Social tariffs for water and waste services in mainland Portugal: An impact analysis

This paper proposes to quantify the effect of social tariffs (ST) in the Portuguese water and waste sector (WWS). It calculates the amount of subsidy implicit in ST schemes, characterising the existing tariffs in 2011 and producing a synthetic tariff scene where the regulator’s recommendation is respected. This is the first time such an exercise is undertaken and it is very relevant in a context of deep economic crisis. Results suggest that there are fewer beneficiaries than what income eligibility criteria would imply and that putting the regulator’s recommendation in practice would considerably raise subsidy amounts, potentially leading to a severe increase in non-subsidised user tariffs to allow for break-even.

Implementation progress of mental health services in Rwanda: Bugesera district case

RESUMO: O Ministério da Saúde do Governo do Ruanda identifica a saúde mental como uma área de prioridade estratégica para a intervenção em resposta à alta carga dos transtornos mentais no Ruanda. Ao longo dos últimos 20 anos após o genocídio, o sector público reconstruiu sua Resposta Nacional de Saúde Mental com base no acesso equitativo aos cuidados, através do desenvolvimento de uma Política Nacional de Saúde Mental e novas estruturas de saúde mental. A política de Saúde Mental do Ruanda, revista em 2010, prima pela descentralização e integração dos serviços de saúde mental em todas as estruturas nacionais do sistema de saúde e ao nível da comunidade. O presente estudo de caso tem como objetivo avaliar a situação do sistema de saúde mental de um distrito típico de uma área rural no Ruanda, e sugerir melhorias, incluindo algumas estratégias para monitoras as mudanças. Os resultados do estudo permitirão ao Ruanda reforçar a sua capacidade para implementar o Plano Nacional de Saúde Mental ao nível dos distritos. O relatório também será útil para monitorar o progresso da implementação de serviços de saúde mental nos distritos, incluindo a prestação de serviços de base comunitária e a participação dos usuários, suas famílias e outros interessados na promoção, prevenção, assistência e reabilitação em saúde mental. Este estudo também procurou avaliar o progresso da implementação dos cuidados de saúde mental a nível descentralizado, com vista a compreender as implicações em termos de recursos desses processos. Foi realizada uma análise situacional num local do distrito, baseado em entrevistas com as principais partes interessadas responsáveis, usando o Instrumento de Avaliação de Sistemas de Saúde Mental da Organização Mundial da Saúde (WHO-AIMS). Os resultados sugerem que os recursos humanos para a saúde mental e serviços de base comunitária de saúde mental no distrito continuam a ser extremamente limitados. Os profissionais de saúde mental são adicionalmente limitados na sua capacidade para oferecer intervenções de emergência a pacientes psiquiátricos e garantir a continuidade do tratamento farmacológico a pacientes com condições crônicas. Para planejar efetivamente, de acordo com as necessidades da comunidade, sugerimos que o sistema de saúde mental deve envolver também os representantes das famílias e dos usuários no processo de planificação de modo a melhorar a sua contribuição no processo de implementação das atividades de saúde mental. Este estudo de caso do Distrito de Bugesera oferece a primeira análise de nível distrital dos serviços de saúde mental no Ruanda, e pode servir como uma mais-valia para a melhoria do sistema de saúde mental, incluindo a advocacia para a melhoria da qualidade dos cuidados de saúde mental a este nível, aumentando o financiamento para a implementação de serviços clínicos de saúde mental e os recursos humanos disponíveis para a prestação de cuidados de saúde mental, principalmente a nível dos cuidados primários.--------------------- ABSTRACT: To deal with the high burden of mental health disorders resulting from consequences of the 1994 genocide against Tutsis, the Rwanda Ministry of Health (MoH) considers mental health as a priority intervention. For the last 20 years, Ministry of Health focused on rebuilding a national and equity-oriented mental health program responding to the population needs in mental health. Mental health services are now decentralized and integrated in the national health system, from the community level up to the referral level. This study assessed the situation of mental health services in one rural district in Rwanda. It was aimed at assessing the progress of implementation of mental health care at the decentralized level, focusing on resource implications and processes. This study is based on interviews conducted with key stakeholders, using the World Health Organization's Assessment Instrument for Mental Health Systems (WHO-AIMS). Findings show that human resources for mental health care and community-based mental health services of the assessed district remain extremely limited. Mental health professionals face limitation regarding the ability to provide emergency management of psychiatric patients and to ensure continuity of psychopharmacological treatment of patients with chronic conditions. To improve the implementation process of mental health interventions and activities, a planning process based on community needs and the involvement of representatives of families and users in planning process should be considered. The Bugesera case study on the situation of mental health services can serve as a baseline for improvement of the mental health program in Rwanda, in terms of quality care services, infrastructure and equipment, human and financial resources.

Consumer satisfaction with water, wastewater and waste services in Portugal

While the concept of consumer satisfaction is a central topic in modern marketing theory and practice, citizens' satisfaction with public services, and especially water and waste services, is a eld that still remains empirically rather unexplored. The following study aims to contribute to this area by analysing the determinants of user satisfaction in the water, wastewater and waste sector in Portugal, using a unique survey of 1070 consumers undertaken by the Portuguese Water and Waste Regulator ERSAR. I perform an analysis of the relation between overall service satisfaction and attributespeci c service satisfaction with an ordered logit model. I then explore if subjective consumer satisfaction can be re ected by ERSAR's technical performance indicators. The results suggest that overall consumer satisfaction is driven by consumer's satisfaction with speci c service aspects but unrelated to socioeconomic and demographic characteristics. Furthermore, I show that there is no monotonic association between ERSAR's technical performance indicators and consumers' levels of satisfaction.

Payments for environmental services in watersheds: insights from a comparative study of three cases in Central America

We have compared three cases of payments for water-related environmental services (PES) in Central America, in terms of socioeconomic background, opportunity costs of forest conservation and stakeholders’ perceptions on the conditions of water resources and other issues. We found that, in general, the foregone benefits from land uses alternative to forest cover are larger than the amount paid, which apparently contradicts the economic foundation of PES schemes. A number of possible explanations are explored. The results also suggest that trade-offs between different environmental and social goals are likely to emerge in PES schemes, posing some doubts on their ability to be multipurpose instruments for environmental improvement and rural development. We also found that PES schemes may work as a conflictresolution instrument, facilitating downstream -upstream problem solving, though at the same time they might introduce changes in social perceptions of property rights.

IPH response to Review of Maternity Services in Northern Ireland

IPH responded to the Department of Health, Social Services and Public Safety consultation on a draft maternity strategy for Northern Ireland. The strategy contains a number of proposals, which, if implemented, will significantly change how maternity services are delivered in the future. The draft strategy aims to provide women, professionals, commissioners and policy makers with a clear pathway for maternity services from preconceptual care through to postnatal care.  It places an emphasis on early direct contact with a midwife and a better understanding of the role of the midwife and obstetricians. It sets out clear recommendations for tackling public health issues such as obesity, smoking and alcohol abuse in pregnancy; providing more choice; providing care closer to home and ensuring safe, high quality care tailored to meet the needs of the woman.

Improving Dementia Services in Northern Ireland - A Regional Strategy - November 2011

Improving Dementia Services in Northern Ireland - A Regional Strategy - November 2011

Statistics on Smoking Cessation Services in Northern Ireland: 08/09: Pre Release Access List

2008/09 Pre-Release Access List

Improving Stroke Services in Northern Ireland (PDF 194 KB)

Stroke can strike anyone, any age, anytime. Today in Northern Ireland around 4000 people each year have their lives and the lives of their families dramatically changed by stroke. A significant number of these could be avoided by simple lifestyle changes. More exercise, less alcohol and more attention to diet can make a major difference. Cutting down or cutting out smoking will make the most significant lifestyle contribution to a reduction in stroke and the enormous personal impact that it brings. åÊThese recommendations seek to make improvements in the key areas of prevention; treatment and rehabilitation of stroke patients in a modern health service setting. The accompanying standards outline the levels to which we must aspire, in the delivery of these services. åÊ

Annual Statistics on Smoking Cessation Services in NI

Annual Reports and Deprivation Maps

Future of Fertility Services in Northern Ireland (From People to Parents)

Future of Fertility Services in Northern Ireland (From People to Parents)

Disability Equipment Services in Northern Ireland Regional Summary (PDF 1815 KB)

March 2003 - main findings of the study, key recommendations and the way forward

Diabetes Services in Northern Ireland Regional Summary August 2002 (PDF 2052 KB)

August 2002 - main findings of study, key recommendations and way forward

Acute Hospital Portfolio - Catering Services in Northern Ireland Regional Summary (PDF 105 KB)

March 2003 - sets out the main findings from the study and key conclusions

Mental Health Services in NI VFM Review Regional Summary (PDF 1650 KB)

June 2000 - to review whether the strategy for mental health services is based on clearly defined needs