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Technical Capacity (technical + capacity)
Selected AbstractsBalancing the funds in the New Cooperative Medical Scheme in rural China: determinants and influencing factors in two provincesINTERNATIONAL JOURNAL OF HEALTH PLANNING AND MANAGEMENT, Issue 2 2010Luying Zhang Abstract In recent years, the central government in China has been leading the re-establishment of its rural health insurance system, but local government institutions have considerable flexibility in the specific design and management of schemes. Maintaining a reasonable balance of funds is critical to ensure that the schemes are sustainable and effective in offering financial protection to members. This paper explores the financial management of the NCMS in China through a case study of the balance of funds and the factors influencing this, in six counties in two Chinese provinces. The main data source is NCMS management data from each county from 2003 to 2005, supplemented by: a household questionnaire survey, qualitative interviews and focus group discussions with all local stakeholders and policy document analysis. The study found that five out of six counties held a large fund surplus, whilst enrolees obtained only partial financial protection. However, in one county greater risk pooling for enrolees was accompanied by relatively high utilisation levels, resulting in a fund deficit. The opportunities to sustainably increase the financial protection offered to NCMS enrolees are limited by the financial pressures on local government, specific political incentives and low technical capacities at the county level and below. Our analysis suggests that in the short term, efforts should be made to improve the management of the current NCMS design, which should be supported through capacity building for NCMS offices. However, further medium-term initiatives may be required including changes to the design of the schemes. Copyright © 2009 John Wiley & Sons, Ltd. [source] Outsourcing Regulation: Analyzing Nongovernmental Systems of Labor Standards and MonitoringPOLICY STUDIES JOURNAL, Issue 1 2003Dara O'Rourke A range of new nongovernmental systems for advancing labor standards and enforcement have emerged over the last 5 years. This article comparatively assesses these multistakeholder systems of codes of conduct and monitoring, discusses their underlying models of regulation, and proposes a set of criteria for evaluating their effectiveness, including their legitimacy, rigor, accountability, and complementarity. Critical issues are raised about the transparency of existing initiatives, independence of monitors, convergence of standards, and dynamics among nongovernmental regulation, unions, and state enforcement. The article concludes by arguing that with increased transparency, improved technical capacities, and new mechanisms of accountability to workers and consumers, nongovernmental monitoring could complement existing state regulatory systems. [source] Harm reduction programmes in the Asia,Pacific RegionDRUG AND ALCOHOL REVIEW, Issue 1 2008GARY REID MPH Abstract Introduction and Aims. This paper reports on the public health intervention of harm reduction to address drug use issues in the Asia , Pacific region. Design and Methods. It is based on the report ,Situational analysis of illicit drug issues and responses in Asia and the Pacific', commissioned by the Australian National Council on Drugs Asia Pacific Drug Issues Committee. A comprehensive desk-based review based on published and unpublished literature and key informant data. Results. Drug use in the Asia , Pacific region is widespread, resulting in serious adverse health consequences. Needle and syringe programmes are found in some parts of Asia, but not in the six Pacific Island countries reviewed. Outreach and peer education programmes are implemented, but overall appear minor in size and scope. Substitution therapy programmes appear to be entering a new era of acceptance in some parts of Asia. Primary health care specifically for drug users overall is limited. Discussion and Conclusions. Harm reduction programmes in the Asia , Pacific region are either small in scale or do not exist. Most programmes lack the technical capacity, human resources and a limited scope of operations to respond effectively to the needs of drug users. Governments in this region should be encouraged to endorse evidence-based harm reduction programmes. [source] Does Society Win or Lose as a Result of Privatization?ECONOMICA, Issue 304 2009The Case of Water Sector Privatization in Colombia This paper evaluates the impact of water sector privatization in Colombia on access, price and water quality, as well as health outcomes using differences-in-differences methodology. The main findings of the impact of water privatization are: (i) an improvement in the quality of water and an increase in the frequency of the service in privatized urban municipalities for the lower quintiles; (ii) a positive effect on health outcomes in both urban and rural areas; (iii) a negative effect on payment for the lower quintiles; and (iv) strong negative effects on access to water in rural areas. Some of these effects appear in municipalities with better technical capacity. [source] Tuberculosis control and managed competition in ColombiaINTERNATIONAL JOURNAL OF HEALTH PLANNING AND MANAGEMENT, Issue S1 2004Maria Patricia Arbelaez Abstract Law 100 introduced the Health Sector Reform in Colombia, a model of managed competition. This article addresses the effects of this model in terms of output and outcomes of TB control. Trends in main TB control indicators were analysed using secondary data sources, and 25 interviews were done with key informants from public and private insurers and provider institutions, and from the health directorate level. We found a deterioration in the performance of TB control: a decreasing number of BCG vaccine doses applied, a reduction in case finding and contacts identification, low cure rates and an increasing loss of follow up, which mainly affects poor people. Fragmentation occurred as the atomization and discontinuity of the technical processes took place, there was a lack of coordination, as well as a breakdown between individual and collective interventions, and the health information system began to disintegrate. The introduction of the Managed Competition (MC) in Colombia appeared to have adverse effects on TB control due to the dominance of the economic rationality in the health system and the weak state stewardship. Our recommendations are to restructure the reform's public health component, strengthen the technical capacity in public health of the state, mainly at the local and departmental levels, and to improve the health information system by reorienting its objectives to public health goals. Copyright © 2004 John Wiley & Sons, Ltd. [source] Developing Options for the Administration of Local Taxes: An International Review,PUBLIC BUDGETING AND FINANCE, Issue 1 2007JOHN L. MIKESELL Do decentralization arguments extend to administration of subnational taxes? While centralized administration promises quality service at reasonable cost, it may dull accountability and slow the revenue flow. Also, central administration may devote less attention to collecting these taxes than for its own. Self-administration brings administration closer to taxpayers and assures representation of jurisdictional interests in revenue apportionment disputes. However, subnational governments may lack technical capacity. That is the dilemma: while the central administration may be indifferent to rigorous collection of subnational taxes, subnational governments may lack capacity for self-administration. In practice, nations use many different alternatives for administering subnational taxes. [source] Natural orifice surgery: applications in colonic surgeryASIAN JOURNAL OF ENDOSCOPIC SURGERY, Issue 2 2010J. Leroy Abstract Natural orifice transluminal endoscopic abdominal surgery, or NOTES, allows invasive operations to be performed through a single or multiple natural-orifice approach either in isolation ("pure") or in combination with a transparietal ("hybrid") access format. Therefore, to facilitate a colonic or rectal resection, the transgastric, transrectal or transcolonic routes, as well as the transvaginal route in women, can all be used either alone or in combination. We are now performing resectional colonic techniques on our patients that have been inspired by this revolutionary concept, carefully planned with storyboarding and validated in porcine models with survival analysis. Adaptation of existing equipment along with the use of new instruments and some simple ideas, such as magnetic fields to retract and mobilize the colon, have allowed us to simplify and standardize the operative technique (the first steps to ensuring procedural reproducibility). Initial potential applications can easily be imagined for partial colonic resections for voluminous benign polyps and for small early cancers, but these applications may extend to incorporate inflammatory bowel diseases such as diverticular disease of the sigmoid colon. For these techniques to further improve and the concept to become a concrete reality, a change in current surgical practice is required, and conventional laparoscopic techniques must be understood to represent a point along the evolutional development of surgery and not considered the final destination. However, as important as technical capacity is, due consideration and assurance of oncological and immunological propriety is essential, as is the issue of clarifying precise patient harm:benefit risk ratios. [source] The Mining Industry and the State: The Politics of Tin Restriction in Bolivia, 1936,1939BULLETIN OF LATIN AMERICAN RESEARCH, Issue 1 2002John Hillman In the aftermath of the Chaco War (1932,1935) a strong left nationalist political current emerged in Bolivia which defined the three large mining companies of Patiño, Hochschild and Aramayo as a superstate, controlling both the economy and the politics of the nation to their own advantage. This article challenges that characterisation by examining the way in which the state exercised control over the two largest producers. Unfortunately, the state lacked the technical capacity to use its powers responsibly, preventing the development of a coherent mining policy. [source] Overcoming barriers to sustainability: an explanation of residential builders' reluctance to adopt clean technologiesBUSINESS STRATEGY AND THE ENVIRONMENT, Issue 8 2009Jonatan Pinkse Abstract The construction industry has great opportunities to significantly reduce CO2 emissions by improving the energy efficiency of residential buildings. However, in this industry, diffusion of cost-effective clean technologies has been notoriously slow and below potential. This paper sheds light on factors that explain why construction companies have been reluctant to adopt energy-efficient technologies. It questions why some companies have intensified their investments in clean technologies, while others are lagging behind. Based on a multiple case study of four Dutch building contractors, the paper shows that contractors that actively gather information and build internal technical capacity are keener on adopting energy-efficient technologies. Findings also reveal that it will be a major challenge for the construction industry to communicate the advantages of clean technologies to (potential) home buyers and create market demand. Copyright © 2008 John Wiley & Sons, Ltd and ERP Environment. [source] | ||||||||||||||||