Legal and regulatory barriers to effective public-private partnership governance in Kazakhstan

Purpose – The purpose of this paper is to provide a critical assessment of legal and regulatory impediments to effective governance of public-private partnerships (PPPs) in Kazakhstan. Design/methodology/approach – The qualitative study develops propositions from the PPP literature and then tests them against findings from in-depth interviews. Interviewees have been selected by a purposeful sampling from PPP projects in Kazakhstan as well as from national and regional PPP centres. Findings – The identified barriers to effective PPP management include irregularities in the PPP legal framework, such as lack of legal definition of a PPP and controversy with the government guarantee’s legal status for its long-term payments to partnerships; bureaucratic tariff setting for partnership services; non-existent opportunity for private asset ownership; and excessive government regulation of PPP workers’ wage rates. Practical implications – The partners’ opposing perspectives on a number of PPP issues show that management needs to identify and carefully reconcile stakeholder values in a partnership in order to achieve more effective PPP governance. Practitioners, particularly those in the public agencies, have to be concerned with ways to reduce the government overregulation of the private operators, which is likely to result in greater PPP flexibility in management and, ultimately, higher efficiency in delivering the public services. Originality/value – By elucidating multiple examples of overregulation and PPPs’ inefficiency, the paper demonstrates that the government dominance in PPP management is conceptually inappropriate. Instead, the government should adopt the concept of co-production and manage its relations with the private sector partner in a collaborative fashion.

Reframing resistance to change: experience from General Motors Poland

This paper describes the successful introduction of a kaizen scheme in a General Motors factory plant in Gliwice, Poland. Employee value systems changed, despite the presence of strong, pre-existing values that might have inhibited this process. These findings are drawn on to examine the concept of ‘resistance to change’ and replace it with a notion of ‘functional persistence’. Our case study illustrates how assuming this position can aid the development of new work attitudes, as opposed to constraining the old ones.

Barriers to “industrialisation” for interwar British retailing? The case of Marks & Spencer Ltd.

Research on international differences in retail productivity has highlighted formidable environmental barriers to the ‘industrialisation’ of mass retailing as a driver of declining British interwar productivity growth in this sector (and in services more generally). We examine evidence for such barriers, using a case study of a firm that built its interwar expansion strategy on ‘American’ retail methods – Marks & Spencer (M&S). We find that, rather than facing barriers to the adoption of American mass retail practices, M&S reaped major productivity gains from this process. This adds further evidence to an emerging literature rejecting the barriers to industrialisation thesis for retailing.

Barriers to interventions aimed at promoting the health of health care workers in Brazil

Objective. To search the literature for circumstances that impede injury and disease prevention and other activities intended to improve the health of the health care worker. Methods. The SciELO database was searched for articles published in 1967-2008. This was supplemented by a PubMed search for the period 1950-2008. The following key words were used to identify articles in English, Portuguese, and Spanish: work, health personnel, occupational, risks, diseases, ergonomics, work ability, quality of life, organization, accidents, work conditions, intervention, and administration. Articles on injury and disease prevention and occupational health in a health care setting in Latin America were selected, along with articles focused on health promotion in the health sector. Results. The following shortcomings were identified: activities lacked a sound theoretical foundation and were not integrated with the health services management; a failure to evaluate the effectiveness of the activity; health surveillance focused solely on a specific disease or injury; management not committed to the proposed activity; miscommunication; inability of workers to participate, or control the work environment; and, programs or efforts that were limited to changing the workers` behaviors. Conclusions. The literature shows that all the barriers identified by this study affect both the health care workers` health as well as their productivity.

COMMUNICATION AND INFORMATION BARRIERS TO HEALTH ASSISTANCE FOR DEAF PATIENTS

IN BRAZIL, recent regulations require changes in private and public health systems to make special services available to deaf patients. in the present article, the researchers analyze the perceptions of 25 sign language using patients regarding this assistance. The researchers found communication difficulties between these patients and health services staff, as well as a culture clash and a harmful inability among the service providers to distinguish among the roles of companions, caretakers, and professional translator/interpreters. Thus, it became common for the patients to experience prejudice in the course of treatment and information exchange, damage to their autonomy, limits on their access to services, and reduced efficacy of therapy. The researchers conclude that many issues must be dealt with if such barriers to health access are to be overcome, in particular the worrying degree of exclusion of deaf patients from health care systems.

Patriarchal values : girls are more apt to change

Patriarchal values: girls are more apt to change How has the family value system changed between generations, especially when taking into account the gender dimension? This article presents some results from a study carried outin 2007 in one village of the Gourani tribe where the people are followers of Ahle Hagh in Islamabad Gharb (west of Iran). The differences between generations (those born and raised before and after the Islamic Revolution) in patriarchal values in the family are statistically significant. The older generation opts for the man of the family to make most of the decisions; on children’s education, marriage, naming, the families expenditure, the place for residence, the social network of the family and even the number of children. The younger generation has a different value system and it has moved towards a more egalitarian type of family. With the gender variable included in the findings we see that although the values of the younger male population have evolved toward a less patriarchal decision making structure inthe family, the degree of changes among the young women is much higher. Looking into the preferences for male sex for the first child as well as a larger number of boys in the family, the difference between generations is significant. However data on the differences analyzed with the gender variable proves that the changes concerning the equality of sexes are mainly due to drastic changes in the young women’s value system. That is, the male population, young or old, still prefer to have a boy as their first born and to have more sons in the family. But the young female generation in the rural area sees less difference in having boys or girls in the family. It is concluded that reforms in the old value system is an evolving process of everyday life and that the girls are the main social force for change.

Barriers to adapt eCommerce by rural microenterprises in Sweden : a case study

Research has shown that small and medium-sized enterprises (SMEs) are rapidly adopting the e-commerce. However, there is nearly no research into how microenterprises are adopting eCommerce. Present paper focus on microenterprise adaption of eCommerce in terms of barriers in relation to already known research on SMEs. A case study, carried out by 12 microenterprises to find out barriers to adapt eCommerce had been done. The empirical results show that the microenterprises share most of the barriers to adapt the eCommerce with studies of SMEs, but also reveal additional factors affecting adaptation option of eCommerce; supplier agreement, communication and customer strategy. Conclusions are that microenterprises need additional support and communication and customer strategy to adapt eCommerce, depending of their requirement and needs of eCommerce.

'They would never receive you without a husband' : Paradoxical barriers to antenatal care scale-up in Rwanda

OBJECTIVE: to explore perspectives and experiences of antenatal care and partner involvement among women who nearly died during pregnancy ('near-miss'). DESIGN: a study guided by naturalistic inquiry was conducted, and included extended in-community participant observation, semi-structured interviews, and focus group discussions. Qualitative data were collected between March 2013 and April 2014 in Kigali, Rwanda. FINDINGS: all informants were aware of the recommendations of male involvement for HIV-testing at the first antenatal care visit. However, this recommendation was seen as a clear link in the chain of delays and led to severe consequences, especially for women without engaged partners. The overall quality of antenatal services was experienced as suboptimal, potentially missing the opportunity to provide preventive measures and essential health education intended for both parents. This seemed to contribute to women's disincentive to complete all four recommended visits and men's interest in attending to ensure their partners' reception of care. However, the participants experienced a restriction of men's access during subsequent antenatal visits, which made men feel denied to their increased involvement during pregnancy. CONCLUSIONS: 'near-miss' women and their partners face paradoxical barriers to actualise the recommended antenatal care visits. The well-intended initiative of male partner involvement counterproductively causes delays or excludes women whereas supportive men are turned away from further health consultations. Currently, the suboptimal quality of antenatal care misses the opportunity to provide health education for the expectant couple or to identify and address early signs of complications IMPLICATIONS FOR PRACTICE: these findings suggest a need for increased flexibility in the antenatal care recommendations to encourage women to attend care with or without their partner, and to create open health communication about women's and men's real needs within the context of their social situations. Supportive partners should not be denied involvement at any stage of pregnancy, but should be received only upon consent of the expectant mother.

Facilitators and barriers to applying a national quality registry for quality improvement in stroke care

BACKGROUND: National quality registries (NQRs) purportedly facilitate quality improvement, while neither the extent nor the mechanisms of such a relationship are fully known. The aim of this case study is to describe the experiences of local stakeholders to determine those elements that facilitate and hinder clinical quality improvement in relation to participation in a well-known and established NQR on stroke in Sweden. METHODS: A strategic sample was drawn of 8 hospitals in 4 county councils, representing a variety of settings and outcomes according to the NQR's criteria. Semi-structured telephone interviews were conducted with 25 managers, physicians in charge of the Riks-Stroke, and registered nurses registering local data at the hospitals. Interviews, including aspects of barriers and facilitators within the NQR and the local context, were analysed with content analysis. RESULTS: An NQR can provide vital aspects for facilitating evidence-based practice, for example, local data drawn from national guidelines which can be used for comparisons over time within the organisation or with other hospitals. Major effort is required to ensure that data entries are accurate and valid, and thus the trustworthiness of local data output competes with resources needed for everyday clinical stroke care and quality improvement initiatives. Local stakeholders with knowledge of and interest in both the medical area (in this case stroke) and quality improvement can apply the NQR data to effectively initiate, carry out, and evaluate quality improvement, if supported by managers and co-workers, a common stroke care process and an operational management system that embraces and engages with the NQR data. CONCLUSION: While quality registries are assumed to support adherence to evidence-based guidelines around the world, this study proposes that a NQR can facilitate improvement of care but neither the registry itself nor the reporting of data initiates quality improvement. Rather, the local and general evidence provided by the NQR must be considered relevant and must be applied in the local context. Further, the quality improvement process needs to be facilitated by stakeholders collaborating within and outside the context, who know how to initiate, perform, and evaluate quality improvement, and who have the resources to do so.

Barriers to entry in monopoly markets: automobile distribution in Brazil

O Objetivo deste Trabalho é Analisar os Efeitos da Entrada de uma Segunda Concessionária de Automóveis em Mercados Previamente Monopolizados. para Tanto, Construiu-Se um Banco de Dados com a Localização de Concessionárias de Automóveis em Microrregiões e Características Demográficas e Econômicas Destas Microrregiões. a Partir Desse Banco de Dados e de Modelos de Escolha Binária, Foram Identificadas Variáveis que Condicionam a Existência e o Número de Concessionárias em Microrregiões. Utilizando-Se de um Modelo Adaptado de Bresnahan e Reiss (1990), Foram Estimados os Custos Fixos de Entrada de Concessionárias em Mercados Monopolizados. os Resultados Obtidos Sugerem que as Barreiras À Entrada não são Significativas, o que Aumenta a Probabilidade de que a Cláusula de Exclusividade nos Contratos de Concessão não Cause Danos À Concorrência no Mercado Brasileiro de Distribuição de Automóveis

On the long run effects of barriers to trade

We study the macroeconomic effects of international trade policy by integrating a Hecksher-Ohlin trade model into an optimal-growth framework. The model predicts that a more open economy will have higher factor productivity. Furthermore, there is a "selective development trap," an additional steady state with low income, to which countries may or may not converge, depending on policy. Income at the development trap falls as trade barriers increase. Hence, cross-country differences in barriers to trade may help explain the dispersion of per-capita income observed across countries. The effects are quantified and we show that protectionism can explain a relevant fraction of TFP and long-run income differentials across countries.

On the growth effects of barriers to trade

We study the macroeconomic effects of international trade policy by integrating a Hecksher-Ohlin trade model into an optimal-growth framework. The model predicts that an open economy will have higher factor productivity and faster growth. Also, under protectionist policies there may be “development traps,” or additional steady states with low income. In the last case, higher tariffs imply lower incomes, so that the large cross-country differences in barriers to trade may explain part of the huge dispersion of per capita income observed across countries. The model simulation shows that the link between trade and macroeconomic performance may be quantitatively important.

Barriers to trade: barriers to growth

We study the cxtent to which differences in international trade policies contribute to the significant cross-country disparities in macroeconomic performance. In particular, wc concentrate on the effect of protectionism on generating differences in leveIs (of income and of measured total factor productivity), in growth rates (of output, productivity and inputs), in volatility and in trends (or development traps). We document that these rclationships are strong in cross country data, integrate a Hecksher-Ohlin mode! of international trade into the standard macroeconomic modcl to derive those rclationships analytically, and to quantify them. Our results suggest that a large fraction of the cros::; country variations can be attributed to trade policy.

Barriers to entry and development

This paper analyzes the effect of an accountability system in the Brazilian college market. For each discipline, colleges were assigned a grade that depended on the scores of their students on the ENC, an annual mandatory exam. Those grades were then disclosed to the public, giving applicants information about college quality. The system also established rewards and penalties based on the colleges’ grades. I find that the ENC had a substantial effect on different measures of college quality, such as faculty education and the proportion of full-time faculty. The detailed information from this unique dataset and the fact that the ENC started being required for different disciplines in different years allow me to control for time-specific effects, thus minimizing the bias caused by policy endogeneity. Indeed, I find strong evidence on the importance of controlling for time-specific effects: estimates of the impact of the ENC on college quality more than double when I do not take those effects into account. The ENC also affects positively the ratio between applicants and vacancies, and it decreases the faculty and the entering class sizes. The results suggest that its introduction fostered competition and favored colleges entering the market.