Cost of malaria control in China: Henan's consolidation programme from community and government perspectives

Objective To assist with strategic planning for the eradication,of malaria in Henan Province, China, which reached the consolidation phase of malaria control in 1992, when only 318 malaria cases were reported, Methods We conducted a prospective two-year study of the costs for Henan's malaria control programme. We used a cost model that could also be applied to other malaria programmes in-mainland China, and analysed the cost of the three components of Henan's malaria programme. suspected malaria case management,, vector surveillance,,and population blood surveys. Primary cost data were collected from the government, and data on suspected malaria patient's were collected in two malaria counties (population 2 093 100). We enlisted the help of 260 village doctors. in six-townships or former communities (population 247 762), and studied all 12 315 reported cases of suspected malaria in catchment areas in 1994 and 1995. Findings The average-annual government investment in malaria control was estimated to be US$ 111 516 (case-management 59%; active blood surveys 25%;vector surveillance 12%; and contingencies and special projects 4%). The average cost (direct and indirect) for-patients seeking-treatment for suspected malaria was US$ 3.48, equivalent,to 10 days' income for rural residents. Each suspected malaria case cost the government an, average of US$ 0.78. Conclusion Further cuts in government funding will increase future costs, when epidemic malaria returns; investment in malaria control should therefore continue at least at current levels,of US$ 0.03 per person a risk.

Survivors and victims: A case study of organisational restructuring in the public health sector

This paper examines a process of major organizational restructuring in an Australian hospital within a context of decentralization of health services and relocation of clients, brought about by changes in government policy. The change process differed from the abrupt downsizing often found in the private sector in that the organization initiated significant job losses concomitantly with the development of new facilities around the State, while attempting to deal with employee issues related to downsizing. The paper focuses on the process involved in the downsizing, from the perspective of both the "survivors" and "victims" of the change. It draws on interviews and focus groups with managers, union officials and employees, as well a survey of employees to assess the outcomes and effectiveness of the restructuring process. Using a stakeholder analysis framework, the paper examines the complex issues and perspectives raised by the downsizing process.

Decentralization and privatization in Portuguese health reforms

ABSTRACT - The Portuguese National Health Service (SNS), a universal, centralized and public owned health care system, exhibits an extraordinary record of equalization in the access to health care and health gains in the late thirty years. However, the most recent history of the Portuguese health reform is pervaded by the influence of decentralization and privatization. Decentralization has been present in the system design since the 1976 Constitution, at least in theory. Private ownership of health care suppliers and out-ofpocket expenditures, on the financing side, both have a long tradition of relevance in the NHS mix of services. The initial aim of this study was to demonstrate expected parallelism between health reforms and public administration reforms, where a common pattern of joint decentralization and privatization was observed in many countries. Observers would be tempted to consider these two movements as common signs of new public management (NPM) developments. They have common objectives, are established around the core concepts of gains in effectiveness, efficiency, equity and quality of public services, through improved accountability. However, in practice, in Portugal, each movement was developed in a totally separated way. Besides those rooted in the NPM theory, there are few visible signs of association between decentralization and privatization. Decentralization, in the Portuguese SNS, was never intended to be followed by a privatization movement; it was seen merely as a public administration tool. Private management of health services, as stated in the most recent SNS legislation, was never intended to have decentralization as a condition or as a consequence. Paradoxically, in the Portuguese context, it has led invariably to centralized control. While presented as separate instruments for a common purpose, the association between decentralization and privatization still lacks a convincing demonstration. Many common health care management stereotypes remain to be checked out if we want to look for eventual associations between these two organizational tools.

Why do differences in the degree of fiscal decentralization endure?

A notable difference between the U.S. and many countries in Europe is in the degree of fiscal decentralization. Regional (and local) governments in the U.S. have significant autonomy in setting their own taxes and determining how to spend their revenues. This is not true of their counterparts in Spain, France, the United Kingdom, Czech Republic and many other European countries. In recent years, many countries formerly subject to dictatorshipsor communism have been considering decentralizing fiscal responsibility to sub-national governments as part of the process of democratization (see Bird and Ebel, forthcoming). Yet, much of Europe remains immune to adopting effective decentralization in which sub-national units have true taxing authority.

Characterizing E-Government in China

Although E-Government (E-G) is one public policy in China, it still has a long way to go in terms of diffusion across the country and interactive participation from citizens. It constitutes a double sided sword since it enhances the features that  China needs to show to the world in international competitiveness and status, but  also poses challenges to the Communist rule inasmuch as it has to be controlled.   Therefore, E-G is both a political and a managerial issue: it is sensitive to the Chinese Communist Party but also leads to economical and administrative prosperity  and efficiency. Some of the keys would be the development of the middle  class, further penetration of the Internet, and more education about virtual tools  in government issues and services.

Partial decentralization as a safeguard against favoritism

In this paper I investigate the optimal level of decentralization of tasks for the provision of a local public good. I enrich the well-known trade-off between internalization of spillovers (that favors centralization) and accountability (that favors decentralization) by considering that public goods are produced through multiple tasks. This adds an additional institutional setting, partial decentralization, to the classical choice between full decentralization and full centralization. The main results are that partial decentralization is optimal when both the variance of exogenous shocks to electorate’s utility is large and the electorate expects high performance from politicians. I also show that the optimal institutional setting depends on the degree of substitutability / complementarity between tasks. In particular, I show that a large degree of substitutability between tasks makes favoritism more likely, which increases the desirability of partial decentralization as a safeguard against favoritism.

Decentralization and education performance: a first view to the Brazilian process

This paper analyses the impact of the decentralization in educational system that is taking place in Brazil in the last decade, as a result of several laws that encourage municipalities to invest in fundamental education. The proficiency tests undertaken by the government allows to follow some public schools in two points in time. Therefore we were able to create an experimental group with the schools that were under state system in the SAEB exam and have migrated to the municipality system by the time of Prova Brasil and a control group with the schools that were under the state system between the two exams and compare the difference in their results using a fixed effect panel data analysis. The difference in difference estimator indicates that there is no significant change in the performance of the students.

Post-decentralization regional economies and actors -- putting the capacity of Local governments to the test

Decentralization in Indonesia was introduced institutionally in 2001, with a democratization drive promoted by international donors and by the intention of the new government to clear away the centralistic image of Soeharto. Decentralization has had some effects on regional economies and on local government administration. Compared to the period before decentralization, the share of gross regional domestic product and local government finance has increased in Java, though investment and bank borrowing have expanded to the outer islands. In qualitative aspects, decentralization has transferred not only administrative authority but also many new vested interests from the center to regions. Local governments have become more extensive economic actors in regional economies. Regional economic actors now compete actively for such vested interests and have missed the opportunity to create market-friendly regional economies. The government sector should not be a mere rent-seeking economic actor, but should play a role as a facilitator promoting private sector activities in regional economies.

Fiscal Decentralization, Chinese Style: Good for Health Outcomes?

This study analyzes the effect of fiscal decentralization on health outcomes in China using a panel data set with nationwide county-level data. We find that counties in more fiscal decentralized provinces have lower infant mortality rates compared to those counties in which the provincial government retains the main spending authority, if certain conditions are met. Spending responsibilities at the local level need to be matched with county government's own fiscal capacity. For those local governments that have only limited revenues, their ability to spend on local public goods such as health care depends crucially upon intergovernmental transfers. The findings of this study thereby support the common assertion that fiscal decentralization can indeed lead to more efficient production of local public goods, but also highlights the necessary conditions to make this happen.

Department of Housing and Urban Development's participation in the Moscow Trade Show [microform] : hearing before a subcommittee of the Committee on Government Operations, House of Representatives, One Hundredth Congress, second session, August 3, 1988.

CIS Microfiche Accession Numbers: CIS 89 H401-7

Sexual harassment in the federal government [microform] : hearings before the Subcommittee on Investigations of the Committee on Post Office and Civil Service, House of Representatives, Ninety-sixth Congress, first and second sessions....

Reuse of record except for individual research requires license from Congressional Information Service, Inc.

Working together for public service : report of the U.S. Secretary of Labor's Task Force on Excellence in State and Local Government Through Labor-Management Cooperation /

"Issued May 1996."

An investigation of the emerging system of host government participation in the international oil industry with particular reference to Libyan participation arrangements

This study has been conceived with the primary objective of identifying and evaluating the financial aspects of the transformation in country/company relations of the international oil industry from the traditional concessionary system to the system of governmental participation in the ownership and operation of oil concessions. The emphasis of the inquiry was placed on assembling a case study of the oil exploitation arrangements of Libya. Through a comprehensive review of the literature, the sociopolitical factors surrounding the international oil business were identified and examined in an attempt to see their influence on contractual arrangements and particularly to gauge the impact of any induced contractual changes on the revenue benefit accruing to the host country from its oil operations. Some comparative analyses were made in the study to examine the viability of the Libyan participation deals both as an investment proposal and as a system of conducting oil activities in the country. The analysis was carried out in the light of specific hypotheses to assess the relative impact of the participation scheme in comparison with the alternative concessionary model on the net revenue resulting to the government from oil operations and the relative effect on the level of research and development within the industry. A discounted cash flow analysis was conducted to measure inputs and outputs of the comparative models and judge their revenue benefits. Then an empirical analysis was carried out to detect any significant behavioural changes in the exploration and development effort associated with the different oil exploitation systems. Results of the investigation of revenues support the argument that the mere introduction of the participation system has not resulted in a significant revenue benefit to the host government. Though there has been a significant increase in government revenue, associated with the period following the emergence of the participation agreements, this increase was mainly due to socio-economic factors other than the participation scheme. At the same time the empirical results have shown an association of the participation scheme with a decline of the oil industry's research and development efforts.

Electronic information sharing in local government authorities:factors influencing the decision-making process

Local Government Authorities (LGAs) are mainly characterised as information-intensive organisations. To satisfy their information requirements, effective information sharing within and among LGAs is necessary. Nevertheless, the dilemma of Inter-Organisational Information Sharing (IOIS) has been regarded as an inevitable issue for the public sector. Despite a decade of active research and practice, the field lacks a comprehensive framework to examine the factors influencing Electronic Information Sharing (EIS) among LGAs. The research presented in this paper contributes towards resolving this problem by developing a conceptual framework of factors influencing EIS in Government-to-Government (G2G) collaboration. By presenting this model, we attempt to clarify that EIS in LGAs is affected by a combination of environmental, organisational, business process, and technological factors and that it should not be scrutinised merely from a technical perspective. To validate the conceptual rationale, multiple case study based research strategy was selected. From an analysis of the empirical data from two case organisations, this paper exemplifies the importance (i.e. prioritisation) of these factors in influencing EIS by utilising the Analytical Hierarchy Process (AHP) technique. The intent herein is to offer LGA decision-makers with a systematic decision-making process in realising the importance (i.e. from most important to least important) of EIS influential factors. This systematic process will also assist LGA decision-makers in better interpreting EIS and its underlying problems. The research reported herein should be of interest to both academics and practitioners who are involved in IOIS, in general, and collaborative e-Government, in particular. © 2013 Elsevier Ltd. All rights reserved.