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

2013 ◽  
Vol 11 (1) ◽  
Author(s):  
Abdul H Mussa ◽  
James Pfeiffer ◽  
Stephen S Gloyd ◽  
Kenneth Sherr
Keyword(s):  
Public Sector ◽  
Health System ◽  
Health Workers ◽  
Health System Strengthening ◽  
Governmental Organizations ◽  
Non Governmental Organizations ◽  
Public Sector Health

scholarly journals The “Sustainability Doctrine” in Donor-Driven Maternal Health Programs in Tanzania

2022 ◽  
pp. 73-91
Author(s):  
Meredith G. Marten
Keyword(s):  
Health System ◽  
Health Systems ◽  
Newborn Care ◽  
Health System Strengthening ◽  
Respectful Maternity Care ◽  
Health Issues ◽  
The Public ◽  
Governmental Organizations ◽  
Non Governmental Organizations ◽  
Sustainable Health

AbstractStrengthening health systems to provide equitable, sustainable health care has been identified as essential for improving maternal and reproductive health. Many donors and non-governmental organizations (NGOs) have contributed to undermining health system strengthening, however, through adhering to what Swidler and Watkins call the “sustainability doctrine,” policies that prioritize time-limited, targeted interventions best suited for short-term funding streams, rather than the long-term needs of local populations. This chapter presents ethnographic data from semi-structured and key informant interviews with 16 policymakers and NGO directors in Dar es Salaam, Tanzania from 2011 to 2012. I illustrate how sustainability doctrine policies were put into practice, and how they have persisted, despite their shortcomings, using examples of donor-prioritized maternal healthcare initiatives in Tanzania rolled-out several years apart: prevention of mother-to-child transmission of HIV (PMTCT) and basic emergency obstetric and newborn care (BEmONC) programs in the late 2000s, and more recent efforts to implement respectful maternity care (RMC) programs. I focus on several issues informants identified as crippling efforts to build strong health systems, particularly the internal brain drain of healthcare workers from the public sector to higher-paying NGO jobs, and the prioritization of types of programs donors believed could be sustained after the funding period ended, specifically trainings and workshops. I describe how despite these issues, international organizations still design and implement less effective programs that often fail to account for local circumstances in their efforts to solve some of the more intractable health issues facing Tanzania today, in particular, the country’s stagnating maternal mortality rate. In this chapter, I argue that practices promoted and implemented under the guise of “sustainability” in policy papers and reports generated by donors paradoxically contribute to health system precarity in Tanzania.

scholarly journals PUBLIC SECTOR INSTITUTIONS OF FOREIGN POLICY EXPERTISE IN UKRAINE:AN ANALYTICAL OVERVIEW

2020 ◽  
Vol 16 (3) ◽  
pp. 340-359
Author(s):  
Oleg Onopko ◽  
Keyword(s):  
Foreign Policy ◽  
Public Sector ◽  
Structural Damage ◽  
Domestic Politics ◽  
Think Tanks ◽  
National Academy Of Sciences ◽  
The Public ◽  
Governmental Organizations ◽  
Non Governmental Organizations ◽  
Political Mythology

An important condition for the effective protection and implementation by Russia of its national interests in Ukraine is an understanding of the circle of actors that influence the development of Ukrainian foreign policy. Among them, there are expert institutions that provide analytical and scientific support for foreign policy decisions made by the highest bodies of state power. For- eign policy expertise in Ukraine is a grey area for Russian political science. The article opens a series of publications whose purpose is to solve this problem. It systematizes information about Ukrainian institutes of foreign policy expertise, those whose activities are directly or indirectly financed by the state. It was revealed that during the presidency of Viktor Yanukovych (2010– 2014), the public sector suffered significant structural damage, and its consequences have not yet been overcome. Today, Ukrainian public institutions of foreign policy expertise include: the National Institute for Strategic Studies, the Institute of World History of the National Academy of Sciences of Ukraine and university think tanks. The author considers these organizations through the prism of constructivism and institutionalism — as political structures (institutions) whose activities affect the context of Ukrainian foreign policy and the behavior of its actors. It has been established that their main scientific and applied research interests are related to problems of national, regional and international security, Russian domestic politics, problems of information, as well as military and political confrontation with Russia. All these issues are considered by institutions exclusively through the prism of Euro-Atlanticism and anti-Russian political mythology. Since at least 2014, they have been transmitting ideas hostile to Russia to the Ukrainian political and academic elite. In the same vein, the political socialization of students is carried out, in which university think tanks actively work in close collaboration with state and non-governmental organizations of NATO member countries. Today, the public sector of foreign policy expertise in Ukraine is not in the best condition, but it invariably retains its analytical and scientific potential, as well as its tough anti-Russian position.

scholarly journals Lessons from a Health Policy and Systems Research programme exploring the quality and coverage of newborn care in Kenya

2020 ◽  
Vol 5 (1) ◽  
pp. e001937
Author(s):  
Mike English ◽  
David Gathara ◽  
Jacinta Nzinga ◽  
Pratap Kumar ◽  
Fred Were ◽  
...  
Keyword(s):  
Health System ◽  
Low Income ◽  
Health Workers ◽  
Newborn Care ◽  
Well Being ◽  
Public Hospitals ◽  
Urban Setting ◽  
Health System Strengthening ◽  
Research Approach ◽  
Systems Research

There are global calls for research to support health system strengthening in low-income and middle-income countries (LMICs). To examine the nature and magnitude of gaps in access and quality of inpatient neonatal care provided to a largely poor urban population, we combined multiple epidemiological and health services methodologies. Conducting this work and generating findings was made possible through extensive formal and informal stakeholder engagement linked to flexibility in the research approach while keeping overall goals in mind. We learnt that 45% of sick newborns requiring hospital care in Nairobi probably do not access a suitable facility and that public hospitals provide 70% of care accessed with private sector care either poor quality or very expensive. Direct observations of care and ethnographic work show that critical nursing workforce shortages prevent delivery of high-quality care in high volume, low-cost facilities and likely threaten patient safety and nurses’ well-being. In these challenging settings, routines and norms have evolved as collective coping strategies so health professionals maintain some sense of achievement in the face of impossible demands. Thus, the health system sustains a functional veneer that belies the stresses undermining quality, compassionate care. No one intervention will dramatically reduce neonatal mortality in this urban setting. In the short term, a substantial increase in the number of health workers, especially nurses, is required. This must be combined with longer term investment to address coverage gaps through redesign of services around functional tiers with improved information systems that support effective governance of public, private and not-for-profit sectors.

scholarly journals Barriers to increase surgical productivity in Sierra Leone: a qualitative study

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e056784
Author(s):  
Juul Bakker ◽  
A J van Duinen ◽  
Wouter W E Nolet ◽  
Peter Mboma ◽  
Tamba Sam ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Health System ◽  
Sierra Leone ◽  
Health Workers ◽  
Health System Strengthening ◽  
Financial Barriers ◽  
Public And Private ◽  
Factors Influencing ◽  
Surgical Workforce ◽  
Training Opportunities

ObjectiveTo explore factors influencing surgical provider productivity and identify barriers against and opportunities to increase individual surgical productivity in Sierra Leone, in order to explain the observed increase in unmet surgical need from 92.2% to 92.7% and the decrease in surgical productivity to 1.7 surgical procedures per provider per week between 2012 and 2017.Design and methodsThis explanatory qualitative study consisted of in-depth interviews about factors influencing surgical productivity in Sierra Leone. Interviews were analysed with a thematic network analysis and used to develop a conceptual framework.Participants and setting21 surgical providers and hospital managers working in 12 public and private non-profit hospitals in all regions in Sierra Leone.ResultsSurgical providers in Sierra Leone experience a broad range of factors within and outside the health system that influence their productivity. The main barriers involve both patient and facility financial constraints, lack of equipment and supplies, weak regulation of providers and facilities and a small surgical workforce, which experiences a lack of recognition. Initiation of a Free Health Care Initiative for obstetric and paediatric care, collaborations with partners or non-governmental organisations, and increased training opportunities for highly motivated surgical providers are identified as opportunities to increase productivity.DiscussionBroader nationwide health system strengthening is required to facilitate an increase in surgical productivity and meet surgical needs in Sierra Leone. Development of a national strategy for surgery, obstetrics and anaesthesia, including methods to reduce financial barriers for patients, improve supply-mechanisms and expand training opportunities for new and established surgical providers can increase surgical capacity. Establishment of legal frameworks and appropriate remuneration are crucial for sustainability and retention of surgical health workers.

Health strike is unlikely to shape Kenya national vote

2017 ◽  
Keyword(s):  
Public Health ◽  
Public Sector ◽  
Health System ◽  
Public Health System ◽  
Health Workers ◽  
Content Type ◽  
The Public ◽  
General Elections ◽  
Slow Progress ◽  
National Settlement

Significance Public sector doctors have been on strike since early December citing multiple grievances including pay, conditions at facilities and lack of investment in the public health system. The bitter dispute is the latest in a series of public-sector strikes and comes amid campaigning for August’s general elections. Impacts Agreeing to the strikers' full demands would add pressure for higher salaries in private facilities and the public sector. A national settlement could slow progress towards full devolution of health responsibilities to the counties. Elite segments of society do not rely on the public health system and may be less sympathetic to health workers’ grievances.

scholarly journals Lobbying in the European union – regulation and public sector economics perspective

2013 ◽  
Vol 61 (2) ◽  
pp. 327-333 ◽  
Author(s):  
Daniela Dvořáková ◽  
Michal Petrůj
Keyword(s):  
Public Sector ◽  
Self Regulation ◽  
Code Of Conduct ◽  
Economic Consequences ◽  
The European Union ◽  
Governmental Organizations ◽  
European Institutions ◽  
Non Governmental Organizations ◽  
Rules Of Procedure ◽  
Civil Sector

Lobbying has become an inseparable companion of the decision-making process and firms but also other social actors (non-governmental organizations, individuals, private and civil sector) are forced to reflect this fact, if they want to promote their interests effectively and if they want to avoid regulation that would harm their interests. The paper analyses the regulation of lobbying in European institutions and focuses on two major institutions which are under pressure of the lobbyists, the European Commission and the European Parliament. The paper discusses and presents the both ways of regulation which occur in the European institutions- the concept of self-regulation and the binding Code of Conduct under the Rules of Procedure in the European Parliament.The paper contains also possible economic consequences of lobbying based on the Public Sector Economics perspective and the methodology of the principal-agent relationship.

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