Vertical funding, non-governmental organizations, and health system strengthening: perspectives of public sector health workers in Mozambique.

Science.gov (United States)

Mussa, Abdul H; Pfeiffer, James; Gloyd, Stephen S; Sherr, Kenneth

2013-06-14

In the rapid scale-up of human immunodeficiency virus (HIV) care and acquired immunodeficiency syndrome (AIDS) treatment, many donors have chosen to channel their funds to non-governmental organizations and other private partners rather than public sector systems. This approach has reinforced a private sector, vertical approach to addressing the HIV epidemic. As progress on stemming the epidemic has stalled in some areas, there is a growing recognition that overall health system strengthening, including health workforce development, will be essential to meet AIDS treatment goals. Mozambique has experienced an especially dramatic increase in disease-specific support over the last eight years. We explored the perspectives and experiences of key Mozambican public sector health managers who coordinate, implement, and manage the myriad donor-driven projects and agencies. Over a four-month period, we conducted 41 individual qualitative interviews with key Ministry workers at three levels in the Mozambique national health system, using open-ended semi-structured interview guides. We also reviewed planning documents. All respondents emphasized the value and importance of international aid and vertical funding to the health sector and each highlighted program successes that were made possible by recent increased aid flows. However, three serious concerns emerged: 1) difficulties coordinating external resources and challenges to local control over the use of resources channeled to international private organizations; 2) inequalities created within the health system produced by vertical funds channeled to specific services while other sectors remain under-resourced; and 3) the exodus of health workers from the public sector health system provoked by large disparities in salaries and work. The Ministry of Health attempted to coordinate aid by implementing a "sector-wide approach" to bring the partners together in setting priorities, harmonizing planning, and coordinating

Public health workforce employment in US public and private sectors.

Science.gov (United States)

Kennedy, Virginia C

2009-01-01

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

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

Science.gov (United States)

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

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

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

Science.gov (United States)

Johnston, Lee M; Finegood, Diane T

2015-03-18

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

The politics of public sector change.

Science.gov (United States)

Harvey, Peter

2003-05-01

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

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

Science.gov (United States)

Perkins, R; Barnett, P; Powell, M

2000-01-01

New Zealand public hospitals and related services were grouped into 23 Crown Health Enterprises and registered as companies in 1993. Integral to this change was the introduction of corporate governance. New directors, largely from the business sector, were appointed to govern these organisations as efficient and effective businesses. This article presents the results of a survey of directors of New Zealand publicly-owned health provider organisations. Although directors thought they performed well in business systems development, they acknowledged their shortcomings in meeting government expectations in respect to financial performance and social responsibility. Changes in public health sector provider performance indicators have resulted in a mixed report card for the sector six years after corporate governance was instituted.

The skills gap in nursing management in the South African public health sector.

Science.gov (United States)

Pillay, Rubin

2011-01-01

Nurse managers are central to health delivery in South Africa. However, there is a paucity of research that analyzes their competence to successfully discharge their managerial role. To identify the competencies perceived to be important for effective nursing management in the South African public sector and the managers' self-assessed proficiency in these. A cross-sectional survey using a self-administered questionnaire. 215 senior nursing managers at South African public sector hospitals. Respondents rated the level of importance that 51 proposed competencies had in their job and indicated their proficiency in each. Public sector managers ranked controlling as the most important competency, followed by leading, organizing, and self-management. Health/clinical skills, planning, and legal/ethical competencies were ranked as being relatively less important. They assessed themselves as being most competent in self-management, followed by planning, controlling, leading, and specific health skills. The competency gap was the largest for legal/ethical issues, organizing, and controlling. The competency gap for planning and self-management was relatively smaller. This research confirms that there is a lack of management capacity within the public health sector and also identifies the areas in which the lack of knowledge or skills is most significant. © 2011 Wiley Periodicals, Inc.

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

Science.gov (United States)

Shoven, John B; Slavov, Sita Nataraj

2014-12-01

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

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

Science.gov (United States)

Darling, Helen

2006-01-01

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

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

Science.gov (United States)

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

2010-11-25

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

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

Science.gov (United States)

Liu, Hsi-Chen; Cheng, Yawen

2018-04-01

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

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

Science.gov (United States)

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

2002-04-01

Motivation in the work context can be defined as an individual's degree of willingness to exert and maintain an effort towards organizational goals. Health sector performance is critically dependent on worker motivation, with service quality, efficiency, and equity, all directly mediated by workers' willingness to apply themselves to their tasks. Resource availability and worker competence are essential but not sufficient to ensure desired worker performance. While financial incentives may be important determinants of worker motivation, they alone cannot and have not resolved all worker motivation problems. Worker motivation is a complex process and crosses many disciplinary boundaries, including economics, psychology, organizational development, human resource management, and sociology. This paper discusses the many layers of influences upon health worker motivation: the internal individual-level determinants, determinants that operate at organizational (work context) level, and determinants stemming from interactions with the broader societal culture. Worker motivation will be affected by health sector reforms which potentially affect organizational culture, reporting structures, human resource management, channels of accountability, types of interactions with clients and communities, etc. The conceptual model described in this paper clarifies ways in which worker motivation is influenced and how health sector reform can positively affect worker motivation. Among others, health sector policy makers can better facilitate goal congruence (between workers and the organizations they work for) and improved worker motivation by considering the following in their design and implementation of health sector reforms: addressing multiple channels for worker motivation, recognizing the importance of communication and leadership for reforms, identifying organizational and cultural values that might facilitate or impede implementation of reforms, and understanding that reforms

Staff and bed distribution in public sector mental health services in ...

African Journals Online (AJOL)

Background. The Eastern Cape Province of South Africa is a resource-limited province with a fragmented mental health service. Objective. To determine the current context of public sector mental health services in terms of staff and bed distribution, and how this corresponds to the population distribution in the province.

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

Science.gov (United States)

Reynolds, Megan M

2018-04-01

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

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

Directory of Open Access Journals (Sweden)

Pawan Kumar

2013-01-01

Full Text Available Introduction: Job satisfaction is determined by a discrepancy between what one wants in a job and what one has in a job. The core components of information necessary for what satisfies and motivates the health work force in our country are missing at policy level. Therefore present study will help us to know the factors for job satisfaction among primary health care providers in public sector. Materials and Methods: Present study is descriptive in nature conducted in public sector dispensaries/primary urban health centers in Delhi among health care providers. Pretested structured questionnaire was administered to 227 health care providers. Data was analyzed using SPSS and relevant statistical test were applied. Results: Analysis of study reveals that ANMs are more satisfied than MOs, Pharmacist and Lab assistants/Lab technicians; and the difference is significant (P < 0.01. Age and education level of health care providers don′t show any significant difference in job satisfaction. All the health care providers are dissatisfied from the training policies and practices, salaries and opportunities for career growth in the organization. Majority of variables studied for job satisfaction have low scores. Five factor were identified concerned with job satisfaction in factor analysis. Conclusion: Job satisfaction is poor for all the four groups of health care providers in dispensaries/primary urban health centers and it is not possible to assign a single factor as a sole determinant of dissatisfaction in the job. Therefore it is recommended that appropriate changes are required at the policy as well as at the dispensary/PUHC level to keep the health work force motivated under public sector in Delhi.

Staff/population ratios in South African public sector mental health ...

African Journals Online (AJOL)

To document existing staff/population ratios per 100 000 population in South African public sector mental health services. Design. Cross-sectional survey. ... The staff/population ratios per 100 000 population for selected personnel categories (with the interprovincial ranges in brackets) were as follows: total nursing staff 15.6 ...

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

Science.gov (United States)

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

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

Public-Private health sector mix- way forward

African Journals Online (AJOL)

Bank.1. The World Bank articulated its position in two reports,2,3 basically recommending ... lution in public sector management thinking, termed “new public management” The new public man- ..... Buso DL, Hausler H, Jinabhai N. Knowledge,.

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

Science.gov (United States)

Slipicevic, Osman; Malicbegovic, Adisa

2012-01-01

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

Public sector innovation

DEFF Research Database (Denmark)

Wegener, Charlotte

2012-01-01

This paper explores the value dimension of public innovation in the light of practitioners’ values and asks why there seems to be a clash between innovation imperatives and workplace practices in the public sector. The paper contributes to the research on public innovation from a practice...... perspective by providing evidence from an ethnographic field study on innovation in social and health care studies in Denmark. These studies are part of the vocational education and training (VET) system, which combines coursework at a college and internship in the elder care sector. The study is thus cross...... initiate innovations grounded in their values. The main point put forward is that the value dimension of public innovation must be understood not only in terms of value creation (economic or non-economic), which frontline practitioners are required to contribute to, but also as value-based practices...

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

Science.gov (United States)

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

2016-11-21

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

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

Science.gov (United States)

Kumar, Ramesh; Ahmed, Jamil; Shaikh, Babar Tasneem; Hafeez, Rehan; Hafeez, Assad

2013-01-09

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

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

Directory of Open Access Journals (Sweden)

Mahapatra Prasanta

2010-11-01

Full Text Available Abstract Background Ensuring health worker job satisfaction and motivation are important if health workers are to be retained and effectively deliver health services in many developing countries, whether they work in the public or private sector. The objectives of the paper are to identify important aspects of health worker satisfaction and motivation in two Indian states working in public and private sectors. Methods Cross-sectional surveys of 1916 public and private sector health workers in Andhra Pradesh and Uttar Pradesh, India, were conducted using a standardized instrument to identify health workers' satisfaction with key work factors related to motivation. Ratings were compared with how important health workers consider these factors. Results There was high variability in the ratings for areas of satisfaction and motivation across the different practice settings, but there were also commonalities. Four groups of factors were identified, with those relating to job content and work environment viewed as the most important characteristics of the ideal job, and rated higher than a good income. In both states, public sector health workers rated "good employment benefits" as significantly more important than private sector workers, as well as a "superior who recognizes work". There were large differences in whether these factors were considered present on the job, particularly between public and private sector health workers in Uttar Pradesh, where the public sector fared consistently lower (P P Conclusion There are common areas of health worker motivation that should be considered by managers and policy makers, particularly the importance of non-financial motivators such as working environment and skill development opportunities. But managers also need to focus on the importance of locally assessing conditions and managing incentives to ensure health workers are motivated in their work.

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

Science.gov (United States)

Graaf, Genevieve; Snowden, Lonnie

2018-01-22

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

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

Directory of Open Access Journals (Sweden)

Kumar Ramesh

2013-01-01

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

Work Motivation and Incentives in the Public Sector

OpenAIRE

Zoutenbier, Robin

2015-01-01

markdownabstractThe public sector makes up for an important part of our economy. According to estimates by the OECD (2008) a large share of the labor force in OECD countries is employed by the public sector. These public sector workers provide a wide range of goods and services to the public. Examples of services that are publicly provided range from education, health care, transport, garbage collection, to public safety. This large variety in public services suggests that all people, at some...

Public sector achievement in 36 countries

NARCIS (Netherlands)

Benedikt Goderis

2015-01-01

This report examines the inputs, outputs and outcomes of the public sector in 36 countries (including the EU-28) over the period 1995-2012. We study two sectors – education and health – in some detail, while taking a more general look at the sectors social safety, housing, social security and

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

Science.gov (United States)

Namakula, Justine; Witter, Sophie; Ssengooba, Freddie

2016-05-05

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

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

Science.gov (United States)

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

2013-09-27

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

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

Science.gov (United States)

Kröger, H

2016-04-01

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

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

DEFF Research Database (Denmark)

Ashton, Toni; Brown, Paul M.; Sopina, Elizaveta (Liza)

2013-01-01

and professional development, key sources of dissatisfaction are workload pressures, mentally demanding work and managerial interference. In the private sector specialists value the opportunity to work independently and apply their own ideas in the workplace. Conclusion Sources of job satisfaction...... and dissatisfaction amongst specialists are different for the public and private sectors. Allowing specialists more freedom to work independently and to apply their own ideas in the workplace may enhance recruitment and retention of specialists in the public health system....

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

Science.gov (United States)

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

2013-10-18

Continued inequities in coverage, low quality of care, and high out-of-pocket expenses for health services threaten attainment of Millennium Development Goals 4 and 5 in many sub-Saharan African countries. Existing health systems largely rely on input-based supply mechanisms that have a poor track record meeting the reproductive health needs of low-income and underserved segments of national populations. As a result, there is increased interest in and experimentation with results-based mechanisms like supply-side performance incentives to providers and demand-side vouchers that place purchasing power in the hands of low-income consumers to improve uptake of facility services and reduce the burden of out-of-pocket expenditures. This paper describes a reproductive health voucher program that contracts private facilities in Uganda and explores the policy and implementation issues associated with expansion of the program to include public sector facilities. Data presented here describes the results of interviews of six district health officers and four health facility managers purposefully selected from seven districts with the voucher program in southwestern Uganda. Interviews were transcribed and organized thematically, barriers to seeking RH care were identified, and how to address the barriers in a context where voucher coverage is incomplete as well as opportunities and challenges for expanding the program by involving public sector facilities were investigated. The findings show that access to sexual and reproductive health services in southwestern Uganda is constrained by both facility and individual level factors which can be addressed by inclusion of the public facilities in the program. This will widen the geographical reach of facilities for potential clients, effectively addressing distance related barriers to access of health care services. Further, intensifying ongoing health education, continuous monitoring and evaluation, and integrating the voucher

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

Science.gov (United States)

Vujicic, Marko

2010-01-01

Health workers play a key role in increasing access to health care services. Global and country-level estimates show that staffing in many developing countries - particularly in Sub-Saharan Africa - is far leaner than needed to deliver essential health services to the population. One factor that can limit scaling up the health workforce in developing countries is the government's overall wage policy which sometimes creates restrictions on hiring in the health sector. But while there is considerable debate, the information base in this important area has been quite limited. This paper summarizes the process that determines the budget for health wages in the public sector, how it is linked to overall wage policies, and how this affects staffing in the health sector. The author draws mainly from a recent World Bank report.

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

Science.gov (United States)

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

2015-12-23

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

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

Science.gov (United States)

Morgan, Rosemary; Ensor, Tim; Waters, Hugh

2016-08-06

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

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

Science.gov (United States)

Nandi, Sulakshana; Schneider, Helen; Dixit, Priyanka

2017-01-01

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

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

Science.gov (United States)

Bíró, Anikó; Hellowell, Mark

2016-07-01

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

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

Science.gov (United States)

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

2016-02-01

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

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

Science.gov (United States)

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

2018-06-01

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

Public Sector Wage Growth in Alberta

Directory of Open Access Journals (Sweden)

Ken Boessenkool

2012-01-01

Full Text Available In recent years, Alberta’s fiscal stance has shifted from large surpluses to deficits, and a large part of the blame appears to be due to rising public sector salaries. Since 2000, the province’s public sector wage bill has shot up by 119 percent — almost double the rate of growth in the rest of Canada. Wages, previously roughly at par with the rest of the country, are now higher (in many cases very substantially across all public sector categories, including health care, social services, education and government, consuming 95 percent of the increase in provincial revenues over the past decade. At the same time, the number of public sector employees has grown faster than the overall population; it is difficult to attribute this sharp uptick to a rise in productivity, or the need to compete with private industry for skilled workers. This paper breaks down the increases in every category, arguing that if the provincial government is looking to trim expenditures, public sector salaries are a good place to start. The authors make their case using detailed Statistics Canada data, throwing down the gauntlet to defenders of the status quo and challenging them to justify these disparate increases.

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

Science.gov (United States)

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

2016-01-01

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

Staff and bed distribution in public sector mental health services in the Eastern Cape Province, South Africa

Directory of Open Access Journals (Sweden)

Kiran Sukeri

2014-11-01

Full Text Available Background. The Eastern Cape Province of South Africa is a resource-limited province with a fragmented mental health service.  Objective. To determine the current context of public sector mental health services in terms of staff and bed distribution, and how this corresponds to the population distribution in the province. Method. In this descriptive cross-sectional study, an audit questionnaire was submitted to all public sector mental health facilities. Norms and indicators were calculated at provincial and district level. This article investigates staff and bed distribution only. Results. Results demonstrated that within the province, only three of its seven districts have acute beds above the national baseline norm requirement of 13/100 000. The private mental health sector provides approximately double the number of medium- to long-stay beds available in the public sector. Only two regions have staff/population ratios above the baseline norm of 20/100 000. However, there are significant differences in this ratio among specific staff categories. There is an inequitable distribution of resources between the eastern and western regions of the province. When compared with the western regions, the eastern regions have poorer access to mental health facilities, human resources and non-governmental organisations.  Conclusion. Owing to the inequitable distribution of resources, the provincial authorities urgently need to develop an equitable model of service delivery. The province has to address the absence of a reliable mental health information system.

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

Directory of Open Access Journals (Sweden)

Sulakshana Nandi

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

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

Science.gov (United States)

Qin, Paige; Chernew, Michael

2014-12-01

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

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

Science.gov (United States)

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

2016-01-01

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

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

NARCIS (Netherlands)

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

2018-01-01

During the Ebola outbreak in West Africa in 2014-2015, close cooperation between the curative sector and the public health sector in the Netherlands was necessary for timely identification, referral, and investigation of patients with suspected Ebola virus disease (EVD).

Private health purchasing practices in the public sector: a comparison of state employers and the Fortune 500.

Science.gov (United States)

Maxwell, James; Temin, Peter; Petigara, Tanaz

2004-01-01

State governments are influential purchasers of health benefits but have not been studied extensively. In a recent survey of senior benefit managers, we examine the extent to which states have followed the private-sector approach to purchasing health care. We found that states have adopted "industrial purchasing" practices similar to those of large private employers but offer greater choice of carriers and pay a higher percentage of premiums. Unions continue to influence health care purchasing in both the public and private sectors. Double-digit increases in health costs and the current budget crisis may force states to align their purchasing practices with the private sector to cut costs.

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

Science.gov (United States)

Franco, Massimo; Tursunbayeva, Aizhan

2016-01-01

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

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

Science.gov (United States)

Franco, Massimo; Tursunbayeva, Aizhan; Pagliari, Claudia

2016-03-11

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

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

NARCIS (Netherlands)

C. Swaan (Corien); Öry, A.V. (Alexander V.); Schol, L.G.C. (Lianne G. C.); A. Jacobi (Andre); J.H. Richardus (Jan Hendrik); A. Timen (Aura)

2017-01-01

markdownabstractContext: During the Ebola outbreak in West Africa in 2014-2015, close cooperation between the curative sector and the public health sector in the Netherlands was necessary for timely identification, referral, and investigation of patients with suspected Ebola virus disease (EVD).

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

Science.gov (United States)

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

2004-01-01

This paper describes factors affecting health worker motivation and satisfaction in the public sector in Ghana. The data are from a survey of public sector health care providers carried out in January 2002 and repeated in August 2003 using an interviewer administered structured questionnaire. It is part of a continuous quality improvement (CQI) effort in the health sector in the Greater Accra region of Ghana. Workplace obstacles identified that caused dissatisfaction and de-motivated staff in order of the most frequently mentioned were low salaries such that obtaining basic necessities of daily living becomes a problem; lack of essential equipment, tools and supplies to work with; delayed promotions; difficulties and inconveniences with transportation to work; staff shortages; housing, additional duty allowances and in-service (continuous) training. Others included children's education, vehicles to work with such as ambulances and pickups, staff transfer procedures, staff pre-service education inadequate for job requirements, and the effect of the job on family and other social factors. There were some differences in the percentages of staff selecting a given workplace obstacle between the purely rural districts, the highly urbanized Accra metropolis and the districts that were a mixture of urbanized and rural. It is unlikely that the Ghana Health Service can provide high quality of care to its end users (external customers) if workplace obstacles that de-motivate staff (internal customers) and negatively influence their performance are not properly recognized and addressed as a complex of inter-related problems producing a common result--dissatisfied poorly motivated staff and resulting poor quality services.

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

Science.gov (United States)

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

2011-07-01

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

The Ariadne's thread in co-payment, primary health care usage and financial crisis: findings from Cyprus public health care sector.

Science.gov (United States)

Petrou, P

2015-11-01

Cyprus entered a prolonged financial recession in 2011 and by early 2013 it applied for an international bail-out agreement. This presupposed massive reforms in public governance. Health sector was considerably reformed and one of the measures was the introduction of co-payment for outpatient visits to public health care sector. The scope of this study is to assess the impact of financial crisis and co-payment to public outpatient visits in Nicosia urban and greater Nicosia region. An Interrupted time-series analysis. All outpatient visits to public health care family doctor/general practitioners in Nicosia urban and greater Nicosia region from January 2011 until May of 2014 were registered and analysed. Financial crisis did not alter outpatient visits. Introduction of co-payment led to a statistically significant decrease from the second month after its introduction (p = 0.048) (R(2) = 0.329, Q = 23.75, p = 0.137). This decrease was consistent until the end of the observational period and it did not level off. Financial crisis did not affect outpatient visits while co-payment can be considered as a potent cost containment measure during financial recession, by normalising utilisation of healthcare resources. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Process Evaluation of Communitisation Programme in Public Sector Health Facilities, Mokokchung District, Nagaland, 2015.

Science.gov (United States)

Tushi, Aonungdok; Kaur, Prabhdeep

2017-01-01

Public sector health facilities were poorly managed due to a history of conflict in Nagaland, India. Government of Nagaland introduced "Nagaland Communitisation of Public Institutions and Services Act" in 2002. Main objectives of the evaluation were to review the functioning of Health Center Managing Committees (HCMCs), deliver health services in the institutions managed by HCMC, identify strengths as well as challenges perceived by HCMC members in the rural areas of Mokokchung district, Nagaland. The evaluation was made using input, process and output indicators. A doctor, the HCMC Chairman and one member from each of the three community health centers (CHC) and four primary health centers (PHC) were surveyed using a semi-structured questionnaire and an in-depth interview guide. Proportions for quantitative data were computed and key themes from the same were identified. Overall; the infrastructure, equipment and outpatient/inpatient service availability was satisfactory. There was a lack of funds and shortage of doctors, drugs as well as laboratory facilities. HCMCs were in place and carried out administrative activities. HCMCs felt ownership, mobilized community contributions and managed human resources. HCMC members had inadequate funds for their transport and training. They faced challenges in service delivery due to political interference and lack of adequate human, material, financial resources. Communitisation program was operational in the district. HCMC members felt the ownership of health facilities. Administrative, political support and adequate funds from the government are needed for effective functioning of HCMCs and optimal service delivery in public sector facilities.

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

Science.gov (United States)

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

2013-02-01

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

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

Science.gov (United States)

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

2016-09-01

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

The Free Trade Agreement and the Mexican health sector.

Science.gov (United States)

Laurell, A C; Ortega, M E

1992-01-01

This article presents a discussion of the probable implications for the Mexican health sector of the Free Trade Agreement (FTA) between the United States, Canada, and Mexico. The authors argue that the FTA should be seen as part of neoliberal policies adopted by the Mexican government in 1983 that are based on large-scale privatization and deregulation of labor relations. In this general context the health sector, which traditionally has been dominated by public institutions, is undergoing a deep restructuring. The main trends are the decapitalization of the public sector and a selective process of privatization that tends to constitute the private health sector in a field of capital accumulation. The FTA is likely to force a change in Mexican health legislation, which includes health services in the public social security system and recognizes the right to health, and to accelerate selective privatization. The U.S. insurance industry and hospital corporations are interested in promoting these changes in order to gain access to the Mexican market, estimated at 20 to 25 million persons. This would lead to further deterioration of the public institutions, increasing inequalities in health and strengthening the private sector. The historical trend toward the integration of a National Health Service in Mexico would be interrupted in favor of formation of a dual private-public system.

What is the Meaning of Public Sector Health?

DEFF Research Database (Denmark)

Waldorff, Susanne Boch

2013-01-01

This study explores the dynamics involved in establishing discourses necessary for constructing organizational change within the public sector. Drawing upon critical discourse analysis, the study identifies two competing discourses – a ‘patient’ and a ‘healthy citizen’ discourse, which exist...... in the context of public sector change. First, the study shows that discourses not only provide different senses of meaning and warrant particular social actors a louder voice than others, but that these actors also develop discursive legitimizing strategies and translate particular meanings...... into the organization and organizational practices. Second, when the strategies make a discourse resonate with the local context, in this case a highly political context, then specific organizational practices become more legitimate than others, and the discourse is more inclined to become manifest. Finally...

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

OpenAIRE

Morgan, R; Ensor, T; Waters, H

2016-01-01

Although the private sector is an important health-care provider in many low-income and middle-income countries, its role in progress towards universal health coverage varies. Studies of the performance of the private sector have focused on three main dimensions: quality, equity of access, and efficiency. The characteristics of patients, the structures of both the public and private sectors, and the regulation of the sector influence the types of health services delivered, and outcomes. Combi...

A spatial national health facility database for public health sector planning in Kenya in 2008

Directory of Open Access Journals (Sweden)

Gething Peter W

2009-03-01

improving planning. Expansion in public health care in Kenya has resulted in significant increases in geographic access although several areas of the country need further improvements. This information is key to future planning and with this paper we have released the digital spatial database in the public domain to assist the Kenyan Government and its partners in the health sector.

A spatial national health facility database for public health sector planning in Kenya in 2008.

Science.gov (United States)

Noor, Abdisalan M; Alegana, Victor A; Gething, Peter W; Snow, Robert W

2009-03-06

resulted in significant increases in geographic access although several areas of the country need further improvements. This information is key to future planning and with this paper we have released the digital spatial database in the public domain to assist the Kenyan Government and its partners in the health sector.

Process evaluation of communitisation programme in public sector health facilities, Mokokchung district, Nagaland, 2015

Directory of Open Access Journals (Sweden)

Aonungdok Tushi

2017-01-01

Full Text Available Background: Public sector health facilities were poorly managed due to a history of conflict in Nagaland, India. Government of Nagaland introduced “Nagaland Communitisation of Public Institutions and Services Act” in 2002. Main objectives of the evaluation were to review the functioning of Health Center Managing Committees (HCMCs, deliver health services in the institutions managed by HCMC, identify strengths as well as challenges perceived by HCMC members in the rural areas of Mokokchung district, Nagaland. Materials and Methods: The evaluation was made using input, process and output indicators. A doctor, the HCMC Chairman and one member from each of the three community health centers (CHC and four primary health centers (PHC were surveyed using a semi-structured questionnaire and an in-depth interview guide. Proportions for quantitative data were computed and key themes from the same were identified. Results: Overall; the infrastructure, equipment and outpatient/inpatient service availability was satisfactory. There was a lack of funds and shortage of doctors, drugs as well as laboratory facilities. HCMCs were in place and carried out administrative activities. HCMCs felt ownership, mobilized community contributions and managed human resources. HCMC members had inadequate funds for their transport and training. They faced challenges in service delivery due to political interference and lack of adequate human, material, financial resources. Conclusions: Communitisation program was operational in the district. HCMC members felt the ownership of health facilities. Administrative, political support and adequate funds from the government are needed for effective functioning of HCMCs and optimal service delivery in public sector facilities.

Public Sector Expatriate Managers:

DEFF Research Database (Denmark)

Fenner, Charles, R., Jr.; Selmer, Jan

2008-01-01

Although public sector expatriates are becoming increasingly common, research on them is very limited. There is reason to believe that the situation for expatriates from the public sector may be different than for those from the private sector. This study investigated U.S. Department of Defense a...

Public Sector Organizations

DEFF Research Database (Denmark)

Meyer, Renate; Leixnering, Stephan

2015-01-01

New public management-inspired reforms created numerous autonomous units with many different faces and labels. This variety of organizations and organizational forms precludes a straightforward definition of what constitutes a public sector organization and blurs the boundaries between the public...... and private sectors as well as the boundaries of single organizations. In addition, the complexity of the interlocking arrangements and relationships in this public organizational landscape has resulted in considerable governance problems with serious implications for coordination and policy coherence....

Sector and Occupational Differences in Public Service Motivation: A Qualitative Study

DEFF Research Database (Denmark)

Kjeldsen, Anne Mette

2012-01-01

The relationship between employment sector and public service motivation remains unclear since previous studies fail to control for the occupation of the investigated employees. Based on 32 semi-structured interviews with Danish nurses and nursing assistants working in the public or private health...... sector, this study shows that occupation and employment sector have very different relationships with the separate dimensions of public service motivation. This suggests that future studies of sector differences in public service motivation should pay attention to employees' occupation as an important...... control variable, and the benefits of using a qualitative approach to measure public service motivation....

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

Science.gov (United States)

Do, Mai

2009-05-01

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

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

Science.gov (United States)

Zhang, Wei

2011-01-01

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

Structural integration and performance of inter-sectoral public health-related policy networks: An analysis across policy phases.

Science.gov (United States)

Peters, D T J M; Raab, J; Grêaux, K M; Stronks, K; Harting, J

2017-12-01

Inter-sectoral policy networks may be effective in addressing environmental determinants of health with interventions. However, contradictory results are reported on relations between structural network characteristics (i.e., composition and integration) and network performance, such as addressing environmental determinants of health. This study examines these relations in different phases of the policy process. A multiple-case study was performed on four public health-related policy networks. Using a snowball method among network actors, overall and sub-networks per policy phase were identified and the policy sector of each actor was assigned. To operationalise the outcome variable, interventions were classified by the proportion of environmental determinants they addressed. In the overall networks, no relation was found between structural network characteristics and network performance. In most effective cases, the policy development sub-networks were characterised by integration with less interrelations between actors (low cohesion), more equally distributed distances between the actors (low closeness centralisation), and horizontal integration in inter-sectoral cliques. The most effective case had non-public health central actors with less connections in all sub-networks. The results suggest that, to address environmental determinants of health, sub-networks should be inter-sectorally composed in the policy development rather than in the intervention development and implementation phases, and that policy development actors should have the opportunity to connect with other actors, without strong direction from a central actor. Copyright © 2017 Elsevier B.V. All rights reserved.

Exploring corruption in the South African health sector.

Science.gov (United States)

Rispel, Laetitia C; de Jager, Pieter; Fonn, Sharon

2016-03-01

Recent scholarly attention has focused on weak governance and the negative effects of corruption on the provision of health services. Employing agency theory, this article discusses corruption in the South African health sector. We used a combination of research methods and triangulated data from three sources: Auditor-General of South Africa reports for each province covering a 9-year period; 13 semi-structured interviews with health sector key informants and a content analysis of print media reports covering a 3-year period. Findings from the Auditor-General reports showed a worsening trend in audit outcomes with marked variation across the nine provinces. Key-informants indicated that corruption has a negative effect on patient care and the morale of healthcare workers. The majority of the print media reports on corruption concerned the public health sector (63%) and involved provincial health departments (45%). Characteristics and complexity of the public health sector may increase its vulnerability to corruption, but the private-public binary constitutes a false dichotomy as corruption often involves agents from both sectors. Notwithstanding the lack of global validated indicators to measure corruption, our findings suggest that corruption is a problem in the South African healthcare sector. Corruption is influenced by adverse agent selection, lack of mechanisms to detect corruption and a failure to sanction those involved in corrupt activities. We conclude that appropriate legislation is a necessary, but not sufficient intervention to reduce corruption. We propose that mechanisms to reduce corruption must include the political will to run corruption-free health services, effective government to enforce laws, appropriate systems, and citizen involvement and advocacy to hold public officials accountable. Importantly, the institutionalization of a functional bureaucracy and public servants with the right skills, competencies, ethics and value systems and whose

Unionism Comes to the Public Sector

OpenAIRE

Richard B. Freeman

1984-01-01

This paper argues that public sector labor relations is best understood in a framework that focuses on unions' ability to shift demand curves rather than to raise wages, as is the case in the private sector. It reviews the public sector labor relations literature and finds that: (i) public sector unionism has flourished as a result of changes in laws; (2) the effects of public sector unions on wages are likely to have been underestimated; (3) public sector unions have a somewhat different eff...

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

Science.gov (United States)

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

2014-01-27

Kenya's human resources for health shortage is well documented, yet in line with the new constitution, responsibility for health service delivery will be devolved to 47 new county administrations. This work describes the public sector nursing workforce likely to be inherited by the counties, and examines the relationships between nursing workforce density and key indicators. National nursing deployment data linked to nursing supply data were used and analyzed using statistical and geographical analysis software. Data on nurses deployed in national referral hospitals and on nurses deployed in non-public sector facilities were excluded from main analyses. The densities and characteristics of the public sector nurses across the counties were obtained and examined against an index of county remoteness, and the nursing densities were correlated with five key indicators. Of the 16,371 nurses in the public non-tertiary sector, 76% are women and 53% are registered nurses, with 35% of the nurses aged 40 to 49 years. The nursing densities across counties range from 1.2 to 0.08 per 1,000 population. There are statistically significant associations of the nursing densities with a measure of health spending per capita (P value = 0.0028) and immunization rates (P value = 0.0018). A higher county remoteness index is associated with explaining lower female to male ratio of public sector nurses across counties (P value public sector countrywide is complicated by mal-distribution and varying workforce characteristics (for example, age profile) across counties. All stakeholders should support improvements in human resources information systems and help address personnel shortages and mal-distribution if equitable, quality health-care delivery in the counties is to be achieved.

Costs and utilization of public sector family planning services in Pakistan.

Science.gov (United States)

Abbas, Khadija; Khan, Adnan Ahmad; Khan, Ayesha

2013-04-01

The public sector provides a third of family planning (FP) services in Pakistan. However, these services are viewed as being underutilized and expensive. We explored the utilization patterns and costs of FP services in the public sector. We used overall budgets and time allocation by health and population departments to estimate the total costs of FP by these departments, costs per woman served, and costs per couple-year of protection (CYP). The public sector is the predominant provider of FP to the poorest and is the main provider of female sterilization services. The overall costs of FP in the public sector are USD 55 per woman served, annually (USD 17 per CYP). Within the public sector, the population welfare departments provide services at USD 72 per woman served, annually (USD 17 per CYP) and the health departments at USD 39 per woman per year (USD 29 per CYP). While the public sector has a critical niche in serving the poor and providing female sterilization, its services are considerably more expensive compared to international and even some Pakistani non-government organization (NGO) costs. This reflects inefficiencies in services provided, client mistrust in the quality of services provided, and inadequate referrals, and will require specific actions for improving referrals and the quality of services.

Containing costs in public sector hospitals - a strategy for the future ...

African Journals Online (AJOL)

Containing costs in public sector hospitals - a strategy for the future. ... is increasing concern about expenditure in the public and the private health care sectors. ... at the micro-level comparison of expenditure over a 14-year period in one major ...

The root causes of ineffective and inefficient healthcare technology management in Benin public health sector

NARCIS (Netherlands)

Houngbo, T.; Zweekhorst, M.B.M.; Bunders- Aelen, J.G.F.; Coleman, H.L.S.; Medenou, D.; Dakpanon, L.Y.; de Cock Buning, Tjard

2017-01-01

This study aims to identify the root causes and solutions of main problems facing Healthcare Technology Management in Benin׳s public health sector. Conducted in Benin from 2008 to 2010, two surveys were used with key actors in Healthcare Technology Management. The first survey was based on 377

From Public to Private Sector: Motives and Explanations for Sector Switching

DEFF Research Database (Denmark)

Hansen, Jesper Rosenberg

2014-01-01

Sector switching is interesting in relation to understanding how to get and keep people working in the public sector as well as to understand public and private differences. This paper focuses on why public employees leave public organizations to work in the private sector. We use a design studying...... higher educated Danish employees who recently worked in the state, comparing those who shift job to another public organization with those who switch to the private sector. We focus on different motives for job shifts which may influence sector switching such as salary, job security, organizational...... characteristics and public service motivation....

Authentic leadership as a source of optimism, trust in the organisation and work engagement in the public health care sector

Directory of Open Access Journals (Sweden)

Frederick W. Stander

2015-06-01

Full Text Available Orientation: The orientation of this study is towards authentic leadership (AL and its influence on optimism, trust in the organisation and work engagement of employees in the public health care sector. Research purpose: The objectives of this study were to determine whether the leadership style of AL could predict optimism, trust in the organisation and work engagement amongst a large sample of employees from various functions in public hospitals and clinics in Gauteng and to establish whether optimism and trust in the organisation could mediate the relationship between AL and work engagement. Research approach, design and method: A convenience sample of 633 public health employees from various functions within 27 public hospitals and clinics in the province was used in this research. A cross-sectional research design was implemented. Structural equation modelling was utilised to investigate the Authentic Leadership Inventory (ALI, and the validity and fit of the measurement model, to position AL as a job resource within the nomological net and to test its mediating effects. Main findings: The statistical analysis revealed that AL was a significant predictor of optimism and trust in the organisation and that optimism and trust in the organisation mediated the relationship between AL and work engagement. Practical/managerial implications: The research results suggested that organisations in the public health care sector should encourage their managers to adopt a more authentic leadership style. This will lead to higher levels of optimism, trust in the organisation and eventually work engagement. This will greatly assist employees in the domain of public health care to manage their demanding working environment. Contribution: This study provides evidence that the ALI can be used reliably within the South African context and specifically within the public health care sector. It further substantiates for the implementation of AL as a leadership

Public Sector and Europeanization Challenges

Directory of Open Access Journals (Sweden)

Lucica Matei

2006-04-01

Full Text Available The paper emphasises the role of the market-type mechanisms within the activity of the organisations from the public sector. The end of the 20th century was defined by the effects of the public sector reform. The public sector is placed within the cultural and political environment of each country and the reforms have aimed to redefine the structures of the state organisations in the economy and the relationships such as market-government, government-bureaucracy, government- citizens, bureaucracy-citizens, civil servants-politicians-citizens. The public sector reform, achieved at the managerial systems, organisational structures and regulations levels is accompanied by specific and structural reforms. Accepting the market-type mechanisms instead of bureaucratic mechanisms, meaning not the simple provision of public services but the creation of some governmental “actors”, functioning completely on commercial bases, supporting the development of the partnerships between the public and private sector, introducing privatisation is achieved in view of creating “the facilitating state”. We discuss about “facilities” such as citizens and society involvement in public businesses, making public administration more citizen-friendly and the state closer to the public need. The citizens’ involvement, as customers in the flow of the public service contributes to creating an organic ensemble characterised by two fundamental dimensions: level and type of influence of the customers and the private-public dichotomy. Synthesising, the relationships and market mechanisms enable to the public sector to get closer to the public needs and to create a modern administration based on efficiency, effectiveness and openness towards change.

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

Science.gov (United States)

Martin, Graham P

2011-01-01

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

Public sector pay in the UK

OpenAIRE

Cribb, Jonathan; Emmerson, Carl; Sibieta, Luke

2014-01-01

This report looks at trends in public sector pay and compares these with what has been happening in the private sector. We start by analysing the overall levels of public and private sector pay, including how they have evolved over recent years and the differences after accounting for the different composition of the public and private sector workforces. We then examine how the difference between pay in the public and private sector varies across different groups of workers and areas of the c...

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

Science.gov (United States)

Aguilera Dreyse, Bernardo; López Gaete, Gonzalo

2017-12-22

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

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

Science.gov (United States)

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

2015-11-01

The age of diagnosis of congenital hearing loss is one of the most important determinants of communication outcome. A previous study by the lead author had evaluated the performance of the public health services in Bloemfontein, South Africa (SA), in this regard. This study aimed to examine whether the private health services in the same city were any better. To determine whether the age of diagnosis of congenital hearing loss (CHL) in children seen in the private healthcare sector in Bloemfontein, Free State Province, SA, was lower than that in the public healthcare system in the same city. A comparative study design was utilised and a retrospective database review conducted. Data obtained from this study in the private healthcare sector were compared with data from a previous study in the public healthcare sector using the same study design. Forty-eight children aged private healthcare sector during the study period; 33/47 (70.2%) did not undergo hearing screening at birth. The median age of diagnosis of DHI in the private healthcare sector was 2.24 years, and this was statistically significantly lower than the median age of diagnosis of 3.71 years in the public healthcare sector (pprivate healthcare sector was 3.01 years in children who were not screened at birth, and 1.25 years in those who were screened at birth. This difference was statistically significant (pprivate healthcare sector who were not screened at birth (median 3.01 years) with that in children in the public healthcare sector (median 3.71 years). This difference was statistically significant (pprivate healthcare sector than in the public healthcare sector. With the social and economic benefits of early intervention in cases of DHI well established internationally, SA healthcare providers in both the public and private sectors need to develop screening, diagnostic and (re)habilitation services for children with hearing impairment.

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

Science.gov (United States)

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

2015-01-01

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

Explaining Quality Management in the Danish and Swedish Public Health Sectors

DEFF Research Database (Denmark)

Örnerheim, Mattias; Triantafillou, Peter

2016-01-01

was introduced in the Danish health services in 2009. Nationwide quality indicator projects are also found in Sweden, but there has been political attempt to introduce a compulsory system. This article seeks to explain this difference. It argues, first, that resistance from the medical professions blocked......This article examines the development of diverse quality systems in the otherwise quite similar Danish and Swedish public health sectors. After decades of numerous piecemeal medical and managerial quality development programs in both countries, a nationwide mandatory accreditation system...... the introduction of compulsory, nationwide quality systems in both countries for decades. Second, the implementation of the Danish accreditation system was triggered by a combination of unintended policy learning produced by local reforms in two counties and of the Ministry of Health’s carefully orchestrated...

Work-related violence and its association with self-rated general health among public sector employees in Sweden.

Science.gov (United States)

Vaez, Marjan; Josephson, Malin; Vingård, Eva; Voss, Margaretha

2014-01-01

Work-related violence is one of the most serious threats to employee safety and health. To ascertain the extent of self-reported violence or threats of violence at work in relation to the general health of public sector employees. The study population comprised 9,611 female (83%) and male public employees in Sweden. A questionnaire based on items derived mainly from validated instruments was constructed to cover aspects such as health, lifestyle, and physical and psychosocial work conditions. One in three employees reported work-related violence, with the highest proportions among psychiatric nurses (79%) and psychiatric attendants (75%). Work-related violence more often affected those who were worked worked nights, or reported poor health. Regardless of gender, age, hours of work, night work, and type of occupation, exposure to work-related violence was associated with less than good general health, and this relationship was strongest for psychiatric nurses (OR=3.19; 95% CI=1.28-7.98), medical doctors/dentists (OR=2.46; 95% CI=1.35-4.49), compulsory school teachers (OR=2.14; 95% CI=1.33-3.45), and other nurses (OR=1.87; 95% CI=1.23-2.84). Work-related violence was frequently reported by employees in the most common public sector occupations, and it was associated with poor health in both genders.

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

Science.gov (United States)

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

2009-04-01

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

How can psychiatrists offer psychotherapeutic leadership in the public sector?

Science.gov (United States)

Cammell, Paul; Amos, Jackie; Baigent, Michael

2016-06-01

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

Between Public - Private Partnerships and public finance in the public infrastructure sector: The water and sanitation sector in Albania

Directory of Open Access Journals (Sweden)

Fjona Zeneli

2017-03-01

Full Text Available It’s known in the literature that public-private partnerships (PPPs are one the main instruments that permit private collaboration in projects that are public otherwise. It’s also clear that their implementation is different depending on the rules of the countries, their market level of acceptance etc. The first objective of this paper is to revise PPPs projects in the water sector in Albania, seen in the context of alternative financing ways for joint-stock companies of Albanian water sector, due to the nature of the market (a developing emerging market, in the context of bad financial times after 2008 (the start of the international financial crisis. The second objective is to describe the development of the Albanian legislation for management contracts introduced for the first time in the waters and sanitation sector in 2004 and privatization practices in public sector. The main conclusion is that in the developing markets creating possibilities for private sector participation in the infrastructure public services (especially in the drinking water and sanitation sector will be seen with skepticism because of failed previous privatization practices or the sensitivity degree of the water sector related to the penetration level of private factor in the sector. Public finance will be explored as a convenient alternative.

Self-Rated Health of the Temporary Employees in a Nordic Welfare State: Findings From the Finnish Public Sector Study.

Science.gov (United States)

Virtanen, Pekka; Pentti, Jaana; Vahtera, Jussi; Kivimäki, Mika; Virtanen, Marianna

2018-02-01

This 9-year follow-up study explores a possible association between temporary employment and declining health. Years in temporary employment from 2004 to 2008 to 2009 were measured for a cohort of 26,886 public sector employees. Self-rated health was measured by surveys in 2004 (baseline), 2008/2009 (short-term follow-up), and 2012/2013 (long-term follow-up). Compared with the permanently employed, the baseline health-adjusted odds of poor health were lower both in the short-term and long-term follow-up, but the differences became nonsignificant when adjusted for sociodemographic and work-related factors. The results would suggest that temporary employment in public sector of a Nordic welfare state does not entail health risks. Future research is needed to elucidate if this is true also among those exposed to nonpermanent employment in the private labor market, in particular those with most atypical jobs and unstable job careers.

Comparing public and private sector switchers

DEFF Research Database (Denmark)

Frederiksen, Anders; Hansen, Jesper Rosenberg; Bozeman, Barry

are related to sector switching and the pattern of sector switch, public to private versus private to public. We propose a life stage model arguing that people's needs change in different life stages of their lives. We further suggest that this can help explain why they switch sector. We use unique Danish...... labor market data that include information on all employees in Denmark (both private and public sector). The data are for the period 1980 to 2006, and this longitudinal database includes abundant information about job changes, including sector switching. Our findings indicate mixed support....... Finally, we find that people with more education are likely to switch from private to public sector....

Utilisation and costs of nursing agencies in the South African public health sector, 2005-2010.

Science.gov (United States)

Rispel, Laetitia C; Angelides, George

2014-01-01

Globally, insufficient information exists on the costs of nursing agencies, which are temporary employment service providers that supply nurses to health establishments and/or private individuals. The aim of the study was to determine the utilisation and direct costs of nursing agencies in the South African public health sector. A survey of all nine provincial health departments was conducted to determine utilisation and management of nursing agencies. The costs of nursing agencies were assumed to be equivalent to expenditure. Provincial health expenditure was obtained for five financial years (2005/6-2009/10) from the national Basic Accounting System database, and analysed using Microsoft Excel. Each of the 166,466 expenditure line items was coded. The total personnel and nursing agency expenditure was calculated for each financial year and for each province. Nursing agency expenditure as a percentage of the total personnel expenditure was then calculated. The nursing agency expenditure for South Africa is the total of all provincial expenditure. The 2009/10 annual government salary scales for different categories of nurses were used to calculate the number of permanent nurses who could have been employed in lieu of agency expenditure. All expenditure is expressed in South African rands (R; US$1 ∼ R7, 2010 prices). Only five provinces reported utilisation of nursing agencies, but all provinces showed agency expenditure. In the 2009/10 financial year, R1.49 billion (US$212.64 million) was spent on nursing agencies in the public health sector. In the same year, agency expenditure ranged from a low of R36.45 million (US$5.20 million) in Mpumalanga Province (mixed urban-rural) to a high of R356.43 million (US$50.92 million) in the Eastern Cape Province (mixed urban-rural). Agency expenditure as a percentage of personnel expenditure ranged from 0.96% in KwaZulu-Natal Province (mixed urban-rural) to 11.96% in the Northern Cape Province (rural). In that financial year

Analysis of Health Sector Budget of Nepal.

Science.gov (United States)

Dulal, R K; Magar, A; Karki, S D; Khatiwada, D; Hamal, P K

2014-01-01

Primarily, health sector connects two segments - medicine and public health, where medicine deals with individual patients and public health with the population health. Budget enables both the disciplines to function effectively. The Interim Constitution of Nepal, 2007 has adapted the inspiration of federalism and declared the provision of basic health care services free of cost as a fundamental right, which needs strengthening under foreseen federalism. An observational retrospective cohort study, aiming at examining the health sector budget allocation and outcome, was done. Authors gathered health budget figures (2001 to 2013) and facts published from authentic sources. Googling was done for further information. The keywords for search used were: fiscal federalism, health care, public health, health budget, health financing, external development partner, bilateral and multilateral partners and healthcare accessibility. The search was limited to English and Nepali-language report, articles and news published. Budget required to meet the population's need is still limited in Nepal. The health sector budget could not achieve even gainful results due to mismatch in policy and policy implementation despite of political commitment. Since Nepal is transforming towards federalism, an increased complexity under federated system is foreseeable, particularly in the face of changed political scenario and its players. It should have clear goals, financing policy and strict implementation plans for budget execution, task performance and achieving results as per planning. Additionally, collection of revenue, risk pooling and purchasing of services should be better integrated between central government and federated states to horn effectiveness and efficiency.

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

Science.gov (United States)

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

2012-02-01

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

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

Science.gov (United States)

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

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

[Harassment in the public sector].

Science.gov (United States)

Puech, Paloma; Pitcho, Benjamin

2013-01-01

The French Labour Code, which provides full protection against moral and sexual harassment, is not applicable to public sector workers. The public hospital is however not exempt from such behaviour, which could go unpunished. Public sector workers are therefore protected by the French General Civil Service Regulations and the penal code.

Cybersecurity Public Sector Threats and Responses

CERN Document Server

Andreasson, Kim J

2011-01-01

The Internet has given rise to new opportunities for the public sector to improve efficiency and better serve constituents in the form of e-government. But with a rapidly growing user base globally and an increasing reliance on the Internet, digital tools are also exposing the public sector to new risks. An accessible primer, Cybersecurity: Public Sector Threats and Responses focuses on the convergence of globalization, connectivity, and the migration of public sector functions online. It identifies the challenges you need to be aware of and examines emerging trends and strategies from around

[The use of management contracts and professional incentives in the public health sector].

Science.gov (United States)

Ditterich, Rafael Gomes; Moysés, Simone Tetu; Moysés, Samuel Jorge

2012-04-01

Results-based management is a cornerstone of reform in public administration, including the health field, and has become the basis for other innovations such as the institutionalization of management contracts and the use of professional incentives. This review article aims to introduce and discuss the use of such management contracts in the public health sector. Management by results has developed means and tools that highlight the importance of shared responsibility and mutual commitment between workers and management-level directors. Thus, preset goals are negotiated among all the stakeholders and are evaluated periodically in order to grant professional incentives. It is necessary to improve the mechanisms for control and observation, to more precisely determine the healthcare and management indicators and their patterns, to train stakeholders in designing the plan, and to improve the use of professional incentives in order to effectively increase accountability vis-à-vis the desired results.

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

Science.gov (United States)

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

2007-01-01

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

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

Science.gov (United States)

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

2013-04-01

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

[Notes for understanding the problem of "public" health in the health sector].

Science.gov (United States)

Guimarães, Cristian Fabiano; da Silva, Rosane Azevedo Neves

2015-03-01

This paper presents a theoretical review of how the public health concept has been perceived in health practices, based on the problematic field introduced in Italian and Brazilian health reforms, in order to understand the construction of public health and the meanings that this term acquires in the health arena. The main goal is to understand how public health appears in the context of health movements in Italy and Brazil, as well as its movement of variation. In this sense, an attempt is made to identify elements that contribute to the composition of a genealogy of public health. From the investigation of public health practices, the tensions produced by this concept are analyzed, giving visibility to those practices that demonstrate the public health experience as a force in the world of health.

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

Directory of Open Access Journals (Sweden)

Steven van de Vijver

2013-10-01

Full Text Available Introduction: Cardiovascular disease (CVD is a leading cause of death in sub-Saharan Africa (SSA, with annual deaths expected to increase to 2 million by 2030. Currently, most national health systems in SSA are not adequately prepared for this epidemic. This is especially so in slum settlements where access to formal healthcare and resources is limited. Objective: To develop and introduce a model of cardiovascular prevention in the slums of Nairobi by integrating public health and private sector approaches. Study design: Two non-profit organizations that conduct public health research, Amsterdam Institute for Global Health and Development (AIGHD and African Population and Health Research Center (APHRC, collaborated with private-sector Boston Consulting Group (BCG to develop a service delivery package for CVD prevention in slum settings. A theoretic model was designed based on the integration of public and private sector approaches with the focus on costs and feasibility. Results: The final model includes components that aim to improve community awareness, a home-based screening service, patient and provider incentives to seek and deliver treatment specifically for hypertension, and adherence support. The expected outcomes projected by this model could prove potentially cost effective and affordable (1 USD/person/year. The model is currently being implemented in a Nairobi slum and is closely followed by key stakeholders in Kenya including the Ministry of Health, the World Health Organization (WHO, and leading non-governmental organizations (NGOs. Conclusion: Through the collaboration of public health and private sectors, a theoretically cost-effective model was developed for the prevention of CVD and is currently being implemented in the slums of Nairobi. If results are in line with the theoretical projections and first impressions on the ground, scale-up of the service delivery package could be planned in other poor urban areas in Kenya by

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

Science.gov (United States)

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

2013-10-21

Cardiovascular disease (CVD) is a leading cause of death in sub-Saharan Africa (SSA), with annual deaths expected to increase to 2 million by 2030. Currently, most national health systems in SSA are not adequately prepared for this epidemic. This is especially so in slum settlements where access to formal healthcare and resources is limited. To develop and introduce a model of cardiovascular prevention in the slums of Nairobi by integrating public health and private sector approaches. Two non-profit organizations that conduct public health research, Amsterdam Institute for Global Health and Development (AIGHD) and African Population and Health Research Center (APHRC), collaborated with private-sector Boston Consulting Group (BCG) to develop a service delivery package for CVD prevention in slum settings. A theoretic model was designed based on the integration of public and private sector approaches with the focus on costs and feasibility. The final model includes components that aim to improve community awareness, a home-based screening service, patient and provider incentives to seek and deliver treatment specifically for hypertension, and adherence support. The expected outcomes projected by this model could prove potentially cost effective and affordable (1 USD/person/year). The model is currently being implemented in a Nairobi slum and is closely followed by key stakeholders in Kenya including the Ministry of Health, the World Health Organization (WHO), and leading non-governmental organizations (NGOs). Through the collaboration of public health and private sectors, a theoretically cost-effective model was developed for the prevention of CVD and is currently being implemented in the slums of Nairobi. If results are in line with the theoretical projections and first impressions on the ground, scale-up of the service delivery package could be planned in other poor urban areas in Kenya by relevant policymakers and NGOs.

Engagement of Sectors Other than Health in Integrated Health Governance, Policy, and Action.

Science.gov (United States)

de Leeuw, Evelyne

2017-03-20

Health is created largely outside the health sector. Engagement in health governance, policy, and intervention development and implementation by sectors other than health is therefore important. Recent calls for building and implementing Health in All Policies, and continued arguments for intersectoral action, may strengthen the potential that other sectors have for health. This review clarifies the conceptual foundations for integral health governance, policy, and action, delineates the different sectors and their possible engagement, and provides an overview of a continuum of methods of engagement with other sectors to secure integration. This continuum ranges from institutional (re)design to value-based narratives. Depending on the lens applied, different elements can be identified within the continuum. This review is built on insights from political science, leadership studies, public health, empirical Health in All Policy research, knowledge and evidence nexus approaches, and community perspectives. Successful integration of health governance, policy, and action depends on integration of the elements on the continuum.

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

Science.gov (United States)

Hutchinson, Marie; Jackson, Debra

2015-03-01

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

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

Science.gov (United States)

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

2016-01-01

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

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

Science.gov (United States)

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

2012-07-06

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

Analysis of Public Sector Efficiency in Developed Countries

Directory of Open Access Journals (Sweden)

Ivan Lovre

2017-06-01

Full Text Available The public sector in developed countries went through various forms of transformation in the twentieth century. The expansion of the public sector resulted in high levels of public spending in developed countries. The financial crisis of 2008 led to recessions in the economies of developed countries, the public debt growth, and actualized the issue of the public sector optimal size and efficiency. This study analysed the public sector efficiency in 19 developed countries. The analysis focuses on the relationship between the size of public expenditure and economic growth in the global financial crisis and the measures implemented. The aim of the research in this paper is a comparison of total and partial efficiency of the public sector in developed countries, in order to determine the characteristics of the public sector operations. The comparison covers the areas of the public sector operations in order to identify sources of inefficiency. Partial and overall efficiency of countries are analysed with different size and concept of the public sector, to determine the relationship between the public sector size, efficiency and welfare of citizens. The research results clearly indicate (unjustified state intervention in developed countries.

Improving Cross-Sector Comparisons: Going Beyond the Health-Related QALY.

Science.gov (United States)

Brazier, John; Tsuchiya, Aki

2015-12-01

The quality-adjusted life-year (QALY) has become a widely used measure of health outcomes for use in informing decision making in health technology assessment. However, there is growing recognition of outcomes beyond health within the health sector and in related sectors such as social care and public health. This paper presents the advantages and disadvantages of ten possible approaches covering extending the health-related QALY and using well-being and monetary-based methods, in order to address the problem of using multiple outcome measures to inform resource allocation within and between sectors.

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

Science.gov (United States)

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

2013-01-01

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

[Managment system in safety and health at work organization. An Italian example in public sector: Inps].

Science.gov (United States)

Di Loreto, G; Felicioli, G

2010-01-01

The Istituto Nazionale della Previdenza Sociale (Inps) is one of the biggest Public Sector organizations in Italy; about 30.000 people work in his structures. Fifteen years ago, Inps launched a long term project with the objective to create a complex and efficient safety and health at work organization. Italian law contemplates a specific kind of physician working on safety and health at work, called "Medico competente", and 85 Inps's physicians work also as "Medico competente". This work describes how IT improved coordination and efficiency in this occupational health's management system.

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

Science.gov (United States)

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

2015-01-01

Many public health systems in high- and middle-income countries are under increasing financial pressures as a result of ageing populations, a rise in chronic and non-communicable diseases and shrinking public resources. At the same time the rise in patient mobility and concomitant market in medical tourism provides opportunities for additional income. This is especially the case where public sector hospitals have a reputation as global centres of excellence. Yet, this requires public sector entrepreneurship which, given the unique features of the public sector, means a change to professional culture. This paper examines how and under what conditions public sector entrepreneurship develops, drawing on the example of international patients in the UK NHS. It reports on a subset of data from a wider study of UK medical tourism, and explores inward flows and NHS responses through the lens of public entrepreneurship. Interviews in the English NHS were conducted with managers of Foundation Trusts with interest in international patient work. Data is from seven Foundation Trusts, based on indepth, semi-structured interviews with a range of NHS managers, and three other key stakeholders (n = 16). Interviews were analysed using a framework on entrepreneurship developed from academic literature. Empirical findings showed that Trust managers were actively pursuing a strategy of expanding international patient activity. Respondents emphasised that this was in the context of the current financial climate for the NHS. International patients were seen as a possible route to ameliorating pressure on stretched NHS resources. The analysis of interviews revealed that public entrepreneurial behaviour requires an organisational managerial or political context in order to develop, such as currently in the UK. Public sector workers engaged in this process develop entrepreneurship - melding political, commercial and stakeholder insights - as a coping mechanism to health system constraints

Public Sector IS Maturity Models

DEFF Research Database (Denmark)

Zinner Henriksen, Helle; Andersen, Kim Normann; Medaglia, Rony

2011-01-01

Online applications and processing of tax forms, driver licenses, and construction permits are examples of where policy attention and research have been united in efforts aiming to categorize the maturity level of e-services. Less attention has been attributed to policy areas with continuous online...... citizenpublic interaction, such as in public education. In this paper we use a revised version of the Public Sector Process Rebuilding (PPR) maturity model for mapping 200 websites of public primary schools in Denmark. Findings reveal a much less favorable picture of the digitization of the Danish public sector...... compared to the high ranking it has received in the international benchmark studies. This paper aims at closing the gap between the predominant scope of maturity models and the frequency of citizen-public sector interaction, and calls for increased attention to the activities of government where the scale...

Medical and health care sector

International Nuclear Information System (INIS)

Ainul Hayati Daud; Hazmimi Kasim

2010-01-01

The medical and health care sector in general supplies products and provides services that can be categorized as diagnostic radiology, therapeutic application and nuclear medicine (both, diagnostic and/ or therapeutic). The institutions offer different categories of services. Some provide only one category of service, for example, diagnostic radiology. Others may provide more than one categories, for example, diagnostic nuclear medicine and therapeutic nuclear medicine services. A total of 90 entities comprising 65 public agencies and 34 private companies were selected in this study for this sector. The majority of the entities, 75.6 %, operate in Peninsular Malaysia. The remainders operate in Sabah and Sarawak. The findings of the study on both public agencies and private companies are presented in subsequent sections of this chapter. (author)

PUBLIC SECTOR OF CANADA: RATING RESEARCH OF LABOUR

Directory of Open Access Journals (Sweden)

Olesia Leontiivna TOTSKA

2013-12-01

Full Text Available n this article an author conducted the analysis of labour in the public sector of Canada after such nine subgroups of establishments: 1 federal general government; 2 provincial and territorial general government; 3 health and social service institutions (provincial and territorial; 4 universities, colleges, vocational and trade institutes (provincial and territorial; 5 local general government; 6 local school boards; 7 federal government business enterprises; 8 provincial and territorial government business enterprises; 9 local government business enterprises. On the basis of statistical information about these sub-groups for 2007-2011 from a web-site «Statistics Canada» the maximal and minimum values of such three indexes are found: amount of employees, general annual sums of wages and annual sums of wages per employee. Rating for nine sub-groups of establishments of public sector of Canada on these indexes is certain. The got results testify, that during an analysable period most of the employees of public sector was concentrated in health and social service institutions, the least – in local government business enterprises. In 2007– 2011 a most general sum was earned also by the employees of health and social service institutions, the least – by the employees of local government business enterprises. At the same time in an analysable period among the state employees of Canada a most wage in a calculation on one person was got by the employees of federal general government, the least – by the employees of local general government.

Africa's health: could the private sector accelerate the progress towards health MDGs?

Directory of Open Access Journals (Sweden)

Sambo Luis G

2011-11-01

Full Text Available Abstract Background Out of 1.484 billion disability-adjusted life years lost globally in 2008, 369.1 million (25% were lost in the WHO African Region. Despite the heavy disease burden, the majority of countries in the Region are not on track to achieve Millennium Development Goals (MDG 4 (reducing child mortality, 5 (improving maternal health, and 6 (combating HIV/AIDS, malaria and other diseases. This article provides an overview of the state of public health, summarizes 2010-2015 WHO priorities, and explores the role that private sector could play to accelerate efforts towards health MDGs in the African Region. Discussion Of the 752 total resolutions adopted by the WHO Regional Committee for Africa (RC between years 1951 and 2010, 45 mention the role of the private sector. We argue that despite the rather limited role implied in RC resolutions, the private sector has a pivotal role in supporting the achievement of health MDGs, and articulating efforts with 2010-2015 priorities for WHO in the African Region: provision of normative and policy guidance as well as strengthening partnerships and harmonization; supporting the strengthening of health systems based on the Primary Health Care approach; putting the health of mothers and children first; accelerating actions on HIV/AIDS, malaria and tuberculosis; intensifying the prevention and control of communicable and noncommunicable diseases; and accelerating response to the determinants of health. Conclusion The very high maternal and children mortality, very high burden of communicable and non-communicable diseases, health systems challenges, and inter-sectoral issues related to key determinants of health are too heavy for the public sector to address alone. Therefore, there is clear need for the private sector, given its breadth, scope and size, to play a more significant role in supporting governments, communities and partners to develop and implement national health policies and strategic plans

Africa's health: could the private sector accelerate the progress towards health MDGs?

Science.gov (United States)

Sambo, Luis G; Kirigia, Joses M

2011-11-25

Out of 1.484 billion disability-adjusted life years lost globally in 2008, 369.1 million (25%) were lost in the WHO African Region. Despite the heavy disease burden, the majority of countries in the Region are not on track to achieve Millennium Development Goals (MDG) 4 (reducing child mortality), 5 (improving maternal health), and 6 (combating HIV/AIDS, malaria and other diseases). This article provides an overview of the state of public health, summarizes 2010-2015 WHO priorities, and explores the role that private sector could play to accelerate efforts towards health MDGs in the African Region. Of the 752 total resolutions adopted by the WHO Regional Committee for Africa (RC) between years 1951 and 2010, 45 mention the role of the private sector. We argue that despite the rather limited role implied in RC resolutions, the private sector has a pivotal role in supporting the achievement of health MDGs, and articulating efforts with 2010-2015 priorities for WHO in the African Region: provision of normative and policy guidance as well as strengthening partnerships and harmonization; supporting the strengthening of health systems based on the Primary Health Care approach; putting the health of mothers and children first; accelerating actions on HIV/AIDS, malaria and tuberculosis; intensifying the prevention and control of communicable and noncommunicable diseases; and accelerating response to the determinants of health. The very high maternal and children mortality, very high burden of communicable and non-communicable diseases, health systems challenges, and inter-sectoral issues related to key determinants of health are too heavy for the public sector to address alone. Therefore, there is clear need for the private sector, given its breadth, scope and size, to play a more significant role in supporting governments, communities and partners to develop and implement national health policies and strategic plans; strengthen health systems capacities; and implement

Modernize the Public Sector through Innovation?

DEFF Research Database (Denmark)

Hansson, Finn; Norn, Maria Theresa; Vad, Torben Bundgaard

2014-01-01

The New Public Management drive to innovate in the public sector has become less influential and new initiatives to drive innovation are now sought. There are well-known challenges when using social science research to inform innovation in the public sector. In order to address these challenges, ...

Community/hospital indicators in South African public sector mental health services.

Science.gov (United States)

Lund, Crick; Flisher, Alan J

2003-12-01

The need to balance resources between community and hospital-based mental health services in the post-deinstitutionalisation era has been well-documented. However, few indicators have been developed to monitor the relationship between community and hospital services, in either developed or developing countries. There is a particular need for such indicators in the South African context, with its history of inequitable services based in custodial institutions under apartheid, and a new policy that proposes the development of more equitable community-based care. Indicators are needed to measure the distribution of resources and the relative utilisation of community and hospital-based services during the reform process. These indicators are potentially useful for assessing the implementation of policy objectives over time. To develop and document community/hospital indicators in public sector mental health services in South Africa. A questionnaire was distributed to provincial mental health coordinators requesting numbers of full-time equivalent (FTE) staff who provide mental health care at all service levels, annual patient admissions to hospitals and annual patient attendances at ambulatory care facilities. The information was supplemented by consultations with mental health coordinators in each of the 9 provinces. Population data were obtained from preliminary findings of the 1996 census. The community/hospital indicator measuring staff distribution was defined as the ratio of staff employed in community settings to all staff, expressed as a percentage. The community/hospital indicator measuring patient service utilisation was defined as the ratio of the annual ambulatory care attendance rate per 100,000 population to the sum of this rate and the annual hospital admission rate per 100,000 population, expressed as a percentage. Of psychiatric public sector staff, 25% are located in community settings in South Africa (provincial range: 11-70%). If hospital outpatient

The art of the possible. On the necessary conditions for cross-sector cooperation in a New Public Management oriented health service

DEFF Research Database (Denmark)

Høgsgaard, Ditte Merete

2017-01-01

Despite the current mantra that cross-sector teamwork and communication are the decisive factors in any attempt at creating an integrated and holistically oriented health service, the current institutional structures and conditions seem to actively stymie such cooperation. A high powered debate...... on the necessity of properly functioning cross-sector cooperation in the health service proceeds in its own isolated context and is also challenged at its very roots by the New Public Management (NPM) creed that has informed health service management in recent decades. The aim here is to investigate how tension...... and paradoxes in that cross-sector teamwork impact upon the ability of healthcare professionals across the relevant sectors to work together effectively towards the discharge of a patient. All this with a view to creating an integrated and holistic process for that patient....

Coopetition Segments in a Public-Sector Context

DEFF Research Database (Denmark)

Stentoft, Jan; Mikkelsen, Ole Stegmann; Ingstrup, Mads Bruun

2018-01-01

The concept of coopetition is well-known in a private-sector context, but it is greatly neglected in a public-sector context. In continuation of this, the article sets out to explore and further position coopetition in the public sector. This is achieved through a study of coopetition among seven...... municipalities located in a Danish business region named the Triangle Region. The article concludes by identifying and describing four public-sector coopetition segments, and by providing a segmentation model to categorize and discuss different coopetition initiatives. Furthermore, the model can help public...

Public and private sector interactions: an economic perspective.

Science.gov (United States)

Maynard, A

1986-01-01

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

Microeconomic principles in the health sector: The demand for health services in the Republic of Serbia

Directory of Open Access Journals (Sweden)

Stošić Sanja

2015-01-01

Full Text Available Health has become a dominant economic and political issue over the past years, where many nations experience rapid rises in health care spending. The main reason why the health care sector does not operate entirely in accordance with economic market principles is the fact that inequalities in health and access to health care are understood as the lack of humanity and justice. Health care demands might seem as quite inelastic, but because of the health insurance, it shows a certain degree of price, income, cross - price and time elasticity. The subject of this study was the demand for health services in the Republic of Serbia in order to assess the ability of the public sector to meet the demand for providing these services. The underlying assumption was that public health can not adequately meet the needs of citizens due to insufficient investment in the sector and inefficient allocation of resources. To confirm this assumption, basic characteristics of health care market and the factors affecting the supply and demand for health services were discussed. Based on the analysis of investment in the health sector, the existing capacity and organization of health services, our research has shown that the public health system in the Republic of Serbia is not able to adequately meet the demand for health services. In the current economic situation in the Republic of Serbia, which already spends a significant portion of its GDP on health, there is no realistic possibility of increased spending on public health care system, although it can be expected that there will be increasing demand for health services and increase of costs. The health sector is not, and does not have the ability to be a perfectly competitive market, and the questions of its financing, rational and efficient organization is extremely delicate. However, health care economists and experts in health economics should give a significantly higher contribution in organizing health sector

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

Science.gov (United States)

Pfeifer, Christian

2013-03-01

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

The Future of Public Health Informatics: Alternative Scenarios and Recommended Strategies

Science.gov (United States)

Edmunds, Margo; Thorpe, Lorna; Sepulveda, Martin; Bezold, Clem; Ross, David A.

2014-01-01

Background: In October 2013, the Public Health Informatics Institute (PHII) and Institute for Alternative Futures (IAF) convened a multidisciplinary group of experts to evaluate forces shaping public health informatics (PHI) in the United States, with the aim of identifying upcoming challenges and opportunities. The PHI workshop was funded by the Robert Wood Johnson Foundation as part of its larger strategic planning process for public health and primary care. Workshop Context: During the two-day workshop, nine experts from the public and private sectors analyzed and discussed the implications of four scenarios regarding the United States economy, health care system, information technology (IT) sector, and their potential impacts on public health in the next 10 years, by 2023. Workshop participants considered the potential role of the public health sector in addressing population health challenges in each scenario, and then identified specific informatics goals and strategies needed for the sector to succeed in this role. Recommendations and Conclusion: Participants developed recommendations for the public health informatics field and for public health overall in the coming decade. These included the need to rely more heavily on intersectoral collaborations across public and private sectors, to improve data infrastructure and workforce capacity at all levels of the public health enterprise, to expand the evidence base regarding effectiveness of informatics-based public health initiatives, and to communicate strategically with elected officials and other key stakeholders regarding the potential for informatics-based solutions to have an impact on population health. PMID:25848630

Active and retired public employees' health insurance: potential data sources.

Science.gov (United States)

Morrill, Melinda Sandler

2014-12-01

Employer-provided health insurance for public sector workers is a significant public policy issue. Underfunding and the growing costs of benefits may hinder the fiscal solvency of state and local governments. Findings from the private sector may not be applicable because many public sector workers are covered by union contracts or salary schedules and often benefit modifications require changes in legislation. Research has been limited by the difficulty in obtaining sufficiently large and representative data on public sector employees. This article highlights data sources researchers might utilize to investigate topics concerning health insurance for active and retired public sector employees. Copyright © 2014 Elsevier B.V. All rights reserved.

Cost of delivering secondary-level health care services through public sector district hospitals in India

Science.gov (United States)

Prinja, Shankar; Balasubramanian, Deepak; Jeet, Gursimer; Verma, Ramesh; Kumar, Dinesh; Bahuguna, Pankaj; Kaur, Manmeet; Kumar, Rajesh

2017-01-01

Background & objectives: Despite an impetus for strengthening public sector district hospitals for provision of secondary health care in India, there is lack of robust evidence on cost of services provided through these district hospitals. In this study, an attempt was made to determine the unit cost of an outpatient visit consultation, inpatient bed-day of hospitalization, surgical procedure and overall per-capita cost of providing secondary care through district hospitals. Methods: Economic costing of five randomly selected district hospitals in two north Indian States - Haryana and Punjab, was undertaken. Cost analysis was done using a health system perspective and employing bottom-up costing methodology. Quantity of all resources - capital or recurrent, used for delivering services was measured and valued. Median unit costs were estimated along with their 95 per cent confidence intervals. Sensitivity analysis was undertaken to assess the effect of uncertainties in prices and other assumptions; and to generalize the findings for Indian set-up. Results: The overall annual cost of delivering secondary-level health care services through a public sector district hospital in north India was 11,44,13,282 [US Dollars (USD) 2,103,185]. Human resources accounted for 53 per cent of the overall cost. The unit cost of an inpatient bed-day, surgical procedure and outpatient consultation was 844 (USD 15.5), i; 3481 (USD 64) and 170 (USD 3.1), respectively. With the current set of resource allocation, per-capita cost of providing health care through district hospitals in north India was 139 (USD 2.5). Interpretation & conclusions: The estimates obtained in our study can be used for Fiscal planning of scaling up secondary-level health services. Further, these may be particularly useful for future research such as benefit-incidence analysis, cost-effectiveness analysis and national health accounts including disease-specific accounts in India. PMID:29355142

Cost of delivering secondary-level health care services through public sector district hospitals in India.

Science.gov (United States)

Prinja, Shankar; Balasubramanian, Deepak; Jeet, Gursimer; Verma, Ramesh; Kumar, Dinesh; Bahuguna, Pankaj; Kaur, Manmeet; Kumar, Rajesh

2017-09-01

Despite an impetus for strengthening public sector district hospitals for provision of secondary health care in India, there is lack of robust evidence on cost of services provided through these district hospitals. In this study, an attempt was made to determine the unit cost of an outpatient visit consultation, inpatient bed-day of hospitalization, surgical procedure and overall per-capita cost of providing secondary care through district hospitals. Economic costing of five randomly selected district hospitals in two north Indian States - Haryana and Punjab, was undertaken. Cost analysis was done using a health system perspective and employing bottom-up costing methodology. Quantity of all resources - capital or recurrent, used for delivering services was measured and valued. Median unit costs were estimated along with their 95 per cent confidence intervals. Sensitivity analysis was undertaken to assess the effect of uncertainties in prices and other assumptions; and to generalize the findings for Indian set-up. The overall annual cost of delivering secondary-level health care services through a public sector district hospital in north India was ' 11,44,13,282 [US Dollars (USD) 2,103,185]. Human resources accounted for 53 per cent of the overall cost. The unit cost of an inpatient bed-day, surgical procedure and outpatient consultation was ' 844 (USD 15.5), ' 3481 (USD 64) and ' 170 (USD 3.1), respectively. With the current set of resource allocation, per-capita cost of providing health care through district hospitals in north India was ' 139 (USD 2.5). The estimates obtained in our study can be used for Fiscal planning of scaling up secondary-level health services. Further, these may be particularly useful for future research such as benefit-incidence analysis, cost-effectiveness analysis and national health accounts including disease-specific accounts in India.

Training public health superheroes: five talents for public health leadership.

Science.gov (United States)

Day, Matthew; Shickle, Darren; Smith, Kevin; Zakariasen, Ken; Moskol, Jacob; Oliver, Thomas

2014-12-01

Public health leaders have been criticized for their policy stances, relationships with governments and failure to train the next generation. New approaches to the identification and training of public health leaders may be required. To inform these, lessons can be drawn from public health 'superheroes'; public health leaders perceived to be the most admired and effective by their peers. Members and Fellows of the UK Faculty of Public Health were contacted via e-newsletter and magazine and asked to nominate their 'Public Health Superhero'. Twenty-six responses were received, nominating 40 different people. Twelve semi-structured interviews were conducted. Thematic analysis, based on 'grounded theory', was conducted. Five leadership 'talents' for public health were identified: mentoring-nurturing, shaping-organizing, networking-connecting, knowing-interpreting and advocating-impacting. Talent-based approaches have been effective for leadership development in other sectors. These talents are the first specific to the practice of public health and align with some aspects of existing frameworks. An increased focus on identifying and developing talents during public health training, as opposed to 'competency'-based approaches, may be effective in strengthening public health leadership. Further research to understand the combination and intensity of talents across a larger sample of public health leaders is required. © The Author 2014. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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

Science.gov (United States)

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

2014-06-01

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

Climate Services to Improve Public Health

Science.gov (United States)

Jancloes, Michel; Thomson, Madeleine; Costa, María Máñez; Hewitt, Chris; Corvalan, Carlos; Dinku, Tufa; Lowe, Rachel; Hayden, Mary

2014-01-01

A high level expert panel discussed how climate and health services could best collaborate to improve public health. This was on the agenda of the recent Third International Climate Services Conference, held in Montego Bay, Jamaica, 4–6 December 2013. Issues and challenges concerning a demand led approach to serve the health sector needs, were identified and analysed. Important recommendations emerged to ensure that innovative collaboration between climate and health services assist decision-making processes and the management of climate-sensitive health risk. Key recommendations included: a move from risk assessment towards risk management; the engagement of the public health community with both the climate sector and development sectors, whose decisions impact on health, particularly the most vulnerable; to increase operational research on the use of policy-relevant climate information to manage climate- sensitive health risks; and to develop in-country capacities to improve local knowledge (including collection of epidemiological, climate and socio-economic data), along with institutional interaction with policy makers. PMID:24776719

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

Science.gov (United States)

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

2018-06-01

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

The public spending crisis: a case study of Nigeria public sector

Directory of Open Access Journals (Sweden)

PhD(AccountingMBA.Mukoro Dick Oluku

2011-12-01

Full Text Available The objective of this paper is to discuss the differences in the concept and measurement of efficiency between the private and public sectors, stressing that the lessons from the private sector can only be transferred to the public sector if there is a proper awareness of these issues and constrains imposed by considerations of equity. In evaluating policy initiatives, the governments method for all the talk of “rolling back the public sector” and opposition companies of “cuts,” the public expenditure/EDP ration went up steadily during Obasanjo’s first term. However deep the divisions over what ought to be in the public sector, it is of paramount importance to all concerned that the resources are managed effectively. The paper argued that an attempt to instill into the public sector the cost consciousness of the best parts of the private sector is wholly admirable. In conclusion, the severity of the impending budgetary crises will make the search for greater efficiency in the public sector of paramount importance. The paper recommends that the common theme of all these cases in that an appropriate set of relative prices can encourage resources to be minimized. very great care has to be taken when introducing piecemeal charging in order to ensure that this does not have side-effects at odds with programme objectives

Interventions to reduce corruption in the health sector

OpenAIRE

Gaitonde, Rakhal; Oxman, Andrew D; Okebukola, Peter O; Rada, Gabriel

2016-01-01

Background Corruption is the abuse or complicity in abuse, of public or private position, power or authority to benefit oneself, a group, an organisation or others close to oneself; where the benefits may be financial, material or non-material. It is wide-spread in the health sector and represents a major problem. Objectives Our primary objective was to systematically summarise empirical evidence of the effects of strategies to reduce corruption in the health sector. Our secondary objective w...

Public Health 3.0: A Call to Action for Public Health to Meet the Challenges of the 21st Century.

Science.gov (United States)

DeSalvo, Karen B; Wang, Y Claire; Harris, Andrea; Auerbach, John; Koo, Denise; O'Carroll, Patrick

2017-09-07

Public health is what we do together as a society to ensure the conditions in which everyone can be healthy. Although many sectors play key roles, governmental public health is an essential component. Recent stressors on public health are driving many local governments to pioneer a new Public Health 3.0 model in which leaders serve as Chief Health Strategists, partnering across multiple sectors and leveraging data and resources to address social, environmental, and economic conditions that affect health and health equity. In 2016, the US Department of Health and Human Services launched the Public Health 3.0 initiative and hosted listening sessions across the country. Local leaders and community members shared successes and provided insight on actions that would ensure a more supportive policy and resource environment to spread and scale this model. This article summarizes the key findings from those listening sessions and recommendations to achieve Public Health 3.0.

Cost of Delivering Health Care Services in Public Sector Primary and Community Health Centres in North India.

Science.gov (United States)

Prinja, Shankar; Gupta, Aditi; Verma, Ramesh; Bahuguna, Pankaj; Kumar, Dinesh; Kaur, Manmeet; Kumar, Rajesh

2016-01-01

With the commitment of the national government to provide universal healthcare at cheap and affordable prices in India, public healthcare services are being strengthened in India. However, there is dearth of cost data for provision of health services through public system like primary & community health centres. In this study, we aim to bridge this gap in evidence by assessing the total annual and per capita cost of delivering the package of health services at PHC and CHC level. Secondly, we determined the per capita cost of delivering specific health services like cost per antenatal care visit, per institutional delivery, per outpatient consultation, per bed-day hospitalization etc. We undertook economic costing of fourteen public health facilities (seven PHCs and CHCs each) in three North-Indian states viz., Haryana, Himachal Pradesh and Punjab. Bottom-up costing method was adopted for collection of data on all resources spent on delivery of health services in selected health facilities. Analysis was undertaken using a health system perspective. The joint costs like human resource, capital, and equipment were apportioned as per the time value spent on a particular service. Capital costs were discounted and annualized over the estimated life of the item. Mean annual costs and unit costs were estimated along with their 95% confidence intervals using bootstrap methodology. The overall annual cost of delivering services through public sector primary and community health facilities in three states of north India were INR 8.8 million (95% CI: 7,365,630-10,294,065) and INR 26.9 million (95% CI: 22,225,159.3-32,290,099.6), respectively. Human resources accounted for more than 50% of the overall costs at both the level of PHCs and CHCs. Per capita per year costs for provision of complete package of preventive, curative and promotive services at PHC and CHC were INR 170.8 (95% CI: 131.6-208.3) and INR162.1 (95% CI: 112-219.1), respectively. The study estimates can be used

Primary health care and public health: foundations of universal health systems.

Science.gov (United States)

White, Franklin

2015-01-01

The aim of this review is to advocate for more integrated and universally accessible health systems, built on a foundation of primary health care and public health. The perspective outlined identified health systems as the frame of reference, clarified terminology and examined complementary perspectives on health. It explored the prospects for universal and integrated health systems from a global perspective, the role of healthy public policy in achieving population health and the value of the social-ecological model in guiding how best to align the components of an integrated health service. The importance of an ethical private sector in partnership with the public sector is recognized. Most health systems around the world, still heavily focused on illness, are doing relatively little to optimize health and minimize illness burdens, especially for vulnerable groups. This failure to improve the underlying conditions for health is compounded by insufficient allocation of resources to address priority needs with equity (universality, accessibility and affordability). Finally, public health and primary health care are the cornerstones of sustainable health systems, and this should be reflected in the health policies and professional education systems of all nations wishing to achieve a health system that is effective, equitable, efficient and affordable. © 2015 S. Karger AG, Basel.

Practices regarding hospital waste management at public and private sector hospitals of Lahore

International Nuclear Information System (INIS)

Mahmood, S.; Din, N.U.; Mohsin, J.

2011-01-01

Health care (Biomedical) waste is a term used for all waste arising from health care establishments. In most of health care centers of Pakistan, including Lahore, hospital wastes are simply mixed with the municipal waste in collecting bins at road-sides and disposed off similarly. Proper Management of biomedical waste, especially the hazardous one, being produced in hospital settings is important in terms of their ability to cause harm to the related per-sons and the environment as well. To Observe and compare the practices regarding Hospital Waste management of the public sector hospital with private sector hospital. Descriptive, Cross sectional. Methodology: Standardized checklist was used to assess the practices of nursing and sanitary staff. Practices regarding waste segregation were same at both hospitals. While practices regarding waste collection and transportation were better at The Children's Hospital. Public sector hospital has, paradoxically, better practices regarding hospital waste management in comparison to private sector hospital. (author)

ACCRUAL ACCOUNTING ADOPTION IN THE ROMANIAN PUBLIC SECTOR

Directory of Open Access Journals (Sweden)

Ileana Cosmina PITULICE

2013-02-01

Full Text Available In Romania the development of public sector accounting was initiated in 2002, and enlarged for all public sector entities in 2005, but the transition is a static process although there are many issues that should be changed. Based on Hepworth’s (2003 preconditions of success in adoption accrual accounting for public sector, this paper aims to analyse through a qualitative research whether accruals implementation in Romanian public sector was fulfilling its purposes or not. Financial information disclosed through public sector entities’ financial statements make the connection between citizens and state over the last one’s capacity to respond to community’s goals.

Work Motivation and Incentives in the Public Sector

NARCIS (Netherlands)

R. Zoutenbier (Robin)

2015-01-01

markdownabstractThe public sector makes up for an important part of our economy. According to estimates by the OECD (2008) a large share of the labor force in OECD countries is employed by the public sector. These public sector workers provide a wide range of goods and services to the public.

Public sector nurses in Swaziland: can the downturn be reversed?

Directory of Open Access Journals (Sweden)

Van Damme Wim

2006-05-01

Full Text Available Abstract Background The lack of human resources for health (HRH is increasingly being recognized as a major bottleneck to scaling up antiretroviral treatment (ART, particularly in sub-Saharan Africa, whose societies and health systems are hardest hit by HIV/AIDS. In this case study of Swaziland, we describe the current HRH situation in the public sector. We identify major factors that contribute to the crisis, describe policy initiatives to tackle it and base on these a number of projections for the future. Finally, we suggest some areas for further research that may contribute to tackling the HRH crisis in Swaziland. Methods We visited Swaziland twice within 18 months in order to capture the HRH situation as well as the responses to it in 2004 and in 2005. Using semi-structured interviews with key informants and group interviews, we obtained qualitative and quantitative data on the HRH situation in the public and mission health sectors. We complemented this with an analysis of primary documents and a review of the available relevant reports and studies. Results The public health sector in Swaziland faces a serious shortage of health workers: 44% of posts for physicians, 19% of posts for nurses and 17% of nursing assistant posts were unfilled in 2004. We identified emigration and attrition due to HIV/AIDS as major factors depleting the health workforce. The annual training output of only 80 new nurses is not sufficient to compensate for these losses, and based on the situation in 2004 we estimated that the nursing workforce in the public sector would have been reduced by more than 40% by 2010. In 2005 we found that new initiatives by the Swazi government, such as the scale-up of ART, the introduction of retention measures to decrease emigration and the influx of foreign nurses could have the potential to improve the situation. A combination of such measures, together with the planned increase in the training capacity of the country's nursing

Knowledge management initiatives benefits for the Slovenian public sector

Directory of Open Access Journals (Sweden)

Simon Colnar

2017-01-01

Full Text Available This paper highlights the importance of knowledge management in Slovenian public sector organizations. Knowledge management has received a lot of attention in the past two decades, however in the public sector it is still under-researched. The global financial and economic crisis revealed some important organizational weaknesses in the Republic of Slovenia, some particularly due to the ineffectiveness of the Slovenian public sector, which ranks amongst the worst in the Euro zone. Authors argue that a stronger commitment to knowledge management, which is currently unused in the Slovenian public sector, represents an opportunity to coordinate and exploit public sector organizational knowledge resources. After analysing existing literature, authors have identified examples of good practices from foreign countries that could be partially transferred and adapted into the Slovenian environment. Since the efficient use of knowledge is linked to the performance of public sector organizations, the paper suggests that successful implementation of knowledge management initiatives should result in a more efficient public sector and, indirectly, in improved international public sector competitiveness rankings. This paper is also considered to be important for public sector practitioners and managers, as it proposes implementation of a knowledge management pilot project in Slovenian public sector.

Comparing Performance of Public and Cooperative Health Centers

Directory of Open Access Journals (Sweden)

Mostafa Farahbakhsh

2012-04-01

Full Text Available Background: Health cooperatives in similar structure of health network in Iran, give primary health cares to defined population with supervisory of public sector. Materials and method: This study compares health system performance between public (PHC and cooperative (CHC health centers. Results: Client's satisfaction was 4.14 in CHC and 3.9 in PHC in 5 point Likert scale. The mean for daily health services of CHC and PHC were 110.8 and 85 respectively. Conclusion: Health cooperatives are appropriate strategy for downsizing of government in health sector

Public Sector and Europeanization Challenges

Directory of Open Access Journals (Sweden)

Lucica Matei

2006-02-01

Accepting the market-type mechanisms instead of bureaucratic mechanisms, meaning not the simple provision of public services but the creation of some governmental “actors”, functioning completely on commercial bases, supporting the development of the partnerships between the public and private sector, introducing privatisation is achieved in view of creating “the facilitating state”. We discuss about “facilities” such as citizens and society involvement in public businesses, making public administration more citizen-friendly and the state closer to the public need. The citizens’ involvement, as customers in the flow of the public service contributes to creating an organic ensemble characterised by two fundamental dimensions: level and type of influence of the customers and the private-public dichotomy. Synthesising, the relationships and market mechanisms enable to the public sector to get closer to the public needs and to create a modern administration based on efficiency, effectiveness and openness towards change.

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

Science.gov (United States)

Ashmore, John

2013-01-03

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

Public Sector Employment in the Czech Republic after 1989: Old Legacy in New Realities?

Directory of Open Access Journals (Sweden)

Tomáš Sirovátka

2014-01-01

Full Text Available The relationship between the public and private sectors in post-communist countries was shaped under different circumstances when compared to the old EU countries: ‘non-productive’ occupations like health care, education and social services, which form the core of the public sector, were disadvantaged under the communist regime. In this paper we address the question of how the public sector developed in terms of size and structure of employment and salary levels between 1989 and 2010 (in the long-term and in times of crisis in the Czech Republic and how these changes can be explained. The trends which we have identified in the developments of public sector employment in the Czech Republic mirror the legacy of communism, the processes of transformation and privatization and the political preferences of the governments. We do not find many changes in overall public sector employment during the period of 1989–2010, except for the privatization of state-owned companies resulting from a strategy by government to prevent unemployment. The dynamics of wages in the public sector document the legacy of the communist past, when the salaries in non-productive sectors like education, health and social care were traditionally low relative to the productive branches. The resistance of public sector employees to their increasing disadvantage regarding salaries has been successful only to a limited extent. In the rare cases of highly specialized professional categories (like doctors it was possible to profit from a specific bargaining position. These developments may be best explained by the protest avoidance strategy of the post-communist governments and the political business cycle in its short-term outlook. In the long-term, the drivers which boost the development of social services generally do play a role, contrary to political manipulation.

Colombian public policies contributing to the achievement of Millennium Development Goals in the health sector, 2006

Directory of Open Access Journals (Sweden)

Lina M. Grisales

2008-02-01

Full Text Available During the General Assembly of the United Nations, in September 2000,189 countries (including Colombia committed to eight objectives leading to a more human and fairer world. Such objectives are called the Millennium Development Goals (mdg and to achieve them it is crucial to incorporate them in the action agendas of each country. The purpose of this monograph is to recognize current public policies in Colombia and Antioquia leading the achievement of the Millennium Development Goals, specifically those related to the reduction of mortality among children less than 5 years of age, improvement of maternal health and fighting against hiv/aids, malaria and dengue.In Colombia, Conpes 91 of 2005 is the only guideline given by the Government establishing goals and strategies to achieve the Millennium Development Goals in 2015. Nevertheless, other policies, programs and projects before and even after the Millennium Statement (but without explicit purpose contribute to achieving such goals. Revision of those policies is an effort for the research project “Degree of contribution of public policies to the achievement of the Millennium Development Goals related to the health sector, Antioquia, 2006”, which will evaluate the impact these guidelines have had in the achievement of the development goals in that particular sector.

Jurisdictional Competition Between Private and Public Sector Auditors

DEFF Research Database (Denmark)

Klarskov Jeppesen, Kim

2012-01-01

This paper explores the apparent paradox that while public sector auditors have become more powerful by claiming performance auditing expertise and linking this to New Public Management reforms, the same reforms have provided an opening for competition between private and public sector auditors....... In Denmark, the competitive relation has led to a jurisdictional dispute between public and private sector auditors in which the former have developed a special qualification for public sector auditors. The paper analyses the development of this qualification using Abbott's (1988) theory of the system...... of professions, thus focusing on how the involved groups have attempted to build networks of support for their competing jurisdictional claims of expertise. The case contributes to knowledge about the potential for development of a distinct public sector auditor identity. The case suggests that to develop...

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

Science.gov (United States)

Almeida, Celia

2017-10-02

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

Private sector health reform in South Africa.

Science.gov (United States)

Van Den Heever, A M

1998-06-01

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

[Health, hospitality sector and tobacco industry].

Science.gov (United States)

Abella Pons, Francesc; Córdoba Garcia, Rodrigo; Suárez Bonel, Maria Pilar

2012-11-01

To present the strategies used by the tobacco industry to meet government regulatory measures of its products. To demonstrate the relationship between tobacco industry and the hospitality sector. Note that the arguments and strategies used routinely by the hospitality industry have been previously provided by the tobacco industry. Location of key documents by meta-search, links to declassified documents, specific websites of the tobacco and hospitality industry, news sources and published articles in health journals. This review reveals the close relationship between tobacco industry and hospitality sector. It highlights the strategies carried out by the tobacco industry, including strategic hoarding of information, public relations, lobbying, consultation program, smoker defence groups, building partnerships, intimidation and patronage. The arguments and strategies used by the hospitality industry to match point by point that used by the tobacco industry. These arguments are refutable from the point of view of public health as it is scientifically proven that totally smoke-free environments are the only way to protect non-smokers from tobacco smoke exposure and its harmful effects on health. Copyright © 2011 Elsevier España, S.L. All rights reserved.

Rethinking health sector procurement as developmental linkages in East Africa.

Science.gov (United States)

Mackintosh, Maureen; Tibandebage, Paula; Karimi Njeru, Mercy; Kariuki Kungu, Joan; Israel, Caroline; Mujinja, Phares G M

2018-03-01

Health care forms a large economic sector in all countries, and procurement of medicines and other essential commodities necessarily creates economic linkages between a country's health sector and local and international industrial development. These procurement processes may be positive or negative in their effects on populations' access to appropriate treatment and on local industrial development, yet procurement in low and middle income countries (LMICs) remains under-studied: generally analysed, when addressed at all, as a public sector technical and organisational challenge rather than a social and economic element of health system governance shaping its links to the wider economy. This article uses fieldwork in Tanzania and Kenya in 2012-15 to analyse procurement of essential medicines and supplies as a governance process for the health system and its industrial links, drawing on aspects of global value chain theory. We describe procurement work processes as experienced by front line staff in public, faith-based and private sectors, linking these experiences to wholesale funding sources and purchasing practices, and examining their implications for medicines access and for local industrial development within these East African countries. We show that in a context of poor access to reliable medicines, extensive reliance on private medicines purchase, and increasing globalisation of procurement systems, domestic linkages between health and industrial sectors have been weakened, especially in Tanzania. We argue in consequence for a more developmental perspective on health sector procurement design, including closer policy attention to strengthening vertical and horizontal relational working within local health-industry value chains, in the interests of both wider access to treatment and improved industrial development in Africa. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

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

Science.gov (United States)

Furtado, Kheya Melo; Kar, Anita

2014-04-01

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

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

Science.gov (United States)

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

2017-08-01

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

Authentic leadership and organisational citizenship behaviour in the public health care sector: The role of workplace trust

Directory of Open Access Journals (Sweden)

Lynelle Coxen

2016-10-01

Full Text Available Orientation: The orientation of this study was towards authentic leadership and its influence on workplace trust and organisational citizenship behaviour in the public health care sector. Research purpose: The aim of this study was to investigate the influence of authentic leadership on organisational citizenship behaviour, through workplace trust among public health care employees in South Africa. The objective was to determine whether authentic leadership affects organisational citizenship behaviour through workplace trust (conceptualised as trust in the organisation, immediate supervisor and co-workers. Motivation for the study: Employees in the public health care industry are currently being faced with a demanding work environment which includes a lack of trust in leadership. This necessitated the need to determine whether authentic leadership ultimately leads to extra-role behaviours via workplace trust in its three referents. Research design, approach and method: A quantitative cross-sectional survey design was used with employees the public health care sector in South Africa (N = 633. The Authentic Leadership Inventory, Workplace Trust Survey and Organisational Citizenship Behaviour Scale were administered to these participants. Main findings: The results indicated that authentic leadership has a significant influence on trust in all three referents, namely the organisation, the supervisor and co-workers. Both trust in the organisation and trust in co-workers positively influenced organisational citizenship behaviour. Conversely, authentic leadership did not have a significant influence on organisational citizenship behaviour. Finally, authentic leadership had a significant indirect effect on organisational citizenship behaviour through trust in the organisation and trust in co-workers. Trust in the organisation was found to have the strongest indirect effect on the relationship between authentic leadership and organisational citizenship

Public-Private Partnerships as Hybrid Organizational Drivers of Innovation in the Public Sector

DEFF Research Database (Denmark)

Dam, Sofie

Decision-makers increasingly mention public-private partnerships (PPPs) as potential tools for innovation in the public sector. In contrast, literature on PPPs has mostly evaluated their economic efficiency, whereas their ability to enhance innovation has been subordinated and sometimes assumed....... Empirical investigations of innovations in PPPs have been rather scarce and scattered between different PPP types and sectors. This article strives for a more comprehensive and reflexive approach and contribute to an increasing body of literature on public sector innovation by constructing a conceptual...... framework, which can be used to investigate the potential for innovation in different PPP types across sectors. The last decades have seen sequential waves of public sector reforms, which have resulted in an increased hybridity in the public sector, where ideas, goals and tools from hierarchy, market...

US Health Care Reform and Transplantation, Part II: impact on the public sector and novel health care delivery systems.

Science.gov (United States)

Axelrod, D A; Millman, D; Abecassis, M M

2010-10-01

The Patient Protection and Affordable Care Act passed in 2010 will result in dramatic expansion of publically funded health insurance coverage for low-income individuals. It is estimated that of the 32 million newly insured, 16 million will obtain coverage through expansion of the Medicaid Program, and the remaining 16 million will purchase coverage through their employer or newly legislated insurance exchanges. While the Act contains numerous provisions to improve access to private insurance as discussed in Part I of this analysis, public sector coverage will significantly be affected. The cost of health care reform will be borne disproportionately by Medicare, which faces nearly $500 billion in cuts to be identified by a new independent board. Transplant centers should be concerned about the impact of the reform on the financial aspects of transplantation. In addition, this legislation also utilizes the Medicare Program to drive reform of the health care delivery system, by encouraging the development of integrated Accountable Care Organizations, experimentation with new 'models' of healthcare delivery, and expanded support for Comparative Effectiveness Research. Transplant providers, including transplant centers and physicians/surgeons need to lead this movement, drawing on our experience providing comprehensive multidisciplinary care under global budgets with publically reported outcomes.

Building the national health information infrastructure for personal health, health care services, public health, and research

Directory of Open Access Journals (Sweden)

Detmer Don E

2003-01-01

Full Text Available Abstract Background Improving health in our nation requires strengthening four major domains of the health care system: personal health management, health care delivery, public health, and health-related research. Many avoidable shortcomings in the health sector that result in poor quality are due to inaccessible data, information, and knowledge. A national health information infrastructure (NHII offers the connectivity and knowledge management essential to correct these shortcomings. Better health and a better health system are within our reach. Discussion A national health information infrastructure for the United States should address the needs of personal health management, health care delivery, public health, and research. It should also address relevant global dimensions (e.g., standards for sharing data and knowledge across national boundaries. The public and private sectors will need to collaborate to build a robust national health information infrastructure, essentially a 'paperless' health care system, for the United States. The federal government should assume leadership for assuring a national health information infrastructure as recommended by the National Committee on Vital and Health Statistics and the President's Information Technology Advisory Committee. Progress is needed in the areas of funding, incentives, standards, and continued refinement of a privacy (i.e., confidentiality and security framework to facilitate personal identification for health purposes. Particular attention should be paid to NHII leadership and change management challenges. Summary A national health information infrastructure is a necessary step for improved health in the U.S. It will require a concerted, collaborative effort by both public and private sectors. If you cannot measure it, you cannot improve it. Lord Kelvin

PUBLIC SECTOR PLANT BREEDING IN A PRIVATIZING WORLD

OpenAIRE

Thirtle, Colin G.; Srinivasan, Chittur S.; Heisey, Paul W.

2001-01-01

Intellectual property protection, globalization, and pressure on public budgets in many industrialized countries have shifted the balance of plant breeding activity from the public to the private sector. Several economic factors influence the relative shares of public versus private sector plant breeding activity, with varying results over time, over country, and over crop. The private sector, for example, dominates corn breeding throughout the industrialized world, but public and private act...

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

Science.gov (United States)

2013-01-01

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

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

Directory of Open Access Journals (Sweden)

Ashmore John

2013-01-01

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

Public Service Motivation and Attraction to Public Versus Private Sector Employment

DEFF Research Database (Denmark)

Pedersen, Mogens Jin

2013-01-01

of economics, political science, and law, this article tests (1) the relationship between PSM and attraction to public versus private sector employment, and (2) the moderating effect on this relationship of students’ academic field of study (i.e., their profession once graduated). Overall, results underscore...... the multidimensionality of the PSM construct, as the PSM dimension of “public interest” is positively associated with attraction to public sector employment and negatively associated with attraction to private sector employment, while the PSM dimension of “compassion” is unrelated to both. Importantly, however......Despite extensive public service motivation (PSM) research, our knowledge of PSM’s influence on individuals’ sector employment preferences is limited. Few studies examine this relationship by suitable research designs and the empirical findings are mixed. Using a sample of 718 Danish students...

Does it pay to be a public-sector employee?

OpenAIRE

Fabien Postel-Vinay

2015-01-01

Direct wage comparisons show that public-sector 
employees earn around 15% more than private-sector employees. But should these differences be interpreted as a “public-sector premium”? Two points need to be considered. First, the public and private sectors differ in the jobs they offer and the type of workers they employ, which explains a large share of the wage gap. Second, public- and private-sector careers also differ in other important dimensions, such as job stability and income progress...

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

Science.gov (United States)

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

2017-11-01

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

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

Science.gov (United States)

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

2012-07-01

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

Public and Private Responsibility for Mental Health: Mental Health's Fourth Revolution.

Science.gov (United States)

Dokecki, Paul R.

Three revolutions in the history of mental health were identified by Nicholas Hobbs: the humane revolution, the scientific and therapeutic revolution, and the public health revolution. The shift of responsibilities for mental health and substance abuse services from the public to the private sector may constitute a fourth mental health revolution.…

Product market integration, tax distortions and public sector size

DEFF Research Database (Denmark)

Andersen, Torben M.; Sørensen, Allan

of product market integration for the public sector are far from straightforward. The reason is gains-from-trade effects which tend to increase the tax base and decrease the opportunity costs of public consumption (marginal utility of private consumption falls). It follows that the retrenchment view...... that product market integration inevitable leads to a downward pressure on public sector activities does not get support in a standard setting. A particularly noteworthy finding is that a country with a large public sector (strong preferences for public consumption) may benefit more by integrating......The implications of product market integration for public sector activities (transfers and public consumption) are considered in a standard setting. The analysis supports that a larger public sector (higher tax rate) tends to increase wages and worsen wage competitiveness. However, the implications...

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

Science.gov (United States)

Reichert, Janice M; Milne, Christopher-Paul

2002-01-01

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

Staff/bed and staff/patient ratios in South African public sector mental ...

African Journals Online (AJOL)

Objectives. To document staff/bed and staff/patient ratios in public. sector mental health services in South Africa. Design. Cross-sectional survey. Method. Aquestionnaire was distributed to provincial mental health co-ordinators requesting numbers of full-time equivalent (FTE) staff who provide mental health care at all ...

Public and Private Sector IT Governance: Identifying Contextual Differences

OpenAIRE

John Campbell; Craig McDonald; Tsholofelo Sethibe

2010-01-01

This paper highlights systemic contextual differences and the unique IT Governance issues that might arise in public and private sector organizations. Public sector organizations constitute a significant component of economic activity in most countries. Like their private sector counterparts, many public sector agencies are struggling to cope with reduced or inadequate IT budgets and are continuously looking for ways to extract maximum value from IT resources. While both sectors face similar ...

Strategy in the Public and Private Sectors

DEFF Research Database (Denmark)

Alford, John; Greve, Carsten

2017-01-01

Strategic concepts and practices first evolved in the private sector, so they evoked much controversy when they migrated to the public sector from the late 1970s onwards. Partly this was about their (in)applicability to the distinctive features of government organizations, in particular their focus...... on public as well as private value, their situation in a political rather than a market environment, their almost exclusive capacity to use legal authority to achieve purposes, and the extent to which they often need to share power over personnel and resources with other public sector agencies....... These and other factors complicated efforts to apply New Public Management and similar frameworks in strategy concepts in a governmental context. Partly also the traditional private-sector focus on single organizations did not resonate with the growth of network governance from the 1990s. The authors argue...

Behavioral economics perspectives on public sector pension plans.

Science.gov (United States)

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

2011-04-01

We describe the pension plan features of the states and the largest cities and counties in the U.S. Unlike in the private sector, defined benefit (DB) pensions are still the norm in the public sector. However, a few jurisdictions have shifted toward defined contribution (DC) plans as their primary savings plan, and fiscal pressures are likely to generate more movement in this direction. Holding fixed a public employee's work and salary history, we show that DB retirement income replacement ratios vary greatly across jurisdictions. This creates large variation in workers' need to save for retirement in other accounts. There is also substantial heterogeneity across jurisdictions in the savings generated in primary DC plans because of differences in the level of mandatory employer and employee contributions. One notable difference between public and private sector DC plans is that public sector primary DC plans are characterized by required employee or employer contributions (or both), whereas private sector plans largely feature voluntary employee contributions that are supplemented by an employer match. We conclude by applying lessons from savings behavior in private sector savings plans to the design of public sector plans.

Public and Private Sector IT Governance: Identifying Contextual Differences

Directory of Open Access Journals (Sweden)

John Campbell

2010-01-01

Full Text Available This paper highlights systemic contextual differences and the unique IT Governance issues that might arise in public and private sector organizations. Public sector organizations constitute a significant component of economic activity in most countries. Like their private sector counterparts, many public sector agencies are struggling to cope with reduced or inadequate IT budgets and are continuously looking for ways to extract maximum value from IT resources. While both sectors face similar managerial-level IT issues and challenges, we argue that there are systemic differences between private and public sector organizations suggesting that a one size fits all approach to IT Governance may not apply.

EDI in the Public Sector

DEFF Research Database (Denmark)

Falch, Morten

1998-01-01

Introduction of EDI in the public administration is apriority for the Danish Government. EDI is both seen as a catlyst for development towards an information society ans as a means for more efficient use of scarce resources. EDI in the banking sector and the retail sector is reviewed, drivers...

Crowding out intrinsic motivation in the public sector

OpenAIRE

Georgellis, Y; Iossa, E; Tabvuma, V

2011-01-01

Employing intrinsically motivated individuals has been proposed as a means of improving public sector performance. In this article, we investigate whether intrinsic motivation affects the sorting of employees between the private and the public sectors, paying particular attention to whether extrinsic rewards crowd out intrinsic motivation. Using British longitudinal data, we find that individuals are attracted to the public sector by the intrinsic rather than the extrinsic rewards that the se...

Public Relations in the Public Sector

DEFF Research Database (Denmark)

Valentini, Chiara

2013-01-01

the findings. The study also suffers from the limits of a quantitative research approach, which provides less elaborate accounts of public communication officers’ perceptions of the strategic role of communication in the public sector. Originality/value of paper: This study contributes to the existing......Purpose of the paper: The aim of this study is to examine the level of strategic management of public administrations and information and communication programs by public communication officers in Italy. Methodology: The study is quantitative in nature. It was constructed according to the findings...... of the Excellence Project in Public Relations and thus applies a research instrument similar to that used in other international scholarly investigations in public relations. The population comprises civil servants working in information and communication activities for Italian public administrations. Findings...

Recruitment and retention strategies for public sector optometrists in KwaZulu-Natal Province, South Africa

Directory of Open Access Journals (Sweden)

Prasidh Ramson

2016-09-01

Full Text Available Background: In South Africa, there is a paucity of optometrists serving the needs of the larger public sector. KwaZulu-Natal is one of the most densely populated provinces and home to several of the poorest districts. Despite an optometry school in the province, and with a lack of compulsory community service for new graduates, more optometrists are needed to serve the public sector. While studies on the recruitment and retention of medical and allied health professionals have been conducted, limited evidence exists on work trends of public sector optometrists. Methods: A cross-sectional study design using both quantitative and qualitative data collection methods was used. All public sector optometrists and local district health co-ordinators in the province were contacted, with an 80% (41 out of 51 and 75% (9 out of 12 response rate, respectively. Questionnaires containing demographic, recruitment, retention and open-ended questions were distributed by post, fax and email and via an online survey to both groups. Telephonic interviews were also conducted using semi-structured techniques. Frequency distributions, Fisher’s exact test and odds ratios were used to statistically describe the demographic data, while qualitative responses were recorded and analysed for commonly occurring themes. Results: The present public sector optometry workforce comprises mainly young (73%, black (70%, women (66%. They chose to work in the public sector to ‘make a difference’ and were attracted by ‘good working hours’ and ‘job security’. Fifty-three percent of optometrists work in the public sector due to a study bursary, for which there was a statistically significant association for race (p = 0.01, gender (p = 0.05 and background origin (p = 0.05. To aid their retention in public service, improved salaries, career progression, recognition, improved management relations and improved instrumentation were ranked highest by these optometrists

Dual practice in the health sector: review of the evidence

Directory of Open Access Journals (Sweden)

Hipólito Fátima

2004-10-01

Full Text Available Abstract This paper reports on income generation practices among civil servants in the health sector, with a particular emphasis on dual practice. It first approaches the subject of public–private overlap. Thereafter it focuses on coping strategies in general and then on dual practice in particular. To compensate for unrealistically low salaries, health workers rely on individual coping strategies. Many clinicians combine salaried, public-sector clinical work with a fee-for-service private clientele. This dual practice is often a means by which health workers try to meet their survival needs, reflecting the inability of health ministries to ensure adequate salaries and working conditions. Dual practice may be considered present in most countries, if not all. Nevertheless, there is surprisingly little hard evidence about the extent to which health workers resort to dual practice, about the balance of economic and other motives for doing so, or about the consequences for the proper use of the scarce public resources dedicated to health. In this paper dual practice is approached from six different perspectives: (1 conceptual, regarding what is meant by dual practice; (2 descriptive, trying to develop a typology of dual practices; (3 quantitative, trying to determine its prevalence; (4 impact on personal income, the health care system and health status; (5 qualitative, looking at the reasons why practitioners so frequently remain in public practice while also working in the private sector and at contextual, personal life, institutional and professional factors that make it easier or more difficult to have dual practices; and (6 possible interventions to deal with dual practice.

An evaluation of the public sector optometric service provided within the health districts in KwaZulu-Natal, South Africa

Directory of Open Access Journals (Sweden)

Moraka E. Maake

2018-04-01

Full Text Available Background: In South Africa, optometry has been traditionally positioned within the private sector. The situation has gradually changed over the past two decades, with optometry being introduced into the public sector in many parts of the country. Despite the growing numbers, optometrists are still new within the public health sector, motivating this study to evaluate the eye care services they provide. Methods: A cross-sectional, retrospective, descriptive study was undertaken. Stratified random selection was applied to select the study sites, and systematic sampling was used to select patients’ files. A saturated sample of public sector optometrists employed in the selected districts completed study questionnaires. Data were analysed using the Statistical Package for Social Sciences, Version 21. Results: A total of 2968 records were reviewed, and gender distribution was 67.6% female and 32.4% male. Refraction (86.73% was the most frequently conducted test, followed by ophthalmoscopy (74.73%, colour vision (0.07% and gonioscopy (0.03%. The response rate for the questionnaires was 64.7%. Optometric outreach services were conducted by 54.5% of optometrists, and the majority (83.3% reported that the farthest outreach facility was more than 50 km from their base hospital. The availability of equipment at outreach facilities was less as compared to base hospitals, while some reported not having the necessary equipment even at base hospitals. None of the optometrists did contact lens fitting at outreach facilities. A lack of equipment was cited as one of the reasons for not providing this service by 100% of optometrists. Most optometrists (63.6% believed that more than 30% of their referrals might have been avoided if they had prescribed therapeutic agents to manage ocular conditions. Conclusion: Introducing optometrists within the public sector improves access to services for rural communities. However, the minimum standard of optometric care

Strategic planning for public health practice using macroenvironmental analysis.

Science.gov (United States)

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

1991-01-01

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

Collaborative Innovation in the Public Sector

DEFF Research Database (Denmark)

Agger, Annika; Hedensted Lund, Dorthe

2017-01-01

Collaborative innovation in the public sector is increasingly used as a strategy for balancing citizens’ rising expectations for public services with limited public resources. This article suggests that public polices construct citizens as clients, consumers, or coproducers and thereby encourage...

Specifics of the employment process in the public sector

Directory of Open Access Journals (Sweden)

Raluca DIMITRIU

2012-06-01

Full Text Available The labour legislation applicable in public sector is very different from the one applicable in private sector. Unlike the private sector where the market is the most efficient regulator and sanctions all errors made by the assessor, in the public sector there isn’t always a feed-back from the economic realities that may prove the accuracy and the efficiency of the assessment. Consequently, the law goes further on and imposes requirements, deadlines and procedures. While the private sector enjoys a certain flexibility regarding the assessment of the staff, in order to adjust it to the requirements of the economic realities, in the public sector, flexibility can lead to manifestations of subjectivism and arbitrariness. On the other hand, the excessive amount of regulations applicable in public sector may provide versatile and even contradictory results.

The changing face of public sector employment 1999–2009

OpenAIRE

David Matthews

2010-01-01

SUMMARYThis article presents an analysis of public sector employment (PSE) and makes comparisons with the private sector, using data from the Labour Force Survey and Annual Survey of Hours and Earnings. It looks at the nature of employment in the public sector before discussing the characteristics that differentiate people employed in both the public and private sector, comparing proportions of public and private sector workers in different groups: by sex, age, ethnicity, disability, working ...

What is required to retain registered nurses in the public health ...

African Journals Online (AJOL)

What is required to retain registered nurses in the public health sector in Malawi? ... public sector in search for better remuneration in the private sector including ... The results indicate that poor salaries, heavy workloads, lack of promotional ...

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

Science.gov (United States)

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

2017-07-12

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

Challenges and Opportunities for Advancing Work on Climate Change and Public Health.

Science.gov (United States)

Gould, Solange; Rudolph, Linda

2015-12-09

Climate change poses a major threat to public health. Strategies that address climate change have considerable potential to benefit health and decrease health inequities, yet public health engagement at the intersection of public health, equity, and climate change has been limited. This research seeks to understand the barriers to and opportunities for advancing work at this nexus. We conducted semi-structured in-depth interviews (N = 113) with public health and climate change professionals and thematic analysis. Barriers to public health engagement in addressing climate change include individual perceptions that climate change is not urgent or solvable and insufficient understanding of climate change's health impacts and programmatic connections. Institutional barriers include a lack of public health capacity, authority, and leadership; a narrow framework for public health practice that limits work on the root causes of climate change and health; and compartmentalization within and across sectors. Opportunities include integrating climate change into current public health practice; providing inter-sectoral support for climate solutions with health co-benefits; and using a health frame to engage and mobilize communities. Efforts to increase public health sector engagement should focus on education and communications, building leadership and funding, and increasing work on the shared root causes of climate change and health inequities.

Challenges and Opportunities for Advancing Work on Climate Change and Public Health

Science.gov (United States)

Gould, Solange; Rudolph, Linda

2015-01-01

Climate change poses a major threat to public health. Strategies that address climate change have considerable potential to benefit health and decrease health inequities, yet public health engagement at the intersection of public health, equity, and climate change has been limited. This research seeks to understand the barriers to and opportunities for advancing work at this nexus. We conducted semi-structured in-depth interviews (N = 113) with public health and climate change professionals and thematic analysis. Barriers to public health engagement in addressing climate change include individual perceptions that climate change is not urgent or solvable and insufficient understanding of climate change’s health impacts and programmatic connections. Institutional barriers include a lack of public health capacity, authority, and leadership; a narrow framework for public health practice that limits work on the root causes of climate change and health; and compartmentalization within and across sectors. Opportunities include integrating climate change into current public health practice; providing inter-sectoral support for climate solutions with health co-benefits; and using a health frame to engage and mobilize communities. Efforts to increase public health sector engagement should focus on education and communications, building leadership and funding, and increasing work on the shared root causes of climate change and health inequities. PMID:26690194

Public versus private sector: Do workers’ behave differently?

Directory of Open Access Journals (Sweden)

Paulo Aguiar do Monte

2017-05-01

Full Text Available It has been widely assumed in the literature that public sector organization operates in a different way compared to private sector organization. This paper intends to contribute to develop further this issue by investigating whether the relationship between worker efforts differs significantly both in the public and in the private sector. By drawing on data from the Monthly Employment Survey (PME, Brazil 2003–2012, and proxies for worker effort (unpaid overtime work and absences, it was observed, initially, significant differences between worker’s profiles depending on the sector they are employed. In turn, the estimation results of the dynamic panel models confirm that the level of worker effort alters according to their switches from one sector to another in the labor market. Briefly, public sector workers do not tend to do unpaid overtime work comparable to those in private sector, and they are more likely to be absent at work.

Towards a Public Sector GIS Evaluation Methodology | Kurwakumire ...

African Journals Online (AJOL)

Towards a Public Sector GIS Evaluation Methodology. ... AFRICAN JOURNALS ONLINE (AJOL) · Journals · Advanced Search · USING AJOL · RESOURCES ... However, evaluation methodologies for public sector GIS are largely lacking.

Unemployment, public-sector health-care spending and breast cancer mortality in the European Union: 1990-2009.

Science.gov (United States)

Maruthappu, Mahiben; Watkins, Johnathan A; Waqar, Mueez; Williams, Callum; Ali, Raghib; Atun, Rifat; Faiz, Omar; Zeltner, Thomas

2015-04-01

The global economic crisis has been associated with increased unemployment, reduced health-care spending and adverse health outcomes. Insights into the impact of economic variations on cancer mortality, however, remain limited. We used multivariate regression analysis to assess how changes in unemployment and public-sector expenditure on health care (PSEH) varied with female breast cancer mortality in the 27 European Union member states from 1990 to 2009. We then determined how the association with unemployment was modified by PSEH. Country-specific differences in infrastructure and demographic structure were controlled for, and 1-, 3-, 5- and 10-year lag analyses were conducted. Several robustness checks were also implemented. Unemployment was associated with an increase in breast cancer mortality [P unemployment rises (P unemployment and breast cancer mortality remained in all robustness checks. Rises in unemployment are associated with significant short- and long-term increases in breast cancer mortality, while increases in PSEH are associated with reductions in breast cancer mortality. Initiatives that bolster employment and maintain total health-care expenditure may help minimize increases in breast cancer mortality during economic crises. © The Author 2014. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Environmental Impacts of the U.S. Health Care System and Effects on Public Health.

Science.gov (United States)

Eckelman, Matthew J; Sherman, Jodi

2016-01-01

The U.S. health care sector is highly interconnected with industrial activities that emit much of the nation's pollution to air, water, and soils. We estimate emissions directly and indirectly attributable to the health care sector, and potential harmful effects on public health. Negative environmental and public health outcomes were estimated through economic input-output life cycle assessment (EIOLCA) modeling using National Health Expenditures (NHE) for the decade 2003-2013 and compared to national totals. In 2013, the health care sector was also responsible for significant fractions of national air pollution emissions and impacts, including acid rain (12%), greenhouse gas emissions (10%), smog formation (10%) criteria air pollutants (9%), stratospheric ozone depletion (1%), and carcinogenic and non-carcinogenic air toxics (1-2%). The largest contributors to impacts are discussed from both the supply side (EIOLCA economic sectors) and demand side (NHE categories), as are trends over the study period. Health damages from these pollutants are estimated at 470,000 DALYs lost from pollution-related disease, or 405,000 DALYs when adjusted for recent shifts in power generation sector emissions. These indirect health burdens are commensurate with the 44,000-98,000 people who die in hospitals each year in the U.S. as a result of preventable medical errors, but are currently not attributed to our health system. Concerted efforts to improve environmental performance of health care could reduce expenditures directly through waste reduction and energy savings, and indirectly through reducing pollution burden on public health, and ought to be included in efforts to improve health care quality and safety.

Environmental Impacts of the U.S. Health Care System and Effects on Public Health.

Directory of Open Access Journals (Sweden)

Matthew J Eckelman

Full Text Available The U.S. health care sector is highly interconnected with industrial activities that emit much of the nation's pollution to air, water, and soils. We estimate emissions directly and indirectly attributable to the health care sector, and potential harmful effects on public health. Negative environmental and public health outcomes were estimated through economic input-output life cycle assessment (EIOLCA modeling using National Health Expenditures (NHE for the decade 2003-2013 and compared to national totals. In 2013, the health care sector was also responsible for significant fractions of national air pollution emissions and impacts, including acid rain (12%, greenhouse gas emissions (10%, smog formation (10% criteria air pollutants (9%, stratospheric ozone depletion (1%, and carcinogenic and non-carcinogenic air toxics (1-2%. The largest contributors to impacts are discussed from both the supply side (EIOLCA economic sectors and demand side (NHE categories, as are trends over the study period. Health damages from these pollutants are estimated at 470,000 DALYs lost from pollution-related disease, or 405,000 DALYs when adjusted for recent shifts in power generation sector emissions. These indirect health burdens are commensurate with the 44,000-98,000 people who die in hospitals each year in the U.S. as a result of preventable medical errors, but are currently not attributed to our health system. Concerted efforts to improve environmental performance of health care could reduce expenditures directly through waste reduction and energy savings, and indirectly through reducing pollution burden on public health, and ought to be included in efforts to improve health care quality and safety.

Public sector leadership: New perspectives for research and practice

OpenAIRE

D. Orazi; A.Turrini; G. Valotti

2013-01-01

In this paper, we aim to portray the state of the art in public sector leadership in order to recommend directions for research and training practice. To this end, we review the scattered strands of literature on public sector leadership (PSL) and classify them in a single framework. The results of the study suggest that public sector leadership is emerging as a distinctive and autonomous domain in public administration/public management studies, although the debate is still underdeveloped co...

CORPORATE SOCIAL RESPONSIBILITY: COMMUNICATING IN PUBLIC SECTOR ORGANIZATIONS

Directory of Open Access Journals (Sweden)

Йолита Ричардовна Вайнхардт

2014-04-01

Full Text Available Objective: to examine the details of declared activities of social responsibility in the public sector. To achieve the objective the following tasks are formulated: (1 to review the CSR research carried out inLithuania; (2 to analyse the communicative actions of public sector organizations concerning socially responsible activities. Method of work: the article is written using the methods of content analysis, analogy and reflection.  Results: Corporate social responsibility (CSR activities focused on external interest groups and their representation are analysed in the article. The survey covers state capital enterprises or enterprises, in which a larger part of the portfolio of shares is owned by the public sector, and educational organizations, the founder of which is the state. The research of CSR carried out in Lithuania in recent years is overviewed and analysis of the way the public sector organizations, which belong to United Nations Global Compact (hereafter GC network communicate their socially responsible activities is provided. It has been found that the membership of the majority of public sector organizations in the GC is rather formal, and insufficient attention is given for communicating socially responsible activities in information carriers, most easily accessible to the user.  Application of results: management in the public sector.DOI: http://dx.doi.org/10.12731/2218-7405-2013-10-32

Health factors in the everyday life and work of public sector employees in Sweden.

Science.gov (United States)

Erlandsson, Lena-Karin; Carlsson, Gunilla; Horstmann, Vibeke; Gard, Gunvor; Holmström, Eva

2012-01-01

The aim was to explore aspects of everyday life in addition to established risk factors and their relationship to subjective health and well-being among public sector employees in Sweden. Gainful employment impact on employees' health and well-being, but work is only one part of everyday life and a broader perspective is essential in order to identify health-related factors. Data were obtained from employees at six Social Insurance Offices in Sweden, 250 women and 50 men. A questionnaire based on established instruments and questions specifically designed for this study was used. Relationships between five factors of everyday life, subjective health and well-being were investigated by means of multivariate logistic regression analysis. The final model revealed a limited importance of certain work-related factors. A general satisfaction with everyday activities, a stress-free environment and general control in addition to not having monotonous movements at work were found to be factors explaining 46.3% of subjective good health and well-being. A person's entire activity pattern, including work, is important, and strategies for promoting health should take into account the person's situation as a whole. The interplay between risk and health factors is not clear and further research is warranted.

Micro and small firms contracted the works of third sector contracting and public

Directory of Open Access Journals (Sweden)

Daniela Juliano Silva

2015-06-01

Full Text Available In a scenario of successive changes, we are faced today with a "new" State of design (First Sector subsidiary and developer, embracing new contracting models, involving private non-profit institutions (Third Sector ahead of social services relevance (health, education, technology, among others. To comply with the obligations entered into with the public entity (end-obligations, this Third Sector performs hires (to perform their half-bonds with the second sector (market, where they operate Micro and Small Businesses. This study aims a reflective look at these contracts, usually the result of simplified bidding process in order to verify their specificities and whether they take place in compliance with the prerogatives and differential treatment meted especially those business companies (art. 170, X, SC / 1988. In this endeavor, it was decided, besides a literature review by an investigative approach from the point of view of three different social organizations that have management contracts in health care with public entities and therefore have signed contracts with ME and EPP for the fulfillment of their obligations to the government.      

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

Science.gov (United States)

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

2014-12-01

Policy-makers working at the interface of agri-food and public health often deal with complex and cross-cutting issues that have broad health impacts and socio-economic implications. They have a responsibility to ensure that policy-making based on these issues is accountable and informed by the best available scientific evidence. We conducted a qualitative descriptive study of agri-food public health policy-makers and research and policy analysts in Ontario, Canada, to understand their perspectives on how the policy-making process is currently informed by scientific evidence and how to facilitate this process. Five focus groups of 3-7 participants and five-one-to-one interviews were held in 2012 with participants from federal and provincial government departments and industry organizations in the agri-food public health sector. We conducted a thematic analysis of the focus group and interview transcripts to identify overarching themes. Participants indicated that the following six key principles are necessary to enable and demonstrate evidence-informed policy-making (EIPM) in this sector: (i) establish and clarify the policy objectives and context; (ii) support policy-making with credible scientific evidence from different sources; (iii) integrate scientific evidence with other diverse policy inputs (e.g. economics, local applicability and stakeholder interests); (iv) ensure that scientific evidence is communicated by research and policy stakeholders in relevant and user-friendly formats; (V) create and foster interdisciplinary relationships and networks across research and policy communities; and (VI) enhance organizational capacity and individual skills for EIPM. Ongoing and planned efforts in these areas, a supportive culture, and additional education and training in both research and policy realms are important to facilitate evidence-informed policy-making in this sector. Future research should explore these findings further in other countries and contexts. �

The case for transforming governmental public health.

Science.gov (United States)

Salinsky, Eileen; Gursky, Elin A

2006-01-01

Changing threats to the public's health necessitate a profound transformation of the public health enterprise. Despite recent attention to the biodefense role of public health, policymakers have not developed a clear, realistic vision for the structure and functionality of the governmental public health system. Lack of leadership and organizational disconnects across levels of government have prevented strategic alignment of resources and undermined momentum for meaningful change. A transformed public health system is needed to address the demands of emergency preparedness and health protection. Such transformation should include focused, risk-based resource allocation; regional planning; technological upgrades; workforce restructuring; improved integration of private-sector assets; and better performance monitoring.

Public Health Adaptation to Climate Change in OECD Countries

Science.gov (United States)

Austin, Stephanie E.; Biesbroek, Robbert; Berrang-Ford, Lea; Ford, James D.; Parker, Stephen; Fleury, Manon D.

2016-01-01

Climate change is a major challenge facing public health. National governments play a key role in public health adaptation to climate change, but there are competing views on what responsibilities and obligations this will—or should—include in different nations. This study aims to: (1) examine how national-level public health adaptation is occurring in Organization for Economic Cooperation and Development (OECD) countries; (2) examine the roles national governments are taking in public health adaptation; and (3) critically appraise three key governance dimensions of national-level health adaptation—cross-sectoral collaboration, vertical coordination and national health adaptation planning—and identify practical examples suited to different contexts. We systematically reviewed publicly available public health adaptation to climate change documents and webpages by national governments in ten OECD countries using systematic web searches, assessment of self-reporting, and content analysis. Our findings suggest national governments are primarily addressing infectious disease and heat-related risks posed by climate change, typically emphasizing capacity building or information-based groundwork initiatives. We find national governments are taking a variety of approaches to public health adaptation to climate change that do not follow expected convergence and divergence by governance structure. We discuss practical options for incorporating cross-sectoral collaboration, vertical coordination and national health adaptation planning into a variety of contexts and identify leaders national governments can look to to inform their public health adaptation planning. Following the adoption of the Paris Agreement and subsequent increased momentum for adaptation, research tracking adaptation is needed to define what health adaptation looks like in practice, reveal insights that can be taken up across states and sectors, and ensure policy orientated learning. PMID:27618074

Public Health Adaptation to Climate Change in OECD Countries.

Science.gov (United States)

Austin, Stephanie E; Biesbroek, Robbert; Berrang-Ford, Lea; Ford, James D; Parker, Stephen; Fleury, Manon D

2016-09-07

Climate change is a major challenge facing public health. National governments play a key role in public health adaptation to climate change, but there are competing views on what responsibilities and obligations this will-or should-include in different nations. This study aims to: (1) examine how national-level public health adaptation is occurring in Organization for Economic Cooperation and Development (OECD) countries; (2) examine the roles national governments are taking in public health adaptation; and (3) critically appraise three key governance dimensions of national-level health adaptation-cross-sectoral collaboration, vertical coordination and national health adaptation planning-and identify practical examples suited to different contexts. We systematically reviewed publicly available public health adaptation to climate change documents and webpages by national governments in ten OECD countries using systematic web searches, assessment of self-reporting, and content analysis. Our findings suggest national governments are primarily addressing infectious disease and heat-related risks posed by climate change, typically emphasizing capacity building or information-based groundwork initiatives. We find national governments are taking a variety of approaches to public health adaptation to climate change that do not follow expected convergence and divergence by governance structure. We discuss practical options for incorporating cross-sectoral collaboration, vertical coordination and national health adaptation planning into a variety of contexts and identify leaders national governments can look to to inform their public health adaptation planning. Following the adoption of the Paris Agreement and subsequent increased momentum for adaptation, research tracking adaptation is needed to define what health adaptation looks like in practice, reveal insights that can be taken up across states and sectors, and ensure policy orientated learning.

Knowledge, attitudes, and practices regarding dengue infection among public sector healthcare providers in Machala, Ecuador

OpenAIRE

Handel, Andrew S.; Ayala, Efra?n Beltr?n; Borbor-Cordova, Mercy J.; Fessler, Abigail G.; Finkelstein, Julia L.; Espinoza, Roberto Xavier Robalino; Ryan, Sadie J.; Stewart-Ibarra, Anna M.

2016-01-01

Background Dengue fever is a rapidly emerging infection throughout the tropics and subtropics with extensive public health burden. Adequate training of healthcare providers is crucial to reducing infection incidence through patient education and collaboration with public health authorities. We examined how public sector healthcare providers in a dengue-endemic region of Ecuador view and manage dengue infections, with a focus on the 2009 World Health Organization (WHO) Dengue Guidelines. Metho...

Improving Performances in the Public Sector: The Scientific ...

African Journals Online (AJOL)

Improving Performances in the Public Sector: The Scientific Management Theory ... adopts the principles for enhanced productivity, efficiency and the attainment of ... of the public sector, as observed and reported by several scholars over time.

Public-Private Partnership in Cultural Heritage Sector

Directory of Open Access Journals (Sweden)

Daniela Angelina JELINČIĆ

2017-12-01

Full Text Available Over the past few decades public-private partnership or PPP has become a new way for delivering and fi nancing public sector projects. It may involve investment in fully economic infrastructure such as highways, railways, airports, seaports, etc. up to the investments in social infrastructure projects, such as schools, hospitals, museums and other signifi cant and historic buildings of public interest. The main objective of this article is to analyze the situation in Croatia, Poland, Slovakia and Slovenia concerning the topic of public- private partnership (PPP in order to provide grounds for possible future investments in cultural heritage in these countries. For this purpose, a comparative analysis of legal and institutional frameworks was carried out as well as structured interviews with key stakeholders (public and private sector representatives. Special attention has been paid to the use of PPP projects in the revitalization of cultural heritage. The results of the analysis showed the lack of PPP investments in the cultural sector, and also identifi ed possible obstacles in public sector administrative procedures. The results of the analysis may be further used to stimulate both public authorities to set strategic directions for heritage revitalization plans based on PPP schemes as well as private investors who may seek feasible business models complemented with social responsibility benefits.

Capital dynamics and local health systems: searching for a comprehensive analysis of the health sector

Directory of Open Access Journals (Sweden)

Maria de Fátima Siliansky de Andreazzi

2006-01-01

Full Text Available The article presents a proposal of a methodology aimed to analyze the health care sector according to the dynamics of capital accumulation. That approach could be summed up to more traditional approaches founded in the Public Health field, based in a political perspective. The proposal departs from concepts and methods of Industrial Organization, already used for health care markets, in the European and Latin-American (CEPAL contexts. We aggregated economic and historical variables to these approaches, which delimitate possibilities and impose constraints to the strategies of the local agents. The objective of the paper is to give methodological support to public managers at state and local level, whose role as the single commander in their territories is prescribed by the present health policy in Brazil. That includes all the fields related to private sector regulation in health: from planning the supply to quality control of providers.

New public management in Iran's health complex: a management framework for primary health care system.

Science.gov (United States)

Tabrizi, Jafar Sadegh; HaghGoshayie, Elaheh; Doshmangir, Leila; Yousefi, Mahmood

2018-05-01

New public management (NPM) was developed as a management reform to improve the efficiency and effectiveness in public organizations, especially in health sector. Using the features of private sector management, the managers of health organizations may try to implement the elements of NPM with the hope to improve the performance of their systems.AimsOur aim in the present study was to identify the elements and infrastructures suitable for implementing NPM in the Iranian health complex. In this qualitative study with conventional content analysis approach, we tried to explore the NPM elements and infrastructures in Iranian public health sector. A series of semi-structured interviews (n=48) were conducted in 2016 with a managers in public and private health complex. Three focus group discussions with nine faculty members were also conducted. A data collection form was used to collect the demographic characteristics and perspectives of the participants.FindingsFrom the perspective of managers, managerialism, decentralization, using market mechanism, performance management, customer orientation and performance budgeting were the main elements of NPM in the Iranian context. The most important infrastructures for implementing this reform were as follows: education and training, information technology, the proper use of human resources, decision support systems, top management commitment, organizational culture, flexibility of rules, rehabilitating of the aging infrastructures, and expanding the coverage of services. The NPM was generally identified to be an effective replacement for the traditional administration method. These reforms may be helpful in strengthening the public health complex and the management capacity, as well. NPM also seems to be useful in interacting the public health sector with the private sector in terms of personnel and resources, performance, reward structure, and methods of doing business.

Responsible leader behavior in health sectors.

Science.gov (United States)

Longest, Beaufort

2017-02-06

Purpose The purpose of this paper is to expand attention to responsible leader behavior in the world's health sectors by explaining how this concept applies to health sectors, considering why health sector leaders should behave responsibly, reviewing how they can do so, and asserting potential impact through an applied example. Design/methodology/approach This paper is a viewpoint, reflecting conceptualizations rooted in leadership literature which are then specifically applied to health sectors. A definition of responsible leader behavior is affirmed and applied specifically in health sectors. Conceptualizations and viewpoints about practice of responsible leader behavior in health sectors and potential consequences are then discussed and asserted. Findings Leadership failures and debacles found in health, but more so in other sectors, have led leadership researchers to offer insights, many of them empirical, into the challenges of leadership especially by more clearly delineating responsible leader behavior. Practical implications Much of what has been learned in the research about responsible leader behavior offers pathways for health sector leaders to more fully practice responsible leadership. Social implications This paper asserts and provides a supporting example that greater levels of responsible leader behavior in health sectors hold potentially important societal benefits. Originality/value This paper is the first to apply emerging conceptualizations and early empirical findings about responsible leader behavior specifically to leaders in health sectors.

Intrinsic Motivations of Public Sector Employees: Evidence for Germany

NARCIS (Netherlands)

A.J. Dur (Robert); R. Zoutenbier (Robin)

2012-01-01

textabstractWe examine differences in altruism and laziness between public sector employees and private sector employees. Our theoretical model predicts that the likelihood of public sector employment increases with a worker's altruism, and increases or decreases with a worker's laziness depending

The impact of slow economic growth on health sector reform: a cross-national perspective.

Science.gov (United States)

Saltman, Richard B

2018-01-24

This paper assesses recent health sector reform strategies across Europe adopted since the onset of the 2008 financial crisis. It begins with a brief overview of the continued economic pressure on public funding for health care services, particularly in tax-funded Northern European health care systems. While economic growth rates across Europe have risen a bit in the last year, they remain below the level necessary to provide the needed expansion of public health sector revenues. This continued public revenue shortage has become the central challenge that policymakers in these health systems confront, and increasingly constrains their potential range of policy options. The paper then examines the types of targeted reforms that various European governments have introduced in response to this increased fiscal stringency. Particularly in tax-funded health systems, these efforts have been focused on two types of changes on the production side of their health systems: consolidating and/or centralizing administrative authority over public hospitals, and revamping secondary and primary health services as well as social services to reduce the volume, cost and less-than-optimal outcomes of existing public elderly care programs. While revamping elderly care services also was pursued in the social health insurance (SHI) system in the Netherlands, both the Dutch and the German health systems also made important changes on the financing side of their health systems. Both types of targeted reforms are illustrated through short country case studies. Each of these country assessments flags up new mechanisms that have been introduced and which potentially could be reshaped and applied in other national health sector contexts. Reflecting the tax-funded structure of the Canadian health system, the preponderance of cases discussed focus on tax-funded countries (Norway, Denmark, Sweden, Finland, England, Ireland), with additional brief assessments of recent changes in the SHI

Good governance and corruption in the health sector: lessons from the Karnataka experience.

Science.gov (United States)

Huss, R; Green, A; Sudarshan, H; Karpagam, Ss; Ramani, Kv; Tomson, G; Gerein, N

2011-11-01

Strengthening good governance and preventing corruption in health care are universal challenges. The Karnataka Lokayukta (KLA), a public complaints agency in Karnataka state (India), was created in 1986 but played a prominent role controlling systemic corruption only after a change of leadership in 2001 with a new Lokayukta (ombudsman) and Vigilance Director for Health (VDH). This case study of the KLA (2001-06) analysed the:Scope and level of poor governance in the health sector; KLA objectives and its strategy; Factors which affected public health sector governance and the operation of the KLA. We used a participatory and opportunistic evaluation design, examined documents about KLA activities, conducted three site visits, two key informant and 44 semi-structured interviews and used a force field model to analyse the governance findings. The Lokayukta and his VDH were both proactive and economically independent with an extended social network, technical expertise in both jurisdiction and health care, and were widely perceived to be acting for the common good. They mobilized media and the public about governance issues which were affected by factors at the individual, organizational and societal levels. Their investigations revealed systemic corruption within the public health sector at all levels as well as in public/private collaborations and the political and justice systems. However, wider contextual issues limited their effectiveness in intervening. The departure of the Lokayukta, upon completing his term, was due to a lack of continued political support for controlling corruption. Governance in the health sector is affected by positive and negative forces. A key positive factor was the combined social, cultural and symbolic capital of the two leaders which empowered them to challenge corrupt behaviour and promote good governance. Although change was possible, it was precarious and requires continuous political support to be sustained.

Applying Business Process Re-Engineering to Public Sector as A New Public Management Strategy

Directory of Open Access Journals (Sweden)

Ropinder Oberoi

2013-08-01

Full Text Available The introduction of Business Process Reengineering (BPR to the public sector follows the much broader trend of New Public Management. BPR in the public sector mostly means amalgamation of business processes, computerization of various activities and removal of some unnecessary ones. BPR assimilates a radical premeditated scheme of business pro-cess reengineering and an additional progressive technique of uninterrupted process improvement with adequate information technology (IT and e-business infrastructure strategies. Public organizations have specific and exclusive features that differentiae-ate them from private sector organizations. Based on the literature review and examining of study find-ings, it is argued that a public sector organization can employ BPR to get better its process and overall organizational performance, if it (1 has accrues a collection of BPR-relevant resources and capabilities; (2 has embarked on BPR with adequate depth and breadth; (3 is developing a post-BPR complementary set of skills, systems and technologies, which are essential to further develop the organizational impact of the BPR; and (4 has successfully mitigated the effects of BPR implementation problems. In addition to its effect on administration and ser-vice delivery processes through reduction of the processing time, work steps and cost of government processes, BPR also contributes to enhancing citizen/customer and employee satisfaction, increasing organizational transparency and responsiveness which have also become an essential objective of New Public Management. Therefore, public sector BPR is emerging as an indispensable to performance of organizations in the developing economy. The essential questions addressed in this paper are: What are the scenario and impending problems of reengineering applications in the public sector? Can it be functional for the public sector in attending to frequent problems blockading bureaucracies of developed and

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

Science.gov (United States)

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

2017-11-27

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

Creating an integrated public sector? Labour's plans for the modernisation of the English health care system

Directory of Open Access Journals (Sweden)

Nick Goodwin

2002-03-01

Full Text Available The current Labour Government has embarked on radical public sector reform in England. A so-called ‘Modernisation Agenda’ has been developed that is encapsulated in the NHS Plan—a document that details a long-term vision for health care. This plan involves a five-fold strategy: investment through greater public funding; quality assurance; improving access; service integration and inter-professional working; and providing a public health focus. The principles of Labour's vision have been broadly supported. However, achieving its aims appears reliant on two key factors. First, appropriate resources are required to create capacity, particularly management capacity, to enable new functions to develop. Second, promoting access and service integration requires the development of significant co-ordination, collaboration and networking between agencies and individuals. This is particularly important for health and social care professionals. Their historically separate professions suggest that a significant period of change management is required to allow new roles and partnerships to evolve. In an attempt to secure delivery of its goals, however, the Government has placed the emphasis on further organisational restructuring. In doing so, the Government may have missed the key challenges faced in delivering its NHS Plan. As this paper argues, cultural and behavioural change is probably a far more appropriate and important requirement for success than a centrally directed approach that emphasises the rearrangement of structural furniture.

Public Sector Employee Assistance Programs.

Science.gov (United States)

Kemp, Donna R.; Verlinde, Beverly

This document discusses employee assistance programs (EAPs), programs which have been developed to help employees deal with personal problems that seriously affect job performance. It reviews literature which specifically addresses EAPs in the public sector, noting that there are no exact figures on how many public entities have EAPs. Previous…

Conceptualizations of postpartum depression by public-sector health care providers in Mexico.

Science.gov (United States)

Place, Jean Marie S; Billings, Deborah L; Blake, Christine E; Frongillo, Edward A; Mann, Joshua R; deCastro, Filipa

2015-04-01

In this article we describe the knowledge frameworks that 61 physicians, nurses, social workers, and psychologists from five public-sector health care facilities in Mexico used to conceptualize postpartum depression. We also demonstrate how providers applied social and behavioral antecedents in their conceptualizations of postpartum depression. Using grounded theory, we identify two frameworks that providers used to conceptualize postpartum depression: biochemical and adjustment. We highlight an emerging model of the function of social and behavioral antecedents within the frameworks, as well as the representation of postpartum depression by symptoms of distress and the perception among providers that these symptoms affected responsibilities associated with motherhood. The results provide a foundation for future study of how providers' conceptualizations of postpartum depression might affect detection and treatment practices and might be useful in the development of training materials to enhance the quality of care for women who experience any form of distress in the postpartum period. © The Author(s) 2014.

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

CSIR Research Space (South Africa)

Hwabamungu, B

2018-01-01

Full Text Available in fulfilling their mandate. The public health sector in particular needs to engage with a diversity of stakeholders at local, regional and national levels when strategising. The purpose of this study is to investigate the influence of stakeholder relations...

Modernize the Public Sector Through Innovation?

DEFF Research Database (Denmark)

Hansson, Finn; Norn, Maria Theresa; Vad, Torben Bundgaard

2013-01-01

. The paper will discuss how to plan and execute research-based knowledge in innovation in the public sector. The paper discusses and criticizes the often-met linear thinking in the application of new knowledge, especially in relation to innovation. It also suggests, by the help of a model based on ideas from...... organizational learning, another strategy for organizing the use of social science research for innovation in the public sector. As a consequence the paper advocates new evaluation strategies, where learning and dialogue is in focus....

Digitalization and Public Sector Transformations

DEFF Research Database (Denmark)

Schou, Jannick; Hjelholt, Morten

This book provides a study of governmental digitalization, an increasingly important area of policymaking within advanced capitalist states. It dives into a case study of digitalization efforts in Denmark, fusing a national policy study with local institutional analysis. Denmark is often framed....... Digitalization and Public Sector Transformations pushes for a renewed approach to governmental digitalization and will be of interest to scholars working in the intersections of critical political economy, state theory and policy studies....... as an international forerunner in terms of digitalizing its public sector and thus provides a particularly instructive setting for understanding this new political instrument. Advancing a cultural political economic approach, Schou and Hjelholt argue that digitalization is far from a quick technological fix. Instead...

Role of government in public health: Current scenario in India and future scope

Directory of Open Access Journals (Sweden)

Subitha Lakshminarayanan

2011-01-01

Full Text Available The new agenda for Public Health in India includes the epidemiological transition, demographical transition, environmental changes and social determinants of health. Based on the principles outlined at Alma-Ata in 1978, there is an urgent call for revitalizing primary health care in order to meet these challenges. The role of the government in influencing population health is not limited within the health sector but also by various sectors outside the health systems. This article is a literature review of the existing government machinery for public health needs in India, its success, limitations and future scope. Health system strengthening, human resource development and capacity building and regulation in public health are important areas within the health sector. Contribution to health of a population also derives from social determinants of health like living conditions, nutrition, safe drinking water, sanitation, education, early child development and social security measures. Population stabilization, gender mainstreaming and empowerment, reducing the impact of climate change and disasters on health, improving community participation and governance issues are other important areas for action. Making public health a shared value across the various sectors is a politically challenging strategy, but such collective action is crucial.

The Korean economic crisis and coping strategies in the health sector: pro-welfarism or neoliberalism?

Science.gov (United States)

Kim, Chang-Yup

2005-01-01

In South Korea, there have been debates on the welfare policies of the Kim Dae-jung government after the economic crisis beginning in late 1997, but it is unquestionable that health and health care policies have followed the trend of neoliberal economic and social polices. Public health measures and overall performance of the public sector have weakened, and the private health sector has further strengthened its dominance. These changes have adversely affected the population's health status and access to health care. However, the anti-neoliberal coalition is preventing the government's drive from achieving a full success.

Working in the health sector: implementation of workplace health promotion

Directory of Open Access Journals (Sweden)

Eliana Castro S

2011-11-01

Full Text Available Objective: to discuss issues that are relevant to the implementation of workplace health promotion (whp in organization processes of the health sector as a strategic tool to manage health and safety at the workplace. Methods: after a conceptual review of whp in 2009, a qualitative case study on the development of this strategy in third level hospitals of Bogotá was carried out. This descriptive and cross-sectional study was approved by the Ethics Committee of the Faculty of Nursing at the National University of Colombia. Results: although there are occupational health programs that convey the spirit of whp in their content, its level of development is not consistently linked to it. The following criteria were analyzed: strategy and commitment, human resources and organization, social responsibility, planning, and development and results, all of which were not well valued by workers. Final considerations: the traditional approach to occupational health and the poor integration of the WHP principles into organizational processes are reflected in the actions taken and the expectations regarding the subject. Therefore, actions should be taken in terms of public policies to strengthen the institutional capacity to ensure the feasibility of whp in the health sector.

Collective bargaining: An analysis of hurdles and applicability in the public sector

Directory of Open Access Journals (Sweden)

Daniel Chigudu

2015-04-01

Full Text Available This article discusses the arguments against adopting collective bargaining in the public sector and its benefits. Collective bargaining in the public sector is viewed primarily as undermining democratic governance in one way and paradoxically it is seen as an essential part of democratic governance. In the former view, collective bargaining in the public sector is seen as an interference with administrative law for personal benefit to the detriment of the taxpayer. Proponents of this view argue that unionising public sector employees encourages disloyalty to the government at the expense of public welfare. In the later view, public sector collective bargaining is viewed as a fundamental human right in a pluralistic society. Advocates of this view posit that, public sector unions provide a collective voice that stimulates improvement of government services as well as sound administration of law. They also argue that, public sector collective bargaining represents public policy interests and serves as a watchdog to government’s monopoly power in employment matters. Public sector unions raise employee salaries and perks to levels higher than they would have been in the absence of collective bargaining. These two opposite views are subjected to a critical analysis in this paper, with empirical evidence for both the benefits of public sector collective bargaining and arguments against public sector unions. The article found that public sector collective bargaining depends on the socio-economic background of states although international laws favour public sector unionism.

Museums and art galleries as partners for public health interventions.

Science.gov (United States)

Camic, Paul M; Chatterjee, Helen J

2013-01-01

The majority of public health programmes are based in schools, places of employment and in community settings. Likewise, nearly all health-care interventions occur in clinics and hospitals. An underdeveloped area for public health-related planning that carries international implications is the cultural heritage sector, and specifically museums and art galleries. This paper presents a rationale for the use of museums and art galleries as sites for public health interventions and health promotion programmes through discussing the social role of these organisations in the health and well-being of the communities they serve. Recent research from several countries is reviewed and integrated into a proposed framework for future collaboration between cultural heritage, health-care and university sectors to further advance research, policy development and evidence-based practice.

The public role in promoting child health information technology.

Science.gov (United States)

Conway, Patrick H; White, P Jonathan; Clancy, Carolyn

2009-01-01

The public sector plays an important role in promoting child health information technology. Public sector support is essential in 5 main aspects of child health information technology, namely, data standards, pediatric functions in health information systems, privacy policies, research and implementation funding, and incentives for technology adoption. Some innovations in health information technology for adult populations can be transferred to or adapted for children, but there also are unique needs in the pediatric population. Development of health information technology that addresses children's needs and effective adoption of that technology are critical for US children to receive care of the highest possible quality in the future.

Environmental Aspects of Social Responsibility of Public Sector Organizations

Directory of Open Access Journals (Sweden)

Liliana Hawrysz

2015-12-01

Full Text Available In addition to determining social responsibility policies that affect the market and social actors, certain governments also set objectives related to their internal activity. For example, one of the activities of the German government is to implement the concept of social responsibility into public institutions. In the Netherlands, one of the government tasks is to set an example for responsible practices (government as a role model. The aim of this paper is to examine firstly whether public sector entities set an example for responsible practices, especially with regard to respect for the environment, and secondly, whether public sector organizations in Poland significantly differ from organizations abroad in terms of their practices in the field of environmental protection. A questionnaire was a basis for data collection. The questionnaires were distributed to representatives of deliberately selected public sector organizations located primarily in Europe. The study was conducted in 2012–2013 on a group of 220 public sector organizations (102 Polish and 118 other European. The paper presents only the selected part of research. Public sector organizations in Poland do not have internal mechanisms of environmental responsibility. There is a significant discrepancy between the state of the environmental responsibility of organizations located in Poland and abroad. Obtained results show that public sector organizations, those in Poland in particular, are making their first steps in developing internal environmental responsibility.

Competence Development in the Public Sector

DEFF Research Database (Denmark)

Hjort, Katrin

2009-01-01

The article analyses the popular concept of Competence Development as constructed of at least three different discourses (Life Long Learning, New Public Management and professionalisation) and discusses the relations between the transformations of the public sectors in Scandinavian Welfare States......, Competence Development and Professionalisation/Deprofessionalisation among the public employees....

29 CFR 801.10 - Exclusion for public sector employers.

Science.gov (United States)

2010-07-01

... 29 Labor 3 2010-07-01 2010-07-01 false Exclusion for public sector employers. 801.10 Section 801... public sector employers. (a) Section 7(a) provides an exclusion from the Act's coverage for the United... public officials (i.e., appointed by an elected public official(s) and/or subject to removal procedures...

Gender and Leadership in the Public Sector

DEFF Research Database (Denmark)

Hansen, Morten Balle

Traditionally, men have occupied top managerial positions in the public as well as the private sector. In recent decades this tradition has gradually changed. Although slowly and with significant variation between countries and sectors, the share of female top managers has been increasing....... This article analyzes whether this demographic change may be related to the leadership priorities of public top managers. Is gender significantly related to the leadership priorities of public sector top managers? The article presents a short review of theories and empirical research in the relations between...... gender and leadership behavior. Based on this review, hypotheses are formulated and tested in an empirical analysis of survey data from the Danish local government context. The results indicate that the behavior of female top managers is significantly more task and change oriented and significantly less...

Public sector cost management practices in The Netherlands

NARCIS (Netherlands)

Verbeeten, Frank H.m.

2011-01-01

Purpose – The purpose of this research project is to validate the claim that recent developments in the public sector have increased the demand for and use of cost management information in public sector organizations. Design/methodology/approach – The approach taken is a survey of financial

Motivating Public Sector Employees: Evidence from Greece

Directory of Open Access Journals (Sweden)

Koronios, K.

2017-03-01

Full Text Available Purpose: The object of this research is to investigate work motivating factors in the public sector in Greece, as well as to study demographic attributes, placing emphasis on age and gender as determinants of employee motives. Design/methodology/approach: To answer our research questions, a questionnaire was distributed at the beginning of 2015 to a public - sector organization in central Greece. A total of 318 anonymous survey responses were collected and analysed with SPSS. Findings: In the public organization under survey, the leading employee motives are an increase in salaries, opportunities for hierarchical advancement in the organization, as well as the development of personal skills. Moreover, motivational differences are noted among Baby Boomers, Generation X and Generation Y. Research limitations/implications: As the present study has been conducted on a single public organization, awareness should be raised as far as the generalizability of the results providing useful insights for further exploration. Originality/value: Limited research has been conducted in the Greek public sector comparing motives among generations.

Return on Investment in the Public Sector

National Research Council Canada - National Science Library

Bigham, Joshua

2004-01-01

.... This demand has created a trend in the public sector, not only in the United States, but worldwide as well, towards the importation of private sector business practices to improve accountability-oriented analysis...

Examination of the Work Organization Assessment Questionnaire in public sector workers.

Science.gov (United States)

Wynne-Jones, Gwenllian; Varnava, Alice; Buck, Rhiannon; Karanika-Murray, Maria; Griffiths, Amanda; Phillips, Ceri; Cox, Tom; Kahn, Sayeed; Main, Chris J

2009-05-01

To investigate the utility of the Work and Organization Assessment Questionnaire (WOAQ) for public sector data. A cross-sectional survey was performed in public sector organizations measuring demographics, work characteristics, work perceptions (WOAQ), sickness absence, and work performance. Confirmatory factor analysis of the WOAQ showed that factor structure derived for the manufacturing sector, for which the questionnaire was developed, could be replicated moderately well with public sector data. The study then considered whether a better more specific fit for public sector data was possible. Principal components analysis of the public sector data identified a two-factor structure linked to four of the five scales of the WOAQ assessing Management and Work Design, and Work Culture. These two factors may offer a context-sensitive scoring method for the WOAQ in public sector populations. These two factors were found to have good internal consistency, and correlated with the full WOAQ scales and the measures of performance and absence. The WOAQ is a useful and potentially transferable tool. The modified scoring may be used to assess work and organizational factors in the public sector.

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

Science.gov (United States)

Agha, Sohail; Do, Mai

2009-04-01

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

Self-initiated expatriates in the private vs. the public sector

DEFF Research Database (Denmark)

Lauring, Jakob; Selmer, Jan

2013-01-01

Although research on private-sector expatriates is abundant, not much is known about their public-sector counterparts, especially self-initiated expatriates, who themselves initiate the move to live and work abroad. Comparing work outcomes and creativity of self-initiated expatriates in the private...... vs. the public sector, the results of a survey including 329 respondents indicated that performance and effectiveness were higher in the private sector. However, only in the public sector was there a positive association between creativity and the two work outcomes. These findings are discussed...

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

Science.gov (United States)

2010-10-01

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

Leadership in the public sector : Promises and pitfalls

NARCIS (Netherlands)

Teelken, Christine; Ferlie, Ewan; Dent, Mike

2013-01-01

In view of the approaching age of austerity for the public sector, leadership is likely to continue to become a key theme. This edited volume brings together a host of material from the public sector to analyzethe issue internationally. Teelken, Dent & Ferlie lead a team of contributors in examining

Public Sector Reforms: New Public Management without Marketization?

DEFF Research Database (Denmark)

Löfgren, Karl; Pedersen, John Storm

2012-01-01

Is it possible to imagine New Public Management without marketization? In Denmark the present liberal-conservative Government has, throughout its 10 years in power, designed and implemented more than 15 major management reforms in the public sector. Although most of the reforms are rhetorically...... firmly rooted in neo-liberal ideologies they have, in practice, promoted tools and mechanisms of the “traditional,” or Old, Public Management. Based on an empirical study of the reforms, we suggest that the notion of “pragmatic” New Public Management is introduced to enhance the current understanding...... of New Public Management in the Western industrialized societies....

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

Science.gov (United States)

Laird, Jennifer

2017-02-01

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

The role of public sector libraries on enhancing public officers ...

African Journals Online (AJOL)

GOJEH

enhance public officers' quality service delivery in Ethiopia. Most public ... Ethiopia. The study concluded the Libraries in the Ethiopian public sector are inadequately ... portion of a nation's affairs, especially economic ... and in some cases considered an irrelevant arm of the ..... approving the sponsorship of this research ...

Comparing public and private sector employees' innovative behaviour

DEFF Research Database (Denmark)

Bysted, Rune; Hansen, Jesper Rosenberg

2015-01-01

Innovation is argued to be of key importance in the public sector. Little is known about possible sector differences in innovative behaviour. The stereotype in literature is that public employees are less innovative. We analyse whether sector is associated with innovative behaviour...... and the influence of job/organizational characteristics. We test this by using a three-country representative survey in Scandinavia with 8,310 respondents. We control for subsectors/industries and job functions. We do not find that public employees are less innovative. Furthermore, the study emphasizes...... the importance of understanding the major differences in innovative behaviour between different subsectors/industries and job types....

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

Science.gov (United States)

Ashmore, John; Gilson, Lucy

2015-01-19

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

Practice Variation in Public Sector Internal Auditing

DEFF Research Database (Denmark)

Arena, Marika; Jeppesen, Kim Klarskov

2016-01-01

This article aims to analyze the rise of practice variations in public sector internal auditing (IA), giving special attention to the role of agents’ embeddedness in multiple institutional arrangements. IA's trends of development and the characteristics of the public sector context, in fact, make...... types of IA developed in three case settings, shaped by the agents’ embeddedness in different institutional fields. This article provides a more comprehensive approach to the study of IA adoption and development in public sector organizations than previous literature, and it highlights the relevance...... of the interplay between actors’ contemporary embeddedness in professional systems and the focal social system as a relevant source of practice variation. In this respect, the case of IA can contribute to previous studies of practice variation in the field of management accounting, shedding some light on the types...

Harmonisation efforts in the field of accounting of public sector

Directory of Open Access Journals (Sweden)

Milena Otavová

2011-01-01

Full Text Available Increasing requirements for financial reporting of public sector led to a need to create a system that would provide relevant and reliable information for management of accounting entities of public sector and also to increase the quality of accounting and financial statements of public institutions. The International Public Sector Accounting Standards Board (IPSASB is therefore creating high-quality financial reporting standards for public sector (IPSAS. Paper points out the ongoing reform of accounting in the field of public finances in the Czech Republic, where there are substantial changes in accounting rules and it also introduces new accounting methods. Regarding the fact that accounting of public sector is nowadays accounting system perhaps with the greatest potential of development, paper highlights the differences in financial reporting in accordance with Czech legislation and IPSAS system. It tries to catch the essential differences that arise from the financial legislation, the accounting basis and also from the content of financial statements. The paper also indicates the difference between Czech Accounting Standards for selected accounting entities that maintain accounts in accordance with Decree No. 410/2009 Coll. and International Public Sector Accounting Standards (IPSAS. There is also recommended approach to the creation of national standards with regard to international harmonization.

Public health communications for safe motherhood.

Science.gov (United States)

Kessel, E

1994-03-30

Public health communication aims to influence health practices of large populations, including maternal health care providers (traditional birth attendants, (TBAs), nurse-midwives, other indigenous practitioners, and physicians). A quality assurance process is needed to give public sector health providers feedback. Computerized record keeping is needing for quality assurance of maternal health programs. The Indian Rural Medical Association has trained more than 20,000 rural indigenous practitioners in West Bengal. Training of TBAs is expensive and rarely successful. However, trained health professional leading group discussions of TBAs is successful at teaching them about correct maternity care. Health education messages integrated into popular songs and drama is a way to reach large illiterate audiences. Even though a few donor agencies and governments provide time and technical assistance to take advantage of the mass media as a means to communicate health messages, the private sector has most of the potential. Commercial advertisements pay for Video on Wheels, which, with 100 medium-sized trucks each fitted with a 100-inch screen, plays movies for rural citizens of India. They are exposed to public and family planning messages. Jain Satellite Television (JST) broadcasts 24 hours a day and plans to broadcast programs on development, health and family planning, women's issues, and continuing education for all health care providers (physicians, nurses, TBAs, community workers, and indigenous practitioners). JST and the International Federation for Family Health plan to telecast courses as part of an Open University of Health Sciences.

LEADERSHIP STYLES: A STUDY OF AUSTRALIAN AND THAI PUBLIC SECTORS

Directory of Open Access Journals (Sweden)

Nattavud Pimpa

2012-01-01

Full Text Available Leadership is deeply attached to culture. This study compares leadership styles in Thai and Australian public sectors. The data were collected from staff in public sector settings in Australia and Thailand. The results confirm four leadership styles that suit the public sector culture in both countries: communication-oriented, strategic thinking and planning, relationship building, and conflict management. In the Thai public sector system, leadership that focuses on goal orientation is ranked most highly: Australian public sector organisations focus on leadership that fosters equity among organisational members, creates a supportive environment in the workplace, and facilitates participation. It is evident from this study that significant distinctions between the organisational cultures of Thailand and Australia are matched by marked dissimilarities of preferred leadership styles. Thus, an understanding of local organisational culture is important for effective leadership at all levels.

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

Science.gov (United States)

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

2015-12-01

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

Ethics in public health research: masters of marketing: bringing private sector skills to public health partnerships.

Science.gov (United States)

Curtis, Valerie A; Garbrah-Aidoo, Nana; Scott, Beth

2007-04-01

Skill in marketing is a scarce resource in public health, especially in developing countries. The Global Public-Private Partnership for Handwashing with Soap set out to tap the consumer marketing skills of industry for national handwashing programs. Lessons learned from commercial marketers included how to (1) understand consumer motivation, (2) employ 1 single unifying idea, (3) plan for effective reach, and (4) ensure effectiveness before national launch. After the first marketing program, 71% of Ghanaian mothers knew the television ad and the reported rates of handwashing with soap increased. Conditions for the expansion of such partnerships include a wider appreciation of what consumer marketing is, what it can do for public health, and the potential benefits to industry. Although there are practical and philosophical difficulties, there are many opportunities for such partnerships.

Assessing public and private sector contributions in reproductive health financing and utilization for six sub-Saharan African countries.

Science.gov (United States)

Nguyen, Ha; Snider, Jeremy; Ravishankar, Nirmala; Magvanjav, Oyunbileg

2011-05-01

The present study provides evidence to support enhanced attention to reproductive health and comprehensive measures to increase access to quality reproductive health services. We compare and contrast the financing and utilization of reproductive health services in six sub-Saharan African countries using data from National Health Accounts and Demographic and Health Surveys. Spending on reproductive health in 2006 ranged from US$4 per woman of reproductive age in Ethiopia to US$17 in Uganda. These are below the necessary level for assuring adequate services given that an internationally recommended spending level for family planning alone was US$16 for 2006. Moreover, reproductive health spending shows signs of decline in tandem with insufficient improvement in service utilization. Public providers played a predominant role in antenatal and delivery care for institutional births, but home deliveries with unqualified attendants dominated. The private sector was a major supplier of condoms, oral pills and IUDs. Private clinics, pharmacies and drug vendors were important sources of STI treatment. The findings highlight the need to commit greatly increased funding for reproductive health services as well as more policy attention to the contribution of public, private and informal providers and the role of collaboration among them to expand access to services for under-served populations. Copyright © 2011 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

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

Science.gov (United States)

Shaikh, Babar Tasneem

2015-01-01

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

Gambling and the Health of the Public: Adopting a Public Health Perspective.

Science.gov (United States)

Korn, David A.; Shaffer, Howard J.

1999-01-01

During the last decade there has been an unprecedented expansion of legalized gambling throughout North America. Three primary forces appear to be motivating this growth: (1) the desire of governments to identify new sources of revenue without invoking new or higher taxes; (2) tourism entrepreneurs developing new destinations for entertainment and leisure; and (3) the rise of new technologies and forms of gambling (e.g., video lottery terminals, powerball mega-lotteries, and computer offshore gambling). Associated with this phenomenon, there has been an increase in the prevalence of problem and pathological gambling among the general adult population, as well as a sustained high level of gambling-related problems among youth. To date there has been little dialogue within the public health sector in particular, or among health care practitioners in general, about the potential health impact of gambling or gambling-related problems. This article encourages the adoption of a public health perspective towards gambling. More specifically, this discussion has four primary objectives:1. Create awareness among health professionals about gambling, its rapid expansion and its relationship with the health care system;2. Place gambling within a public health framework by examining it from several perspectives, including population health, human ecology and addictive behaviors;3. Outline the major public health issues about how gambling can affect individuals, families and communities;4. Propose an agenda for strengthening policy, prevention and treatment practices through greater public health involvement, using the framework of The Ottawa Charter for Health Promotion as a guide.By understanding gambling and its potential impacts on the public's health, policy makers and health practitioners can minimize gambling's negative impacts and appreciate its potential benefits.

Use of hormone replacement therapy in the Hong Kong public health sector after the Women's Health Initiative trial.

Science.gov (United States)

Leung, K Y; Ling, Matina; Tang, G W K

2005-01-01

To determine the impact of Women Health Initiative (WHI) trial on the use of hormone replacement therapy (HRT) in the Hong Kong public health sector. The central prescription database of the Hospital Authority was used to describe the half-yearly trend in the use of HRT between July 2000 and December 2003. The data of hysterectomy was retrieved from another clinical database. Before the publication of the WHI trial in July 2002, conjugated equine estrogens (CEE) and its related products dominated HRT prescribing. Relative to the first half of 2002, there was an immediate and substantial decline by 43.5% in the prescriptions of combined CEE/progestogen products and a modest decline by 22.4% in the prescriptions of CEE-alone therapy in the second half of 2002. In the first half of 2003, a decline in the prescriptions of all HRT preparations except raloxifene was observed. However, in the second half of 2003, there were no more declines in overall HRT users. Relative to the first half of 2002, the decline in the overall HRT users in the first half of 2003 was more than 46% in women aged 50-69. The decline was greater in women with a history of hysterectomy (60.3%) than women without (38.6%), but was similar between gynaecology specialty (41.7%) and non-gynaecology specialty (43.9%). Similar to the U.S., an immediate and substantial decline in the use of CEE and its related products was observed in Hong Kong after the publication of the WHI trial.

Globalization, tax distortions and public sector retrenchment

DEFF Research Database (Denmark)

Andersen, Torben M.; Sørensen, Allan

is strengthened by globalization, it is inferred that the marginal costs of public funds increase and a retrenchment of the public sector follows. We challenge whether these conclusions have support in a general equilibrium model featuring standard effects from open macroeconomics and trade theory. Even though...... income taxation unambiguously worsens wage competitiveness, it does not follow that marginal costs of public funds increase with product market integration due to gains from trade. Moreover, non-cooperative fiscal policies do not have a race-to-the-bottom bias despite that taxes harm competitiveness......It is widely perceived that globalization is a threat to tax financed public sector activities. The argument is that public activities (public consumption and transfers) financed by income taxes distort labour markets and cause higher wages and thus a loss of competitiveness. Since this link...

SIMILARITY OR DISSIMILARITY BETWEEN PUBLIC AND PRIVATE SECTOR

Directory of Open Access Journals (Sweden)

ANDREEA CÎRSTEA

2015-08-01

Full Text Available Consolidated financial statements represent one of the main benefits that the public sector reforms brought. The novelty of the subject sparked out interest for a detailed research, research that can bring an added value to the development of this issue in the public sector. The paper aims to analyze the degree of similarity and dissimilarity between the initial regulations regarding the issue of consolidated reporting in the public and private sector. In order to obtain information about the similarity or dissimilarity between IPSAS and IAS regarding to consolidation we used correlation and/or association coefficients. We conclude that there is a high similarity between the two sets of standards, thing that is not surprising, because it is known that IPSAS are based on IAS. Even if IPSAS are based on IAS, there still are differences which arouse from the specificity of each sector.

Trust and Control in Public Sector Reform

DEFF Research Database (Denmark)

Vallentin, Steen; Thygesen, Niels Thyge

2017-01-01

to a substitution view when it comes to accounting for public sector reform as structure and process. Also, we propose a widening of the theoretical lens in the form of an emergent view of how trust and control, instead of being beforehand determinable and more or less stable identities, emerge in multiple......This paper provides an analysis of trust-based management reform in the Danish public sector from the point of view of the trust–control nexus. Based on a qualitative case study of home care in the municipality of Copenhagen we argue that a complementary view of trust and control is superior...... and singular ways from multiple events in the organisation. Noticing a dearth of research that explicitly addresses trust issues with regard to public sector management and organisation, the paper is a response to the call for more studies of trust as an institutionally embedded phenomenon....

Relational differences in interpersonal communication during third sector and public sector work

DEFF Research Database (Denmark)

Frederiksen, Dennis Jim

-going establishment and negotiation of interpersonal relations always takes place (Madsen, 1996). Using pragmatic speech act theory (Alrø & Kristiansen, 2006; Searle, 1969; Vagle, Sandvik, & Svennevig, 1993), the aim is to gain insight into the relation building in the two types of work and to show how micro level...... they are not interested in (Scheibel, 2014). The debate seems to boil down to a concern, that people doing volunteer work in the third sector, would loose their motivation to volunteer, if their work was like working in the public sector. As a contribution to this debate, this paper will examine the role interpersonal...... organisational communication can play in understanding how working in the third sector can differ from working in the public sector. This is based on Ryan & Deci who argue that the way people relate to other people and consequently communicate with them, plays a key role in their motivation for conducting...

Crowdsourcing applications for public health.

Science.gov (United States)

Brabham, Daren C; Ribisl, Kurt M; Kirchner, Thomas R; Bernhardt, Jay M

2014-02-01

Crowdsourcing is an online, distributed, problem-solving, and production model that uses the collective intelligence of networked communities for specific purposes. Although its use has benefited many sectors of society, it has yet to be fully realized as a method for improving public health. This paper defines the core components of crowdsourcing and proposes a framework for understanding the potential utility of crowdsourcing in the domain of public health. Four discrete crowdsourcing approaches are described (knowledge discovery and management; distributed human intelligence tasking; broadcast search; and peer-vetted creative production types) and a number of potential applications for crowdsourcing for public health science and practice are enumerated. © 2013 American Journal of Preventive Medicine Published by American Journal of Preventive Medicine All rights reserved.

Public and private sector wages in the Netherlands

NARCIS (Netherlands)

Hartog, J.; Oosterbeek, H.

1993-01-01

There is much debate in the Netherlands about underpayment of public-sector workers relative to private-sector workers. In this paper, the authors analyze the wage structures in both sectors using an endogenous switching regression model. Unlike previous Dutch studies, the authors find that the

The Distribution of Gender and Public Sector Pay Premia: Evidence from the Egyptian Organised Sector

OpenAIRE

Mona Said

2003-01-01

Using earnings functions estimates on a survey of Egyptian establishments conducted in 1990, standard decomposition techniques of wage differentials show that both males and females have an earnings disadvantage in the public enterprise and government sectors after correcting for a range of personal and job characteristics. Gender based pay discrimination is small in the public sector. In contrast, it is quite high by international comparisons in the private sector and mainly takes place by p...

Public Service Motivation and Employment Sector: Attraction or Socialization?

DEFF Research Database (Denmark)

Kjeldsen, Anne Mette; Jacobsen, Christian Bøtcher

2013-01-01

Numerous studies have shown that public service motivation (PSM) is positively associated with public sector employment. However, the question of whether PSM influences or is influenced by employment decisions remains open, since previous studies have mostly relied on cross-sectional samples...... with experienced employees. This article investigates the relationship between PSM and employment sector in pre-entry and post-entry settings using data from a panel of Danish physiotherapy students surveyed before and after their first job in the public or private sector. The analyses show that PSM is neither...

Innovation environments and innovation capacity in the public sector

DEFF Research Database (Denmark)

Lewis, Jenny; Ricard, Lykke Margot; Klijn, Erik-Hans

Social innovation in the public sector has become an important focus for governments around the world over the last decade, as they try to solve intractable policy problems. The pressure on governments to do more with less in response to shrinking budgets and expanding community expectations...... and obligations has increased attention on how the public sector manages change and innovation. This heightened focus has created a need to understand the social innovation capacity of public sector environments. Work package 1of the LIPSE project on social innovation, examined this for four municipalities...

Assessing Private Sector Involvement in Health Care and Universal Health Coverage in Light of the Right to Health.

Science.gov (United States)

Hallo De Wolf, Antenor; Toebes, Brigit

2016-12-01

The goal of universal health coverage is to "ensure that all people obtain the health services they need without suffering financial hardship when paying for them." There are many connections between this goal and the state's legal obligation to realize the human right to health. In the context of this goal, it is important to assess private actors' involvement in the health sector. For example, private actors may not always have the incentives to deal with externalities that affect the availability, accessibility, acceptability, and quality of health care services; they may not be in a position to provide "public goods"; or they may operate under imperfect information. This paper sets out to answer the question, what legal human rights obligations do states have in terms of regulating private sector involvement in health care?

[Central purchasing bodies and spending review in health sector].

Science.gov (United States)

Spampinato, Luigi

2017-01-01

The aim of this paper is to analyze the new model of centralization of purchases in Italy after the approval of the 2016 Stability Law, with particular reference to the health sector. In fact, the spending review process in Italy in the health sector has had a strong evolution with the 2016 Stability Law, which has introduced the obligation for the institutions of the National Health Service to obtain supplies, exclusively, from aggregators subjects, for certain product categories of the health sector. The legislature, over the years, was mainly characterized by measures to reduce the spending limits for purchases of goods and services or by resetting the fees, including the provision of an obligation for the renegotiation of health goods and services contracts, in order to ensure the effective implementation of the expenditure rationalization by aggregation of goods and services. From 2016, the legislature has provided an innovative model of centralization of purchases based on a new network governance model on several levels, national and regional, which should ensure an efficiency of procurement processes. The proper functioning of the governance model adopted can be an important driver of economic policy in order to understand that it is important not only to spend less, but to spend better. This can be realized in the public administration with a strong innovation process in this administration and also with a strong investment in skills, in order to ensure the same service quality throughout the national territory to the health sector.

Can a fifty percent increase in public sector wages improve the position of public sector employees in the long run? An assessment of the public-private income gap in Hungary

OpenAIRE

Szilvia Hamori; Anna Lovasz

2011-01-01

We provide a detailed descriptive analysis of the long-term effects of the 50 percent public sector wage increase initiated by the government in 2002 in order to improve the relative situation of public sector workers. The aim of this policy was to attract high quality workers to the public sector, and to counteract the problem of "brain drain," the loss of high-skilled workers to abroad. To study the effects on the public-private income gap - and on high-skilled workers in particular - we em...

Beyond bridging the know-do gap: a qualitative study of systemic interaction to foster knowledge exchange in the public health sector in The Netherlands.

Science.gov (United States)

van den Driessen Mareeuw, Francine; Vaandrager, Lenneke; Klerkx, Laurens; Naaldenberg, Jenneken; Koelen, Maria

2015-09-19

Despite considerable attention currently being given to facilitating the use of research results in public health practice, several concerns remain, resulting in the so-called know-do gap. This article aims to identify the key tensions causing the know-do gap from a broad perspective by using a systemic approach and considering the public health sector as an innovation system. An exploratory qualitative design including in-depth semi-structured interviews was used, with 33 interviewees from different actor categories in the Dutch public health innovation system. The analyses employed an innovation system matrix to highlight the principal tensions causing the know-do gap. Seven key tensions were identified, including: research priorities determined by powerful players; no consensus about criteria for knowledge quality; different perceptions about the knowledge broker role; competition engendering fragmentation; thematic funding engendering fragmentation; predominance of passive knowledge sharing; and lack of capacity among users to use and influence research. The identified tensions indicate that bridging the know-do gap requires much more than linking research to practice or translating knowledge. An innovation system perspective is crucial in providing information on the total picture of knowledge exchange within the Dutch public health sector. Such a system includes broader stakeholder involvement as well as the creation of social, economic, and contextual conditions (achieving shared visions, building networks, institutional change, removing financial and infrastructural barriers), as these create conducive factors at several system levels and induce knowledge co-creation and innovation.

Surveying Public Attitudes of Security Sector Reforms in the Arab ...

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

The notion that the security sector's primary responsibility is to protect and preserve autocratic Arab regimes is widely discredited today. ... of public opinion in security sector reform by providing evidence-based information on public perceptions, and in so doing, encouraging civilian oversight and transparency in the sector.

The Use of Evidence in Public Debates in the Media: The Case of Swiss Direct-Democratic Campaigns in the Health Policy Sector

Science.gov (United States)

Stucki, Iris

2016-01-01

This article analyses the reporting of evidence in Swiss direct-democratic campaigns in the health policy sector, assuming that an informed public helps democracy function successfully. A content analysis of the media's news reporting shows that of 5030 media items retrieved, a reference to evidence is found in 6.8%. The voter receives evidence in…

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

Directory of Open Access Journals (Sweden)

Christa L. Fischer Walker

2015-02-01

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

The Public-Private Sector Pay Gap in Ireland: What Lies Beneath?

OpenAIRE

Kelly, Elish; McGuinness, Seamus; O'Connell, Philip J.

2009-01-01

This paper provides a sub-sectoral analysis of changes in the public-private sector pay gap in Ireland between 2003 and 2006. We find that between March 2003 and October 2006 the public sector pay premium increased from 14 to 26 per cent and that there was substantial variation between subsectors of the public service. Within the public service the premium in 2006 was highest in Education and Security Services and lowest in the Civil Service and Local Authorities. In the private sector the pa...

Contemporary specificities of labour in the health care sector: introductory notes for discussion.

Science.gov (United States)

Campos, Francisco Eduardo; Albuquerque, Eduardo da Motta e

2005-08-18

This paper combines the literature on public health, on economics of health and on economics of technological innovation to discuss the peculiarities of labour in the health care sector. METHOD AND FRAMEWORK: The starting point is the investigation of the economic peculiarities of medical care. This investigation leads to the identification of the prevalence of non-market forms of medical care in the countries of the Organisation for Economic Co-operation and Development (OECD). Furthermore, the health care system has a distinctive characteristic from other economic sectors: it is the intersection between social welfare and innovation systems. The relationship between technological innovation and cost in the health care sector is surveyed. Finally, the Brazilian case is discussed as an example of a developing country. The peculiarities of labour in the health care sector suggest the need to recognize the worth of sectoral labour and to cease to treat it separately. This process should take into account the rapid development of the health innovation system and one important consequence: the obsolescence of the acquired knowledge. One way to dignify labour is to implement continued education and training of health professions personnel.

Contemporary specificities of labour in the health care sector: introductory notes for discussion

Directory of Open Access Journals (Sweden)

Albuquerque Eduardo

2005-08-01

Full Text Available Abstract Background This paper combines the literature on public health, on economics of health and on economics of technological innovation to discuss the peculiarities of labour in the health care sector. Method and framework The starting point is the investigation of the economic peculiarities of medical care. Results and discussions This investigation leads to the identification of the prevalence of non-market forms of medical care in the countries of the Organisation for Economic Co-operation and Development (OECD. Furthermore, the health care system has a distinctive characteristic from other economic sectors: it is the intersection between social welfare and innovation systems. The relationship between technological innovation and cost in the health care sector is surveyed. Finally, the Brazilian case is discussed as an example of a developing country. Conclusion The peculiarities of labour in the health care sector suggest the need to recognize the worth of sectoral labour and to cease to treat it separately. This process should take into account the rapid development of the health innovation system and one important consequence: the obsolescence of the acquired knowledge. One way to dignify labour is to implement continued education and training of health professions personnel.

Contemporary specificities of labour in the health care sector: introductory notes for discussion

Science.gov (United States)

Campos, Francisco Eduardo; Albuquerque, Eduardo da Motta e

2005-01-01

Background This paper combines the literature on public health, on economics of health and on economics of technological innovation to discuss the peculiarities of labour in the health care sector. Method and framework The starting point is the investigation of the economic peculiarities of medical care. Results and discussions This investigation leads to the identification of the prevalence of non-market forms of medical care in the countries of the Organisation for Economic Co-operation and Development (OECD). Furthermore, the health care system has a distinctive characteristic from other economic sectors: it is the intersection between social welfare and innovation systems. The relationship between technological innovation and cost in the health care sector is surveyed. Finally, the Brazilian case is discussed as an example of a developing country. Conclusion The peculiarities of labour in the health care sector suggest the need to recognize the worth of sectoral labour and to cease to treat it separately. This process should take into account the rapid development of the health innovation system and one important consequence: the obsolescence of the acquired knowledge. One way to dignify labour is to implement continued education and training of health professions personnel. PMID:16109174

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

Science.gov (United States)

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

2002-03-01

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

Government stewardship of the for-profit private health sector in Afghanistan.

Science.gov (United States)

Cross, Harry E; Sayedi, Omarzaman; Irani, Laili; Archer, Lauren C; Sears, Kathleen; Sharma, Suneeta

2017-04-01

Since 2003, Afghanistan's largely unregulated for-profit private health sector has grown at a rapid pace. In 2008, the Ministry of Public Health (MoPH) launched a long-term stewardship initiative to oversee and regulate private providers and align the sector with national health goals. We examine the progress the MoPH has made towards more effective stewardship, consider the challenges and assess the early impacts on for-profit performance. We reviewed publicly available documents, publications and the grey literature to analyse the development, adoption and implementation of strategies, policies and regulations. We carried out a series of key informant/participant interviews, organizational capacity assessments and analyses of hospital standards checklists. Using a literature review of health systems strengthening, we proposed an Afghan-specific definition of six key stewardship functions to assess progress towards MoPH stewardship objectives. The MoPH and its partners have achieved positive results in strengthening its private sector stewardship functions especially in generating actionable intelligence and establishing strategic policy directions, administrative structures and a legal and regulatory framework. Progress has also been made on improving accountability and transparency, building partnerships and applying minimum required standards to private hospitals. Procedural and operational issues still need resolution and the MoPH is establishing mechanisms for resolving them. The MoPH stewardship initiative is notable for its achievements to date under challenging circumstances. Its success is due to the focus on developing a solid policy framework and building institutions and systems aimed at ensuring higher quality private services, and a rational long-term and sustainable role for the private sector. Although the MoPH stewardship initiative is still at an early stage, the evidence suggests that enhanced stewardship functions in the MoPH are leading to a

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

Science.gov (United States)

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

2017-06-01

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

AGENCY PROBLEMS IN PUBLIC SECTOR

Directory of Open Access Journals (Sweden)

Gyorgy Attila

2012-07-01

Full Text Available Agency theory analyses the effects of contractual behaviour between two parties: principal(s and agent(s. This relation is inevitably characterized by information asymmetry because agent holds a substantially larger volume of information than the principal. Due the negative effects of information asymmetry for the principal, this should cover supplementary costs with monitoring agents and/or grant incentives. The first objective of this paper is to emphasize the effects of information asymmetry, particularly on adverse selection and moral hazard. The second objective is to evaluate the negative effects of information asymmetry and to assess the viability of solutions proposed by scholars for mitigation. The third objective is linked with personal contribution, respectively to highlight specificity of agency theory in public sector and the mechanisms of action in this particular field. In this paper, literature is mainly based on scholars’ contribution to the proposed theme. Little literature approaches agency theory in public sector, in most cases the analysis being restricted to general issues. Research methodology is based on synthesizing relevant information from literature and adapting them to public sector particularities. The results reflect some threats for public bodies in their contracting activity. Conclusions present also a set of solutions which could be used by public institutions to optimize their activity of mitigating information asymmetry’s effects. These solution guidelines could represent a useful instrument for make more efficient public money spending. Personal contribution and the novelty of this paper consist in presenting a new approach regarding mechanisms of managing information by agents. In case of public institutions, principals have more opportunities the take possession over the information managed by the agent. Nevertheless, agents can limit the principal’s access

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

Science.gov (United States)

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

2014-06-24

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

Organizational factors influencing successful primary care and public health collaboration.

Science.gov (United States)

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

2018-06-07

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

PUBLIC SECTOR CONCEPTUALIZATION OF ECONOMY IN SYSTEM OF ECONOMIC AND THEORETICAL KNOWLEDGE

Directory of Open Access Journals (Sweden)

Y. Hirnyk

2017-06-01

Full Text Available The article examines trends shaping the problem of "public sector". The research shows the history of the formation of the concept of "social economy", its relationship with the basic principles of theoretical economic analysis and development. The paper investigates process of establishing the structure of the phenomenon of the public sector and its interaction with the challenges of the modern world and the global economy. The article deals with the role of the public sector in the production of public goods. The researchers evaluated the effect of its scale in indicators of social, economic and i institutional development. The study singled out performance criteria for public sector institutions and analyzed changes of vectors public choice in terms of globalization changes. It was revealed the impact of global institutional transformation and structural reforms in the public sector, in-depth conceptual basis of improving the efficiency of public sector functions.

Strategic Human Resource Management and the Australian Public Sector

Directory of Open Access Journals (Sweden)

Karen MANNING

2010-06-01

Full Text Available The connection between human resources and performance in firms in the private sector is well documented. What is less clear is whether the move towards managerialism that has taken place within the Australian public sector during the last twenty years has brought with it some of the features of the relationships between Human Resource Management (HRM and performance experienced within the private sector. The research begins with a review of the literature. In particular the conceptual thinking surrounding the connection between HRM and performance within private sector organizations is explored. Issues of concern are the direction of the relationship between HRM and performance and definitional questions as to the nature and level of HRM to be investigated and the measurement of performance. These conceptual issues are also debated within the context of a public sector and particularly the Australian environment. An outcome of this task is the specification of a set of appropriate parameters for a study of these linkages within Australian public sector organizations.

The size of the public sector: Case of Albania

Directory of Open Access Journals (Sweden)

Dosti Bernard

2014-01-01

Full Text Available The government is one of the key players in the economic area of each country. Its impact is evident in all areas, such as political, economic and socio-cultural ones. This impact is measured by an indicator which economists call 'the size of the public sector'. As government's influence is so significant a question naturally arises: Should the impact of the government be big or small? There are many arguments in favor and against this issue and it is difficult to come to a consensus on the extent of government's intervention in the economy. That is why the purpose of this paper is to present a picture of this intervention in the economic life of our country by connecting this indicator with the budget deficit. First, we will elaborate the progress of the size of the public sector in Albania and its measurement by various indicators. Secondly, we will compare the size of the public sector in Albanian with the sizes of the public sector of other countries in the region. Finally, we will present the results of a study on the optimal size of the public sector in the economy of a country being analyzed and in terms of our country.

Implementation of Public-Private Partnership in Turkish Agricultural Sector

Directory of Open Access Journals (Sweden)

Suleyman TULUCEOGLU

2017-05-01

Full Text Available In this study, it is aimed to determine the situation of the public-private partnership model in agriculture sector, which has been started to apply in Turkey since 1980’s and in which an extensive increase has been observed in the number of projects in some fields such as airport, hospital, electric, etc. in recent years. In this scope, the legislation and the practices related to public-private partnership in Turkish agricultural sector have been examined after referring the literature, development process, features, advantages/disadvantages and various models of public-private partnership model, and the situation in the World and Europe respectively. The findings collected indicate that the public-private partnership model has been applied especially in major-substructure projects such as construction of electric, airport, road and healthcare facilities in Turkey since 1990, and that the budget allocated into the projects of agricultural sector has been quite low in comparison with other fields, although the number of projects executed in agriculture sector has been quite much. However, it is predicted that the practices of public-private partnership in agriculture sector in Turkey will increase much more in line with the legislative arrangements implemented and increasing experience in the projects.

Public-private partnerships and responsibility under international law: a global health perspective

NARCIS (Netherlands)

Clarke, L.

2014-01-01

Partnerships between the public and private sectors are an increasingly accepted method to deal with pressing global issues, such as those relating to health. Partnerships, comprised of states and international organizations (public sector) and companies, non-governmental organizations, research

Elements of a Knowledge Management Guide for Public Sector Organizations

Science.gov (United States)

Harris, Mark Cameron

2013-01-01

This study explored the factors that are critical to the success of public (government) sector knowledge management initiatives and the lessons from private sector knowledge management and organizational learning that apply in the public sector. The goal was to create a concise guide, based on research-validated success factors, to aid government…

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

Science.gov (United States)

Kumar, Sanjeev; Roy, Rajashree; Dutta, Sucharita

2015-12-01

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

Assessing Private Sector Involvement in Health Care and Universal Health Coverage in Light of the Right to Health

Science.gov (United States)

2016-01-01

Abstract The goal of universal health coverage is to “ensure that all people obtain the health services they need without suffering financial hardship when paying for them.” There are many connections between this goal and the state’s legal obligation to realize the human right to health. In the context of this goal, it is important to assess private actors’ involvement in the health sector. For example, private actors may not always have the incentives to deal with externalities that affect the availability, accessibility, acceptability, and quality of health care services; they may not be in a position to provide “public goods”; or they may operate under imperfect information. This paper sets out to answer the question, what legal human rights obligations do states have in terms of regulating private sector involvement in health care? PMID:28559678

Public Sector Employees: Risk Averse and Altruistic?

NARCIS (Netherlands)

M.W.J.M. Buurman (Margaretha); A.J. Dur (Robert); S. Bossche, van den (Seth)

2009-01-01

textabstractWe assess whether public sector employees have a stronger inclination to serve others and are more risk averse than employees in the private sector. A unique feature of our study is that we use revealed rather than stated preferences data. Respondents of a large-scale survey were offered

Public sector employees: risk averse and altruistic?

NARCIS (Netherlands)

Buurman, M.; Delfgaauw, J.; Dur, R.; Bossche, S.N.J. van den

2012-01-01

We assess whether public sector employees have a stronger inclination to serve others and are more risk averse than employees in the private sector. A unique feature of our study is that we use revealed rather than stated preferences data. Respondents of a large-scale survey were offered a

Public sector employees: risk averse and altruistic?

NARCIS (Netherlands)

Buurman, M.; Dur, R.; Bossche, S.N.J. van den

2009-01-01

We assess whether public sector employees have a stronger inclination to serve others and are more risk averse than employees in the private sector. A unique feature of our study is that we use revealed rather than stated preferences data. Respondents of a large-scale survey were offered a

Exploitation of Natural Resources and the Public Sector in Greenland

DEFF Research Database (Denmark)

Nielsen, Søren Bo

This paper considers the role of the public sector in future exploitation of non-renewable resources, especially minerals, in Greenland. The focus is on fiscal sustainability, principles for public sector involvement and the form of government take from mining activities. At present, the public...... budget in Greenland is nearly in balance, but at unchanged policies and standards public expenditures relative to GDP are bound to increase dramatically over the next decades due to population ageing. At the same time, the freezing of the block grant from Denmark implies a decrease in revenues relative...... to GDP. Hence, fiscal policy is quite far from being sustainable. Apart from a need for reforms, these facts also constrain the possible role of the public sector in future resource exploitation. In any case, the government should preferably adhere to strict principles when developing the mineral sector...

Improving Outcomes in the Nigeria Healthcare Sector through Public ...

African Journals Online (AJOL)

PPP) model in the Country's healthcare sector. Public - Private Interaction offers opportunity of leveraging private sector investment in the sector and further enhances improvements in service delivery as well as increases access to quality ...

Why the public health sector couldn’t create Pokémon Go

Directory of Open Access Journals (Sweden)

Becky Freeman

2017-07-01

Full Text Available Pokémon Go has been subject to much attention – from both the players that download the augmented reality game and the news media. Amid the exaggerated media reports, Pokémon Go may have unintended health benefits. Players have reported walking more, spending more time with family, experiencing improvements in their mental health and feeling more connected to their communities. It is hard to imagine public health researchers developing a similar game that is fun, taps into pop culture, reaches a wide target audience, makes use of physical and virtual environments, creates a sense of both competition and community, and has spin-off health benefits. Companies that endanger public health immediately recognised the value of the Pokémon Go app, and exploited it to advertise and promote consumption of unhealthy foods. Public health stakeholders need to develop mobile-based interventions within a framework that embraces pleasure, rewards, participation and community. Public health agencies need to be just as nimble and responsive as companies that are harmful to health, or forever be creating games that nobody plays.

Why the public health sector couldn't create Pokémon Go.

Science.gov (United States)

Freeman, Becky; Chau, Josephine; Mihrshahi, Seema

2017-07-26

Pokémon Go has been subject to much attention - from both the players that download the augmented reality game and the news media. Amid the exaggerated media reports, Pokémon Go may have unintended health benefits. Players have reported walking more, spending more time with family, experiencing improvements in their mental health and feeling more connected to their communities. It is hard to imagine public health researchers developing a similar game that is fun, taps into pop culture, reaches a wide target audience, makes use of physical and virtual environments, creates a sense of both competition and community, and has spin-off health benefits. Companies that endanger public health immediately recognised the value of the Pokémon Go app, and exploited it to advertise and promote consumption of unhealthy foods. Public health stakeholders need to develop mobile-based interventions within a framework that embraces pleasure, rewards, participation and community. Public health agencies need to be just as nimble and responsive as companies that are harmful to health, or forever be creating games that nobody plays.

The interrelations amongst control system elements in public sector organizations.

NARCIS (Netherlands)

Verbeeten, F.H.M.

2013-01-01

The aim of this study is to explain the decisions that public sector organizations make with regard to the design and use of their management control system. New Public Management, based on economics theory, suggests that employees in the public sector should be freed from traditional bureaucratic

Corruption, Trust and their Public Sector Consequences

DEFF Research Database (Denmark)

Fritzen, Scott A.; Serritzlew, Søren; Svendsen, Gert Tinggaard

2014-01-01

Corruption and trust are two important determinants of the quality of public sectors. Empirical studies in different literatures suggest that corruption and trust have effects on factors such as economic growth, the quality of democratic institutions, life quality, the size and effectiveness....... The aim is to show that these two concepts are highly relevant to each other, and that their interconnections are important to understand the public sector consequences of corruption and trust. By focusing on these concepts, we hope that this special issue can pave the road for further comparative...

Additional financial statements preparation for the purposes of business success review of public sector entities according to IAS for the public sector