this population. Poor, uninsured and minority children may be at increased risk for inferior coordination of services. Further, the United States health care delivery system is primarily organized for the diagnosis and treatment of acute conditions. For pediatric patients with chronic health conditions, the typical acute problem-oriented visit actually serves as a barrier to care. The biomedical model of patient education prevails, characterized by unilateral transfer of medical information. However, the evidence basis for improvement in disease outcomes supports the use of the chronic care model, initially proposed by Dr. Edward Wagner. Six inter-related elements distinguish the success of the chronic care model, which include self-management support and care coordination by a prepared, proactive team. United States health care lacks a coherent policy direction for the management of high cost chronic conditions, including rheumatic diseases. A fundamental restructure of United States health care delivery must urgently occur which places the patient at the center of care. For the pediatric rheumatology workforce, reimbursement policies and the actions of health plans and insurers are consistent barriers to chronic disease improvement. United States reimbursement policy and overall fragmentation of health care services pose specific challenges for widespread implementation of the chronic care model. Team-based multidisciplinary care, care coordination and self-management are integral to improve outcomes. Pediatric rheumatology demand in the United States far exceeds available workforce supply. This article reviews the career choice decision-making process

  9. Policy challenges for the pediatric rheumatology workforce: Part II. Health care system delivery and workforce supply

    Directory of Open Access Journals (Sweden)

    Henrickson Michael

    2011-08-01

    Full Text Available Abstract The United States pediatric population with chronic health conditions is expanding. Currently, this demographic comprises 12-18% of the American child and youth population. Affected children often receive fragmented, uncoordinated care. Overall, the American health care delivery system produces modest outcomes for this population. Poor, uninsured and minority children may be at increased risk for inferior coordination of services. Further, the United States health care delivery system is primarily organized for the diagnosis and treatment of acute conditions. For pediatric patients with chronic health conditions, the typical acute problem-oriented visit actually serves as a barrier to care. The biomedical model of patient education prevails, characterized by unilateral transfer of medical information. However, the evidence basis for improvement in disease outcomes supports the use of the chronic care model, initially proposed by Dr. Edward Wagner. Six inter-related elements distinguish the success of the chronic care model, which include self-management support and care coordination by a prepared, proactive team. United States health care lacks a coherent policy direction for the management of high cost chronic conditions, including rheumatic diseases. A fundamental restructure of United States health care delivery must urgently occur which places the patient at the center of care. For the pediatric rheumatology workforce, reimbursement policies and the actions of health plans and insurers are consistent barriers to chronic disease improvement. United States reimbursement policy and overall fragmentation of health care services pose specific challenges for widespread implementation of the chronic care model. Team-based multidisciplinary care, care coordination and self-management are integral to improve outcomes. Pediatric rheumatology demand in the United States far exceeds available workforce supply. This article reviews the career

  10. Service delivery and ethical conduct in the public service: the missing links

    Directory of Open Access Journals (Sweden)

    L. Lues

    2007-07-01

    Full Text Available There are a multitude of policies, strategies and programmes directed at the rendering of effective services to the citizens of South Africa by public service managers. However, in spite of the pursuit of effectiveness and the condemning of unethical behaviour by public service managers, scandals still occur and allegations are still made. So, where are the missing links? In this article, a brief description is given of some ethical concepts viewed as important in addressing the question posed. The concluding remarks are twofold: public service organisations need to provide continuous commitment, enforcement, and modelling of leadership in professional ethics by means of, among other things, policy structures; and public service managers need to realise the importance of changing their own mindset and accepting the ethical standards that are established by the public service organisation, even if these differ from their own beliefs and culture.

  11. Identification of Technical Requirement for Improving Quality of Local Online Food Delivery Service in Yogyakarta

    OpenAIRE

    Elvandari, , Cecilia Desvita Ratna; Sukartiko, Anggoro Cahyo; Nugrahini, Arita Dewi

    2017-01-01

    Increased internet usage and fast-paced consumer’s demands have created business opportunities, including online food delivery services. However, competition with similar national-scale businesses allegedly contributed to the decline in the number of XYZ company orders, one of the food-delivery service providers in Yogyakarta. Therefore, this study aimed to identify the need’s attributes of the daring food delivery service consumers, to find out the service-quality satisfaction level, and to ...

  12. Quality of IT service delivery — Analysis and framework for human error prevention

    KAUST Repository

    Shwartz, L.; Rosu, D.; Loewenstern, D.; Buco, M. J.; Guo, S.; Lavrado, Rafael Coelho; Gupta, M.; De, P.; Madduri, V.; Singh, J. K.

    2010-01-01

    In this paper, we address the problem of reducing the occurrence of Human Errors that cause service interruptions in IT Service Support and Delivery operations. Analysis of a large volume of service interruption records revealed that more than 21

  13. The role of transformational leadership and organizational culture in service delivery within a public service organization

    Directory of Open Access Journals (Sweden)

    Ophillia Ledimo

    2014-08-01

    Full Text Available Continuous changes in the external environment deriving from legislative, economic and technological factors, puts pressure not only to corporate organizations, but also to public service organizations. These changes have increased pressure on service delivery and calls for accountability in public service organizations. With this increased pressure comes the need for public service organizations to discover how to most effectively enhance their organizational performance. Two of the most effective ways to improve performance are through the organizational leadership and culture. Although many studies were conducted on transformational leadership and organizational culture, there is still a need to investigate the link between these constructs in public service organizations. Hence the objective of this study was to explore the relationship between transformational leadership and organizational culture for service delivery practices. The Leadership Practice Inventory (LPI and Organizational Culture Inventory (OCI were administered to a random sample size of N=238, from a population of 4350 employees working within the public service organization. Descriptive statistics and Pearson’s correlation were conducted to analyse the data. The results of this study indicated a significant positive relationship between transformational leadership and the constructive dimension of organizational culture within a public service organization. In terms of contributions and practical implications, insight gained from the findings may be used in proposing leadership and organizational development interventions and future research

  14. Patients’ perception of quality service delivery of public hospitals in Nigeria using analytical hierarchy process

    Directory of Open Access Journals (Sweden)

    Emmanuel Olateju Oyatoye

    2016-07-01

    weights and rank order of the criteria (service quality dimensions and the alternatives (sub-criteria are essential research driven output for policy formulation and implementation in the healthcare sector for workers’ capacity building towards better service delivery. JEL Code: I1, I12, C80, C83.

  15. The role of short messaging service in supporting the delivery of healthcare: An umbrella systematic review.

    Science.gov (United States)

    Househ, Mowafa

    2016-06-01

    Short messaging service (SMS) messages may present a convenient and cost-effective method to support healthcare interventions. This work assesses the effects of short messaging service on various healthcare interventions found in systematic reviews. The search strategy was based on two key concepts: short messaging service and healthcare delivery. The initial search was conducted in December 2012 and was updated in June 2013. Of the 550 identified references, 13 systematic reviews met the inclusion criteria, of which 8 were published in peer-reviewed journals and 5 were retrieved from the Cochrane library. Data analysis shows that low to moderate research evidence exists on the benefits of short messaging service interventions for appointment reminders, promoting health in developing countries and preventive healthcare. In many interventions, however, there were a few studies that were of high quality, and most of the studies were rated from low to moderate quality or had no rating at all. Healthcare organizations, policy makers, or clinicians using short messaging service messages to support healthcare interventions should (1) implement interventions that have been found to work in healthcare settings, (2) continue evaluating short messaging service interventions that have not been adequately assessed, and (3) improve collaboration between various healthcare entities to develop studies targeted at specific populations to evaluate the long-term impact of short messaging service on healthcare outcomes. © The Author(s) 2014.

  16. Using attachment theory to inform the design and delivery of mental health services: a systematic review of the literature.

    Science.gov (United States)

    Bucci, Sandra; Roberts, Nicola H; Danquah, Adam N; Berry, Katherine

    2015-03-01

    The aim of this review was to propose and describe the design and delivery of an attachment-informed general mental health service. We systematically searched the PsycINFO, MEDLINE, Web of Knowledge, COPAC, CINAHL, and Science Direct databases from 1960 to 2013. We also searched reference lists of relevant papers and directly contacted authors in the field. Literature describing attachment theory and its applicability in designing and delivering general mental health services was synthesized using thematic analysis. Papers published in English, books or chapters in edited books that described applying attachment theory in designing and delivering mental health services for adults and adolescents were included in the review. Of the 1,105 articles identified, 14 met inclusion criteria for the review. Eight key themes, and four subthemes, were extracted and organized to reflect the experience of a service user moving through the mental health system. Key themes extracted were as follows: service policy and evaluation; referrals; assessment and formulation; intervention; support for staff; support for carers; moving on; and potential service benefits. Papers reviewed suggested that service users with severe mental health problems have attachment needs that should be met in general mental health services. Attachment theory provides a useful framework to inform the design and delivery of general mental health services. The resource implications for services are discussed, as are limitations of the review and recommendations for future research. Attachment theory should be used to inform the design and delivery of general mental health services. Mental health services should evaluate the extent to which they meet service users' attachment needs. Attachment-informed mental health services should assess outcomes, including cost-effectiveness over time. Papers included in this review focus on long-stay residential care or secure services and there is a limited experimental

  17. Extending access to essential services against constraints: the three-tier health service delivery system in rural China (1949-1980).

    Science.gov (United States)

    Feng, Xing Lin; Martinez-Alvarez, Melisa; Zhong, Jun; Xu, Jin; Yuan, Beibei; Meng, Qingyue; Balabanova, Dina

    2017-05-23

    China has made remarkable progress in scaling up essential services during the last six decades, making health care increasingly available in rural areas. This was partly achieved through the building of a three-tier health system in the 1950s, established as a linked network with health service facilities at county, township and village level, to extend services to the whole population. We developed a Theory of Change to chart the policy context, contents and mechanisms that may have facilitated the establishment of the three-tier health service delivery system in rural China. We systematically synthesized the best available evidence on how China achieved universal access to essential services in resource-scarce rural settings, with a particular emphasis on the experiences learned before the 1980s, when the country suffered a particularly acute lack of resources. The search identified only three peered-reviewed articles that fit our criteria for scientific rigor. We therefore drew extensively on government policy documents, and triangulated them with other publications and key informant interviews. We found that China's three-tier health service delivery system was established in response to acute health challenges, including high fertility and mortality rates. Health system resources were extremely low in view of the needs and insufficient to extend access to even basic care. With strong political commitment to rural health and a "health-for-all" policy vision underlying implementation, a three-tier health service delivery model connecting villages, townships and counties was quickly established. We identified several factors that contributed to the success of the three-tier system in China: a realistic health human resource development strategy, use of mass campaigns as a vehicle to increase demand, an innovative financing mechanisms, public-private partnership models in the early stages of scale up, and an integrated approach to service delivery. An

  18. The free delivery and caesarean policy in Morocco: how much do households still pay?

    Science.gov (United States)

    Boukhalfa, C; Abouchadi, S; Cunden, N; Witter, S

    2016-02-01

    The Free Deliveries and Caesarean Policy (FDCP) entitles all women in Morocco to deliver free of charge within public hospitals. This study assesses the policy's effectiveness by analysing household expenditures related to childbirth, by delivery type and quintile. Structured exit survey of 973 women in six provinces at five provincial hospitals, two regional hospitals, two university hospitals and three primary health centres with maternity units. Households reported spending a median of US$ 59 in total for costs inside and outside of hospitals. Women requiring caesareans payed more than women with uncomplicated deliveries (P < 0.0001). The median cost was US$45 for a uncomplicated delivery, US$50 for a complicated delivery and US$65 for a caesarean section. The prescription given upon exiting the hospital comprised 62% of the total costs. Eighty-eight per cent of women from the poorest quintiles faced catastrophic expenditures. The women's perception of their hospital stay and the FDCP policy was overwhelmingly positive, but differences were noted at the various sites. The policy has been largely but not fully effective in removing financial barriers for delivery care in Morocco. More progress should also be made on increasing awareness of the policy and on easing the financial burden, which is still borne by households with lower incomes. © 2015 John Wiley & Sons Ltd.

  19. PACS and diagnostic imaging service delivery-A UK perspective

    International Nuclear Information System (INIS)

    Sutton, Laurence N.

    2011-01-01

    This review sets out the current position with regard to the implementation of PACS throughout the United Kingdom and the impact this has had on improving patient care. In December 2007 England had implemented full hospital-wide PACS in all hospitals: a major achievement in the relatively short time period of three years. The different approaches used by each country of the UK to achieve full national PACS are described in addition to the current issues with the sharing of images and reports across different healthcare organisations with regard to technical solutions, clinical safety and governance. The review gives insight into the changing methods of service delivery to address increasing demand pressures on diagnostic imaging services and how the national PACS implementation, specifically in England, has made a significant contribution to measures to improve efficiencies. The role of Teleradiology is discussed in the context of supporting local patient services rather than undermining them and the concept of cross-healthcare reporting 'Grids' is described. Finally, in the summary it is recognised that the vast wealth of knowledge accumulated during the national implementations has placed the UK in a strong position to facilitate full national data sharing across all healthcare organisations to improve patient care.

  20. Channel integration in governmental service delivery: the effects on citizen behavior and perceptions

    NARCIS (Netherlands)

    Pieterson, Willem Jan; Teerling, Marije; Wimmer, Maria A.; Scholl, Hans J.; Janssen, Marijn; Traunmüller, Roland

    2009-01-01

    Governmental agencies continuously work on the improvement of their service delivery through an array of channels. To improve service satisfaction and to reduce the cost of service delivery, channel integration gets more popular with governmental agencies. In a quasi experimental longitudinal field

  1. Design of price incentives for adjunct policy goals in formula funding for hospitals and health services

    Directory of Open Access Journals (Sweden)

    Duckett Stephen J

    2008-04-01

    Full Text Available Abstract Background Hospital policy involves multiple objectives: efficiency of service delivery, pursuit of high quality care, promoting access. Funding policy based on hospital casemix has traditionally been considered to be only about promoting efficiency. Discussion Formula-based funding policy can be (and has been used to pursue a range of policy objectives, not only efficiency. These are termed 'adjunct' goals. Strategies to incorporate adjunct goals into funding design must, implicitly or explicitly, address key decision choices outlined in this paper. Summary Policy must be clear and explicit about the behaviour to be rewarded; incentives must be designed so that all facilities with an opportunity to improve have an opportunity to benefit; the reward structure is stable and meaningful; and the funder monitors performance and gaming.

  2. Predictors of Safe Delivery Service Utilization in Arsi Zone, South-East Ethiopia

    OpenAIRE

    Abera, Mulumebet; Gebremariam, Abebe; Belachew, Tefera

    2011-01-01

    Background Evidence show that lack of access to and use of, essential obstetric care services to be a crucial factor that contributes to the high maternal morbidity and mortality. Skilled attendance during labor, delivery and early post-partum period could reduce deaths due to obstructed labor, hemorrhage, sepsis and eclampsia. There is limited information on the mothers' use of skilled delivery services in the study area. This study assessed the predictors of safe delivery service utilizatio...

  3. Equity and financing for sexual and reproductive health service delivery: current innovations.

    Science.gov (United States)

    Montagu, Dominic; Graff, Maura

    2009-07-01

    National and international decisions on financing for sexual and reproductive health (SRH) services have profound effects on the type, unit costs and distribution of SRH commodities and services produced, and on their availability and consumption. Much international and national funding is politically driven and is doing little for equity and quality improvement. Financing remains a significant challenge in most developing countries and demands creative responses. While no "one-size-fits-all" solution exists, there are numerous ongoing examples of successful innovations, many of which are focusing on resource pooling and on purchasing or subsidising SRH services. In this article we have used interviews, grey literature and presentations made at a range of recent public fora to identify new and innovative ways of financing SRH services so as to increase equity in developing countries. Because SRH services are often of low value as a personal good but high value as a public good, we summarise the issues from a societal perspective, highlighting the importance of financing and policy decisions for SRH services. We provide a structured overview of what novel approaches to financing appear to have positive effects in a range of developing countries. Targeting, government payment mechanisms, subsidy delivery and co-financing for sustainability are highlighted as showing particular promise. Examples are used throughout the article to illustrate innovative strategies.

  4. The perceptions and nature of service delivery innovation among government employees: An exploratory study

    Directory of Open Access Journals (Sweden)

    Nico Martins

    2015-11-01

    Full Text Available Innovation has become prominent within the leadership literature as an underlying and important aspect of service delivery. This study set out to determine the perceptions and nature of service delivery innovation among employees of a South African government department, using a sample of 289 participants. Statistical analysis was conducted to analyse the data which indicate that innovation is an important aspect of service delivery. This study suggests that to enhance service delivery employees should be encouraged to be innovative. The implications of the findings are discussed and recommendations for future research are made.

  5. The effect of service delivery in public ‘community service centres’: A case of an emerging economy

    Directory of Open Access Journals (Sweden)

    Ndabazinhle Ngobese

    2017-07-01

    Full Text Available This study investigated public perceptions of the service delivery provided by the Community Service Centres (CSC of the South African Police Service (SAPS Durban, South Africa. The study focuses on measuring service quality and service delivery. SERVQUAL was used to compare clients’ perceptions against expectations of service quality. Four hundred respondents were surveyed at three community service centres (previously known as ‘police stations’, with expectations and perceptions being assessed via the dimensions of tangibility, reliability, responsiveness, assurance and empathy. The results indicate that in all five dimensions there is a significant negative quality gap, implying that the quality of service received is below what is expected by clients. Improvements are required in all five dimensions if service delivery is to be improved. Actions needed to improve service quality include regular assessment and monitoring of clients’ experiences, as well as employees’ behaviour

  6. New CLGF Four-Year Grant to Help Local Government Service Delivery and Boost CLGF’s Research Capacity

    Directory of Open Access Journals (Sweden)

    Lucy Slack

    2012-12-01

    Full Text Available The UK Department for International Development (UK AID has agreed £4.5 million funding for a four-year CLGF programme to improve governance and service delivery at local level in several areas of the Commonwealth including Africa and Asia from 2012-16. It will also help to support national policy frameworks for local government service delivery, and increase engagement of local government in regional policy planning and implementation. CLGF will continue to work with its members, UN partners and others to mobilise more resources towards the support of local government in the Commonwealth. The new programme will focus on local government pilot projects in LED, supporting ministries and local government associations in strengthening their national policy making for local government, and establish regional forums to enable local government to engage in and influence regional policy making to reflect the needs and priorities of local government. It will also boost CLGF’s research capacity with targeted research to strengthen CLGF’s policy making and advocacy, including more sustained engagement in international policy debates on key issues affecting local government, such as climate change.

  7. Food Service Guideline Policies on State Government-Controlled Properties.

    Science.gov (United States)

    Zaganjor, Hatidza; Bishop Kendrick, Katherine; Warnock, Amy Lowry; Onufrak, Stephen; Whitsel, Laurie P; Ralston Aoki, Julie; Kimmons, Joel

    2016-09-13

    Food service guideline (FSG) policies can impact millions of daily meals sold or provided to government employees, patrons, and institutionalized persons. This study describes a classification tool to assess FSG policy attributes and uses it to rate FSG policies. Quantitative content analysis. State government facilities in the United States. Participants were from 50 states and District of Columbia in the United States. Frequency of FSG policies and percentage alignment to tool. State-level policies were identified using legal research databases to assess bills, statutes, regulations, and executive orders proposed or adopted by December 31, 2014. Full-text reviews were conducted to determine inclusion. Included policies were analyzed to assess attributes related to nutrition, behavioral supports, and implementation guidance. A total of 31 policies met the inclusion criteria; 15 were adopted. Overall alignment ranged from 0% to 86%, and only 10 policies aligned with a majority of the FSG policy attributes. Western states had the most FSG policies proposed or adopted (11 policies). The greatest number of FSG policies were proposed or adopted (8 policies) in 2011, followed by the years 2013 and 2014. The FSG policies proposed or adopted through 2014 that intended to improve the food and beverage environment on state government property vary considerably in their content. This analysis offers baseline data on the FSG landscape and information for future FSG policy assessments. © The Author(s) 2016.

  8. Food Service Guideline Policies on State Government Controlled Properties

    Science.gov (United States)

    Zaganjor, Hatidza; Bishop Kendrick, Katherine; Warnock, Amy Lowry; Onufrak, Stephen; Whitsel, Laurie P.; Ralston Aoki, Julie; Kimmons, Joel

    2017-01-01

    Purpose Food service guidelines (FSG) policies can impact millions of daily meals sold or provided to government employees, patrons, and institutionalized persons. This study describes a classification tool to assess FSG policy attributes and uses it to rate FSG policies. Design Quantitative content analysis. Setting State government facilities in the U.S. Subjects 50 states and District of Columbia. Measures Frequency of FSG policies and percent alignment to tool. Analysis State-level policies were identified using legal research databases to assess bills, statutes, regulations, and executive orders proposed or adopted by December 31, 2014. Full-text reviews were conducted to determine inclusion. Included policies were analyzed to assess attributes related to nutrition, behavioral supports, and implementation guidance. Results A total of 31 policies met inclusion criteria; 15 were adopted. Overall alignment ranged from 0% to 86%, and only 10 policies aligned with a majority of FSG policy attributes. Western States had the most FSG policy proposed or adopted (11 policies). The greatest number of FSG policies were proposed or adopted (8 policies) in 2011, followed by the years 2013 and 2014. Conclusion FSG policies proposed or adopted through 2014 that intended to improve the food and beverage environment on state government property vary considerably in their content. This analysis offers baseline data on the FSG landscape and information for future FSG policy assessments. PMID:27630113

  9. ROLES OF TRADITIONAL BIRTH ATTENDANTS AND PERCEPTIONS ON THE POLICY DISCOURAGING HOME DELIVERY IN COASTAL KENYA.

    Science.gov (United States)

    Wanyua, S; Kaneko, S; Karama, M; Makokha, A; Ndemwa, M; Kisule, A; Changoma, M; Goto, K; Shimada, M

    2014-03-01

    To describe the roles of Traditional Birth Attendants (TBAs), to determine the perceptions of TBAs and Skilled Birth Attendants (SBAs) towards the policy discouraging home delivery by TBAs and to establish the working relationship between TBAs and SBAs in Kwale, Kenya. Community based cross-sectional study. Mwaluphamba, Kinango and Golini locations of Kwale County, Kenya. Fifty eight participants were involved in the study. Interviews were conducted with 22 TBAs and 8 SBAs as well as 3 FGDs with 28 TBAs were carried out in July 2012. Roles of TBAs, policy awareness and support as well as the working relationship between TBAs and SBAs. Before delivery, the main role of TBAs was checking position of the baby in the womb (86%) while during delivery, the main role was stomach massage (64%). However, majority (95%) of the TBAs did not provide any after delivery. All SBAs and 59% of TBAs were aware of the policy while 88% SBAs and 36% of TBAs supported it. The working relationship between TBAs and SBAs mainly involved the referral of women to health facilities (HFs). Sometimes, TBAs accompanied women to the HF offering emotional support until after delivery. TBAs in Kwale have a big role to play especially during pregnancy and delivery periods. Awareness and support of the policy as well as the collaboration between SBAs and TBAs should be enhanced in Kwale.

  10. A spatial model to quantify the mortality impact of service delivery in Sub-Saharan Africa: an ecological design utilizing data from South Africa.

    Science.gov (United States)

    Sartorius, Kurt; Sartorius, Benn K D

    2013-02-20

    Sub Saharan Africa is confronted with a wide range of interlinked health and economic problems that include high levels of mortality and poor service delivery. The objective of the paper is to develop a spatial model for Sub-Saharan Africa that can quantify the mortality impact of (poor) service delivery at sub-district level in order to integrate related health and local level policy interventions. In this regard, an expanded composite service delivery index was developed, and the data were analysed using a Bayesian Poisson spatial model. The results indicate significant differences in the risk of mortality and poor service delivery at sub-district level. In particular, the results indicate clusters of high mortality and poor service delivery in two of the bigger, poorer provinces with large rural communities. Conversely, two of the wealthier provinces have lower levels of mortality and higher levels of service delivery, but income inequality is more widespread. The bivariate and multivariate models, moreover, reflect significant positive linkages (p service delivery after adjusting for HIV/AIDS, income inequality, population density and the protective influence of metropolitan areas. Finally, the hypothesized provision of a basket of services reduced the mortality rate in South Africa's 248 sub-districts by an average of 5.3 (0.3-15.4) deaths per 1000. The results indicate that the model can accurately plot mortality and service delivery "hotspots' at sub-district level, as well as explain their associations and causality. A mortality reduction index shows that mortality in the highest risk sub-districts can be reduced by as much as 15.4 deaths per 1000 by providing a range of basic services. The ability to use the model in a wider SSA context and elsewhere is also feasible given the innovative use of available databases. Finally, the paper illustrates the importance of developing policy in SSA that can simultaneously solve both economic and health problems.

  11. Policy Framework for the Next Generation Platform as a Service

    DEFF Research Database (Denmark)

    Kentis, Angelos Mimidis; Ollora Zaballa, Eder; Soler, José

    2018-01-01

    The Platform-as-a-Service (PaaS) model, allows service providers to build and deploy their services following streamlined work-flows. However, platforms deployed through the PaaS model can be very diverse in terms of technologies and involved subsystems (e.g. infrastructure, orchestration). Thus,......-wide and technology-agnostic policies to NGPaaS, by means of abstraction of the underlying platforms and the use of generic interfaces. The paper also presents a specific use case for the proposed framework, which targets network-oriented policies......., the means for deploying and managing a service can significantly vary depending on the deployed platform. To address this issue, this paper proposes a policy-based framework designed for the Next Generation Platform-as-a-Service (NGPaaS). This framework allows service providers to define platform...

  12. Global Document Delivery, User Studies, and Service Evaluation: The Gateway Experience

    Science.gov (United States)

    Miller, Rush; Xu, Hong; Zou, Xiuying

    2008-01-01

    This study examines user and service data from 2002-2006 at the East Asian Gateway Service for Chinese and Korean Academic Journal Publications (Gateway Service), the University of Pittsburgh. Descriptive statistical analysis reveals that the Gateway Service has been consistently playing the leading role in global document delivery service as well…

  13. The influences of patient's satisfaction with medical service delivery, assessment of medical service, and trust in health delivery system on patient's life satisfaction in China.

    Science.gov (United States)

    Tang, Liyang

    2012-09-14

    Patient's satisfaction with medical service delivery/assessment of medical service/trust in health delivery system may have significant influence on patient's life satisfaction in China's health delivery system/in various kinds of hospitals.The aim of this study was to test whether and to what extent patient's satisfaction with medical service delivery/patient's assessments of various major aspects of medical service/various major aspects of patient's trust in health delivery system influenced patient's life satisfaction in China's health delivery system/in various kinds of hospitals. This study collaborated with National Bureau of Statistics of China to carry out a 2008 national urban resident household survey in 17 provinces, autonomous regions, and municipalities directly under the central government (N = 3,386), and specified ordered probit models were established to analyze dataset from this household survey. The key considerations in generating patient's life satisfaction involved patient's overall satisfaction with medical service delivery, assessment of doctor-patient communication, assessment of medical cost, assessment of medical treatment process, assessment of medical facility and hospital environment, assessment of waiting time for medical service, trust in prescription, trust in doctor, and trust in recommended medical examination. But the major considerations in generating patient's life satisfaction were different among low level public hospital, high level public hospital, and private hospital. The promotion of patient's overall satisfaction with medical service delivery, the improvement of doctor-patient communication, the reduction of medical cost, the improvement of medical treatment process, the promotion of medical facility and hospital environment, the reduction of waiting time for medical service, the promotion of patient's trust in prescription, the promotion of patient's trust in doctor, and the promotion of patient's trust in

  14. Controlling outsourced service delivery : Managing service quality in business service triads

    NARCIS (Netherlands)

    van Iwaarden, J.; van der Valk, W.

    2013-01-01

    Organisations are increasingly sourcing services that become part of their value proposition to their (business) customers from external providers. Often, these services are directly delivered by the service provider to the customer. The buying organisation, service provider and customer operate in

  15. Improving the effectiveness of service delivery in the public healthcare sector: the case of ophthalmology services in Malaysia.

    Science.gov (United States)

    Foo, Chee Yoong; Lim, Ka Keat; Sivasampu, Sheamini; Dahian, Kamilah Binti; Goh, Pik Pin

    2015-08-28

    Rising demand of ophthalmology care is increasingly straining Malaysia's public healthcare sector due to its limited human and financial resources. Improving the effectiveness of ophthalmology service delivery can promote national policy goals of population health improvement and system sustainability. This study examined the performance variation of public ophthalmology service in Malaysia, estimated the potential output gain and investigated several factors that might explain the differential performance. Data for 2011 and 2012 on 36 ophthalmology centres operating in the Ministry of Health hospitals were used in this analysis. We first consulted a panel of ophthalmology service managers to understand the production of ophthalmology services and to verify the production model. We then assessed the relative performance of these centres using Data Envelopment Analysis (DEA). Efficiency scores (ES) were decomposed into technical, scale, and congestion component. Potential increase in service output was estimated. Sensitivity analysis of model changes was performed and stability of the result was assessed using bootstrap approach. Second stage Tobit regression was conducted to determine if hospital type, availability of day services and population characteristics were related to the DEA scores. In 2011, 33% of the ophthalmology centres were found to have ES > 1 (mean ES = 1.10). Potential output gains were 10% (SE ± 2.92), 7.4% (SE ± 2.06), 6.9% (SE ± 1.97) if the centres could overcome their technical, scale and congestion inefficiencies. More centres moved to the performance frontier in 2012 (mean ES = 1.07), with lower potential output gain. The model used has good stability. Robustness checks show that the DEA correctly identified low performing centres. Being in state hospital was significantly associated with better performance. Using DEA to benchmarking service performance of ophthalmology care could provide insights for policy

  16. servicom policy intervention: improving service quality in nigerian ...

    African Journals Online (AJOL)

    Admin

    customer orientation in the Nigerian public sector. The policy goes by ..... Graham Effect' (Arnold, Cooper and Robertson,. 1995). .... system and budgeting time and money to pursue services ... customer relationships, and facilitating a safe and.

  17. Negotiated complexity in ecostystem services science and policy making

    OpenAIRE

    Keune, Hans; Dendoncker, Nicolas

    2014-01-01

    Abstract: Its a long way from scientific knowledge to concrete policy action. Along the way many decisions have to be made. A lot of these decisions relate to setting priorities. With regard to policy uptake of scientific knowledge on ecosystem services, the need for an integrated decision-making framework is crucial. Framing complexity is a crucial aspect of any ecosystem services approach: How do we deal with ecological and social complexity? The complexity to be taken into account and the ...

  18. Servicom policy intervention: Improving service quality in Nigerian ...

    African Journals Online (AJOL)

    In this case study we examine the raison d'être and implementation of a policy intervention, which was promulgated in 2005 for the purpose of eradicating inefficiency and corruption, and inculcating customer orientation in the Nigerian public sector. The policy goes by the acronym 'SERVICOM' -'service compact with all ...

  19. Expanding services in a shrinking economy: desktop document delivery in a dental school library.

    Science.gov (United States)

    Gushrowski, Barbara A

    2011-07-01

    How can library staff develop and promote a document delivery service and then expand the service to a wide audience? The setting is the library at the Indiana University School of Dentistry (IUSD), Indianapolis. A faculty survey and a citation analysis were conducted to determine potential use of the service. Volume of interlibrary loan transactions and staff and equipment capacity were also studied. IUSD Library staff created a desktop delivery service (DDSXpress) for faculty and then expanded the service to practicing dental professionals and graduate students. The number of faculty using DDSXpress remains consistent. The number of practicing dental professionals using the service is low. Graduate students have been quick to adopt the service. Through careful analysis of capacity and need for the service, staff successfully expanded document delivery service without incurring additional costs. Use of DDSXpress is continually monitored, and opportunities to market the service to practicing dental professionals are being investigated.

  20. Mobile government implementation for government service delivery in developing countries: a South Africa context

    CSIR Research Space (South Africa)

    Ogunleye, OS

    2014-07-01

    Full Text Available an opportunity to use of this platform to provide better service delivery to the citizens of the developing countries. This paper identifies major service delivery issues in South Africa. Various m-government systems that have been implemented in other countries...

  1. How to achieve optimal organization of primary care service delivery at system level: lessons from Europe

    NARCIS (Netherlands)

    Pelone, Ferruccio; Kringos, Dionne S.; Spreeuwenberg, Peter; de Belvis, Antonio G.; Groenewegen, Peter P.

    2013-01-01

    To measure the relative efficiency of primary care (PC) in turning their structures into services delivery and turning their services delivery into quality outcomes. Cross-sectional study based on the dataset of the Primary Healthcare Activity Monitor for Europe project. Two Data Envelopment

  2. How to achieve optimal organization of primary care service delivery at system level: Lessons from Europe

    NARCIS (Netherlands)

    Pelone, F.; Kringos, D.S.; Spreeuwenberg, P.; de Belvis, A.; Groenewegen, P.P.

    2013-01-01

    OBJECTIVE: To measure the relative efficiency of primary care (PC) in turning their structures into services delivery and turning their services delivery into quality outcomes. DESIGN: Cross-sectional study based on the dataset of the Primary Healthcare Activity Monitor for Europe project. Two Data

  3. How to achieve optimal organization of primary care service delivery at system level: lessons from Europe.

    NARCIS (Netherlands)

    Pelone, F.; Kringos, D.S.; Spreeuwenberg, P.; Belvis, A.G. de; Groenewegen, P.P.

    2013-01-01

    Objective: To measure the relative efficiency of primary care (PC) in turning their structures into services delivery and turning their services delivery into quality outcomes. Design: Cross-sectional study based on the dataset of the Primary Healthcare Activity Monitor for Europe project. Two Data

  4. Social Insurance for Delivery (Jampersal Policy in Indonesia: Culture-Based Approach for Improving Delivery by Health Workers in Rural Areas

    Directory of Open Access Journals (Sweden)

    Riswati Riswati

    2015-06-01

    Full Text Available Background: Jampersal program was launched in Indonesia in January of 2011 by Permenkes No.631/Menkes/PER/III/2011. The aim was to improve the coverage of antenatal care, delivery, postpartum care, postnatal, and family planning by health professionals free of charge. After over a year Jampersal program runs, The ANC figures of Jampersal utilization were still very low. Methods:Quantitative and qualitative research on socio- cultural factors in relation to the selection of health personnel by utilizing Jampersal conducted in 2012 which was then followed by a round table discussion to review the policy options related to the Jampersal utilization of the 6 rural districts. Results: Policy options suggested in Jampersal socialization activities need Intersectoral Commitment:The Ministry of Home Affairs, Ministry of Religious Affairs, and BKKBN, followed by a clear and decisive political commitment. They need active partnerships of the midwives, TBAs and cadres in Jampersal socialization. Midwives in the health center level should be prohibited from private practice, but the total amount of compensation of midwife in helping delivery should be adjusted. Regulations are required and procedures should be set for Jamkesnas, Jamkesda, and Jampersal; They need regulation on cooperation between the health centers staffs and village chiefs to further reinforce ID requirement;The transportation cost to refferal unit; TBAs services (division of task and cost; Financial restrictions to cover by Jampersal on second or third delivery. Additionally need a regulation of reward and punishment for midwives,TBAs and cadres involvement in serving pregnancy and delivery. In village level, they need to establish regulation, that TbaS AND Cadres should write the pregnat women data at the board office of village chiefts. Lastly, MoU between head of district health center and midwife assosiation related to midwife understanding of cultural approaches and on

  5. Informal learning processes in support of clinical service delivery in a service-oriented community pharmacy.

    Science.gov (United States)

    Patterson, Brandon J; Bakken, Brianne K; Doucette, William R; Urmie, Julie M; McDonough, Randal P

    The evolving health care system necessitates pharmacy organizations' adjustments by delivering new services and establishing inter-organizational relationships. One approach supporting pharmacy organizations in making changes may be informal learning by technicians, pharmacists, and pharmacy owners. Informal learning is characterized by a four-step cycle including intent to learn, action, feedback, and reflection. This framework helps explain individual and organizational factors that influence learning processes within an organization as well as the individual and organizational outcomes of those learning processes. A case study of an Iowa independent community pharmacy with years of experience in offering patient care services was made. Nine semi-structured interviews with pharmacy personnel revealed initial evidence in support of the informal learning model in practice. Future research could investigate more fully the informal learning model in delivery of patient care services in community pharmacies. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Siemens's spectrum of deliveries and services for nuclear power plants

    International Nuclear Information System (INIS)

    2011-01-01

    In 2001, Siemens and Framatome merged their nuclear activities in the present Areva NP joint venture. Siemens has since focused on the construction and further development of conventional power plants and on the so-called conventional island (CI), the non-nuclear part of a nuclear power plant, i.e. the steam turbine, generator, and plant I and C systems, and also on service for the conventional part of nuclear power plants. Its role as a minority shareholder in Areva NP constrained Siemens. For this reason, the company in January 2009 decided to terminate its interest in Areva NP effective January 30, 2012. By January 2012 at the latest, Siemens will transfer to the majority shareholder Areva, holding 66 percent of the shares, its interest in the joint venture. For the time being, the joint venture still entails certain limitations to Siemens's activities in the nuclear field. Its delivery of the conventional island for the Olkiluoto 3 (OL3) nuclear power plant in Finland confirms the company's know-how in power plant construction. When commissioned, its 1,720 MW power will make OL3 the world's largest nuclear generating unit. The turbo-generator of the CI comprises a double-flow HP turbine and a 6-flow LP turbine. The driven 4-pole generator with a power of up to 2,200 MVA consists of a water-cooled stator and a hydrogen-cooled rotor. (orig.)

  7. Opening the Black Box: Exploring the Effect of Transformation on Online Service Delivery in Local Governments

    Science.gov (United States)

    van Veenstra, Anne Fleur; Zuurmond, Arre

    To enhance the quality of their online service delivery, many government organizations seek to transform their organization beyond merely setting up a front office. This transformation includes elements such as the formation of service delivery chains, the adoption of a management strategy supporting process orientation and the implementation of enterprise architecture. This paper explores whether undertaking this transformation has a positive effect on the quality of online service delivery, using data gathered from seventy local governments. We found that having an externally oriented management strategy in place, adopting enterprise architecture, aligning information systems to business and sharing activities between processes and departments are positively related to the quality of online service delivery. We recommend that further research should be carried out to find out whether dimensions of organizational development too have an effect on online service delivery in the long term.

  8. Guidance to employers on integrating e-cigarettes/electronic nicotine delivery systems into tobacco worksite policy.

    Science.gov (United States)

    Whitsel, Laurie P; Benowitz, Neal; Bhatnagar, Aruni; Bullen, Chris; Goldstein, Fred; Matthias-Gray, Lena; Grossmeier, Jessica; Harris, John; Isaac, Fikry; Loeppke, Ron; Manley, Marc; Moseley, Karen; Niemiec, Ted; OʼBrien, Vince; Palma-Davis, LaVaughn; Pronk, Nico; Pshock, Jim; Stave, Gregg M; Terry, Paul

    2015-03-01

    In recent years, new products have entered the marketplace that complicate decisions about tobacco control policies and prevention in the workplace. These products, called electronic cigarettes (e-cigarettes) or electronic nicotine delivery systems, most often deliver nicotine as an aerosol for inhalation, without combustion of tobacco. This new mode of nicotine delivery raises several questions about the safety of the product for the user, the effects of secondhand exposure, how the public use of these products should be handled within tobacco-free and smoke-free air policies, and how their use affects tobacco cessation programs, wellness incentives, and other initiatives to prevent and control tobacco use. In this article, we provide a background on e-cigarettes and then outline key policy recommendations for employers on how the use of these new devices should be managed within worksite tobacco prevention programs and control policies.

  9. Trends in health surveillance and joint service delivery for pastoralists in West and Central Africa.

    Science.gov (United States)

    Abakar, M F; Schelling, E; Béchir, M; Ngandolo, B N; Pfister, K; Alfaroukh, I O; Hassane, H M; Zinsstag, J

    2016-11-01

    In most sub-Saharan African countries, pastoralism represents an important economic resource and contributes significantly to national growth; however, challenges remain, particularly in providing social services to pastoralists (especially health and education) and in avoiding conflict with local sedentary communities and local authorities. All of this takes place while pastoralists try to maintain their mobile lifestyle within a rapidly changing ecosystem. Transdisciplinary approaches, such as 'One Health', which covers both human and animal health, have proven effective in delivering services and reaching mobile pastoralists in remote areas. The pastoralist way of life could be described as being linked to both their livestock and their environment, which makes social science an important element when researching the delivery and adaptation of social services to pastoralists. Early or pre-diagnostic detection of emerging and endemic infectious disease remains a vital aspect of health surveillance targeted at preventing further transmission and spread. Community-based syndromic surveillance, coupled with visual mobile phone technology, adapted to the high levels of illiteracy among nomads, could offer an alternative to existing health surveillance systems. Such an approach could contribute to accelerated reporting, which could in turn lead to targeted intervention among mobile pastoralists in sub-Saharan Africa. Although considerable efforts have been made towards integrating mobile pastoralists into social services, obstacles remain to the adoption of a clear, specific and sustainable policy on pastoralism in sub-Saharan Africa.

  10. 3PAC: Enforcing Access Policies for Web Services

    NARCIS (Netherlands)

    van Bemmel, J.; Wegdam, M.; Lagerberg, K.

    Web Services fail to deliver on the promise of ubiquitous deployment and seamless interoperability due to the lack of a uniform, standards-based approach to all aspects of security. In particular, the enforcement of access policies in a Service Oriented Architecture is not addressed adequately. We

  11. Mapping and modelling ecosystem services for science, policy and practice

    NARCIS (Netherlands)

    Burkhard, B.; Crossman, N.; Nedkov, S.; Petz, K.; Alkemade, R.

    2013-01-01

    Ecosystem services are a significant research and policy topic and there are many modelling and mapping approaches aimed at understanding the stocks, demands and flows of ecosystem services on different spatial and temporal scales. The integration of geo-biophysical processes and structure

  12. Partnership working and improved service delivery: views of staff providing sexual health services.

    Science.gov (United States)

    Pow, Janette; Elliott, Lawrie; Raeside, Robert; Themessl-Huber, Markus; Claveirole, Anne

    2013-07-01

    Successful partnership working has theoretically been linked to improvements in service delivery and is dependent on the strength of the partnership, trust, communication, professional roles and resource sharing. Empirical evidence to confirm the relationships between these factors and improved service provision, however, is lacking. Our aim was to assess the views of staff as to the conditions required for partnership working. This study was a cross-sectional survey of 687 staff offering sexual health education, information or support to young people in the Healthy Respect intervention area in Scotland. Views of each variable were scored and structural equation modelling was used to assess the theoretical model. Responses were received from 284 (41%) staff. Greater strength of partnership was directly associated with increasing the number of referrals. Establishing professional roles between organizations was also associated with increasing the number of referrals. Strength of partnership was indirectly associated with working more effectively with young people and this relationship depended on clear communication, trust, established professional roles and shared resources. Effective partnership working depends on a number of interdependent relationships between organizations, which act synergistically to improve organizational outcomes. Effective partnership working leads to improved service delivery though there is a need for better controlled studies which demonstrate the effect on health outcomes.

  13. Advancing LGBT Elder Policy and Support Services: The Massachusetts Model.

    Science.gov (United States)

    Krinsky, Lisa; Cahill, Sean R

    2017-12-01

    The Massachusetts-based LGBT Aging Project has trained elder service providers in affirming and culturally competent care for LGBT older adults, supported development of LGBT-friendly meal programs, and advanced LGBT equality under aging policy. Working across sectors, this innovative model launched the country's first statewide Legislative Commission on Lesbian, Gay, Bisexual, and Transgender Aging. Advocates are working with policymakers to implement key recommendations, including cultural competency training and data collection in statewide networks of elder services. The LGBT Aging Project's success provides a template for improving services and policy for LGBT older adults throughout the country.

  14. Integrating ecosystem services into national Forest Service policy and operations

    Science.gov (United States)

    Robert Deal; Lisa Fong; Erin Phelps; Emily Weidner; Jonas Epstein; Tommie Herbert; Mary Snieckus; Nikola Smith; Tania Ellersick; Greg Arthaud

    2017-01-01

    The ecosystem services concept describes the many benefits people receive from nature. It highlights the importance of managing public and private lands sustainably to ensure these benefits continue into the future, and it closely aligns with the U.S. Forest Service (USFS) mission to “sustain the health, diversity, and productivity of the Nation’s forests and...

  15. Space assets, technology and services in support of energy policy

    Science.gov (United States)

    Vasko, C. A.; Adriaensen, M.; Bretel, A.; Duvaux-Bechon, I.; Giannopapa, C. G.

    2017-09-01

    Space can be used as a tool by decision and policy makers in developing, implementing and monitoring various policy areas including resource management, environment, transport, security and energy. This paper focuses on the role of space for the energy policy. Firstly, the paper summarizes the European Union's (EU) main objectives in energy policy enclosed in the Energy Strategy 2020-2030-2050 and demonstrates how space assets can contribute to achieving those objectives. Secondly, the paper addresses how the European Space Agency (ESA) has established multiple initiatives and programs that directly finance the development of space assets, technology and applications that deliver services in support of the EU energy policy and sector. These efforts should be continued and strengthened in order to overcome identified technological challenges. The use of space assets, technology and applications, can help achieve the energy policy objectives for the next decades.

  16. Policy challenges for the pediatric rheumatology workforce: Part II. Health care system delivery and workforce supply

    OpenAIRE

    Henrickson Michael

    2011-01-01

    Abstract The United States pediatric population with chronic health conditions is expanding. Currently, this demographic comprises 12-18% of the American child and youth population. Affected children often receive fragmented, uncoordinated care. Overall, the American health care delivery system produces modest outcomes for this population. Poor, uninsured and minority children may be at increased risk for inferior coordination of services. Further, the United States health care delivery syste...

  17. Mapping the ecosystem service delivery chain: Capacity, flow, and demand pertaining to aesthetic experiences in mountain landscapes.

    Science.gov (United States)

    Egarter Vigl, Lukas; Depellegrin, Daniel; Pereira, Paulo; de Groot, Rudolf; Tappeiner, Ulrike

    2017-01-01

    Accounting for the spatial connectivity between the provision of ecosystem services (ES) and their beneficiaries (supply-benefit chain) is fundamental to understanding ecosystem functioning and its management. However, the interrelationships of the specific chain links within ecosystems and the actual benefits that flow from natural landscapes to surrounding land have rarely been analyzed. We present a spatially explicit model for the analysis of one cultural ecosystem service (aesthetic experience), which integrates the complete ecosystem service delivery chain for Puez-Geisler Nature Park (Italy): (1) The potential service stock (ES capacity) relies on an expert-based land use ranking matrix, (2) the actual supply (ES flow) is based on visibility properties of observation points along recreational routes, (3) the beneficiaries of the service (ES demand) are derived from socioeconomic data as a measure of the visitation rate to the recreation location, and (4) the supply-demand relationship (ES budget) addresses the spatially explicit oversupply and undersupply of ES. The results indicate that potential ES stocks are substantially higher in core and buffer zones of protected areas than in surrounding land owing to the specific landscape composition. ES flow maps reveal service delivery to 80% of the total area studied, with the highest actual service supply to locations with long and open vistas. ES beneficiary analyses show the highest demand for aesthetic experiences in all-season tourist destinations like Val Badia and Val Gardena, where both recreational amenity and overnight stays are equally high. ES budget maps identify ES hot and cold spots in terms of ES delivery, and they highlight ES undersupply in nature protection buffer zones although they are characterized by highest ES capacity. We show how decision/policy makers can use the presented methodology to plan landscape protection measures and develop specific regulation strategies for visitors based on

  18. An Evaluation of the Cybersecurity Policies for the United States Health & Human Services Department: Criteria, Regulations, and Improvements

    Directory of Open Access Journals (Sweden)

    Derek Mohammed

    2014-04-01

    Full Text Available This paper examines the criteria necessary for the evaluation of the cybersecurity policies for the United States Health and Human Services Department of the Federal Government. The overall purpose of cybersecurity policies and procedures is supported through compliance with Federal mandated regulation and standards, which serve to protect the organizational services and goals of the United States Health and Human Services Department, and to promote the best possible security practices in the protection of information systems from unauthorized actors and cyber-threats. The criteria of the cybersecurity evaluation is identified and analyzed for quality, strengths, weaknesses, and future applicability. Topics within the criteria include organizational operation, regulations and industrial standards compliance, service delivery to national customers, and the prevention and mitigation of IT system and security failure. This analysis determines the strengths and weaknesses, and makes recommendations for revising the cybersecurity policies within the United States Health and Human Services Department.

  19. Early and late preterm delivery rates - a comparison of differing tocolytic policies in a single urban population.

    LENUS (Irish Health Repository)

    Hehir, Mark P

    2012-11-01

    Preterm delivery results in neonatal morbidity and mortality. We set out to estimate the difference in rates of preterm delivery in two institutions, serving a single population, with differing policies regarding use of tocolytic drugs for the prevention of preterm delivery.

  20. Current state of seagrass ecosystem services: Research and policy integration

    KAUST Repository

    Ruiz-Frau, A.

    2017-10-12

    Seagrasses contribute to the maintenance of human wellbeing. However certain aspects of their role as ecosystem service (ES) providers remain understudied. Here, we synthesise the state of seagrass ES (SGES) research and policy implications. Additionally, we recommend ways in which SGES research can be integrated in to policy design, by drawing lessons from the case of Blue Carbon (BC). SGES research suffers from three main biases: a geographical bias, SGES has been restricted to chartered seagrass areas; a type of service research bias, provisioning and regulating services have received extensive attention while cultural services remain understudied; a type of discipline bias, the ecological aspects of SGES have been well documented while economic and social aspects remain in comparison understudied. These are particularly important, as an understanding of the social and economic considerations of the provision of ES is fundamental to facilitate its integration into policy frameworks. Lessons drawn from the operationalization process of BC show the reoccurrence of certain aspects that have enabled the integration of BC into policy. These aspects are grouped under 4 different categories. From the analysis of these elements we draw lessons that could facilitate the operationalization of other ecosystem services and their incorporation into management policy frameworks.

  1. Older Adults and Emerging Digital Service Delivery: A Mixed Methods Study on Information and Communications Technology Use, Skills, and Attitudes.

    Science.gov (United States)

    Siren, Anu; Knudsen, Sine Grønborg

    2017-01-01

    Based on data from a survey (n = 3291) and 14 qualitative interviews among Danish older adults, this study investigated the use of, and attitudes toward, information communications technology (ICT) and the digital delivery of public services. While age, gender, and socioeconomic status were associated with use of ICT, these determinants lost their explanatory power when we controlled for attitudes and experiences. We identified three segments that differed in their use of ICT and attitudes toward digital service delivery. As nonuse of ICT often results from the lack of willingness to use it rather than from material or cognitive deficiencies, policy measures for bridging the digital divide should focus on skills and confidence rather than on access or ability.

  2. The use of a policy dialogue to facilitate evidence-informed policy development for improved access to care: the case of the Winnipeg Central Intake Service (WCIS).

    Science.gov (United States)

    Damani, Zaheed; MacKean, Gail; Bohm, Eric; DeMone, Brie; Wright, Brock; Noseworthy, Tom; Holroyd-Leduc, Jayna; Marshall, Deborah A

    2016-10-18

    Policy dialogues are critical for developing responsive, effective, sustainable, evidence-informed policy. Our multidisciplinary team, including researchers, physicians and senior decision-makers, comprehensively evaluated The Winnipeg Central Intake Service, a single-entry model in Winnipeg, Manitoba, to improve patient access to hip/knee replacement surgery. We used the evaluation findings to develop five evidence-informed policy directions to help improve access to scheduled clinical services across Manitoba. Using guiding principles of public participation processes, we hosted a policy roundtable meeting to engage stakeholders and use their input to refine the policy directions. Here, we report on the use and input of a policy roundtable meeting and its role in contributing to the development of evidence-informed policy. Our evidence-informed policy directions focused on formal measurement/monitoring of quality, central intake as a preferred model for service delivery, provincial scope, transparent processes/performance indicators, and patient choice of provider. We held a policy roundtable meeting and used outcomes of facilitated discussions to refine these directions. Individuals from our team and six stakeholder groups across Manitoba participated (n = 44), including patients, family physicians, orthopaedic surgeons, surgical office assistants, Winnipeg Central Intake team, and administrators/managers. We developed evaluation forms to assess the meeting process, and collected decision-maker partners' perspectives on the value of the policy roundtable meeting and use of policy directions to improve access to scheduled clinical services after the meeting, and again 15 months later. We analyzed roundtable and evaluation data using thematic analysis to identify key themes. Four key findings emerged. First, participants supported all policy directions, with revisions and key implementation considerations identified. Second, participants felt the policy roundtable

  3. ‘Trust and teamwork matter’: Community health workers' experiences in integrated service delivery in India

    Science.gov (United States)

    Mishra, Arima

    2014-01-01

    A comprehensive and integrated approach to strengthen primary health care has been the major thrust of the National Rural Health Mission (NRHM) that was launched in 2005 to revamp India's rural public health system. Though the logic of horizontal and integrated health care to strengthen health systems has long been acknowledged at policy level, empirical evidence on how such integration operates is rare. Based on recent (2011–2012) ethnographic fieldwork in Odisha, India, this article discusses community health workers' experiences in integrated service delivery through village-level outreach sessions within the NRHM. It shows that for health workers, the notion of integration goes well beyond a technical lens of mixing different health services. Crucially, they perceive ‘teamwork’ and ‘building trust with the community’ (beyond trust in health services) to be critical components of their practice. However, the comprehensive NRHM primary health care ideology – which the health workers espouse – is in constant tension with the exigencies of narrow indicators of health system performance. Our ethnography shows how monitoring mechanisms, the institutionalised privileging of statistical evidence over field-based knowledge and the highly hierarchical health bureaucratic structure that rests on top-down communications mitigate efforts towards sustainable health system integration. PMID:25025872

  4. 'Trust and teamwork matter': community health workers' experiences in integrated service delivery in India.

    Science.gov (United States)

    Mishra, Arima

    2014-01-01

    A comprehensive and integrated approach to strengthen primary health care has been the major thrust of the National Rural Health Mission (NRHM) that was launched in 2005 to revamp India's rural public health system. Though the logic of horizontal and integrated health care to strengthen health systems has long been acknowledged at policy level, empirical evidence on how such integration operates is rare. Based on recent (2011-2012) ethnographic fieldwork in Odisha, India, this article discusses community health workers' experiences in integrated service delivery through village-level outreach sessions within the NRHM. It shows that for health workers, the notion of integration goes well beyond a technical lens of mixing different health services. Crucially, they perceive 'teamwork' and 'building trust with the community' (beyond trust in health services) to be critical components of their practice. However, the comprehensive NRHM primary health care ideology - which the health workers espouse - is in constant tension with the exigencies of narrow indicators of health system performance. Our ethnography shows how monitoring mechanisms, the institutionalised privileging of statistical evidence over field-based knowledge and the highly hierarchical health bureaucratic structure that rests on top-down communications mitigate efforts towards sustainable health system integration.

  5. Telemedicine services in the Republic of Ireland: an evolving policy context.

    Science.gov (United States)

    MacFarlane, Anne; Murphy, Andrew William; Clerkin, Pauline

    2006-05-01

    The Republic of Ireland is characterised by few urban conurbations and a high rural population, including significant numbers of island dwellers. Information communication technologies (ICT), including telemedicine, present opportunities to address rural health-service delivery issues. As in other countries, the recent National Health Information Strategy is regarded as pivotal to the modernisation of the Irish health care system. There is, however, a dearth of research about telemedicine in Ireland. This paper reports, to the best of our knowledge, the first systematic review of telemedicine in the two regional health boards in the Republic of Ireland. Details of 11 telemedicine services, all initiated by local policy, will be presented. Results of an interview study with service providers about their experiences of the practices and processes involved in telemedicine service delivery are also provided. The focus of our analysis is two-fold. We assess the resonance of these Irish data with the international literature with particular reference to a recently developed model for the normalisation of telemedicine. For the first time, this model which was developed in the United Kingdom is applied to a fresh set of empirical data in a different health care context. We then discuss a number of health information policy issues for Ireland and elsewhere arising from our analysis.

  6. Key Informant Views of a Free Delivery and Caesarean Policy in ...

    African Journals Online (AJOL)

    Erah

    The policy was introduced in 2005 in five more deprived regions ... informants who had technical and administrative or political responsibility for the policy at .... the first year of leadership from the ..... rhetoric of free services and the reality of .... augmented to include the materials to ..... mothers and children in Bolivia.

  7. Service delivery innovation architecture: An empirical study of antecedents and outcomes

    Directory of Open Access Journals (Sweden)

    Rajeev Verma

    2014-06-01

    Full Text Available The research examines service delivery innovation architecture and its role in achieving sustainable competitive advantage of firms. The study develops and empirically examines an antecedent based model of service delivery innovation. We collected data from 203 service sector professionals working in Mexican financial and information technology firms, and tested the proposed relationship. Further, the study investigates the moderating role of customer orientation on innovation driven performance outcomes. Results show that customer orientation strengthens the service delivery–performance relationship. This paper aims to contribute to the strategic planning of service firms by guiding their resource allocation to ensure sustainable growth.

  8. Older individuals' experiences during the assistive technology device service delivery process.

    Science.gov (United States)

    Gramstad, Astrid; Storli, Sissel Lisa; Hamran, Torunn

    2014-07-01

    Providing assistive technology devices to older individuals living in their ordinary homes is an important intervention to increase and sustain independence and to enable ageing at home. However, little is known about older individuals' experiences and needs in the assistive technology device (ATD) service delivery process. The purpose of this study was to investigate older individuals' experiences during the service delivery process of ATDs. Nine older individuals were interviewed three times each throughout the ATD service delivery process. The interviews were analysed within a hermeneutical phenomenological perspective. The results show that the service delivery process could be interpreted as an enigmatic journey and described using four themes: "hope and optimistic expectations", "managing after delivery or needing additional help", "having available help versus being abandoned", and "taking charge or putting up". The results emphasize the need for occupational therapists to maintain an individualized approach towards older clients throughout the service delivery process. The experiences of older individuals were diverse and related to expectations that were not necessarily articulated to the occupational therapist. The situation when the ATD is delivered to the client was highlighted by the clients as an important event with the potential to facilitate a successful service delivery process.

  9. The dynamics of the service delivery process : a value-based approach

    NARCIS (Netherlands)

    Ruyter, de J.C.; Wetzels, M.G.M.; Lemmink, J.G.A.M.; Mattsson, J.

    1997-01-01

    Recent research linking service quality and service satisfaction has raised issues which require conceptual and empirical elaboration. Among these are the formation of satisfaction during the service delivery process and the role of customer value. In this article, the focus is on how different

  10. A conceptual model of physician work intensity: guidance for evaluating policies and practices to improve health care delivery.

    Science.gov (United States)

    Horner, Ronnie D; Matthews, Gerald; Yi, Michael S

    2012-08-01

    Physician work intensity, although a major factor in determining the payment for medical services, may potentially affect patient health outcomes including quality of care and patient safety, and has implications for the redesign of medical practice to improve health care delivery. However, to date, there has been minimal research regarding the relationship between physician work intensity and either patient outcomes or the organization and management of medical practices. A theoretical model on physician work intensity will provide useful guidance to such inquiries. To describe an initial conceptual model to facilitate further investigations of physician work intensity. A conceptual model of physician work intensity is described using as its theoretical base human performance science relating to work intensity. For each of the theoretical components, we present relevant empirical evidence derived from a review of the current literature. The proposed model specifies that the level of work intensity experienced by a physician is a consequence of the physician performing the set of tasks (ie, demands) relating to a medical service. It is conceptualized that each medical service has an inherent level of intensity that is experienced by a physician as a function of factors relating to the physician, patient, and medical practice environment. The proposed conceptual model provides guidance to researchers as to the factors to consider in studies of how physician work intensity impacts patient health outcomes and how work intensity may be affected by proposed policies and approaches to health care delivery.

  11. Toward a Blueprint for Trauma-Informed Service Delivery in Schools

    Science.gov (United States)

    Chafouleas, Sandra M.; Johnson, Austin H.; Overstreet, Stacy; Santos, Natascha M.

    2016-01-01

    Recognition of the benefits to trauma-informed approaches is expanding, along with commensurate interest in extending delivery within school systems. Although information about trauma-informed approaches has quickly burgeoned, systematic attention to integration within multitiered service delivery frameworks has not occurred yet is essential to…

  12. QoC-based Optimization of End-to-End M-Health Data Delivery Services

    NARCIS (Netherlands)

    Widya, I.A.; van Beijnum, Bernhard J.F.; Salden, Alfons

    2006-01-01

    This paper addresses how Quality of Context (QoC) can be used to optimize end-to-end mobile healthcare (m-health) data delivery services in the presence of alternative delivery paths, which is quite common in a pervasive computing and communication environment. We propose min-max-plus based

  13. Service requirement for terminal delivery: An empirical study from the perspective of online shoppers

    Directory of Open Access Journals (Sweden)

    Junjie Xu

    2013-09-01

    Full Text Available To investigate customer’s service requirement for parcel delivery, combining with theoretical analysis and empirical test, a measuring model of customer service requirement was proposed for terminal delivery. Based on literature reviews, five potential dimensions with 27 items were initially discussed. Through exploratory factor analysis on samples collected from Taobao networks, four dimensions with 18 measurement items were finally confirmed including service attitude, service reliability, service standardization and service flexibility. By further confirmatory factor analysis, the fitness of this measuring model was proved to be acceptable. The research revealed that online shoppers paid attention to not only service result but also service process, so related suggestions were also proposed for express firms to promote their service management.

  14. New delivery technology for financial services and the changing role of financial intermediaries

    OpenAIRE

    Buhl, Hans Ulrich

    1998-01-01

    New delivery technology for financial services and the changing role of financial intermediaries / H. U. Buhl ; A. Will. - In: Business Information Systems ´98 / W. Abramowicz (ed.). - Poznan : Akad. Ekonomiczna w Poznaniu, 1998. - S. 203-215

  15. The Cost of Health Services Delivery in Health Houses of Alborz: A Case Study

    Directory of Open Access Journals (Sweden)

    Javad Ghoddousinejad

    2015-07-01

    Full Text Available Background and Objectives : Health houses play an active role to improve health status of rural population.Furthermore, it is important to know the costs of provided services. This research was designed to determine the costs of healthcare delivery in health houses of ALBORZ district. Material and Methods : In this cross-sectional descriptive study, Activity Based Costing (ABC was used to analyze the costs of services. Results : The average Direct Costs (DC of healthcare delivery in health houses was estimated 37033365 Rials. Direct and Indirect Costs (IC of service delivery in health houses were 65.91% and 34.09% of Total Costs (TC respectively. Conclusion : Since human resources play the most important role in determining the costs of health services delivery in healthcare, reforming payment mechanisms would be a suitable solution to reduce extra costs. Moreover, in order to decrease extra costs, it is essential to modify activities and eliminate parallel tasks.

  16. Progress in the utilization of antenatal and delivery care services in Bangladesh: where does the equity gap lie?

    Science.gov (United States)

    Pulok, Mohammad Habibullah; Sabah, Md Nasim-Us; Uddin, Jalal; Enemark, Ulrika

    2016-07-29

    Universal access to health care services does not automatically guarantee equity in the health system. In the post Millennium Development Goals (MDGs) era, the progress towards universal access to maternal health care services in a developing country, like Bangladesh requires an evaluation in terms of equity lens. This study, therefore, analysed the trend in inequity and identified the equity gap in the utilization of antenatal care (ANC) and delivery care services in Bangladesh between 2004 and 2011. The data of this study came from the Bangladesh Demographic and Health Survey. We employed rate ratio, concentration curve and concentration index to examine the trend in inequity of ANC and delivery care services. We also used logistic regression models to analyse the relationship between socioeconomic factors and maternal health care services. The concentration index for 4+ ANC visits dropped from 0.42 in 2004 to 0.31 in 2011 with a greater decline in urban area. There was almost no change in the concentration index for ANC services from medically trained providers during this period. We also found a decreasing trend in inequity in the utilization of both health facility delivery and skilled birth assistance but this trend was again more pronounced in urban area compared to rural area. The concentration index for C-section delivery decreased by about 33 % over 2004-2011 with a similar rate in both urban and rural areas. Women from the richest households were about 3 times more likely to have 4+ ANC visits, delivery at a health facility and skilled birth assistance compared to women from the poorest households. Women's and their husbands' education were significantly associated with greater use of maternal health care services. In addition, women's exposure to mass media, their involvement in microcredit programs and autonomy in healthcare decision-making appeared as significant predictors of using some of these health care services. Bangladesh faces not only a

  17. Healthcare service providers' and facility administrators' perspectives of the free maternal healthcare services policy in Malindi District, Kenya: a qualitative study.

    Science.gov (United States)

    Lang'at, Evaline; Mwanri, Lillian

    2015-06-27

    Globally, there are increasing efforts to improve maternal health outcomes including the reduction in maternal mortality rates. Improved access to skilled care utilisation during pregnancy and delivery has been one of the strategies employed to improve maternal health outcomes. In Kenya, more than half of the women deliver without the assistance of a skilled attendant and this has contributed to high maternal mortality rates. The free maternal healthcare services policy in all public facilities was initiated as a strategy to improve access to skilled care and reduce poor maternal health outcomes. This study aimed to explore the perspectives of the service providers and facility administrators of the free maternal health care service policy that was introduced in Kenya in 2013. A qualitative inquiry using semi-structured one-on-one interviews was conducted in Malindi District, Kenya. The participants included maternal health service providers and facility administrators recruited from five different healthcare facilities. Data were analysed using a thematic framework analysis. Free maternal healthcare service provision was perceived to boost skilled care utilisation during pregnancy and delivery. However, challenges including; delays in the reimbursement of funds by the government to the facilities, stock outs of essential commodities in the facilities to facilitate service provision, increased workload amidst staff shortage and lack of consultation and sensitisation of key stakeholders were perceived as barriers to effective implementation of this policy. Free maternal healthcare services can be one of the strategies to improve a range of maternal health outcomes. However, the implementation of this policy would be more effective if; the healthcare facilities were upgraded, equipped with adequate supplies, funds and staff; the community are continually sensitized on the importance of seeking skilled care during pregnancy and delivery; and inclusivity and

  18. Records management and service delivery: the case of Department ...

    African Journals Online (AJOL)

    Ngulup

    The principal records management unit within the Department of Corporate Services ... ies services (15), Finance and Accounting (3); however, only 59 participated in it. Data col- ...... records and public-sector financial management.

  19. assessment of clients' satisfaction with health service deliveries

    African Journals Online (AJOL)

    Abrham

    showed that the overall client satisfaction level with the health services rendered at ... Therefore, the Hospital management should understand these weak service areas and plan for a better .... for use”, which means the consumer's perception.

  20. An assessment of policies and services provision to the physically ...

    African Journals Online (AJOL)

    The researcher recommended among others that Academic library policy must be redesigned to include disability resources and services in conformity with ALA standard and Library management should create a disability liaison office on the ground floor of their multiple storey buildings and affiliate such offices with any ...

  1. The ethics of health service delivery: a challenge to public health leadership.

    Science.gov (United States)

    DeLuca, D M

    1989-01-01

    The ethical distribution of health care is a central issue now that AIDS has started to be a drain on health care resources. If the worst predictions are true, the next half century will be capitalized by a great stress of the health care delivery system in the Pacific. The critical challenges that face the current leadership are: sustaining commitment to all levels of administration to reduce social and health inequities; making sound decisions on policies, priorities and goals that are based on valid information; strengthen health infrastructure, based on the principle of primary health care, including appropriate distribution of staffing, skills, technology and resources. The goals of the Pacific Health Promotion and Development center must not focus exclusively on AIDs. Hepatitis B control measures, hypertension and diabetes, primary care in remote areas, and rehabilitation initiatives must be kept in place. Humanitarian interests for AIDs patients must be balanced with the pragmatic reality of saving children's hearing, or extending useful lives. The attributes of respect, accountability, leadership, judgement, fairness, integrity and honesty controlled by principles of social justice must be part of the administrative decision making process. The 2 major issues facing public health professional are: (1) the financial considerations involved with increasingly expensive technology, services and research, contrasted against the need to prioritize their use and development; (2) pragmatic and ideological needs must be balanced to maximize preventative and curative services and make them available to those who can benefit from them.

  2. A Universal Design Approach to Government Service Delivery: The Case of ChileAtiende.

    Science.gov (United States)

    Sandoval, Leonardo

    2016-01-01

    A common challenge for government administrations that aim to improve the delivery of information and services to citizens is to go beyond a government-centred approach. By focusing on citizens and the needs of a wide range of citizens, Universal Design (UD) can help to increase the effectiveness, efficiency and satisfaction of government services. This paper examines the case of an internationally recognised Chilean government service delivery programme inspired by UD principles known as ChileAtiende ("ChileService"). A brief account of its creation and current status is provided.

  3. Towards comprehensive early abortion service delivery in high income countries: insights for improving universal access to abortion in Australia

    Directory of Open Access Journals (Sweden)

    Angela Dawson

    2016-10-01

    Full Text Available Abstract Background Improving access to safe abortion is an essential strategy in the provision of universal access to reproductive health care. Australians are largely supportive of the provision of abortion and its decriminalization. However, the lack of data and the complex legal and service delivery situation impacts upon access for women seeking an early termination of pregnancy. There are no systematic reviews from a health services perspective to help direct health planners and policy makers to improve access comprehensive medical and early surgical abortion in high income countries. This review therefore aims to identify quality studies of abortion services to provide insight into how access to services can be improved in Australia. Methods We undertook a structured search of six bibliographic databases and hand-searching to ascertain peer reviewed primary research in English between 2005 and 2015. Qualitative and quantitative study designs were deemed suitable for inclusion. A deductive content analysis methodology was employed to analyse selected manuscripts based upon a framework we developed to examine access to early abortion services. Results This review identified the dimensions of access to surgical and medical abortion at clinic or hospital-outpatient based abortion services, as well as new service delivery approaches utilising a remote telemedicine approach. A range of factors, mostly from studies in the United Kingdom and United States of America were found to facilitate improved access to abortion, in particular, flexible service delivery approaches that provide women with cost effective options and technology based services. Standards, recommendations and targets were also identified that provided services and providers with guidance regarding the quality of abortion care. Conclusions Key insights for service delivery in Australia include the: establishment of standards, provision of choice of procedure, improved provider

  4. Alternative Public Service Delivery Models in Health, Water and ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    This project seeks to analyze health, water and electricity delivery models in Africa, Asia and Latin America in order to identify and document successful alternatives to commercialization. Researchers will draw up a set of ... Documents. Environmental and water management law in post-apartheid South Africa. Documents.

  5. Alternative Public Service Delivery Models in Health, Water and ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    This project seeks to analyze health, water and electricity delivery models in Africa, Asia and Latin America in order to identify and document successful alternatives to commercialization. ... Contradictions in municipal transformation from apartheid to democracy : the battle over local water privatization in South Africa.

  6. How do we capture the emergency nurse practitioners' contribution to value in health service delivery?

    Science.gov (United States)

    Jennings, Natasha; Lutze, Matthew; Clifford, Stuart; Maw, Michael

    2017-03-01

    The emergency nurse practitioner is now a well established and respected member of the healthcare team. Evaluation of the role has focused on patient safety, effectiveness and quality of care outcomes. Comparisons of the role continue to focus on cost, with findings based on incomplete and almost impossible to define, recognition of contribution to service delivery by paralleled practitioners. Currently there is no clear definition as to how nurse practitioners contribute to value in health service delivery. Robust and rigorous research needs to be commissioned taking into consideration the unique hybrid nature of the emergency nurse practitioner role and focusing on the value they contribute to health care delivery.

  7. User involvement in service delivery predicts outcomes of assistive technology use: A cross-sectional study in Bangladesh

    Directory of Open Access Journals (Sweden)

    Borg Johan

    2012-09-01

    Full Text Available Abstract Background Knowledge about the relation between user involvement in the provision of assistive technology and outcomes of assistive technology use is a prerequisite for the development of efficient service delivery strategies. However, current knowledge is limited, particularly from low-income countries where affordability is an issue. The objective was therefore to explore the relation between outcomes of assistive technology use and user involvement in the service delivery process in Bangladesh. Methods Using structured interviews, data from 136 users of hearing aids and 149 users of manual wheelchairs were collected. Outcomes were measured using the International Outcome Inventory for Hearing Aids (IOI-HA, which was adapted for wheelchair users. Predictors of user involvement included preference, measurement and training. Results Users reported outcomes comparable to those found in other high- and low-income countries. User involvement increased the likelihood for reporting better outcomes except for measurement among hearing aid users. Conclusions The findings support the provision of assistive technology as a strategy to improve the participation of people with disabilities in society. They also support current policies and guidelines for user-involvement in the service delivery process. Simplified strategies for provision of hearing aids may be explored.

  8. Perceived service delivery and productivity in the food and beverage sector in Potchefstroom / Adam Herman Viljoen

    OpenAIRE

    Viljoen, Adam Herman

    2012-01-01

    The importance of management in the food and beverage sector as well as managing food and beverage service employees are crucial aspects that influence quality service delivery. The food and beverage sector is a large service orientated segment of the greater tourism industry, and effective management of employees is therefore necessary since employees are regarded as the primary resource through which establishments deliver services. One might further argue that an employee is...

  9. Energy, emissions and emergency medical services: Policy matters

    International Nuclear Information System (INIS)

    Brown, Lawrence H.; Blanchard, Ian E.

    2012-01-01

    Understanding the energy consumption and emissions associated with health services is important for minimizing their environmental impact and guiding their adaptation to a low-carbon economy. In this post-hoc analysis, we characterize the energy burden of North American emergency medical services (EMS) agencies and estimate the potential marginal damage costs arising from their emissions as an example of how and why health services matter in environmental and energy policy, and how and why environmental and energy policy matter to health services. We demonstrate EMS systems are energy intensive, and that vehicle fuels represent 80% of their energy burden while electricity and natural gas represent 20%. We also demonstrate that emissions from EMS operations represent only a small fraction of estimated health sector emissions, but for EMS systems in the United States the associated marginal damage costs are likely between $2.7 million and $9.7 million annually. Significant changes in the supply or price of energy, including changes that arise from environmental and energy policy initiatives designed to constrain fossil fuel consumption, could potentially affect EMS agencies and other health services. We encourage cross disciplinary research to proactively facilitate the health system's adaptation to a low-carbon economy. - Highlights: ► Estimated EMS-related emissions less than 1% of health sector emissions. ► Damage costs of U.S. EMS-related emissions estimated at $2.7 to $9.7 million. ► EMS energy burden is approximately 442 MJ per ambulance response. ► Approximately 80% of EMS energy burden is vehicle fuels. ► Energy supply, price and policy could impact EMS (and other health) services. ► Research needed to facilitate health services’ adaptation to a low carbon economy.

  10. Potentiality of the Usage of Compressed Natural Gas for Competitiveness in Service Delivery Industries

    Directory of Open Access Journals (Sweden)

    Gazi Mohammad Hasan Jamil

    2014-08-01

    Full Text Available Abstract. With the rising costs of gasoline, many vehicle owners are looking for alternatives of it. Compressed natural gas (CNG has been tested for this very purpose in some countries and found as a better alternative so far. CNG comes from country’s natural resources and it is clean and less costly to use. This paper is mainly an analysis of the potential benefits of using natural gas as a transportation fuel by the service delivery industries. It will examine CNG’s potential contribution in reducing delivery and vehicle maintenance cost, saving money in the long run projects, improving fuel efficiency, enhancing physical safety and assuring environment friendly emissions of carbon monoxide or reactive gases for the service delivery industries.Keywords: Compressed natural gas (CNG, Service Delivery, Fossil fuel, Global warming, Competitiveness

  11. Who benefits from removing user fees for facility-based delivery services? Evidence on socioeconomic differences from Ghana, Senegal and Sierra Leone.

    Science.gov (United States)

    McKinnon, Britt; Harper, Sam; Kaufman, Jay S

    2015-06-01

    Coverage of skilled delivery care has been increasing across most low-income countries; however, it remains far from universal and is very unequally distributed according to socioeconomic position. In an effort to increase coverage of skilled delivery care and reduce socioeconomic inequalities, governments of several countries in sub-Saharan Africa have recently adopted policies that remove user fees for facility-based delivery services. There is little rigorous evidence of the impact of these policies and few studies have examined effects on socioeconomic inequalities. This study investigates the impact of recent delivery fee exemption policies in Ghana, Senegal, and Sierra Leone on socioeconomic differences in the use of facility-based delivery services. Using Demographic and Health Survey data from nine sub-Saharan African countries, we evaluated the user fee policy changes using a difference-in-differences approach that accounts for underlying common secular trends and time invariant differences among countries, and allows for differential effects of the policy by socioeconomic position. Removing user fees was consistent with meaningful increases in facility deliveries across all categories of household wealth and maternal education. We found little evidence of differential effects of removing user fees across quartiles of household wealth, with increases of 5.4 facility deliveries per hundred live births (95% CI: 2.1, 8.8) among women in the poorest quartile and 6.8 per hundred live births (95% CI: 4.0, 9.7) for women in the richest quartile. However, our results suggest that educated women benefited more from removing user fees compared to women with no education. For women with at least some secondary education, the estimated effect was 8.6 facility deliveries per hundred live births (95% CI: 5.4, 11.9), but only 4.6 per hundred live births (95% CI: 2.2, 7.0) for women with no education (heterogeneity p-value = 0.04). Thus, while removing fees at the point

  12. Universalization of access to modern energy services in Indian households. Economic and policy analysis

    International Nuclear Information System (INIS)

    Reddy, B. Sudhakara; Nathan, Hippu Salk Kristle; Balachandra, P.

    2009-01-01

    Provision of modern energy services for cooking (with gaseous fuels) and lighting (with electricity) is an essential component of any policy aiming to address health, education or welfare issues; yet it gets little attention from policy-makers. Secure, adequate, low-cost energy of quality and convenience is core to the delivery of these services. The present study analyses the energy consumption pattern of Indian domestic sector and examines the urban-rural divide and income energy linkage. A comprehensive analysis is done to estimate the cost for providing modern energy services to everyone by 2030. A public-private partnership-driven business model, with entrepreneurship at the core, is developed with institutional, financing and pricing mechanisms for diffusion of energy services. This approach, termed as EMPOWERS (entrepreneurship model for provision of wholesome energy-related basic services), if adopted, can facilitate large-scale dissemination of energy-efficient and renewable technologies like small-scale biogas/biofuel plants, and distributed power generation technologies to provide clean, safe, reliable and sustainable energy to rural households and urban poor. It is expected to integrate the processes of market transformation and entrepreneurship development involving government, NGOs, financial institutions and community groups as stakeholders. (author)

  13. The importance of measuring the delivery of services via commercial presence of offshore foreign affiliates: Some case studies from Australian business experience

    OpenAIRE

    Drake-Brockman, Jane

    2011-01-01

    6TThere are major difficulties associated with measurement of each of the four modes of services trade delivery as defined in the General Agreement on Trade in Services (GATS) : cross-border supply, consumption abroad, commercial presence, and movement of natural persons. The consequence is that the extent of global trade in services is hugely underestimated and the services sector does not receive the trade and economic policy attention it deserves. The global economy meanwhile miss...

  14. Improving access to skilled attendance at delivery: a policy brief for Uganda.

    Science.gov (United States)

    Nabudere, Harriet; Asiimwe, Delius; Amandua, Jacinto

    2013-04-01

    This study describes the process of production, findings for a policy brief on Increasing Access to Skilled Birth Attendance, and subsequent use of the report by policy makers and others from the health sector in Uganda. The methods used to prepare the policy brief use the SUPPORT Tools for evidence-informed health policy making. The problem that this evidence brief addresses was identified through an explicit priority setting process involving policy makers and other stakeholders, further clarification with key informant interviews of relevant policy makers, and review of relevant documents. A working group of national stakeholder representatives and external reviewers commented on and contributed to successive drafts of the report. Research describing the problem, policy options, and implementation considerations was identified by reviewing government documents, routinely collected data, electronic literature searches, contact with key informants, and reviewing the reference lists of relevant documents that were retrieved. The proportion of pregnant women delivering from public and private non-profit facilities was low at 34 percent in 2008/09. The three policy options discussed in the report could be adopted independently or complementary to the other to increase access to skilled care. The Ministry of Health in deliberating to provide intrapartum care at first level health facilities from the second level of care, requested for research evidence to support these decisions. Maternal waiting shelters and working with the private-for-profit sector to facilitate deliveries in health facilities are promising complementary interventions that have been piloted in both the public and private health sector. A combination of strategies is needed to effectively implement the proposed options as discussed further in this article. The policy brief report was used as a background document for two stakeholder dialogue meetings involving members of parliament, policy makers

  15. Farmers’ Awareness of Ecosystem Services and the Associated Policy Implications

    Directory of Open Access Journals (Sweden)

    Fangfang Xun

    2017-09-01

    Full Text Available This study analyzes the primary factors influencing farmers’ awareness of ecosystem services. This study, through questionnaires, conducts research on farmers’ awareness of and demand for ecosystem service functions. The research encapsulates 156 households from 21 groups of villagers in the Guangxi Karst Ecological Immigration District in China. The results of the factors influencing farmers’ awareness of ecosystem services, analyzed using a regression model, show that: (1 Farmers are concerned with ecosystem service functions that directly benefit them; however, they do not sufficiently understand the ecosystem’s ecological security maintenance or cultural landscape functions; (2 Farmers’ awareness of ecosystem service functions is not consistent with their corresponding demand, including the ecosystem’s leisure and entertainment, social security, disaster prevention and water purification services; (3 Education level, land area cultivated by the household, proportion of the household’s income from agriculture and immigration status directly affect farmers’ awareness of ecosystem services; (4 Farmers’ personal characteristics, family characteristics and subjective attitudes have different effects on the level of ecological service cognition. Understanding farmers’ awareness of ecosystem services, and the influencing factors can help policymakers and development managers plan local development and policies, and enable harmonious development of the human-earth system in immigration regions of China.

  16. Base stock policies with degraded service to larger orders

    DEFF Research Database (Denmark)

    Du, Bisheng; Larsen, Christian

    We study an inventory system controlled by a base stock policy assuming a compound renewal demand process. We extend the base stock policy by incorporating rules for degrading the service of larger orders. Two specific rules are considered, denoted Postpone(q,t) and Split(q), respectively. The aim...... of using these rules is to achieve a given order fill rate of the regular orders (those of size less than or equal to the parameter q) having less inventory. We develop mathematical expressions for the performance measures order fill rate (of the regular orders) and average on-hand inventory level. Based...

  17. Optical broadband in-home networks for converged service delivery

    NARCIS (Netherlands)

    Shi, Y.

    2013-01-01

    Broadband access networks, and in particular fibre-to-the-home (FTTH) networks, are offering abundantly available bandwidth in the local loop with high quality of services. Under such broadband connectivity conditions, in-home networks should not represent the bottleneck for high capacity service

  18. Pricing: A Normative Strategy in the Delivery of Human Services.

    Science.gov (United States)

    Moore, Stephen T.

    1995-01-01

    Discusses a normative strategy toward pricing human services, which will allow providers to develop pricing strategies within the context of organizational missions, goals, and values. Pricing is an effective tool for distributing resources and improving efficiency, and can be used as a tool for encouraging desired patterns of service utilization.…

  19. New Perspectives on Child Welfare; Services, Staffing, Delivery System.

    Science.gov (United States)

    Madison, Bernice Q.; Schapiro, Michael

    This is a report of a three-year demonstration and research project which addressed itself to three objectives: (1) To explore the need for planned, long-term foster family care for minority children as one of the services to be made available by a multiple child welfare services program in a public agency. (2) To assess the readiness of seniors…

  20. A review of the present state and future policy alternatives for home visit nursing services in Korea.

    Science.gov (United States)

    Lim, Ji Young; Noh, Wonjung; Kim, Eunjoo; Choi, Kyung Won

    2014-01-01

    The aim of this study was to describe the current state of home visit nursing services in the Korean context and to suggest future policy directions. First, the three home visit nursing services that have developed in Korea are compared using the analytic framework provided by Gilbert and Terrell in 2012. The framework is based on four dimensions of social welfare: users, services, source of funds, and service delivery process. Second, we perform a strength, weakness, opportunity, and threat analysis to suggest comprehensive and constructive home visit nursing service policies for the future. Specifically, we advocate the creation of an organization that steers the central government to operate an integrated management organization to distribute services and reduce redundancy for preventing the waste of both medical and state financial resources. This study also recommends the development of educational programs to improve the quality of services and service evaluation criteria for the objective assessment of those services. These policy guidelines may prove useful both for Korea and for other countries that intend to prepare or revise their home visit nursing service systems. © 2014 Wiley Periodicals, Inc.

  1. The Dilemma of Accountability and Good Governance for Improved Public Service Delivery in Nigeria

    Directory of Open Access Journals (Sweden)

    Kehinde David Adejuwon

    2012-12-01

    Full Text Available The public sector in Nigeria is irrefutably beset with gross  incompetence and ineffective management. Perplexing difficulties endure in the Nigerian public sector in spite of a number of reform programmes that have been designed to enhance efficient and effective service delivery for almost two decades. The fact that public service has failed dismally to achieve its laudable objectives is the reason for the vote of no confidence passed on its administrators by majority of the Nigerian populace. The article examines the dilemma of accountability and good governance in Nigeria and demonstrates that the critical point in achieving meaningful developments in the country intrinsically lay with improved service delivery in the public sector. The basic reason why the public service has become the scorn of the people is because for too long, both the government and public servants have paid lip service to the crucial issue of effective and efficient service delivery. The article argues that improved service delivery will improve both the performance and the image of public service and re-awaken the citizens’ interest and trust in them to do business with public servants. It suggests that  in order to bring sanity back to the Nigerian Public Service,  all unprofessional tendencies such as ethnicity bias and nepotism in appointments and promotions, lack of security of tenure of office, and appointment of non-career public servants into key positions in the public service must stop. Also,  effective service delivery must be tailored to the circumstances of Nigeria. The study made use of secondary data obtained from various sources. It therefore concludes that without a reawakening of the culture of accountability and transparency lost over the years, the trusting relationship needed to forge between the government and the governed for the actualization of good governance will not materialize.

  2. The Role of Libraries in eHealth Service Delivery in Australia

    Science.gov (United States)

    Rao, Sarada

    2009-01-01

    eHealth is an emerging service sector which has great potential to improve health care delivery to rural and remote communities, facilitate health surveillance, and promote health education and research. Despite the critical need for eHealth services in Australia based on the challenges of distance and human resources, its utility has yet to be…

  3. The role of value in the delivery process of hospitality services

    NARCIS (Netherlands)

    Lemmink, J.G.A.M.; Ruyter, de J.C.; Wetzels, M.G.M.

    1998-01-01

    In the services marketing literature only scant attention has been paid to the concept of customer value as a basis for evaluative judgment. So far, value has been defined primarily in monetary terms ("value for money"). In this paper the role of customer value in the service delivery process is

  4. Perceptions of International Students on Service Quality Delivery in a Malaysian Public University

    Science.gov (United States)

    Njie, Baboucarr; Asimiran, Soaib; Baki, Roselan

    2012-01-01

    Purpose: The purpose of this study is to explore the perceptions of international students of service quality delivery (SQD) in a Malaysian public university. Design/methodology/approach: The study was limited to the University's immediate physical environment and its associated human and systems-based services. The physical environment in this…

  5. Costs and outcomes of VCT delivery models in the context of scaling up services in Indonesia

    NARCIS (Netherlands)

    Siregar, A.Y.M.; Komarudin, D.; Wisaksana, R.; Crevel, R. van; Baltussen, R.M.P.M.

    2011-01-01

    OBJECTIVE: To evaluate costs and outcomes of voluntary counselling and testing (VCT) service delivery models in urban Indonesia. METHODS: We collected primary data on utilization, costs and outcomes of VCT services in a hospital clinic (568 clients), HIV community clinic (28 clients), sexually

  6. Challenges in implementing individual placement and support in the Australian mental health service and policy context.

    Science.gov (United States)

    Stirling, Yolande; Higgins, Kate; Petrakis, Melissa

    2018-02-01

    health practitioners are typically skilled in their understanding of individual or micro-level challenges faced by consumers in achieving vocational goals: working with symptoms, medication side effects, motivation and anxiety. The present study was designed to offer practitioners an increased understanding of service-level factors, because these present considerable challenges to achieving sustained employment. This paper is a call for greater advocacy towards better integration of employment and mental health service delivery in the Australian policy and practice context.

  7. Alternative Public Service Delivery Models in Health, Water and ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Documents. Debating supply and demand characteristics of bulk infrastructure : Lesotho-Johannesburg water transfer. Documents. Transformation in infrastructure policy from apartheid to democracy. Documents. Immigration and homelessness in the new South Africa. Articles de revue. Minding the undertow : assessing ...

  8. Methods for the economic evaluation of changes to the organisation and delivery of health services: principal challenges and recommendations.

    Science.gov (United States)

    Meacock, Rachel

    2018-04-20

    There is a requirement for economic evaluation of health technologies seeking public funding across Europe. Changes to the organisation and delivery of health services, including changes to health policy, are not covered by such appraisals. These changes also have consequences for National Health Service (NHS) funds, yet undergo no mandatory cost-effectiveness assessment. The focus on health technologies may have occurred because larger-scale service changes pose more complex challenges to evaluators. This paper discusses the principal challenges faced when performing economic evaluations of changes to the organisation and delivery of health services and provides recommendations for overcoming them. The five principal challenges identified are as follows: undertaking ex-ante evaluation; evaluating impacts in terms of quality-adjusted life years; assessing costs and opportunity costs; accounting for spillover effects; and generalisability. Of these challenges, methods for estimating the impact on costs and quality-adjusted life years are those most in need of development. Methods are available for ex-ante evaluation, assessing opportunity costs and examining generalisability. However, these are rarely applied in practice. The general principles of assessing the cost-effectiveness of interventions should be applied to all NHS spending, not just that involving health technologies. Advancements in this area have the potential to improve the allocation of scarce NHS resources.

  9. EDITORIAL Reinvigorating maternal health service delivery in Ethiopia

    African Journals Online (AJOL)

    kim

    awareness, access to services and building the capacity of health facilities. Such measures however ... skilled providers, which is staggering below. 15% (6). This figure may ... health workers and local structures irrespective of their interest?

  10. Assessment of Extension Service Delivery on Improved Cassava ...

    African Journals Online (AJOL)

    SH

    1Department of Agricultural Extension and Rural Development, Landmark University, Omu –Aran, Kwara. State. 2Department ... production technologies among cassava farmers in Osun State, Nigeria. Multistage ... included fertilizer procurement, agrochemicals, cooperative facilities, social networks, tractor hiring services,.

  11. Towards effective telephone-based delivery of government services

    CSIR Research Space (South Africa)

    Barnard, E

    2003-09-01

    Full Text Available Government regulations have combined with a tremendous growth in prepaid cellular telephony to bring telephone connectivity to an unprecedented number of South African citizens – thus creating an ideal platform for delivering services to a wide...

  12. Egypt : Operational Framework for Integrated Rural Sanitation Service Delivery

    OpenAIRE

    World Bank

    2005-01-01

    The Framework presented in this report links - for the first time in the Egyptian context - access to investment in rural sanitation services to quantifiable water quality (and health) improvements, in a given hydrologic basin. The Framework provides an integrated, institutional structure of relevant Government agencies and of serviced communities, which is built on integrated water resources management (IWRM) principles: treating water as a holistic resource, management at the lowest appropr...

  13. Linking ecosystem characteristics to final ecosystem services for public policy

    Science.gov (United States)

    Wong, Christina P; Jiang, Bo; Kinzig, Ann P; Lee, Kai N; Ouyang, Zhiyun

    2015-01-01

    Governments worldwide are recognising ecosystem services as an approach to address sustainability challenges. Decision-makers need credible and legitimate measurements of ecosystem services to evaluate decisions for trade-offs to make wise choices. Managers lack these measurements because of a data gap linking ecosystem characteristics to final ecosystem services. The dominant method to address the data gap is benefit transfer using ecological data from one location to estimate ecosystem services at other locations with similar land cover. However, benefit transfer is only valid once the data gap is adequately resolved. Disciplinary frames separating ecology from economics and policy have resulted in confusion on concepts and methods preventing progress on the data gap. In this study, we present a 10-step approach to unify concepts, methods and data from the disparate disciplines to offer guidance on overcoming the data gap. We suggest: (1) estimate ecosystem characteristics using biophysical models, (2) identify final ecosystem services using endpoints and (3) connect them using ecological production functions to quantify biophysical trade-offs. The guidance is strategic for public policy because analysts need to be: (1) realistic when setting priorities, (2) attentive to timelines to acquire relevant data, given resources and (3) responsive to the needs of decision-makers. PMID:25394857

  14. Linking ecosystem characteristics to final ecosystem services for public policy.

    Science.gov (United States)

    Wong, Christina P; Jiang, Bo; Kinzig, Ann P; Lee, Kai N; Ouyang, Zhiyun

    2015-01-01

    Governments worldwide are recognising ecosystem services as an approach to address sustainability challenges. Decision-makers need credible and legitimate measurements of ecosystem services to evaluate decisions for trade-offs to make wise choices. Managers lack these measurements because of a data gap linking ecosystem characteristics to final ecosystem services. The dominant method to address the data gap is benefit transfer using ecological data from one location to estimate ecosystem services at other locations with similar land cover. However, benefit transfer is only valid once the data gap is adequately resolved. Disciplinary frames separating ecology from economics and policy have resulted in confusion on concepts and methods preventing progress on the data gap. In this study, we present a 10-step approach to unify concepts, methods and data from the disparate disciplines to offer guidance on overcoming the data gap. We suggest: (1) estimate ecosystem characteristics using biophysical models, (2) identify final ecosystem services using endpoints and (3) connect them using ecological production functions to quantify biophysical trade-offs. The guidance is strategic for public policy because analysts need to be: (1) realistic when setting priorities, (2) attentive to timelines to acquire relevant data, given resources and (3) responsive to the needs of decision-makers. © 2014 The Authors. Ecology Letters published by John Wiley & Sons Ltd and CNRS.

  15. Home delivery of medication - the role of a patient information leaflet on maximising service uptake.

    Science.gov (United States)

    Watson, L; Ahmed, N; Mccall, H; Minton, J; Benn, P; Edwards, S; Waters, L

    2014-12-01

    There are currently over 30,000 HIV-positive individuals in London and over 25,000 on anti-retroviral therapy. In 2009/2010, this equated to £170m spent by London's NHS on anti-retroviral drugs. Ways employed to reduce this cost include standardising the drugs patients are on and delivering medication to patients at home. Home delivery (HD) medication is exempt from value-added tax. The savings made from 10 patients using the home delivery service would free up resources to provide anti-retroviral therapy to one further patient. Studies have shown that concerns surrounding potential breaches of confidentiality are a potential barrier to some people using the home delivery service. In order to challenge these concerns, a leaflet was devised highlighting the major benefits to both the patient and the NHS of home delivery and addressing concerns over confidentiality. The leaflet was handed out to patients at the Mortimer Market Centre who were currently on anti-retroviral medication but not on home delivery. They were asked to complete a survey on their views of the service before and after reading the leaflet, whether they had been previously aware of the service and whether their concerns had been addressed. Some 79% felt that the patient information leaflet addressed all of their concerns, and it helped 11% decide whether to consider using home delivery. However, as more patients were opposed to the service after reading the patient information leaflet than those considering it, more work needs to be done to explore patients' concerns and other factors influencing home delivery service uptake. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  16. In-flight food delivery and waste collection service: the passengers’ perspective and potential improvement

    Science.gov (United States)

    Romli, F. I.; Rahman, K. Abdul; Ishak, F. D.

    2016-10-01

    Increased competition in the commercial air transportation industry has made service quality of the airlines as one of the key competitive measures to attract passengers against their rivals. In-flight services, particularly food delivery and waste collection, have a notable impact on perception of the overall airline's service quality because they are directly and interactively provided to passengers during flight. An online public survey is conducted to explore general passengers' perception of current in-flight food delivery and waste collection services, and to identify potential rooms for improvement. The obtained survey results indicate that in-flight service does have an effect on passengers' choice of airlines. Several weaknesses of the current service method and possible improvements have been established from the collected responses.

  17. Exploring Challenges of Municipal Service Delivery in South Africa (1994 - 2013

    Directory of Open Access Journals (Sweden)

    Modimowabarwa Kanyane

    2014-03-01

    Full Text Available This article aims to explore municipal service delivery challenges in South Africa between 1994 and 2013 in order to stimulate debate in addressing problems and challenges confronting municipalities. A fundamental question to be asked stems from the challenges of municipal service delivery. Why, in spite of the existence of regulatory and institutional frameworks, are municipalities still struggling to satisfy basic community needs such as water and electricity amongst others? All of government’s official documents and contemporary literature reviewed, including the summative record of historical facts and narrative data, are evidence of the qualitative research design employed in this study. It is clearly articulated in this article that the existence of a local municipality with poor service delivery is, amongst others, a direct consequence or manifestation of municipal capacity constraints, financial viability problems, service delivery protests, convoluted political process, corruption and poor planning as well as monitoring and evaluation challenges. In the main, the article accounts for why service delivery has failed to meet the expectations of the communities and thereby provide some possible propositions for consideration to attempt to bring a resolve to critical issues raised.

  18. Analysis and Design Information System Logistics Delivery Service in Pt Repex Wahana

    Directory of Open Access Journals (Sweden)

    Stephanie Surja

    2015-12-01

    Full Text Available Analysis and Design of Logistic Delivery System in PT Repex Wahana aims to analyze company’s need in existing business process of logistic delivery service. This will then be used in the development of an integrated system that can address the problems in the running process of sending and tracking the whereaboutsor status of the delivered goods which are the core business processes in the enterprise. The result then will be used as basis in the development of integrated information system in pursuit of corporate solution for process business automation, delivery process, inventory, and logistic delivery tracking, which is the core of the company business process, and it will be documented using Unified Modeling Language. The information system is meant to simplify the delivery and tracking process in the company, besides will minimize lost and error of data which is often happened because of the manual and unorganized transaction data processing.

  19. The LIFEspan model of transitional rehabilitative care for youth with disabilities: healthcare professionals' perspectives on service delivery.

    Science.gov (United States)

    Hamdani, Yani; Proulx, Meghann; Kingsnorth, Shauna; Lindsay, Sally; Maxwell, Joanne; Colantonio, Angela; Macarthur, Colin; Bayley, Mark

    2014-01-01

    LIFEspan is a service delivery model of continuous coordinated care developed and implemented by a cross-organization partnership between a pediatric and an adult rehabilitation hospital. Previous work explored enablers and barriers to establishing the partnership service. This paper examines healthcare professionals' (HCPs') experiences of 'real world' service delivery aimed at supporting transitional rehabilitative care for youth with disabilities. This qualitative study - part of an ongoing mixed method longitudinal study - elicited HCPs' perspectives on their experiences of LIFEspan service delivery through in-depth interviews. Data were categorized into themes of service delivery activities, then interpreted from the lens of a service integration/coordination framework. Five main service delivery themes were identified: 1) addressing youth's transition readiness and capacities; 2) shifting responsibility for healthcare management from parents to youth; 3) determining services based on organizational resources; 4) linking between pediatric and adult rehabilitation services; and, 5) linking with multi-sector services. LIFEspan contributed to service delivery activities that coordinated care for youth and families and integrated inter-hospital services. However, gaps in service integration with primary care, education, social, and community services limited coordinated care to the rehabilitation sector. Recommendations are made to enhance service delivery using a systems/sector-based approach.

  20. New challenges for the quality of librarian services delivery

    OpenAIRE

    Carvalho, Margarida; Dominguez, Caroline

    2012-01-01

    Purpose – The purpose of this paper is to reflect on the user's assessment of the level of quality of the library services of the Portuguese University of Trás‐os‐Montes e Alto Douro (UTAD) in order to identify its potential improvement. Design/methodology/approach – Following a literature review on library service quality assessment focusing on the ServQual, Lib Qual, or Biqual conceptual tools, a survey was designed and applied to a sample of the UTAD library's users, and then sub...

  1. Innovations in the Delivery of Regulatory Services in Australia

    International Nuclear Information System (INIS)

    Dillich, J.

    2016-01-01

    The Australian Radiation Protection and Nuclear Safety Agency (ARPANSA) is the country’s primary authority on radiation protection and nuclear safety. ARPANSA aims to promote safety, security, and emergency preparedness through efficient and effective regulation of nuclear installations, controlled facilities, and radiation sources. Recent initiatives to improve regulation by ‘cutting red tape’ and reducing regulatory burden have been introduced. ARPANSA’s Regulatory Delivery Model emphasises the key elements to good regulation and describes initiatives such as baseline inspection schedule, Performance Objectives and Criteria, and performance deficiencies. These and other initiatives have streamlined inspection efforts, increased risk-based oversight and risk-informed decision making, leading to increased efficiencies for both regulator and licence holder. In addition, ARPANSA has introduced 12 key performance indicators in its self-assessment of regulatory performance against the Australian Government’s Regulator Performance Framework. (author)

  2. The Effect of Service Compact (SERVICOM) on Service Delivery in Nnamdi Azikiwe University Teaching Hospital Nnewi, Nigeria

    OpenAIRE

    Jude Kennedy Emejulu; M. C. Muo; E. E.O. Chukwuemeka

    2014-01-01

    This study examined the effect of service compact (Servicom Service delivery) in Nnamdi Azikiwe University Teaching Hospital Nnewi. Questionnaire and face-to-face interviews were used in the collection of data. The hypotheses were tested using descriptive statistics. The study discovered among other things that with the inauguration of the SERVICOM Charter by the Federal Government of Nigeria, the Management of Nnamdi Azikiwe University Teaching Hospital Nnewi identified key areas that requir...

  3. Organizational Structure in the Delivery of Complex Services.

    Science.gov (United States)

    Checkland, Beth Young

    1984-01-01

    Essential features of the absolute bureaucracy and the organic structure are outlined and related to intrinsic requirements for the provision of complex services such as teaching and counselling. The two organizational patterns are examined in terms of influence relationships, plasticity, and administrators' assumptions. (TE)

  4. Delivery of community information service as corporate social ...

    African Journals Online (AJOL)

    This necessitated the study, with a view to ascertaining if librarians in academic institutions, considering their location in rural areas, are involved in corporate social responsibility (CSR) by way of providing library and information services in communities? Using four federal tertiary institutions in Imo and Ebonyi states, South ...

  5. Skilled delivery care service utilization in Ethiopia: analysis of rural ...

    African Journals Online (AJOL)

    Only 4.5% women in rural areas received assistance from skilled birth attendants (SBAs) compared to 64.1 % of their urban counter parts. Through Bayesian logistic regression analysis, place of residence, ANC utilization, women's education, age and birth order were identified as key predictors of service utilization.

  6. Improving Service Delivery of the Finance and Budget Section ...

    African Journals Online (AJOL)

    The action research has disclosed that there were not efficient service in paying different payments like-evening, part time, fees ascribing to absence of incentives finance and budget section workers. Students' monthly payments were not done on time and this resulted in serious disciplinary problems on the students\\' side.

  7. Quality service delivery for the community, by the community: an innovative Eastern Cape infrastructure and job creation success

    CSIR Research Space (South Africa)

    Wall, K

    2013-10-01

    Full Text Available ; and service delivery; through O/&M activities that increase the availability and utility of infrastructure, and the quality and reliability of services. ... of Municipal Engineering of Southern Africa Annual (IMIESA) Conference, Port Elizabeth, October 2013 Quality service delivery for the community, by the community: an innovative Eastern Cape infrastructure and job creation success Wall K, Ive O, Bhagwan J...

  8. Rural and urban women entrepreneurs: A comparison of service needs and delivery methods priorities

    Directory of Open Access Journals (Sweden)

    Davis, A.

    2011-01-01

    Full Text Available Women entrepreneurs face a wide variety of barriers and challenges throughout the life and growth of their entrepreneurial venture. This study expands the knowledge base on women entrepreneurs’ needs, specifically their needs in terms of service areas and service delivery method preferences. Twenty three “needed” service areas were identified by 95 Manitoba based women entrepreneurs. The first five included: finding new customers, growth benefits and tools, market expansion, general marketing, and networking skills. This study also examined the differences between urban and rural based entrepreneurs. Two service need areas “how to find mentors and role models” and “legal issues” exhibited statistically significant priority differences. Service delivery methods did not produce any statistically significant differences. Overall, this study concludes that regardless of location, women entrepreneurs’ training and support needs are not significantly that different. The effects of entrepreneurial stage and years in business on entrepreneurial support needs are also examined.

  9. Capacity, pressure, demand, and flow: A conceptual framework for analyzing ecosystem service provision and delivery

    Science.gov (United States)

    Villamagna, Amy M.; Angermeier, Paul L.; Bennett, Elena M.

    2013-01-01

    Ecosystem services provide an instinctive way to understand the trade-offs associated with natural resource management. However, despite their apparent usefulness, several hurdles have prevented ecosystem services from becoming deeply embedded in environmental decision-making. Ecosystem service studies vary widely in focal services, geographic extent, and in methods for defining and measuring services. Dissent among scientists on basic terminology and approaches to evaluating ecosystem services create difficulties for those trying to incorporate ecosystem services into decision-making. To facilitate clearer comparison among recent studies, we provide a synthesis of common terminology and explain a rationale and framework for distinguishing among the components of ecosystem service delivery, including: an ecosystem's capacity to produce services; ecological pressures that interfere with an ecosystem's ability to provide the service; societal demand for the service; and flow of the service to people. We discuss how interpretation and measurement of these four components can differ among provisioning, regulating, and cultural services. Our flexible framework treats service capacity, ecological pressure, demand, and flow as separate but interactive entities to improve our ability to evaluate the sustainability of service provision and to help guide management decisions. We consider ecosystem service provision to be sustainable when demand is met without decreasing capacity for future provision of that service or causing undesirable declines in other services. When ecosystem service demand exceeds ecosystem capacity to provide services, society can choose to enhance natural capacity, decrease demand and/or ecological pressure, or invest in a technological substitute. Because regulating services are frequently overlooked in environmental assessments, we provide a more detailed examination of regulating services and propose a novel method for quantifying the flow of

  10. A Service Delivery Model for Addressing Activity and Social Participation Needs of People Living with HIV

    Directory of Open Access Journals (Sweden)

    Gayle Restall

    2017-05-01

    Full Text Available Background: Occupational therapy can contribute to the health and well-being of people with human immunodeficiency virus (HIV who are experiencing health consequences of living long term with this disease. However, there are no comprehensive rehabilitation service delivery models to guide this emerging area of practice. The purpose of this study was to obtain critical feedback about a service delivery model to address the activity and social participation needs of people living with HIV. Method: We developed a service delivery model from a synthesis of the literature. Using a qualitative research design, we conducted individual and focus group interviews with 35 informants from diverse backgrounds and involvement in HIV-related research, service provision, and policymaking to provide critical feedback about the model. The interviews were audio-recorded, transcribed verbatim, and analyzed using inductive qualitative methods. Results: The informants identified the strengths and limitations of the model and supports and barriers to its implementation. They highlighted the importance of principle-based services, increasing resources for service navigation, building capacity of rehabilitation services to address the needs of people with HIV, and increasing research and program evaluation targeted to achieving activity and social participation outcomes. Conclusions: The model provides a framework for occupational therapists to design and evaluate services for this population.

  11. Going the distance: Service delivery for the Danish National swimming team during the Olympics

    DEFF Research Database (Denmark)

    Larsen, Carsten Hvid

    In this presentation I will outline the service delivery for the Danish National swimming team and provide an example of my work based on mindfulness and acceptance and commitment therapy (ACT) with an individual swimmer during the Olympics. Being part of the Olympics involves a range of stressors...... and distractions such as a tight packed swimming schedule (up to 12 starts across seven days), a lot of media attention, social media, others and own expectations. In my service delivery during the Olympics I tried to create an awareness of these stressors and distractions. On a normal day at the Olympics I had...

  12. The quality of free antenatal and delivery services in Northern Sierra Leone.

    Science.gov (United States)

    Koroma, Manso M; Kamara, Samuel S; Bangura, Evelyn A; Kamara, Mohamed A; Lokossou, Virgil; Keita, Namoudou

    2017-07-12

    The number of maternal deaths in sub-Saharan Africa continues to be overwhelmingly high. In West Africa, Sierra Leone leads the list, with the highest maternal mortality ratio. In 2010, financial barriers were removed as an incentive for more women to use available antenatal, delivery and postnatal services. Few published studies have examined the quality of free antenatal services and access to emergency obstetric care in Sierra Leone. A cross-sectional survey was conducted in 2014 in all 97 peripheral health facilities and three hospitals in Bombali District, Northern Region. One hundred antenatal care providers were interviewed, 276 observations were made and 486 pregnant women were interviewed. We assessed the adequacy of antenatal and delivery services provided using national standards. The distance was calculated between each facility providing delivery services and the nearest comprehensive emergency obstetric care (CEOC) facility, and the proportion of facilities in a chiefdom within 15 km of each CEOC facility was also calculated. A thematic map was developed to show inequities. The quality of services was poor. Based on national standards, only 27% of women were examined, 2% were screened on their first antenatal visit and 47% received interventions as recommended. Although 94% of facilities provided delivery services, a minority had delivery rooms (40%), delivery kits (42%) or portable water (46%). Skilled attendants supervised 35% of deliveries, and in only 35% of these were processes adequately documented. None of the five basic emergency obstetric care facilities were fully compliant with national standards, and the central and northernmost parts of the district had the least access to comprehensive emergency obstetric care. The health sector needs to monitor the quality of antenatal interventions in addition to measuring coverage. The quality of delivery services is compromised by poor infrastructure, inadequate skilled staff, stock-outs of

  13. Punishment at the Frontlines of Public Service Delivery

    DEFF Research Database (Denmark)

    Pedersen, Mogens Jin; Stritch, Justin Michael; Thuesen, Frederik

    2018-01-01

    that affects clients can occasionally be marked by racial biases and disparities. Drawing on the Racial Classification Model (RCM) for a theoretical model, this article examines how client ethnicity shapes public employees’ decisions to sanction clients. Using Danish employment agencies as our empirical......Many public welfare programs give public employees discretionary authority to dispense sanctions when clients do not follow or comply with the policies and procedures required for receiving welfare benefits. Yet research also shows that public employees’ use of discretion in decision making...... and caseworkers’ decisions to sanction clients. While we find no moderation effects for ethnicity or gender, work experience appears to diminish the influence of client ethnicity on the caseworkers’ sanctioning decisions. Overall, our studies support the likelihood that ethnic minority clients will be punished...

  14. Can branding by health care provider organizations drive the delivery of higher technical and service quality?

    Science.gov (United States)

    Snihurowych, Roman R; Cornelius, Felix; Amelung, Volker Eric

    2009-01-01

    Despite the widespread use of branding in nearly all other major industries, most health care service delivery organizations have not fully embraced the practices and processes of branding. Facilitating the increased and appropriate use of branding among health care delivery organizations may improve service and technical quality for patients. This article introduces the concepts of branding, as well as making the case that the use of branding may improve the quality and financial performance of organizations. The concepts of branding are reviewed, with examples from the literature used to demonstrate their potential application within health care service delivery. The role of branding for individual organizations is framed by broader implications for health care markets. Branding strategies may have a number of positive effects on health care service delivery, including improved technical and service quality. This may be achieved through more transparent and efficient consumer choice, reduced costs related to improved patient retention, and improved communication and appropriateness of care. Patient satisfaction may be directly increased as a result of branding. More research into branding could result in significant quality improvements for individual organizations, while benefiting patients and the health system as a whole.

  15. How to achieve optimal organization of primary care service delivery at system level: lessons from Europe.

    Science.gov (United States)

    Pelone, Ferruccio; Kringos, Dionne S; Spreeuwenberg, Peter; De Belvis, Antonio G; Groenewegen, Peter P

    2013-09-01

    To measure the relative efficiency of primary care (PC) in turning their structures into services delivery and turning their services delivery into quality outcomes. Cross-sectional study based on the dataset of the Primary Healthcare Activity Monitor for Europe project. Two Data Envelopment models were run to compare the relative technical efficiency. A sensitivity analysis of the resulting efficiency scores was performed. PC systems in 22 European countries in 2009/2010. Model 1 included data on PC governance, workforce development and economic conditions as inputs and access, coordination, continuity and comprehensiveness of care as outputs. Model 2 included the previous process dimensions as inputs and quality indicators as outputs. There is relatively reasonable efficiency in all countries at delivering as many as possible PC processes at a given level of PC structure. It is particularly important to invest in economic conditions to achieve an efficient structure-process balance. Only five countries have fully efficient PC systems in turning their services delivery into high quality outcomes, using a similar combination of access, continuity and comprehensiveness, although they differ on the adoption of coordination of services. There is a large variation in efficiency levels obtained by countries with inefficient PC in turning their services delivery into quality outcomes. Maximizing the individual functions of PC without taking into account the coherence within the health-care system is not sufficient from a policymaker's point of view when aiming to achieve efficiency.

  16. Reforming health service delivery at district level in Ghana: the perspective of a district medical officer.

    Science.gov (United States)

    Agyepong, I A

    1999-03-01

    Many countries in sub-Saharan Africa face the problem of organizing health service delivery in a manner that provides adequate quality and coverage of health care to their populations against a background of economic recession and limited resources. In response to these challenges, different governments, including that of Ghana, have been considering or are in the process of implementing varying degrees of reform in the health sector. This paper examines aspects of health services delivery, and trends in utilization and coverage, using routine data over time in the Dangme West district of the Greater Accra region of Ghana, from the perspective of a district health manager. Specific interventions through which health services delivery and utilization at district level could be improved are suggested. Suggestions include raising awareness among care providers and health managers that increased resource availability is only a success in so far as it leads to improvements in coverage, utilization and quality; and developing indicators of performance which assess and reward use of resources at the local level to improve coverage, utilization and quality. Also needed are more flexibility in Central Government regulations for resource allocation and use; integration of service delivery at district level with more decentralized planning to make services better responsive to local needs; changes in basic and inservice training strategies; and exploration of how the public and private sectors can effectively collaborate to achieve maximum coverage and quality of care within available resources.

  17. “Just-in-Time” Unmediated Document Delivery Service Provides Fast Delivery, Helps Identify Collection Gaps, but Incurs Extra Costs

    Directory of Open Access Journals (Sweden)

    Heather MacDonald

    2017-06-01

    Full Text Available A Review of: Chan, E. K., Mune, C., Wang, Y., & Kendall, S. L. (2016. Three years of unmediated document delivery: An analysis and consideration of collection development priorities. Medical Reference Services Quarterly, 35(1, 42-51. Retrieved from: http://dx.doi.org/10.1080/02763869.2016.1117288 Abstract Objective – Examine the collection development opportunities and challenges of an unmediated document delivery service. Design – Case study. Setting – Large comprehensive public university in the United States of America. Subjects – 11,981 document delivery requests. Methods – This library implemented Copyright Clearance Center’s Get It Now (CCC-GiN service in November 2011 to supplement existing holdings, provide access to embargoed content and help support two new programs. The CCC-GiN service was offered in addition to regular ILL service. Statistical analysis was done using usage data collected for the academic years 2012-2013, 2013-2014, and 2014-2015 (excluding June and July. Usage data included: order date and time, fulfillment date and time, publication name, publication date, article name, article author, publisher name, cost, delivery e-mail address. Taylor and Francis publications were added to the CCC-GiN service in November of 2014. Main Results – The average yearly cost of titles with the largest number of CCC-GiN requests was compared to the annual subscription cost of the same titles. If the annual subscription cost was less than the average yearly cost of CCC-GiN requests, the library purchased a subscription. Patrons ordered older journal content through CCC-GiN requests. This suggested that backfile subscriptions could be cost effective means of providing content. The authors are in the process of analyzing what historical journal content should be purchased. The addition of Taylor and Francis publications resulted in an increase in the average cost per article. Taylor and Francis publications were popular with

  18. Total Quality Management (TQM: A Catalyst for Service Delivery in the South African Police Service

    Directory of Open Access Journals (Sweden)

    Michael Reddy

    2014-12-01

    Full Text Available September 2014 marked the release of the 2013/14 crime statistics in South Africa by the National Commissioner of the SAPS and the Minister of Police. Does a sense of safety and security fill the atmosphere? Do most South Africans, investors, and tourists alike believe that the crime rate in South Africa is reflective of a war zone and that South Africa is in a quagmire that engenders irretrievable damage to the lives of the citizenry and the economy? It is accepted that crime is a conflation of a number of economic, social and cultural factors; hence as a reviewable point, can the SAPS ensure the development of unassailable and perpetual policy solutions, underpinned with the highest quality that provides a guarantee of the citizen’s basic constitutional right to freedom and life. This article reviews literature on TQM and extrapolates lessons learnt to the practical functioning of the SAPS with a view to provide a myriad of TQM principles that may be considered by SAPS Management; this could serve as a catalyst for an improved policing service in South Africa.

  19. Policy delivery for low carbon energy infrastructure in the UK, april 5th 2013: Conference overview

    International Nuclear Information System (INIS)

    Heffron, Raphael J.; Johnston, Angus; McCauley, Darren; Jenkins, Kirsten

    2013-01-01

    The ambition of this conference was to deliver a first examination of how policy is delivered in the context of low-carbon energy infrastructure in the UK. The UK has been developing policy in this area since 2002 (Heffron, 2013). Finally, as the decade passed, in November 2012 an Energy Bill was put before the UK Parliament. One of the chief purposes of this Energy Bill is to establish the right environment for new electricity generation infrastructure in the low-carbon sector. There is significant debate on how this will be achieved and, indeed, whether this piece of legislation will actually deliver this outcome. This conference aimed to examine the dynamics of policy delivery. Throughout the day, there was entertaining discussion as a variety of conference presenters provided interesting contributions on how to deliver such policy goals. In total, there were twelve speakers throughout the day representing the UK (University of Oxford, Pinsent Masons Law Firm, University of Stirling, University of Dundee and University of Aberdeen), and also those who provided lessons from abroad from the University of Copenhagen, Central European University, Milieu Ltd., Pillsbury Law Firm (Washington DC, US) and the Conservation Law Foundation (MA, US)

  20. An extended EPQ-based problem with a discontinuous delivery policy, scrap rate, and random breakdown.

    Science.gov (United States)

    Chiu, Singa Wang; Lin, Hong-Dar; Song, Ming-Syuan; Chen, Hsin-Mei; Chiu, Yuan-Shyi P

    2015-01-01

    In real supply chain environments, the discontinuous multidelivery policy is often used when finished products need to be transported to retailers or customers outside the production units. To address this real-life production-shipment situation, this study extends recent work using an economic production quantity- (EPQ-) based inventory model with a continuous inventory issuing policy, defective items, and machine breakdown by incorporating a multiple delivery policy into the model to replace the continuous policy and investigates the effect on the optimal run time decision for this specific EPQ model. Next, we further expand the scope of the problem to combine the retailer's stock holding cost into our study. This enhanced EPQ-based model can be used to reflect the situation found in contemporary manufacturing firms in which finished products are delivered to the producer's own retail stores and stocked there for sale. A second model is developed and studied. With the help of mathematical modeling and optimization techniques, the optimal run times that minimize the expected total system costs comprising costs incurred in production units, transportation, and retail stores are derived, for both models. Numerical examples are provided to demonstrate the applicability of our research results.

  1. An Extended EPQ-Based Problem with a Discontinuous Delivery Policy, Scrap Rate, and Random Breakdown

    Directory of Open Access Journals (Sweden)

    Singa Wang Chiu

    2015-01-01

    Full Text Available In real supply chain environments, the discontinuous multidelivery policy is often used when finished products need to be transported to retailers or customers outside the production units. To address this real-life production-shipment situation, this study extends recent work using an economic production quantity- (EPQ- based inventory model with a continuous inventory issuing policy, defective items, and machine breakdown by incorporating a multiple delivery policy into the model to replace the continuous policy and investigates the effect on the optimal run time decision for this specific EPQ model. Next, we further expand the scope of the problem to combine the retailer’s stock holding cost into our study. This enhanced EPQ-based model can be used to reflect the situation found in contemporary manufacturing firms in which finished products are delivered to the producer’s own retail stores and stocked there for sale. A second model is developed and studied. With the help of mathematical modeling and optimization techniques, the optimal run times that minimize the expected total system costs comprising costs incurred in production units, transportation, and retail stores are derived, for both models. Numerical examples are provided to demonstrate the applicability of our research results.

  2. Matrix approach for the design of service delivery systems

    Directory of Open Access Journals (Sweden)

    Dina Davis-Castro

    2017-04-01

    Full Text Available The gradual change that is occurring from a purely functional approach to one of process, is conditioned from outside and from within organizations. The world changes faster, from one to the next decade. The politic-economic, social and technological conditions of the first half of the 20th century in the world in general, and in Latin America in particular, are far from the last 50 years of the 20th century. The number of changes that have occurred in the first 15 years of the 21st century is also immeasurable. There is a close relationship between the speed of technological change and changes in a good measure socioeconomic.  It leads to uncertain ways of planning the organizations.  Insofar as the cycles innovation - development are shortened, there is a gap between the appearance of products with superior performance in the market and the duration of similar goods previously acquired by users. This phenomenon shows a trend in the behavior of customers. Clients tends to request services solutions, rather than on specific products.  This essay examines some of the phenomena that affect the design of processes of services with a matrix approach, Result of research carried out in this field.

  3. Integrating personal medicine into service delivery: empowering people in recovery.

    Science.gov (United States)

    MacDonald-Wilson, Kim L; Deegan, Patricia E; Hutchison, Shari L; Parrotta, Nancy; Schuster, James M

    2013-12-01

    Illness management and recovery strategies are considered evidence-based practices. The article describes how a web-based application, CommonGround, has been used to support implementation of such strategies in outpatient mental health services and assess its impact. The specific focus of this article is Personal Medicine, self-management strategies that are a salient component of the CommonGround intervention. With support from counties and a not-for-profit managed care organization, CommonGround has been introduced in 10 medication clinics, one Assertive Community Treatment (ACT) team, and one peer support center across Pennsylvania. Methods include analysis of data from the application's database and evaluation of health functioning, symptoms, and progress toward recovery. Health functioning improved over time and use of self-management strategies was associated with fewer concerns about medication side effects, fewer concerns about the impact of mental health medicine on physical health, more reports that mental health medicines were helping, and greater progress in individuals' recovery. Using Personal Medicine empowers individuals to work with their prescribers to find a "right balance" between what they do to be well and what they take to be well. This program helps individuals and their service team focus on individual strengths and resilient self-care strategies. More research is needed to assess factors that may predict changes in outcomes and how a web-based tool focused on self-management strategies may moderate those factors. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  4. 18 CFR 2.22 - Pricing policy for transmission services provided under the Federal Power Act.

    Science.gov (United States)

    2010-04-01

    ... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false Pricing policy for... INTERPRETATIONS Statements of General Policy and Interpretations Under the Federal Power Act § 2.22 Pricing policy... Policy Statement on its pricing policy for transmission services provided under the Federal Power Act...

  5. Feasibility Study of Document Delivery Services in Special Libraries in Tehran

    Directory of Open Access Journals (Sweden)

    Assiyeh Pour- Emam- Ali

    2006-10-01

    Full Text Available The present study investigates the feasibility of establishing document delivery services in special libraries in Tehran. Document delivery services is copyright-cleared hard copy or electronic copy supply to individuals or corporations on a non-profit or for-profit basis. A descriptive survey was conducted over 105 special libraries located within Tehran. Capabilities studied included manual and automated equipments, skilled and motivated manpower, adequate budget and etc. Investigations show that 8.42% of these libraries use web-sites for resource location. 5.43% employ bibliographies. 5.36% of users lodge their requests by phone. 2.32% of the libraries receive requests in person. 3.14% of librarians are familiar with English while 6.28% are familiar with IT. 5.27% of the libraries studied use British library Document Supply Center at Boston Spa as their primary source of Foreign Document acquisition. 5.32% of the libraries consider membership in Interlibrary Cooperative Schemes as appropriate means of meeting patrons’ information needs. Maximum request response time is 3-4 weeks. 3.28% of the requests are for books. 6.88% of the special libraries, lack staff training courses for skill acquisition in the area of document delivery. 8.29% of libraries cite lack of adequate equipment as the main document delivery obstacle. The findings demonstrate the document delivery service among special libraries in Tehran is not appropriate given the existing capabilities.

  6. The role of government policy in service development in a New Zealand statutory mental health service: implications for policy planning and development.

    Science.gov (United States)

    Stanley-Clarke, Nicky; Sanders, Jackie; Munford, Robyn

    2014-12-01

    To explore the relationship between government policy and service development in a New Zealand statutory mental health provider, Living Well. An organisational case study utilising multiple research techniques including qualitative interviews, analysis of business and strategic documents and observation of meetings. Staff understood and acknowledged the importance of government policy, but there were challenges in its implementation. Within New Zealand's statutory mental health services staff struggled to know how to implement government policy as part of service development; rather, operational concerns, patient need, local context and service demands drove the service development process. © The Royal Australian and New Zealand College of Psychiatrists 2014.

  7. Fiscal Decentralization and Delivery of Public Services: Evidence from Education Sector in Pakistan

    Directory of Open Access Journals (Sweden)

    Rauf Abdur

    2017-04-01

    Full Text Available Fiscal Decentralization is the devolution of fiscal assignments to lower governments for high growth and better delivery of public services. The current study covering the period from 1972 to 2009 is an attempt to find out the impacts of fiscal decentralization on public services deliveries in Pakistan. Public services are proxy by Gross enrollment at primary school level while fiscal decentralization by fiscal transfer and expenditure sides of devolution. Using time series data, it is found that the individual impacts of fiscal transfer are although insignificant but still support the theoretical proposition regarding fiscal decentralization and public services relationship while delegation of expenditure responsibilities helps in improving the gross enrollment at primary school level. Furthermore the study evident that complete delegation of fiscal responsibilities to lower governments enhance enrollment ratio in Pakistan.

  8. Engineering Consultancy: An Assessment of IT-enabled International Delivery of Services

    DEFF Research Database (Denmark)

    Baark, Erik

    1999-01-01

    The delivery of engineering consultancy services in global markets has been dominated by a small group of firms located in Europe and the US. Like many other service industries, engineering consultants have depended on the movement of highly qualified people and establishment of local affiliates...... services in arms-length transactions across national borders does not appear to have been significantly exploited. Nevertheless, IT-enabled delivery of engineering consultancy services opens up possibilities for business process reengineering that may provide some firms new competitive advantages in global...... markets and lead to further integration of design and construction in partnerships or project consortia, or in the strengthening of design-build approaches in project execution....

  9. Quality of IT service delivery — Analysis and framework for human error prevention

    KAUST Repository

    Shwartz, L.

    2010-12-01

    In this paper, we address the problem of reducing the occurrence of Human Errors that cause service interruptions in IT Service Support and Delivery operations. Analysis of a large volume of service interruption records revealed that more than 21% of interruptions were caused by human error. We focus on Change Management, the process with the largest risk of human error, and identify the main instances of human errors as the 4 Wrongs: request, time, configuration item, and command. Analysis of change records revealed that the humanerror prevention by partial automation is highly relevant. We propose the HEP Framework, a framework for execution of IT Service Delivery operations that reduces human error by addressing the 4 Wrongs using content integration, contextualization of operation patterns, partial automation of command execution, and controlled access to resources.

  10. A national survey of health service infrastructure and policy impacts on access to computerised CBT in Scotland

    Directory of Open Access Journals (Sweden)

    Kenicer David

    2012-09-01

    Full Text Available Abstract Background NICE recommends computerised cognitive behavioural therapy (cCBT for the treatment of several mental health problems such as anxiety and depression. cCBT may be one way that services can reduce waiting lists and improve capacity and efficiency. However, there is some doubt about the extent to which the National Health Service (NHS in the UK is embracing this new health technology in practice. This study aimed to investigate Scottish health service infrastructure and policies that promote or impede the implementation of cCBT in the NHS. Methods A telephone survey of lead IT staff at all health board areas across Scotland to systematically enquire about the ability of local IT infrastructure and IT policies to support delivery of cCBT. Results Overall, most of the health boards possess the required software to use cCBT programmes. However, the majority of NHS health boards reported that they lack dedicated computers for patient use, hence access to cCBT at NHS sites is limited. Additionally, local policy in the majority of boards prevent staff from routinely contacting patients via email, skype or instant messenger, making the delivery of short, efficient support sessions difficult. Conclusions Conclusions: Overall most of the infrastructure is in place but is not utilised in ways that allow effective delivery. For cCBT to be successfully delivered within a guided support model, as recommended by national guidelines, dedicated patient computers should be provided to allow access to online interventions. Additionally, policy should allow staff to support patients in convenient ways such as via email or live chat. These measures would increase the likelihood of achieving Scottish health service targets to reduce waiting time for psychological therapies to 18 weeks.

  11. Morphological analysis: a method for selecting ICT applications in South African government service delivery

    CSIR Research Space (South Africa)

    Plauché, M

    2010-01-01

    Full Text Available by trial and error, as every attempt counts signi?cantly. 6. Wicked problems do not have an enumerable (or an exhaustively describable) set of potential solutions, nor is there a well-described set of permissible operations that may be incorporated... scheduled clinical visits. Access to information about entitled services alone has been found to improve the delivery of health and social services to resource-poor popula- tions (Pandey, Sehgal, Riboud, Levine, & Goyal, 2007). In South Africa, however...

  12. Factors associated with the utilization of institutional delivery services in Bangladesh.

    Science.gov (United States)

    Yaya, Sanni; Bishwajit, Ghose; Ekholuenetale, Michael

    2017-01-01

    Bangladesh has made remarkable progress towards reducing its maternal mortality rate (MMR) over the last two decades and is one of the few countries on track to achieving the MMR-related Millennium Development Goals (MDG-5A). However, the provision of universal access to reproductive healthcare (MDG-5B) and the utilization of maternal healthcare services (MHS) such as institutional delivery, which are crucial to the reduction of maternal mortality, are far behind the internationally agreed-upon target. Effective policymaking to promote the utilization of MHS can be greatly facilitated by the identification of the factors that hinder service uptake. In this study, we therefore aim to measure the prevalence of institutional delivery services and explore the factors associated with their utilization in Bangladesh. Data for this study were extracted from the 2011 Bangladesh Demographic and Health Survey (BDHS, 2011); participants were 7,313 women between the ages of 15 and 49 years, selected from both urban and rural households. Data were analyzed using Chi-square analysis, and conditional logistic regression. According to the findings, fewer than one in three women reported delivering at a health facility. The multivariable regression analysis showed that participants from rural areas were 46.9% less likely to have institutional deliveries compared to urban dwellers (OR = 0.531; pdelivery service utilization compared to those aged 15 to 29 years (OR = 1.236; p = 0.006; 95%CI: 1.062-1.437). Moreover, participants with higher educational attainment were about twice as likely to deliver at a standard health facility when compared to those without formal education (OR = 2.081; pservice utilization of institutional delivery facilities compared to those without formal education (OR = 1.709; pdelivery service use, with participants belonging to the highest economic stratum being more likely to receive skilled care compared to the lowest economic stratum (OR = 2

  13. Cost evaluation of reproductive and primary health care mobile service delivery for women in two rural districts in South Africa.

    Directory of Open Access Journals (Sweden)

    Kathryn Schnippel

    Full Text Available Cervical cancer screening is a critical health service that is often unavailable to women in under-resourced settings. In order to expand access to this and other reproductive and primary health care services, a South African non-governmental organization established a van-based mobile clinic in two rural districts in South Africa. To inform policy and budgeting, we conducted a cost evaluation of this service delivery model.The evaluation was retrospective (October 2012-September 2013 for one district and April-September 2013 for the second district and conducted from a provider cost perspective. Services evaluated included cervical cancer screening, HIV counselling and testing, syndromic management of sexually transmitted infections (STIs, breast exams, provision of condoms, contraceptives, and general health education. Fixed costs, including vehicle purchase and conversion, equipment, operating costs and mobile clinic staffing, were collected from program records and public sector pricing information. The number of women accessing different services was multiplied by ingredients-based variable costs, reflecting the consumables required. All costs are reported in 2013 USD.Fixed costs accounted for most of the total annual costs of the mobile clinics (85% and 94% for the two districts; the largest contributor to annual fixed costs was staff salaries. Average costs per patient were driven by the total number of patients seen, at $46.09 and $76.03 for the two districts. Variable costs for Pap smears were higher than for other services provided, and some services, such as breast exams and STI and tuberculosis symptoms screening, had no marginal cost.Staffing costs are the largest component of providing mobile health services to rural communities. Yet, in remote areas where patient volumes do not exceed nursing staff capacity, incorporating multiple services within a cervical cancer screening program is an approach to potentially expand access to

  14. Single-Commodity Vehicle Routing Problem with Pickup and Delivery Service

    Directory of Open Access Journals (Sweden)

    Goran Martinovic

    2008-01-01

    Full Text Available We present a novel variation of the vehicle routing problem (VRP. Single commodity cargo with pickup and delivery service is considered. Customers are labeled as either cargo sink or cargo source, depending on their pickup or delivery demand. This problem is called a single commodity vehicle routing problem with pickup and delivery service (1-VRPPD. 1-VRPPD deals with multiple vehicles and is the same as the single-commodity traveling salesman problem (1-PDTSP when the number of vehicles is equal to 1. Since 1-VRPPD specializes VRP, it is hard in the strong sense. Iterative modified simulated annealing (IMSA is presented along with greedy random-based initial solution algorithm. IMSA provides a good approximation to the global optimum in a large search space. Experiment is done for the instances with different number of customers and their demands. With respect to average values of IMSA execution times, proposed method is appropriate for practical applications.

  15. Factors associated with the utilization of institutional delivery services in Bangladesh.

    Directory of Open Access Journals (Sweden)

    Sanni Yaya

    Full Text Available Bangladesh has made remarkable progress towards reducing its maternal mortality rate (MMR over the last two decades and is one of the few countries on track to achieving the MMR-related Millennium Development Goals (MDG-5A. However, the provision of universal access to reproductive healthcare (MDG-5B and the utilization of maternal healthcare services (MHS such as institutional delivery, which are crucial to the reduction of maternal mortality, are far behind the internationally agreed-upon target. Effective policymaking to promote the utilization of MHS can be greatly facilitated by the identification of the factors that hinder service uptake. In this study, we therefore aim to measure the prevalence of institutional delivery services and explore the factors associated with their utilization in Bangladesh.Data for this study were extracted from the 2011 Bangladesh Demographic and Health Survey (BDHS, 2011; participants were 7,313 women between the ages of 15 and 49 years, selected from both urban and rural households. Data were analyzed using Chi-square analysis, and conditional logistic regression.According to the findings, fewer than one in three women reported delivering at a health facility. The multivariable regression analysis showed that participants from rural areas were 46.9% less likely to have institutional deliveries compared to urban dwellers (OR = 0.531; p<0.001; 95%CI: 0.467-0.604, and participants aged between 30 and 49 years had a 23.6% higher prevalence of institutional delivery service utilization compared to those aged 15 to 29 years (OR = 1.236; p = 0.006; 95%CI: 1.062-1.437. Moreover, participants with higher educational attainment were about twice as likely to deliver at a standard health facility when compared to those without formal education (OR = 2.081; p<0.001; 95%CI: 1.650-2.624, and similarly, husbands with higher educational attainment exhibited an approximately 71% higher service utilization of institutional

  16. Building Service Delivery Networks: Partnership Evolution Among Children's Behavioral Health Agencies in Response to New Funding.

    Science.gov (United States)

    Bunger, Alicia C; Doogan, Nathan J; Cao, Yiwen

    2014-12-01

    Meeting the complex needs of youth with behavioral health problems requires a coordinated network of community-based agencies. Although fiscal scarcity or retrenchment can limit coordinated services, munificence can stimulate service delivery partnerships as agencies expand programs, hire staff, and spend more time coordinating services. This study examines the 2-year evolution of referral and staff expertise sharing networks in response to substantial new funding for services within a regional network of children's mental health organizations. Quantitative network survey data were collected from directors of 22 nonprofit organizations that receive funding from a county government-based behavioral health service fund. Both referral and staff expertise sharing networks changed over time, but results of a stochastic actor-oriented model of network dynamics suggest the nature of this change varies for these networks. Agencies with higher numbers of referral and staff expertise sharing partners tend to maintain these ties and/or develop new relationships over the 2 years. Agencies tend to refer to agencies they trust, but trust was not associated with staff expertise sharing ties. However, agencies maintain or form staff expertise sharing ties with referral partners, or with organizations that provide similar services. In addition, agencies tend to reciprocate staff expertise sharing, but not referrals. Findings suggest that during periods of resource munificence and service expansion, behavioral health organizations build service delivery partnerships in complex ways that build upon prior collaborative history and coordinate services among similar types of providers. Referral partnerships can pave the way for future information sharing relationships.

  17. 20 CFR 669.310 - What are the basic components of an NFJP service delivery strategy?

    Science.gov (United States)

    2010-04-01

    ... include: (a) A customer-centered case management approach; (b) The provision of workforce investment... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false What are the basic components of an NFJP service delivery strategy? 669.310 Section 669.310 Employees' Benefits EMPLOYMENT AND TRAINING...

  18. Decision making at the frontline: Exploring coping with moral conflicts during public service delivery

    NARCIS (Netherlands)

    Vink, E.; Tummers, L.G.; Bekkers, V.J.J.M.; Musheno, M.

    2015-01-01

    Moral conflicts, where a person is confronted with two or more clashing values, norms or responsibilities, are common in public service delivery. Choosing one is realized at the cost of the other(s). Frontline professionals, such as physicians and police officers, often experience clashes over the

  19. Service Delivery and Related Issues at the Trace Research and Development Center.

    Science.gov (United States)

    Smith, R. O.

    The environmental context of the Trace Center is first briefly described as background for a more detailed description of the center's service delivery activities in the field of rehabilitation/education technology. Trace serves four major functions in rehabilitation/education technology. As a nationally funded rehabilitation engineering center,…

  20. Health service delivery models for the provision of antiretroviral therapy in sub-Saharan Africa

    DEFF Research Database (Denmark)

    Lazarus, Jeffrey V; Safreed-Harmon, Kelly; Nicholson, Joey

    2014-01-01

    OBJECTIVES: In response to the lack of evidence-based guidance for how to continue scaling up antiretroviral therapy (ART) in ways that make optimal use of limited resources, to assess comparative studies of ART service delivery models implemented in sub-Saharan Africa. METHODS: A systematic lite...

  1. Improving Service Delivery: Investigating the Role of Information Sharing, Job Characteristics, and Employee Satisfaction

    Science.gov (United States)

    Bontis, Nick; Richards, David; Serenko, Alexander

    2011-01-01

    Purpose: The purpose of this study is to propose and test a model designed to investigate the impact of job characteristics, employee satisfaction, and information sharing on two key indicators of quality service delivery, such as worker perceptions of their efficiency and customer focus. Design/methodology/approach: During the project, 9,060…

  2. Diffusion of electronic service delivery innovations: the case of e-policing

    NARCIS (Netherlands)

    E.H. Korteland (Evelien); V.J.J.M. Bekkers (Victor)

    2009-01-01

    textabstractThis article examines the diffusion and adoption process of an electronic service delivery innovation, which can be seen as an example of e-policing – called SMS-alert – among Dutch police forces. Important is not only to pay attention to the question how an innovation has spread - and

  3. Compliance With Legal Age Restrictions on Adolescent Alcohol Sales for Alcohol Home Delivery Services (AHDS)

    NARCIS (Netherlands)

    van Hoof, Joris Jasper; van den Wildenberg, Esther; de Bruijn, Dorien

    2014-01-01

    Purpose: Alcohol availability is an important predictor of alcohol use in adolescents and its negative consequences. Within this study, we zoomed in on availability through alcohol home delivery services (AHDS) by measuring compliance with the legal age limit in this sector. Methods: Two methods

  4. Where to go in the near future: diverging perspectives on online public service delivery

    NARCIS (Netherlands)

    van Deursen, Alexander Johannes Aloysius Maria; Wimmer, Maria A.; Scholl, Jochen; Grönlund, Åke

    2007-01-01

    Although the electronic government is under heavy development, a clear vision doesn’t seem to exist. In this study 20 interviews among leaders in the field of e-government in the Netherlands resulted in different perspectives on the future of electronic public service delivery. The interviews

  5. Does co-creation impact public service delivery? The importance of state and governance traditions

    NARCIS (Netherlands)

    Voorberg, Willem; Bekkers, Victor; Flemig, Sophie; Timeus, Krista; Tõnurist, Piret; Tummers, L.G.

    2017-01-01

    Co-creation in public service delivery requires partnerships between citizens and civil servants. The authors argue that whether or not these partnerships will be successful depends on state and governance traditions (for example a tradition of authority sharing or consultation). These traditions

  6. Addressing service delivery in rural areas through deployment of information and communication technology platforms

    CSIR Research Space (South Africa)

    Foko, Thato E

    2017-05-01

    Full Text Available deployment of ICT Platforms in the rural areas. The contribution of ICT Platform adds to the important notion of access which enhances service delivery. This is seen through the Technology Acceptance Models used in this paper. The main research methodology...

  7. An experiment framework to identify community functional components driving ecosystem processes and services delivery.

    NARCIS (Netherlands)

    Dias, A.; Berg, M.P.; de Bello, F.; van Oosten, A.R.; Bila, K.; Moretti, M.

    2013-01-01

    There is a growing consensus that the distribution of species trait values in a community can greatly determine ecosystem processes and services delivery. Two distinct components of community trait composition are hypothesized to chiefly affect ecosystem processes: (i) the average trait value of the

  8. Delivery through innovation: CSIR research on water services infrastructure operation through franchising

    CSIR Research Space (South Africa)

    Wall, K

    2006-02-01

    Full Text Available There is a great need for institutional innovations aimed at improving access to basic water services in South Africa, and sustaining that improvement. In support of effective delivery, the CSIR, with the support of the Water Research Commission...

  9. The delivery of medical services in a retail shopping mall: a strategy for growth.

    Science.gov (United States)

    Hayden, K R

    1989-01-01

    The successful medical practice of the future will continually search for growth strategies. This writer believes the location of a primary care medical clinic in a retail shopping mall, with a full menu of primary services, is one strategy for growth. It is an effective method of health care delivery to a community.

  10. Integration and transformation of rural service delivery: The role of management information and decision support systems

    CSIR Research Space (South Africa)

    Mashiri, M

    2005-01-01

    Full Text Available The paper deals with two main themes: 1) the integration and transformation of rural service delivery; and 2) role of management information and decision support systems in this process. Referring specifically to the types of rural areas, conditions...

  11. Funding issues and the delivery of public library services in Nigeria ...

    African Journals Online (AJOL)

    This paper examined the impact of government public expenditure on education and the effect of special funding in enhancing the delivery of public library services in Nigeria. secondary data were collected from the websites of the Central Bank of Nigeria (CBN) and Education Trust Fund (ETF.). Results from the regression ...

  12. The Internet of Things in bridging the gap in municipal service delivery in South Africa

    CSIR Research Space (South Africa)

    Dlodlo, N

    2012-05-01

    Full Text Available There continues to be high expectations of the government from the citizens of South Africa to improve the delivery of services , and hence the need to come up with comprehensive measures to alleviate the problem. This paper proposes the adoption...

  13. Fault Activity Aware Service Delivery in Wireless Sensor Networks for Smart Cities

    Directory of Open Access Journals (Sweden)

    Xiaomei Zhang

    2017-01-01

    Full Text Available Wireless sensor networks (WSNs are increasingly used in smart cities which involve multiple city services having quality of service (QoS requirements. When misbehaving devices exist, the performance of current delivery protocols degrades significantly. Nonetheless, the majority of existing schemes either ignore the faulty behaviors’ variability and time-variance in city environments or focus on homogeneous traffic for traditional data services (simple text messages rather than city services (health care units, traffic monitors, and video surveillance. We consider the problem of fault-aware multiservice delivery, in which the network performs secure routing and rate control in terms of fault activity dynamic metric. To this end, we first design a distributed framework to estimate the fault activity information based on the effects of nondeterministic faulty behaviors and to incorporate these estimates into the service delivery. Then we present a fault activity geographic opportunistic routing (FAGOR algorithm addressing a wide range of misbehaviors. We develop a leaky-hop model and design a fault activity rate-control algorithm for heterogeneous traffic to allocate resources, while guaranteeing utility fairness among multiple city services. Finally, we demonstrate the significant performance of our scheme in routing performance, effective utility, and utility fairness in the presence of misbehaving sensors through extensive simulations.

  14. Predictors of safe delivery service utilization in arsi zone, South-East ethiopia.

    Science.gov (United States)

    Abera, Mulumebet; Gebremariam, Abebe; Belachew, Tefera

    2011-08-01

    Evidence show that lack of access to and use of, essential obstetric care services to be a crucial factor that contributes to the high maternal morbidity and mortality. Skilled attendance during labor, delivery and early post-partum period could reduce deaths due to obstructed labor, hemorrhage, sepsis and eclampsia. There is limited information on the mothers' use of skilled delivery services in the study area. This study assessed the predictors of safe delivery service utilization in Arsi Zone, Southeast Ethiopia. A cross- sectional community based study using quantitative and qualitative methods was conducted from February 15(th) to March 15(th) 2006. A total of 1089 women who had at least one birth one year prior to the study were involved in the study from nine rural and four urban kebeles in three Woredas (Districts) selected using a systematic sampling method from all households in the study area. A pre-tested structured interviewer administered questionnaire was used to collect data. Information on the utilization of safe delivery service and socio-demographic, individual and institutional factors and past obstetric history were collected. Focus Group Discussion guide was used for qualitative data collection. The data were edited, cleaned, and entered into a computer and analyzed using SPSS for windows version 12.0. One thousand seventy four women who had at least one birth were interviewed making a response rate 98.6%. Two hundred seventy one (75.0%) of urban and 373(52.0%) rural women received antenatal care from skilled health professional at least once during their last pregnancy. Thirty-one (4.3%) of rural and 145 (40.4%) of urban women delivered in health institution. In multivariate analysis showed that residential area OR= 8.5, 95%CI; (5.1,13.9), parity OR=0.18, 95%CI; (0.08, 0.42), and ANC service use OR= 4.5, 95%CI; (2.2,8.9), and maternal education OR=4.6, 95%CI; (1.7,12.8), were most significant predictors of safe delivery service use by mothers

  15. Innovation in Public Service Delivery: Civic Participation in Slovakia

    Directory of Open Access Journals (Sweden)

    Beata M. Merickova

    2016-06-01

    Full Text Available Participation as such is connected with political, social and civic dimensions. Through participation, citizens can directly or indirectly help to make the public process become more transparent and more efficient. It allows citizens “to see" into a decision-making process, to understand it, as well as contribute and be able to control it. In practice, civic participation has various forms; it includes both formal civic associations and informal groups of citizens that develop activities in order to solve local problems. In this paper we focus on civic participation in the innovation in the provision of public services, i.e. co-creation. Our objective is to map the best practices of co-creation in social innovations at the local government level in Slovakia. The main findings of our analysis are that co-created innovations are mostly initiated by non-governmental actors. Our study uses a qualitative approach and is based on original survey data from our own research, conducted mainly within the LIPSE research project.

  16. The impact of price and tobacco control policies on the demand for electronic nicotine delivery systems.

    Science.gov (United States)

    Huang, Jidong; Tauras, John; Chaloupka, Frank J

    2014-07-01

    While much is known about the demand for conventional cigarettes, little is known about the determinants of demand for electronic nicotine delivery systems (ENDS or e-cigarettes). The goal of this study is to estimate the own and cross-price elasticity of demand for e-cigarettes and to examine the impact of cigarette prices and smoke-free policies on e-cigarette sales. Quarterly e-cigarette prices and sales and conventional cigarette prices from 2009 to 2012 were constructed from commercial retail store scanner data from 52 U.S. markets, for food, drug and mass stores, and from 25 markets, for convenience stores. Fixed-effects models were used to estimate the own and cross-price elasticity of demand for e-cigarettes and associations between e-cigarette sales and cigarette prices and smoke-free policies. Estimated own price elasticities for disposable e-cigarettes centred around -1.2, while those for reusable e-cigarettes were approximately -1.9. Disposable e-cigarette sales were higher in markets where reusable e-cigarette prices were higher and where less of the population was covered by a comprehensive smoke-free policy. There were no consistent and statistically significant relationships between cigarette prices and e-cigarette sales. E-cigarette sales are very responsive to own price changes. Disposable e-cigarettes appear to be substitutes for reusable e-cigarettes. Policies increasing e-cigarette retail prices, such as limiting rebates, discounts and coupons and imposing a tax on e-cigarettes, could potentially lead to significant reductions in e-cigarette sales. Differential tax policies based on product type could lead to substitution between different types of e-cigarettes. 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.

  17. The impact of price and tobacco control policies on the demand for electronic nicotine delivery systems

    Science.gov (United States)

    Huang, Jidong; Tauras, John; Chaloupka, Frank J

    2014-01-01

    Background While much is known about the demand for conventional cigarettes, little is known about the determinants of demand for electronic nicotine delivery systems (ENDS or e-cigarettes). The goal of this study is to estimate the own and cross-price elasticity of demand for e-cigarettes and to examine the impact of cigarette prices and smoke-free policies on e-cigarette sales. Methods Quarterly e-cigarette prices and sales and conventional cigarette prices from 2009 to 2012 were constructed from commercial retail store scanner data from 52 US markets, for food, drug and mass stores, and from 25 markets, for convenience stores. Fixed-effects models were used to estimate the own and cross-price elasticity of demand for e-cigarettes and associations between e-cigarette sales and cigarette prices and smoke-free policies. Results Estimated own price elasticities for disposable e-cigarettes centred around −1.2, while those for reusable e-cigarettes were approximately −1.9. Disposable e-cigarette sales were higher in markets where reusable e-cigarette prices were higher and where less of the population was covered by a comprehensive smoke-free policy. There were no consistent and statistically significant relationships between cigarette prices and e-cigarette sales. Conclusions E-cigarette sales are very responsive to own price changes. Disposable e-cigarettes appear to be substitutes for reusable e-cigarettes. Policies increasing e-cigarette retail prices, such as limiting rebates, discounts and coupons and imposing a tax on e-cigarettes, could potentially lead to significant reductions in e-cigarette sales. Differential tax policies based on product type could lead to substitution between different types of e-cigarettes. PMID:24935898

  18. The Effect of Service Compact (SERVICOM on Service Delivery in Nnamdi Azikiwe University Teaching Hospital Nnewi, Nigeria

    Directory of Open Access Journals (Sweden)

    Jude Kennedy Emejulu

    2014-12-01

    Full Text Available This study examined the effect of service compact (Servicom Service delivery in Nnamdi Azikiwe University Teaching Hospital Nnewi. Questionnaire and face-to-face interviews were used in the collection of data. The hypotheses were tested using descriptive statistics. The study discovered among other things that with the inauguration of the SERVICOM Charter by the Federal Government of Nigeria, the Management of Nnamdi Azikiwe University Teaching Hospital Nnewi identified key areas that required re-evaluation and attention based on the submissions of every service unit and department, after an analysis of the Strengths, Weaknesses, Opportunities and Threats (SWOT of each of the service areas. A pre-SERVICOM Charter workshop which was supervised by the Federal Government was held in the various institutions nationwide to enable care providers enumerate their current service capacity and identify their impediments. In the light of the foregoing, some of the recommendations proffered are that the SERVICOM Charter project should be sustained and supervision and control of the SERVICOM Charter project should be intensified in order to ensure that the Nigerian factor of service-fatigue would not supervene in care delivery in the near future.

  19. Enhancing Human Capital Development and Service Delivery in Nigerian Tertiary Institutions through Effective Academic Staff

    Directory of Open Access Journals (Sweden)

    Chinyeaka Igbokwe-Ibeto

    2014-09-01

    Full Text Available Within the framework of bureaucratic and human capital theories, an eclectic approach, the study examines the nexus between academic staff recruitment in Nigerian tertiary institutions and human capital development as well as service delivery with specific reference to universities. It is generally agreed that higher education is a sine-qua-non for human capital development and efficient service delivery. Higher education is a prerequisite for the production of highly competent experts, which in turn, contributes to the development of organizations and the economy at large. For these to be achieved, the right content and academic staff  must be in place to perform this varied function.  However, over the years the quality of human capital coming out of Nigerian universities and its impact on service delivery has become a source of concern to employers of labour and all stakeholders. Inferential opinions have traced the problem to the recruitment of incompetent academic staff. To investigate the issues raised, the study relied heavily on primary and secondary data and multi stage sampling was used to select the sample population. The data collected was presented in pie chart and simple percentage. Similarly, in order to test the hypotheses and establish the degree of dependence or independence of the variables under investigation, the chi-square statistical technique was used. The findings of the study revealed among others, that Nigerian universities do not employ merit, qualification and competency in the academic staff recruitment. It also established that there is a significant relationship between merit, qualification and competency based academic staff recruitment and human capital development and service delivery. To enhance human capital development and service delivery in Nigerian universities, the study recommends among others, that an independent body like the National University Commission (NUC should be given the responsibility of

  20. Quality of the delivery services in health facilities in Northern Ethiopia.

    Science.gov (United States)

    Fisseha, Girmatsion; Berhane, Yemane; Worku, Alemayehu; Terefe, Wondwossen

    2017-03-09

    Substantial improvements have been observed in the coverage of and access to maternal health service, especially in skilled birth attendants, in Ethiopia. However, the quality of care has been lagging behind. Therefore, this study investigated the status of the quality of delivery services in Northern Ethiopia. A facility based survey was conducted from December 2014 to February 2015 in Northern Ethiopia. The quality of delivery service was assessed in 32 health facilities using a facility audit checklist, by reviewing delivery, by conducting in-depth interview and observation, and by conducting exit interviews with eligible mothers. Facilities were considered as 'good quality' if they scored positively on 75% of the quality indicators set in the national guidelines for all the three components; input (materials, infrastructure, and human resource), process (adherence to standard care procedures during intrapartum and immediate postpartum periods) and output (the mothers' satisfaction and utilization of lifesaving procedures). Overall 2 of 32 (6.3%) of the study facilities fulfilled all the three quality components; input, process and output. Two of the three components were assessed as good in 11 of the 32 (34.4%) health facilities. The input quality was the better of the other quality components; which was good in 21 out of the 32 (65.6%) health facilities. The process and output quality was good in only 10 of the 32 (31.3%) facilities. Only 6.3% of the studied health facilities had good quality in all three dimensions of quality measures that was done in accordance to the national delivery service guidelines. The most compromised quality component was the process. Systematic and sustained efforts need to be strengthened to improve all dimensions of quality in order to achieve the desired quality of delivery services and increase the proportion of births occurring in health facilities.

  1. Women's perceptions of antenatal, delivery, and postpartum services in rural Tanzania

    Directory of Open Access Journals (Sweden)

    Gladys Reuben Mahiti

    2015-10-01

    Full Text Available Background: Maternal health care provision remains a major challenge in developing countries. There is agreement that the provision of quality clinical services is essential if high rates of maternal death are to be reduced. However, despite efforts to improve access to these services, a high number of women in Tanzania do not access them. The aim of this study is to explore women's views about the maternal health services (pregnancy, delivery, and postpartum period that they received at health facilities in order to identify gaps in service provision that may lead to low-quality maternal care and increased risks associated with maternal morbidity and mortality in rural Tanzania. Design: We gathered qualitative data from 15 focus group discussions with women attending a health facility after child birth and transcribed it verbatim. Qualitative content analysis was used for analysis. Results: ‘Three categories emerged that reflected women's perceptions of maternal health care services: “mothers perceive that maternal health services are beneficial,” “barriers to accessing maternal health services” such as availability and use of traditional birth attendants (TBAs and the long distances between some villages, and “ambivalence regarding the quality of maternal health services” reflecting that women had both positive and negative perceptions in relation to quality of health care services offered’. Conclusions: Mothers perceived that maternal health care services are beneficial during pregnancy and delivery, but their awareness of postpartum complications and the role of medical services during that stage were poor. The study revealed an ambivalence regarding the perceived quality of health care services offered, partly due to shortages of material resources. Barriers to accessing maternal health care services, such as the cost of transport and the use of TBAs, were also shown. These findings call for improvement on the services

  2. Characteristics of Indigenous primary health care service delivery models: a systematic scoping review.

    Science.gov (United States)

    Harfield, Stephen G; Davy, Carol; McArthur, Alexa; Munn, Zachary; Brown, Alex; Brown, Ngiare

    2018-01-25

    Indigenous populations have poorer health outcomes compared to their non-Indigenous counterparts. The evolution of Indigenous primary health care services arose from mainstream health services being unable to adequately meet the needs of Indigenous communities and Indigenous peoples often being excluded and marginalised from mainstream health services. Part of the solution has been to establish Indigenous specific primary health care services, for and managed by Indigenous peoples. There are a number of reasons why Indigenous primary health care services are more likely than mainstream services to improve the health of Indigenous communities. Their success is partly due to the fact that they often provide comprehensive programs that incorporate treatment and management, prevention and health promotion, as well as addressing the social determinants of health. However, there are gaps in the evidence base including the characteristics that contribute to the success of Indigenous primary health care services in providing comprehensive primary health care. This systematic scoping review aims to identify the characteristics of Indigenous primary health care service delivery models. This systematic scoping review was led by an Aboriginal researcher, using the Joanna Briggs Institute Scoping Review Methodology. All published peer-reviewed and grey literature indexed in PubMed, EBSCO CINAHL, Embase, Informit, Mednar, and Trove databases from September 1978 to May 2015 were reviewed for inclusion. Studies were included if they describe the characteristics of service delivery models implemented within an Indigenous primary health care service. Sixty-two studies met the inclusion criteria. Data were extracted and then thematically analysed to identify the characteristics of Indigenous PHC service delivery models. Culture was the most prominent characteristic underpinning all of the other seven characteristics which were identified - accessible health services, community

  3. Delivery Practices and Associated Factors among Mothers Seeking Child Welfare Services in Selected Health Facilities in Nyandarua South District, Kenya

    Directory of Open Access Journals (Sweden)

    Wanjira Carol

    2011-05-01

    Full Text Available Abstract Background A measure of the proportion of deliveries assisted by skilled attendants is one of the indicators of progress towards achieving Millennium Development Goal (MDG 5, which aims at improving maternal health. This study aimed at establishing delivery practices and associated factors among mothers seeking child welfare services at selected health facilities in Nyandarua South district, Kenya to determine whether mothers were receiving appropriate delivery care. Methods A hospital-based cross-sectional survey among women who had recently delivered while in the study area was carried out between August and October 2009. Binary Logistic regression was used to identify factors that predicted mothers' delivery practice. Results Among the 409 mothers who participated in the study, 1170 deliveries were reported. Of all the deliveries reported, 51.8% were attended by unskilled birth attendants. Among the deliveries attended by unskilled birth attendants, 38.6% (452/1170 were by neighbors and/or relatives. Traditional Birth Attendants attended 1.5% (17/1170 of the deliveries while in 11.7% (137/1170 of the deliveries were self administered. Mothers who had unskilled birth attendance were more likely to have Conclusion Among the mothers interviewed, utilization of skilled delivery attendance services was still low with a high number of deliveries being attended by unqualified lay persons. There is need to implement cost effective and sustainable measures to improve the quality of maternal health services with an aim of promoting safe delivery and hence reducing maternal mortality.

  4. Exploration of the administrative aspects of the delivery of home health care services: a qualitative study.

    Science.gov (United States)

    Shahsavari, Hooman; Nasrabadi, Alireza Nikbakht; Almasian, Mohammad; Heydari, Heshmatolah; Hazini, Abdolrahim

    2018-01-01

    Because of the variety of services and resources offered in the delivery of home health care, its management is a challenging and difficult task. The purpose of this study was to explore the administrative aspects of the delivery of home health care services. This qualitative study was conducted based on the traditional content analysis approach in 2015 in Iran. The participants were selected using the purposeful sampling method and data were collected through in-depth semi-structured personal interviews and from discussions in a focus group. The collected data were analyzed using the Lundman and Graneheim method. 23 individuals participated in individual interviews, and the collected data were categorized into the two main themes of policymaking and infrastructures, each of which consisted of some subcategories. Health policymakers could utilize the results of this study as baseline information in making decisions about the delivery of home health care services, taking into account the contextual dimensions of home care services, leading to improvements in home health care services.

  5. The Changing Political Undercurrents in Health Services Delivery in Sub-Saharan Africa.

    Science.gov (United States)

    Ichoku, H E; Ifelunini, A I

    2017-07-01

    This article reviews the changing political undercurrent in health service delivery in Sub-Saharan Africa, chronicling the ideological shift in orientation toward neoliberalism in the health sector, an ideology crafted and introduced into Sub-Saharan Africa by the International Monetary Fund and the World Bank. The article examines the implication of this neoliberal reform on the efficiency in health care provision and on the quality and accessibility of health services by the poor and vulnerable. Drawing inference from countries like Nigeria, the authors argue that the ascendency of neoliberalism in the health systems of Sub-Saharan Africa has engendered unethical practices and introduced elements of moral hazard in the health sector, reducing the incentive for governments to develop effective service delivery over the long term. The authors therefore advocate for a rejection of neoliberal ideology in favor of a universal coverage principle if an inclusive health system is to be developed.

  6. Viability of healthcare service delivery alternatives for the Australian mining sector.

    Science.gov (United States)

    Williams, Patricia A H; Giles, Margaret

    2012-01-01

    The changing and demanding nature of the mining workforce in rural and remote Australia brings unique challenges to the delivery of healthcare services. In an attempt to control costs whilst delivering cost effective and quality healthcare, new models of delivery must be considered. For a workforce that is fly-in/fly-out, the provision of healthcare is problematic given the lack of consistency in location. A cost-benefit framework is analysed comparing three models of service provision using travel to a major location, locum services and remote health monitoring. Ultimately, new models of care must be considered to address the issues of increasing workforce turnover, to cater for rising healthcare costs, and to improve the health of such communities.

  7. Can trained lay providers perform HIV testing services? A review of national HIV testing policies.

    Science.gov (United States)

    Flynn, David E; Johnson, Cheryl; Sands, Anita; Wong, Vincent; Figueroa, Carmen; Baggaley, Rachel

    2017-01-04

    Only an estimated 54% of people living with HIV are aware of their status. Despite progress scaling up HIV testing services (HTS), a testing gap remains. Delivery of HTS by lay providers may help close this testing gap, while also increasing uptake and acceptability of HIV testing among key populations and other priority groups. 50 National HIV testing policies were collated from WHO country intelligence databases, contacts and testing program websites. Data regarding lay provider use for HTS was extracted and collated. Our search had no geographical or language restrictions. This data was then compared with reported data from the Global AIDS Response Progress Reporting (GARPR) from July 2015. Forty-two percent of countries permit lay providers to perform HIV testing and 56% permit lay providers to administer pre-and post-test counseling. Comparative analysis with GARPR found that less than half (46%) of reported data from countries were consistent with their corresponding national HIV testing policy. Given the low uptake of lay provider use globally and their proven use in increasing HIV testing, countries should consider revising policies to support lay provider testing using rapid diagnostic tests.

  8. The role of the document delivery service at an evolving research library in Saudi Arabia

    KAUST Repository

    Vijayakumar, J.K.

    2015-01-01

    Design/methodology/approach – To collect the responses of document delivery service users, an online questionnaire was used with 12 multiple-choice questions and two open-ended questions. The questionnaires were sent only to the users of this service, and the responses were collected anonymously. Two surveys were conducted, in 2010 and 2013, with the same questions. The responses are displayed graphically prepared to compare the results. There were 71 responses in 2010 and 95 in 2013. Findings – In both surveys, the majority of users rated the service, staff behaviour, speed, quality, etc. with a high satisfaction level. Document delivery order statistics are a major decision-making tool, in addition to usage analysis, for developing a better, economical and highly utilized collection in brand new libraries. delivery order statistics are a major decision-making tool, in addition to usage analysis, for developing a better, economical and highly utilized collection in brand new libraries. Originality/value – This is the first published study of user perception of document delivery in Saudi Arabia.

  9. Routine Immunization Service Delivery Through the Basic Package of Health Services Program in Afghanistan: Gaps, Challenges, and Opportunities.

    Science.gov (United States)

    Mbaeyi, Chukwuma; Kamawal, Noor Shah; Porter, Kimberly A; Azizi, Adam Khan; Sadaat, Iftekhar; Hadler, Stephen; Ehrhardt, Derek

    2017-07-01

    The Basic Package of Health Services (BPHS) program has increased access to immunization services for children living in rural Afghanistan. However, multiple surveys have indicated persistent immunization coverage gaps. Hence, to identify gaps in implementation, an assessment of the BPHS program was undertaken, with specific focus on the routine immunization (RI) component. A cross-sectional survey was conducted in 2014 on a representative sample drawn from a sampling frame of 1858 BPHS health facilities. Basic descriptive analysis was performed, capturing general characteristics of survey respondents and assessing specific RI components, and χ2 tests were used to evaluate possible differences in service delivery by type of health facility. Of 447 survey respondents, 27% were health subcenters (HSCs), 30% were basic health centers, 32% were comprehensive health centers, and 12% were district hospitals. Eighty-seven percent of all respondents offered RI services, though only 61% of HSCs did so. Compared with other facility types, HSCs were less likely to have adequate stock of vaccines, essential cold-chain equipment, or proper documentation of vaccination activities. There is an urgent need to address manpower and infrastructural deficits in RI service delivery through the BPHS program, especially at the HSC level. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

  10. Service contract of Renault Kerax 440 truck with deductible and policy limit coverage modification

    Science.gov (United States)

    Bustami, Pasaribu, Udjianna. S.; Husniah, Hennie

    2016-02-01

    In this paper we discuss a service contracts with coverage modification that only offer preventive maintenance and corrective maintenance for Renault Kerax 440 Truck by service contract provider. Corrective maintenance costs is modified with deductible and policy limit during the period of the service contract. Demand for a service contract is only influenced by the price of the service contract, deductible, and policy limit offered by producer to consumer. The main problem in this thesis is determining the price of a service contract, deductible, and policy limit to get maximum profit for producer for each of service contract.

  11. Characteristics of Indigenous primary health care models of service delivery: a scoping review protocol.

    Science.gov (United States)

    Harfield, Stephen; Davy, Carol; Kite, Elaine; McArthur, Alexa; Munn, Zachary; Brown, Ngiare; Brown, Alex

    2015-11-01

    The objective of the scoping review is to identify and describe within the existing literature the characteristics (values, principles, components and suggest practical applications) of primary health care models of service delivery for Indigenous people. More specifically, the review question is:What are the characteristics (values, principles, components and suggested practical applications) of primary health care models of service delivery for Indigenous people?Findings from this scoping review will inform two systematic reviews. One of these will explore the acceptability and the other the effectiveness of identified characteristics. The scoping review will follow the JBI Scoping Review methodology as outlined in the 2015 Joanna Briggs Institute Reviewers' Manual. Indigenous populations in colonized countries experience worse health outcomes relative to their non-Indigenous counterparts. In Australia, in the period 2010 to 2012 the estimated gap in life expectancy between Aboriginal and Torres Strait Islander Australians compared to non-Indigenous Australians was 10 years Similar gaps in life expectancy between Indigenous and non-Indigenous have been demonstrated in other countries, such as New Zealand, Canada and the United StatesThe gap in life expectancy and the health disadvantage experienced by Indigenous people is in part the result of mainstream health services not adequately meeting the health needs of Indigenous people and Indigenous people's inability to access mainstream services Part of the solution has been the establishment of primary health care services for and in many cases run by Indigenous people. Indigenous primary health services have been developed to provide culturally appropriate services that meet the needs of local Indigenous communities.In Australia, the first Aboriginal medical service was established in 1971 in Redfern, New South Wales, by "community activists in response to ongoing discrimination against Aboriginal people within

  12. Customer's Perceptions and Intentions on Online Travel Service Delivery: An Empirical Study in China

    Science.gov (United States)

    Li, Hongxiu; Suomi, Reima

    With the wide adoption of e-commerce in travel and tourism industry, the Internet has become an important travel service delivery channel, and traditional travel agency has been under severe disintermediation threat. This paper reports on a survey conducted to explore the Chinese consumer's current usage of the Internet as the channel to search travel information and to book travel services. It also investigates customer's future intentions on using the Internet to book travel services. This paper aims to examine whether there are difference between different consumer segments in terms of gender and age, and to find the hypothesis of disintermediation or intermediation in travel industry. The results indicates that online travel service delivery has grown as a popular direct distribution channel in travel industry, but more of the customers still turn to the traditional travel agencies, which support both the disintermediation and intermediation in travel industry. The results also reveal that online travel services provided by travel service providers still need to be improved since the number of online bookers is declined. This paper concludes by discussing the limitation of this study and highlighting areas for the future research in online travel service field.

  13. Measurement and evaluation of the public administration performance through delivery of electronic services

    Directory of Open Access Journals (Sweden)

    Mirlinda Batalli

    2015-07-01

    Full Text Available The purpose of this paper concerns the relation between delivery of electronic services (e-services and evaluation of public administration performance. Public sector organizations should pay attention and determine the strategies to be followed in order to increase the satisfaction of citizens and businesses in relation to delivery of electronic services. The study aims to review the demands toward progress to the competitiveness, the sustainability, efficiency and effectives in public administration that have rapidly enforced the wide reforms in the public sector, in order to modernize the initiatives to offer better electronic services for the citizens. The article aims to present that the transformation process toward providing electronic services to the citizens should be assessed continuously, in light with challenges, demands and process of globalization, in order to strengthen the capacities of public administration and make it more efficient. In this regard, the regular evaluation and measurement of the public administration performance leads toward the promotion of enhanced public services and higher level of accountability. Through receiving the e-services, citizens can save their time, can reduce the expenses and create an easier access of communication with all levels of the government.

  14. Corruption in the Civil Service: The dearth of effective service delivery

    African Journals Online (AJOL)

    The paper discussed the origin of the Nigerian Civil Service and the consequences of corruption that has crippled the service in the recent times. The paper was of the opinion that today's Civil Service in Nigeria is a carryover of the British imperialist administrative structure. The paper stated that the reasons for the corrupt ...

  15. Mental Health Service Delivery Systems and Perceived Qualifications of Mental Health Service Providers in School Settings

    Science.gov (United States)

    Dixon, Decia Nicole

    2009-01-01

    Latest research on the mental health status of children indicates that schools are key providers of mental health services (U.S. Department of Health and Human Services, 2003). The push for school mental health services has only increased as stakeholders have begun to recognize the significance of sound mental health as an essential part of…

  16. Private Sector in Indian Healthcare Delivery: Consumer Perspective and Government Policies to promote private Sector

    Directory of Open Access Journals (Sweden)

    Utkarsh Shah, Ragini Mohanty

    2011-01-01

    Full Text Available This research paper attempts to collate literature from various sources, in an attempt to answer three pertinent questions related to healthcare in India. Firstly, what is it meant by ‘private sector’ in healthcare delivery system of India, secondly how has the private sector evolved over the decades and what has been the role of the government in propelling the growth. Finally, the paper tries to highlight some of the factors that have promoted the growth of private sector in India with specific reference to quality of medical care. The paper explicitly indicates that the deficiencies in the public health delivery system of India, was the key to growth of private infrastructure in healthcare.The shift of hospital industry for ‘welfare orientation’ to ‘business orientation’ was marked by the advent of corporate hospitals, supported by various policy level initiatives made by the government. Today, there are over 20 international healthcare brands in India with several corporate hospitals.However, a large section of the ‘private healthcare delivery segment’ is scattered and quality of medical care continues to remain a matter of concern. This paper tracks the various government initiatives to promote private investment in healthcare and attempts to explore the reasons for preference of the private sector. Surprisingly, in contrast to contemporary belief, quality of medical care doesn’t seem to be the leading cause for preference of the private sector. Except for a few select corporate and trust hospitals, quality of medical care in private sector seems to be poor and at times compromised.

  17. 49 CFR 1242.76 - Administration; pickup and delivery, marine line haul, and rail substitute service; loading...

    Science.gov (United States)

    2010-10-01

    ... haul, and rail substitute service; loading, unloading and local marine; protective services; freight... SEPARATION OF COMMON OPERATING EXPENSES BETWEEN FREIGHT SERVICE AND PASSENGER SERVICE FOR RAILROADS 1 Operating Expenses-Transportation § 1242.76 Administration; pickup and delivery, marine line haul, and rail...

  18. Data Resources for Conducting Health Services and Policy Research.

    Science.gov (United States)

    Blewett, Lynn A; Call, Kathleen Thiede; Turner, Joanna; Hest, Robert

    2018-04-01

    Rich federal data resources provide essential data inputs for monitoring the health and health care of the US population and are essential for conducting health services policy research. The six household surveys we document in this article cover a broad array of health topics, including health insurance coverage (American Community Survey, Current Population Survey), health conditions and behaviors (National Health Interview Survey, Behavioral Risk Factor Surveillance System), health care utilization and spending (Medical Expenditure Panel Survey), and longitudinal data on public program participation (SIPP). New federal activities are linking federal surveys with administrative data to reduce duplication and response burden. In the private sector, vendors are aggregating data from medical records and claims to enhance our understanding of treatment, quality, and outcomes of medical care. Federal agencies must continue to innovate to meet the continuous challenges of scarce resources, pressures for more granular data, and new multimode data collection methodologies.

  19. Service quality of delivered care from the perception of women with caesarean section and normal delivery.

    Science.gov (United States)

    Tabrizi, Jafar S; Askari, Samira; Fardiazar, Zahra; Koshavar, Hossein; Gholipour, Kamal

    2014-01-01

    Our aim was to determine the service quality of delivered care for people with Caesarean Section and Normal Delivery. A cross-sectional study was conducted among 200 people who had caesarean section and normal delivery in Al-Zahra Teaching Hospital in Tabriz, north western Iran. Service quality was calculated using: Service Quality = 10 - (Importance × Performance) based on importance and performance of service quality aspects from the postpartum women's perspective.A hierarchical regression analysis was applied in two steps using the enter method to examine the associations between demographics and SQ scores. Data were analysed using the SPSS-17 software. "Confidentiality", "autonomy", "choice of care provider" and "communication" achieved scores at the highest level of quality; and "support group", "prompt attention", "prevention and early detection", "continuity of care", "dignity", "safety", "accessibility and "basic amenities" got service quality score less than eight. Statistically significant relationship was found between service quality score and continuity of care (P=0.008). A notable gap between the participants‟ expectations and what they have actually received in most aspects of provided care. So, there is an opportunityto improve the quality of delivered care.

  20. Service Quality of Delivered Care from the Perception of Women with Caesarean Section and Normal Delivery

    Directory of Open Access Journals (Sweden)

    Jafar S. Tabrizi

    2014-12-01

    Full Text Available Background: Our aim was to determine the service quality of delivered care for people with Caesarean Section and Normal Delivery. Methods: A cross-sectional study was conducted among 200 people who had caesarean section and normal delivery in Al-Zahra Teaching Hospital in Tabriz, north western Iran. Service quality was calculated using: Service Quality = 10 – (Importance × Performance based on importance and performance of service quality aspects from the postpartum women‟s perspective.A hierarchical regression analysis was applied in two steps using the enter method to examine the associations between demographics and SQ scores. Data were analysed using the SPSS-17 software. Results: “Confidentiality”, “autonomy”, “choice of care provider” and “communication” achieved scores at the highest level of quality; and “support group”, “prompt attention”, “prevention and early detection”, “continuity of care”, “dignity”, “safety”, “accessibility and “basic amenities” got service quality score less than eight. Statistically significant relationship was found between service quality score and continuity of care (P=0.008. Conclusion: A notable gap between the participants‟ expectations and what they have actually received in most aspects of provided care. So, there is an opportunityto improve the quality of delivered care.

  1. Economic regulation of Canada's natural gas delivery industry : policy and regulatory principles

    International Nuclear Information System (INIS)

    Gormley, B.

    2006-03-01

    This policy paper demonstrated how restoring balance and clarity to Canada's regulatory environment will ensure the continued strength of the economy, environment, and communities. It was noted that regulatory outcomes that reflect the broad public interest can be achieved if 4 basic principles for economic regulation are pursued. These principles include strength, balance, efficiency, and clarity. In particular, this paper addressed the challenge facing Canada's natural gas delivery industry in terms of increased energy demand, tight supply, ageing infrastructure and increasing cost pressures on the energy system. It emphasized that transparent, efficient energy policy developed through informed debate can provide the foundation for a reliable, environmentally acceptable and sustainable energy future. It was suggested that immediate attention be given to rebalancing the regulatory processes that have placed short term considerations above the longer term strength of the natural gas system; improving the support for new natural gas supply development; reconsidering pricing in some energy markets where information has been distorted; and revisiting the regulatory processes that have become inefficient

  2. Leadership styles of service professionals aiding women of abuse: enhancing service delivery.

    Science.gov (United States)

    Haeseler, Lisa Ann

    2013-01-01

    Leadership styles of service professionals--including social workers and teachers--in the area of family abuse were investigated. Leadership characteristics of the professionals were measured by their responses to a survey. Results indicated that the interviewed service professionals demonstrated productive leadership traits. Study findings are congruent with leadership styles described in the research. Holistic and collaborative services are required to enhance care for women of abuse, as their needs are multifaceted and complex. Specific leadership styles promote better care for women; leaders need to collaboratively initiate and deliver more interdisciplinary and unified service.

  3. Analysis of the project parameters of the fixed price projects in the IT services delivery organization

    Directory of Open Access Journals (Sweden)

    Miroslav Kral

    2012-04-01

    Full Text Available The success rate of IS/IT projects is low. Thus, in response, a large variety of methods and approaches to managing IS/IT projects has been developed over the years. The purpose of this paper is to analyse the relationships between the project parameters of fixed-price projects that take place within an IT service delivery organization. There is some evidence that simply using traditional project parameters (such as project duration, costs, reserves, and so on isn't enough to increase the success of projects; rather, new approaches and methods, including our applied systems approach, should also be considered. This paper aims to highlight issues from the perspective of an IT services delivery organization from the CEE region. The output of the paper should be a contribution to the project management of IS/IT projects and to systems research, as well.

  4. Impact of Access to Online Databases on Document Delivery Services within Iranian Academic Libraries

    Directory of Open Access Journals (Sweden)

    Zohreh Zahedi

    2007-04-01

    Full Text Available The present study investigates the impact of access to online databases on the document delivery services in Iranian Academic Libraries, within the framework of factors such as number of orders lodged over the years studied and their trends, expenditures made by each university, especially those universities and groups that had the highest number of orders. This investigation was carried out through a survey and by calling on the library document supply unit in universities as well as in-person interview with librarians in charge. The study sample was confined to the universities of Shiraz, Tehran and Tarbiyat Modaress along with their faculties. Findings indicate that the rate of document requests in various universities depends on the target audience, capabilities, students’ familiarity as well as mode of document delivery services..

  5. Constraints in animal health service delivery and sustainable improvement alternatives in North Gondar, Ethiopia

    Directory of Open Access Journals (Sweden)

    Hassen Kebede

    2014-11-01

    Full Text Available Poor livestock health services remain one of the main constraints to livestock production in many developing countries, including Ethiopia. A study was carried out in 11 districts of North Gondar, from December 2011 to September 2012, with the objective of identifying the existing status and constraints of animal health service delivery, and thus recommending possible alternatives for its sustainable improvement. Data were collected by using pre-tested questionnaires and focus group discussion. Findings revealed that 46.34% of the responding farmers had taken their animals to government veterinary clinics after initially trying treatments with local medication. More than 90.00% of the clinical cases were diagnosed solely on clinical signs or even history alone. The antibacterial drugs found in veterinary clinics were procaine penicillin (with or without streptomycin, oxytetracycline and sulphonamides, whilst albendazole, tetramisole and ivermectin were the only anthelmintics. A thermometer was the only clinical aid available in all clinics, whilst only nine (45.00% clinics had a refrigerator. In the private sector, almost 95.00% were retail veterinary pharmacies and only 41.20% fulfilled the requirement criteria set. Professionals working in the government indicated the following problems: lack of incentives (70.00%, poor management and lack of awareness (60.00% and inadequate budget (40.00%. For farmers, the most frequent problems were failure of private practitioners to adhere to ethical procedures (74.00% and lack of knowledge of animal diseases and physical distance from the service centre (50.00%. Of all responding farmers, 58.54% preferred the government service, 21.14% liked both services equally and 20.33% preferred the private service. Farmers’ indiscriminate use of drugs from the black market (23.00% was also mentioned as a problem by private practitioners. Sustainable improvement of animal health service delivery needs increased

  6. Constraints in animal health service delivery and sustainable improvement alternatives in North Gondar, Ethiopia.

    Science.gov (United States)

    Kebede, Hassen; Melaku, Achenef; Kebede, Elias

    2014-11-12

    Poor livestock health services remain one of the main constraints to livestock production in many developing countries, including Ethiopia. A study was carried out in 11 districts of North Gondar, from December 2011 to September 2012, with the objective of identifying the existing status and constraints of animal health service delivery, and thus recommending possible alternatives for its sustainable improvement. Data were collected by using pre-tested questionnaires and focus group discussion. Findings revealed that 46.34% of the responding farmers had taken their animals to government veterinary clinics after initially trying treatments with local medication. More than 90.00% of the clinical cases were diagnosed solely on clinical signs or even history alone. The antibacterial drugs found in veterinary clinics were procaine penicillin (with or without streptomycin), oxytetracycline and sulphonamides, whilst albendazole, tetramisole and ivermectin were the only anthelmintics. A thermometer was the only clinical aid available in all clinics, whilst only nine (45.00%) clinics had a refrigerator. In the private sector, almost 95.00% were retail veterinary pharmacies and only 41.20% fulfilled the requirement criteria set. Professionals working in the government indicated the following problems: lack of incentives (70.00%), poor management and lack of awareness (60.00%) and inadequate budget (40.00%). For farmers, the most frequent problems were failure of private practitioners to adhere to ethical procedures (74.00%) and lack of knowledge of animal diseases and physical distance from the service centre (50.00%). Of all responding farmers, 58.54% preferred the government service, 21.14% liked both services equally and 20.33% preferred the private service. Farmers' indiscriminate use of drugs from the black market (23.00%) was also mentioned as a problem by private practitioners. Sustainable improvement of animal health service delivery needs increased awareness for all

  7. ASSESSMENT OF E-COMMERCE USAGE FOR EFFECTIVE SERVICE DELIVERY IN NIGERIA BANKING SECTOR

    OpenAIRE

    Soneye Gbolade Michael

    2017-01-01

    This study assessed the extent of e-commerce usage for effective service delivery in Nigeria banking sector. Four research questions and four null hypotheses guided the study. Descriptive survey research design was adopted for the study. The study covered 64 microfinance banks in Oyo State, South-West, Nigeria. The population was made up of 1275 staffs from the 64 microfinance banks. The sample size consisted of 28 microfinance banks of which 280 staffs were purposively selected. A 28-item st...

  8. Access-technology agnostic delivery platform for ICT4D services

    CSIR Research Space (South Africa)

    Makitla, I

    2012-10-01

    Full Text Available .kashan.co.za] CONTEXT Capitalising on target resource-constrained rural communities? technological capabilities can be considered a critical consideration when delivering Information and Communication Technology for Development (ICT4D) content and services... to these communities. The core approach of this research project, which is informed by the concept of ?digital difference?[1], is to leverage the existing technological infrastructure and capacity (know-how) in a community to enable delivery of ICT4D content...

  9. Customer satisfaction of mobile telecommunication networks in Ghana: service delivery perspective

    OpenAIRE

    A.R. ABDUL-AZIZ; Bashiru I.I. SAEED; Ayogyam ALEXANDER

    2014-01-01

    Organizations, both private and public, in today’s dynamic marketplaces are increasingly leaving antiquated marketing philosophies and strategies to the adoption of more customer driven initiatives that seek to understand, attract, retain and build intimate long term relationship with profitable customers. This article analyzed customer satisfaction with the service delivery of mobile telecommunication networks in Ghana using a binary logistic regression model. Primary data was collected thro...

  10. Stuttering Intervention in Three Service Delivery Models (Direct, Hybrid, and Telepractice): Two Case Studies

    OpenAIRE

    VALENTINE, DANIEL T.

    2015-01-01

    This study assessed outcomes in stuttering intervention across three service delivery models: direct, hybrid, and telepractice for two 11-year old children who stutter. The goal of the study was to investigate whether short-term goals were maintained through the telepractice sessions. The Stuttering Severity Instrument, Fourth Edition (SSI-4) was administered to each child before and after each intervention period and weekly fluency samples (percentage of stuttered syllables in a monologue) w...

  11. Organisation and delivery of imaging services: The contributions of ethics and political economy

    International Nuclear Information System (INIS)

    Durand-Zaleski, I.

    2009-01-01

    The objective of this discussion is to explore how theories from other disciplines can contribute to the debate on organisation and delivery of diagnostic and therapeutic exposures. The first part explores how theories of justice suggest that health services should be provided; the second part explores how stakeholders in the field of public health and health care incorporate their own strategies in the deployment of health technologies and health-care programmes. (authors)

  12. Vocal effectiveness of speech-language pathology students: Before and after voice use during service delivery

    OpenAIRE

    Couch, Stephanie; Zieba, Dominique; van der Linde, Jeannie; van der Merwe, Anita

    2015-01-01

    Background: As a professional voice user, it is imperative that a speech-language pathologist’s(SLP) vocal effectiveness remain consistent throughout the day. Many factors may contribute to reduced vocal effectiveness, including prolonged voice use, vocally abusive behaviours,poor vocal hygiene and environmental factors. Objectives: To determine the effect of service delivery on the perceptual and acoustic features of voice. Method: A quasi-experimental., pre-test–post-test research de...

  13. Quasi-Markets and Service Delivery Flexibility Following a Decade of Employment Assistance Reform in Australia

    DEFF Research Database (Denmark)

    Considine, Mark; Lewis, Jenny; O’Sullivan, S

    2011-01-01

    In 1998, we were witnessing major changes in frontline social service delivery across the OECD and this was theorised as the emergence of a post-Fordist welfare state. Changes in public management thinking, known as New Public Management (NPM), informed this shift, as did public choice theory. A ...... of flexibility so often identified as a desirable outcome of reform. Rather, agencies adopted more conservative practices over time in response to more detailed external regulation and more exacting internal business methods....

  14. The Effect of Product Quality and Delivery Service on Online-customer Satisfaction in Zalora Indonesia

    OpenAIRE

    Handoko, Laras Putri

    2016-01-01

    The number of online transaction in Indonesia has increased in recent years with fashion products currently dominate the e-commerce market as the most frequently purchased products. The aims of this study are to analyze the effects of product quality and delivery service on online-customer satisfaction withdrawing taking online fashion retailer Zalora Indonesia as its research object. This research is causal type of research which uses primary data obtained through questionnaires and uses Mul...

  15. Governance and Public Sector Transformation in South Africa: Reporting and Providing Assurance on Service Delivery Information

    OpenAIRE

    Mariaan Roos

    2012-01-01

    Reporting on performance was legislatively established in South Africa in terms of the Public Finance Management Act, Act 1 of 1999, section 40 (3)(a). The auditing of the reported information was legislated in the Public Audit Act, Act 25 of 2004, section 20(2) (c). The objectives of the article are firstly to provide an overview of the development and application of the reporting and secondly providing assurance on service delivery information and thirdly to reflect on challenges to the imp...

  16. Ante natal care services utilization, delivery practices and factors affecting them in tribal area of North Maharashtra

    Directory of Open Access Journals (Sweden)

    Sachin S Mumbare

    2011-01-01

    Full Text Available Background: Utilization of Ante natal care (ANC services is poor in the tribal areas, causing increased maternal morbidity and mortality. Objective: This study was carried out to find out ANC services utilization, delivery practices and factors affecting them in a tribal area of North Maharashtra in Nashik district. Design: Cross-sectional study. Materials and Methods: The study was carried out in two tribal blocks of Nashik district. Cluster sampling technique was used. 210 mothers in the selected clusters, who had delivered within last 1 year, were interviewed. Information about the ANC services utilization and place of delivery was recorded. Relevant socio-demographic data were also collected. Results: Adequate ANC services utilization was found to be 64.76%. Home deliveries were 34.29% and home deliveries conducted by untrained persons were 15.24%. Conclusion: The utilization of ANC services and deliveries at health centers were significantly associated with education of the women and their spouses, and the socioeconomic status of the family. Main reasons for inadequate utilization of ANC services were financial, unawareness about ANC services, etc. Place of delivery was associated with the type of the family. Traditional practices were the most common reason for conducting the deliveries at home.

  17. Alternate service delivery models in cancer genetic counseling: a mini-review

    Directory of Open Access Journals (Sweden)

    Adam Hudson Buchanan

    2016-05-01

    Full Text Available Demand for cancer genetic counseling has grown rapidly in recent years as germline genomic information has become increasingly incorporated into cancer care and the field has entered the public consciousness through high-profile celebrity publications. Increased demand and existing variability in the availability of trained cancer genetics clinicians place a priority on developing and evaluating alternate service delivery models for genetic counseling. This mini-review summarizes the state of science regarding service delivery models such as telephone counseling, telegenetics and group counseling. Research on comparative effectiveness of these models in traditional individual, in-person genetic counseling has been promising for improving access to care in a manner acceptable to patients. Yet, it has not fully evaluated the short- and long-term patient- and system-level outcomes that will help answer the question of whether these models achieve the same beneficial psychosocial and behavioral outcomes as traditional cancer genetic counseling. We propose a research agenda focused on comparative effectiveness of available service delivery models and how to match models to patients and practice settings. Only through this rigorous research can clinicians and systems find the optimal balance of clinical quality, ready and secure access to care, and financial sustainability. Such research will be integral to achieving the promise of genomic medicine in oncology.

  18. Corporate municipal governance for effective and efficient public service delivery in South Africa.

    Directory of Open Access Journals (Sweden)

    Paulin Mbecke

    2014-10-01

    Full Text Available This research acknowledges the current service delivery chaos manifested through numerous protests justifying the weakness of the “Batho Pele” good governance principles to facilitate, improve and sustain service delivery by local governments. The success of corporate governance in corporate companies and state owned enterprises is recognised prompting suggestions that local governments should too adopt corporate governance principles or King III to be effective. The research reviews the King III and literature to ascertain the lack of research on corporate governance in local governments in South Africa. Considering the particular set-up of local governments, the research doubts the successful application of King III in local governments. Through critical research theory, the current service delivery crisis in local governments in South Africa is described. The success of corporate governance systems in the United Kingdom and Australian local governments justify the need for a separate corporate municipal governance system as a solution to the crisis. A specific change of legislation and corporate governance guidelines is necessary to address the uniqueness of local governments. Hence, corporate municipal governance should be compulsory and based on ten standardised good governance principles via a code of corporate governance and a corporate governance framework responding to specific prerequisites for success

  19. Privatization of Electricity Service Delivery in Developing Nations: Issues and Challenges

    Directory of Open Access Journals (Sweden)

    Olamide Eniola Victor

    2015-09-01

    Full Text Available The provision of public utilities and infrastructures particularly electricity by the public sector (Government especially in the Developing Nations has been heavily criticized. This has been attributed to many reasons including poor electricity supply, poor distribution of service delivery of electricity due to the absence of spatial planning, insufficient government investment into the power industry, ineptitude operation on the part of the technicians, poor administration and managerial control. However, efforts to move away from government ownership, control or participation in this sector of economy towards free enterprise and increased inclusive private sector participation known as privatization, has been adopted as one of the solutions. This paper presents a critical review of privatization practices of alternative Service Delivery approach of selected Asian and African nations. The paper would elicit the common variants of privatization models adopted by these nations and the different implementation strategies which resulted in divergence in effectiveness and efficiency in the service delivery of electricity. The selected Asian countries are; Malaysia, India, and China, while the selected African nations are Nigeria, Cameroun and South Africa. The paper will draw from the literatures the various approaches, concepts adopted, practices, issues and challenges faced by these countries.

  20. Coherent detection passive optical access network enabling converged delivery of broadcast and dedicated broadband services

    DEFF Research Database (Denmark)

    Osadchiy, Alexey Vladimirovich; Prince, Kamau; Guerrero Gonzalez, Neil

    2011-01-01

    We propose a passive optical network architecture based on coherent detection for converged delivery of broadcast services from a dedicated remote broadcast server and user-specific services from a local central office. We experimentally demonstrate this architecture with mixed traffic types....... The broadcast channels were transmitted over 78 km of single mode fiber to a central office where they were multiplexed with the unicast channels for further fiber transmission over 34-km to reach the access network. Successful detection of all channels is demonstrated....

  1. A Framework for Describing the Influence of Service Organisation and Delivery on Participation in Fetal Anomaly Screening in England

    Directory of Open Access Journals (Sweden)

    Hyacinth O. Ukuhor

    2017-01-01

    Full Text Available Objective. The aim of this research was to explore the influence of service organisation and delivery on providers and users’ interactions and decision-making in the context of Down’s syndrome screening. Methods. A qualitative descriptive study involving online interviews conducted with a purposive sample of 34 community midwives, 35 pregnant women, and 15 partners from two maternity services in different health districts in England. Data were analysed using a combination of grounded theory principles and content analysis and a framework was developed. Results. The main emerging concepts were organisational constraints, power, routinisation, and tensions. Providers were concerned about being time-limited that encouraged routine, minimal information-giving and lacked skills to check users’ understanding. Users reported their participation was influenced by providers’ attitudes, the ambience of the environment, asymmetric power relations, and the offer and perception of screening as a routine test. Discordance between the national programme’s policy of nondirective informed choice and providers’ actions of recommending and arranging screening appointments was unexpected. Additionally, providers and users differing perceptions of emotional effects of information, beliefs, and expectations created tensions within them, between them, and in the antenatal environment. Conclusions. A move towards a social model of care may be beneficial to empower service users and create less tension for providers and users.

  2. Profile of pregnant women using delivery hut services of the Ballabgarh Health and Demographic Surveillance System in rural north India.

    Science.gov (United States)

    Kant, Shashi; Haldar, Partha; Singh, Arvind K; Archana, S; Misra, Puneet; Rai, Sanjay

    2016-08-01

    To describe women who attended two delivery huts in rural Haryana, India. The present observational study assessed routinely collected service provision data from two delivery huts located at primary health centers in the district of Faridabad. Data on sociodemographic characteristics, prenatal care, use of free transport services, and maternal and neonatal indicators at delivery were assessed for all pregnant women who used the delivery hut services from January 2012 to June 2014. During the study period, 1796 deliveries occurred at the delivery huts. The mean age of the mothers was 23.3 ± 3.3 years (95% confidence interval 23.1-23.5). Of 1648 mothers for whom data were available, 1039 (63.0%) had travelled less than 5 km to the delivery hut. The proportion of mothers who belonged to a lower caste increased from 31.0% (193/622) in 2012 to 41.1% (162/394) in 2014. The proportion of mothers who were illiterate also increased, from 8.1% (53/651) in 2012 to 26.4% (104/394) in 2014. Belonging to a disadvantaged social group (in terms of caste or education) was not an obstacle to use of delivery hut services. The delivery huts might have satisfied some unmet needs of community members in rural India. Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  3. Efficacy of a process improvement intervention on delivery of HIV services to offenders: a multisite trial.

    Science.gov (United States)

    Pearson, Frank S; Shafer, Michael S; Dembo, Richard; Del Mar Vega-Debién, Graciela; Pankow, Jennifer; Duvall, Jamieson L; Belenko, Steven; Frisman, Linda K; Visher, Christy A; Pich, Michele; Patterson, Yvonne

    2014-12-01

    We tested a modified Network for the Improvement of Addiction Treatment (NIATx) process improvement model to implement improved HIV services (prevention, testing, and linkage to treatment) for offenders under correctional supervision. As part of the Criminal Justice Drug Abuse Treatment Studies, Phase 2, the HIV Services and Treatment Implementation in Corrections study conducted 14 cluster-randomized trials in 2011 to 2013 at 9 US sites, where one correctional facility received training in HIV services and coaching in a modified NIATx model and the other received only HIV training. The outcome measure was the odds of successful delivery of an HIV service. The results were significant at the .05 level, and the point estimate for the odds ratio was 2.14. Although overall the results were heterogeneous, the experiments that focused on implementing HIV prevention interventions had a 95% confidence interval that exceeded the no-difference point. Our results demonstrate that a modified NIATx process improvement model can effectively implement improved rates of delivery of some types of HIV services in correctional environments.

  4. Interim policy on establishment and operation of internet open, anonymous information servers and services

    OpenAIRE

    Acting Dean of Computer and Information Services

    1995-01-01

    Purpose. To establish interim NPS general policy regarding establishment and operation of Open, Anonymous Information Servers and Services, such as World Wide Web (http), Gopher, Anonymous FTP, etc...

  5. Improving consistency and quality of service delivery: implications for the addiction treatment field.

    Science.gov (United States)

    Knott, Anne Marie; Corredoira, Rafael; Kimberly, John

    2008-09-01

    Addiction treatment providers face serious problems in delivering consistent, high-quality services over time. Among those providers with multiple treatment sites, there is also intersite variability. This is a serious problem in the addiction field, likely to be made worse as new technologies are introduced and/or as there is industry consolidation (Corredoira, R., Kimberly, J. (2006) Industry evolution through consolidation: Implications for addiction treatment. Journal of Substance Abuse Treatment 31, 255-265.). Although serious, these problems in managing and monitoring to assure consistent service quality have been faced by many other industries. Here, we review evidence from research in other industries regarding three different forms of management (vertical integration, franchising, and licensing) across a chain of individual service providers. We show how each management form affects the level, consistency, and improvement of service delivery over time. In addition, we discuss how such performance advantages affect customer demand as well as regulatory endorsement of the consolidated firm and its approach.

  6. Delivery of crop pollination services is an insufficient argument for wild pollinator conservation

    Science.gov (United States)

    Kleijn, David; Winfree, Rachael; Bartomeus, Ignasi; Carvalheiro, Luísa G; Henry, Mickaël; Isaacs, Rufus; Klein, Alexandra-Maria; Kremen, Claire; M'Gonigle, Leithen K; Rader, Romina; Ricketts, Taylor H; Williams, Neal M; Lee Adamson, Nancy; Ascher, John S; Báldi, András; Batáry, Péter; Benjamin, Faye; Biesmeijer, Jacobus C; Blitzer, Eleanor J; Bommarco, Riccardo; Brand, Mariëtte R; Bretagnolle, Vincent; Button, Lindsey; Cariveau, Daniel P; Chifflet, Rémy; Colville, Jonathan F; Danforth, Bryan N; Elle, Elizabeth; Garratt, Michael P.D.; Herzog, Felix; Holzschuh, Andrea; Howlett, Brad G; Jauker, Frank; Jha, Shalene; Knop, Eva; Krewenka, Kristin M; Le Féon, Violette; Mandelik, Yael; May, Emily A; Park, Mia G; Pisanty, Gideon; Reemer, Menno; Riedinger, Verena; Rollin, Orianne; Rundlöf, Maj; Sardiñas, Hillary S; Scheper, Jeroen; Sciligo, Amber R; Smith, Henrik G; Steffan-Dewenter, Ingolf; Thorp, Robbin; Tscharntke, Teja; Verhulst, Jort; Viana, Blandina F; Vaissière, Bernard E; Veldtman, Ruan; Westphal, Catrin; Potts, Simon G

    2015-01-01

    There is compelling evidence that more diverse ecosystems deliver greater benefits to people, and these ecosystem services have become a key argument for biodiversity conservation. However, it is unclear how much biodiversity is needed to deliver ecosystem services in a cost-effective way. Here we show that, while the contribution of wild bees to crop production is significant, service delivery is restricted to a limited subset of all known bee species. Across crops, years and biogeographical regions, crop-visiting wild bee communities are dominated by a small number of common species, and threatened species are rarely observed on crops. Dominant crop pollinators persist under agricultural expansion and many are easily enhanced by simple conservation measures, suggesting that cost-effective management strategies to promote crop pollination should target a different set of species than management strategies to promote threatened bees. Conserving the biological diversity of bees therefore requires more than just ecosystem-service-based arguments. PMID:26079893

  7. Limits to Decentralization in Mozambique: Leadership, Politics and Local Government Capacities for Service Delivery

    NARCIS (Netherlands)

    A.P.J. Machohe (Antonio)

    2011-01-01

    textabstractMozambique has been a centralized State since its independence in 1975. During this time, local government has depended on the Central Government and has lacked autonomy in both local policy decisions and resource management in addition to the complete failure of effective local services

  8. Inequality in the use of maternal and child health services in the Philippines: do pro-poor health policies result in more equitable use of services?

    Science.gov (United States)

    Paredes, Karlo Paolo P

    2016-11-10

    The Philippines failed to achieve its Millennium Development Goal (MDG) commitment to reduce maternal deaths by three quarters. This, together with the recently launched Sustainable Development Goals (SDGs), reinforces the need for the country to keep up in improving reach of maternal and child health (MCH) services. Inequitable use of health services is a risk factor for the differences in health outcomes across socio-economic groups. This study aims to explore the extent of inequities in the use of MCH services in the Philippines after pro-poor national health policy reforms. This paper uses data from the 2008 and 2013 Demographic and Health Survey (DHS) in the Philippines. Socio-economic inequality in MCH services use was measured using the concentration index. The concentration index was also decomposed in order to examine the contribution of different factors to the inequalities in the use of MCH services. In absolute figures, women who delivered in facilities increased from 2008 to 2013. Little change was noted for women who received complete antenatal care and caesarean births. Facility deliveries remain pro-rich although a pro-poor shift was noted. Women who received complete antenatal care services also remain concentrated to the rich. Further, there is a highly pro-rich inequality in caesarean deliveries which did not change much from 2008 to 2013. Household income remains as the most important contributor to the resulting inequalities in health services use, followed by maternal education. For complete antenatal care use and deliveries in government facilities, regional differences also showed to have important contribution. The findings suggest inequality in the use of MCH services had limited pro-poor improvements. Household income remains to be the major driver of inequities in MCH services use in the Philippines. This is despite the recent national government-led subsidy for the health insurance of the poor. The highly pro-rich caesarean deliveries

  9. Investigation of the mediating effects of IT governance-value delivery on service quality and ERP performance

    Science.gov (United States)

    Tsai, Wen-Hsien; Chou, Yu-Wei; Leu, Jun-Der; Chao Chen, Der; Tsaur, Tsen-Shu

    2015-02-01

    This study aimed to explore the mediating effects of IT governance (ITG)-value delivery in the relationships among the quality of vendor service, the quality of consultant services, ITG-value delivery and enterprise resource planning (ERP) performance. The sampling of this research was acquired from a questionnaire survey concerning ERP implementations in Taiwan. In this survey, 4366 questionnaires were sent to manufacturing and service companies listed in the TOP 5000: The Largest Corporations in Taiwan 2009. The results showed that an ERP system will exhibit a decreased error rate and improved performance if ERP system vendors and consultants provide good service quality. The results also demonstrated that significant relationships exist among the quality of vendor service, the quality of consultant services and value delivery. The contribution of this article is twofold. First, it found that value delivery provides an effective measure of ERP performance under an ITG framework. Second, it provides evidence of the partial mediating effects of value delivery between service quality and ERP performance. In other words, if enterprises want to improve ERP performance, they need to consider factors such as value delivery and the quality of a vendor/consultant's service.

  10. Proposal of a service delivery integration index of home care for older persons: application in several European cities

    Directory of Open Access Journals (Sweden)

    Jean-Claude Henrard

    2006-07-01

    Full Text Available Purpose: To propose an integration index of home care delivery to older persons, to study its validity and to apply it to home care services of European cities. Theory: Home care delivery integration was based on two dimensions referring to process-centred integration and organisational structure approach. Method: Items considered as part of both dimensions according to an expert consensus (face validity were extracted from a standardised questionnaire used in “Aged in Home care” (AdHoc study to capture basic characteristics of home care services. Their summation leads to a services' delivery integration index. This index was applied to AdHoc services. A factor analysis was computed in order to empirically test the validity of the theoretical constructs. The plot of the settings was performed. Results: Application of the index ranks home care services in four groups according to their score. Factor analysis identifies a first factor which opposes working arrangement within service to organisational structure bringing together provisions for social care. A second factor corresponds to basic nursing care and therapies. Internal consistency for those three domains ranges from 0.78 to 0.93. When plotting the different settings different models of service delivery appear. Conclusion: The proposed index shows that behind a total score several models of care delivery are hidden. Comparison of service delivery integration should take into account this heterogeneity.

  11. Tax administration as health policy: hospitals, the Internal Revenue Service, and the courts.

    Science.gov (United States)

    Fox, D M; Schaffer, D C

    1991-01-01

    Since 1969 federal tax policy has permitted nonprofit hospitals to turn away indigent patients or to transfer them to public hospitals. The Internal Revenue Service made health policy, but its officials remain convinced that they were not making policy at all. Convinced that it was reasoning from legal principles, the Revenue Service accepted the hospital industry's view of the history and purpose of hospitals. The federal courts further obscured the problem. Moreover, the Revenue Service took no interest in the effects of its ruling on the services provided by tax-exempt hospitals until 1989. We describe these events and seek to explain them by linking the recent history of health policy to the assumptions that govern the making of tax policy. We conclude that the making of health policy by tax officials who are not accountable for it and who believe that they are not making policy at all is not in the public interest.

  12. 78 FR 49445 - Wildlife Services Policy on Wildlife Damage Management in Urban Areas

    Science.gov (United States)

    2013-08-14

    ... Health Inspection Service's Wildlife Services (APHIS-WS) program is making a policy decision on how to... this definition. Otherwise, APHIS will refer all requests for operational assistance with urban rodent...

  13. An African account of ecosystem service provision: Use, threats and policy options for sustainable livelihoods

    CSIR Research Space (South Africa)

    Egoh, Benis N

    2012-12-01

    Full Text Available -1 Ecosystem Services December 2012/ Vol. 2 An African account of ecosystem service provision: Use, threats and policy options for sustainable livelihoods Benis N. Egoh a, , , , Patrick J. O'Farrellb, Aymen Charefa, Leigh Josephine Gurney a...

  14. Big Data in Action for Government : Big Data Innovation in Public Services, Policy, and Engagement

    OpenAIRE

    World Bank

    2017-01-01

    Governments have an opportunity to harness big data solutions to improve productivity, performance and innovation in service delivery and policymaking processes. In developing countries, governments have an opportunity to adopt big data solutions and leapfrog traditional administrative approaches

  15. The value of express delivery services for cross-border e-commerce in European Union markets

    OpenAIRE

    Kim, Thai Young; Dekker, Rommert; Heij, Christiaan

    2016-01-01

    textabstractFurther growth of cross-border e-commerce in the European Union markets requires improved express delivery services. The framework presented in this paper identifies relevant contextual factors that affect express delivery adoption rates in European cross-border e-commerce. This framework leads to a set of hypotheses, both on the effects of express deliveries on financial performance indicators (order incidence, order size, and repurchase rate) and on the factors that drive demand...

  16. Change Best: Task 2.3. Analysis of policy mix and development of Energy Efficiency Services

    International Nuclear Information System (INIS)

    Boonekamp, P.; Vethman, P.

    2010-04-01

    The aim of the Change Best project is to promote the development of an energy efficiency service (EES) market and to give good practice examples of changes in energy service business, strategies, and supportive policies and measures in the course of the implementation of Directive 2006/32/EC on Energy End-Use Efficiency and Energy Services. This report addresses task 2.3: Analysis of policy mix and development of Energy Efficiency Services.

  17. Distributor pricing approaches enabled in Smart Grid to differentiate delivery service quality

    Directory of Open Access Journals (Sweden)

    Zhongwei Jake Zhang

    2014-12-01

    Full Text Available Industry practitioners who advocate retail competition and Demand-side Participation now look for approaches to link both initiatives through distributor pricing. As distributors incrementally convert more traditional assets into Smart Grid assets, they also need to consider different pricing approaches to recover the investment costs and meet the regulatory business requirements. Small electricity consumers need incentives to take part in these initiatives but their delivery service quality should also be closely guarded. Hence this paper addresses the above needs as a whole and investigates a set of distributor pricing approaches with Smart Grid technologies. Pricing of network and non-network based solutions should follow the incremental basis, such as the long run average incremental cost (LRAIC. The benefit of deferring network investment is calculated and should be passed to consumers as peak pricing rebate. A concept of reliability premium (RP based on load point reliability index is proposed, through which customers can express their preference of service quality and adjust their network tariff payment accordingly. A service delivery model is also proposed to utilize the savings from wholesale market trading to compensate for the downgraded service when loads are controlled. The IEEE 123-node distribution test feeder and the IEEE distribution system for RBTS Bus No. 2 are simulated, and solved using General Algebraic Modeling System (GAMS to demonstrate the proposed distributor pricing approaches in Smart Grid.

  18. Pharmacist and physician perspectives on diabetes service delivery within community pharmacies in Indonesia: a qualitative study.

    Science.gov (United States)

    Wibowo, Yosi; Sunderland, Bruce; Hughes, Jeffery

    2016-05-01

    To explore perspectives of physicians and pharmacists on diabetes service delivery within community pharmacies in Indonesia. In depth interviews were conducted with 10 physicians and 10 community pharmacists in Surabaya, Indonesia, using a semi-structured interview guide. Nvivo version 9 was used to facilitate thematic content analysis to identify barriers/facilitators for community pharmacists to provide diabetes services. The identified themes indicating barriers/facilitators for diabetes service delivery within Indonesian community pharmacies included: (1) pharmacist factors - i.e. positive views (facilitator) and perceived lack of competence (barrier); (2) pharmacist-physician relationships - i.e. physicians' lack of support and accessibility (barriers); (3) pharmacist-patient relationships - i.e. perceived patients' lack of support and accessibility (barriers); (4) pharmacy environment - i.e. business orientation (barrier), lack of staff and poor pharmacist availability (barriers), and availability of supporting resources, such as counselling areas/rooms, procedures/protocols and IT systems for labelling and patient records (facilitators); and (5) external environment - i.e. a health system to support pharmacist roles, remuneration, marketing and professional assistance (facilitators). Issues related to the pharmacist-physician-patient relationships, pharmacy environment and external environment need to be addressed before Indonesian community pharmacists can provide additional pharmacy services for type 2 diabetes patients. Collaboration between the Government, Ikatan Apoteker Indonesia (Indonesian Pharmacists Association) and Ikatan Dokter Indonesia (Indonesian Medical Association) is required to improve the pharmacy professional environment and facilities. © 2015 Royal Pharmaceutical Society.

  19. Proposal of a service delivery integration index of home care for older persons: application in several European cities.

    NARCIS (Netherlands)

    Henrard, J.C.; Ankri, J.; Frijters, D.; Carpenter, I.; Topinkova, E.; Garms-Homolova, V.; Finne-Soveri, H.; Wergeland Sorbye, L.; Jonsson, P.V.; Ljunggren, G.; Schroll, M.; Wagner, C.; Bernabei, R.

    2006-01-01

    PURPOSE: To propose an integration index of home care delivery to older persons, to study its validity and to apply it to home care services of European cities. THEORY: Home care delivery integration was based on two dimensions referring to process-centred integration and organisational structure

  20. The value of express delivery services for cross-border e-commerce in European Union markets

    NARCIS (Netherlands)

    T.Y. Kim (Thai Young); R. Dekker (Rommert); C. Heij (Christiaan)

    2016-01-01

    textabstractFurther growth of cross-border e-commerce in the European Union markets requires improved express delivery services. The framework presented in this paper identifies relevant contextual factors that affect express delivery adoption rates in European cross-border e-commerce. This

  1. Families at risk of poor parenting: a model for service delivery, assessment, and intervention.

    Science.gov (United States)

    Ayoub, C; Jacewitz, M M

    1982-01-01

    The At Risk Parent Child Program is a multidisciplinary network agency designed for the secondary prevention of poor parenting and the extremes of child abuse and neglect. This model system of service delivery emphasizes (1) the coordination of existing community resources to access a target population of families at risk of parenting problems, (2) the provision of multiple special services in a neutral location (ambulatory pediatric clinic), and (3) the importance of intensive individual contact with a clinical professional who serves as primary therapist, social advocate and service coordinator for client families. Identification and assessment of families is best done during prenatal and perinatal periods. Both formal and informal procedures for screening for risk factors are described, and a simple set of at risk criteria for use by hospital nursing staff is provided. Preventive intervention strategies include special medical, psychological, social and developmental services, offered in an inpatient; outpatient, or in-home setting. Matching family needs to modality and setting of treatment is a major program concern. All direct services to at risk families are supplied by professionals employed within existing local agencies (hospital, public health department, state guidance center, and medical school pediatric clinic). Multiple agency involvement allows a broad-based screening capacity which allows thousands of families routine access to program services. The administrative center of the network stands as an independent, community-funded core which coordinates and monitors direct clinical services, and provides local political advocacy for families at risk of parenting problems.

  2. Perception, acquisition and use of ecosystem services: human behavior, and ecosystem management and policy implications

    Science.gov (United States)

    Stanley T. Asah; Anne D. Guerry; Dale J. Blahna; Joshua J. Lawler

    2014-01-01

    Ecosystem services, fundamental to livelihoods and well-being, are reshaping environmental management and policy. However, the behavioral dimensions of ecosystem services and the responses of ordinary people to the management of those services, is less well understood. The ecosystem services framework lends itself to understanding the relationship between ecosystems...

  3. Recent changes in Medicaid policy and their possible effects on mental health services.

    Science.gov (United States)

    Buck, Jeffrey A

    2009-11-01

    As Medicaid has emerged as the primary funder of public mental health services, its character has affected the organization and delivery of such services. Recent changes to the program, however, promise to further affect the direction of changes in states' mental health service systems. One group of changes will further limit the flexibility of Medicaid mental health funding, while increasing provider accountability and the authority of state Medicaid agencies. Others will increase incentives for deinstitutionalization and community-based care and promote person-centered treatment principles. These changes will likely affect state mental health systems, mental health providers, and the nature of service delivery.

  4. Task shifting of HIV/AIDS case management to Community Health Service Centers in urban China: a qualitative policy analysis.

    Science.gov (United States)

    Ma, Fuchang; Lv, Fan; Xu, Peng; Zhang, Dapeng; Meng, Sining; Ju, Lahong; Jiang, Huihui; Ma, Liping; Sun, Jiangping; Wu, Zunyou

    2015-07-02

    The growing number of people living with HIV/AIDS (PLWHA) in China points to an increased need for case management services of HIV/AIDS. This study sought to explore the challenges and enablers in shifting the HIV/AIDS case management services from Centers for Disease Control and Prevention (CDCs) to Community Health Service Centers (CHSCs) in urban China. A qualitative method based on the Health Policy Triangle (HPT) framework was employed to gain in-depth insights into four elements of the task shifting strategy. This included a review on published literature and health policy documents, 15 focus group discussions (FGDs) and 30 in-depth interviews (IDIs) with four types of key actors from three cities in China. A total of 78 studies and 17 policy files at the national, municipal and local levels were obtained and reviewed comprehensively. Three semi-structured interview guides were used to explore key actors' views on shifting the HIV/AIDS case management services to CHSCs. It is necessary and feasible for CHSCs to engage in case management services for PLWHA in local communities. The increasing number of PLWHA and shortage of qualified health professionals in CDCs made shifting case management services downwards to CHSCs an urgent agenda. CHSCs' wide distribution, technical capacity, accessibility and current practice enabled them to carry out case management services for PLWHA. However our findings indicated several challenges in this task shifting process. Those challenges included lack of specific policy and stable financial support for CHSCs, inadequate manpower, relatively low capacity for health service delivery, lack of coordination among sectors, PLWHA's fear for discrimination and privacy disclosure in local communities, which may compromise the effectiveness and sustainability of those services. Shifting the HIV/AIDS case management services from CDCs to CHSCs is a new approach to cope with the rising number of PLWHA in China, but it should be

  5. A rapid assessment of service deliveries at Anganwadi Centres in Ranchi district of Jharkhand

    Directory of Open Access Journals (Sweden)

    Shamim Haider

    2014-03-01

    Full Text Available Introduction: Proper functioning of Anganwadi Centres (AWCs are important for better service delivery which will lead to healthy mother and child , and ultimately better development of human resources in order to build a healthy and productive nation. Objectives: To assess the functioning of AWCs. 2 To measure the quantitative gap in coverage of beneficiaries. 3 To find out bottlenecks in proper service delivery of AWCs. Methods: Randomly selected 50 AWCs in Ranchi district were surveyed during July 2012 to September 2012. Semi-structured questionnaire was used to collect information from Anganwadi workers (AWWs. Existing records at AWCs were also accessed to collect data.  Statistical analysis: Frequency distribution and chi - square test were done. Results: 3941(>73% out of 5387 eligible children aged 6-71 months were enrolled at AWCs and 3870(97.45% enrolled children were availing food under Supplementary Nutrition Programme (SNP. Growth charts were available and properly maintained at all AWCs however; regular health check-up of all children was done in only 5(10% AWCs. Pre-School Education (PSE materials, mainly in form of charts and posters were available at 47(94% AWCs. More than 90% pregnant & lactating women were enrolled at AWCs and almost all centres were providing maternal health services like Ante natal care (ANC and Tetanus Toxoid (TT to them. Only 955 (33% out of 2859 eligible adolescent girls were enrolled in AWCs. Iron-Folic Acid (IFA supplementations to pregnant women were available at 25 (50% AWCs. Conclusions:  Though coverage and supplementary nutrition of children is good; poor coverage, lack of health education and supplementary nutrition of adolescent girls is a matter of concern. Low honorarium, excess workload and poor infrastructure of AWCs are main impediment in proper service delivery.

  6. A rapid assessment of service deliveries at Anganwadi Centres in Ranchi district of Jharkhand

    Directory of Open Access Journals (Sweden)

    Shamim Haider

    2014-03-01

    Full Text Available Introduction: Proper functioning of Anganwadi Centres (AWCs are important for better service delivery which will lead to healthy mother and child , and ultimately better development of human resources in order to build a healthy and productive nation. Objectives: To assess the functioning of AWCs. 2 To measure the quantitative gap in coverage of beneficiaries. 3 To find out bottlenecks in proper service delivery of AWCs. Methods: Randomly selected 50 AWCs in Ranchi district were surveyed during July 2012 to September 2012. Semi-structured questionnaire was used to collect information from Anganwadi workers (AWWs. Existing records at AWCs were also accessed to collect data.  Statistical analysis: Frequency distribution and chi - square test were done. Results: 3941(>73% out of 5387 eligible children aged 6-71 months were enrolled at AWCs and 3870(97.45% enrolled children were availing food under Supplementary Nutrition Programme (SNP. Growth charts were available and properly maintained at all AWCs however; regular health check-up of all children was done in only 5(10% AWCs. Pre-School Education (PSE materials, mainly in form of charts and posters were available at 47(94% AWCs. More than 90% pregnant & lactating women were enrolled at AWCs and almost all centres were providing maternal health services like Ante natal care (ANC and Tetanus Toxoid (TT to them. Only 955 (33% out of 2859 eligible adolescent girls were enrolled in AWCs. Iron-Folic Acid (IFA supplementations to pregnant women were available at 25 (50% AWCs. Conclusions:  Though coverage and supplementary nutrition of children is good; poor coverage, lack of health education and supplementary nutrition of adolescent girls is a matter of concern. Low honorarium, excess workload and poor infrastructure of AWCs are main impediment in proper service delivery.

  7. The politics of service delivery in South Africa: The local government sphere in context

    Directory of Open Access Journals (Sweden)

    Purshottama S. Reddy

    2016-12-01

    Full Text Available The post-1994 democratic developmental South African state opted for a strong local government system which has been constitutionalised, in terms of Chapter 7 of the Constitution of the Republic of South Africa Act 108 of 1996. The politicisation of the local bureaucracy was inevitable as the ruling party sought to ensure that the executive leadership of municipalities shared the same political ideology and vision to facilitate local development. This raises the question, where does politicisation commence and end, and what is the ideal local political interface for efficient and effective service delivery and, more importantly, to ensure good governance? These questions have to take cognisance of the fact that South Africa is a ‘struggle democracy’ and development has to take place in historically disadvantaged areas, where services have been poor or non-existent. The historically advantaged areas have to also be maintained and upgraded, as they are key to financial sustainability of the municipalities. The increasing service delivery protests is a matter for concern, if one has to take cognisance of the popular adage highlighted in official literature, ‘if local government fails, South Arica fails’. Given that the struggles for a democratic South Africa were fought at the grassroots level, this has to translate to an improved quality of life for local communities. Consequently, sound political management is key to enhanced municipal service delivery and ultimately good local governance. This paper reviews political trends and developments up to 2016, but excludes any discussion on the recent local government elections.

  8. Optimal pricing policies for services with consideration of facility maintenance costs

    Science.gov (United States)

    Yeh, Ruey Huei; Lin, Yi-Fang

    2012-06-01

    For survival and success, pricing is an essential issue for service firms. This article deals with the pricing strategies for services with substantial facility maintenance costs. For this purpose, a mathematical framework that incorporates service demand and facility deterioration is proposed to address the problem. The facility and customers constitute a service system driven by Poisson arrivals and exponential service times. A service demand with increasing price elasticity and a facility lifetime with strictly increasing failure rate are also adopted in modelling. By examining the bidirectional relationship between customer demand and facility deterioration in the profit model, the pricing policies of the service are investigated. Then analytical conditions of customer demand and facility lifetime are derived to achieve a unique optimal pricing policy. The comparative statics properties of the optimal policy are also explored. Finally, numerical examples are presented to illustrate the effects of parameter variations on the optimal pricing policy.

  9. Effect of Brain Drain (Human Capital Flight of Librarians on Service Delivery in Some Selected Nigerian Universities

    Directory of Open Access Journals (Sweden)

    Clara Chinyere Okoro

    2014-06-01

    Full Text Available This study seeks to describe and analyze the challenges occasioned by brain drain or human capital flight of librarians on service delivery in Nigerian Universities. The research adopted a descriptive survey design. A purposive sampling technique was used to select two geopolitical zones (South-South and South-West from the six geopolitical zones of Nigeria. Total enumeration was used because the population under study was considered appropriate for the research. The instrument used for data collection was questionnaire. Sixty copies of the instrument were distributed to 60 librarians in the two selected geopolitical zones. Copies of all the questionnaires were completed, retrieved, and found usable, thus giving a response rate of 100%. Survey results indicated that 315 librarians emigrated to foreign lands for various reasons, including unstable academic calendar and prospects for further training among others. This loss of personnel in the university libraries has a negative impact on service delivery as qualified information professionals and Information and Communication Technology (ICT experts are limited to mentor the younger professionals. Shift duties in academic libraries are also scaled down for lack of manpower. Based on the findings, the researchers recommend that the Federal Government of Nigeria should, as a matter of urgency, robustly fund tertiary education to enhance productivity. As they do this, the National Universities Commission (NUC is to empower academic libraries by ensuring that the staff development policy is strictly adhered to. This will translate into self-enhancement for staff, positive job attitude, and retention of professionals in the system.

  10. Public policy alienation of public service workers : A conceptual framework

    NARCIS (Netherlands)

    L.G. Tummers (Lars); V.J.J.M. Bekkers (Victor); A.J. Steijn (Bram)

    2007-01-01

    textabstractNowadays, many public professionals face identification problems towards public policies they have to implement; that is, they experience policy alienation. This is troublesome, as for a proper implementation a minimal level of identification with the public policy is required. We use

  11. Pasundan Delivery Services (PT. Wahana Bumi Raya) Business Strategy Formulation and Implementation to Create Sustain Future Competition

    OpenAIRE

    Haryanto, Iman; Wandebori, Harimukti

    2012-01-01

    Pasundan Delivery Services (PDS) is the delivery services provider using motorcycle provide solutions for visitors and Bandung citizens to effective and efficient their valuable time, run its costumer order through smartphone and social media, lucrative demand leads PDS to formulate its strategy to reach more costumers among existing competitors to win the competition in and as the leader the future. Formulation of strategic management involving small team discussion group as the management o...

  12. Determinants of institutional delivery service utilization among pastorals of Liben Zone, Somali Regional State, Ethiopia, 2015

    Directory of Open Access Journals (Sweden)

    Zepro NB

    2016-12-01

    Full Text Available Nejimu Biza Zepro,1 Ahmed Tahir Ahmed2 1College of Health Sciences, Samara University, Samara, Afar, Ethiopia; 2College of Health Science, Jigjiga University, Jigjiga, Somali, Ethiopia Abstract: Maternal health service utilizations are poorly equipped, inaccessible, negligible, and not well documented in the pastoral society. This research describes a quantitative and qualitative study on the determinants of institutional delivery among pastoralists of Liben Zone with special emphasis on Filtu and Deka Suftu woredas of Somali Region, Ethiopia. The study was funded by the project “Fostering health care for refugees and pastoral communities in Somali Region, Ethiopia”. This community-based cross-sectional study was conducted during November 2015. Interviews through a questionnaire and focus group discussions were used to collect the data. Proportional to size allocation followed by systematic sampling technique was used to identify the study units. The major determinants of institutional delivery in the study area were as follows: being apparently healthy, lack of knowledge, long waiting time, poor quality services, cultural beliefs, religious misconception, partner decision, and long travel. Around one-third (133, 34.5% of the women had visited at least once for their pregnancy. More than half (78, 58.6% of the women had visited health facilities due to health problems and only 27 (19.9% women had attended the recommended four antenatal care visits. Majority (268, 69.6% of the pregnant women preferred to give birth at home. Women who attended antenatal care were two times more likely to deliver at health facilities (AOR, 95% confidence interval [CI] =2.38, 1.065–4.96. Women whose family members preferred health facilities had 14 times more probability to give birth in health institutions (AOR, 95% CI =13.79, 5.28–35.8. Women living in proximity to a health facility were 13 times more likely to give birth at health facilities than women

  13. Current state of seagrass ecosystem services: Research and policy integration

    KAUST Repository

    Ruiz-Frau, A.; Gelcich, S.; Hendriks, I.E.; Duarte, Carlos M.; Marbà , N.

    2017-01-01

    areas; a type of service research bias, provisioning and regulating services have received extensive attention while cultural services remain understudied; a type of discipline bias, the ecological aspects of SGES have been well documented while economic

  14. Econometric estimation of WHO-CHOICE country-specific costs for inpatient and outpatient health service delivery.

    Science.gov (United States)

    Stenberg, Karin; Lauer, Jeremy A; Gkountouras, Georgios; Fitzpatrick, Christopher; Stanciole, Anderson

    2018-01-01

    Policy makers require information on costs related to inpatient and outpatient health services to inform resource allocation decisions. Country data sets were gathered in 2008-2010 through literature reviews, website searches and a public call for cost data. Multivariate regression analysis was used to explore the determinants of variability in unit costs using data from 30 countries. Two models were designed, with the inpatient and outpatient models drawing upon 3407 and 9028 observations respectively. Cost estimates are produced at country and regional level, with 95% confidence intervals. Inpatient costs across 30 countries are significantly associated with the type of hospital, ownership, as well as bed occupancy rate, average length of stay, and total number of inpatient admissions. Changes in outpatient costs are significantly associated with location, facility ownership and the level of care, as well as to the number of outpatient visits and visits per provider per day. These updated WHO-CHOICE service delivery unit costs are statistically robust and may be used by analysts as inputs for economic analysis. The models can predict country-specific unit costs at different capacity levels and in different settings.

  15. Granting authority to a new policy. A community benefit services policy becomes part of the general business strategy.

    Science.gov (United States)

    Karibo, J

    1994-05-01

    Bon Secours Health System's new strategic plan and community benefit services policy integrates the planning, budgeting, evaluating, and reporting of community benefit services into management processes at the same level of authority as other operational activities. The strategic plan of Bon Secours Health System, headquartered in Marriottsville, MD, documents the system's mission, operating principles, vision, and five goals, one of which is to improve the communities' health status. The community benefit services operating policy requires that the Bon Secours Health System chief executive officer (CEO) and each local system CEO and nursing home administrator form a multidisciplinary local work group to be responsible for community benefit services. Each local work group assesses the needs of its community within the framework of the annual planning process. Determining what services are needed and how to deliver them is relatively easy. The difficult task is determining which of the many needs to address. What a community lacks may be the result of poor or inadequate public policy. For example, its priority may not be healthcare. In these situations healthcare providers may be best able to serve the community by providing indirect support to social service providers or by advocating for change. The community benefit services operating policy provides a standard approach to match the community's priority needs with the institution's resources and produce a measurable improvement in health status.

  16. Non-communicable diseases and HIV care and treatment: models of integrated service delivery.

    Science.gov (United States)

    Duffy, Malia; Ojikutu, Bisola; Andrian, Soa; Sohng, Elaine; Minior, Thomas; Hirschhorn, Lisa R

    2017-08-01

    Non-communicable diseases (NCD) are a growing cause of morbidity in low-income countries including in people living with human immunodeficiency virus (HIV). Integration of NCD and HIV services can build upon experience with chronic care models from HIV programmes. We describe models of NCD and HIV integration, challenges and lessons learned. A literature review of published articles on integrated NCD and HIV programs in low-income countries and key informant interviews were conducted with leaders of identified integrated NCD and HIV programs. Information was synthesised to identify models of NCD and HIV service delivery integration. Three models of integration were identified as follows: NCD services integrated into centres originally providing HIV care; HIV care integrated into primary health care (PHC) already offering NCD services; and simultaneous introduction of integrated HIV and NCD services. Major challenges identified included NCD supply chain, human resources, referral systems, patient education, stigma, patient records and monitoring and evaluation. The range of HIV and NCD services varied widely within and across models. Regardless of model of integration, leveraging experience from HIV care models and adapting existing systems and tools is a feasible method to provide efficient care and treatment for the growing numbers of patients with NCDs. Operational research should be conducted to further study how successful models of HIV and NCD integration can be expanded in scope and scaled-up by managers and policymakers seeking to address all the chronic care needs of their patients. © 2017 John Wiley & Sons Ltd.

  17. Framing in policy processes: a case study from hospital planning in the National Health Service in England.

    Science.gov (United States)

    Jones, Lorelei; Exworthy, Mark

    2015-01-01

    This paper reports from an ethnographic study of hospital planning in England undertaken between 2006 and 2009. We explored how a policy to centralise hospital services was espoused in national policy documents, how this shifted over time and how it was translated in practice. We found that policy texts defined hospital planning as a clinical issue and framed decisions to close hospitals or hospital departments as based on the evidence and necessary to ensure safety. We interpreted this framing as a rhetorical strategy for implementing organisational change in the context of community resistance to service closure and a concomitant policy emphasising the importance of public and patient involvement in planning. Although the persuasive power of the framing was limited, a more insidious form of power was identified in the way the framing disguised the political nature of the issue by defining it as a clinical problem. We conclude by discussing how the clinical rationale constrains public participation in decisions about the delivery and organisation of healthcare and restricts the extent to which alternative courses of action can be considered. Copyright © 2014 Elsevier Ltd. All rights reserved.

  18. An innovative HIV testing service using the internet: Anonymous urine delivery testing service at drugstores in Beijing, China.

    Directory of Open Access Journals (Sweden)

    Xiaoxia He

    Full Text Available Innovative human immunodeficiency virus (HIV testing services will be needed to achieve the first 90 (90% of HIV-positive persons aware of their infection status of the 90-90-90 target in China. Here, we describe an internet-based urine delivery testing service delivered through three pilot drugstores in Beijing that send specimens to a designated laboratory for HIV. From May 2016 to January 2017, we provided 500 HIV urine-testing service packs for display at the drugstores, and a total of 430 (86.0% urine specimens were mailed back. All of the 430 urine specimens were of good quality and were tested. 70 urine specimens were HIV positive, showing a 16.3% (70/430 positivity rate. A total of 94.3% (66/70 of the HIV-positive participants obtained their test results through the internet, and 69.7% (46/66 of these participants received follow-up care. A total of 40 out of 46 (87.0% participants agreed to have their results confirmed by a blood test, and 39 out of 40 (97.5% participants were confirmed as HIV-1 positive, including two individuals that were previously diagnosed. Lastly, 28 out of 37 (75.7% of the study participants were referred to the hospital and provided free antiviral treatment. Our data indicate that this innovative HIV testing service is effective and play an important role in HIV testing and surveillance.

  19. An innovative HIV testing service using the internet: Anonymous urine delivery testing service at drugstores in Beijing, China.

    Science.gov (United States)

    He, Xiaoxia; Liu, Guowu; Xia, Dongyan; Feng, Xia; Lv, Yi; Cheng, Huanyi; Wang, Yuehua; Lu, Hongyan; Jiang, Yan

    2018-01-01

    Innovative human immunodeficiency virus (HIV) testing services will be needed to achieve the first 90 (90% of HIV-positive persons aware of their infection status) of the 90-90-90 target in China. Here, we describe an internet-based urine delivery testing service delivered through three pilot drugstores in Beijing that send specimens to a designated laboratory for HIV. From May 2016 to January 2017, we provided 500 HIV urine-testing service packs for display at the drugstores, and a total of 430 (86.0%) urine specimens were mailed back. All of the 430 urine specimens were of good quality and were tested. 70 urine specimens were HIV positive, showing a 16.3% (70/430) positivity rate. A total of 94.3% (66/70) of the HIV-positive participants obtained their test results through the internet, and 69.7% (46/66) of these participants received follow-up care. A total of 40 out of 46 (87.0%) participants agreed to have their results confirmed by a blood test, and 39 out of 40 (97.5%) participants were confirmed as HIV-1 positive, including two individuals that were previously diagnosed. Lastly, 28 out of 37 (75.7%) of the study participants were referred to the hospital and provided free antiviral treatment. Our data indicate that this innovative HIV testing service is effective and play an important role in HIV testing and surveillance.

  20. Architectural Principles for Orchestration of Cross-Organizational Service Delivery: Case Studies from the Netherlands

    Science.gov (United States)

    van Veenstra, Anne Fleur; Janssen, Marijn

    One of the main challenges for e-government is to create coherent services for citizens and businesses. Realizing Integrated Service Delivery (ISD) requires government agencies to collaborate across their organizational boundaries. The coordination of processes across multiple organizations to realize ISD is called orchestration. One way of achieving orchestration is to formalize processes using architecture. In this chapter we identify architectural principles for orchestration by looking at three case studies of cross-organizational service delivery chain formation in the Netherlands. In total, six generic principles were formulated and subsequently validated in two workshops with experts. These principles are: (i) build an intelligent front office, (ii) give processes a clear starting point and end, (iii) build a central workflow application keeping track of the process, (iv) differentiate between simple and complex processes, (v) ensure that the decision-making responsibility and the overview of the process are not performed by the same process role, and (vi) create a central point where risk profiles are maintained. Further research should focus on how organizations can adapt these principles to their own situation.

  1. Outpatients’ experiences of quality service delivery at a teaching hospital in Gauteng

    Directory of Open Access Journals (Sweden)

    Ebin J Arries

    2008-11-01

    Full Text Available Quality service delivery to the consumer of health is a legal reality as it is emphasised in the White Paper on the Transformation of Public Service delivery (South Africa, 1997. The guiding philosophy adopted within this framework is that of Batho Pele, which means placing the consumer at the centre of healthcare service delivery. Increasing attention has been paid to hospital processes from a quality perspective. By analogy, outpatient departments can be viewed as industrial plants where technological know-how is transferred to patients through service delivery, which is a cornerstone of a hospital’s business. Outpatients, as consumers of healthcare, draw conclusions about the quality of service delivery based on their experiences of such services. In this vein, an outpatient’s experience of a particular service is an indicator of his/her level of satisfaction with the quality of that service. No South African study can be found in the literature on out-patients’ experiences of quality service delivery. This study’s purpose is to explore and describe outpatients’ experiences of the quality of service delivery at a teaching hospital in Gauteng. A qualitative, explorative, descriptive study that was contextual in nature was conducted to achieve this aim. Focus group interviews were conducted with outpatients who met the selection criteria. Open coding was used to analyse the contents from the transcripts and field notes typed verbatim. Strategies for trustworthiness, namely co-coding, prolonged engagement, triangulation and adequate referencing, were employed to ensure the credibility of the study and research findings. The results reflect themes that were reduced into two main categories, namely positive and negative experiences. The positive experiences reflect outpatients’ experience of their relationship with medical staff and their satisfaction with the quality of medical care. Negative experiences relate predominantly to a lack

  2. [Innovation in the organization of health services delivery within the Metropolitan System of Solidarity in Peru].

    Science.gov (United States)

    Arroyo, Juan; Pastor-Goyzueta, Ada

    2013-06-01

    Based on the results achieved to date by the Metropolitan System of Solidarity (SISOL) in Peru, this study undertook to analyze the extent to which SISOL has contributed to innovation in the organization of health services delivery. SISOL performance indicators were analyzed and compared with those of other health services delivery models in Peru, drawing on data from a survey of 4 570 SISOL users conducted in the last quarter of 2011, National Household Surveys from 2003 through 2011, and statistical data from the Peruvian Ministry of Health and Social Security. SISOL rated high in terms of growth of the demand served in Lima, productivity of human resources in office visits, and levels of user satisfaction. These results are attributed to: (a) the presence of specialists at the first level of care; (b) an innovative public-private structure, as opposed to outsourcing; and (c) a system of incentives based on shared risk management. The findings support the need for primary health care renewal, especially in urban areas to reduce the proliferation of unnecessary levels and sublevels of care. They also point to the possibility of developing synergistic public-private partnerships in which both sectors share risks and act in collaboration within a single service system. And finally, they indicate that primary care needs to be articulated into the segmented models.

  3. Society of Behavioral Medicine's (SBM) position on emerging policy issues regarding electronic nicotine delivery systems (ENDS): A need for regulation.

    Science.gov (United States)

    Rojewski, Alana M; Coleman, Nortorious; Toll, Benjamin A

    2016-09-01

    Electronic nicotine delivery systems (ENDS), commonly known as electronic cigarettes (or e-cigarettes), are widely available in the USA, yet almost entirely unregulated on a national level. Researchers are currently gathering data to understand the individual and public health effects of ENDS, as well as the role that ENDS may play in tobacco treatment. Given these uncertainties, regulatory efforts should be aimed at understanding and minimizing any potential harms of ENDS. The Society of Behavioral Medicine (SBM) supports stronger regulation of ENDS, incorporation of ENDS into clean air policies, and special consideration of safety standards to protect vulnerable populations. SBM also supports research on ENDS to guide policy decisions.

  4. Effective Technological Delivery in Nigerian Polytechnics:Need for Academic Manpower Development Policy

    Directory of Open Access Journals (Sweden)

    J. K. Adeyemi

    2004-06-01

    Full Text Available Technical education, especially as provided in the Nigerian polytechnics, leads to the acquisition of practical and applied skills as well as basic scientific knowledge. The production function of the polytechnics in terms of producing quality middle-level manpower through effective teaching delivery depends largely on the quantity and quality of teachers available. However, teacher adequacy is a function of many factors, which include funding, student enrollment overtime, and staff turnover. This article, however, revealed a mismatch between enrollment and available teachers, with huge staff shortfall over the years when the student enrollment was matched with the available teachers, using the ideal teacher-student ratios. Student and teacher projections were carried out based on five-percent annual increase and average teacher-student ratio of 1:12, so as to meet the vision 2010 target year set by the Nigerian government for total development. The projection showed that the polytechnics would require a large additional number of teachers. An all-inclusive funding approach for the polytechnics was recommended so as to increase their financial status, which would allow for improved facilities, workshops, equipment and also improved conditions of service of teachers. We believe that if this was done, more teachers would be attracted from across the world, those who left would return, and new and younger ones will be encouraged to join the teaching force. Such development would to a great extent meet and sustain the anticipated growth for the target year.

  5. Why do some women still prefer traditional birth attendants and home delivery?: a qualitative study on delivery care services in West Java Province, Indonesia.

    Science.gov (United States)

    Titaley, Christiana R; Hunter, Cynthia L; Dibley, Michael J; Heywood, Peter

    2010-08-11

    Trained birth attendants at delivery are important for preventing both maternal and newborn deaths. West Java is one of the provinces on Java Island, Indonesia, where many women still deliver at home and without the assistance of trained birth attendants. This study aims to explore the perspectives of community members and health workers about the use of delivery care services in six villages of West Java Province. A qualitative study using focus group discussions (FGDs) and in-depth interviews was conducted in six villages of three districts in West Java Province from March to July 2009. Twenty FGDs and 165 in-depth interviews were conducted involving a total of 295 participants representing mothers, fathers, health care providers, traditional birth attendants and community leaders. The FGD and in-depth interview guidelines included reasons for using a trained or a traditional birth attendant and reasons for having a home or an institutional delivery. The use of traditional birth attendants and home delivery were preferable for some community members despite the availability of the village midwife in the village. Physical distance and financial limitations were two major constraints that prevented community members from accessing and using trained attendants and institutional deliveries. A number of respondents reported that trained delivery attendants or an institutional delivery were only aimed at women who experienced obstetric complications. The limited availability of health care providers was reported by residents in remote areas. In these settings the village midwife, who was sometimes the only health care provider, frequently travelled out of the village. The community perceived the role of both village midwives and traditional birth attendants as essential for providing maternal and health care services. A comprehensive strategy to increase the availability, accessibility, and affordability of delivery care services should be considered in these West Java

  6. Why do some women still prefer traditional birth attendants and home delivery?: a qualitative study on delivery care services in West Java Province, Indonesia

    Directory of Open Access Journals (Sweden)

    Titaley Christiana R

    2010-08-01

    Full Text Available Abstract Background Trained birth attendants at delivery are important for preventing both maternal and newborn deaths. West Java is one of the provinces on Java Island, Indonesia, where many women still deliver at home and without the assistance of trained birth attendants. This study aims to explore the perspectives of community members and health workers about the use of delivery care services in six villages of West Java Province. Methods A qualitative study using focus group discussions (FGDs and in-depth interviews was conducted in six villages of three districts in West Java Province from March to July 2009. Twenty FGDs and 165 in-depth interviews were conducted involving a total of 295 participants representing mothers, fathers, health care providers, traditional birth attendants and community leaders. The FGD and in-depth interview guidelines included reasons for using a trained or a traditional birth attendant and reasons for having a home or an institutional delivery. Results The use of traditional birth attendants and home delivery were preferable for some community members despite the availability of the village midwife in the village. Physical distance and financial limitations were two major constraints that prevented community members from accessing and using trained attendants and institutional deliveries. A number of respondents reported that trained delivery attendants or an institutional delivery were only aimed at women who experienced obstetric complications. The limited availability of health care providers was reported by residents in remote areas. In these settings the village midwife, who was sometimes the only health care provider, frequently travelled out of the village. The community perceived the role of both village midwives and traditional birth attendants as essential for providing maternal and health care services. Conclusions A comprehensive strategy to increase the availability, accessibility, and

  7. Public Spending on Health Service and Policy Research in Canada, the United Kingdom, and the United States: A Modest Proposal

    Directory of Open Access Journals (Sweden)

    Vidhi Thakkar

    2017-11-01

    Full Text Available Health services and policy research (HSPR represent a multidisciplinary field which integrates knowledge from health economics, health policy, health technology assessment, epidemiology, political science among other fields, to evaluate decisions in health service delivery. Health service decisions are informed by evidence at the clinical, organizational, and policy level, levels with distinct, managerial drivers. HSPR has an evolving discourse spanning knowledge translation, linkage and exchange between research and decision-maker partners and more recently, implementation science and learning health systems. Local context is important for HSPR and is important in advancing health reform practice. The amounts and configuration of national investment in this field remain important considerations which reflect priority investment areas. The priorities set within this field or research may have greater or lesser effects and promise with respect to modernizing health services in pursuit of better value and better population outcomes. Within Canada an asset map for HSPR was published by the national HSPR research institute. Having estimated publiclyfunded research spending in Canada, we sought identify best available comparable estimates from the United States and the United Kingdom. Investments from industry and charitable organizations were not included in these numbers. This commentary explores spending by the United States, Canada, and the United Kingdom on HSPR as a fraction of total public spending on health and the importance of these respective investments in advancing health service performance. Proposals are offered on the merits of common nomenclature and accounting for areas of investigation in pursuit of some comparable way of assessing priority HSPR investments and suggestions for earmarking such investments to total investment in health services spending.

  8. Out-of-hours MRI provision in the UK and models of service delivery

    International Nuclear Information System (INIS)

    Hauptfleisch, J.; Meagher, T.M.; King, D.; López de Heredia, L.; Hughes, R.J.

    2013-01-01

    Aim: To examine current out-of-hours magnetic resonance imaging (MRI) provision through a snapshot survey of National Health Service (NHS) trusts and to assay how radiographer staffing cover was provided for out-of-hours services. Materials and methods: A snapshot postal survey was mailed to heads of service of all 234 trusts in England and Wales. A literature search on the models of service delivery and correlation with the authors' internal MRI rota, which has provided a full on-call service for 20 years was undertaken. Results: The response rate was 45.7% (107 of 234); 14% of responders provided full access to MRI 24 h a day; 63% provided extended weekday service, typically to 20.00 h; and 81% provided a weekend daytime service. The radiographers running the service were typically from the core MRI team. Approximately one-third (29.9%) of trusts provided training in basic brain and spine MRI to non-core MRI team members, but they typically did not participate in out-of-hours provision. Conclusion: There is currently a paucity of information on the provision of out-of-hours MRI in the NHS. However, there is increasing pressure to provide complex imaging out of hours, and in the future, trauma centres may be required to provide MRI to assess spinal injury. The authors describe a system to provide access to MRI at no additional cost to the organization based on 20 years of experience. A minority of surveyed acute NHS trusts have full out-of-hours access to MRI. Demand for MRI provision out of core hours is likely to increase

  9. Alternative Service Delivery in Africa: The Case for International Regional Organisations

    Directory of Open Access Journals (Sweden)

    Moses N. Kiggundu

    2016-06-01

    Full Text Available Alternative service delivery (ASD is generally confined to the provision opublic services within the boundaries of a single nation state. This paper extends thisconceptualization and practice beyond a single nation state by focusing on services provided  by international regional organizations (IROs, which encompass more than a single country. Recognizing that the regional approach may not be suitable under all circumstances, the papertakes a contingency approach and discusses with illustrations the conditions under which the regional or continental approaches may provide superior public services to the wider population. Three examples from the East African Community (EAC, Africa’s riparian river basins, and cross-border illicit trade of conflict minerals in the Great Lakes region are given as illustrative cases. Noting that Africa’s growing aspirations for inclusive development and rapid transformation call for better governance and quality public services, the paper ends by calling for more scholarly work and field experiments on ASD and other models applicable at local, national, regional and continental levels.

  10. Amendment of the assured delivery provisions of BPA's Long-Term Intertie Access Policy and increased assured delivery: Access for non-scheduling utilities. Record of decision

    International Nuclear Information System (INIS)

    1994-06-01

    Bonneville Power Administration's BPA's preferred alternative for providing non-Federal Pacific Northwest-Pacific Southwest (PNW-PSW) Intertie access is to adopt the Capacity Ownership alternative combined with the Increased Assured Delivery--Access for Non-Scheduling Utilities alternative. BPA's decision to offer Capacity Ownership was documented in a March 1994 Non-Federal Capacity Ownership Record of Decision (ROD). This ROD documents BPA's decision to facilitate PNW-PSW Intertie access by proceeding with (1) bidirectional Increased Assured Delivery--Access for Non Scheduling Utilities; and (2) amending the Assured Delivery provisions of BPA's Long-Term Intertie Access Policy (LTIAP). Given that the various non-Federal PNW-PSW Intertie access alternatives in the NFP EIS all allowed for different types of contracts, little environmental impact difference among the alternatives was found. Rather, environmental impact was found to be associated with whether exchange contracts or firm power sales contracts would predominate. Such impacts and related environmental analysis are discussed further in section 3.0 of this ROD

  11. Toward social system theory: implications for older people with developmental disabilities and service delivery.

    Science.gov (United States)

    Dossa, P A

    1990-01-01

    The literature refers to older people with developmental disabilities as the "new service population." How and why this population emerged as a special category is discussed conceptually with reference to social systems theory. A brief review of social systems theory and some basic systemic tenets are presented. Systemic tenets are employed in examining the historical development of social gerontology and present trends in the service-delivery system. I show that the systemic variable of the economic model of human development has significantly impacted on the making of older people with developmental disabilities a dependent population. In the conclusion the systems perspective is explored in relation to recognizing the liminal, in-between parts between components. It is argued that such a perception minimizes the dichotomy between older people with developmental disabilities and the non-disabled population, paving the way for a genuine encounter.

  12. Experiences of community pharmacists involved in the delivery of a specialist asthma service in Australia.

    Science.gov (United States)

    Emmerton, Lynne M; Smith, Lorraine; LeMay, Kate S; Krass, Ines; Saini, Bandana; Bosnic-Anticevich, Sinthia Z; Reddel, Helen K; Burton, Deborah L; Stewart, Kay; Armour, Carol L

    2012-06-18

    innovative service delivery model, supported by the researchers, yet trained and empowered to implement the clinical service throughout the trial period and beyond. The balance between support and independence appeared crucial in the pharmacists' engagement with the trial. Their feedback was overwhelmingly positive, while useful suggestions were identified for future academic trials.

  13. Experiences of community pharmacists involved in the delivery of a specialist asthma service in Australia

    Directory of Open Access Journals (Sweden)

    Emmerton Lynne M

    2012-06-01

    PAMS provided pharmacists an opportunity to become involved in an innovative service delivery model, supported by the researchers, yet trained and empowered to implement the clinical service throughout the trial period and beyond. The balance between support and independence appeared crucial in the pharmacists’ engagement with the trial. Their feedback was overwhelmingly positive, while useful suggestions were identified for future academic trials.

  14. Sport Psychology Service Provision: Preferences for Consultant Characteristics and Mode of Delivery among Elite Malaysian Athletes.

    Science.gov (United States)

    Ponnusamy, Vellapandian; Grove, J Robert

    2014-09-01

    Factors relevant to the working alliance between athletes and sport psychology consultants were investigated in a sample of elite Malaysian athletes (n = 217). The athletes represented a variety of team and individual sports, and they provided information about the perceived importance of seven consultant characteristics/behaviors as well as seven program delivery options. At a full-sample level, general preferences were expressed for consultants to lead a physically active lifestyle, regularly attend training sessions and competitions, and have prior experience as an athlete or coach. General preferences were also expressed for program content to be determined by the coach or consultant, and for regular, small doses of mental skills training to be delivered in a face-to-face context throughout the year. At a sub-group level, team sport athletes had stronger preferences than individual sport athletes for program delivery on a group/team basis, while individual sport athletes had stronger preferences than team sport athletes for having a role in determining program content. Findings are discussed in relation to dominant value themes within Malaysian society and the reinforcement of these themes within specific sport subcultures. Key pointsConsultant characteristics and program delivery methods have an impact on the effectiveness of sport psychology services.Preferred consultant characteristics and preferred methods of delivery may be affected by cultural and subcultural values.Elite Malaysian athletes prefer consultants to lead a physically active lifestyle; to regularly attend training/competition; and to have prior experience as an athlete or coach.Elite Malaysian athletes also prefer that the coach or consultant determine program content, and that mental skills training take place in a face-to-face context throughout the year.

  15. Sport Psychology Service Provision: Preferences for Consultant Characteristics and Mode of Delivery among Elite Malaysian Athletes

    Science.gov (United States)

    Ponnusamy, Vellapandian; Grove, J. Robert

    2014-01-01

    Factors relevant to the working alliance between athletes and sport psychology consultants were investigated in a sample of elite Malaysian athletes (n = 217). The athletes represented a variety of team and individual sports, and they provided information about the perceived importance of seven consultant characteristics/behaviors as well as seven program delivery options. At a full-sample level, general preferences were expressed for consultants to lead a physically active lifestyle, regularly attend training sessions and competitions, and have prior experience as an athlete or coach. General preferences were also expressed for program content to be determined by the coach or consultant, and for regular, small doses of mental skills training to be delivered in a face-to-face context throughout the year. At a sub-group level, team sport athletes had stronger preferences than individual sport athletes for program delivery on a group/team basis, while individual sport athletes had stronger preferences than team sport athletes for having a role in determining program content. Findings are discussed in relation to dominant value themes within Malaysian society and the reinforcement of these themes within specific sport subcultures. Key points Consultant characteristics and program delivery methods have an impact on the effectiveness of sport psychology services. Preferred consultant characteristics and preferred methods of delivery may be affected by cultural and subcultural values. Elite Malaysian athletes prefer consultants to lead a physically active lifestyle; to regularly attend training/competition; and to have prior experience as an athlete or coach. Elite Malaysian athletes also prefer that the coach or consultant determine program content, and that mental skills training take place in a face-to-face context throughout the year. PMID:25177193

  16. Distance from health facility and mothers' perception of quality related to skilled delivery service utilization in northern Ethiopia.

    Science.gov (United States)

    Fisseha, Girmatsion; Berhane, Yemane; Worku, Alemayehu; Terefe, Wondwossen

    2017-01-01

    Poor maternal health service utilization is one of the contributing factors to a high level of maternal and newborn mortality in Ethiopia. The factors associated with utilization of services are believed to differ from one context to another. We assessed the factors associated with skilled delivery service utilization in rural northern Ethiopia. A community-based survey was conducted among mothers who gave birth in the 12 months preceding the study period, from January to February 2015, in the Tigray region of Ethiopia. Multistage sampling technique was used to select mothers from the identified clusters. Households within a 10 km radius of the health facility were taken as a cluster for a community survey. Data were collected using face-to-face interview at the household level. We compared the mothers who reported giving birth to the index child in a health facility and those who reported delivering at home, in order to identify the predictors of skilled delivery utilization. Multivariable logistic regression model was used to determine the predictors of skilled delivery service utilization. The results are presented with odds ratio (OR) and 95% confidence interval (CI). A total of 1,796 mothers participated in the study, with a 100% response rate. Distance to health facilities (adjusted odds ratio [AOR] =0.53 [95% CI: 0.39, 0.71]), perception of mothers to the availability of adequate equipment in the delivery service in their catchment area (AOR =1.5 [95% CI: 1.11, 2.13]), experiencing any complication during childbirth, using antenatal care, lower birth order and having an educated partner were the significant predictors of skilled delivery service utilization. Implementing community-based intervention programs that will address the physical accessibility of delivery services, such as the ambulance service, road issues and waiting rooms, and improving quality maternity service will likely reduce the current problem.

  17. Distance from health facility and mothers’ perception of quality related to skilled delivery service utilization in northern Ethiopia

    Science.gov (United States)

    Fisseha, Girmatsion; Berhane, Yemane; Worku, Alemayehu; Terefe, Wondwossen

    2017-01-01

    Background Poor maternal health service utilization is one of the contributing factors to a high level of maternal and newborn mortality in Ethiopia. The factors associated with utilization of services are believed to differ from one context to another. We assessed the factors associated with skilled delivery service utilization in rural northern Ethiopia. Subjects and methods A community-based survey was conducted among mothers who gave birth in the 12 months preceding the study period, from January to February 2015, in the Tigray region of Ethiopia. Multistage sampling technique was used to select mothers from the identified clusters. Households within a 10 km radius of the health facility were taken as a cluster for a community survey. Data were collected using face-to-face interview at the household level. We compared the mothers who reported giving birth to the index child in a health facility and those who reported delivering at home, in order to identify the predictors of skilled delivery utilization. Multivariable logistic regression model was used to determine the predictors of skilled delivery service utilization. The results are presented with odds ratio (OR) and 95% confidence interval (CI). Results A total of 1,796 mothers participated in the study, with a 100% response rate. Distance to health facilities (adjusted odds ratio [AOR] =0.53 [95% CI: 0.39, 0.71]), perception of mothers to the availability of adequate equipment in the delivery service in their catchment area (AOR =1.5 [95% CI: 1.11, 2.13]), experiencing any complication during childbirth, using antenatal care, lower birth order and having an educated partner were the significant predictors of skilled delivery service utilization. Conclusion Implementing community-based intervention programs that will address the physical accessibility of delivery services, such as the ambulance service, road issues and waiting rooms, and improving quality maternity service will likely reduce the current

  18. Impact of ICT on Agricultural Extension Services Delivery: Evidence from the Catholic Relief Services SMART Skills and Farmbook Project in Kenya

    Science.gov (United States)

    Tata, Joyous S.; McNamara, Paul E.

    2018-01-01

    Purpose: The study was carried out to assess the impact of the Catholic Relief Services (CRS) Skills for Marketing and Rural Transformation (SMART) skills and Farmbook information communication technology (ICT) on agricultural extension service delivery by front-line extension officers in two counties in Kenya. The second objective was to assess…

  19. Realizing IoT service's policy privacy over publish/subscribe-based middleware.

    Science.gov (United States)

    Duan, Li; Zhang, Yang; Chen, Shiping; Wang, Shiyao; Cheng, Bo; Chen, Junliang

    2016-01-01

    The publish/subscribe paradigm makes IoT service collaborations more scalable and flexible, due to the space, time and control decoupling of event producers and consumers. Thus, the paradigm can be used to establish large-scale IoT service communication infrastructures such as Supervisory Control and Data Acquisition systems. However, preserving IoT service's policy privacy is difficult in this paradigm, because a classical publisher has little control of its own event after being published; and a subscriber has to accept all the events from the subscribed event type with no choice. Few existing publish/subscribe middleware have built-in mechanisms to address the above issues. In this paper, we present a novel access control framework, which is capable of preserving IoT service's policy privacy. In particular, we adopt the publish/subscribe paradigm as the IoT service communication infrastructure to facilitate the protection of IoT services policy privacy. The key idea in our policy-privacy solution is using a two-layer cooperating method to match bi-directional privacy control requirements: (a) data layer for protecting IoT events; and (b) application layer for preserving the privacy of service policy. Furthermore, the anonymous-set-based principle is adopted to realize the functionalities of the framework, including policy embedding and policy encoding as well as policy matching. Our security analysis shows that the policy privacy framework is Chosen-Plaintext Attack secure. We extend the open source Apache ActiveMQ broker by building into a policy-based authorization mechanism to enforce the privacy policy. The performance evaluation results indicate that our approach is scalable with reasonable overheads.

  20. Examining leadership as a strategy to enhance health care service delivery in regional hospitals in South Africa

    Science.gov (United States)

    Govender, Sagaren; Gerwel Proches, Cecile N; Kader, Abdulla

    2018-01-01

    Background Four public hospitals in South Africa, which render both specialized and nonspecialized services to thousands of patients, were examined to determine the impact of leadership on health care service delivery. These hospitals were inundated by various problems that were impacting negatively on health care service delivery. Purpose This research study aimed to gain a comprehensive understanding of the challenges, complexities and constraints facing public health care in KwaZulu-Natal (KZN) and to examine leadership as a strategy to enhance healthcare service delivery with a particular focus on four regional hospitals in the KZN Province. Methods The mixed-method research approach was utilized. Purposive sampling and stratified random sampling were employed in the research setting, and in-depth, semistructured interviews and questionnaires were used to collect data. Data were analyzed using the Nvivo computer software package for in-depth interviews and the Statistical Package for the Social Sciences (SPSS) software for the quantitative analysis. Results The research findings showed that the current leadership framework adopted by the health care leaders in regional hospitals in KZN is weak and is contributing to poor health care service delivery. Conclusion This study, therefore, aimed to address the current challenges and weaknesses that are impacting negatively on health care service delivery in regional hospitals in the KZN Province and made recommendations for improvement. PMID:29535529

  1. Examining leadership as a strategy to enhance health care service delivery in regional hospitals in South Africa.

    Science.gov (United States)

    Govender, Sagaren; Gerwel Proches, Cecile N; Kader, Abdulla

    2018-01-01

    Four public hospitals in South Africa, which render both specialized and nonspecialized services to thousands of patients, were examined to determine the impact of leadership on health care service delivery. These hospitals were inundated by various problems that were impacting negatively on health care service delivery. This research study aimed to gain a comprehensive understanding of the challenges, complexities and constraints facing public health care in KwaZulu-Natal (KZN) and to examine leadership as a strategy to enhance healthcare service delivery with a particular focus on four regional hospitals in the KZN Province. The mixed-method research approach was utilized. Purposive sampling and stratified random sampling were employed in the research setting, and in-depth, semistructured interviews and questionnaires were used to collect data. Data were analyzed using the Nvivo computer software package for in-depth interviews and the Statistical Package for the Social Sciences (SPSS) software for the quantitative analysis. The research findings showed that the current leadership framework adopted by the health care leaders in regional hospitals in KZN is weak and is contributing to poor health care service delivery. This study, therefore, aimed to address the current challenges and weaknesses that are impacting negatively on health care service delivery in regional hospitals in the KZN Province and made recommendations for improvement.

  2. Personalizing Knowledge Delivery Services for Emerging Knowledge Processes (EKPs): A Conceptual Framework

    Science.gov (United States)

    Majchrzak, Ann; Chellappa, Ramnath K.; Cooper, Lynne P.; Hars, Alexander

    2003-01-01

    The contents include: 1) What do most KMS in use today assume?; 2) Assumptions are violated when KMS is used by EKP workers - Why?; 3) Current State of KMS for EKPs are inadequate; 4) What would an "adequate" KMS for EKPs look like?; 5) "User-as-Consumer" Analogue: Ecommerce/Eem ployee Services; 6) Why is an ideal KMS for EKPs hard to achieve?; 7) So, what type of KMS design would work?; 8) Human-Based KMS for EKP - Proposal Call Managers at R&DLAB; 9) Proposal Call Managers (PCMs); 10) Specific PCM tasks; 11) Why is a R&DLAB PCM a human metaphor for a KMS for EKP?; 12) Data Collection; 13) Finding #1; 14) Finding #2; 15) Finding #3; 16) Factors affecting How/when; 17) Finding #4; 18) Finding #5; 19) Implication#l for a KMS for EKP: From System to Service; 20) Implication #2: From technology or human-centric to Mixed Mode; 21) Implication #3: From Simple User Profiles to Dynamic Delivery Profiles; 22) Implication #4: Maintaining a trustworthy environment; 23) Implication #5: Constructing a dynamic delivery profile; 24) Implications for Research: Model; and 25) Example Research Qs on KMS Support for EKPs.

  3. Vocal effectiveness of speech-language pathology students: Before and after voice use during service delivery

    Science.gov (United States)

    Couch, Stephanie; Zieba, Dominique; van der Merwe, Anita

    2015-01-01

    Background As a professional voice user, it is imperative that a speech-language pathologist's (SLP) vocal effectiveness remain consistent throughout the day. Many factors may contribute to reduced vocal effectiveness, including prolonged voice use, vocally abusive behaviours, poor vocal hygiene and environmental factors. Objectives To determine the effect of service delivery on the perceptual and acoustic features of voice. Method A quasi-experimental., pre-test–post-test research design was used. Participants included third- and final-year speech-language pathology students at the University of Pretoria (South Africa). Voice parameters were evaluated in a pre-test measurement, after which the participants provided two consecutive hours of therapy. A post-test measurement was then completed. Data analysis consisted of an instrumental analysis in which the multidimensional voice programme (MDVP) and the voice range profile (VRP) were used to measure vocal parameters and then calculate the dysphonia severity index (DSI). The GRBASI scale was used to conduct a perceptual analysis of voice quality. Data were processed using descriptive statistics to determine change in each measured parameter after service delivery. Results A change of clinical significance was observed in the acoustic and perceptual parameters of voice. Conclusion Guidelines for SLPs in order to maintain optimal vocal effectiveness were suggested. PMID:26304213

  4. Mapping ecosystem services for policy support and decision making in the European Union

    NARCIS (Netherlands)

    Maes, J.; Egoh, B.; Willemen, L.; Liquete, C.; Vihervaara, P.; Schägner, J.P.; Grizzetti, B.; Drakou, E.G.; Notte, La A.; Zulian, G.; Bouraoui, F.; Parcchini, M.L.; Braat, L.C.

    2012-01-01

    Mainstreaming ecosystem services into policy and decision making is dependent on the availability of spatially explicit information on the state and trends of ecosystems and their services. In particular, the EU Biodiversity Strategy to 2020 addresses the need to account for ecosystem services

  5. 45 CFR 61.9 - Reporting civil judgments related to the delivery of a health care item or service.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Reporting civil judgments related to the delivery of a health care item or service. 61.9 Section 61.9 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION HEALTHCARE INTEGRITY AND PROTECTION DATA BANK FOR FINAL ADVERSE INFORMATION...

  6. Quasi-Experimental Study of the Effectiveness of an Integrated Service Delivery Network for the Frail Elderly

    Science.gov (United States)

    Tourigny, Andre; Durand, Pierre J.; Bonin, Lucie; Hebert, Rejean; Rochette, Louis

    2004-01-01

    The aim of this study was to examine the effectiveness of a new, integrated service delivery (ISD) network of health and social services for frail elderly living in a semi-urban community. A quasi-experimental study was conducted from 1997 to 2000, with measures taken before implementation (T0) and every 12 months after implementation for a 3-year…

  7. Preventing Elder Abuse: The Texas Plan for a Coordinated Service Delivery System. Collaborative Elder Abuse Prevention Project.

    Science.gov (United States)

    McDaniel, Garry L.

    The Texas Department of Human Services, in collaboration with 13 other public and private organizations, co-sponsored a statewide Collaborative Elder Abuse Prevention project. The goal of this project is to develop a comprehensive, long-range plan for the prevention of elder abuse, a method for achieving a coordinated service delivery system for…

  8. Public policy and regulatory implications for the implementation of Opportunistic Cloud Computing Services for Enterprises

    DEFF Research Database (Denmark)

    Kuada, Eric; Olesen, Henning; Henten, Anders

    2012-01-01

    Opportunistic Cloud Computing Services (OCCS) is a social network approach to the provisioning and management of cloud computing services for enterprises. This paper discusses how public policy and regulations will impact on OCCS implementation. We rely on documented publicly available government...... and corporate policies on the adoption of cloud computing services and deduce the impact of these policies on their adoption of opportunistic cloud computing services. We conclude that there are regulatory challenges on data protection that raises issues for cloud computing adoption in general; and the lack...... of a single globally accepted data protection standard poses some challenges for very successful implementation of OCCS for companies. However, the direction of current public and corporate policies on cloud computing make a good case for them to try out opportunistic cloud computing services....

  9. Utilization of Service Delivery Insurance (Jampersal for Maternal and Child Health Services in 12 Districts/Cities: Eliminate the Socio-cultural Obstacle on Safe Delivery

    Directory of Open Access Journals (Sweden)

    Lestari Handayani

    2014-08-01

    Full Text Available Background: The Government launched Jampersal as one of efforts to suppress the number of Maternal and Infant Mortality Ratio (MMR & IMR as well as a booster to achieve the MDGs by 2015. Delivery assistance seek are influencedby many factors including a socio-cultural factor. This research aimed to provide a study on the socio-cultural role inimproving the utilization of Service Delivery Insurance (Jampersal. Methods: Data about Jampersal was collected throughin-depth interviews, focus group discussion to community leaders, traditional birth attendants, midwives and head of thehealth center. In addition, as a supporting data, a quantitative survey to mothers who gave birth in the last year was alsoconducted. The research was located in 6 province in Indonesia. Each covered one health center in a rural area and one in a urban area. Results: The result of this research showed a strong evidence that rituals or traditions were still mostlyconducted. So the role of traditional birth attendants were still needed. Lack of transportation was to be the main obstacleto acces health facilities. Mean while, social interaction in rural area and a well-developed infrastructure in urban areawere important to enable the accessibility to access health facilities. Midwives were well-accepted by the people who hada good knowledge on health despite having less formal education both in rural or urban area. Labor financing by utilizingJampersal are good but not maximized or tend to be low in certain urban areas. Conclusions: People prefered to chosemidwives as birth attendants financed by Jampersal although some delivered at home. TBAs are still needed for maternal and baby care as well as to assist the implementation of rituals. Midwife-TBAs partnerships already on the right track butthe labor financing by Jampersal only support health care practitioner. Recommendation: Jampersal also support social and cultural-related financing, such as honorarium for TBAs who

  10. An Item Bank to Measure Systems, Services, and Policies: Environmental Factors Affecting People With Disabilities.

    Science.gov (United States)

    Lai, Jin-Shei; Hammel, Joy; Jerousek, Sara; Goldsmith, Arielle; Miskovic, Ana; Baum, Carolyn; Wong, Alex W; Dashner, Jessica; Heinemann, Allen W

    2016-12-01

    To develop a measure of perceived systems, services, and policies facilitators (see Chapter 5 of the International Classification of Functioning, Disability and Health) for people with neurologic disabilities and to evaluate the effect of perceived systems, services, and policies facilitators on health-related quality of life. Qualitative approaches to develop and refine items. Confirmatory factor analysis including 1-factor confirmatory factor analysis and bifactor analysis to evaluate unidimensionality of items. Rasch analysis to identify misfitting items. Correlational and analysis of variance methods to evaluate construct validity. Community-dwelling individuals participated in telephone interviews or traveled to the academic medical centers where this research took place. Participants (N=571) had a diagnosis of spinal cord injury, stroke, or traumatic brain injury. They were 18 years or older and English speaking. Not applicable. An item bank to evaluate environmental access and support levels of services, systems, and policies for people with disabilities. We identified a general factor defined as "access and support levels of the services, systems, and policies at the level of community living" and 3 local factors defined as "health services," "community living," and "community resources." The systems, services, and policies measure correlated moderately with participation measures: Community Participation Indicators (CPI) - Involvement, CPI - Control over Participation, Quality of Life in Neurological Disorders - Ability to Participate, Quality of Life in Neurological Disorders - Satisfaction with Role Participation, Patient-Reported Outcomes Measurement Information System (PROMIS) Ability to Participate, PROMIS Satisfaction with Role Participation, and PROMIS Isolation. The measure of systems, services, and policies facilitators contains items pertaining to health services, community living, and community resources. Investigators and clinicians can measure

  11. Office-Based Tools and Primary Care Visit Communication, Length, and Preventive Service Delivery.

    Science.gov (United States)

    Lafata, Jennifer Elston; Shay, L Aubree; Brown, Richard; Street, Richard L

    2016-04-01

    The use of physician office-based tools such as electronic health records (EHRs), health risk appraisal (HRA) instruments, and written patient reminder lists is encouraged to support efficient, high-quality, patient-centered care. We evaluate the association of exam room use of EHRs, HRA instruments, and self-generated written patient reminder lists with patient-physician communication behaviors, recommended preventive health service delivery, and visit length. Observational study of 485 office visits with 64 primary care physicians practicing in a health system serving the Detroit metropolitan area. Study data were obtained from patient surveys, direct observation, office visit audio-recordings, and automated health system records. Outcome measures included visit length in minutes, patient use of active communication behaviors, physician use of supportive talk and partnership-building communication behaviors, and percentage of delivered guideline-recommended preventive health services for which patients are eligible and due. Simultaneous linear regression models were used to evaluate associations between tool use and outcomes. Adjusted models controlled for patient characteristics, physician characteristics, characteristics of the relationship between the patient and physician, and characteristics of the environment in which the visit took place. Prior to adjusting for other factors, visits in which the EHR was used on average were significantly (p communication behaviors facilitating patient involvement (2.1 vs. 2.6 occurrences), but more use of active patient communication behaviors (4.4 vs. 2.6). Likewise, HRA use was significantly associated with increased preventive services delivery (62.1 percent vs. 57.0 percent). All relationships remained significant (p > .05) in adjusted models with the exception of that between HRA use and preventive service delivery. Office-based tools intended to facilitate the implementation of desired primary care practice

  12. The effectiveness of the PRISMA integrated service delivery network: preliminary report on methods and baseline data

    Directory of Open Access Journals (Sweden)

    Réjean Hébert

    2008-02-01

    Full Text Available Purpose: The PRISMA study analyzes an innovative coordination-type integrated service delivery (ISD system developed to improve continuity and increase the effectiveness and efficiency of services, especially for older and disabled populations. The objective of the PRISMA study is to evaluate the effectiveness of this system to improve health, empowerment and satisfaction of frail older people, modify their health and social services utilization, without increasing the burden of informal caregivers. The objective of this paper is to present the methodology and give baseline data on the study participants. Methods: A quasi-experimental study with pre-test, multiple post-tests, and a comparison group was used to evaluate the impact of PRISMA ISD. Elders at risk of functional decline (501 experimental, 419 control participated in the study. Results: At entry, the two groups were comparable for most variables. Over the first year, when the implementation rate was low (32%, participants from the control group used fewer services than those from the experimental group. After the first year, no significant statistical difference was observed for functional decline and changes in the other outcome variables. Conclusion: This first year must be considered a baseline year, showing the situation without significant implementation of PRISMA ISD systems. Results for the following years will have to be examined with consideration of these baseline results.

  13. Ecosystem services and economic theory: integration for policy-relevant research.

    Science.gov (United States)

    Fisher, Brendan; Turner, Kerry; Zylstra, Matthew; Brouwer, Roy; de Groot, Rudolf; Farber, Stephen; Ferraro, Paul; Green, Rhys; Hadley, David; Harlow, Julian; Jefferiss, Paul; Kirkby, Chris; Morling, Paul; Mowatt, Shaun; Naidoo, Robin; Paavola, Jouni; Strassburg, Bernardo; Yu, Doug; Balmford, Andrew

    2008-12-01

    It has become essential in policy and decision-making circles to think about the economic benefits (in addition to moral and scientific motivations) humans derive from well-functioning ecosystems. The concept of ecosystem services has been developed to address this link between ecosystems and human welfare. Since policy decisions are often evaluated through cost-benefit assessments, an economic analysis can help make ecosystem service research operational. In this paper we provide some simple economic analyses to discuss key concepts involved in formalizing ecosystem service research. These include the distinction between services and benefits, understanding the importance of marginal ecosystem changes, formalizing the idea of a safe minimum standard for ecosystem service provision, and discussing how to capture the public benefits of ecosystem services. We discuss how the integration of economic concepts and ecosystem services can provide policy and decision makers with a fuller spectrum of information for making conservation-conversion trade-offs. We include the results from a survey of the literature and a questionnaire of researchers regarding how ecosystem service research can be integrated into the policy process. We feel this discussion of economic concepts will be a practical aid for ecosystem service research to become more immediately policy relevant.

  14. Evaluating the Effect of Lead Time on Quality Service Delivery in the Banking Industry in Kumasi Metropolis of Ghana

    Directory of Open Access Journals (Sweden)

    Stephen Okyere

    2015-07-01

    Full Text Available Customers are becoming more attracted to quality service delivery and are being impatience and unsatisfied when they had to be delayed or wait for longer times before they are served.  Hence, Quality Service Delivery is of utmost importance to every service organisation especially financial industry. Most financial institutions focus attention on product innovation at the expense of lead time management which is a major factor in ensuring service quality and customer satisfaction. Consequently, this research looks at evaluating the effect of lead time on quality service delivery in the Banking Industry in Kumasi Metropolis of Ghana. The study relied on Primary data collected through questionnaires, observation and interview instruments, administered to staff and customers of some selected branches of a commercial bank in the study area. The data was analysed qualitatively. The researchers realised that despite the immense importance of lead time on quality service delivery, little attention is given to the concept. It was revealed that, customers were dissatisfied with the commercial bank’s services as a result of the unnecessary delays and queuing at the bank premises. The long lead time was found to be attributable to plant/system failure, skill gap on the part of employees, ATM underutilization and frequent breakdowns, among others. This has consequently resulted into long lead time, waiting, queuing and unnecessary delay at the banking hall. It is recommended that Tellers should be provided with electronic card readers for verification of customer’s data and processing to be faster.

  15. Fairness and legitimacy of decisions during delivery of malaria services and ITN interventions in zambia

    Directory of Open Access Journals (Sweden)

    Bloch Paul

    2010-11-01

    Full Text Available Abstract Background Malaria is the leading cause of morbidity and the second leading cause of mortality in Zambia. Perceptions of fairness and legitimacy of decisions relating to treatment of malaria cases within public health facilities and distribution of ITNs were assessed in a district in Zambia. The study was conducted within the framework of REsponse to ACcountable priority setting for Trust in health systems (REACT, a north-south collaborative action research study, which evaluates the Accountability for Reasonableness (AFR approach to priority setting in Zambia, Tanzania and Kenya. Methods This paper is based on baseline in-depth interviews (IDIs conducted with 38 decision-makers, who were involved in prioritization of malaria services and ITN distribution at district, facility and community levels in Zambia, one Focus Group Discussion (FGD with District Health Management Team managers and eight FGDs with outpatients' attendees. Perceptions and attitudes of providers and users and practices of providers were systematized according to the four AFR conditions relevance, publicity, appeals and leadership. Results Conflicting criteria for judging fairness were used by decision-makers and patients. Decision-makers argued that there was fairness in delivery of malaria treatment and distribution of ITNs based on alleged excessive supply of free malaria medicines, subsidized ITNs, and presence of a qualified health-provider in every facility. Patients argued that there was unfairness due to differences in waiting time, distances to health facilities, erratic supply of ITNs, no responsive appeal mechanisms, inadequate access to malaria medicines, ITNs and health providers, and uncaring providers. Decision-makers only perceived government bodies and donors/NGOs to be legitimate stakeholders to involve during delivery. Patients found government bodies, patients, indigenous healers, chiefs and politicians to be legitimate stakeholders during both

  16. Fairness and legitimacy of decisions during delivery of malaria services and ITN interventions in Zambia.

    Science.gov (United States)

    Tuba, Mary; Sandoy, Ingvild F; Bloch, Paul; Byskov, Jens

    2010-11-01

    Malaria is the leading cause of morbidity and the second leading cause of mortality in Zambia. Perceptions of fairness and legitimacy of decisions relating to treatment of malaria cases within public health facilities and distribution of ITNs were assessed in a district in Zambia. The study was conducted within the framework of REsponse to ACcountable priority setting for Trust in health systems (REACT), a north-south collaborative action research study, which evaluates the Accountability for Reasonableness (AFR) approach to priority setting in Zambia, Tanzania and Kenya. This paper is based on baseline in-depth interviews (IDIs) conducted with 38 decision-makers, who were involved in prioritization of malaria services and ITN distribution at district, facility and community levels in Zambia, one Focus Group Discussion (FGD) with District Health Management Team managers and eight FGDs with outpatients' attendees. Perceptions and attitudes of providers and users and practices of providers were systematized according to the four AFR conditions relevance, publicity, appeals and leadership. Conflicting criteria for judging fairness were used by decision-makers and patients. Decision-makers argued that there was fairness in delivery of malaria treatment and distribution of ITNs based on alleged excessive supply of free malaria medicines, subsidized ITNs, and presence of a qualified health-provider in every facility. Patients argued that there was unfairness due to differences in waiting time, distances to health facilities, erratic supply of ITNs, no responsive appeal mechanisms, inadequate access to malaria medicines, ITNs and health providers, and uncaring providers. Decision-makers only perceived government bodies and donors/NGOs to be legitimate stakeholders to involve during delivery. Patients found government bodies, patients, indigenous healers, chiefs and politicians to be legitimate stakeholders during both planning and delivery. Poor status of the AFR

  17. From Conception Through Delivery: Developing a Just and Equitable Faculty Maternity Leave Policy

    Science.gov (United States)

    Untener, Joseph

    2008-01-01

    While much has been written on the need for faculty maternity leave policies in institutions of higher learning, the development of such policies is difficult given inherent administrative complexities and multiple approval processes. As a result, many institutions have either no policy or one that is inadequate or out of compliance with…

  18. Context matters in NGO-government contracting for health service delivery: a case study from Pakistan.

    Science.gov (United States)

    Zaidi, Shehla; Mayhew, Susannah H; Cleland, John; Green, Andrew T

    2012-10-01

    Contracting non-governmental organizations (NGOs) for health service provision is gaining increasing importance in low- and middle-income countries. However, the role of the wider context in influencing the effectiveness of contracting is not well studied and is of relevance given that contracting has produced mixed results so far. This paper applies a policy analysis approach to examine the influence of policy and political factors on contracting origin, design and implementation. Evidence is drawn from a country case study of Pakistan involving extensive NGO contracting for human immunodeficiency virus (HIV) prevention services supported by international donor agencies. A multilevel study was conducted using 84 in-depth interviews, 22 semi-structured interviews, document review and direct observation to examine the national policy design, provincial management of contracting and local contract implementation. There were three main findings. First, contracting origin and implementation was an inherently political process affected by the wider policy context. Although in Pakistan a combination of situational events successfully managed to introduce extensive and sophisticated contracting, it ran into difficulties during implementation due to ownership and capacity issues within government. Second, wide-scale contracting was mis-matched with the capacity of local NGOs, which resulted in sub-optimal contract implementation challenging the reliance on market simulation through contracting. Third, we found that contracting can have unintended knock-on effects on both providers and purchasers. As a result of public sector contracts, NGOs became more distanced from their grounded attributes. Effects on government purchasers were more unpredictable, with greater identification with contracting in supportive governance contexts and further distancing in unsupportive contexts. A careful approach is needed in government contracting of NGOs, taking into account acceptance of

  19. Asking the right questions: Scoping studies in the commissioning of research on the organisation and delivery of health services

    Directory of Open Access Journals (Sweden)

    Peckham Stephen

    2008-07-01

    Full Text Available Abstract Scoping studies have been used across a range of disciplines for a wide variety of purposes. However, their value is increasingly limited by a lack of definition and clarity of purpose. The UK's Service Delivery and Organisation Research Programme (SDO has extensive experience of commissioning and using such studies; twenty four have now been completed. This review article has four objectives; to describe the nature of the scoping studies that have been commissioned by the SDO Programme; to consider the impact of and uses made of such studies; to provide definitions for the different elements that may constitute a scoping study; and to describe the lessons learnt by the SDO Programme in commissioning scoping studies. Scoping studies are imprecisely defined but usually consist of one or more discrete components; most commonly they are non-systematic reviews of the literature, but other important elements are literature mapping, conceptual mapping and policy mapping. Some scoping studies also involve consultations with stakeholders including the end users of research. Scoping studies have been used for a wide variety of purposes, although a common feature is to identify questions and topics for future research. The reports of scoping studies often have an impact that extends beyond informing research commissioners about future research areas; some have been published in peer reviewed journals, and others have been published in research summaries aimed at a broader audience of health service managers and policymakers. Key lessons from the SDO experience are the need to relate scoping studies to a particular health service context; the need for scoping teams to be multi-disciplinary and to be given enough time to integrate diverse findings; and the need for the research commissioners to be explicit not only about the aims of scoping studies but also about their intended uses. This necessitates regular contact between researchers and

  20. Integration of social media with healthcare big data for improved service delivery

    Directory of Open Access Journals (Sweden)

    Sibulela Mgudlwa

    2018-04-01

    Full Text Available Background: In the last decade, social media users across the world have crossed 1 billion, making it one of the fastest growing sources of big data. Also, people needing healthcare continue to increase in every society. Through accessibility, communication and interaction between health practitioners and patients, this type of ever-growing, social media subscriber–based platform can be of significant use in improving healthcare delivery to society. However, users encounter serious challenges in their attempts to make use of social media and big data for health-related services. The challenges are primarily caused by factors such as integration, complexity, security and privacy. The challenges are mainly owing to the sensitive nature of the healthcare environment, as a result of personalisation and privacy of information.   Objectives: The objectives of the study were to examine and gain a better understanding of the complexities that are associated with the use of social media and healthcare big data, through influencing factors, and to develop a framework that can be used to improve health-related services to the patients.   Methods: The interpretivist approach was employed, within which qualitative data were collected. This included documents and existing literature in the areas of social media and healthcare big data. To have a good spread of both previous and current state of events within the phenomena being studied, literature published between 2006 and 2016 were gathered. The data were interpretively analysed.   Results: Based on the analysis of the data, factors of influence were found, which were used to develop a model. The model illustrates how the factors of influence can enable and at the same time constrain the use of social media for healthcare services. The factors were interpreted from which a framework was developed. The framework is intended to guide integration of social media with healthcare big data through which

  1. Government policy and access to natural gas service in Canada

    International Nuclear Information System (INIS)

    Plourde, A.; Ryan, D.L.

    1995-01-01

    As part of the Canadian energy policy between the mid-1970's to the mid-1980's, consumers were encouraged to use fuels alternative to oil. The first set of policy issues involved measures to provide consumers with incentives to switch to non-oil-burning equipment, whereas the second set of. policy papers emphasized the expansion of the natural gas distribution system. More than $1 billion have been spent on the gas pipeline expansion project. Consequences of program expenditures in each province were examined. With the exception of Manitoba, it was found that annual net pipeline additions were higher during the program period, indicating that the program policies induced these activities to occur sooner than if the policies were not in place. Kilometres of gas pipeline per individual constructed was highest in Quebec, where construction proceeded mainly between the more densely populated centres. In contrast, in Saskatchewan and Alberta, the program encouraged natural gas pipeline construction in rural areas with lower populations. Without the program, these areas may not have had access to natural gas for a very long time. It was concluded that, in this, and some other instances, public investment had the effect of accelerating developments, or encouraging the completion of projects that otherwise would not have been undertaken. It was suggested that in the future decision-makers consider the costs of changes in activity patterns prior to designing such programs. 2 figs., 1 table

  2. Financial incentives and psychiatric services in Australia: an empirical analysis of three policy changes.

    Science.gov (United States)

    Doessel, D P; Scheurer, Roman W; Chant, David C; Whiteford, Harvey

    2007-01-01

    Australia has a national, compulsory and universal health insurance scheme, called Medicare. In 1996 the Government changed the Medicare Benefit Schedule Book in such a way as to create different financial incentives for consumers or producers of out-of-hospital private psychiatric services, once an individual consumer had received 50 such services in a 12-month period. The Australian Government introduced a new Item (319) to cover some special cases that were affected by the policy change. At the same time, the Commonwealth introduced a 'fee-freeze' for all medical services. The purpose of this study is two-fold. First, it is necessary to describe the three policy interventions (the constraints on utilization, the operation of the new Item and the general 'fee-freeze'.) The new Item policy was essentially a mechanism to 'dampen' the effect of the 'constraint' policy, and these two policy changes will be consequently analysed as a single intervention. The second objective is to evaluate the policy intervention in terms of the (stated) Australian purpose of reducing utilization of psychiatric services, and thus reducing financial outlays. Thus, it is important to separate out the different effects of the three policies that were introduced at much the same time in November 1996 and January 1997. The econometric results indicate that the composite policy change (constraining services and the new 319 Item) had a statistically significant effect. The analysis of the Medicare Benefit (in constant prices) indicates that the 'fee-freeze' policy also had a statistically significant effect. This enables separate determination of the several policy changes. In fact, the empirical results indicate that the Commonwealth Government underestimated the 'savings' that would arise from the 'constraint' policy.

  3. Vehicle to Grid regulation services of electric delivery trucks: Economic and environmental benefit analysis

    International Nuclear Information System (INIS)

    Zhao, Yang; Noori, Mehdi; Tatari, Omer

    2016-01-01

    Highlights: • Potential net present revenues of electric truck based V2G regulation services are investigated. • GHG emission mitigation of V2G regulation services provided by electric trucks are quantified. • The total cost of ownership and the life-cycle GHG emissions of electric trucks are also analyzed. • V2G regulation services for electric trucks could yield considerable revenues and GHG emission savings. - Abstract: Concerns regarding the fuel costs and climate change impacts associated with petroleum combustion are among the main driving factors for the adoption of electric vehicles. Future commercial delivery truck fleets may include Battery Electric Vehicles (BEVs) and Extended Range Electric Vehicles (EREVs); in addition to savings on fuel and maintenance costs, the introduction of these grid accessible electric vehicles will also provide fleet owners with possible Vehicle to Grid (V2G) opportunities. This study investigates the potential net present revenues and greenhouse gas (GHG) emission mitigation of V2G regulation services provided by electric trucks in a typical fleet. The total cost of ownership and the life-cycle GHG emissions of electric trucks are also analyzed and compared to those of traditional diesel trucks. To account for uncertainties, possible ranges for key parameters are considered instead of only considering fixed single data values for each parameter. The results of this research indicate that providing V2G regulation services for electric trucks could yield considerable additional revenues ($20,000–50,000) and significant GHG emission savings (approximately 300 ton CO_2) compared to conventional diesel trucks.

  4. Policy-Aware Sender Anonymity in Location-Based Services

    Science.gov (United States)

    Vyas, Avinash

    2011-01-01

    Sender anonymity in Location-based services (LBS) refers to hiding the identity of a mobile device user who sends requests to the LBS provider for services in her proximity (e.g. "find the nearest gas station etc."). The goal is to keep the requester's interest private even from attackers who (via hacking or subpoenas) gain access to the LBS…

  5. Part C Service Coordination: State Policies and Models. Synthesis Brief.

    Science.gov (United States)

    Markowitz, Joy

    This brief paper summarizes data from a survey of state coordinators of Part C of the Individuals with Disabilities Education Act concerning service coordination to infants and toddlers with disabilities. The survey examined variations in service coordination at the state level including roles of parents, values of key stakeholders, sources of…

  6. The Delivery of Health Promotion and Environmental Health Services; Public Health or Primary Care Settings?

    Directory of Open Access Journals (Sweden)

    Lene Bjørn Jensen

    2018-05-01

    Full Text Available The WHO Regional Office for Europe developed a set of public health functions resulting in the ten Essential Public Health Operations (EPHO. Public health or primary care settings seem to be favorable to embrace all actions included into EPHOs. The presented paper aims to guide readers on how to assign individual health promotion and environmental health services to public health or primary care settings. Survey tools were developed based on EPHO 2, 3 and 4; there were six key informant surveys out of 18 contacted completed via e-mails by informants working in Denmark on health promotion and five face-to-face interviews were conducted in Australia (Melbourne and Victoria state with experts from environmental health, public health and a physician. Based on interviews, we developed a set of indicators to support the assignment process. Population or individual focus, a system approach or one-to-one approach, dealing with hazards or dealing with effects, being proactive or reactive were identified as main element of the decision tool. Assignment of public health services to one of two settings proved to be possible in some cases, whereas in many there is no clear distinction between the two settings. National context might be the one which guides delivery of public health services.

  7. The Delivery of Health Promotion and Environmental Health Services; Public Health or Primary Care Settings?

    Science.gov (United States)

    Bjørn Jensen, Lene; Lukic, Irena; Gulis, Gabriel

    2018-05-07

    The WHO Regional Office for Europe developed a set of public health functions resulting in the ten Essential Public Health Operations (EPHO). Public health or primary care settings seem to be favorable to embrace all actions included into EPHOs. The presented paper aims to guide readers on how to assign individual health promotion and environmental health services to public health or primary care settings. Survey tools were developed based on EPHO 2, 3 and 4; there were six key informant surveys out of 18 contacted completed via e-mails by informants working in Denmark on health promotion and five face-to-face interviews were conducted in Australia (Melbourne and Victoria state) with experts from environmental health, public health and a physician. Based on interviews, we developed a set of indicators to support the assignment process. Population or individual focus, a system approach or one-to-one approach, dealing with hazards or dealing with effects, being proactive or reactive were identified as main element of the decision tool. Assignment of public health services to one of two settings proved to be possible in some cases, whereas in many there is no clear distinction between the two settings. National context might be the one which guides delivery of public health services.

  8. Role Of E-Government In Delivery Of Public Services In Tanzania Electric Supply Company In Ruvuma Region Tanzania

    Directory of Open Access Journals (Sweden)

    Emmanuel Jackson Petro Gunda

    2015-06-01

    Full Text Available ABSTRACT E-government facilitates delivery of public services of relevant government information in electronic form to citizens in a timely manner and better service delivery to citizens. E-government is a kind of governmental administration which is based on Information Communication and Technology Services. Electronic government describes the use of technologies to facilitate the operation of government and disperse of government information and services. The scope of the work was limited to Tanzania Electric Supply Company Limited TANESCO in Ruvuma region. The population of thirty 31 were selected from a total population of 169 public servants use both purposive and stratified random sampling techniques applied. The major findings of study revealed that about 67.7 of response from respondents agree that ICT infrastructures specifically modern computer connected to internet reliable internet speed well organized organization website power availability in public operation contribute to efficient in delivery of services it also noted by respondents to faster decision making speeding up transaction processing and reduce cost. The study greatly recommends that capacity building to public servants on ICT install and strengthening ICT infrastructures to government organizational are inevitable to realise relevant role of e-government in delivery of public services.

  9. From concept to application: the impact of a community-wide intervention to improve the delivery of preventive services to children.

    Science.gov (United States)

    Margolis, P A; Stevens, R; Bordley, W C; Stuart, J; Harlan, C; Keyes-Elstein, L; Wisseh, S

    2001-09-01

    for which there was existing evidence of efficacy. The interventions involved community-, practice-, and family-level strategies to improve processes of care delivery to families and children. The objectives of the community-level intervention were: 1) to achieve policy level changes that would result in changes in resources available at the level of clinical care, 2) to engage multiple practice organizations in the intervention to achieve an effect on most, if not all, families in the community, and 3) to enhance communication between, among, and within public and private practice organizations to improve coordination and avoid duplication of services. The objective of the practice-level interventions was to overcome specific barriers in the process of care delivery so that preventive services could be effectively delivered. To assist the health department in implementing the family-level intervention, we provided assistance in hiring and training staff and ongoing consultation on staff supervision, including the use of structured protocols for care delivery, and regular feedback data about implementation of the program. Interventions with primary care practices focused on the design of the delivery system within the office and the use of teamwork and data in an "office systems" approach to improving clinical preventive care. All practices (N = 8) that enrolled at least 5 infants/month received help in assessing performance and developing systems (eg, preventive services flow sheets) for preventive services delivery. Family-level interventions addressed the process of care delivery to high-risk pregnant women (poverty) and their infants. Mothers were recruited for the home visiting intervention when they first sought prenatal care at the community health center, the county's largest provider of prenatal care to underserved women. The home visiting intervention involved teams of nurses and educators and involved 2 to 4 visits per month through the infant's first year

  10. Future Organization of Oral Health Services Delivery: From 2012 to 2042.

    Science.gov (United States)

    Brown, L Jackson

    2017-09-01

    The United States is currently experiencing a vortex of change in both general health and oral health care delivery, the ultimate outcome of which is still not well understood. The specific focus of this article is to examine the future organization of the oral health services delivery system (OHSDS) in the U.S., with special attention given to the role of large group dental practices (LGDPs) in that future. The article describes the various types of LGDPs and their ability to change the economic characteristics of the OHSDS. Large geographically distributed corporate group dental practices (LGDCGDPs) are the type that may expand their market share to the extent that they could change the economic characteristics of the OHSDS. A wide range of scenarios is used to project the expansion of LGDCGDPs into the future. The scenarios modeled are not intended as predictions but rather to present a range of possible OHSDS market structures that may emerge over the next 30 years. The implications of each scenario for the economic competition within the OHSDS are described. Possible implications of these trends for dental education are also discussed. This article was written as part of the project "Advancing Dental Education in the 21 st Century."

  11. Time Dependent Heterogeneous Vehicle Routing Problem for Catering Service Delivery Problem

    Science.gov (United States)

    Azis, Zainal; Mawengkang, Herman

    2017-09-01

    The heterogeneous vehicle routing problem (HVRP) is a variant of vehicle routing problem (VRP) which describes various types of vehicles with different capacity to serve a set of customers with known geographical locations. This paper considers the optimal service deliveries of meals of a catering company located in Medan City, Indonesia. Due to the road condition as well as traffic, it is necessary for the company to use different type of vehicle to fulfill customers demand in time. The HVRP incorporates time dependency of travel times on the particular time of the day. The objective is to minimize the sum of the costs of travelling and elapsed time over the planning horizon. The problem can be modeled as a linear mixed integer program and we address a feasible neighbourhood search approach to solve the problem.

  12. Stuttering Intervention in Three Service Delivery Models (Direct, Hybrid, and Telepractice: Two Case Studies

    Directory of Open Access Journals (Sweden)

    Daniel T. Valentine

    2015-01-01

    Full Text Available This study assessed outcomes in stuttering intervention across three service delivery models: direct, hybrid, and telepractice for two 11-year old children who stutter. The goal of the study was to investigate whether short-term goals were maintained through the telepractice sessions. The Stuttering Severity Instrument, Fourth Edition (SSI-4 was administered to each child before and after each intervention period and weekly fluency samples (percentage of stuttered syllables in a monologue were obtained in each of the 10-week intervention periods. In addition, the Communication Attitudes Test-Revised was used to assess the children’s attitudes toward speaking. Following the telepractice period, parents and children completed a questionnaire concerning the therapy experience via telepractice. Both children continued to improve fluency as measured by the weekly fluency samples. SSI-4 severity ratings improved for one child and remained consistent for the other. These outcomes appear to demonstrate that telepractice is viable for improving and maintaining fluency.

  13. SUSTAINABILITY INDICES AS MEASURES OF SERVICE DELIVERY IN OPEN AND DISTANCE LEARNING INSTITUTIONS IN NIGERIA

    Directory of Open Access Journals (Sweden)

    Salawu, I. O, Adeoye, Felix A & Olugbenga David OJO

    2010-01-01

    Full Text Available Open and Distance Education if well organized, is an adequate alternative to conventional education. For acceptability of this assertion, the public, governments, employers of labour and other stakeholders need to be convinced that ODL institutions are not providing half-baked education. Also, for the public and other shareholders enthusiasm and interest that are usually hard earned to be sustained, there is need for total commitment to the implementation of some established indices of sustainability. The thrust of this paper is in the appraisal of the extent to which two ODL institutions in Nigeria adhere to the principles of sustainability. A set of questionnaire was developed and used to collect data which were analyzed using simple non-parametric statistics. Suggestions which were aimed at improving the service delivery, in the institutions used for the study in particular, and other sister institutions especially in the developed countries were highlighted.

  14. Service delivery innovation for hospital emergency management using rich organizational modelling.

    Science.gov (United States)

    Dhakal, Yogit; Bhuiyan, Moshiur; Prasad, Pwc; Krishna, Aneesh

    2018-04-01

    The purpose of this article is to identify and assess service delivery issues within a hospital emergency department and propose an improved model to address them. Possible solutions and options to these issues are explored to determine the one that best fits the context. In this article, we have analysed the emergency department's organizational models through i* strategic dependency and rational modelling technique before proposing updated models that could potentially drive business process efficiencies. The results produced by the models, framework and improved patient journey in the emergency department were evaluated against the statistical data revealed from a reputed government organization related to health, to ensure that the key elements of the issues such as wait time, stay time/throughput, workload and human resource are resolved. The result of the evaluation was taken as a basis to determine the success of the project. Based on these results, the article recommends implementing the concept on actual scenario, where a positive result is achievable.

  15. How well are we doing? Families of adolescents or young adults with cerebral palsy share their perceptions of service delivery.

    Science.gov (United States)

    Darrah, J; Magil-Evans, J; Adkins, R

    2002-07-10

    The satisfaction of families of adolescents and young adults with a diagnosis of cerebral palsy with the service delivery they had experienced in the areas of health, education, recreation, employment, housing and transportation was examined. Common themes across the six service areas were identified. Forty-nine adolescents (13-15 years) and 39 young adults (19-23 years) and their families rated their satisfaction with services and then participated in semi-structured interviews to discuss their experiences. Using a constant comparative method of analysis, common themes were identified from the transcribed interviews. Four themes were identified and named: caring and supportive people; fighting and fatigue; communication/information; and disability awareness. Families continue to experience dissatisfaction and frustration with service delivery in the six areas examined. Both bureaucratic structure and attitudes of service providers contribute to their dissatisfaction.

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

    Science.gov (United States)

    White, Julia N; Corker, Jamaica

    2016-01-01

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

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

    Science.gov (United States)

    White, Julia N; Corker, Jamaica

    2016-08-11

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

  18. Correlates of and Barriers to the Utilization of Health Services for Delivery in South Asia and Sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    Nai-Peng Tey

    2013-01-01

    Full Text Available The high maternal and neonatal mortality rates in South Asia and Sub-Saharan Africa can be attributed to the lack of access and utilization of health services for delivery. Data from the Demographic and Health Surveys conducted in Bangladesh, India, Pakistan, Kenya, Nigeria, and Tanzania show that more than half of the births in these countries were delivered outside a health facility. Institutional delivery was closely associated with educational level, family wealth, place of residence, and women’s media exposure status, but it was not influenced by women’s work status and their roles in decision-making (with the exception of Nigeria. Controlling for other variables, higher parity and younger women were less likely to use a health facility for delivery. Within each country, the poorer, less educated and rural women had higher unmet need for maternal care services. Service related factors (accessibility in terms of cost and distance and sociocultural factors (e.g., did not perceive the need for the services and objections from husband and family also posed as barriers to institutional delivery. The paper concludes with some suggestions to increase institutional delivery.

  19. The determinations of remote sensing satellite data delivery service quality: A positivistic case study in Chinese context

    Science.gov (United States)

    Jin, Jiahua; Yan, Xiangbin; Tan, Qiaoqiao; Li, Yijun

    2014-03-01

    With the development of remote sensing technology, remote-sensing satellite has been widely used in many aspects of national construction. Big data with different standards and massive users with different needs, make the satellite data delivery service to be a complex giant system. How to deliver remote-sensing satellite data efficiently and effectively is a big challenge. Based on customer service theory, this paper proposes a hierarchy conceptual model for examining the determinations of remote-sensing satellite data delivery service quality in the Chinese context. Three main dimensions: service expectation, service perception and service environment, and 8 sub-dimensions are included in the model. Large amount of first-hand data on the remote-sensing satellite data delivery service have been obtained through field research, semi-structured questionnaire and focused interview. A positivist case study is conducted to validate and develop the proposed model, as well as to investigate the service status and related influence mechanisms. Findings from the analysis demonstrate the explanatory validity of the model, and provide potentially helpful insights for future practice.

  20. The determinations of remote sensing satellite data delivery service quality: A positivistic case study in Chinese context

    International Nuclear Information System (INIS)

    Jin, Jiahua; Yan, Xiangbin; Tan, Qiaoqiao; Li, Yijun

    2014-01-01

    With the development of remote sensing technology, remote-sensing satellite has been widely used in many aspects of national construction. Big data with different standards and massive users with different needs, make the satellite data delivery service to be a complex giant system. How to deliver remote-sensing satellite data efficiently and effectively is a big challenge. Based on customer service theory, this paper proposes a hierarchy conceptual model for examining the determinations of remote-sensing satellite data delivery service quality in the Chinese context. Three main dimensions: service expectation, service perception and service environment, and 8 sub-dimensions are included in the model. Large amount of first-hand data on the remote-sensing satellite data delivery service have been obtained through field research, semi-structured questionnaire and focused interview. A positivist case study is conducted to validate and develop the proposed model, as well as to investigate the service status and related influence mechanisms. Findings from the analysis demonstrate the explanatory validity of the model, and provide potentially helpful insights for future practice

  1. Impact and economic evaluation of a novel HIV service delivery model in rural Malawi.

    Science.gov (United States)

    McBain, Ryan K; Petersen, Elizabeth; Tophof, Nora; Dunbar, Elizabeth L; Kalanga, Noel; Nazimera, Lawrence; Mganga, Andrew; Dullie, Luckson; Mukherjee, Joia; Wroe, Emily B

    2017-09-10

    We performed an impact and cost-effectiveness analysis of a novel HIV service delivery model in a high prevalence, remote district of Malawi with a population of 143 800 people. A population-based retrospective analysis of 1-year survival rates among newly enrolled HIV-positive patients at 682 health facilities throughout Malawi, comparing facilities implementing the service delivery model (n = 13) and those implementing care-as-usual (n = 669). Through district-level health surveillance data, we evaluated 1-year survival rates among HIV patients newly enrolled between July 2013 and June 2014 - representing 129 938 patients in care across 682 health facilities - using a multilevel modeling framework. The model, focused on social determinants of health, was implemented throughout Neno District at 13 facilities and compared with facilities in all other districts. Activity-based costing was used to annualize financial and economic costs from a societal perspective. Incremental cost-effectiveness ratios were expressed as quality-adjusted life-years gained. The national average 1-year survival rate for newly enrolled antiretroviral therapy clients was 78.9%: this rate was 87.9% in Neno District, compared with 78.8% across all other districts in Malawi (P cost of receiving care in Neno district (n = 6541 patients) was $317/patient/year, compared with an estimated $219/patient in other districts. This translated to $906 per quality-adjusted life-year gained. Neno District's comprehensive model of care, featuring a strong focus on the community, is $98 more expensive per capita per annum but demonstrates superior 1-year survival rates, despite its remote location. Moreover, it should be considered cost-effective by traditional international standards.

  2. Governance and Public Sector Transformation in South Africa: Reporting and Providing Assurance on Service Delivery Information

    Directory of Open Access Journals (Sweden)

    Mariaan Roos

    2012-12-01

    Full Text Available Reporting on performance was legislatively established in South Africa in terms of the Public Finance Management Act, Act 1 of 1999, section 40 (3(a. The auditing of the reported information was legislated in the Public Audit Act, Act 25 of 2004, section 20(2 (c. The objectives of the article are firstly to provide an overview of the development and application of the reporting and secondly providing assurance on service delivery information and thirdly to reflect on challenges to the implementation thereof in South Africa. The aim through deploying these set objectives is to formulate possible future considerations for improved governance. As central part of the methodology, review of literature on reporting and audit of non-financialwas conducted. The research included scrutiny of the different philosophies and approaches adopted by different countries to the reporting and providing assurance on service delivery information. In this respect, the research reflects a comparative element. In South Africa the Auditor-General adopted a phasing-in approach. The development of the audit approach and audit procedures has reached a stable stage, nine years after the initial process started. The audit of performance information now forms an integral part of the regularity audit process. The analysis of audit findings of the period under study indicates a considerable improvement once initiated, but stagnation persists in subsequent years. Numerous challenges remain around the application of performance reporting in South Africa including non-compliance, the lack of sufficient and appropriate audit evidence, inconsistencies between the various strategic documents and the need to improve the usefulness of performance information. In conclusion the article proposes some steps to address the challenges.

  3. Neuropsychologists as primary care providers of cognitive health: A novel comprehensive cognitive wellness service delivery model.

    Science.gov (United States)

    Pimental, Patricia A; O'Hara, John B; Jandak, Jessica L

    2018-01-01

    By virtue of their extensive knowledge base and specialized training in brain-behavior relationships, neuropsychologists are especially poised to execute a unique broad-based approach to overall cognitive wellness and should be viewed as primary care providers of cognitive health. This article will describe a novel comprehensive cognitive wellness service delivery model including cognitive health, anti-aging, lifelong wellness, and longevity-oriented practices. These practice areas include brain-based cognitive wellness, emotional and spiritually centric exploration, and related multimodality health interventions. As experts in mind-body connections, neuropsychologists can provide a variety of evidence-based treatment options, empowering patients with a sense of value and purpose. Multiple areas of clinical therapy skill-based learning, tailor-made to fit individual needs, will be discussed including: brain stimulating activities, restorative techniques, automatic negative thoughts and maladaptive thinking reduction, inflammation and pain management techniques, nutrition and culinary focused cognitive wellness, spirituality based practices and mindfulness, movement and exercise, alternative/complimentary therapies, relationship restoration/social engagement, and trauma healing/meaning. Cognitive health rests upon the foundation of counteracting mind-body connection disruptions from multiple etiologies including inflammation, chronic stress, metabolic issues, cardiac conditions, autoimmune disease, neurological disorders, infectious diseases, and allergy spectrum disorders. Superimposed on these issues are lifestyle patterns and negative health behaviors that develop as ill-fated compensatory mechanisms used to cope with life stressors and aging. The brain and body are electrical systems that can "short circuit." The therapy practices inherent in the proposed cognitive wellness service delivery model can provide preventative insulation and circuit breaking against

  4. Wheeling and transmission system service policy in North America

    International Nuclear Information System (INIS)

    Casazza, J.A.; Schultz, A.J.; Limmer, H.D.

    1991-01-01

    This paper provides a review and discussion of the status of wheeling in the USA and Canada; the pros and cons of the new policies that are evolving and under consideration for wheeling and transmission access; specific case examples of some of the difficulties that have arisen; and the potential for new transmission technology. (author)

  5. Distance from health facility and mothers’ perception of quality related to skilled delivery service utilization in northern Ethiopia

    Directory of Open Access Journals (Sweden)

    Fisseha G

    2017-10-01

    Full Text Available Girmatsion Fisseha,1 Yemane Berhane,2 Alemayehu Worku,2,3 Wondwossen Terefe1 1Mekelle University, College of Health Science, School of Public Health, Mekelle, Ethiopia; 2Addis Continental Institute of Public Health, Epidemiology Department, Addis Ababa, Ethiopia; 3Addis Ababa University, School of Public Health, Biostatistics Department, Addis Ababa, Ethiopia Background: Poor maternal health service utilization is one of the contributing factors to a high level of maternal and newborn mortality in Ethiopia. The factors associated with utilization of services are believed to differ from one context to another. We assessed the factors associated with skilled delivery service utilization in rural northern Ethiopia.Subjects and methods: A community-based survey was conducted among mothers who gave birth in the 12 months preceding the study period, from January to February 2015, in the Tigray region of Ethiopia. Multistage sampling technique was used to select mothers from the identified clusters. Households within a 10 km radius of the health facility were taken as a cluster for a community survey. Data were collected using face-to-face interview at the household level. We compared the mothers who reported giving birth to the index child in a health facility and those who reported delivering at home, in order to identify the predictors of skilled delivery utilization. Multivariable logistic regression model was used to determine the predictors of skilled delivery service utilization. The results are presented with odds ratio (OR and 95% confidence interval (CI.Results: A total of 1,796 mothers participated in the study, with a 100% response rate. Distance to health facilities (adjusted odds ratio [AOR] =0.53 [95% CI: 0.39, 0.71], perception of mothers to the availability of adequate equipment in the delivery service in their catchment area (AOR =1.5 [95% CI: 1.11, 2.13], experiencing any complication during childbirth, using antenatal care, lower

  6. Nature as capital: Advancing and incorporating ecosystem services in United States federal policies and programs.

    Science.gov (United States)

    Schaefer, Mark; Goldman, Erica; Bartuska, Ann M; Sutton-Grier, Ariana; Lubchenco, Jane

    2015-06-16

    The concept of nature as capital is gaining visibility in policies and practices in both the public and private sectors. This change is due to an improved ability to assess and value ecosystem services, as well as to a growing recognition of the potential of an ecosystem services approach to make tradeoffs in decision making more transparent, inform efficient use of resources, enhance resilience and sustainability, and avoid unintended negative consequences of policy actions. Globally, governments, financial institutions, and corporations have begun to incorporate natural capital accounting in their policies and practices. In the United States, universities, nongovernmental organizations, and federal agencies are actively collaborating to develop and apply ecosystem services concepts to further national environmental and economic objectives. Numerous federal agencies have begun incorporating these concepts into land use planning, water resources management, and preparations for, and responses to, climate change. Going forward, well-defined policy direction will be necessary to institutionalize ecosystem services approaches in federal agencies, as well as to guide intersector and interdisciplinary collaborative research and development efforts. In addition, a new generation of decision support tools are needed to further the practical application of ecosystem services principles in policymaking and commercial activities. Improved performance metrics are needed, as are mechanisms to monitor the status of ecosystem services and assess the environmental and economic impacts of policies and programs. A greater national and international financial commitment to advancing ecosystem services and natural capital accounting would likely have broad, long-term economic and environmental benefits.

  7. A qualitative study of nulliparous women's decision making on mode of delivery under China's two-child policy.

    Science.gov (United States)

    Gu, Chunyi; Zhu, Xinli; Ding, Yan; Setterberg Simone; Wang, Xiaojiao; Tao, Hua; Zhang, Yu

    2018-07-01

    To explore nulliparous women's perceptions of decision making regarding mode of delivery under China's two-child policy. Qualitative descriptive design with in-depth semi-structured interviews. Postnatal wards at a tertiary specialized women's hospital in Shanghai, China. 21 nulliparous women 2-3 days postpartum were purposively sampled until data saturation. In-depth semi-structured interviews were conducted between October 8th, 2015 and January 31st, 2016. Two overarching descriptive categories were identified: (1) women's decision-making process: stability versus variability, and (2) factors affecting decision making: variety versus interactivity. Four key themes emerged from each category: (1) initial decision making with certainty: anticipated trial of labour, failed trial of labour, 'shy away' and compromise, anticipated caesarean delivery; (2) initial decision making with uncertainty: anticipated trial of labour, failed trial of labour, 'shy away' and compromise; (3) internal factors affecting decision making: knowledge and attitude, and childbirth self-efficacy; and (4) external factors affecting decision making: social support, and the situational environment. At the initial period of China's two-child policy, nulliparous women have perceived their decision-making process regarding mode of delivery as one with complexity and uncertainty, influenced by both internal and external factors. This may have implications for the obstetric setting to develop a well-designed decision support system for pregnant women during the entire pregnancy periods. And it is recommended that care providers should assess women's preferences for mode of delivery from early pregnancy and provide adequate perinatal support and continuity of care for them. Copyright © 2018 Elsevier Ltd. All rights reserved.

  8. Institutional delivery service utilization in Munisa Woreda, South East Ethiopia: a community based cross-sectional study.

    Science.gov (United States)

    Amano, Abdella; Gebeyehu, Abebaw; Birhanu, Zelalem

    2012-10-08

    Reducing maternal morbidity and mortality is a global priority which is particularly relevant to developing countries like Ethiopia. One of the key strategies for reducing maternal morbidity and mortality is increasing institutional delivery service utilization of mothers under the care of skilled birth attendants. The aim of this study was to determine the level of institutional delivery service utilization and associated factors. A community-based cross-sectional survey was conducted from April 1-20, 2011, among mothers who gave birth 12 months before the study began in Munesa Woreda, Arsi Zone, Oromia Region, Southeast Ethiopia. A stratified cluster sampling was used to select a sample of 855 participants. Out of all deliveries, only 12.3% took place at health facilities. Women who were urban residents (AOR = 2.27, 95%CI: 1.17, 4.40), women of age at interview less than 20 years (AOR = 6.06, 95%CI: 1.54, 23.78), women with first pregnancy (AOR = 2.41, 95%CI: 1.17, 4.97) and, women who had ANC visit during the last pregnancy (AOR = 4.18, 95%CI: 2.54, 6.89) were more likely to deliver at health institutions. Secondary and above level of mother`s and husband`s education had also a significant effect on health institution delivery with AOR = 4.31 (95%CI: 1.62, 11.46) and AOR = 2.77 (95%CI: 1.07, 7.19) respectively. Institutional delivery service utilization was found to be low in the study area. Secondary and above level of mother`s and husband`s education, urban residence and ANC visit were amongst the main factors that had an influence on health institution delivery. Increasing the awareness of mothers and their partners about the benefits of institutional delivery services are recommended.

  9. Associations between perceptions of drinking water service delivery and measured drinking water quality in rural Alabama.

    Science.gov (United States)

    Wedgworth, Jessica C; Brown, Joe; Johnson, Pauline; Olson, Julie B; Elliott, Mark; Forehand, Rick; Stauber, Christine E

    2014-07-18

    Although small, rural water supplies may present elevated microbial risks to consumers in some settings, characterizing exposures through representative point-of-consumption sampling is logistically challenging. In order to evaluate the usefulness of consumer self-reported data in predicting measured water quality and risk factors for contamination, we compared matched consumer interview data with point-of-survey, household water quality and pressure data for 910 households served by 14 small water systems in rural Alabama. Participating households completed one survey that included detailed feedback on two key areas of water service conditions: delivery conditions (intermittent service and low water pressure) and general aesthetic characteristics (taste, odor and color), providing five condition values. Microbial water samples were taken at the point-of-use (from kitchen faucets) and as-delivered from the distribution network (from outside flame-sterilized taps, if available), where pressure was also measured. Water samples were analyzed for free and total chlorine, pH, turbidity, and presence of total coliforms and Escherichia coli. Of the 910 households surveyed, 35% of participants reported experiencing low water pressure, 15% reported intermittent service, and almost 20% reported aesthetic problems (taste, odor or color). Consumer-reported low pressure was associated with lower gauge-measured pressure at taps. While total coliforms (TC) were detected in 17% of outside tap samples and 12% of samples from kitchen faucets, no reported water service conditions or aesthetic characteristics were associated with presence of TC. We conclude that consumer-reported data were of limited utility in predicting potential microbial risks associated with small water supplies in this setting, although consumer feedback on low pressure-a risk factor for contamination-may be relatively reliable and therefore useful in future monitoring efforts.

  10. Associations between Perceptions of Drinking Water Service Delivery and Measured Drinking Water Quality in Rural Alabama

    Directory of Open Access Journals (Sweden)

    Jessica C. Wedgworth

    2014-07-01

    Full Text Available Although small, rural water supplies may present elevated microbial risks to consumers in some settings, characterizing exposures through representative point-of-consumption sampling is logistically challenging. In order to evaluate the usefulness of consumer self-reported data in predicting measured water quality and risk factors for contamination, we compared matched consumer interview data with point-of-survey, household water quality and pressure data for 910 households served by 14 small water systems in rural Alabama. Participating households completed one survey that included detailed feedback on two key areas of water service conditions: delivery conditions (intermittent service and low water pressure and general aesthetic characteristics (taste, odor and color, providing five condition values. Microbial water samples were taken at the point-of-use (from kitchen faucets and as-delivered from the distribution network (from outside flame-sterilized taps, if available, where pressure was also measured. Water samples were analyzed for free and total chlorine, pH, turbidity, and presence of total coliforms and Escherichia coli. Of the 910 households surveyed, 35% of participants reported experiencing low water pressure, 15% reported intermittent service, and almost 20% reported aesthetic problems (taste, odor or color. Consumer-reported low pressure was associated with lower gauge-measured pressure at taps. While total coliforms (TC were detected in 17% of outside tap samples and 12% of samples from kitchen faucets, no reported water service conditions or aesthetic characteristics were associated with presence of TC. We conclude that consumer-reported data were of limited utility in predicting potential microbial risks associated with small water supplies in this setting, although consumer feedback on low pressure—a risk factor for contamination—may be relatively reliable and therefore useful in future monitoring efforts.

  11. Associations between Perceptions of Drinking Water Service Delivery and Measured Drinking Water Quality in Rural Alabama

    Science.gov (United States)

    Wedgworth, Jessica C.; Brown, Joe; Johnson, Pauline; Olson, Julie B.; Elliott, Mark; Forehand, Rick; Stauber, Christine E.

    2014-01-01

    Although small, rural water supplies may present elevated microbial risks to consumers in some settings, characterizing exposures through representative point-of-consumption sampling is logistically challenging. In order to evaluate the usefulness of consumer self-reported data in predicting measured water quality and risk factors for contamination, we compared matched consumer interview data with point-of-survey, household water quality and pressure data for 910 households served by 14 small water systems in rural Alabama. Participating households completed one survey that included detailed feedback on two key areas of water service conditions: delivery conditions (intermittent service and low water pressure) and general aesthetic characteristics (taste, odor and color), providing five condition values. Microbial water samples were taken at the point-of-use (from kitchen faucets) and as-delivered from the distribution network (from outside flame-sterilized taps, if available), where pressure was also measured. Water samples were analyzed for free and total chlorine, pH, turbidity, and presence of total coliforms and Escherichia coli. Of the 910 households surveyed, 35% of participants reported experiencing low water pressure, 15% reported intermittent service, and almost 20% reported aesthetic problems (taste, odor or color). Consumer-reported low pressure was associated with lower gauge-measured pressure at taps. While total coliforms (TC) were detected in 17% of outside tap samples and 12% of samples from kitchen faucets, no reported water service conditions or aesthetic characteristics were associated with presence of TC. We conclude that consumer-reported data were of limited utility in predicting potential microbial risks associated with small water supplies in this setting, although consumer feedback on low pressure—a risk factor for contamination—may be relatively reliable and therefore useful in future monitoring efforts. PMID:25046635

  12. 'Demand pull' government policies to support Product-Service System activity: The case of Energy Service Companies in the UK

    OpenAIRE

    Hannon, MJ; Foxon, TJ; Gale, WF

    2015-01-01

    Product-Service Systems (PSSs) constitute a family of service-based business models designed to satisfy our societal needs in an economically and environmentally sustainable manner. To date however PSS application has remained niche due to a variety of critical barriers. This paper explores how ‘demand pull’ national government policies could support PSS activity by addressing these barriers and cultivating market demand. Lessons are drawn from a case study of how regulatory, economic incenti...

  13. Factors influencing the selection of delivery with no one present in Northern Nigeria: implications for policy and programs

    Directory of Open Access Journals (Sweden)

    Fapohunda B

    2014-01-01

    Full Text Available Bolaji Fapohunda,1 Nosakhare Orobaton1,21International Division, John Snow Inc, Rosslyn, VA, USA; 2Targeted States High Impact Project (TSHIP, Bauchi, NigeriaAbstract: This paper examines the effects of demographic, socioeconomic, and women's autonomy factors on the utilization of delivery assistance in Sokoto State, Nigeria. Data were obtained from the Nigeria 2008 Demographic and Health Survey (DHS. Bivariate analysis and logistic regression procedures were conducted. The study revealed that delivery with no one present and with unskilled attendance accounted for roughly 95% of all births in Sokoto State. Mothers with existing high risk factors, including higher parity, were more likely to select unsafe/unskilled delivery practices than younger, lower-parity mothers. Evidenced by the high prevalence of delivery with traditional birth attendants, this study demonstrates that expectant mothers are willing to obtain care from a provider, and their odds of using accessible, affordable, skilled delivery is high, should such an option be presented. This conclusion is supported by the high correlation between a mother's socioeconomic status and the likelihood of using skilled attendance. To improve the access to, and increase the affordability of, skilled health attendants, we recommended two solutions: 1 the use of cash subsidies to augment women's incomes in order to reduce finance-related barriers in the use of formal health services, thus increasing demand; and 2 a structural improvement that will increase women's economic security by improving their access to higher education, income, and urban ideation.Keywords: Sokoto State, delivery attendance, maternal mortality rate, maternal health, reproductive health, demographic and health surveys, poverty

  14. Women veterans' healthcare delivery preferences and use by military service era: findings from the National Survey of Women Veterans.

    Science.gov (United States)

    Washington, Donna L; Bean-Mayberry, Bevanne; Hamilton, Alison B; Cordasco, Kristina M; Yano, Elizabeth M

    2013-07-01

    The number of women Veterans (WVs) utilizing the Veterans Health Administration (VA) has doubled over the past decade, heightening the importance of understanding their healthcare delivery preferences and utilization patterns. Other studies have identified healthcare issues and behaviors of WVs in specific military service eras (e.g., Vietnam), but delivery preferences and utilization have not been examined within and across eras on a population basis. To identify healthcare delivery preferences and healthcare use of WVs by military service era to inform program design and patient-centeredness. Cross-sectional 2008-2009 survey of a nationally representative sample of 3,611 WVs, weighted to the population. Healthcare delivery preferences measured as importance of selected healthcare features; types of healthcare services and number of visits used; use of VA or non-VA; all by military service era. Military service era differences were present in types of healthcare used, with World War II and Korea era WVs using more specialty care, and Vietnam era-to-present WVs using more women's health and mental health care. Operations Enduring Freedom, Iraqi Freedom, New Dawn (OEF/OIF/OND) WVs made more healthcare visits than WVs of earlier military eras. The greatest healthcare delivery concerns were location convenience for Vietnam and earlier WVs, and cost for Gulf War 1 and OEF/OIF/OND WVs. Co-located gynecology with general healthcare was also rated important by a sizable proportion of WVs from all military service eras. Our findings point to the importance of ensuring access to specialty services closer to home for WVs, which may require technology-supported care. Younger WVs' higher mental health care use reinforces the need for integration and coordination of primary care, reproductive health and mental health care.

  15. 47 CFR 64.401 - Policies and procedures for provisioning and restoring certain telecommunications services in...

    Science.gov (United States)

    2010-10-01

    ... 47 Telecommunication 3 2010-10-01 2010-10-01 false Policies and procedures for provisioning and restoring certain telecommunications services in emergencies. 64.401 Section 64.401 Telecommunication... procedures for provisioning and restoring certain telecommunications services in emergencies. The...

  16. Determination of Appropriate Service Delivery Level for Quantitative Attributes of Household Toilets in Rural Settlements of India from Users' Perspective

    Science.gov (United States)

    Rashid, Mohammad; Pandit, Debapratim

    2018-04-01

    Improvement of quality of sanitation services in rural settlements is an important development goal in developing countries including India and accordingly several strategies are adopted which promote the demand and use of household toilets through creating awareness and providing subsidies to poor people for construction of household toilets with service-level standards specified from experts' perspective. In many cases, users are unsatisfied with the quality of toilets constructed using subsidies and the same remain unused. Users' satisfaction depends on their perceptions of service quality of individual attributes and overall service quality of the household toilets, which is an important determinant of sustainability and sustained use of toilets. This study aims to assess and benchmark the appropriate service delivery level for quantitative attributes of rural household toilets based on user perception. The service quality is determined with the help of level of service (LOS) scales developed using successive interval scaling technique, the zone of tolerance (ZOT), and users satisfaction level (USL) which relates service delivery levels with user satisfaction directly. The study finds that the service quality of most of the attributes of household toilets constructed using subsidies is perceived as poor. The results also suggest that most of the users expect to have a toilet with the service level of attributes ranging between LOS A and LOS B.

  17. 78 FR 36725 - Numbering Policies for Modern Communications; IP-Enabled Services; Telephone Number Requirements...

    Science.gov (United States)

    2013-06-19

    ... help speed the delivery of innovative services to consumers and businesses, while preserving the... available for public inspection during regular business hours in the FCC Reference Information Center... already broken the historical tie between a number and a specific device. For example, Skype permits users...

  18. Emergency recompression: clinical audit of service delivery at a national level.

    Science.gov (United States)

    Ross, John As; Sayer, Martin Dj

    2009-03-01

    Clinical audit is an essential element to the maintenance or improvement of delivery of any medical service. During the development phase of a National Recompression Registration Service for Scotland, clinical audit was initiated to provide a standardised tool to monitor the quality of outcome with respect to the severity of presentation. A functional audit process was an essential consideration for planned future measurement of treatment efficacy at local (single hyperbaric unit) and national (multiple hyperbaric units) scales. The audit process was designed to be undemanding, robust and informative, irrespective of the experience of treatment centre and of the clinician in charge of treatment. The clinical records from 104 cases of divers with decompression illness were used to derive and evaluate measures of severity and clinical outcome that could be used for audit and quality assurance. The various measures of disease severity were examined against clinical outcome and days spent in care after admission to a hyperbaric unit. An initial version of the clinical audit format that was developed from this process is presented.

  19. State Policies on Service Dogs for Military Veterans.

    Science.gov (United States)

    Reed, James B

    2015-12-01

    U.S. service members returning home from combat often face physical, mental and emotional challenges. Providing service dogs to these veterans is one method being used successfully to help address the difficulties they face. Under the federal Americans with Disabilities Act (ADA), a service animal is defined as "any dog that is individually trained to do work or perform tasks for the benefit of an individual with a disability, including a physical, sensory, psychiatric, intellectual or other mental disability." The work the dog undertakes must be directly related to the person's disability. Examples include guiding people who are blind, pulling a wheelchair, alerting a person with hearing loss, protecting a person having a seizure, and calming someone with post-traumatic stress disorder (PTSD) during an anxiety attack or psychiatric episode.

  20. Long term warranty and after sales service concept, policies and cost models

    CERN Document Server

    Rahman, Anisur

    2015-01-01

    This volume presents concepts, policies and cost models for various long-term warranty and maintenance contracts. It offers several numerical examples for estimating costs to both the manufacturer and consumer. Long-term warranties and maintenance contracts are becoming increasingly popular, as these types of aftersales services provide assurance to consumers that they can enjoy long, reliable service, and protect them from defects and the potentially high costs of repairs. Studying long-term warranty and service contracts is important to manufacturers and consumers alike, as offering long-term warranty and maintenance contracts produce additional costs for manufacturers / service providers over the product’s service life. These costs must be factored into the price, or the manufacturer / dealer will incur losses instead of making a profit. On the other hand, the buyer / consumer needs to weigh the cost of maintaining it over its service life and to decide whether or not these policies are worth purchasing....