Effectiveness of the Value Added Tax Exemption Policy on Gross Domestic Product in Selected ASEAN Countries Towards a Conducive Business Environment Model

Excessive exemption is detrimental to the effectiveness of the whole Value Added Tax system. This research is primarily focused on VAT exemption affecting the business industry as it influences the Gross Domestic Product of the three (3) selected ASEAN countries, namely, the Philippines, Indonesia, and Singapore. The result of the study showed a negative relationship between VAT exemption policy and GDP growth rate among the selected ASEAN economies. Although the VAT collections among the selected ASEAN countries are significantly increasing with the course of time, the results showed that as the number of VAT exemptions increases by one unit, the degree of growth of the GDP is expected to decrease at a rate of 0.900 units. Thus, a conducive business environment may be achieved by decreasing the number of VAT exemptions and, accordingly, increasing the GDP growth rate.

Women’s decision-making power in a context of free reproductive healthcare and family planning in rural Burkina Faso

Background In 2016, the national user fee exemption policy for women and children under five was introduced in Burkina Faso. It covers most reproductive healthcare services for women including prenatal care, delivery, and postnatal care. In subsequent years, the policy was gradually extended to include family planning. While studies have shown that user fee abolition policies increase visits to health centers and improve access to reproductive healthcare and family planning, there are also indications that other barriers remain, notably women’s lack of decision-making power. The objective of the study is to investigate women’s decision-making power regarding access to reproductive health and family planning in a context of free healthcare in rural Burkina Faso. Methods A descriptive qualitative study was carried out in rural areas of the Cascades and Center-West regions. Qualitative data were collected using individual semi-structured interviews (n = 20 participants) and focus groups (n = 15 participants) with Burkinabe women of childbearing age, their husbands, and key informants in the community. Data was analyzed using thematic analysis. Results A conceptual framework describing women’s participation in the decision-making process was built from the analysis. Results show that the user fee exemption policy contributes to improving access to reproductive care and family planning by facilitating the negotiation processes between women and their families within households. However, social norms and gender inequalities still limit women’s decision-making power. Conclusion In light of these results, courses of action that go beyond the user fee exemption policy should be considered to improve women’s decision-making power in matters of health, particularly with regard to family planning. Interventions that involve men and community members may be necessary to challenge the social norms, which act as determinants of women’s health and empowerment.

Applying the Realist Evaluation Approach to the Complex Process of Policy Implementation—The Case of the User Fee Exemption Policy for Cesarean Section in Benin

Realist evaluation is making inroads in the field of health policy and systems research to a large extent because of its good fit with complex issues. Until now, most realist studies focused on evaluating interventions or projects related to health care delivery, organization of health services, education, management, and leadership of health workers in high income countries. With this paper, we apply the realist approach to the study of national health policy implementation in a low resource country. We use the case of the user fee exemption policy for cesarean section in Benin, which we followed up from 2009 to 2018. We report on how realist evaluation can be applied for policy implementation research. We illustrate how we developed the initial programme theory—the starting point of any realist evaluation -, how we designed the study and data collection tools, and how we analyzed the data. For each step, we present current good practices, how we adapted them when needed, the challenges and the lessons learned. We report also on how the dynamic interactions between the central level (the national implementing agency) and the peripheral level (an implementing hospital) shaped the policy implementation. We found that at central level, availability of resources for a given policy is constantly challenged in the competitive national resource allocation arena. Key factors include the political power and the legitimacy of the group supporting the policy. These are influenced by the policy implementation structure, how the actual outputs of the implementation align with promises of the group supporting the policy and consequently how these outputs, the policy and its promoters are perceived by the community. We found that the service providers are key to the implementation, and that they are constrained or influenced by the dependability of the funding, their autonomy, their personal background, and the accountability arrangements. This study can inform the design and implementation of national health policies that involve interactions between central and operational level in other low-income countries.

Scaling-Up Performance-Based Financing in Burkina Faso: From PBF to User Fees Exemption Strategic Purchasing

Background: Numerous countries have undertaken performance-based financing (PBF) reforms to improve quality and quantity of healthcare services. However, only few reforms have successfully managed to achieve the different scale-up phases. In Burkina Faso, a pilot project was implemented, but was put on hold before being scaled. During the writing of this article, discussions to scale-up were still ongoing on a national strategic purchasing strategy within a government led user fee exemption policy. Methods: This study’s objective is to identify facilitators and barriers to scaling-up for that pilot, based on the World Health Organization’s (WHO’s) theoretical framework. Interviews were conducted in three health centres and in Ouagadougou to discuss the scale-up with different actors. The software QDA Miner© was used to help in the framework analysis. Results: The low involvement of some key stakeholders (mainly decision-makers) and the unstable context hindered ownership of the project, thus its priority on the political agenda. PBF reform therefore lost its momentum to the benefit of a user fee exemption policy. This latter program was seen to be more beneficial since it addressed access to healthcare services, in comparison to service quality, which was the PBF’s relative advantage. A scale-up of some PBF elements (eg, strategic purchasing tools) is however still in discussion in 2019, but would be integrated within the user fee exemption program. Increased costs during the PBF’s implementation gave the impression that the project was too costly and not scalable. The involvement of an important funding agency (World Bank, WB) also fed the impression of high costs, which demotivated the actors, especially decision-makers. Conclusion: Contextual factors remain central to the implementation of PBF, while their evaluation and mitigation have remained unclear. The participation of key actors in scaling-up operations and the use of social science as tools to better understand the context is therefore primordial.

Analysis on Fees Exemption Policy of Land and BuildingRights Acquisition in Jakarta

The policy for imposing 0% (zero-percent) Land and Building Title Acquisition Fee in DKI Jakarta Province under Governor Regulation Number 126 of 2017 has been implemented for a period of 4 (four) years. In practice there have been found various advantages and weaknesses in the course of policy implementation. This study aims to describe the result of the evaluation on the implementation of the policy imposing zero-percent of Tax Object Acquisition Value (BPHTB). This study used qualitative descriptive method which suggests the explanation and understanding of the phenomenon in the grant of tax incentive. The outcome from the study reveals that the benefit from the policy is the ease of tax burden for the lower middle class communities to own house in DKI Jakarta and to encourage the acceleration of the land certification. The policy implementation also however implies that many taxpayers avoid the tax by using loophole in the Governor Regulation to enjoy this tax facility.

Analisis Implementasi Kebijakan Pembebasan Bea Perolehan Hak Atas Tanah dan Bangunan dalam Rangka Pencapaian Penerimaan Pajak pada Badan Pajak Retribusi Daerah Jakarta Pusat Tahun 2018

The purpose of this study was to determine the Implementation of acquisition duty of right on land and building exemption policy in terms of achieving tax revenues at the regional tax and retribution agency jakarta pusat in 2018 as well as the obstacles and efforts made in the acquisition duty of right on land and building exemption policy. This study used a qualitative method of descriptive approach, the data collection techniques were by observation, interviews, documentation, and triangulation. The study used the theory of G. Shabbir Cheema and Dennis A. Roninelli based on the factors of environmental conditions, relationships between organizations, resources, and the characteristics of the implementers. The obstacle factor in this study is the low level of public awareness, especially the people of Jakarta Pusat, they are not active in checking in the field for differences in acquisition value of the taxable object. The efforts made to solve the obstacles are the public and open socialization and conducting field checks on the basis of acquisition value of the taxable object calculations.