WorldWideScience

Sample records for public health sectors

  1. Private sector in public health care systems

    OpenAIRE

    Matějusová, Lenka

    2008-01-01

    This master thesis is trying to describe the situation of private sector in public health care systems. As a private sector we understand patients, private health insurance companies and private health care providers. The focus is placed on private health care providers, especially in ambulatory treatment. At first there is a definition of health as a main determinant of a health care systems, definition of public and private sectors in health care systems and the difficulties at the market o...

  2. 'Where is the public health sector?' Public and private sector healthcare provision in Madhya Pradesh, India.

    Science.gov (United States)

    De Costa, Ayesha; Diwan, Vinod

    2007-12-01

    This paper aims to empirically demonstrate the size and composition of the private health care sector in one of India's largest provinces, Madhya Pradesh. It is based on a field survey of all health care providers in Madhya Pradesh (60.4 million in 52,117 villages and 394 towns). Seventy-five percent of the population is rural and 37% live below poverty line. This survey was done as part of the development of a health management information system. The distribution of health care providers in the province with regard to sector of work (public/private), rural-urban location, qualification, commercial orientation and institutional set-up are described. Of the 24,807 qualified doctors mapped in the survey, 18,757 (75.6%) work in the private sector. Fifteen thousand one hundred forty-two (80%) of these private physicians work in urban areas. The 72.1% (67793) of all qualified paramedical staff work in the private sector, mostly in rural areas. The paper empirically demonstrates the dominant heterogeneous private health sector and the overall the disparity in healthcare provision in rural and urban areas. It argues for a new role for the public health sector, one of constructive oversight over the entire health sector (public and private) balanced with direct provision of services where necessary. It emphasizes the need to build strong public private partnerships to ensure equitable access to healthcare for all.

  3. 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.

  4. Chiropractic practice in the Danish public health care sector

    DEFF Research Database (Denmark)

    Myburgh, Corrie

    2009-01-01

    This commentary offers preliminary considerations around a phenomenological investigation of chiropractic services in a Danish public sector setting. In this narrative description, the main venue for chiropractic public (secondary) sector practice in the Danish context is briefly described...... and defined. Furthermore, a contextually relevant definition of an integral health care service is presented; and the professional importance for chiropractic in providing such services is also discussed. Finally, salient questions requiring empirical investigation in this context are posed; and selected...

  5. How does retiree health insurance influence public sector employee saving?

    Science.gov (United States)

    Clark, Robert L; Mitchell, Olivia S

    2014-12-01

    Economic theory predicts that employer-provided retiree health insurance (RHI) benefits have a crowd-out effect on household wealth accumulation, not dissimilar to the effects reported elsewhere for employer pensions, Social Security, and Medicare. Nevertheless, we are unaware of any similar research on the impacts of retiree health insurance per se. Accordingly, the present paper utilizes a unique data file on respondents to the Health and Retirement Study, to explore how employer-provided retiree health insurance may influence net household wealth among public sector employees, where retiree healthcare benefits are still quite prevalent. Key findings include the following: Most full-time public sector employees anticipate having employer-provided health insurance coverage in retirement, unlike most private sector workers.Public sector employees covered by RHI had substantially less wealth than similar private sector employees without RHI. In our data, Federal workers had about $82,000 (18%) less net wealth than private sector employees lacking RHI; state/local workers with RHI accumulated about $69,000 (or 15%) less net wealth than their uninsured private sector counterparts.After controlling on socioeconomic status and differences in pension coverage, net household wealth for Federal employees was $116,000 less than workers without RHI and the result is statistically significant; the state/local difference was not. Copyright © 2014 Elsevier B.V. All rights reserved.

  6. Bargaining and idle public sector capacity in health care

    OpenAIRE

    Xavier Martinez-Giralt; Barros Pedro Pita

    2005-01-01

    A feature present in countries with a National Health Service is the co-existence of a public and a private sector. Often, the public payer contracts with private providers while holding idle capacity. This is often seen as inefficiency from the management of public facilities. We present here a different rationale for the existence of such idle capacity: the public sector may opt to have idle capacity as a way to gain bargaining power vis-Ã -vis the private provider, under the assumption of ...

  7. The Healthcare and Public Health Sector Challenges and Strategies to Conducting Sector Wide Assessments

    OpenAIRE

    Meyer, Harry

    2008-01-01

    Our Healthcare and Public Health (HPH) sector is vast, complex and essential to virtually all other sectors of our nation’s infrastructure. Without a healthy workforce modern society quickly grinds to a halt. The often messy networks of healthcare providers, insurance companies, emergency departments, pharmaceutical manufactures and other equally important actors are bound together in fragile alliances to maintain and restore basic health. Thus the HPH sector becomes an important cog in the w...

  8. Bargaining and idle public sector capacity in health care

    OpenAIRE

    Barros, Pedro Pita

    2005-01-01

    A feature present in countries with a National Health Service is the co−existence of a públic and a private sector. Often, the public payer contracts with private providers while holding idle capacity. This is often seen as inefficiency from the management of public facilities. We present here a different rationale for the existence of such idle capacity: the public sector may opt to have idle capacity as a way to gain bargaining power vis−à−vis the private provider, under the assumption of a...

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

    Science.gov (United States)

    Marutani, Miki; Okada, Yumiko; Hasegawa, Takashi

    2016-01-01

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

  10. Adaptation to climate change in the Ontario public health sector

    Directory of Open Access Journals (Sweden)

    Paterson Jaclyn A

    2012-06-01

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

  11. Adaptation to climate change in the Ontario public health sector

    Science.gov (United States)

    2012-01-01

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

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

    Science.gov (United States)

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

    2017-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Cameron Lister

    2017-08-01

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

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

    Science.gov (United States)

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

    2013-01-01

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

  15. 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,.

  16. 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.

  17. 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

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

    Science.gov (United States)

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

    2015-06-01

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

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

    Science.gov (United States)

    Prinja, Shankar; Kanavos, Panos; Kumar, Rajesh

    2012-09-01

    Income inequality is associated with poor health. Inequities exist in service utilization and financing for health care. Health care costs push high number of households into poverty in India. We undertook this study to ascertain inequities in health status, service utilization and out-of-pocket (OOP) health expenditures in two States in north India namely, Haryana and Punjab, and Union Territory of Chandigarh. Data from National Sample Survey 60 th Round on Morbidity and Health Care were analyzed by mean consumption expenditure quintiles. Indicators were devised to document inequities in the dimensions of horizontal and vertical inequity; and redistribution of public subsidy. Concentration index (CI), and equity ratio in conjunction with concentration curve were computed to measure inequity. Reporting of morbidity and hospitalization rate had a pro-rich distribution in all three States indicating poor utilization of health services by low income households. Nearly 57 and 60 per cent households from poorest income quintile in Haryana and Punjab, respectively faced catastrophic OOP hospitalization expenditure at 10 per cent threshold. Lower prevalence of catastrophic expenditure was recorded in higher income groups. Public sector also incurred high costs for hospitalization in selected three States. Medicines constituted 19 to 47 per cent of hospitalization expenditure and 59 to 86 per cent OPD expenditure borne OOP by households in public sector. Public sector hospitalizations had a pro-poor distribution in Haryana, Punjab and Chandigarh. Our analysis indicates that public sector health service utilization needs to be improved. OOP health care expenditures at public sector institutions should to be curtailed to improve utilization of poorer segments of population. Greater availability of medicines in public sector and regulation of their prices provide a unique opportunity to reduce public sector OOP expenditure.

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

    Science.gov (United States)

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

    2016-06-22

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

  1. 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...

  2. 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.

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

    Directory of Open Access Journals (Sweden)

    Lethbridge Jane

    2004-11-01

    Full Text Available Abstract This article considers some of the effects of health sector reform on human resources for health (HRH in developing countries and countries in transition by examining the effect of fiscal reform and the introduction of decentralisation and market mechanisms to the health sector. Fiscal reform results in pressure to measure the staff outputs of the health sector. Financial decentralisation often leads to hospitals becoming "corporatised" institutions, operating with business principles but remaining in the public sector. The introduction of market mechanisms often involves the formation of an internal market within the health sector and market testing of different functions with the private sector. This has immediate implications for the employment of health workers in the public sector, because the public sector may reduce its workforce if services are purchased from other sectors or may introduce more short-term and temporary employment contracts. Decentralisation of budgets and administrative functions can affect the health sector, often in negative ways, by reducing resources available and confusing lines of accountability for health workers. Governance and regulation of health care, when delivered by both public and private providers, require new systems of regulation. The increase in private sector provision has led health workers to move to the private sector. For those remaining in the public sector, there are often worsening working conditions, a lack of employment security and dismantling of collective bargaining agreements. Human resource development is gradually being recognised as crucial to future reforms and the formulation of health policy. New information systems at local and regional level will be needed to collect data on human resources. New employment arrangements, strengthening organisational culture, training and continuing education will also be needed.

  4. 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.

  5. Occupational Health and Safety in the Nigerian Public Sector ...

    African Journals Online (AJOL)

    The focus of this paper is to explore the issue of occupational health and safety ... this paper seeks to examine major causes of occupational hazards in the public ... not report to the management for fear of negative effect that may result from it.

  6. Public-Private health sector mix- way forward | Buso | South African ...

    African Journals Online (AJOL)

    The debate on Public-Private mix has been around in South Africa (SA) for the past ten years. The debate arose out of a realisation of the weaknesses in the public health parallel with the ever-increasing private sector worldwide. The concept has been referred to in different terminologies, public-private mix, public private ...

  7. 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....

  8. 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.

  9. 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.

  10. Engaging the private sector in public health challenges in Namibia

    NARCIS (Netherlands)

    de Beer, I.H.

    2017-01-01

    Engaging the private sector in healthcare is a central theme in the work of PharmAccess Foundation, a Dutch not-for-profit organization, based in Amsterdam, with offices in several African countries, including Namibia. This thesis describes interventions developed and applied in Namibia to engage

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

    Science.gov (United States)

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

    2012-04-05

    Severe shortages of qualified health workers and geographical imbalances in the workforce in many low-income countries require the national health sector management to closely monitor and address issues related to the distribution of health workers across various types of health facilities. This article discusses health workers' preferences for workplace and their perceptions and experiences of the differences in working conditions in the public health sector versus the church-run health facilities in Tanzania. The broader aim is to generate knowledge that can add to debates on health sector management in low-income contexts. The study has a qualitative study design to elicit in-depth information on health workers' preferences for workplace. The data comprise ten focus group discussions (FGDs) and 29 in-depth interviews (IDIs) with auxiliary staff, nursing staff, clinicians and administrators in the public health sector and in a large church-run hospital in a rural district in Tanzania. The study has an ethnographic backdrop based on earlier long-term fieldwork in Tanzania. The study found a clear preference for public sector employment. This was associated with health worker rights and access to various benefits offered to health workers in government service, particularly the favourable pension schemes providing economic security in old age. Health workers acknowledged that church-run hospitals generally were better equipped and provided better quality patient care, but these concerns tended to be outweighed by the financial assets of public sector employment. In addition to the sector specific differences, family concerns emerged as important in decisions on workplace. The preference for public sector employment among health workers shown in this study seems to be associated primarily with the favourable pension scheme. The overall shortage of health workers and the distribution between health facilities is a challenge in a resource constrained health system

  12. 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.

  13. 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.

  14. 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...

  15. 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.

  16. 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.

  17. 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.

  18. 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.

  19. How Does Retiree Health Insurance Influence Public Sector Employee Saving?

    OpenAIRE

    Robert Clark; Olivia S. Mitchell

    2013-01-01

    Economic theory predicts that employer-provided retiree health insurance (RHI) benefits have a crowd-out effect on household wealth accumulation, not dissimilar to the effects reported elsewhere for employer pensions, Social Security, and Medicare. Nevertheless, we are unaware of any similar research on the impacts of retiree health insurance per se. Accordingly, the present paper utilizes a unique data file on respondents to the Health and Retirement Study, to explore how employer-provided r...

  20. Public-private partnerships in the Potuguese health sector.

    Science.gov (United States)

    Simões, Jorge; Barros, Pedro Pita; Temido, Marta

    2010-01-01

    In Portugal, the PPP in the healthcare sector appeared only at the dawn of the new century, with the central feature of including clinical activities within its scope. Currently--except for one hospital--the Portuguese PPP experience can only be assessed in terms of conceptual model and tender processes. The analysis showed that, based on arguments associated with non-contractible investment and ex-post renegotiation opportunities, hospitals with higher technological complexity should exclude clinical activities from the PPP contract, and also that, despite the time-consuming process, the PPP can be considered a success in price competition dimension. The analysis also showed that, assessing the performance of the single PPP hospital in Portugal with two comparable units, there is no evidence that the best or worst results are correlated with the legal status and with the established management model.

  1. Electronic records management in the public health sector of the ...

    African Journals Online (AJOL)

    Ngulup

    Document and Records Management System, medical records, service delivery, public ... standard operating procedures and formal methodologies for managing .... cords is the “information which is generated electronically and stored by means of a computer ..... This is because the disadvantages of one instrument are the.

  2. SA's ailing public health sector 'responding to treatment'? | Bateman ...

    African Journals Online (AJOL)

    Only one of the most vital patient care domains in public healthcare facilities today meets minimum local and international standards – that of positive caring staff attitudes – but while patient waiting times have increased, other critical areas show 'marginal to good' improvements.

  3. Electronic records management in the public health sector of the ...

    African Journals Online (AJOL)

    Ngulup

    records) ... cally related administrative decision-making and problem-solving. ... This implies that a successful e-health system needs maximum support from proper ...... disaster backup for recovery in case it is affected by disaster like fire and water.

  4. Introduction of EDI in the public sector

    DEFF Research Database (Denmark)

    Falch, Morten

    1997-01-01

    Reviews the status of EDI in the sectors of health, public transport and taxation and public administration. The impact of this on the diffusion of EDI in other sectors is analysed.......Reviews the status of EDI in the sectors of health, public transport and taxation and public administration. The impact of this on the diffusion of EDI in other sectors is analysed....

  5. 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...

  6. 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.

  7. The Impact of Electricity Sector Privatization on Public Health

    DEFF Research Database (Denmark)

    Gonzalez-Eiras, Martin; Rossi, Martín

    2008-01-01

    We use province-level data for Argentina to test for the causal relation between electricity distribution and health. We are interested in the impact of privatization on two output measures, incidence of low birth weight and child mortality rates caused by food poisoning. Privatization improves...... service coverage which, through the use of refrigerators, may improve nutritional intake. Privatization also results in a reduction in the frequency of interruptions, and thus may reduce the likelihood of food poisoning. We find some evidence that privatization reduced the frequency of low birth weight...... and child mortality rates caused by food poisoning. Results are not strong enough to inform the policy debate with respect to the benefits that privatizations have on the welfare of the poor....

  8. 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 ...

  9. 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

  10. 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.

  11. 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.

  12. 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.

  13. 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....

  14. [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.

  15. 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.

  16. 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

  17. 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

  18. [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.

  19. 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.

  20. 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.

  1. 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.

  2. 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.

  3. 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.

  4. 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).

  5. 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

  6. Contracting private sector providers for public sector health services in Jalisco, Mexico: perspectives of system actors

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    González Luz

    2009-10-01

    Full Text Available Abstract Introduction Contracting out health services is a strategy that many health systems in the developing world are following, despite the lack of decisive evidence that this is the best way to improve quality, increase efficiency and expand coverage. A large body of literature has appeared in recent years focusing on the results of several contracting strategies, but very few papers have addressed aspects of the managerial process and how this can affect results. Case description This paper describes and analyses the perceptions and opinions of managers and workers about the benefits and challenges of the contracting model that has been in place for almost 10 years in the State of Jalisco, Mexico. Both qualitative and quantitative information was collected. An open-ended questionnaire was used to obtain information from a group of managers, while information provided by a self-selected group of workers was collected via a closed-ended questionnaire. The analysis contrasted the information obtained from each source. Discussion and Evaluation Findings show that perceptions of managers and workers vary for most of the items studied. For managers the model has been a success, as it has allowed for expansion of coverage based on a cost-effective strategy, while for workers the model also possesses positive elements but fails to provide fair labour relationships, which negatively affects their performance. Conclusion Perspectives of the two main groups of actors in Jalisco's contracting model are important in the design and adjustment of an adequate contracting model that includes managerial elements to give incentives to worker performance, a key element necessary to achieve the model's ultimate objectives. Lessons learnt from this study could be relevant for the experience of contracting models in other developing countries.

  7. 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

  8. 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

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

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    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.

  10. [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.

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

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    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.

  12. 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).

  13. 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).

  14. 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

  15. 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

  16. 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.

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

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    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.

  18. 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

  19. 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.

  20. 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

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

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    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.

  2. 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...

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

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    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.

  4. 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.

  5. 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.

  6. Conceptual framework of public health surveillance and action and its application in health sector reform

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    Alemu Wondi

    2002-01-01

    Full Text Available Abstract Background Because both public health surveillance and action are crucial, the authors initiated meetings at regional and national levels to assess and reform surveillance and action systems. These meetings emphasized improved epidemic preparedness, epidemic response, and highlighted standardized assessment and reform. Methods To standardize assessments, the authors designed a conceptual framework for surveillance and action that categorized the framework into eight core and four support activities, measured with indicators. Results In application, country-level reformers measure both the presence and performance of the six core activities comprising public health surveillance (detection, registration, reporting, confirmation, analyses, and feedback and acute (epidemic-type and planned (management-type responses composing the two core activities of public health action. Four support activities – communications, supervision, training, and resource provision – enable these eight core processes. National, multiple systems can then be concurrently assessed at each level for effectiveness, technical efficiency, and cost. Conclusions This approach permits a cost analysis, highlights areas amenable to integration, and provides focused intervention. The final public health model becomes a district-focused, action-oriented integration of core and support activities with enhanced effectiveness, technical efficiency, and cost savings. This reform approach leads to sustained capacity development by an empowerment strategy defined as facilitated, process-oriented action steps transforming staff and the system.

  7. 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.

  8. 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.

  9. 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.

  10. 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

  11. 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.

  12. [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.

  13. 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

  14. 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

  15. 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

  16. 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

  17. 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

  18. 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.

  19. Public Health England survey of eye lens doses in the UK medical sector

    International Nuclear Information System (INIS)

    Ainsbury, E A; Bouffler, S; Gilvin, P; Peters, S; Slack, K; Cocker, M; Holt, E; Williamson, A

    2014-01-01

    The ICRP has recently recommended that the occupational exposure limit for the lens of the eye be reduced to 20 mSv in a year, averaged over defined periods of 5 years, with no single year exceeding 50 mSv. There has been concern amongst some groups of individuals, particularly interventional cardiologists and radiologists as well as relevant professional bodies, that implementation of these recommendations into UK law will adversely affect working patterns. However, despite a number of informative European studies, there is currently little UK dosimetry data available upon which judgements can effectively be based. In order to address this knowledge gap, Public Health England has carried out a small, targeted survey of UK lens doses to medical staff undertaking procedures likely to involve the highest levels of radiation exposure. Two out of a total of 61 individuals surveyed had projected annual doses which could be close to 20 mSv, measured outside lead glasses. Use of protective equipment was generally good; however, lead glasses were only used by 9 participants. The results of this survey suggest that compliance with the ICRP recommendations is likely to be possible for most individuals in the UK medical sector. (paper)

  20. 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.

  1. 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

  2. [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.

  3. 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.

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

    Directory of Open Access Journals (Sweden)

    Cline Gregory B

    2013-01-01

    Full Text Available Abstract Background The public healthcare sector in developing countries faces many challenges including weak healthcare systems and under-resourced facilities that deliver poor outcomes relative to total healthcare expenditure. Global references demonstrate that information technology has the ability to assist in this regard through the automation of processes, thus reducing the inefficiencies of manually driven processes and lowering transaction costs. This study examines the impact of hospital information systems implementation on service delivery, user adoption and organisational culture within two hospital settings in South Africa. Methods Ninety-four interviews with doctors, nurses and hospital administrators were conducted in two public sector tertiary healthcare facilities (in two provinces to record end-user perceptions. Structured questionnaires were used to conduct the interviews with both qualitative and quantitative information. Results Noteworthy differences were observed among the three sample groups of doctors, nurses and administrators as well as between our two hospital groups. The impact of automation in terms of cost and strategic value in public sector hospitals is shown to have yielded positive outcomes with regard to patient experience, hospital staff workflow enhancements, and overall morale in the workplace. Conclusion The research provides insight into the reasons for investing in system automation, the associated outcomes, and organisational factors that impact the successful adoption of IT systems. In addition, it finds that sustainable success in these initiatives is as much a function of the technology as it is of the change management function that must accompany the system implementation.

  5. 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.

  6. 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.

  7. Continuation rate of hormone replacement therapy in Hong Kong public health sector.

    Science.gov (United States)

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

    2004-12-10

    To assess the 1-year continuation rate of HRT prescribed in Hong Kong public health sector and to identify factors affecting this continuation rate. All women who received at least one dispensed prescription of estrogens between January 1998 and December 2000 from 36 specialist outpatient clinics of the Hospital Authority were selected, and observed for at least 2 years and at most 3 years. The duration of use and variables including age, types of hormones, routes of delivery, dose of estrogen, and prescribing specialty were retrieved from the central prescription database of the Hospital Authority. Of 12,711 incident users of HRT, more than half were aged 50-59. Most (78.5%) of the users took conjugated equine estrogens (CEE) 0.625 mg or related products. Only a small proportion (3.0%) of women used CEE 0.3 mg. Initial estrogen prescriptions were written by gynaecologists in 86.7%. The overall 1-year continuation rate was 68.3%. The highest and lowest continuation rates were observed in women aged 40-49 and the two extreme age groups (35-39 and 70-79), respectively. Better continuation rate was observed in women taking estrogen-only therapy such as CEE or estradiol (overall 76.3%) than in women using continuous combined therapy (58.6%), sequential combined therapy (64.8%), or transdermal estrogen (60.6%). In the age group 60-69, the use of CEE 0.3 mg was associated with better continuation rate than CEE 0.625 mg. Better continuation rate at 1 year was associated with age younger than 60, oral route of HRT and hysterectomy.

  8. 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

  9. 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.

  10. 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.

  11. 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.

  12. 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.

  13. 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.

  14. 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

  15. 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.

  16. 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...

  17. 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.

  18. 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.

  19. [Public water supply fluoridation in Brazil according to health sector leaders].

    Science.gov (United States)

    Ferreira, Regina Glaucia Lucena Aguiar; Bógus, Cláudia Maria; Marques, Regina Auxiliadora de Amorim; Menezes, Léa Maria Bezerra de; Narvai, Paulo Capel

    2014-09-01

    Various groups have opposed water supply fluoridation in Brazil, while others have supported the measure based on scientific evidence. This article describes the perceptions of delegates to the 13th National Health Conference on mandatory fluoridation of the country's public water supply. Interviews were processed using collective subject discourse analysis. A certain degree of misinformation persists regarding basic characteristics of water fluoridation, which is frequently confused with chlorination. The delegates' discourses showed a continuing need for public awareness-raising regarding fluoridation and the delegates' desire that the National Congress not take measures impacting public health without consulting society's stakeholders. However, most of the interviewees agreed that to repeal mandatory water fluoridation or loosen the control of its implementation could increase the incidence of tooth decay in the population.

  20. 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.

  1. 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...

  2. 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

  3. 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

  4. 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.

  5. 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…

  6. 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...

  7. Introducing the female condom through the public health sector: experiences from South Africa.

    Science.gov (United States)

    Mantell, J E; Scheepers, E; Karim, Q A

    2000-10-01

    The successful implementation of new public health policy is influenced by provider preparedness and user acceptability of the new intervention. This paper describes the development and implementation of a participatory Training of Trainers (TOT) programme as a precursor to launch the South African government's female-initiated HIV prevention strategies in public health clinics. Three hundred peer-trainees from throughout South Africa were trained through a comprehensive, modular and interactive three-day workshop. The workshop content included: HIV/AIDS knowledge, beliefs and attitudes; values clarification regarding HIV infection and sexuality; sexual desensitization; 'hands-on' training in the use of and introduction of the female condom; and counselling, communication and programme planning skills. The TOT generated a cadre of knowledgeable health care workers for training others and provided a support structure at the service delivery level for ensuring potential users' access to the female condom within each province. Qualitative assessments of the training and trainer debriefing sessions suggest that the training was successful in increasing knowledge and promoting positive attitudes about female condoms. In addition, the expanded repertoire of problem-solving approaches left providers feeling confident about recommending this method to clients.

  8. 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.

  9. 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

  10. 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

  11. 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...

  12. 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

  13. 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.

  14. The Implementation of Minimum Service Standards (MMS on Public Service for Health Services Sector in Bondowoso, Indonesia

    Directory of Open Access Journals (Sweden)

    Untung Kuzairi

    2018-04-01

    Full Text Available One of heatlh policies implemented by the hospital is the minimum service standards (MSS. MSS is a benchmark of hospital service quality in providing services to the public. Talking about health service quality problem, it was found out as the field fact that the achievement of MSS indicator in General Hospital of Dr. H. Koesnadi Bondowoso, Indonesia in 2016 still did not fulfill target of standard hospital service (type B and  minimum service standard (MSS of hospital. This fact shows that the quality of health services in general hospital of  dr. H. Koesnadi Bondowoso is still low. So, this research aims to describe the policy implementation of minimum service standard and to analyze the obstacles in the implementation of MSS policy at general hospital of  dr. H. Koesnadi Bondowoso. So, this research would discuss the policy implementation of minimum service standards by using Edward III concept as a tool to analyze it. This research employed qualitative research with phenomenological approach. The results showed that the implementation of MSS policy of dr. H. Koesnadi Bondowoso general hospital still did not run well. This was due to several factors  such as communication, bureaucratic structure, sources, dispositions (attitude and leadership in sectoral ego control. Sectoral ego can be shaped from educational background of specialist doctors who still adhered seniority and lack of individual role of implementor in building interpersonal communication and conflict management.

  15. 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...

  16. 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.

  17. Can public health reconcile profits and pandemics? An analysis of attitudes to commercial sector engagement in health policy and research.

    Science.gov (United States)

    Collin, Jeff; Hill, Sarah E; Kandlik Eltanani, Mor; Plotnikova, Evgeniya; Ralston, Rob; Smith, Katherine E

    2017-01-01

    Public health's terms of engagement with unhealthy commodity industries (alcohol, tobacco and ultra-processed food and drinks) have become increasingly contested in policy and research. We sought to identify approaches that could attract consensus support within and across policy domains. Using snowball sampling, we undertook an online survey of 335 health researchers, advocates and policymakers, in 40 countries, assessing responses to stated principles, claims and recommendations for engaging with unhealthy commodity industries in relation to key policy and research initiatives. Most respondents identified a fundamental conflict between industry interests and public health objectives for all three industries, with agreement greatest in relation to tobacco and weakest for food. This pattern was replicated across diverse questions regarding potential forms of engagement, including in rejecting voluntarism and partnership approaches to health policy. While awareness of tobacco industry tactics to influence policy and research was higher than for alcohol and food, most respondents rejected the view that the influence of the latter was less significant for public health. Proposals that health and research organisations should divest their funds attracted less support with respect to food, while restricting publication of industry-funded research in academic journals was the issue that most divided opinion. Respondents reported most difficulty in answering questions about the food industry. The strong consensus around restricting interactions with the tobacco industry supports increased implementation of the WHO Framework Convention on Tobacco Control's conflict of interest provisions. There is strong support for the extension of such practices to the alcohol industry, challenging current norms. More mixed responses indicate a need for greater clarity in defining the food industry, and for research analyzing links, similarities and differences across different types of

  18. Can public health reconcile profits and pandemics? An analysis of attitudes to commercial sector engagement in health policy and research.

    Directory of Open Access Journals (Sweden)

    Jeff Collin

    Full Text Available Public health's terms of engagement with unhealthy commodity industries (alcohol, tobacco and ultra-processed food and drinks have become increasingly contested in policy and research. We sought to identify approaches that could attract consensus support within and across policy domains.Using snowball sampling, we undertook an online survey of 335 health researchers, advocates and policymakers, in 40 countries, assessing responses to stated principles, claims and recommendations for engaging with unhealthy commodity industries in relation to key policy and research initiatives.Most respondents identified a fundamental conflict between industry interests and public health objectives for all three industries, with agreement greatest in relation to tobacco and weakest for food. This pattern was replicated across diverse questions regarding potential forms of engagement, including in rejecting voluntarism and partnership approaches to health policy. While awareness of tobacco industry tactics to influence policy and research was higher than for alcohol and food, most respondents rejected the view that the influence of the latter was less significant for public health. Proposals that health and research organisations should divest their funds attracted less support with respect to food, while restricting publication of industry-funded research in academic journals was the issue that most divided opinion. Respondents reported most difficulty in answering questions about the food industry.The strong consensus around restricting interactions with the tobacco industry supports increased implementation of the WHO Framework Convention on Tobacco Control's conflict of interest provisions. There is strong support for the extension of such practices to the alcohol industry, challenging current norms. More mixed responses indicate a need for greater clarity in defining the food industry, and for research analyzing links, similarities and differences across

  19. 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.

  20. Hospital volunteerism as human resource solution: Motivation for both volunteers and the public health sector

    Directory of Open Access Journals (Sweden)

    Guinevere M. Lourens

    2017-08-01

    Full Text Available Background: A volunteer programme with 50 registered volunteers was established in 2007 at a secondary-level public, semi-rural regional hospital in the Cape Winelands, South Africa. This was a rapid response to the extensive renovations and system changes brought about by the hospital revitalisation initiated in 2006 and the resultant expanded services, which required additional human resources. This study describes the hospital volunteer programme and provides hospital administrators with practical planning guidance for hospital volunteer programme implementation. Purpose: The purpose of this study is to (1 describe the outcomes of the hospital volunteer programme implementation intervention and (2 to make sound recommendations for volunteer programme implementation. Methodology and approach: A qualitative case-study methodology was employed using purposive sampling as a technique. Participants were recruited from a public hospital in the Western Cape. A case-study design was applied to explore the hospital volunteer programme implementation. In-depth interviews and a focus group discussion with thematic content analysis of transcripts as well as document reviews were conducted to conclude the study during 2015. The key participants were individually interviewed and included two members of the hospital management, two volunteers and one volunteer coordinator. A focus group discussion consisting of three volunteers was also conducted. Findings: The findings of this study indicate that a volunteer programme can meet needs and be a motivational force for both the individual volunteer and the organisation. However, it requires co-ordination and some secure funding to remain sustainable. Such a programme holds huge benefits in terms of human resource supplementation, organisational development, as well as the possibility of gainful employment for the previously unemployed. Practical implications: In practice, a health service contemplating a

  1. 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...

  2. Impact of a private health insurance mandate on public sector autism service use in Pennsylvania.

    Science.gov (United States)

    Stein, Bradley D; Sorbero, Mark J; Goswami, Upasna; Schuster, James; Leslie, Douglas L

    2012-08-01

    Many states have implemented regulations (commonly referred to as waivers) to increase access to publicly insured services for autism spectrum disorders (ASD). In recent years, several states have passed legislation requiring improved coverage for ASD services by private insurers. This study examines the impact of such legislation on use of Medicaid-funded ASD services. We used Medicaid claims data from July 1, 2006, through June 30, 2010, to identify children with ASD and to assess their use of behavioral health services and psychotropic medications. Service and medication use were examined in four consecutive 12-month periods: the 2 years preceding passage of the legislation, the year after passage but before implementation, and the year after implementation. We examined differences in use of services and medications, and used growth rates from nonwaiver children to estimate the impact of the legislation on Medicaid spending for waiver-eligible children with ASD. The number of children with ASD receiving Medicaid services increased 20% from 2006-2007 to 2009-2010. The growth rate among children affected by the legislation was comparable to that of other groups before passage of the legislation but decreased after the legislation's passage. We project that, without the legislation, growth in this population would have been 46% greater in 2009-2010 than observed, associated with spending of more than $8 million in 2009-2010. Passage of legislation increasing private insurance coverage of ASD services may decrease the number of families seeking eligibility to obtain Medicaid-funded services, with an associated substantial decrease in Medicaid expenditures. Copyright © 2012 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

  3. 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.

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

    NARCIS (Netherlands)

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

    2017-01-01

    Background: 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

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

    NARCIS (Netherlands)

    Peters, Dorothee; Raab, J.; Grêaux, Kimberley M.; Stronks, Karien; Harting, Janneke

    2017-01-01

    Background: Inter-sectoral policy networks may be effective in addressing environmental determinants of health with interventions. However, contradictory results are reported on relations between structure and network characteristics (i.e., composition and integration) and network performance, such

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

    Science.gov (United States)

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

    2016-02-01

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

  7. 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...

  8. Health system governance in Tanzania : impact on service delivery in the public sector

    OpenAIRE

    Mikkelsen-Lopez, Inez K.

    2014-01-01

    Governance in the health system has perhaps been the least explored building block of the health system, receiving less attention due to its vague definition and complex nature. When discussed at the country level it often focuses on single elements such as corruption or accountability and doesn’t consider wider interactions of relevance to how policies are formed. How well governed a health system is can often mean the difference between the efficient use of resources and inefficient waste, ...

  9. Public sector district health system: Is seven to ten minutes enough ...

    African Journals Online (AJOL)

    The development of a municipality based district health system has created an opportunity to practice family medicine in Mitchells Plain, but lack of clinical time to practice family medicine in the current setting raises questions about the quality and efficiency of primary health care in the municipality based district based ...

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

    Directory of Open Access Journals (Sweden)

    Shankar Prinja

    2017-01-01

    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.

  11. Employer, insurance, and health system response to long-term sick leave in the public sector: policy implications.

    Science.gov (United States)

    Heijbel, Bodil; Josephson, Malin; Jensen, Irene; Vingård, Eva

    2005-06-01

    This study has been conducted to describe the situation of long-term sick-listed persons employed in the public sector regarding the medical reasons of their sick leave, the duration of their problems, the duration of the actual sick leave, rehabilitation support, rehabilitation measures, and the persons expectations of the future. Response rate of a postal questionnaire, where 484 women and 51 men on long-term sick leave answered, was 69%. The study-group consisted of 90% women with a median age of 50 years. The most common reasons for sick listing were long-lasting musculoskeletal problems, especially neck/shoulder pain, low back pain and osteoarthritis or other joint problems and mental problems, especially depression and burn-out syndromes. Forty-seven procent of the men and 57% of the women had been on the sick list for more than a year. Only half of them had been subjected to the legally required rehabilitation investigation of the employer This half got access to rehabilitation programs and/or vocational rehabilitation to a greater extent than those who not had been subjected to rehabilitation investigation. Less than half had been in contact with the workplace-connected rehabilitation actors, the Occupational Health Service or the Trade Union. In spite of this the sick-listed persons had a positive view of their future return to work. For long-term sick-listed persons in the public sector, there is a great potential for improvements of the rehabilitation at the workplace arena, in the involvement and cooperation between the already existing rehabilitation actors, in order to promote return to work.

  12. 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)

  13. 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

  14. A literature review of teledermatology programs in the South African public health sector

    CSIR Research Space (South Africa)

    Walters, LEM

    2015-10-01

    Full Text Available This is presentation on teledermatology programs in South Africa that indicate the inequitable access to health care, the ineffective and inefficient referral system as well as the shortage of dermatologists....

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

    OpenAIRE

    Lina M. Grisales; Libardo A. Giraldo

    2008-01-01

    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, speci...

  16. 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....

  17. 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....

  18. 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.

  19. Exploring the link between clinical managers involvement in budgeting and performance: Insights from the Italian public health care sector.

    Science.gov (United States)

    Macinati, Manuela S; Rizzo, Marco G

    2016-01-01

    The public health care sector has had an increase in initiatives, mostly inspired by New Public Management principles, aimed at assigning financial accountability to clinical managers. However, clinical managers might experience a scarce alignment between professional values and organizational requirements, which is a potentially important phenomena that may result in negative consequences on clinical managers' job performance. Building on Psychological Ownership Theory and adopting a psychology-based management accounting research approach, we focus on the managerial (nonmedical) role the clinical manager fulfills and explore the budgetary participation-performance link via the indirect effects of job-based psychological ownership, role clarity, and clinical managers' affective commitment toward managerial roles. The data were collected by a survey conducted in an Italian hospital. The research hypotheses were tested employing a path model. Our study revealed new insights that shed some light on underexplored processes through which mental states mediate the participation-performance link. Among these latter, the findings demonstrate that (a) budgetary participation has a direct effect on job-based psychological ownership; (b) role clarity mediates participation- and job-based psychological ownership link; (c) role clarity and job-based psychological ownership partially mediate the participation-commitment link; and (d) job-based psychological ownership, role clarity, and commitment fully mediate the participation-performance link. From a managerial viewpoint, an understanding of how clinical managers' feelings of ownership toward managerial roles could be enhanced is imperative in health care because ownership accounts for important attitudinal and organizational consequences. Results suggest that health care organizations that invest in budgetary participation will directly and indirectly affect clinical managers' psychological ownership, and this, along with

  20. Policy entrepreneurship in the development of public sector strategy: the case of London health reform.

    Science.gov (United States)

    Oborn, Eivor; Barrett, Michael; Exworthy, Mark

    2011-01-01

    The development of health policy is recognized as complex; however, there has been little development of the role of agency in this process. Kingdon developed the concept of policy entrepreneur (PE) within his ‘windows’ model. He argued inter-related ‘policy streams' must coincide for important issues to become addressed. The conjoining of these streams may be aided by a policy entrepreneur. We contribute by clarifying the role of the policy entrepreneur and highlighting the translational processes of key actors in creating and aligning policy windows. We analyse the work in London of Professor Sir Ara Darzi as a policy entrepreneur. An important aspect of Darzi's approach was to align a number of important institutional networks to conjoin related problems. Our findings highlight how a policy entrepreneur not only opens policy windows but also yokes together a network to make policy agendas happen. Our contribution reveals the role of clinical leadership in health reform.

  1. 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...

  2. 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…

  3. Opening the black box of transfer systems in public sector health services in a Western state in India.

    Science.gov (United States)

    Purohit, Bhaskar; Martineau, Tim; Sheikh, Kabir

    2016-08-22

    Limited research on Posting and Transfer (P&T) policies and systems in the public sector health services and the reluctance for an open debate on the issue makes P&T as a black box. Limited research on P&T in India suggests that P&T policies and systems are either non-existent, weak, poorly implemented or characterized by corruption. Hence the current study aimed at opening the "black box" of P&T systems in public sector health services in India by assessing the implementation gaps between P&T policies and their actual implementation. This was a qualitative study carried out in Department of Health, in a Western State in India. To understand the extant P&T policies, a systems map was first developed with the help of document review and Key Informant (KI) Interviews. Next systems audit was carried out to assess the actual implementation of transfer policies by interviewing Medical Officers (MOs), the group mainly affected by the P&T policies. Job histories were constructed from the interviews to understand transfer processes like frequencies of transfers and to assess if transfer rules were adhered. The analysis is based on a synthesis of document review, 19 in-depth interviews with MOs working with state health department and five in-depth interviews with Key Informants (KIs). Framework analysis approach was used to analyze data using NVIVO. The state has a generic transfer guideline applicable to all government officers but there is no specific transfer policy or guideline for government health personnel. The generic transfer guidelines are weakly implemented indicating a significant gap between policy and actual implementation. The formal transfer guidelines are undermined by a parallel system in which desirable posts are attained, retained or sometimes given up by the use of political connections and money. MOs' experiences of transfers were marked by perceptions of unfairness and irregularities reflected through interviews as well as the job histories. The

  4. 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...

  5. Unemployment, public-sector health care expenditure and HIV mortality: An analysis of 74 countries, 1981-2009.

    Science.gov (United States)

    Maruthappu, Mahiben; Da Zhou, Charlie; Williams, Callum; Zeltner, Thomas; Atun, Rifat

    2015-06-01

    The global economic downturn has been associated with increased unemployment and reduced public-sector expenditure on health care (PSEH). We determined the association between unemployment, PSEH and HIV mortality. Data were obtained from the World Bank and the World Health Organisation (1981-2009). Multivariate regression analysis was implemented, controlling for country-specific demographics and infrastructure. Time-lag analyses and robustness-checks were performed. Data were available for 74 countries (unemployment analysis) and 75 countries (PSEH analysis), equating to 2.19 billion and 2.22 billion people, respectively, as of 2009. A 1% increase in unemployment was associated with a significant increase in HIV mortality (men: 0.1861, 95% CI: 0.0977 to 0.2744, P = 0.0000, women: 0.0383, 95% CI: 0.0108 to 0.0657, P = 0.0064). A 1% increase in PSEH was associated with a significant decrease in HIV mortality (men: -0.5015, 95% CI: -0.7432 to -0.2598, P = 0.0001; women: -0.1562, 95% CI: -0.2404 to -0.0720, P = 0.0003). Time-lag analysis showed that significant changes in HIV mortality continued for up to 5 years following variations in both unemployment and PSEH. Unemployment increases were associated with significant HIV mortality increases. PSEH increases were associated with reduced HIV mortality. The facilitation of access-to-care for the unemployed and policy interventions which aim to protect PSEH could contribute to improved HIV outcomes.

  6. How to promote joint participation of the public and private sectors in the organisation of animal health programmes.

    Science.gov (United States)

    Melo, E Correa; Saraiva, V

    2003-08-01

    It is generally accepted that the first recorded outbreaks of foot and mouth disease (FMD) in South America occurred around 1870. The disease emerged almost simultaneously in the province of Buenos Aires (Argentina), in the central region of Chile, in Uruguay and in southern Brazil, due to the introduction of livestock from Europe. Argentina set up an agency for the control and eradication of FMD in 1961, Brazil began disease-control activities in Rio Grande do Sul in 1965, Paraguay and Uruguay initiated similar programmes in 1967, Chile in 1970 and Colombia in 1972. A common characteristic was observed in all early national FMD programmes, namely, they were developed, financed, operated and evaluated by the public sector, without major participation from the private sector, except when buying vaccines and abiding by the regulations. In 1987, the Hemispheric Foot and Mouth Disease Eradication Plan (PHEFA: Plan Hemisférico para la Erradicación de la Fiebre Aftosa) was launched and the private sector played a prominent role in achieving the eradication and control of FMD in several countries. However, this model of co-participation between the public and private sectors has suffered setbacks and a new approach is being developed to find ways in which local structures and activities can be self-sustaining.

  7. 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.

  8. 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

  9. 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.

  10. 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, ...

  11. What systemic factors contribute to collaboration between primary care and public health sectors? An interpretive descriptive study.

    Science.gov (United States)

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

    2017-12-01

    Purposefully building stronger collaborations between primary care (PC) and public health (PH) is one approach to strengthening primary health care. The purpose of this paper is to report: 1) what systemic factors influence collaborations between PC and PH; and 2) how systemic factors interact and could influence collaboration. This interpretive descriptive study used purposive and snowball sampling to recruit and conduct interviews with PC and PH key informants in British Columbia (n = 20), Ontario (n = 19), and Nova Scotia (n = 21), Canada. Other participants (n = 14) were knowledgeable about collaborations and were located in various Canadian provinces or working at a national level. Data were organized into codes and thematic analysis was completed using NVivo. The frequency of "sources" (individual transcripts), "references" (quotes), and matrix queries were used to identify potential relationships between factors. We conducted a total of 70 in-depth interviews with 74 participants working in either PC (n = 33) or PH (n = 32), both PC and PH (n = 7), or neither sector (n = 2). Participant roles included direct service providers (n = 17), senior program managers (n = 14), executive officers (n = 11), and middle managers (n = 10). Seven systemic factors for collaboration were identified: 1) health service structures that promote collaboration; 2) funding models and financial incentives supporting collaboration; 3) governmental and regulatory policies and mandates for collaboration; 4) power relations; 5) harmonized information and communication infrastructure; 6) targeted professional education; and 7) formal systems leaders as collaborative champions. Most themes were discussed with equal frequency between PC and PH. An assessment of the system level context (i.e., provincial and regional organization and funding of PC and PH, history of government in successful implementation of health care reform, etc) along

  12. Maternal and reproductive health financing in Burundi: public-sector contribution levels and trends from 2010 to 2012.

    Science.gov (United States)

    Chaumont, Claire; Muhorane, Carmen; Moreira-Burgos, Isabelle; Juma, Ndereye; Avila-Burgos, Leticia

    2015-10-01

    An understanding of public financial flows to reproductive health (RH) at the country level is key to assessing the extent to which they correspond to political commitments. This is especially relevant for low-income countries facing important challenges in the area of RH. To this end, the present study analyzes public expenditure levels and trends with regards to RH in Burundi between the years 2010 to 2012, looking specifically at financing agents, health providers, and health functions. The analysis was performed using standard RH sub-account methodology. Information regarding public expenditures was gathered from national budgets, the Burundi Ministry of Public Health information system, and from other relevant public institutions. Public RH expenditures in Burundi accounted for $41.163 million international dollars in 2012, which represents an increase of 16 % from 2010. In 2012, this sum represented 0.57 % of the national GDP. The share of total public health spending allocated to RH increased from 15 % in 2010 to 19 % in 2012. In terms of public agents involved in RH financing, the Ministry of Public Health proved to play the most important role. Half of all public RH spending went to primary health care clinics, while more than 70 % of this money was used for maternal health; average public RH spending per woman of childbearing age stagnated during the study period. The flow patterns and levels of public funds to RH in Burundi suggest that RH funding correctly reflects governmental priorities for the period between 2010 and 2012. In a context of general shrinking donor commitment, local governments have come to play a key role in ensuring the efficient use of available resources and the mobilizing of additional domestic funding. A strong and transparent financial tracking system is key to carrying out this role and making progress towards the MDG Goals and development beyond 2015.

  13. 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

  14. An international comparative public health analysis of sex trafficking of women and girls in eight cities: achieving a more effective health sector response.

    Science.gov (United States)

    Macias Konstantopoulos, Wendy; Ahn, Roy; Alpert, Elaine J; Cafferty, Elizabeth; McGahan, Anita; Williams, Timothy P; Castor, Judith Palmer; Wolferstan, Nadya; Purcell, Genevieve; Burke, Thomas F

    2013-12-01

    Sex trafficking, trafficking for the purpose of forced sexual exploitation, is a widespread form of human trafficking that occurs in all regions of the world, affects mostly women and girls, and has far-reaching health implications. Studies suggest that up to 50 % of sex trafficking victims in the USA seek medical attention while in their trafficking situation, yet it is unclear how the healthcare system responds to the needs of victims of sex trafficking. To understand the intersection of sex trafficking and public health, we performed in-depth qualitative interviews among 277 antitrafficking stakeholders across eight metropolitan areas in five countries to examine the local context of sex trafficking. We sought to gain a new perspective on this form of gender-based violence from those who have a unique vantage point and intimate knowledge of push-and-pull factors, victim health needs, current available resources and practices in the health system, and barriers to care. Through comparative analysis across these contexts, we found that multiple sociocultural and economic factors facilitate sex trafficking, including child sexual abuse, the objectification of women and girls, and lack of income. Although there are numerous physical and psychological health problems associated with sex trafficking, health services for victims are patchy and poorly coordinated, particularly in the realm of mental health. Various factors function as barriers to a greater health response, including low awareness of sex trafficking and attitudinal biases among health workers. A more comprehensive and coordinated health system response to sex trafficking may help alleviate its devastating effects on vulnerable women and girls. There are numerous opportunities for local health systems to engage in antitrafficking efforts while partnering across sectors with relevant stakeholders.

  15. 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.

  16. 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.

  17. Is it just religious practice? Exploring patients' reasons for choosing a faith-based primary health clinic over their local public sector primary health clinic.

    Science.gov (United States)

    Porter, James D; Bresick, Graham

    2017-06-29

    Person-centred, re-engineered primary health care (PHC) is a national and global priority. Faith-based health care is a significant provider of PHC in sub-Saharan Africa, but there is limited published data on the reasons for patient choice of faith-based health care, particularly in South Africa. The primary objective was to determine and explore the reasons for patient choice of a faith-based primary care clinic over their local public sector primary care clinic, and secondarily to determine to what extent these reasons were influenced by demography. The study was conducted at Jubilee Health Centre (JHC), a faith-based primary care clinic attached to Jubilee Community Church in Cape Town, South Africa. Focus groups, using the nominal group technique, were conducted with JHC patients and used to generate ranked reasons for attending the clinic. These were collated into the top 15 reasons and incorporated into a quantitative questionnaire which was administered to adult patients attending JHC. A total of 164 patients were surveyed (a response rate of 92.4%) of which 68.3% were female and 57.9% from the Democratic Republic of the Congo (DRC). Of patients surveyed, 98.2% chose to attend JHC because 'the staff treat me with respect', 96.3% because 'the staff are friendly' and 96.3% because 'the staff take time to listen to me'. The reason 'it is a Christian clinic' was chosen by 70.1% of patients. 'The staff speak my home language' was given as a reason by 61.1% of DRC patients and 37.1% of South African patients. 'The clinic is close to me' was chosen by 66.6% of Muslims and 40.8% of Christians. Patients chose to attend JHC (a faith-based primary care clinic) because of the quality of care received. They emphasised the staff-patient relationship and patient-centredness rather than the clinic's religious practices (prayer with patients). These findings may be important in informing efforts to improve public sector primary care.

  18. Public health

    NARCIS (Netherlands)

    Berg, van den A.E.

    2007-01-01

    Agnes van den Berg wrote an essay about human health and nature, establishing that subject as an important policy argument in developing (urban) nature in the Netherlands. She studied the public balance of fear and fascination for nature, summarising benefits on human health. In this chapter, she

  19. 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

  20. 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

  1. 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

  2. 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....

  3. 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...

  4. Return on Investment in the Public Sector

    National Research Council Canada - National Science Library

    Bigham, Joshua

    2004-01-01

    .... Development and application of ROI analysis is challenging in the public sector since most government organizations do not generate profit necessary for calculation of ROI in the manner in which it...

  5. Epidemiology of percutaneous exposure to needlestick and sharp object injuries in the Botswana public health sector: A health facility cross sectional study

    Directory of Open Access Journals (Sweden)

    Styn M Jamu

    2016-01-01

    Full Text Available Objective To evaluate the extent and distribution of needlestick and sharp object injuries in the Botswana public health sector. Methods This was a cross-section study carried out in eight hospitals and 72 clinics and health posts. Results The study comprised of 885 randomly selected healthcare workers. The sample included medical doctors, nurses, laboratory staff, and dental staff and housekeeping staff. The reference group was a sample of housekeeping staff. The lifelong prevalence of needle-stick injuries was 48.9% (95% CI: 45.6, 52.2. Life-long prevalence was significantly higher in nurses (Adjusted Odds ratio [Adj. OR] = 4.1, 95% CI: 3.0, 5.7, medical doctors (Adj. OR = 4.2, 95% CI: 2.1, 8.4 compared with the reference. The prevalence of needlestick and sharp object injuries in six-month duration was 11.8% (95% CI: 9.6%, 14.0%. Nurses (Adj. OR = 3.5, 95% CI: 2.0, 6.1 were three times likely to sustain injuries in a six-month period compared with the reference group. Most injuries occurred at patient’s bedside and in the emergency departments. Disposable syringes caused most of the injuries, often during and immediately after a medical procedure. Conclusions: Healthcare workers in Botswana remain at risk of percutaneous exposure to needlestick and sharp object injuries. They are at an increased risk of bloodborne infections including HIV.

  6. Public Sector Unions and Privatization

    DEFF Research Database (Denmark)

    Foged, Søren Kjær; Aaskoven, Lasse

    2016-01-01

    Privatization varies considerably among local governments. One of the oft-listed explanations is the ability of public employees to block privatization. However, many studies on the influence of public employees on privatization do not use very precise measures of the influence of public employees...... Danish municipalities in 2012, we are able to measure the strength of the public eldercare union as well as the number of the public eldercare workers relative to the number of local voters. We find that the increased union strength measured in terms of union density at the municipal level leads...... to substantially and significantly less privatization through the voucher market. By comparison, the estimated relationship between the relative number of public workers and privatization does not reach statistical significance. Features of the voucher market and qualitative evidence suggest that the union...

  7. 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.

  8. NAICS Sector 92: Public Administration

    Science.gov (United States)

    Find the public administration industries EPA regulations affect, with their North American Industry Classification System (NAICS) code. On those pages you can find a list of laws and regulations that affect your industry as well as compliance information

  9. Food formulation and not processing level: Conceptual divergences between public health and food science and technology sectors.

    Science.gov (United States)

    Botelho, R; Araújo, W; Pineli, L

    2018-03-04

    Observed changes in eating and drinking behaviors in economically developing countries are associated with increase of obesity and related chronic diseases. Researchers from field of public health (PH) have attributed this problem to food processing and have created new food classification systems to support their thesis. These classifications conceptually differ from processing level concepts in food science, and state to people that food processing is directly related to nutritional impact of food. Our work aims to compare the concept of food processing from the standpoint of food science and technology (FST) and public health and to discuss differences related to formulation or level of processing of products and their impact on nutritional quality. There is a misconception between food processing/unit operation/food technology and formulation or recipes. For the public health approach, classification is based on food products selection and the use of ingredients that results in higher consumption of sugar, sodium, fat, and additives, whereas in FST, processing level is based on the intensity and amount of unit operations to enhance shelf life, food safety, food quality, and availability of edible parts of raw materials. Nutritional quality of a product or preparation is associated with formulation/recipe and not with the level of processing, with few exceptions. The impact of these recommendations on the actual comprehension of food processing and quality must be considered by the population.

  10. The psychosocial work environment and certified occupational health and safety management systems in the public sector – experience from two Danish municipalities

    DEFF Research Database (Denmark)

    Hasle, Peter; Hohnen, Pernille; Helbo, Anne

    2014-01-01

    Certified occupational health and safety management (OHSM) systems are expected to cover the psychosocial work environment. We studied certified OHSM systems implemented in two medium-sized to large Danish municipalities. The cases show that the process of adopting OHSM systems from...... their traditional base in manufacturing to a public sector with a focus on the psychosocial work environment is difficult and complex. The management system seems to help maintaining systematic OHS activities but the actors are still searching for ways to fit the systems to the peculiarities of the psychosocial...

  11. Disconnect Between Public Sector Management System and ...

    African Journals Online (AJOL)

    three regional governments, this article exposes how public sector management system (public finance and human resource management system) determines decentralization outcomes. It contends that outcomes of decentralization reforms are shaped not only by political and economic factors, as suggested in the ...

  12. Occupational stress and health-related quality of life among public sector bank employees: A cross-sectional study in Mysore, Karnataka, India.

    Science.gov (United States)

    Malamardi, Sowmya N; Kamath, Ramachandra; Tiwari, Rajnarayan; Nair, Binu Valsalakumari Sreekumaran; Chandrasekaran, Varalakshmi; Phadnis, Sameer

    2015-01-01

    Occupational morbidities have been estimated to cause an economic loss up to 10-20% of the gross national product of a country. It is an important cause of occupational morbidity and decreased quality of life (QOL) for the workers. The aim of the present study is to assess the level of occupational stress and its association with the QOL among the public sector bank employees. The present study was conducted among employees of public sector banks in Mysore district, Karnataka, India. A cross-sectional study design was used for the study. Job stress was measured by using occupational stress index (OSI) scale questionnaire and health-related QOL was measured using the short form 12 (SF-12) questionnaire. The sample size estimated for the study was 526 and cluster random sampling technique was used. Chi-square test was used to find the association between the study variables and level of stress. Multiple linear regression model was used to find the determinants of health-related QOL among the study subjects. The total number of the study subjects was 546 out of which 57% were males and 43% were females. The proportion of study subjects reporting to be current smokers was 4.2% and almost all study subjects reported occasional alcohol consumption. The mean physical component summary (PCS) score and mental component summary (MCS) using the original United States standardization were 47.90 and 48.30, respectively. The individuals with mild stress scored higher in both PCS and MCS than the individuals who had moderate to severe stress levels. There was significant association of health related quality of life with the age of the respondent,presence of at least one morbidity and level of stress with health-related QOL. This study has shown an association of occupational stress with the QOL. There is a need for interventions aimed at mitigating the occupational stress among employees of the banking sector.

  13. Barriers and Potential Improvements for Needle and Syringe Exchange Programs (NSPs in China: A Qualitative Study from Perspectives of Both Health and Public Security Sectors.

    Directory of Open Access Journals (Sweden)

    Fung Kuen Koo

    Full Text Available This study explores the acceptability, the barriers to the implementation of needle and syringe exchange programs (NSPs and the potential improvement strategies in China from the perspectives of governmental health and public security officials. Purposive sampling was used for recruitment of participants who had been involved in NSPs implementation. Semi-Structured individual interviews were conducted in Mandarin to address three aspects of NSPs: (1 participants' attitudes towards NSPs, (2 participants' opinions on the effectiveness and barriers of NSPs, and (3 suggestions for improving the program. Content analysis was used to analyse the translated interview data. A total of 68 participants from 12 Hunan counties were interviewed (34 from each of the Bureau of Health and the Narcotic Division. Both groups recognised the importance and effectiveness of NSPs in HIV prevention, but public security officials regarded NSPs as a temporary intervention in place of punitive measures. Most health officials (32/34 regarded the main barriers to its implementation as administrative and structural, whereas participants from Narcotics Division (n=24 questioned the legitimacy of NSPs and concerned about the poor management of drug users' risk behaviours. Close cooperation between the health and public security sectors, engagement of the drug user community and an enabling policy environment were reportedly to be critical for potential improvements of NSPs in China. Misconceptions about NSPs encourage drug users' addictive behaviour, and an unclear leadership and insufficient support de-motivate the participants from the Bureau of Health and the Narcotics Division to actively support the program implementation.

  14. 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...

  15. Public Sector Information Systems (PSIS)

    DEFF Research Database (Denmark)

    Brooks, Laurence; Zinner Henriksen, Helle; Janssen, Marijn

    2014-01-01

    face the challenge of advancing their policy-making practices to take advantage of these new developments. Many new tools and instruments are available that can help to improve policy-making, yet little is known about their costs, benefits, or contribution. The objective of this panel is to advance our......Policies are traditionally developed by experts with limited forms of stakeholder involvement. New technologies can change policy making practice through new methods of citizens’ engagement. As a result, the traditional boundaries between governments and the public are also changing. Policy makers...

  16. 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...

  17. 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...

  18. 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....

  19. 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 ...

  20. 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...

  1. 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....

  2. 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.

  3. Enhancing collaborative innovation in the public sector

    DEFF Research Database (Denmark)

    Sørensen, Eva; Torfing, Jacob

    2011-01-01

    demand for public innovation, and demonstrates how it can be enhanced through multiactor collaboration. The case for collaborative innovation is supported by insights from three different social science theories. The theoretical discussion leads to the formulation of an analytical model that can be used......Encouraged by the proliferation of governance networks and the growing demands for public innovation, this article aims to advance “collaborative innovation” as a cross-disciplinary approach to studying and enhancing public innovation. The article explains the special conditions and the growing...... in future studies of collaborative innovation in the public sector....

  4. Rethinking Information Systems in the Public Sector

    DEFF Research Database (Denmark)

    Medaglia, Rony

    2014-01-01

    This section of Information Polity consists of papers presented during the workshop “Rethinking Information Systems in the Public Sector: Bridging Academia and Public Service”. The workshop was held on 8 June 2014 in Tel Aviv, Israel, in conjunction with the European Conference on Information...... Systems (ECIS 2014), and it is part of the activities of the Special Interest Group for eGovernment (SIGeGov) of the Association for Information Systems (AIS)....

  5. 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.

  6. Ecological modernisation in the public catering sector

    DEFF Research Database (Denmark)

    Nielsen, Thorkild; Kristensen, Niels Heine; Mikkelsen, Bent Egberg

    2009-01-01

    In this paper we use the concept of ecological modernisation as frame to understand the relationship between two parallel developments in the public catering sector, namely the sustainability discourse and the rationalisation discourse. We argue that the two tendencies are increasingly merging...

  7. Management Control Packages in Public Sector Organizations

    NARCIS (Netherlands)

    van der Kolk, Berend

    2016-01-01

    This thesis examines configurations of management control (MC) packages in public sector organizations, and how they relate to employee motivation and behavior. Using multiple case studies and a survey study, this thesis contributes to the extant literature in three ways. First, it enhances the

  8. Pay for performance in the public sector

    DEFF Research Database (Denmark)

    Bregn, Kirsten

    2015-01-01

    This paper contributes to an explanation of why pay for performance (PFP) in the public sector has difficulties in functioning properly and why, despite the difficulties, its use is continued. To do so, the paper draws on insights from behavioural economics. The explanation focuses on cognitive...

  9. Governance and innovation in public sector services

    DEFF Research Database (Denmark)

    Scupola, Ada; Zanfei, Antonello

    2015-01-01

    Based on a longitudinal case study of ICT adoption and e-services development in a Danish library, we examine how governance modes affect technical and organizational change in the public sector. We contribute to extant literature on the links between governance and innovation by highlighting three...

  10. Behavioral economics and the public sector

    NARCIS (Netherlands)

    Weber, M.G.

    2015-01-01

    This thesis consists of four essays dealing with topics that are relevant for the public sector. The essays cover diverse issues of economics partly overlapping with political science. The topics reach from the taxation of labor over monetary policy to preferences over voting institutions.

  11. Social media campaigns that make a difference: what can public health learn from the corporate sector and other social change marketers?

    Science.gov (United States)

    Freeman, Becky; Potente, Sofia; Rock, Vanessa; McIver, Jacqueline

    2015-03-30

    A great deal of enthusiasm and interest exists in using social media for public health communications, but few research studies have examined its success in promoting and adopting protective health behaviours. To begin to understand how best to develop effective online social marketing campaigns, this paper provides a summary of success factors and key lessons learnt from selected social media campaign case studies. Case study review Methods: A selection of case studies was reviewed for lessons in campaign development, delivery and evaluation from both the corporate and public health sectors. Information about the objective of the campaign, the tactics used and the lessons learnt was extracted from each case study. Lessons learnt from across the case studies were then sorted according to themes. Lessons from the nine case studies selected were categorised into eight themes: planning, use of social media tools, community, content, personal benefits, promotion, costs and challenges. Outcome evaluation data were lacking in the case studies. Overall, the nine case studies show that social media hold promise in changing user behaviours and that social media are highly effective in recruiting participants and motivating them to take small, concrete actions. The case studies also demonstrate that there is room in social media for targeted, inexpensive, small-scale projects, as well as large, well-funded, mass-reach marketing blitzes. Social media campaign process and impact evaluation measures are readily available. Outcome evaluation models and measures are needed to better assess the effectiveness of social media campaigns in changing health behaviours.

  12. 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.

  13. ETHICAL DILEMMAS IN THE PUBLIC SECTOR

    Directory of Open Access Journals (Sweden)

    Silvia PUIU

    2015-06-01

    Full Text Available The article offers an insight on the ethical dilemmas specific to a public sector and brings some suggestions for coping with these. Ethics management is a complex system that deals also with ethical dilemmas. The instruments and tools of ethics management are helpful in dealing with these issues. There are a lot of cases in which public employees do not know what to do or how to react in a certain situation, so, a debate on this subject is very useful for people working in public institutions.

  14. 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 ...

  15. 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....

  16. Public sector managers and work stress

    DEFF Research Database (Denmark)

    Møller, Ann-Kristina Løkke; Madsen, Henning

    2014-01-01

    Purpose: The purpose of this paper is to identify the determinants of perceived work-related stress among public sector managers. Design/methodology/approach: A general questionnaire-based survey of managers at all managerial levels in Danish organizations concerning the content of their job...... and the way it is practiced (n=1,500, response rate 72 per cent) are applied. For the purpose of this paper only specific information related to the perception of work stress among public sector managers is analyzed (n=400). Findings: The perception of stress are influenced by factors like gender, managerial...... - in a positive as well as a negative way. However, the findings point to issues which call for more in-depth analyses. Practical implications: The identified significant determinants influencing the perception of stress point to issues where preventive initiatives can be taken. Social implications: Since work-related...

  17. 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 ...

  18. First line management in the public sector

    DEFF Research Database (Denmark)

    Voxted, Søren

    The paper will examines and discusses the results from a structured observational study, wherein 50 first-line managers from the public sector in Denmark in five areas of employment where observed. These observational studies are a key contribution in the ‘greenhouse for management’ project...... in first-line managers’ practice. Answering this question helps to illustrate and understand the degree of professionalism in terms of managers' usage of time....

  19. Inequalities in health within the health sector.

    OpenAIRE

    Balarajan, R.

    1989-01-01

    Mortality among men employed in the health sector was examined using data surrounding the 1971 (1970-2) and 1981 (1979-83) censuses to assess the differences between social classes in the health service and to study changes over a decade. Relative to men in England and Wales, mortality in the 1980s was significantly lower among dentists (standardised mortality ratio 66), doctors (69), opticians (72), and physiotherapists (79) and significantly higher among hospital porters (151), male nurses ...

  20. The public sector pay gap in Italy

    OpenAIRE

    Giordano Raffaela

    2010-01-01

    I investigate the public-private pay gap using Italian microdata covering the period 1980-2006. Even after controlling for observable characteristics of the labour force, I find a positive wage premium for the public sector, almost negligible during the eighties and averaging at about 12 percent in the period 1993-2006. While the pay gap for women and workers in southern regions turns out to be higher than the average in the whole sample period, the greater advantage from working in the publi...

  1. 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.

  2. 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.

  3. 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 ...

  4. How shall we examine and learn about public-private partnerships (PPPs) in the health sector? Realist evaluation of PPPs in Hong Kong.

    Science.gov (United States)

    Wong, Eliza L Y; Yeoh, Eng-Kiong; Chau, Patsy Y K; Yam, Carrie H K; Cheung, Annie W L; Fung, Hong

    2015-12-01

    The World Health Organization advocates the goal of universal coverage of health systems to ensure that everyone can avail the services they need and are protected from the associated financial risks. Governments are increasingly engaging and interacting with the private sector in initiatives collectively referred to as public-private partnerships (PPPs) to enhance the capacity of health systems to meet this objective. Understanding the values that motivate partners and demonstrating commitment for building relationships were found to be key lessons in building effective PPPs; however there, remain many research gaps. This study focusses on the practice of PPPs at the inter-organisational (meso) level and interpersonal (micro) level in Hong Kong Special Administrative Region (HKSAR). The influence of the structural components of different PPPs on stakeholder interpretation and actions, as well as the eventual outcomes of the PPPs, is examined, in terms of a realist evaluation, which applies a context-mechanism-outcome configuration as the research methodology. Seven key factors initiating commitment in a partnership, critical for sustainable PPPs, were identified as follows: (1) building of trust; (2) clearly defined objectives and roles; (3) time commitment; (4) transparency and candid information, particularly in relation to risk and benefit; (5) contract flexibility; (6) technical assistance or financial incentive behind procedural arrangements; and (7) the awareness and acceptability of structural changes related to responsibility and decisions (power and authority). Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  5. 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...

  6. 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.

  7. 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.

  8. 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.

  9. The Public Sector and Obligation to Contract

    DEFF Research Database (Denmark)

    Olesen, Karsten Naundrup; Indén, Tobias

    2016-01-01

    The paper concerns the situation where public sector bodies are forced to enter into contracts. These obligations to contract are analysed from two angles. First, the paper offers an analysis of the reasons for imposing such obligations to contract under Swedish and Danish law. Secondly the paper...... discusses some consequences of the public entities’ obligations to contract, more specific consequences for the use of rules that usually regulate contracts and the fact that obligations to contract imposed on public entities establish a new market and at the same time the obligations deprive the entities...... of the freedom to contract which is a fundamental to market behaviour. Finally attention is drawn to the fact that obligations to contract are also imposed on private entities. The paper takes Swedish and Danish regulations as a point of departure and provides an insight into regulations from these two countries...

  10. An exploratory study on equity in funding allocation for essential medicines and health supplies in Uganda's public sector.

    Science.gov (United States)

    Kusemererwa, Donna; Alban, Anita; Obua, Ocwa Thomas; Trap, Birna

    2016-08-30

    To ascertain equity in financing for essential medicines and health supplies (EMHS) in Uganda, this paper explores the relationships among government funding allocations for EMHS, patient load, and medicines availability across facilities at different levels of care. We collected data on EMHS allocations and availability of selected vital medicines from 43 purposively sampled hospitals and the highest level health centers (HC IV), 44 randomly selected lower-level health facilities (HC II, III), and from over 400 facility health information system records and National Medical Stores records. The data were analyzed to determine allocations per patient within and across levels of care and the effects of allocations on product availability. EMHS funding allocations per patient varied widely within facilities at the same level, and allocations per patient between levels overlapped considerably. For example, HC IV allocations per patient ranged from US$0.25 to US$2.14 (1:9 ratio of lowest to highest allocation), and over 75 % of HC IV facilities had the same or lower average allocation per patient than HC III facilities. Overall, 43 % of all the facilities had optimal stock levels, 27 % were understocked, and 30 % were overstocked. Using simulations, we reduced the ratio between the highest and lowest allocations per patient within a level of care to less than two and eliminated the overlap in allocation per patient between levels. Inequity in EMHS allocation is demonstrated by the wide range of funding allocations per patient and the corresponding disparities in medicines availability. We show that using patient load to calculate EMHS allocations has the potential to improve equity significantly. However, more research in this area is urgently needed. The article does not report any results of human participants. It is implemented in collaboration with the Uganda's Ministry of Health, Pharmacy Division.

  11. 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....

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

    African Journals Online (AJOL)

    Nigeria's healthcare sector over the years has continued to degenerate with health indicators ... in service delivery as well as increases access to quality healthcare. ... Key words: Nigeria, Healthcare Sector, Health Outcomes, Health Indicators, ...

  13. 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.

  14. Stress Factors among Nurses at the Primary and Secondary Level of Public Sector Health Care: The Case of Slovenia

    OpenAIRE

    Jasmina Starc

    2018-01-01

    BACKGROUND: Working in nursing is mentally and physically demanding and is one of the most stressful professions. AIM: To determine the basic causes of stress and examine the symptoms of stress among healthcare professionals at the primary and secondary level of health care. MATERIAL AND METHODS: The research was based on the descriptive and causal non-experimental method of empirical research. The independent samples t-test was used. RESULTS: The survey results have shown that th...

  15. Evaluating the scope for energy-efficiency improvements in the public sector: Benchmarking NHSScotland's smaller health buildings

    International Nuclear Information System (INIS)

    Murray, Joe; Pahl, O.; Burek, S.

    2008-01-01

    The National Health Service in Scotland (NHSScotland) has, in recent years, done much to reduce energy consumption in its major healthcare buildings (hospitals). On average, a reduction of 2% per year has been achieved since 2000, based on hospital buildings. However, there had been little or no attention paid to smaller premises such as health centres, clinics, dentists, etc. Such smaller healthcare buildings in Scotland constitute 29% of the total treated floor area of all NHSScotland buildings and, therefore, may contribute a similar percentage of carbon and other emissions to the environment. By concentrating on a sample of local health centres in Scotland, this paper outlines the creation of an energy benchmark target, which is part of a wider research project to investigate the environmental impacts of small healthcare buildings in Scotland and the scope for improvements. It was found that energy consumption varied widely between different centres but this variation could not be linked to building style, floor area or volume. Overall, it was found that a benchmark of 0.2 GJ/m 3 would be challenging, but realistic

  16. PUBLIC SECTOR TRANSPARENCY:A CONCEPTUAL DISSECTION

    Directory of Open Access Journals (Sweden)

    Mara Andreea SÎNTEJUDEANU

    2014-06-01

    Full Text Available The concept of transparency has increasingly attracted the attention of academic, political and business areas. Many studies have demonstrated the need for adopting this corporate governance principle also in the public sector, a phenomenon that has become widespread at international level. The academic study field defines transparency as the ability to look clearly through the window of an institution. Starting from this statement, the research focuses on the importance of transparency in public governance and on the framework for identifying and assessing this concept. Furthermore, this paper also analysis the limits of this notion in order to maintain its significance and effectiveness. Thus, based on the literature review, this study summarizes the opinions and arguments of various authors in the field regarding the notion of transparency in the public sector. At the same time, it analysis the conclusions of empirical studies on this topic. The results of the study reveal the importance and necessity of information disclosure among different users for increasing citizens' trust in government and achieving good governance. However, the positive aspects of transparency tend to be overestimated and considering the ambiguity of this concept it should be carefully handled.

  17. Legitimating Change in the Public Sector

    DEFF Research Database (Denmark)

    Hyndman, Noel; Liguori, Mariannunziata; Meyer, Renate E.

    2017-01-01

    This paper explores the deployment of rhetorical legitimation strategies during public-sector accounting reforms by investigating how organizational actors justify related changes in the central governments of the United Kingdom (UK), Italy and Austria. The study shows that changes are largely...... legitimated (and rarely delegitimated) by key actors, with authorization strategies dominating. Country differences and actors’ professional backgrounds also impact upon the use of legitimation strategies, with those from an accounting background and working in the UK being more likely to justify change...... in terms of rationalization and normalization. Italian and Austrian actors more frequently resort to authorization strategies to explain accounting change....

  18. 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.

  19. Abatement of tropospheric ozone: effects of strategies to improve air quality on public health and other sectors.

    Science.gov (United States)

    Guest, C S; Morgan, P; Moss, J R; Woodward, A J; McMichael, A J

    1996-06-01

    The National Health and Medical Research Council's air quality goal for ozone in the troposphere (near the earth's surface) is 0.12 parts per million (ppm), averaged over one hour, similar to the United States standard, but less stringent than the guideline for Europe. We aimed to identify the environmental, economic and social changes that would be associated with changing the goal. Methods included literature review, economic assessments and group interviews. The group to benefit from lower exposures may include outdoor workers, school children and people not in regular day-time work indoors, because ozone is most prevalent during the daylight hours of the warmer months. A lower level could improve the yield of some crops. The causes and effects of tropospheric ozone are not appreciated except among groups with relevant commercial, industrial or scientific experience. However, the consultations identified frustration about the social problems caused by dependence on private motor vehicles. Short-term costs of compliance with a more stringent goal would fall principally on the users of transport. The value of the benefits was enough for many to support making the ozone goal more stringent, but those who required a demonstration of financial benefit (even including savings of health care costs) did not support any change to the goal. Based primarily on averted detriment to health, we recommend the more stringent level of 0.08 ppm (one-hour average) as the goal for the year 2005 in Australia and elsewhere. The addition of a goal with longer averaging time is also proposed.

  20. Public Health

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

    ian health ministry, and the Canadian. International ... Tanzanian and Canadian researchers began work on ... information on the major causes of death ... The effects have been dramatic. Accord- ... destroy mosquito breeding grounds, such.

  1. The importance of public sector health facility-level data for monitoring changes in maternal mortality risks among communities: the case of pakistan.

    Science.gov (United States)

    Jain, Anrudh K; Sathar, Zeba; Salim, Momina; Shah, Zakir Hussain

    2013-09-01

    This paper illustrates the importance of monitoring health facility-level information to monitor changes in maternal mortality risks. The annual facility-level maternal mortality ratios (MMRs), complications to live births ratios and case fatality ratios (CFRs) were computed from data recorded during 2007 and 2009 in 31 upgraded public sector health facilities across Pakistan. The facility-level MMR declined by about 18%; both the number of Caesarean sections and the episodes of complications as a percentage of live births increased; and CFR based on Caesarean sections and episodes of complications declined by 29% and 37%, respectively. The observed increases in the proportion of women with complications among those who come to these facilities point to a reduction in the delay in reaching facilities (first and second delays; Thaddeus & Maine, 1994); the decrease in CFRs points to improvements in treating obstetric complications and a reduction in the delay in receiving treatment once at facilities (the third delay). These findings point to a decline in maternal mortality risks among communities served by these facilities. A system of woman-level data collection instituted at health facilities with comprehensive emergency obstetric care is essential to monitor changes in the effects of any reduction in the three delays and any improvement in quality of care or the effectiveness of treating pregnancy-related complications among women reaching these facilities. Such a system of information gathering at these health facilities would also help policymakers and programme mangers to measure and improve the effectiveness of safe-motherhood initiatives and to monitor progress being made toward achieving the fifth Millennium Development Goal.

  2. [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.

  3. Bureaucracy and Corruption in Public Sector Accounting

    Directory of Open Access Journals (Sweden)

    Luminiţa IONESCU

    2014-03-01

    Full Text Available Bureaucracy and corruption represent major causes of fiscal crises, and structural unemployment all over the world. According to WEF 2014 Global Risk Report, the bureaucracy has a high level in European countries and appreciation is growing that high historical rates of economic progress, especially those experienced by emerging markets, may not be sustainable in the future.  Corruption is growing in a changing global environment and is considered one of the most important geopolitical risks. Most of the time, corruption is associated with fraud and money laundering. European growing cities and public administration have a strong influence over bureaucracy in public sector accounting and more time to process the accounting and fiscal information.

  4. Open Source in Canada's Public Sector

    Directory of Open Access Journals (Sweden)

    Evan Leibovitch

    2008-03-01

    Full Text Available The story of the growth of open source use in Canada has been far more a matter of evolution than revolution, so quiet in its pace that its progress has been difficult to measure. This has posed many challenges to Canadian open source advocates in their efforts to ensure that their country does not lag behind the rest of the world in understanding the social and business benefits open source provides. Perhaps some of the leading soldiers in the trenches might be our civil servants who protect the public purse. In addition to managing and minimizing the costs of delivering necessary services, public sector projects should also advance the social good through the delicate balance of transparency and efficiency.

  5. Stress Factors among Nurses at the Primary and Secondary Level of Public Sector Health Care: The Case of Slovenia

    Directory of Open Access Journals (Sweden)

    Jasmina Starc

    2018-02-01

    Full Text Available BACKGROUND: Working in nursing is mentally and physically demanding and is one of the most stressful professions. AIM: To determine the basic causes of stress and examine the symptoms of stress among healthcare professionals at the primary and secondary level of health care. MATERIAL AND METHODS: The research was based on the descriptive and causal non-experimental method of empirical research. The independent samples t-test was used. RESULTS: The survey results have shown that those employed in nursing are exposed to stressful situations on a daily basis, most often involving psychological or physical violence in the workplace (M = 4.2, dealing with death (M = 3.9, lack of personnel (M = 3.9 and a high frequency of patients (M = 3.8. The following stress factors cause women greater stress than they do men: relationships among co-workers (t = 2.745; p = 0.006, psychological or physical violence in the workplace (t = 3.492; p = 0.001, and working with difficult patients (t = 2.427; p = 0.017. CONCLUSION: To manage risks, employees and employers must work together and establish a suitable safety and organisational culture, which would enable them to manage and reduce stress.

  6. Stress Factors among Nurses at the Primary and Secondary Level of Public Sector Health Care: The Case of Slovenia.

    Science.gov (United States)

    Starc, Jasmina

    2018-02-15

    Working in nursing is mentally and physically demanding and is one of the most stressful professions. To determine the basic causes of stress and examine the symptoms of stress among healthcare professionals at the primary and secondary level of health care. The research was based on the descriptive and causal non-experimental method of empirical research. The independent samples t-test was used. The survey results have shown that those employed in nursing are exposed to stressful situations on a daily basis, most often involving psychological or physical violence in the workplace (M = 4.2), dealing with death (M = 3.9), lack of personnel (M = 3.9) and a high frequency of patients (M = 3.8). The following stress factors cause women greater stress than they do men: relationships among co-workers (t = 2.745; p = 0.006), psychological or physical violence in the workplace (t = 3.492; p = 0.001), and working with difficult patients (t = 2.427; p = 0.017). To manage risks, employees and employers must work together and establish a suitable safety and organisational culture, which would enable them to manage and reduce stress.

  7. 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.

  8. 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....

  9. 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.

  10. 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.

  11. Knowledge, attitudes, and practices of public sector primary health care physicians of rural north karnataka towards obesity management

    Directory of Open Access Journals (Sweden)

    Manjunath S Somannavar

    2014-01-01

    Full Text Available Introduction: Obesity is a risk factor for cardiovascular disease (CVD, diabetes mellitus (DM, and hypertension (HTN. In an era of rapidly growing prevalence of obesity, it is important to explore the current knowledge, attitude, and practices of primary care physicians. Materials and Methods: Study participants were medical officers (MOs of primary health centers in three districts of North Karnataka. The questionnaire was developed by a review of literature in the field and validated with five participants for scope, length, and clarity. Results/Discussion: Of the 102 participants, only 15% were aware about the burden of obesity in India. HTN, DM, and CVD were indicated as comorbidities by 73, 78, and 60 participants, respectively. Only 25 and 12 participants indicated appropriate body mass index (BMI cut-off values for overweight and obesity diagnosis. Of the 102 participants, 54 were not aware of the guidelines for obesity management. Practices and attitudes of the participants were encouraging. Nearly all of them felt that the adults with BMI within the healthy range should be encouraged to maintain their weight and, three-fourth of them agreed that most overweight persons should be treated for weight loss and small weight loss can achieve major medical benefit. However, nearly half of the participants′ responses were stereotypical as they felt only obese and overweight with comorbidities should be treated for weight loss. Two-thirds of them use BMI to diagnose overweight/obese and nearly all of them advice their patients to increase physical activity and restrict fat. Most of the participants were advising their patients to restrict sugar intake, increase fruits and vegetable consumption, reduce red meat, and avoid alcohol consumption. Conclusion: Present study exposed the lack of knowledge regarding obesity. However, practices and attitudes of the participants were promising. There is a need of in-service training to MOs to further

  12. 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.

  13. 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...

  14. 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.

  15. Information and adaptation in a public service sector: The example of the Dutch Public housing sector

    NARCIS (Netherlands)

    Koolma, H.M.

    2013-01-01

    A public service sector can be conceived as a multi agent system subordinated to a principal, mostly a department of a national government. The agents are relative autonomous and have decisional discretion, as long as they respect the boundaries setup by law and legislation. The hierarchy is less

  16. 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.

  17. 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.

  18. 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…

  19. 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

  20. 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...

  1. 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...

  2. Experiences in tick control by acaricide in the traditional cattle sector in Zambia and Burkina Faso: possible environmental and public health implications

    Directory of Open Access Journals (Sweden)

    Daniele De Meneghi

    2016-11-01

    Full Text Available Livestock, especially cattle, play a paramount role in agriculture production systems, particularly in poor countries throughout the world. Ticks and tick-borne diseases (TBDs have an important impact on livestock and agriculture production in Sub-Saharan Africa. The authors review the most common methods used for the control of ticks and TBDs. Special emphasis is given to the direct application of acaricides to the host animals. The possible environmental and public health adverse effects (i.e. risks for the workers, residues in the environment, and in food products of animal origin are mentioned. The authors present two case studies, describing different field experiences in controlling ticks in two African countries. In Zambia (Southern Africa, a strategic dipping regime was used to control Rhipicephalus appendiculatus ticks, vectors of theileriosis, a deadly disease affecting cattle in the traditional livestock sector in Southern Province. The dipping regime adopted allowed to reduce the tick challenge and cattle mortally rate, and at the same time, to employ less acaricide as compared to the intensive dipping used so far, without disrupting the building-up of enzootic stability. In Burkina Faso (West Africa, where dipping was never used for tick control, an acaricide footbath was employed as an alternative method to the traditional technique used locally (portable manual sprayers. This was developed from field observations on the invasion/attachment process of the Amblyomma variegatum ticks –vector of cowdriosis- on the animal hosts, leading to a control method aimed to kill ticks temporarily attached to the interdigital areas before their permanent attachment to the predilection sites. This innovative method has been overall accepted by the local farmers. It has the advantage of greatly reducing costs of treatments and has a minimal environmental impact, making footbath a sustainable and replicable method, adoptable also in other West

  3. 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...

  4. Scaling up ART adherence clubs in the public sector health system in the Western Cape, South Africa: a study of the institutionalisation of a pilot innovation.

    Science.gov (United States)

    MacGregor, Hayley; McKenzie, Andrew; Jacobs, Tanya; Ullauri, Angelica

    2018-04-25

    In 2011, a decision was made to scale up a pilot innovation involving 'adherence clubs' as a form of differentiated care for HIV positive people in the public sector antiretroviral therapy programme in the Western Cape Province of South Africa. In 2016 we were involved in the qualitative aspect of an evaluation of the adherence club model, the overall objective of which was to assess the health outcomes for patients accessing clubs through epidemiological analysis, and to conduct a health systems analysis to evaluate how the model of care performed at scale. In this paper we adopt a complex adaptive systems lens to analyse planned organisational change through intervention in a state health system. We explore the challenges associated with taking to scale a pilot that began as a relatively simple innovation by a non-governmental organisation. Our analysis reveals how a programme initially representing a simple, unitary system in terms of management and clinical governance had evolved into a complex, differentiated care system. An innovation that was assessed as an excellent idea and received political backing, worked well whilst supported on a small scale. However, as scaling up progressed, challenges have emerged at the same time as support has waned. We identified a 'tipping point' at which the system was more likely to fail, as vulnerabilities magnified and the capacity for adaptation was exceeded. Yet the study also revealed the impressive capacity that a health system can have for catalysing novel approaches. We argue that innovation in largescale, complex programmes in health systems is a continuous process that requires ongoing support and attention to new innovation as challenges emerge. Rapid scaling up is also likely to require recourse to further resources, and a culture of iterative learning to address emerging challenges and mitigate complex system errors. These are necessary steps to the future success of adherence clubs as a cornerstone of

  5. 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...

  6. Public Sector Reforms In Africa: A Philosophical Re-Thinking

    African Journals Online (AJOL)

    seriane.camara

    2009-05-14

    May 14, 2009 ... sector management in the name of PSR. ... the importance attached to this agenda, the World Bank created a fully fledged. Public Sector Group in 1997. ..... There is also a need to exploit indigenous knowledge in carrying out.

  7. 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.

  8. 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.

  9. Public Health Departments

    Data.gov (United States)

    Department of Homeland Security — State and Local Public Health Departments in the United States Governmental public health departments are responsible for creating and maintaining conditions that...

  10. Gender Issues in Health Sector

    Directory of Open Access Journals (Sweden)

    Prakash Prabhakarrao Doke

    2015-04-01

    Full Text Available Gender wise analysis of data brings out biological, behavioural and social variables which indicate inequality in the health parameters in male and female sex. There is discrimination against women. Right to birth is denied by sex selective elimination, right to survival is denied by the neglect of girl child resulting in declining trend of child sex ratio which has reached an alarming low level of 914 in 2011 in spite of the fact that the female sex is biologically stronger. The mortality and morbidity indicators are unfavourable to the females. Maternal mortality in developing countries including India is unacceptably high. There is a failure of achievement of Millennium Development Goals in relation to maternal mortality and gender equality and empowerment of women. Crime against women is increasing. Violence is domestic or at workplace or occurring in public places. Social factors like male dominance and subordinate status of women make them vulnerable to unfair treatment, discrimination, denial of basic human rights to survival, education, health, inheritance, etc. The preventive measures in the form of education of masses for effective change in behaviour against gender discrimination, provision of facilities for achieving gender equality, and legislative measures for controlling violence against women at domestic and public level need intensification to achieve social justice of gender equality.

  11. 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 ...

  12. 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...

  13. 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

  14. 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...

  15. 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.

  16. 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...

  17. 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.

  18. Desigualdades en la provisión de asistencia médica en el sector público de salud en Chile Inequalities in public health care provision in Chile

    Directory of Open Access Journals (Sweden)

    Oscar Arteaga

    2002-08-01

    Full Text Available Entre los años 1997 y 1999, el Ministerio de Salud de Chile impulsó la realización de estudios de la red asistencial en cada una de las 13 regiones del país, con el fin de poder orientar en ellas el desarrollo del sector salud y la cartera de inversiones. En este artículo se analizan algunos resultados de estos estudios. La cobertura del aseguramiento presenta variaciones geográficas, de edad y género. La atención médica ambulatoria y de hospitalización en el sector público presenta importantes variaciones geográficas. Sólo alrededor de un 20% de la capacidad total de producción de egresos de los hospitales de referencia nacional estaría siendo ofrecido al 60% de la población chilena que vive en regiones distintas de la Región Metropolitana. La asignación de recursos financieros para el nivel primario de atención muestra que las comunas que destinan mayores aportes per capita a salud no serían aquellas con mayor necesidad. La complementariedad de los sectores público y privado, así como el fortalecimiento de la autoridad sanitaria del Ministerio de Salud son ejes de desarrollo futuro del sector para mejorar la respuesta global del sistema de salud a las necesidades de la población.From 1997 to 1999, the Chilean Ministry of Health conducted studies on the health care networks in each of the country's 13 regions in order to help plan regional health sector development and define investment projects. Health insurance coverage displayed major geographic, age, and gender variations. Out-patient and in-patient medical care in the public sector showed substantial geographic variations. According to patient discharge records from national referral hospitals, only some 20% of total health care capability is used to treat 60% of the Chilean population living in regions outside the Greater Metropolitan area. Analysis of primary care funding shows that municipalities allocating the highest per capita funds are not the ones with the

  19. 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

  20. 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

  1. Perceived Impact of Health Sector Reform on Motivation of Health ...

    African Journals Online (AJOL)

    Perceived Impact of Health Sector Reform on Motivation of Health Workers and Quality of Health Care in Tanzania: the Perspectives of Healthcare Workers and District Council Health Managers in Four Districts.

  2. 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.

  3. 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.

  4. 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...

  5. 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

  6. Staff Indiscipline and Productivity in the Public Sector in Nigeria ...

    African Journals Online (AJOL)

    Staff Indiscipline and Productivity in the Public Sector in Nigeria. ... acts of indiscipline which characterize contemporary public organizations in Nigeria. ... to regularize the payment of workers' salaries and wages to increase their productivity.

  7. 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...

  8. 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.

  9. Wage Gaps Between the Public and Private Sectors in Spain.

    Science.gov (United States)

    Lassibille, Gerard

    1998-01-01

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

  10. 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

  11. Public and Private Sector Managers: Are They Really That Different?

    Science.gov (United States)

    1982-04-01

    16, 17, 18, or equivalent public law positions) and private sector managers and executives in terms of job content, job characteristics, and...2) both groups of managers indicate that they do not have time for reflective, systematic planning, and (3) public and private sector managers agree

  12. 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

  13. 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.

  14. 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.

  15. Information in the public health sector from an anthropological perspective: a study carried out in Minas Gerais, Brazil - DOI: 10.3395/reciis.v3i3.287en

    Directory of Open Access Journals (Sweden)

    José Wanderlei Novato Silva

    2009-09-01

    Full Text Available This study examines the relationship between the organizational culture of municipal health secretariats of the State of Minas Gerais, Brazil – from the perspective of managers and employees - and how these players deal with information in the health sector. Organizational culture was een as a shared means of work that established forms of “informational behavior”, and values and principles that comprise an “informational culture”. This culture was analyzed by taking into consideration, among its external constraints, the local, regional, national and global culture levels. The methodology comprised a qualitative analysis of the health ecretariats of three municipalities deliberately selected. Results showed several different aspects concerning how departments deal with health-related information - in line with aspects of state and national cultures, which oscillate between modernity and backwardness. The study was considered “anthropological” because the author based his analysis on concepts originating from this field of knowledge. The perception of the transdisciplinarity of information in the health sector - political, technical, social, cultural, economic and administrative – intended to understand how the practices and concepts of the public health sector are the bearers of multiple socially conditioned meanings, aiming at broadening the concept of “anthropology of information”.

  16. 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.

  17. 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.

  18. 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.

  19. Public-private sector earnings differentials in a transition economy

    OpenAIRE

    Laušev, Jelena

    2011-01-01

    The aim of this thesis is to analyse how economic transition affected earnings differentials in Eastern European economies. In particular, as the public sector was the sole employer in the pre-transition period, the analysis of public sector pay setting is crucial to understanding how privatisation affected the labour market during the transition.\\ud \\ud The central idea of the first essay is to develop a theoretical model that explains the pay setting behaviour of the employer in the public ...

  20. Gender Wage Differentials in Private and Public Sector Jobs

    OpenAIRE

    Zweimuller, Jopsef; Winter- Ebmer, Rudolf

    1993-01-01

    In this study gender wage differentials in private and public sector jobs in Austria are calculated. Occupational attainment is considered as endogeneous by the use of an ordered response model. Results show that wage discrimination is also present in the public sector,though on a lower level. Both in private firms and for public servants a substantial part of this unwarranted differential is due to unequal professional advancement.

  1. 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.

  2. 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

  3. Public entrepreneurship as innovative management strategy in the public sector : a public choice-approach

    OpenAIRE

    van Mierlo, J.G.A.

    1996-01-01

    Paper Originally Presented at the 65th Annual Conference of the Southern Economic Association , Fairmont Hotel, New Orleans, Louisiana, United States of America, November 18-20, 1995. Bureaucratic service organisations in the public sector are increasingly loosing their previous comfortable monopoly positions in providing services to the public, due to radical structural changes in modern society. The public finance of their services by politicians ordering public services as elected represen...

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

    NARCIS (Netherlands)

    Driessen Mareeuw, F.A. van den; Vaandrager, L.; Klerkx, L.; Naaldenberg, J.; Koelen, M.

    2015-01-01

    BACKGROUND: 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

  5. Using Disability-Adjusted Life Years and Cost-Effectiveness Analysis to define Priorities for the Public Health Care Sector in Zimbabwe

    DEFF Research Database (Denmark)

    Hansen, Kristian Schultz

    by estimates from epidemiological studies from other settings if no Zimbabwean sources were available. Disease and public health experts were consulted about the identification of the best possible sources of information, the quality of these sources and the data adjustments made. Epidemiological information...

  6. 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...

  7. 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...

  8. 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...

  9. 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....

  10. 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...

  11. 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.

  12. 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.

  13. Job factors and Work Outcomes of Public Sector Expatriates

    DEFF Research Database (Denmark)

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

    2009-01-01

     While the literature on private sector expatriates is burgeoning, research on public sector expatriates is scant, despite their increasing numbers. This is unfortunate, since these two groups of expatriates may face different work conditions at their foreign assignment. The target group for this...

  14. The private sector and public space in Dutch city centres

    NARCIS (Netherlands)

    Melik, R.G. van; Aalst, I. van; Weesep, J. van

    2009-01-01

    Relatively rare in the Netherlands. The public sector has traditionally played a central role in spatial planning and development. Since the 1980s, however, local authorities have been sharing the responsibility for urban development with the private sector. This article explores the viability of

  15. 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.

  16. The impact of rationing of health resources on capacity of Australian public sector nurses to deliver nursing care after-hours: a qualitative study.

    Science.gov (United States)

    Henderson, Julie; Willis, Eileen; Toffoli, Luisa; Hamilton, Patricia; Blackman, Ian

    2016-12-01

    Australia, along with other countries, has introduced New Public Management (NPM) into public sector hospitals in an effort to contain healthcare costs. NPM is associated with outsourcing of service provision, the meeting of government performance indicators, workforce flexibility and rationing of resources. This study explores the impact of rationing of staffing and other resources upon delivery of care outside of business hours. Data was collected through semistructured interviews conducted with 21 nurses working in 2 large Australian metropolitan hospitals. Participants identified four strategies associated with NPM which add to workload after-hours and impacted on the capacity to deliver nursing care. These were functional flexibility, vertical substitution of staff, meeting externally established performance indicators and outsourcing. We conclude that cost containment alongside of the meeting of performance indicators has extended work traditionally performed during business hours beyond those hours when less staffing and material resources are available. This adds to nursing workload and potentially contributes to incomplete nursing care. © 2016 John Wiley & Sons Ltd.

  17. 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.

  18. 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 ...

  19. '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

  20. 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.

  1. Gender Issues in Health Sector

    OpenAIRE

    Prakash Prabhakarrao Doke

    2015-01-01

    Gender wise analysis of data brings out biological, behavioural and social variables which indicate inequality in the health parameters in male and female sex. There is discrimination against women. Right to birth is denied by sex selective elimination, right to survival is denied by the neglect of girl child resulting in declining trend of child sex ratio which has reached an alarming low level of 914 in 2011 in spite of the fact that the female sex is biologically st...

  2. Public Sector Reforms In Africa: A Philosophical Re-Thinking

    African Journals Online (AJOL)

    seriane.camara

    2009-05-14

    May 14, 2009 ... and impact on their people provided these policies are part of the new public ... consequent perpetual slavery. So, the two ..... officials are shareholders. ..... those prevailing in non-modern sectors of African society by which.

  3. Record management in the Nigerian public sector and freedom of ...

    African Journals Online (AJOL)

    Record management in the Nigerian public sector and freedom of ... government relies upon policy documents, budget papers, procurement records, property ... play in administrative efficiency and success of Freedom of Information Act 2011.

  4. Building Capacity in the Public Utility Sectors of Basra, Iraq

    National Research Council Canada - National Science Library

    Trainor, Tim; Henderson, Dale

    2007-01-01

    ... in provincial reconstruction efforts. Specifically, the mission was to assist in building the capacity of the public sector utility leadership in project prioritization, project planning and project management in order to enhance...

  5. Introduction Public Sector Reforms and the Quest for Democratic ...

    African Journals Online (AJOL)

    seriane.camara

    substantive (or emancipatory) democracy in the long run”. Democratic .... the paradigm focused exclusively on short-term macro-economic stabilization, with little ..... Paper presented at the Guy Mhone Memorial Conference on Public Sector.

  6. Performance management practices in public sector organizations : Impact on performance

    NARCIS (Netherlands)

    Verbeeten, Frank H.M.

    2008-01-01

    Purpose - The aim of this study is to investigate whether performance management practices affect performance in public sector organizations. Design/methodology/approach - Theoretically, the research project is based on economic as well as behavioral theories. The study distinguishes amongst

  7. 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.

  8. Pigs in Public Health

    DEFF Research Database (Denmark)

    Svendsen, Mette N.

    2017-01-01

    of public health, made me re-evaluate both what ‘public’ and what ‘health’ means in public health. In this commentary I provide a short personal account of that intellectual journey. I argue that entanglements between species make it urgent that public health scholars investigate the moral, socio......Animals are rare topics in public health science texts and speech despite the fact that animal bodies and lives are woven into the health of human populations, and vice versa. Years of ethnographic and documentary research – following pigs and their humans in and out of biomedical research – made......-economic, material, and bacterial passages between humans and animals that constitute the various publics of public health and profoundly shape the health of human and animal populations in a globalized world....

  9. Transportation and public health.

    Science.gov (United States)

    Litman, Todd

    2013-01-01

    This article investigates various ways that transportation policy and planning decisions affect public health and better ways to incorporate public health objectives into transport planning. Conventional planning tends to consider some public health impacts, such as crash risk and pollution emissions measured per vehicle-kilometer, but generally ignores health problems resulting from less active transport (reduced walking and cycling activity) and the additional crashes and pollution caused by increased vehicle mileage. As a result, transport agencies tend to undervalue strategies that increase transport system diversity and reduce vehicle travel. This article identifies various win-win strategies that can help improve public health and other planning objectives.

  10. 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.

  11. Public health financial management competencies.

    Science.gov (United States)

    Honoré, Peggy A; Costich, Julia F

    2009-01-01

    The absence of appropriate financial management competencies has impeded progress in advancing the field of public health finance. It also inhibits the ability to professionalize this sector of the workforce. Financial managers should play a critical role by providing information relevant to decision making. The lack of fundamental financial management knowledge and skills is a barrier to fulfilling this role. A national expert committee was convened to examine this issue. The committee reviewed standards related to financial and business management practices within public health and closely related areas. Alignments were made with national standards such as those established for government chief financial officers. On the basis of this analysis, a comprehensive set of public health financial management competencies was identified and examined further by a review panel. At a minimum, the competencies can be used to define job descriptions, assess job performance, identify critical gaps in financial analysis, create career paths, and design educational programs.

  12. 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 ...

  13. Measuring the internal-market orientation in the public sector

    OpenAIRE

    Emerson Wagner Mainardes; Alexandre dos Santos Cerqueira

    2015-01-01

    The application of internal marketing in organizations has been researched by scholars for nearly three decades, but literature has little empirical research in the public sector. There is a latent debate on the relevance of internal marketing in the public sector, given the need to provide a more effective service to the citizens. Given the possibility that the internal-market orientation is an antecedent of job satisfaction, the objective of this research was to measure the level of interna...

  14. Methodological aspects of accounting production cost of public sector entities

    Directory of Open Access Journals (Sweden)

    Людмила Геннадіївна Ловінська

    2015-09-01

    Full Text Available The necessity of obtaining objective information about the activities of the public sector in various areas of the production is defined. It is proved an expediency of development the Project of «Guidelines for the structure of production costs» on the basis of the approved in the public sector NP(SAPS 135 "Costs". The need for accounting costs by type of activity (operational, financial and investment is marked. The composition of production costs is defined

  15. Risk Aversion and Sorting into Public Sector Employment

    OpenAIRE

    Pfeifer, Christian

    2008-01-01

    This research note uses two German data sets – the large-scale German Socio-Economic Panel and unique data from own student questionnaires – to analyse the relationship between risk aversion and the choice for public sector employment. Main results are: (1) more risk averse individuals sort into public sector employment, (2) the impact of career specific and unemployment risk attitudes is larger than the impact of general risk attitudes, and (3) risk taking is rewarded with higher wages in th...

  16. Recruitment for Competencies in Public and Private Sectors

    OpenAIRE

    Codruța OSOIAN; Monica ZAHARIE

    2014-01-01

    The capacity to attract highly skilled human resources is dependent on the employee recruitment process implemented by organizations, which plays an important role for their competitiveness on the market. As the concern for the success of the recruitment process in public sectors is becoming more salient, the present study compares the use of recruitment practices in public and private sectors through a survey applied to 97 organizations. It also explores the outcomes in terms of quantity and...

  17. 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

  18. Challenges to Public Health

    Indian Academy of Sciences (India)

    First page Back Continue Last page Graphics. Challenges to Public Health. Tracing of the infection. Isolation of patients to stop spread. Laboratory diagnosis. Hospitalization &Treatment. Stock pile & supply of drugs. Planning & mitigation. Information to public. Support to SEARO countries.

  19. Lighting and public health.

    NARCIS (Netherlands)

    Ierland, J. van & Schreuder, D.A.

    1969-01-01

    The following topics; are discussed with respect to public health: - the effect of visible and ultraviolet radiation upon man. - vision with respect to lighting. interior lighting. - artificial lighting of work environments. - day light and windows. - recommendations for lighting. public lighting. -

  20. Transferring technology to the public sector.

    Science.gov (United States)

    Alper, M. E.

    1972-01-01

    Approximately four years ago the Jet Propulsion Laboratory, under NASA sponsorship, began to devote some of its resources to examining ways to transfer space technology to the civil sector. As experience accumulated under this program, certain principles basic to success in technology transfer became apparent. An adequate definition of each problem must be developed before any substantial effort is expended on a solution. In most instances, a source of funds other than the potential user is required to support the problem definition phase of the work. Sensitivity to the user's concerns and effective interpersonal communications between the user and technical personnel are essential to success.

  1. Patient Delay, Diagnosis Delay and Treatment Delay for Breast Cancer: Comparison of the Pattern between Patients in Public and Private Health Sectors

    Directory of Open Access Journals (Sweden)

    Iraj Harirchi

    2015-05-01

    Full Text Available Background: The purpose of this study was to compare patient delay, diagnosis delay and treatment delay in breast cancer patients of selected public and private health centers in Tehran, Iran.Methods: In this cross-sectional study, female patients with newly diagnosed breast cancer in a public medical complex and a private breast clinic within one year were included. Patient delay was considered positive, if the interval between the detection of the first symptom by the patient and the first visit to a health care provider took longer than one month. Delay in diagnosis was defined as the period of more than one week between the first medical visit for the symptoms and the diagnosis of breast cancer. Following the confirmed diagnosis of breast malignancy, if the medical treatment was initiated later than one week, treatment delay had occurred. The potential reasons for patient, diagnosis and treatment delay according to the patients’ reports were also recorded.Results: Overall, 385 patients were included of whom 52.7% were recruited from the public hospitals and 47.3% from a private clinic. The prevalence of patient delay, diagnosis delay and treatment delay were 31.7%, 17.9% and 28.3%, respectively. Patient delay was significantly more common among patients with lower socio-economic status and those recruited from the public hospitals. All the patients with diagnosis delay were in the group recruited from the public hospitals.Conclusions: Gaps between women of different socio-economic levels of the society need to be addressed in order to decrease patient, diagnosis and treatment delay.

  2. HEALTH SECTOR ACTIONS TO IMPROVE NUTRITION ...

    African Journals Online (AJOL)

    Reducing malnutrition-related maternal and childhood morbidity and mortality in Africa requires a systematic and coordinated strategy. This paper discusses a health sector strategy which includes: i) advocating for action in nutrition at all levels; ii) integration of the essential nutrition actions into six key contact points ...

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

    Science.gov (United States)

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

    2009-12-01

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

  4. Environmental Public Health Tracking

    Centers for Disease Control (CDC) Podcasts

    In this podcast series, CDC scientists address frequently asked questions about the National Environmental Public Health Tracking Network, including using and applying data, running queries, and much more.

  5. 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.

  6. Child public health

    National Research Council Canada - National Science Library

    Blair, Mitch

    2010-01-01

    "Despite children making up around a quarter of the population, the first edition of this book was the first to focus on a public health approach to the health and sickness of children and young people...

  7. A public health perspective

    African Journals Online (AJOL)

    user

    EDITORIAL. Enabling local health departments to save more lives: A public ... promoting health through the organized efforts of society” (1) ... and synergistic with achieving the sustainable development goals because its furtherance brings a ...

  8. Health sector employment growth calls for improvements in labor productivity.

    Science.gov (United States)

    Hofmarcher, Maria M; Festl, Eva; Bishop-Tarver, Leslie

    2016-08-01

    While rising costs of healthcare have put increased fiscal pressure on public finance, job growth in the health sector has had a stabilizing force on overall employment levels - not least in times of economic crises. In 2014 EU-15 countries employed 21 million people in the health and social care sector. Between 2000 and 2014 the share of employed persons in this sector rose from 9.5% to 12.5% of the total labor force in EU-15 countries. Over time labor input growth has shifted towards residential care activities and social work while labor in human health activities including hospitals and ambulatory care still comprises the major share. About half of the human health labor force works in hospital. Variation of health and social care employment is large even in countries with generally comparable institutional structures. While standard measures of productivity in health and social care are not yet comparable across countries, we argue that labor productivity of a growing health work force needs more attention. The long-term stability of the health system will require care delivery models that better utilize a growing health work force in concert with smart investments in digital infrastructure to support this transition. In light of this, more research is needed to explain variations in health and social care labor endowments, to identify effective policy measures of labor productivity enhancement including enhanced efforts to develop comparable productivity indicators in these areas. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  9. [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.

  10. 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.

  11. 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)

  12. Governance and innovation in public sector services

    DEFF Research Database (Denmark)

    Scupola, Ada; Zanfei, Antonello

    2016-01-01

    changes; (ii) user-driven innovations have significantly increased with the diffusion of ICTs and Web based public services; and (iii) complex innovations are facilitated by face-to-face meetings between public servants and users. Third, it is suggested that changes in governance modes affect the balance...... between the different actors involved, thus influencing the nature and intensity of innovation. Fourth and finally, it is argued that the transition towards a networked governance approach requires information policies which persist over time, and are designed to increase collaboration between different...

  13. ACCRUAL ACCOUNTING EXPERIENCE IN THE ROMANIAN PUBLIC HIGHER EDUCATION SECTOR

    OpenAIRE

    Tiron Tudor, Adriana; Blidisel, Rodica

    2007-01-01

    The purpose of this paper is to present experiences from the use of accrual accounting information in the public higher education sector in Romania and, thus, to contribute to our understanding of the prospects for using that kind of accounting in public organizations.

  14. Romanian accrual accounting experience in public higher education sector

    OpenAIRE

    Tiron Tudor, Adriana; Blidisel, Rodica

    2007-01-01

    The purpose of this paper is to present experiences from the use of accrual accounting information in the public higher education sector in Romania and, thus, to contribute to our understanding of the prospects for using that kind of accounting in public organizations.

  15. Predicting public sector accountability : From agency drift to forum drift

    NARCIS (Netherlands)

    Schillemans, Thomas|info:eu-repo/dai/nl/229913881; Busuioc, Madalina

    2015-01-01

    Principal-agent theory has been the dominant theory at the heart of public sector accountability research. The notion of the potentially drifting agent-such as independent public agencies, opaque transnational institutions, or recalcitrant street-level bureaucrats-has been the guiding paradigm in

  16. Information Technology and Value Creation in the Public Sector Organizations

    Science.gov (United States)

    Pang, Min-Seok

    2011-01-01

    In this dissertation, I study the performance impact of information technology (IT) investments in the public sector. IT has been one of the key assets in public administration since the early MIS era. Even though the information systems (IS) discipline has witnessed a considerable amount of research efforts on the subject of IT business value for…

  17. 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...

  18. 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...

  19. Healthcare professionals' perceptions related to the provision of clinical pharmacy services in the public health sector of Mexico: a case study.

    Science.gov (United States)

    Díaz de León-Castañeda, Christian; Gutiérrez-Godínez, Jéssica; Colado-Velázquez, Juventino Iii; Toledano-Jaimes, Cairo

    2018-04-22

    In Mexico, the Modelo Nacional de Farmacia Hospitalaria (MNFH, or National Hospital Pharmacy Model), published in 2009, mainly aims to promote the provision of clinical pharmacy services in private and public hospitals. However, there is little scientific documentation about the quality of these services. To explore healthcare professionals' perceptions related to the quality of clinical pharmacy services provision. A case-study based on a qualitative approach was performed at the pharmaceutical services unit at a public hospital located in Mexico City, which operates under the administrative control of the Ministry of Health. Donabedian's conceptual model was adapted to explore health care professionals' perceptions of the quality of clinical pharmacy services provision. Semi-structured interviews were carried out with pharmacists, physicians and nurses and then transcribed and analyzed via discourse analysis and codification techniques, using the software package Atlas. ti. Limitations in pharmaceutical human resources were identified as the main factor affecting coverage and quality in clinical pharmacy services provision. However, the development in pharmacy staff of technical competences and skills for clinical pharmacy service provision were recognized. Significant improvements in the rational use of medicines were associated with clinical pharmacy services provision. The perception analysis performed in this study suggested that it is necessary to increase pharmacy staff in order to improve interprofessional relationships and the quality of clinical pharmacy services provision. Copyright © 2018 Elsevier Inc. All rights reserved.

  20. Public health and Plowshare

    Energy Technology Data Exchange (ETDEWEB)

    Terrill, Jr, J G [Consumer Protection and Environmental Health Service, U.S. PubIic Health Service, Washington, DC (United States)

    1969-07-01

    The protection of public health and safety is a principal area of concern in any application of nuclear energy. A health and safety analysis must be conducted and reviewed by appropriate agencies and the final results made available to interested agencies and groups, both public and private, prior to the application. This is especially important for the Plowshare Program - the peaceful uses of nuclear explosives - where the public is to be the ultimate beneficiary. Because public health must be a primary concern in the Plowshare Program, it is essential that the potential risk be weighed against the expected benefits to the public. Public health agencies must play an increasingly important role in the planning and operational stages of the peaceful applications of nuclear explosives and in the final stage of consumer use of Plowshare-generated products. There are many long term and long distance ramifications of the Plowshare Program, such a the potential radiological contamination of consumer products that may reach the consumer at long times after the event or at great distances from the site of the event. Criteria for evaluating public exposure to radiation from these products need to be developed based on sound scientific research. Standards for radioactivity in consumer products must be developed in relation to potential exposure of the public. Above all, a clear benefit to the public with a minimum of risk must be shown. The major purpose of this Symposium on the Public Health Aspects of Peaceful Uses of Nuclear-Explosives is to focus attention on the health and safety aspects, present the results of safety analyses accomplished to date and other information necessary to an understanding of the public health aspects, and to identify areas where additional research is required. A general overview of the total symposium content is presented with emphasis on the relationship of the topics to public health. (author)

  1. Public health and Plowshare

    International Nuclear Information System (INIS)

    Terrill, J.G. Jr.

    1969-01-01

    The protection of public health and safety is a principal area of concern in any application of nuclear energy. A health and safety analysis must be conducted and reviewed by appropriate agencies and the final results made available to interested agencies and groups, both public and private, prior to the application. This is especially important for the Plowshare Program - the peaceful uses of nuclear explosives - where the public is to be the ultimate beneficiary. Because public health must be a primary concern in the Plowshare Program, it is essential that the potential risk be weighed against the expected benefits to the public. Public health agencies must play an increasingly important role in the planning and operational stages of the peaceful applications of nuclear explosives and in the final stage of consumer use of Plowshare-generated products. There are many long term and long distance ramifications of the Plowshare Program, such a the potential radiological contamination of consumer products that may reach the consumer at long times after the event or at great distances from the site of the event. Criteria for evaluating public exposure to radiation from these products need to be developed based on sound scientific research. Standards for radioactivity in consumer products must be developed in relation to potential exposure of the public. Above all, a clear benefit to the public with a minimum of risk must be shown. The major purpose of this Symposium on the Public Health Aspects of Peaceful Uses of Nuclear-Explosives is to focus attention on the health and safety aspects, present the results of safety analyses accomplished to date and other information necessary to an understanding of the public health aspects, and to identify areas where additional research is required. A general overview of the total symposium content is presented with emphasis on the relationship of the topics to public health. (author)

  2. Supporting SMEs in public sector bids.

    Science.gov (United States)

    James, Edward

    2016-03-01

    Edward James, workstream lead, Estates, Facilities and Professional Services Workstream, at NHS London Procurement Partnership (pictured), looks at the workings and benefits of Dynamic Purchasing Systems--electronic systems used by a public bodies to purchase commonly used goods, works, or services. One of the major benefits, he explains, is that under a 'DPS'--an 'open market' system revised in 2015--smaller businesses have a greater opportunity to win business than in traditional ('closed') framework agreements.

  3. 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.

  4. 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.

  5. 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.

  6. Public sector administration of ecological economics systems using mediated modeling.

    Science.gov (United States)

    van den Belt, Marjan; Kenyan, Jennifer R; Krueger, Elizabeth; Maynard, Alison; Roy, Matthew Galen; Raphael, Ian

    2010-01-01

    In today's climate of government outsourcing and multiple stakeholder involvement in public sector management and service delivery, it is more important than ever to rethink and redesign the structure of how policy decisions are made, implemented, monitored, and adapted to new realities. The traditional command-and-control approach is now less effective because an increasing amount of responsibility to deliver public goods and services falls on networks of nongovernment agencies. Even though public administrators are seeking new decision-making models in an increasingly more complex environment, the public sector currently only sparsely utilizes Mediated Modeling (MM). There is growing evidence, however, that by employing MM and similar tools, public interest networks can be better equipped to deal with their long-term viability while maintaining the short-term needs of their clients. However, it may require a shift in organizational culture within and between organizations to achieve the desired results. This paper explores the successes and barriers to implementing MM and similar tools in the public sector and offers insights into utilizing them through a review of case studies and interdisciplinary literature. We aim to raise a broader interest in MM and similar tools among public sector administrators at various administrative levels. We focus primarily, but not exclusively, on those cases operating at the interface of ecology and socio-economic systems.

  7. 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.

  8. Managing Uncertainty and Risk in Public-sector Investments

    Science.gov (United States)

    2007-04-30

    private sector, Capital Asset Pricing Models ( CAPM ) models provide valuation tools, of which the Black-Scholes equation is the most well known and...maximized mean of discounted cash flows on the assumption that the risk to underlying investment options can be replicated by assets in a financial... assumptions seldom apply for large-scale infra-modernization programs, in either the public or the private sector. In addition, NPV investment is

  9. Evaluation of Principal Performance in Public and Private Sector Schools

    OpenAIRE

    Akhtar, Iram; Cheema, Khaliq Ur Rehman

    2013-01-01

    The purpose of this study is to analyze the performance in context of student learning of principals in public sector and private sector schools. For this purpose five main domains were used as variables are: 1) teaching, learning and professional growth, 2) Inter-personal and inter-professional relationship and collaboration, 3) Parent and faculty involvement in decision making, 4) Vision and values, 5) Innovation and change. The population for this study was selected randomly. The target sa...

  10. Working in the Public Sector. Introduction to the Thematic Issue

    Directory of Open Access Journals (Sweden)

    Annette Kamp

    2013-05-01

    Full Text Available Work in the public sector has been changing dramatically in recent decades. Reforms aimed at increasing the efficiency of public services have been extensive in the Nordic countries and elsewhere since the 1980s. The reforms and changes have to a large extent been associated with so-called New Public Management (NPM principles, emphasizing the market as a central coordination mechanism. Consequently, public institutions have been restructured, their services are standardized and commodified, and market-like relationships between them have been created. In order to create markets and transform citizens into customers on a market, outsourcing and privatization have been stimulated (Blomqvist & Rothstein 2000, Busch et al 2005, Christensen & Lægreid 2007, Greve 2003. At the same time, traditional Weberian bureaucratic principles are still viable and even enhanced within the sector, for instance, as a consequence of the use of contracts as a means of managing public organizations (Greve 2008. Lately, large reforms aimed at centralized coordination of different service providers, such as the integration of the Norwegian welfare administration, have been labeled post-NPM reforms by some researchers. The implication of all these parallel tendencies is that the institutional and organizational landscape surrounding the work situations of employees in the public sector have become increasingly complex, some call them hybrid,  putting a variety of conflicting pressures on the performance of work within the sector (Christensen & Lægreid 2011, Hasselbladh et al. 2008. In this special issue, we explore some of the consequences of these structural and normative changes on the work of public sector employees in different sectors and contexts (...

  11. 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.

  12. XBRL LANGUAGE: SUPPORT TO CONSOLIDATE ACCOUNTS IN THE PUBLIC SECTOR

    OpenAIRE

    Ferreira, Augusta; Santos, Carlos

    2008-01-01

    In the “New Public Management” context , in which  public organisations and institutions are required to adopt management model practices, based on economy, efficiency and efficacy criteria, it is important to obtain information, prepared so as to allow  for the decision-makers to have a global point of view of the public sector. Thus, the accounting information system shall allow the receipt of consolidated information in order to meet the growing needs of information w...

  13. Morale’s role in the public sector

    OpenAIRE

    DeRousse, John W.

    2015-01-01

    Approved for public release; distribution is unlimited This thesis examines the factors that help and hinder employee morale at public safety agencies within the homeland security enterprise. The Department of Homeland Security, and the various agencies that support it, have reported low levels of job satisfaction. Through an in-depth analysis of literature that discusses workplace morale in the public sector, this document provides recommendations for agencies interested in improving it. ...

  14. 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

  15. 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.

  16. 'Negotiating the tensions of having to attach and detach concurrently': a qualitative study on combining breastfeeding and employment in public education and health sectors in New Delhi, India.

    Science.gov (United States)

    Omer-Salim, Amal; Suri, Shoba; Dadhich, Jai Prakash; Faridi, Mohammad Moonis Akbar; Olsson, Pia

    2015-04-01

    the aim of this study was to explore the factors involved in combining breastfeeding and employment in the context of six months of maternity leave in India. qualitative semi-structured interviews were conducted and analysed using a Grounded Theory approach. Health and Education sectors in New Delhi, India. 20 first-time mothers with one 8-12 month-old infant and who had returned to work after six months׳ maternity leave. the interviews followed a pre-tested guide with a vignette, one key question and six thematic areas; intentions, strategies, barriers, facilitators, actual experiences and appraisal of combining breastfeeding and employment. Probing covered pre-pregnancy, pregnancy, maternity leave, the transition and return to work. This study revealed a model of how employed women negotiate the tensions of concurrently having to attach and detach from their infant, work, and family. Women managed competing interests to ensure trusted care and nutrition at home; facing workplace conditions; and meeting roles and responsibilities in the family. In order to navigate these tensions, they used various satisficing actions of both an anticipatory and troubleshooting nature. in spite of a relatively generous maternity leave of six months available to these women, several individual, familial and workplace factors interacted to both hinder and facilitate the process of combining breastfeeding and employment. Tension, negotiation and compromise are inherent to the process. antenatal and postnatal interventions providing information and support for working mothers need to address factors at the individual, family and workplace levels in addition to the provision of paid maternity leave to enable the successful combination of breastfeeding and employment. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. The exclusion of 'public undertakings' from the re-use of public sector information regime

    NARCIS (Netherlands)

    Ricolfi, M.; Drexl, J.; van Eechoud, M.; Salmeron, M.; Sappa, C.; Tziavos, P.; Valero, J.; Pavoni, F.; Patrito, P.

    2011-01-01

    Should public undertakings be covered by the PSI Directive? The definitions of public sector bodies and bodies governed by public law, to which the PSI Directive applies, are currently taken from the public procurement Directives and public undertakings are not covered by these definitions. Should

  18. Distinctive research patterns on public sector performance measurement of public administration and accounting disciplines

    NARCIS (Netherlands)

    van Helden, G. Jan; Johnsen, Age; Vakkuri, Jarmo

    2008-01-01

    This article explores distinctive research patterns of public administration and accounting disciplines concerning public sector performance measurement (PSPM). Our review shows that accounting researchers from Europe investigate reasons for limited PM use and factors explaining a rational or

  19. 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...

  20. Monopolistic competition and the health care sector.

    Science.gov (United States)

    Hilsenrath, P

    1991-07-01

    The model of monopolistic competition is appropriate for describing the behavior of the health care sector in the United States. Uncertainty about quality of medical and related services promotes product differentiation especially when consumers do not bear the full costs of care. New technologies can be used to signal quality even when their clinical usefulness is unproven. Recent cost containment measures may reduce employment of ineffective technologies but may also inhibit the adaptation of genuinely useful developments.

  1. A knowledge sharing framework in the South African public sector

    Directory of Open Access Journals (Sweden)

    Peter L. Mkhize

    2015-06-01

    Full Text Available In the knowledge economy, organisations are shifting their investment focus to intellectual capital in order to sustain a competitive advantage in the global marketplace. Organisational survival is increasingly dependent on the organisation’s ability to create and distribute knowledge that contributes to the improvement of performance. The purpose of this article is to evaluate individual knowledge-acquisition and sharing practices in the South African public sector. I applied the techniques of grounded theory analysis to extract themes from data that could provide insight into the knowledge sharing that takes place in the South African public sector. Findings revealed that the informal sharing of knowledge takes place in discussion forums within communities of practice through web-based, socially orientated platforms. These communities of practice are widespread throughout the public sector and are established with the purpose of soliciting expert knowledge from those who have been using open-source software successfully.

  2. Perspectives on User-Driven Innovation in Public Sector Services

    DEFF Research Database (Denmark)

    Langergaard, Luise Li

    2015-01-01

    of citizenship. Thus, we need to be aware of what different perspectives of user involvement imply for citizenship and collaborative innovation in the public sector. The chapter is based on a literature study and uses an empirical case as an example to illustrate and discuss differences in democratic......The chapter presents and discusses how we can conceptualize user involvement in the public sector, as well as users, in very different ways: As consumers, co-producers, lead users or citizens. One important question which is subsequently discussed, is what such different conceptualizations imply...... for citizenship understood in more traditional terms, i.e. defined by political deliberation and rights. This question is important because conceptualizations of users imply certain ideas about the public sector, state and society, which have political implications as well as implications for our understanding...

  3. A BRIEF ANALYSIS OF PUBLIC SECTOR CONSOLIDATED FINANCIAL STATEMENTS RESEARCHES

    Directory of Open Access Journals (Sweden)

    Andreea CÎRSTEA

    2015-12-01

    Full Text Available The purpose of the paper is to track the evolution of this specific topic of consolidated financial statements in the public sector, in order to be able to present a global picture of the actual knowledge stage of this issue at international level. The study conducted for reaching the proposed objective is a quantitative one. We tried to find out how this issue of public sector consolidated financial statements has sparked the interest of researchers around the world and when the issue was most debated. We concluded that the research of consolidated financial statements in the public sector is in its infancy and nowadays the topic starts to be more and more in the attention of the researchers in this field.

  4. Issues in public health

    National Research Council Canada - National Science Library

    Sim, Fiona; McKee, Martin

    2011-01-01

    ..., there is increasing understanding of the inevitable limits of individual health care and of the need to complement such services with effective public health strategies. Major improvements in people's health will come from controlling communicable diseases, eradicating environmental hazards, improving people's diets and enhancing the availability ...

  5. Shelf stable meals for public sector uses

    Science.gov (United States)

    Schmandt, J. (Editor)

    1977-01-01

    The NASA Meal System was developed with three simple concepts in mind: (1) nutritious, conventional foods are packaged in single-serving units and assembled into complete meals; (2) the meals have an extended shelf-life and can be transported and stored without need for refrigeration or freezing; (3) preparation of the meal by the consumer is an easy task which is accomplished in ten minutes or less. The meal system was tested in 1975 and 1976 by different groups of elderly individuals. NASA and the LBJ School of Public Affairs sponsored a national conference to report on the demonstration of the meal system for the elderly and to explore potential uses of the system for social services, institutional feeding programs, disaster relief, and international aid. The proceedings of the conference and how different groups assessed the potential of the meal system are reported.

  6. Improving quality: bridging the health sector divide.

    Science.gov (United States)

    Pringle, Mike

    2003-12-01

    All too often, quality assurance looks at just one small part of the complex system that is health care. However, evidently each individual patient has one set of experiences and outcomes, often involving a range of health professionals in a number of settings across multiple sectors. In order to solve the problems of this complexity, we need to establish high-quality electronic recording in each of the settings. In the UK, primary care has been leading the way in adopting information technology and can now use databases for individual clinical care, for quality assurance using significant event and conventional auditing, and for research. Before we can understand and quality-assure the whole health care system, we need electronic patient records in all settings and good communication to build a summary electronic health record for each patient. Such an electronic health record will be under the control of the patient concerned, will be shared with the explicit consent of the patient, and will form the vehicle for quality assurance across all sectors of the health service.

  7. 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.

  8. Contracts, Performance Measurement and Accountability in the Public Sector

    DEFF Research Database (Denmark)

    Drewry, Gavin; Greve, Carsten; Tanquerel, Thierry

    This book addresses issues to do with public accountability, audit and performance measurement that are both highly topical and of crucial importance to the theory and practice of public administration in an era of contractualized public management. The literature on public sector contracting...... of audit and accountability in a variety of countries and contexts; the third part offers some wider, cross-cutting perspectives. Based on the work of the EGPA permanent study group on the history of contractualization, Contracts, Performance Measurement and Accountability in the Public Sector draws upon...... - covering both 'hard' agreements (ones that are legally enforceable) and 'soft' agreements (enforced by negotiation and mutual trust) - has been growing for some time and the present book adds a primarily European perspective on contracting, performance-based management and accountability. One important...

  9. Isomorphic Diffusionin Public Sector: Focus on China

    Directory of Open Access Journals (Sweden)

    Cheng CHEN

    2017-10-01

    Full Text Available Based on widely ranged theoretical discus­sion of isomorphic diffusion, this article traces the process of isomorphism in the context of public service center diffusion in China and dis­covers relationships between isomorphism and distance within different time and space. With data for a sample of 238 prefecture level cities collected from China, the authors aim to explore the correlation between isomorphism diffusion and spatial distance. The results of the analysis suggest that local governments will be at a disadvantage if these are stated in a further location when isomorphic diffusion takes place. Moreover, the correlation between isomorphic diffusion and spatial dis­tance varies according to the different phases of the diffusion process. The effect of geographical distance is initially strong in the growth period, but weakens later. The results will build bridges on isomorphic and geographical distance within diverse time and space in China, and have impli­cations both theoretically and practically.

  10. Public health and peace.

    Science.gov (United States)

    Laaser, Ulrich; Donev, Donco; Bjegović, Vesna; Sarolli, Ylli

    2002-04-01

    The modern concept of public health, the New Public Health, carries a great potential for healthy and therefore less aggressive societies. Its core disciplines are health promotion, environmental health, and health care management based on advanced epidemiological methodologies. The main principles of living together in healthy societies can be summarized as four ethical concepts of the New Public Health essential to violence reduction equity, participation, subsidiarity, and sustainability. The following issues are discussed as violence determinants: the process of urbanization; type of neighborhood and accommodation, and consequent stigmatization; level of education; employment status; socialization of the family; women's status; alcohol and drug consumption; availability of the firearms; religious, ethnic, and racial prejudices; and poverty. Development of the health systems has to contribute to peace, since aggression, violence, and warfare are among the greatest risks for health and the economic welfare. This contribution can be described as follows: 1) full and indiscriminate access to all necessary services, 2) monitoring of their quality, 3) providing special support to vulnerable groups, and 4) constant scientific and public accountability of the evaluation of the epidemiological outcome. Violence can also destroy solidarity and social cohesion of groups, such as family, team, neighborhood, or any other social organization. Durkheim coined the term anomie for a state in which social disruption of the community results in health risks for individuals. Health professionals can make a threefold contribution to peace by 1) analyzing the causal interrelationships of violence phenomena, 2) curbing the determinants of violence according to the professional standards, and 3) training professionals for this increasingly important task. Because tolerance is an essential part of an amended definition of health, monitoring of the early signs of public intolerance is

  11. Determinant Factors for Managing Innovation in the Malaysian Public Sector

    Directory of Open Access Journals (Sweden)

    Ab Rahman Zety Norhaiza

    2018-01-01

    Full Text Available Since 1991, the government has started the forces to encourage public sector to innovate in order to strengthen the capability and solve problems at workplace for the benefit of organization and its people. The focuses of this forces is to create value creation, encourage cost reduction, and provide services that meet aspirations and people's expectations through high impact ideas. However, to achieve these focuses, public sector faces few challenges that affect the management of innovation; which includes lack of leadership skills and poor innovative culture to stimulate innovation. Although there are various initiatives conducted to enhance the management innovation, the innovative performance is still less satisfactory. Therefore, this paper aims to discuss the determinant factors that affect managing innovation in the selected public sectors which consist of two categories; patron and executor agencies. Thematic approach was used to analyse the interview data. Findings from the interview suggested that in the organization, an employee especially a leader should show his full commitment towards innovative culture, he needs to be committed and supportive and communicate well with the employees and he also should provide attractive rewards to encourage the innovative culture for an effective management innovation. These determinant factors need to be considered as high significant for the public sector to develop new strategies or approaches in managing innovation towards sustaining their competitive advantages in a long term for the benefit of public.

  12. Children's Health Publications

    Science.gov (United States)

    Each title has a brief description and link for downloading the full text. Includes the publications catalog, the Child Health Champion resource guide, student curriculum materials, reports, fact sheets, and booklets/brochures of advice and tools.

  13. MARKETING CHALLENGES FOR SOUTH AFRICAN PUBLIC SECTOR BUSINESS INCUBATOR

    Directory of Open Access Journals (Sweden)

    Donaldson Walter James

    2017-12-01

    Full Text Available Entrepreneurship and innovation form the cornerstone of economic development in many developing countries. Through this, rather ideal combination employment can be enhanced, communities can be uplifted through education, and growth can be increased through discretionary purchasing power. This cycle has positive spinoffs which can alleviate poverty and decrease famine. Recent local research suggests that more than eighty percent of entrepreneurs, start-ups and Business ‘Incubatees’ don’t make it through their first year of establishment after leaving a Business Incubator programme. This paper tries to identify some of the marketing challenges faced by Business Incubators, and indeed BIMs in the Public Sector environment in South Africa. Identification and highlighting the possible drawbacks for ‘incubatees’ may assist them with success or meeting competitive challenges when they depart from the security of the relevant programmes. This study examines some of the skills, knowledge and attributes required for BIMs in this sector and what is required to meet the business and marketing challenges faced to remain sustainable. The survey was aimed at the largest, focused segment of South African Business Incubators affiliated to the industrial public sector and the hypothesis was to prove that strategic marketing information, acumen and knowledge is a key differentiator towards the growth and sustainability of Business Incubators in that sector. It is notable that these marketing challenges may also compare favourably with several other public sector segments in relevant countries of the southern African region as similar macroeconomic challenges are faced.

  14. GIS and Public Health

    Directory of Open Access Journals (Sweden)

    Stefania Bertazzon

    2014-06-01

    Full Text Available This Special Issue on GIS and public health is the result of a highly selective process, which saw the participation of some 20 expert peer-reviewers and led to the acceptance of one half of the high-quality submissions received over the past year. Many threads link these papers to each other and, indeed, to our original call for papers, but the element that most clearly emerges from these works is the inextricable connection between public health and the environment. Indeed, GIS analysis of public health simply cannot disregard the geospatial dimension of environmental resources and risks. What consistently emerges from these analyses is that current geospatial research can only scratch the surface of the complex interactions of spatial resources, risks, and public health. In today’s world, or at least in the developed world, researchers and practitioners can count on virtually endless data, on inexpensive computational power, and on seamless connectivity. In this research environment, these papers point to the need for improved analytical tools, covering concepts, representation, modeling and reliability. These works are important contributions that help us to identify what advances in geospatial analysis can better address the complex interactions of public health with our physical and cultural environment, and bridge research and practice, so that geospatial analyses can inform public health policy making. [...

  15. Is presenteeism less prevalent among public sector employees than private sector employees?

    OpenAIRE

    Gominho, Nuno Manuel Afonso

    2016-01-01

    Presenteeism is a relatively new concept meaning working while sick. It is though to account for a large amount of productivity loss due to illness. Presenteeism’s body of literature is reviewed. This paper focuses on differences between public and private organizations, and between men and women. Survey data (n=235) was collected from the region of Ferrol, Spain. Evidence is found to suggest that private sector workers, but not public workers, come to work ill because they fea...

  16. Theoretical considerations about Innovation in the Public Sector

    DEFF Research Database (Denmark)

    Martinez, Laia

    Since 2007/2008 governments all over the world are facing considerable economic constraints. Public expenditures are reduced from central and local governments challenging the existing ways of creating and producing welfare. The premise of work smarter not harder is applied in different policy...... in most Western countries with the purpose of reforming the public sector. However, the mechanisms of these modernising reforms do not provide governments the solutions required to the existing problems. Among other reasons for the silo and competitive thinking embedded in NPM. New and creative ideas...... are necessary to transform governments’ capacity to cope with wicked problems. Innovation in the public sector can be a way of rethinking old ideas and practices and find solutions to the new problems. In order to create an innovation culture and work systematically with innovation, politicians and public...

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

    Science.gov (United States)

    Oldfield, Chrissie

    2017-01-01

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

  18. The public healthcare sector and governance in South Africa

    OpenAIRE

    Melody Brauns

    2015-01-01

    This article reviews literature on governance in order to facilitate an analysis of the governance of the South African public healthcare sector. Some of the key theoretical perspectives have been presented on how best to organise the state and its bureaucracy. Theorists have long interrogated in what way public institutions foster or impede economic growth. Evans and Rauch point out for example, that the role of bureaucratic authority structures in facilitating economic growth has been a soc...

  19. Globalisation squeezes the public sector - is it so obvious?

    DEFF Research Database (Denmark)

    Andersen, Torben M.; Sørensen, Allan

    It is widely perceived that globalization squeezes public sector activities by making taxation more costly. This is attributed to increased factor mobility and to a more elastic labour demand due to improved scope for relocation of production and thus employment across countries. We argue...... that this consensus view overlooks that gains from trade unambiguously work to lower the marginal costs of public funds, and moreover that globalization via increased trade in intermediaries may actually lower the labour demand elasticity....

  20. Managing information and knowledge in the public sector

    National Research Council Canada - National Science Library

    Milner, Eileen M

    2000-01-01

    .... In this book Eileen Milner introduces the reader to the concepts of information and knowledge and explores a variety of tools and techniques which may be usefully adopted in actively managing and developing these resources. Wherever possible, real-life public sector cases and examples are used to illustrate good practice, as well as some of the pitfalls of poor application. Down-to-earth and taking into account the critically important characteristics unique to public services, this will be an illuminati...

  1. 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...

  2. Key elements for a measurement framework for public sector innovation

    DEFF Research Database (Denmark)

    Bloch, Carter Walter; Lopez-Bassols, Vladimir

    2013-01-01

    This document provides an overview of recent NESTI work on developing guidelines for measuring public sector innovation (PSI). The paper includes an update on various ongoing activities which will contribute to the development of a measurement framework for PSI and outlines a number of areas which...

  3. Incentives and Their Dynamics in Public Sector Performance Management Systems

    Science.gov (United States)

    Heinrich, Carolyn J.; Marschke, Gerald

    2010-01-01

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

  4. Third Sector Involvement in Public Education: The Israeli Case

    Science.gov (United States)

    Berkovich, Izhak; Foldes, Vincent Jonathan

    2012-01-01

    Purpose: The purpose of this article is to address the involvement of third sector organizations in state public education in Israel, with emphasis on the decision-making processes affecting the geographic distribution of service provision. Design/methodology/approach: A collective case study approach was used to investigate non-governmental…

  5. Public Sector Transformation, Racial Inequality and Downward Occupational Mobility

    Science.gov (United States)

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

    2013-01-01

    New "governance" reforms entailing shifts toward privatization have permeated the public sector over the last decade, possibly affecting workplace-based attainments. We examine the consequences of this reform for African American men, who during the civil rights era reached relative parity with whites. We analyze race-based inequities on one…

  6. The Practice of Evaluation in Public Sector Contexts: A Response

    Science.gov (United States)

    Chouinard, Jill Anne

    2013-01-01

    In the original paper, it was argued that while there is an array of methods and methodologies available, their use is delimited by the culture of accountability that prevails in public sector institutions, a fact that is particularly problematic given the complexity and diversity of evaluation contexts today. This short rejoinder, to responses…

  7. Attributes of ethical employees in Malaysian public sector ...

    African Journals Online (AJOL)

    This study aims to explore the attributes of ethical employees in public sector and to pattern match the attributes with human behavior, social and ethics theories. A qualitative research is used by focusing on first-order attributes (through interviews) and second-order concepts (using theories to explain the facts). This study ...

  8. Palestinian Security Sector Reform : the View of the Public | IDRC ...

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

    PSR will consult with various stakeholders - the Ministry of the Interior, the security services, the judiciary, members of Parliament, human rights organizations and international donors - in extensive surveys of the public's perception of the security sector in all its dimensions, including capacity, mission, performance, service ...

  9. Budgeting for Change in The Nigerian Public Sector: A Qualitative ...

    African Journals Online (AJOL)

    Nneka Umera-Okeke

    departments. The three arms of the central government, the executive, the legislature and the judiciary also come under the conceptual canopy of the public sector in this study. The central research question of the study therefore borders on how the effective management of the national budgetary processes in Nigeria may ...

  10. Organizational capability in the public sector: \\ud a configurational approach

    OpenAIRE

    Andrews, Rhys William; Beynon, Malcolm James; McDermott, Aoife

    2015-01-01

    This paper brings together resource-based theory and contingency theory to analyse organizational capability in the public sector. Fuzzy-set Qualitative Comparative Analysis is used to identify configurations of organizational attributes (department size, structural complexity, agencification, personnel instability, use of temporary employees), associated with high and low organizational capability in UK central government departments. Findings identify a single core configuration of organiza...

  11. Job factors and Work Outcomes of Public Sector Expatriates

    DEFF Research Database (Denmark)

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

    2009-01-01

    with job satisfaction, making it a more important job factor than role conflict, role overload or role discretion. While role clarity may have a similar impact on work outcomes of expatriates both in the private and public sector, the findings regarding role conflict and role overload may constitute...

  12. Evaluation of Large-scale Public Sector Reforms

    DEFF Research Database (Denmark)

    Breidahl, Karen Nielsen; Gjelstrup, Gunnar; Hansen, Hanne Foss

    2017-01-01

    and more delimited policy areas take place. In our analysis we apply four governance perspectives (rational-instrumental, rational-interest based, institutional-cultural and a chaos perspective) in a comparative analysis of the evaluations of two large-scale public sector reforms in Denmark and Norway. We...

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

    Science.gov (United States)

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

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

  14. Teaching Chinese Students: Understanding Their Public Sector Paradigm

    Science.gov (United States)

    Conrad, Cynthia; Coleman, Charles

    2011-01-01

    Teaching Chinese students in an American university can be both challenging and rewarding. Cultural and language differences can lead to some superficial confusion and interpretational problems. However, the vast differences in the ways Chinese students view the role of the public sector, as compared to the US, can mean that the instructors and…

  15. Lessons learned from infertility investigations in the public sector ...

    African Journals Online (AJOL)

    Objectives. To determine the main factors causing infertility in an urban, tertiary hospital population. To establish if any such major causal factor could be used to rationalise and improve the service for infertile couples in the public sector. Design. A retrospective analysis of the hospital records of 206 women who had a tubal ...

  16. International comparisons of public sector performance: how to move ahead?

    NARCIS (Netherlands)

    S.G.J. Van de Walle (Steven)

    2009-01-01

    textabstractMeasuring and comparing the overall performance of countries’ public sectors requires agreement on definitions and objectives of government. I argue that such an agreement is about finding a consensus rather about finding better definitions. Measuring government requires a number of

  17. 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.

  18. Contracepção em usuárias dos setores público e privado de saúde Contraception in users of the public and private sectors of health

    Directory of Open Access Journals (Sweden)

    Daniela Siqueira Prado

    2011-07-01

    Full Text Available OBJETIVO: Verificar os principais métodos anticoncepcionais adotados por mulheres usuárias dos setores público e privado de saúde no município de Aracaju (SE, com enfoque secundário para orientações de uso e razões para eventual interrupção destes. MÉTODOS: Estudo transversal, no qual foram incluídas 210 mulheres, 110 atendidas no serviço público e 100, no privado. Os dados foram obtidos através de aplicação de questionário às pacientes com vida sexual ativa e que concordaram em assinar o termo de consentimento livre e esclarecido. Para análise estatística utilizou-se o programa Statistical Package for Social Sciences (SPSS versão 15.0, aplicando-se os testes do , para variáveis categóricas, e t de Student, para amostras independentes. RESULTADOS: A prevalência global do uso de métodos anticoncepcionais neste estudo foi de 83,3%. Os principais métodos utilizados em ambos os setores, respectivamente público e privado, foram os hormonais (41 e 24%, p=0,008 e os definitivos (20 e 26%, p=0,1. O uso de preservativo masculino apresentou frequência de 17,3% para o setor público e 12% para o setor privado, não havendo diferença significativa (p=0,12. Receberam orientação médica quanto ao uso correto do método escolhido e/ou indicado 37,3% das usuárias do setor público e 48% do setor privado, sendo a interrupção do uso de métodos anticoncepcionais de 14,5%, no setor público e 12%, no privado, principalmente devido a efeitos colaterais e pelo desejo de engravidar. CONCLUSÕES: Os principais métodos anticoncepcionais adotados pelas usuárias dos setores públicos e privados foram anticoncepcionais hormonais e contracepção definitiva. Vale frisar a baixa frequência de uso de preservativo masculino nos dois grupos estudados.PURPOSE: To determine the main contraceptive methods adopted by users of the public and private health sectors in the city of Aracaju (SE, Brazil, with a secondary focus on orientations for

  19. 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.

  20. 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

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

    Directory of Open Access Journals (Sweden)

    Bernardo Aguilera Dreyse

    2017-12-01

    Full Text Available Resumen El presente artículo discute si los médicos tienen obligaciones sociales, y si de éstas se puede desprender un deber moral de trabajar en el sector público de salud. La discusión se sitúa en el marco del sistema de salud chileno en tanto presenta una desigual distribución de médicos en desmedro del sector público de salud, lo cual confiere especial relevancia al tema en cuestión. Tras evaluar argumentos procedentes de distintas teorías éticas y de la evidencia empírica, se concluye que el médico tiene obligaciones sociales en relación con una repartición justa de los recursos sanitarios, y que la excelencia profesional debiera incorporar el cultivo de virtudes orientadas a una mayor justicia social. Asimismo, se plantea que el deber moral de trabajar en el sector público de salud se sitúa en un plano de obligaciones prima facie que admiten excepciones y la posibilidad de conflicto con otras obligaciones profesionales.

  2. A multi-sector assessment of community organizational capacity for promotion of Chinese immigrant worker health.

    Science.gov (United States)

    Tsai, Jenny H-C; Thompson, Elaine A

    2017-12-01

    Community-based collaborative approaches have received increased attention as a means for addressing occupational health disparities. Organizational capacity, highly relevant to engaging and sustaining community partnerships, however, is rarely considered in occupational health research. To characterize community organizational capacity specifically relevant to Chinese immigrant worker health, we used a cross-sectional, descriptive design with 36 agencies from six community sectors in King County, Washington. Joint interviews, conducted with two representatives from each agency, addressed three dimensions of organizational capacity: organizational commitment, resources, and flexibility. Descriptive statistics were used to capture the patterning of these dimensions by community sector. Organizational capacity varied widely across and within sectors. Chinese and Pan-Asian service sectors indicated higher capacity for Chinese immigrant worker health than did Chinese faith-based, labor union, public, and Pan-ethnic nonprofit sectors. Variation in organizational capacity in community sectors can inform selection of collaborators for community-based, immigrant worker health interventions. © 2017 Wiley Periodicals, Inc.

  3. Outsourcing: two case studies from the Victorian public hospital sector.

    Science.gov (United States)

    Young, Suzanne

    2007-02-01

    Outsourcing was one process of privatisation used in the Victorian public health sector in the 1990s. However it was used to varying degrees and across a variety of different services. This paper attempts to answer the questions: Why have managers outsourced? What have managers considered when they have decided to outsource? The research was carried out in a rural hospital and a metropolitan network in Victoria. The key findings highlight the factors that decision makers considered to be important and those that led to negative outcomes. Economic factors, such as frequency of exchange, length of relationships between the parties, and information availability, were often ignored. However, other factors such as outcome measurability, technology, risk, labour market characteristics and goal conflict, and political factors such as relative power of management over labour were often perceived as important in the decision-making process. Negative outcomes from outsourcing were due to the short length of relationships and accompanying difficulties with trust, commitment and loyalty; poor quality; and excessive monitoring and the measurement of outcomes.

  4. Recruitment for Competencies in Public and Private Sectors

    Directory of Open Access Journals (Sweden)

    Codruța OSOIAN

    2014-02-01

    Full Text Available The capacity to attract highly skilled human resources is dependent on the employee recruitment process implemented by organizations, which plays an important role for their competitiveness on the market. As the concern for the success of the recruitment process in public sectors is becoming more salient, the present study compares the use of recruitment practices in public and private sectors through a survey applied to 97 organizations. It also explores the outcomes in terms of quantity and quality of applications received when using various recruitment methods. Common points and differences were identified. Internal recruitment methods and e-recruitment based on job posting on the website of the organization are favored regardless of the type of organization (private or public. The differences weight mostly against public sector as public institutions use less often the recommendations received from acquaintances and networks, post fewer job adds on specialized online job boards, get fewer direct applications from candidates, and participate less often in job fairs. The largest number of applications is received through the use of online job boards, job posting on the website of the hiring organization and job advertising in written press. On the other hand, internal recruitment is perceived to result in attracting the highest quality applications.  

  5. The Harmonization of Public Sector Accounting in European Union

    DEFF Research Database (Denmark)

    Pontoppidan, Caroline Aggestam; Alijarde, Isabel Brusca; Chow, Danny

    accounting standards in Member States. The suitability of IPSAS for the Member States” (European Commission, 2013b). This report takes into account the Public Consultation on the suitability of the IPSAS for EU Member States. The European Commission (2013b, p. 8) considers that IPSASs cannot easily......The European Commission is working on several fronts to achieve the implementation of uniform and comparable accruals-based accounting practices for the European Union Member States and for all the sectors of General Government, that is, Central Government, State Government, Local Government...... and Social Security, considering that at the same time it can help ensure high quality statistics (European Commission, 2013a). In 2012 Eurostat issued a Public Consultation on the suitability of the IPSAS for EU Member States, later publishing the report “Towards implementing harmonised public sector...

  6. A proposed framework of big data readiness in public sectors

    Science.gov (United States)

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

    2016-08-01

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

  7. Veteran status, disability rating, and public sector employment.

    Science.gov (United States)

    Winters, John V

    2018-06-01

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

  8. 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

  9. Public mental health.

    Science.gov (United States)

    Lindert, Jutta; Bilsen, Johan; Jakubauskiene, Marija

    2017-10-01

    Public mental health (PMH) is a major challenge for public health research and practice. This article is organized in six parts. First, we will highlight the significance of PMH; second, we will define mental health and mental disorders; third, we identify and describe determinants of mental health and mental disorders on which we worked in the past 10 years since the establishment of the PMH section such as social determinants and violence. Fourth, we will describe the development of the EUPHA PMH section and provide details on vulnerable groups in the field of PMH, on violence as a main determinant and on suicide as an outcome which affects all countries in the European region. Fifth, we describe policy and practice implications of the development of PMH and highlight the European dimension of PMH. We will conclude this article by providing an outlook on potential further development of PMH as regards research and policy and practice. Finally, we hope that the EUPHA PMH section will contribute to public health in the next 25 years and we can contribute to improvement of PMH in Europe. © The Author 2017. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  10. Synergies between veterinarians and para-professionals in the public and private sectors: organisational and institutional relationships that facilitate the process of privatising animal health services in developing countries.

    Science.gov (United States)

    Woodford, J D

    2004-04-01

    The delivery of veterinary services in most developing countries was, until recently, considered to be the responsibility of the public sector. However, over the past four decades, economic constraints and the imposition of structural adjustment policies (SAPs) have led to a gradual decline in public sector investment in real terms and thus a reduction in the quality and quantity of services available to livestock keepers. Many governments acknowledged that they were no longer able to provide services that were essentially of a 'private good' nature and introduced radical policy changes which sought to introduce the concepts of a market orientated approach towards agriculture and livestock production in particular. The role of government, in the future, would be to provide a reduced range of essential 'public good' services and to create a favourable environment in which the private sector could become established as a provider of 'private good' services and at the same time act as a partner in carrying out certain public functions under contract or 'sanitary mandates'. In almost all developing countries, however, these policy changes were not accompanied by appropriate development strategies. The reasons for this are complex. Firstly, SAPs may be considered to have been foisted upon governments by donors and are thus perceived by many policy-makers as the cause of financial problems, rather than a solution to them. Secondly, most animal health senior policy-makers in the public sector have been trained as veterinarians and lack the required management skills to plan change effectively. Furthermore, as regards clinical veterinary service delivery, especially in rural or more remote areas, the solution fostered by donor investment, which involves deregulation and the deployment of privately operating para-professionals, is often perceived as a threat to the veterinary profession and might result in limiting access to international markets for the trade of livestock

  11. 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

  12. 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

  13. 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

  14. 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

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

    Science.gov (United States)

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

    2012-01-01

    According to public service motivation theory, individuals with a strong public service orientation are attracted to government jobs. This proposition was investigated in three studies by measuring public sector motivation at a pre-entry level as an individual difference variable affecting perceptions of fit and organizational attraction. Results…

  16. 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.

  17. Transparency in Nigeria's public pharmaceutical sector: perceptions from policy makers

    Directory of Open Access Journals (Sweden)

    Kohler Jillian C

    2009-10-01

    Full Text Available Abstract Background Pharmaceuticals are an integral component of health care systems worldwide, thus, regulatory weaknesses in governance of the pharmaceutical system negatively impact health outcomes especially in developing countries 1. Nigeria is one of a number of countries whose pharmaceutical system has been impacted by corruption and has struggled to curtail the production and trafficking of substandard drugs. In 2001, the National Agency for Food and Drug Administration and Control (NAFDAC underwent an organizational restructuring resulting in reforms to reduce counterfeit drugs and better regulate pharmaceuticals 2. Despite these changes, there is still room for improvement. This study assessed the perceived level of transparency and potential vulnerability to corruption that exists in four essential areas of Nigeria's pharmaceutical sector: registration, procurement, inspection (divided into inspection of ports and of establishments, and distribution. Methods Standardized questionnaires were adapted from the World Health Organization assessment tool and used in semi-structured interviews with key stakeholders in the public and private pharmaceutical system. The responses to the questions were tallied and converted to scores on a numerical scale where lower scores suggested greater vulnerability to corruption and higher scores suggested lower vulnerability. Results The overall score for Nigeria's pharmaceutical system was 7.4 out of 10, indicating a system that is marginally vulnerable to corruption. The weakest links were the areas of drug registration and inspection of ports. Analysis of the qualitative results revealed that the perceived level of corruption did not always match the qualitative evidence. Conclusion Despite the many reported reforms instituted by NAFDAC, the study findings suggest that facets of the pharmaceutical system in Nigeria remain fairly vulnerable to corruption. The most glaring deficiency seems to be the

  18. Transparency in Nigeria's public pharmaceutical sector: perceptions from policy makers.

    Science.gov (United States)

    Garuba, Habibat A; Kohler, Jillian C; Huisman, Anna M

    2009-10-29

    Pharmaceuticals are an integral component of health care systems worldwide, thus, regulatory weaknesses in governance of the pharmaceutical system negatively impact health outcomes especially in developing countries 1. Nigeria is one of a number of countries whose pharmaceutical system has been impacted by corruption and has struggled to curtail the production and trafficking of substandard drugs. In 2001, the National Agency for Food and Drug Administration and Control (NAFDAC) underwent an organizational restructuring resulting in reforms to reduce counterfeit drugs and better regulate pharmaceuticals 2. Despite these changes, there is still room for improvement. This study assessed the perceived level of transparency and potential vulnerability to corruption that exists in four essential areas of Nigeria's pharmaceutical sector: registration, procurement, inspection (divided into inspection of ports and of establishments), and distribution. Standardized questionnaires were adapted from the World Health Organization assessment tool and used in semi-structured interviews with key stakeholders in the public and private pharmaceutical system. The responses to the questions were tallied and converted to scores on a numerical scale where lower scores suggested greater vulnerability to corruption and higher scores suggested lower vulnerability. The overall score for Nigeria's pharmaceutical system was 7.4 out of 10, indicating a system that is marginally vulnerable to corruption. The weakest links were the areas of drug registration and inspection of ports. Analysis of the qualitative results revealed that the perceived level of corruption did not always match the qualitative evidence. Despite the many reported reforms instituted by NAFDAC, the study findings suggest that facets of the pharmaceutical system in Nigeria remain fairly vulnerable to corruption. The most glaring deficiency seems to be the absence of conflict of interest guidelines which, if present and

  19. Inovações na intermediação entre os setores público e privado na assistência à saúde Innovations in the intermediation between public and private sectors in health care

    Directory of Open Access Journals (Sweden)

    Rosimary Gonçalves de Souza

    2002-01-01

    Full Text Available Este artigo busca uma aproximação de algumas das mudanças em curso no sistema de saúde, focalizando especificamente o setor privado prestador de serviços de saúde, que, ao longo das últimas décadas, vem mantendo peso decisivo na condução da política de saúde. Nesse sentido, importa mapear as diferentes modalidades sob as quais se insere a iniciativa privada na prestação de serviços de saúde, mostrando as mudanças mais significativas na relação entre o setor público e o privado, tendo como contraponto o contexto das décadas de 1970 e 1980. Algumas dessas modalidades se constituem, na verdade, de uma intensificação ou consolidação de padrões e tendências presentes desde os anos 70, como o setor que integra as seguradoras de saúde e as empresas de medicina de grupo. Outras, como a atuação das cooperativas médicas junto ao setor público, mostram-se como tendências em expansão numa conjuntura de crise fiscal do estado e regressividade dos investimentos no campo social.This article intends an approach with some of the changes in course in the health system, specifically the private supplier of health services, that comes maintaining along the last decades decisive weight in the conduction of the health policy. In that sense, it imports to show the different modalities under which this sector interferes the private initiative in the installment of health services, showing the more important changes in the relationship between the public and the private sectors, tending as counterpoint the context of the decades of 70 and 80. Some of those modalities are constituted, actually, an consolidation of patterns and present tendencies since the seventies, as the section that integrates the insurance companies of health and the group medicine companies. Other, as the performance of the medical cooperatives close to the public section, they are shown as tendencies in expansion in a conjuncture of fiscal crisis of the state and

  20. 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...

  1. Health sector reforms for 21 st century healthcare

    Directory of Open Access Journals (Sweden)

    Darshan Shankar

    2015-01-01

    Full Text Available The form of the public health system in India is a three tiered pyramid-like structure consisting primary, secondary, and tertiary healthcare services. The content of India′s health system is mono-cultural and based on western bio-medicine. Authors discuss need for health sector reforms in the wake of the fact that despite huge investment, the public health system is not delivering. Today, 70% of the population pays out of pocket for even primary healthcare. Innovation is the need of the hour. The Indian government has recognized eight systems of healthcare viz., Allopathy, Ayurveda, Siddha, Swa-rigpa, Unani, Naturopathy, Homeopathy, and Yoga. Allopathy receives 97% of the national health budget, and 3% is divided amongst the remaining seven systems. At present, skewed funding and poor integration denies the public of advantage of synergy and innovations arising out of the richness of India′s Medical Heritage. Health seeking behavior studies reveal that 40-70% of the population exercise pluralistic choices and seek health services for different needs, from different systems. For emergency and surgery, Allopathy is the first choice but for chronic and common ailments and for prevention and wellness help from the other seven systems is sought. Integrative healthcare appears to be the future framework for healthcare in the 21 st century. A long-term strategy involving radical changes in medical education, research, clinical practice, public health and the legal and regulatory framework is needed, to innovate India′s public health system and make it both integrative and participatory. India can be a world leader in the new emerging field of "integrative healthcare" because we have over the last century or so assimilated and achieved a reasonable degree of competence in bio-medical and life sciences and we possess an incredibly rich and varied medical heritage of our own.

  2. Health sector reforms for 21(st) century healthcare.

    Science.gov (United States)

    Shankar, Darshan

    2015-01-01

    The form of the public health system in India is a three tiered pyramid-like structure consisting primary, secondary, and tertiary healthcare services. The content of India's health system is mono-cultural and based on western bio-medicine. Authors discuss need for health sector reforms in the wake of the fact that despite huge investment, the public health system is not delivering. Today, 70% of the population pays out of pocket for even primary healthcare. Innovation is the need of the hour. The Indian government has recognized eight systems of healthcare viz., Allopathy, Ayurveda, Siddha, Swa-rigpa, Unani, Naturopathy, Homeopathy, and Yoga. Allopathy receives 97% of the national health budget, and 3% is divided amongst the remaining seven systems. At present, skewed funding and poor integration denies the public of advantage of synergy and innovations arising out of the richness of India's Medical Heritage. Health seeking behavior studies reveal that 40-70% of the population exercise pluralistic choices and seek health services for different needs, from different systems. For emergency and surgery, Allopathy is the first choice but for chronic and common ailments and for prevention and wellness help from the other seven systems is sought. Integrative healthcare appears to be the future framework for healthcare in the 21(st) century. A long-term strategy involving radical changes in medical education, research, clinical practice, public health and the legal and regulatory framework is needed, to innovate India's public health system and make it both integrative and participatory. India can be a world leader in the new emerging field of "integrative healthcare" because we have over the last century or so assimilated and achieved a reasonable degree of competence in bio-medical and life sciences and we possess an incredibly rich and varied medical heritage of our own.

  3. Towards a public health profession

    DEFF Research Database (Denmark)

    Foldspang, Anders

    2015-01-01

    in the theoretical as well as the practical potential of the public health professional. Thus, he and she must be able to perform, what WHO Europe has developed as Essential Public Health Operations (EPHOs).3 This, in turn, implies that the public health professional possesses the set of intellectual (knowledge...... endorsed by WHO Europe’s member states as the basis for the public health education in Europe.5 The sections of the lists include: Public health methods; Population health and: Its social and economic determinants, and: Its material environmental determinants; Man-made interventions and systems, namely...... Health policy, health economics, organizational theory, health legislation, and public health leadership and management; Health promotion—health education, health protection, disease prevention; public health ethics. This should form the central part of the basis for all public health professionals...

  4. 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.

  5. Music and Public Health

    DEFF Research Database (Denmark)

    Bonde, Lars Ole; Juel, Knud; Ekholm, Ola

    2016-01-01

    Background: ‘Music and public health’ is a new field of study. Few scientific studies with small samples have documented health implications of musical participation. Research questions in this epidemiological study were: 1) Is there an association between self-rated health and active use of musi......: 57%. Multiple logistic regression analyses were performed to investigate associations between musical background/activities and health-related indicators. Discussion: The study documents that a majority of informants use music to regulate physical and psychological states......Background: ‘Music and public health’ is a new field of study. Few scientific studies with small samples have documented health implications of musical participation. Research questions in this epidemiological study were: 1) Is there an association between self-rated health and active use of music...... in daily life? 2) What associations can be observed between musical background, uses and understanding of music as a health factor, and self-reported health? Method: Data came from the Danish Health and Morbidity Survey 2013, based on a simple random sample of 25.000 adult Danes (16+ years). Response rate...

  6. Towards improvement of ethics in the public sector in Zimbabwe

    Directory of Open Access Journals (Sweden)

    Daniel Chigudu

    2015-03-01

    Full Text Available In Zimbabwe reports of abuse of public office have manifested in various forms resulting in public outcry; poor service delivery, and government losing millions of dollars. This study aims to undertake a reflective inquiry on the ethical conduct in the Zimbabwean public sector through content and process analysis in order to provide intervention mechanisms to the problem. Statistical analysis of corruption level is made to benefit the study. Results indicated some legislative gaps and an incapacitated Anti-Corruption Commission which has been unable to execute its mandate fully. Most senior public officials and politicians appear to have too much power and authority with no checks and balances in place. Practical implications of the widespread unethical practices call for the government to plug the glaring legislative gaps; take stern measures against offenders; empowering the Anti-Corruption Commission; term limits for senior public officials as well as for political appointments; and motivating political will to uphold ethical leadership. The recommendations will open a window for the Zimbabwean government and administrators to view how some advanced economies have propped up ethical behaviour in the public sector. It is the way to go for ailing economies like Zimbabwe. The paper demonstrated the importance of ethical awareness in another political and economic setting-Zimbabwe.

  7. Democratizing Process Innovation? On Citizen Involvement in Public Sector BPM

    Science.gov (United States)

    Niehaves, Björn; Malsch, Robert

    ‘Open Innovation’ has been heavily discussed for product innovations; however, an information systems (IS) perspective on ‘process innovation’ has not yet been taken. Analyzing the example of the public sector in Germany, the paper seeks to investigate the factors that hinder and support ‘open process innovation’, a concept we define as the involvement of citizens in business process management (BPM) activities. With the help of a quantitative study (n=358), six factors are examined for their impact on citizen involvement in local government BPM initiatives. The results show that citizen involvement in reform processes is not primarily motivated by the aim of cost reduction, but rather related to legitimacy reasons and the intent to increase employee motivation. Based on these findings, implications for (design) theory and practice are discussed: Instead of detailed collaborative business processes modeling, the key of citizen involvement in public sector BPM lies in communication and mutual understanding.

  8. [Social marketing and public health].

    Science.gov (United States)

    Arcaro, P; Mannocci, A; Saulle, R; Miccoli, S; Marzuillo, C; La Torre, G

    2013-01-01

    Social marketing uses the principles and techniques of commercial marketing by applying them to the complex social context in order to promote changes (cognitive; of action; behavioral; of values) among the target population in the public interest. The advent of Internet has radically modified the communication process, and this transformation also involved medical-scientific communication. Medical journals, health organizations, scientific societies and patient groups are increasing the use of the web and of many social networks (Twitter, Facebook, Google, YouTube) as channels to release scientific information to doctors and patients quickly. In recent years, even Healthcare in Italy reported a considerable application of the methods and techniques of social marketing, above all for health prevention and promotion. Recently the association for health promotion "Social marketing and health communication" has been established to promote an active dialogue between professionals of social marketing and public health communication, as well as among professionals in the field of communication of the companies involved in the "health sector". In the field of prevention and health promotion it is necessary to underline the theme of the growing distrust in vaccination practices. Despite the irrefutable evidence of the efficacy and safety of vaccines, the social-cultural transformation together with the overcoming of compulsory vaccination and the use of noninstitutional information sources, have generated confusion among citizens that tend to perceive compulsory vaccinations as needed and safe, whereas recommended vaccinations as less important. Moreover, citizens scarcely perceive the risk of disease related to the effectiveness of vaccines. Implementing communication strategies, argumentative and persuasive, borrowed from social marketing, also for the promotion of vaccines is a priority of the health system. A typical example of the application of social marketing, as

  9. Gis and public health

    CERN Document Server

    Cromley, Ellen K

    2011-01-01

    Authoritative and comprehensive, this is the leading text and professional resource on using geographic information systems (GIS) to analyze and address public health problems. Basic GIS concepts and tools are explained, including ways to access and manage spatial databases. The book presents state-of-the-art methods for mapping and analyzing data on population, health events, risk factors, and health services, and for incorporating geographical knowledge into planning and policy. Numerous maps, diagrams, and real-world applications are featured. The companion Web page provides lab exercises w

  10. Accounting Changes in the Public Sector in Estonia

    OpenAIRE

    Tikk, Juta

    2010-01-01

    This paper reviews the implementation of the accrual accounting in the entities of the Estonian public sector. It gives a brief overview of the historical development of governmental accounting theories and examines the introduction of theory-based accounting policy. It explains main problems and risks to face in connection with the accounting system change process and offers solutions. This study attempts to answer the following research question: how to gain full benefit from accounting inf...

  11. Applications of aerospace technology in the public sector

    Science.gov (United States)

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

    1971-01-01

    Current activities of the program to accelerate specific applications of space related technology in major public sector problem areas are summarized for the period 1 June 1971 through 30 November 1971. An overview of NASA technology, technology applications, and supporting activities are presented. Specific technology applications in biomedicine are reported including cancer detection, treatment and research; cardiovascular diseases, diagnosis, and treatment; medical instrumentation; kidney function disorders, treatment, and research; and rehabilitation medicine.

  12. Implementing lean office: a successful case in public sector

    OpenAIRE

    Monteiro, Mónica F. J. R.; Pacheco, Claudia C. L.; Dinis-Carvalho, José; Paiva, Francisco C.

    2015-01-01

    Applying lean approaches in office areas can lead to performance improvements and other benefits as achieved in traditional manufacturing environments. The intangibility of office operations may appear as a major difficulty for lean implementations but in fact the benefits achievable are as important as the ones achieved in manufacturing environments. This paper reports a successful case of lean office implementation in a public sector organization giving emphasis to its major performance imp...

  13. Research of quality culture in the public sector organization

    OpenAIRE

    Aškelavičius, Izoldas

    2017-01-01

    RESEARCH OF QUALITY CULTURE IN THE PUBLIC SECTOR ORGANIZATION Izoldas AŠKELAVIČIUS Paper for the Master’s degree Quality Management Master’s Program Vilnius University, Faculty of Economics, Management Department Supervisor – Assoc. Prof. Dr. R. Adomaitienė Vilnius, 2017 SUMMARY 64 pages, 8 charts, 13 pictures, 81 references. The main purpose of this master thesis is to analyze Vilnius local labor exchange quality culture topics, reveal the current state of quality culture. The work consists ...

  14. How useful is consolidation of public sector entities' financial statements ?

    OpenAIRE

    Soguel, N.; Bucher, R.

    2013-01-01

    Whether or not to consolidate financial statements is dealt with in IPSAS#6. This standard is by and large based on IAS#27. It deals with the criterion according to which an entity's financial statements should be considered and which consolidation technique should be used. However, it remains silent when it comes to exposing the reason why a public sector entity should consolidate its financial statements. The literature is almost as silent as IPSAS on this issue. Which means that there is a...

  15. International comparisons of public sector performance: how to move ahead?

    OpenAIRE

    Van de Walle, Steven

    2009-01-01

    textabstractMeasuring and comparing the overall performance of countries’ public sectors requires agreement on definitions and objectives of government. I argue that such an agreement is about finding a consensus rather about finding better definitions. Measuring government requires a number of leaps of faith, where certain definitions, assumptions and statistics are accepted as good enough for measurement and comparison. The political science and economic research community have a different ...

  16. 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.

  17. Open Data Strategies and Experiences to Improve Sharing and Publication of Public Sector Information

    Directory of Open Access Journals (Sweden)

    Laura María Gutiérrez Medina

    2014-11-01

    Full Text Available The Canary Islands receive 10 million tourists every year. Tourism represents a key sector for economic development in the Canaries. This work presents the benefits of open data usages in the tourism sector both in municipalities and in the island government. These public institutions have valuable information that should be shared with other institutions: 600 hotels and apartments, 10,000 bars and restaurants, and more than 15,000 retail businesses. This article describes an open data project to validate and to publish such data across multiple administrations. The main benefits for the public sector are the improvement of the data quality and the interoperability between different administrations.

  18. 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

  19. Globalisation and public health.

    Science.gov (United States)

    Bettcher, D; Lee, K

    2002-01-01

    At the dawn of the 21st century, globalisation is a word that has become a part of everyday communication in all corners of the world. It is a concept that for some holds the promise of a new and brighter future, while for others it represents a threat that needs to be confronted and counteracted. In the area of public health, a wide range of claims have been made about the various impacts, both positive and negative, that can be attributed to globalisation. In the ever expanding literature on globalisation and health, it has become apparent that considerable confusion is emerging in both the ways that terminology is applied and concepts are defined. The determinants of health are increasingly multisectoral, and in tackling these challenges it is necessary to take a multidisciplinary approach that includes policy analyses in such areas as trade, environment, defence/security, foreign policy, and international law. In assembling the terms for this glossary, we have attempted to demonstrate the richness of the globalisation and public health debate, and in so doing have selected some of the core terms that require definition. We hope that this glossary will help to clarify this interesting and challenging area, and will also serve as a useful entry point to this new debate in public health.

  20. Participation in design between public sector and local communities

    DEFF Research Database (Denmark)

    Bødker, Susanne; Zander, Pär-Ola

    2015-01-01

    This paper discusses three cases where design was carried out at the intersection between public sector and citizen communities. Based on three dominant traditions meeting there–public (municipal) decision-making, Web 2.0 and participatory design–we identify challenges and solutions regarding......-win situations, rather than to maximize participation; to work with motivation for long-term projects across municipality and communities; to identify and work with early movers, and not just representative citizens; and to create space for local municipal agencies to develop bottom-up technological solutions...

  1. Private health care sector investment in Brazil: opportunities and obstacles.

    Science.gov (United States)

    Brandt, Reynaldo

    2003-01-01

    The Brazilian health system is based upon the constitutional right formulated in 1988, according to which health is the peoples' right and duty of the State. So being, it is essentially the government's responsibility, expressed in the so-called Sistema Unico de Saúde--SUS (single health system) Since its creation, however, it admits the existence of a supplementary health system, left to the private sector. In general terms, the public system is considered unsatisfactory in the services it renders. Its resources are distributed heterogeneously, favoring centers of advanced medical practice, to the detriment of basic health care. The supplementary system is considered of better quality, however with great variations and frequent accusations of being essentially profit driven, instead of being driven to the needs of the assisted population. The growing search for health plans is a direct consequence of the image perceived by the population regarding the quality and accessibility of the public services, as well as of the peoples' growing consciousness of their needs, rights and duties as citizens. The need for continuous quality improvement and cost reduction offers numberless opportunities for actions and investments. Initiatives to identify and implement the best medical practices, medical guidelines and actions are essential regarding those illnesses which are most frequent, of higher cost and of greater risk. Health plans and healthcare providers will necessarily have to focus on their common client. Therefore, organizations must be created in order to develop initiatives aimed to the quality of patient care, as well as to the collection and dissemination of data regarding the production and results of the main service providers. Consequently, immense opportunities are being opened for investments in the area of Information Technology, collection, analysis, and data dissemination. This paper analyses the main trends in the Brazilian health sector and from the

  2. The public healthcare sector and governance in South Africa

    Directory of Open Access Journals (Sweden)

    Melody Brauns

    2015-05-01

    Full Text Available This article reviews literature on governance in order to facilitate an analysis of the governance of the South African public healthcare sector. Some of the key theoretical perspectives have been presented on how best to organise the state and its bureaucracy. Theorists have long interrogated in what way public institutions foster or impede economic growth. Evans and Rauch point out for example, that the role of bureaucratic authority structures in facilitating economic growth has been a sociological concern since Max Weber’s classic contributions almost 100 years ago. These debates and others are explored in this article with specific reference to the provision of equitable public healthcare. Weber’s theory on rational bureaucracy as well as New Public Management will be reviewed as these theories offer two distinct approaches to governance

  3. 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.

  4. The Immigrant Wage Gap in Canada: Differences between the Public and the Private Sector

    OpenAIRE

    Serge Nadeau

    2013-01-01

    This paper uses 2006 Canadian census data to examine patterns of wage differentials between immigrants and Canadian natives across the public and private sectors. Results reveal that the wage gap is much more a private sector issue than a public sector issue: the average wage gap is in favour of Canadian natives in the private sector but in favour of immigrants in the public sector; compared to natives, immigrants earn significantly less per year of domestic schooling and per year of domestic...

  5. Balancing protection of public health and safety with the free movement of goods in the EU medical device sector : The case of ‘borderline products’ classification

    NARCIS (Netherlands)

    Tseliou, Tasoula

    2015-01-01

    In 2013, the CJEU ruled on the ‘Lyocentre’ case touching upon an important and contemporary issue in the EU Medical Device regime – the classification issue between medical devices and medicinal products. This problem is connected with the internal market v. protection of health dilemma as well as

  6. AUDIT EXPECTATION GAP IN THE PUBLIC SECTOR IN ROMANIA

    Directory of Open Access Journals (Sweden)

    Gherai Dana Simona

    2011-12-01

    Full Text Available Theme – It is know that the large public and auditors hold different beliefs about the auditors’ duties and responsibilities. In this conditions audit expectation gap represents that level of expectation that remains uncovered. In this study paper, audit expectation gap represents the difference between the achievements of public auditors and the expectations that general public (students have beyond those responsibility. Purpose – The evolution of audit expectation gap has been examined in various countries, but the extent of the concept has not been investigated so much in public area. This study attempts to assess the perceptions of possible future auditors, students, regarding the existence of expectation gap in public area. Literature review – A review of the literature identifies many researches who define the concept since was given the first definition of audit expectation gap as the difference between the levels of expected performance and the results that auditors give, but just a few analysis the public area using students’ knowledge to understand the perception of future users of accounting information or potential bidders of accounting information. Methodology – This paper represents the beginning of a broader study that will be part of the doctoral thesis entitled “Organization and exercise of public audit in Romania”, started in 2009 at University Babes Bolyai from Cluj Napoca, coordinated by PhD Professor Matis Dumitru. The aim of this paper is to explore the findings of an empirical study, made on 352 students, were the primary data used were obtained through a questionnaire technique regarding the audit expectation gap in the public sector in Romania, looking into future to obtain responses using a larger respondent group. Findings – A reasonableness gap was uncovered, there is a gap between the expectation of students regarding the public auditors' profession and their results and there are differences

  7. 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.

  8. 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.

  9. Bioethics and Public Health

    Directory of Open Access Journals (Sweden)

    Víctor Penchaszadeh

    2018-06-01

    Full Text Available This article looks at the evolution of bioethics a discipline from its initial focus, concerned with issues of personal autonomy and the conflicts around the use of complex technology in medicine, to where it is now; focused on major population issues in public health, with a focus on equality, justice and the right to health. As part of this it considers the 18 guiding principles and issues in bioethics contained in the Universal Declaration of Bioethics and Human Rights of UNESCO.

  10. Controllership as a Governance Instrument in the Public Sector

    Directory of Open Access Journals (Sweden)

    Mônica Clark Nunes Cavalcante

    2013-03-01

    Full Text Available Controllership is considered a Corporate Governance instrument, to the extent that it can contribute to reduce information asymmetry ad conflicts of interest, deriving from agency problems between organizational owners and managers, by making available information that permit valuing the organization and the extent to which its goals are achieved. Disclosure and accountability are basic pillars of Corporate Governance as well as Controllership. The Public Sector Committee (PSC of the International Federation of Accountants (IFAC developed a study on governance for the public context, considering that governance principles should be present in public entities, reflected in four dimensions, two of which related to control and to the availability of external reports (Federação Internacional dos Contadores [IFAC] (2001. The main goal in this research is to identify which information the Office of the Comptroller General (CGU makes available on its website comply with the type and contents of IFAC recommendations for control and external reports, as governance dimensions in the public sector. Through a bibliographic and documentary research, it was verified that only information related to budgetary and financial reports comply with the type and contents recommended by IFAC. The research also revealed that information related to internal audit and annual Government accountability partially address the contents recommended by IFAC.

  11. Facebook and Public Health

    DEFF Research Database (Denmark)

    Straton, Nadiya; Vatrapu, Ravi; Mukkamala, Raghava Rao

    2017-01-01

    This paper reports on a survey about the perceptions and practices of social media managers and experts in the area of public health. We have collected Facebook data from 153 public health care organizations and conducted a survey on them. 12% of organizations responded to the questionnaire....... The survey results were combined with the findings from our previous work of applying clustering and supervised learning algorithms on big social data from the official Facebook walls of these organizations. In earlier research, we showed that the most successful strategy that leads to higher post engagement...... is visual content. In this paper, we investigated if organisations pursue this strategy or some other strategy that was successful and has not been uncovered by the machine learning algorithms. Performance of each organisation on Facebook is based on the number of posts (volume share) and the number...

  12. Geomatics and public health.

    Science.gov (United States)

    Jaishankar, R; Jhonson, C P

    2006-01-01

    Geomatics technology has tremendous potential to address public health issues particularly under the present circumstances of global climate change and climate or technology induced human migration, which result in an increase in the geographical extent and re-emergence of vector-borne diseases. The authors present an overview of the science of geomatics, describe the potential impacts of climate change on vector-borne diseases and review the applications of remote sensing for disease vector surveillance.

  13. Doping and Public Health

    DEFF Research Database (Denmark)

    Christiansen, Ask Vest

    rad av världens främsta idrottsvetare och dopningsexperter hade mött upp för att presentera papers till en intresserad och engagerad publik. Temat för konferensen var "Doping and Public Health", och den aspekten behandlades också; dock tolkade flera presentatörer temat på sina egna vis, och hela...

  14. 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

  15. Public service motivation and job performance of public sector employees in the Netherlands

    NARCIS (Netherlands)

    Leisink, P.L.M.; Steijn, B.

    2009-01-01

    This article contributes in three ways to our understanding of public service motivation (PSM) and its effects. In the first place, it applies an abridged version of Perry's measurement scale in the Dutch public sector. Although the results of the analysis show that PSM is a valid concept in this

  16. Management Control, Results-Oriented Culture and Public Sector Performance : Empirical Evidence on New Public Management

    NARCIS (Netherlands)

    Verbeeten, Frank H M; Speklé, Roland F.

    2015-01-01

    New Public Management (NPM) has been guiding public sector reform for over 25 years. Its position on the design of effective management control rests on three key ideas: (1) performance improvement requires a results-oriented culture that emphasizes outcomes rather than inputs or processes; (2)

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

    Science.gov (United States)

    Flint, Douglas H

    2003-01-01

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

  18. The EFQM model on Danish public sector aspects of TQM

    DEFF Research Database (Denmark)

    Dahlgaard, Jens Jørn; Madsen, Ole Nørgaard

    The applicability of the EFQM model (or the European Quality Award Model) to the public sector is to be discussed from three different angels referring to projects all funded by the Danish national government. First, as a recent part of the Aarhus Business School research project on quality...... as a guideline for implementing quality management at vocational colleges. This project is referring to the EFQM model as one of the approaches to be used. Thirdly, the EFQM Model is recommended by the Danish national government as the tool for assessing not only private companies business excellence, but public....... The final aim is to empower public institutions to compete with private companies for the Danish National Quality Award based upon the EFQM Model....

  19. Health sector reform in Argentina: a cautionary tale.

    Science.gov (United States)

    Lloyd-Sherlock, Peter

    2005-04-01

    In November 2002 the World Bank published a report on the Argentine health sector. The report accurately portrays the complexity and severity of the problems facing the health care system. It stresses that these problems are not purely a product of the country's economic collapse, noting that the system has suffered from long-standing structural problems and inefficiencies. Curiously, the report makes no mention of the leading role played by the World Bank in health reform efforts during the 1990s. This paper demonstrates that these reforms did much to worsen pre-existing weaknesses of the sector. The paper criticises the content of the reform agenda and the manner in which it was produced, arguing that these were reforms in which considerations of public health were less significant than conformity to the wider model of neo-liberal social and economic development prevailing at the time. It also highlights problems of implementing the reform agenda, which reduced the coherency of the reforms. The paper goes on to examine the impact of the crisis, noting links with the preceding reforms. It identifies a number of insights and lessons of potential value to other countries which are pursuing similar policies.

  20. 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

  1. 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

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

    Science.gov (United States)

    Hope, Kempe Ronald, Sr.

    2013-01-01

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

  3. Knowledge of hypertension and its management among hypertensive patients on chronic medicines at primary health care public sector facilities in South Africa; findings and implications.

    Science.gov (United States)

    Rampamba, Enos M; Meyer, Johanna C; Helberg, Elvera; Godman, Brian

    2017-08-01

    There are high growing prevalence rates of hypertension in South Africa. Consequently, there is a need to assess knowledge and management among hypertensive patients receiving chronic medication from primary health care (PHC) facilities in South Africa as a basis for improving future management. This is important as South Africa seeks to improve its management of chronic diseases. Descriptive, quantitative study amongst chronic hypertensive patients in the chronic disease programme. Patients were interviewed face-to-face by trained pharmacists using a structured questionnaire. Data analysis included descriptive and inferential statistics. Half (53.7%) of the patients had uncontrolled blood pressure (BP). Less than a third of patients (27.7%) knew what hypertension is, the meaning of recorded BP numbers (4.5%), and what normal BP should be (19.9%). All patients who knew the meaning of BP numbers had formal education (p = 0.047). Only 15.6% of the 56.0% patients, who received hypertension information, received it on antihypertensive medicines specifically. The majority of the patients lacked hypertension specific knowledge and only half had controlled BP. Interventions to improve the control of high BP should be targeted at closing knowledge gaps as part of the current chronic treatment initiatives in South Africa to ensure the benefits of increased access to care are realized.

  4. Measuring the internal-market orientation in the public sector

    Directory of Open Access Journals (Sweden)

    Emerson Wagner Mainardes

    2015-03-01

    Full Text Available The application of internal marketing in organizations has been researched by scholars for nearly three decades, but literature has little empirical research in the public sector. There is a latent debate on the relevance of internal marketing in the public sector, given the need to provide a more effective service to the citizens. Given the possibility that the internal-market orientation is an antecedent of job satisfaction, the objective of this research was to measure the level of internal market orientation in the public sector, and the Military Fire Department of the State of Espírito Santo (MFDESS was surveyed using quantitative research. The instrument for data collection was a structured questionnaire, which follows the model used by Gounaris (2006 in research with employees of a hotel chain in Greece. 522 firefighters were surveyed. The choice of this organization was due to the importance of the service performed and the society visibility, given the direct relationship with life and assets of the taxpayers. Therefore, the level of job satisfaction of firefighters is relevant for the achievement of excellence in their missions. The results showed that firefighters have the perception that there is little internal-market orientation in the Military Fire Department and the level of job satisfaction is low. The research result converged with the literature on the direct relationship of the internal-market orientation with job satisfaction. Furthermore, the research concluded that job satisfaction is influenced by the identification of the exchange of value, segment internal market, job description, management concern and training.

  5. From theoretical concept to organizational tool for public sector improvement:

    DEFF Research Database (Denmark)

    Ernst, Jette; Hindhede, Anette Lykke; Andersen, Vibeke

    2018-01-01

    Purpose – The purpose of this paper is to examine, first, how social capital was crafted and transformed from a theoretical concept to an organizational tool for public sector improvement that was adopted by a Danish region and implemented in all regional hospitals. Second, the paper examines...... produce a pressure on the department management and the nurses. Originality/value – The explanatory critical framework combined with the ethnographic approach is a useful approach for theorizing and understanding social capital as an example of the emergence and consequences of new managerial tools...

  6. Power, Governance and Boundary Spanning Leadership in Public Sector Organisations

    DEFF Research Database (Denmark)

    Elmholdt, Claus Westergård; Fogsgaard, Morten

    2015-01-01

    the fact that analysis of boundary spanning leadership and power relations is an essential, significant, and critical tool in questioning different forms of management in public sector organizations. The aim of the workshop is to investigate, elucidate and discuss management across organizational units...... on the practice that evolves on the boundaries that span occupational groups, departments and organizations. The workshop takes it’s starting point in an interdisciplinary Scandinavian research project which deals with the question of how power processes can promote, or hinder, boundary spanning leadership...

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

    Directory of Open Access Journals (Sweden)

    Pillay Rubin

    2008-02-01

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

  8. Health Sector Coordination in Disasters: Barriers & Facilitators

    Directory of Open Access Journals (Sweden)

    Mohammadkarim Bahadori

    2016-07-01

    Full Text Available Background: Coordination is a critical factor in successful organization and appropriate response to disasters. In this regard, a centralized coordination mechanism is the first step towards an effective, efficient, and sustainable response in order to be ensured of the short- and long-term recovery. Thus, this study aimed to identify and prioritize the barriers and facilitators of coordination in disasters. Materials and Methods: This research was a descriptive and cross-sectional study, conducted in 2016. The participants comprised 22 experts in field of disaster. Data collection tool was a researcher-made questionnaire according to the analytical hierarchy process approach. For data analysis, we used Expert Choice software. Results: Based on the results, “dominance of organizational approach instead of national points of view when addressing the health management during disasters,” took the first priority rank, earning the score of 0.344 among the barriers. Furthermore, among the facilitators, “having a processive and organizational view in health management during disasters,” took the first priority rank, earning the score of 0.374. Conclusion: To increase the effective coordination in health area, we should develop infrastructure and structural measures, which include bolstering authorities’ belief about the health system’s role in the response to disasters, reinforcing the national approach rather than organizational approach in the field of health at disasters, implementing the coordination requirements, attending sufficiently and specifically to public participation, reducing the organizational friction in the health field for sharing resources and information, raising the level of readiness with a focus on people and training programs, and finally creating an evolutionary process in the health field at disasters.

  9. Professional and Ethical Conduct in the Public Sector

    Directory of Open Access Journals (Sweden)

    Thozamile Richard Mle

    2012-06-01

    Full Text Available One of the basic values and principles governing public administration enshrined in the Constitution of the Republic of South Africa, 1996 (Chapter 10 is that “a high standard of professional ethics must be promoted and maintained. Ethics is a process by which we clarify right and wrong and act on what we take to be right, that is, a set or system of moral principles that are generally accepted. Ethics simply means  what is right and wrong, what is acceptable or unacceptable and is intertwined with the value system of people. Ethics can also be seen as being relative, not absolute, as ethical behaviour is in the eyes of the beholder. Be that as it may, however, ethical conduct and behaviour normally refer to conforming with generally accepted social norms. Relative to ethics is professionalism, which entails a high standard of work and adherence to certain standards and principles pertaining to specific work to be done. Professionalism embodies skills, competence, efficiency and effectiveness. Public institutions exist for the public good and employ public servants to render services to ensure a better life for all. The public sector is characterised by unprofessional and unethical conduct. The article unearths these and suggests strategies/mechanisms to address this ‘ill’. Can an unethical,  unprofessional public servant be trusted to deliver services? Can, for example, a debt-trapped public servant who survives on borrowing money from micro-lenders, who cannot manage personal finances, be trusted to efficiently manage public funds and thus enhance service delivery? Can an incompetent, corrupt, disloyal, unaccountable, shoddy public servant who flouts the principles of Batho Pele and the code of conduct be entrusted with the  responsibilities of ensuring a better life for all? The answers to these questions constitute the core of this article.

  10. Ideologies in the Swedish health sector today

    DEFF Research Database (Denmark)

    Diderichsen, Finn

    1982-01-01

    Sweden has a long tradition of social democracy and corporate cooperation. Social problems are treated as technological questions that always should be solved through rational and neutral means. Today Sweden faces a crisis of economy as well as a crisis of medicine. In the spirit of consensus, th...... system of primary care and prevention. However, in the context of the current economic crisis, the struggle against health hazards and cuts in public spending has intensified and the gap between the ideology of technological rationalism and reality has widened....

  11. 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

  12. 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.

  13. 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.

  14. A global public health imperative

    African Journals Online (AJOL)

    MESKE

    Actions towards closing the health equity gap: A global public health imperative. Tewabech ... global health development. With only two ... of himself and of his family; including food, clothing .... impact on health equity and in the end issued the.

  15. 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.

  16. 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.

  17. 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.

  18. Nanotechnology and public health

    Directory of Open Access Journals (Sweden)

    Ferdi Tanır

    2015-08-01

    Full Text Available Nanotechnology is a new revolution in technology; being used in different parts of life such as self-cleaning paints, dirt repellent fabrics, the destruction of cancer cells without harming the person, biosensors that can detect even a single bacterium, odorless socks due to the destruction of bacteria, germ-free refrigerators, disinfection etc. In this article, we consider in the perspective of public health the possible risks of this new technology, which is starting to appear in all areas of our daily lives. 

  19. Using climate information in the health sector

    Directory of Open Access Journals (Sweden)

    T. A. Ghebreyesus

    2010-09-01

    Full Text Available Many infectious and chronic diseases are either directly or indirectly sensitive to the climate. Managing this climate sensitivity more effectively requires new working relationships between the health sector and the providers of climate data and information. In Africa, where communities are particularly vulnerable, Ministries of Health and National Meteorological Services need to collaborate to reduce the burden of climate related ill health. The Ministry of Health and the National Meteorological Agency of Ethiopia have made significant progress towards the development of a climate-informed early warning and response system for diseases such as malaria and other climate-sensitive diseases. An important enabling mechanism is a Climate and Health Working Group, which is a multi-sectoral partnership created to spearhead the use of climate information for health interventions. While this is a work in progress, the key ingredients necessary to sustain such a joint venture are described to encourage similar activities in other countries faced with a growing climate-sensitive disease burden, to facilitate networking and to increase the return from the investment.De nombreuses infections et maladies chroniques sont sensibles, directement ou indirectement, au climat. Une gestion plus efficace de cette sensibilité au climat passe par l’instauration d’une coopération entre le secteur de la santé et les fournisseurs de données et d’informations sur le climat. En Afrique, où les communautés sont particulièrement vulnérables, le ministère de la Santé et les Services de météorologie nationale doivent collaborer pour réduire le fardeau des maladies liées au climat.Le ministère de la Santé et l’Agence de météorologie nationale d’Ethiopie ont fait des progrès considérables dans le développement d’un système d’alerte et de réponse précoces basé sur les informations climatiques pour des maladies comme le paludisme et d

  20. Advances in dental public health.

    Science.gov (United States)

    Holt, R D

    2001-07-01

    Dental public health has been defined as 'the science and art of preventing oral diseases, promoting oral health and improving the quality of life through the organised efforts of society'. Dental practitioners most often have the oral health of individual patients as their primary focus but the aim of public health is to benefit populations. Early developments in dental public health were concerned largely with demonstrating levels of disease and with treatment services. With greater appreciation of the nature of oral health and disease, and of their determinants has come recognition of the need for wider public health action if the effects of prevention and oral health promotion are to be maximized.