Housing sector recovery trajectories after the 2021 landslides in Kerala, India

BackgroundTraditional Chinese medicine (TCM) hospitals are vital to China's healthcare system, yet concerns persist about the efficiency and equity of resource allocation. Variations in economic development across cities within a province lead to disparities in allocation efficiency, with many TCM hospitals facing challenges like low technical efficiency and uneven resource distribution. These issues hinder quality healthcare delivery and compromise fairness.MethodsUsing health statistics data (2018–2024) from China's Gansu Provincial Bureau of Statistics, this study employed a three-stage Data Envelopment Analysis (DEA) model, the Malmquist index, and Health Resources Agglomeration Degree (HRAD) to evaluate the efficiency and equity of TCM hospital resource allocation across 14 cities in the province.ResultsIn 2024, the comprehensive technical efficiency of healthcare services at Gansu Provincial TCM Hospital was 0.961, with 10 regions being DEA-effective, 1 showing weak effectiveness, and 3 deemed ineffective. After adjusting environmental variables and random disturbances in the third-stage analysis, the recalculated efficiency metric stands at 0.962, showing minimal variation. This indicates that environmental factors exert a negligible influence on efficiency. From 2018 to 2024, total factor productivity declined annually, indicating significant room for efficiency improvement. Resource allocation equity varied widely across regions, with notable disparities in both geographical concentration and population-based distribution observed during the study period.ConclusionsThe efficiency and equity of resource allocation of TCM hospitals require substantial improvement. Insufficient resources limit hospital performance, and while technical efficiency surpasses allocation efficiency, overall technical standards remain inadequate. Geographic inequities in resource distribution are particularly pronounced. To address these challenges, establishing a provincial resource allocation mechanism, enhancing infrastructure in low-efficiency areas, and coordinating resource distribution across economically diverse cities are essential to optimize both efficiency and fairness.

Equity in resource allocation for health: A comparative study of the Ashanti and Northern Regions of Ghana

BackgroundCounty-level Centers for Disease Control and Prevention (CDCs) are the foundational units of China’s public health system. The COVID-19 pandemic has highlighted the shortcomings of the system, making it urgent to strengthen the functions of county-level CDCs. The efficiency and equity of resource allocation are crucial for enhancing public health outcomes. Therefore, this study aimed to evaluate six-year trends (2018–2023) in equity and efficiency of resource allocation among the ten county-level CDCs in Qingdao and to identify actionable measures for optimizing grassroots public-health capacity in the post-COVID-19 era.MethodsWe used Gini coefficient and Lorenz curve to assess the equity of resource allocation in the county-level CDCs in Qingdao. The efficiency of CDCs was evaluated using data envelopment analysis (DEA) and Bootstrap DEA. Efficiency change was analyzed by employing the Malmquist productivity index (MPI).ResultsThe health resources at the Qingdao CDCs showed an overall upward trend from 2018 to 2023. During 2018–2023, CDC personnel allocation showed good equity in demographic and economic dimensions (Gini < 0.3), but suboptimal equity in geographic distribution (Gini 0.3–0.5). The average technical efficiency was 0.940, pure technical efficiency averaged 0.995, and scale efficiency was 0.944. Among 10 CDCs, 50% achieved DEA efficiency. According to the total factor productivity (TFP) reflected by the indicator system constructed in this study, TFP grew at a rate of 6.0% between 2022 and 2023. Changes in technical efficiency change (TEC) and scale efficiency change (SEC) generally exceeded those in technological progress (TC).ConclusionIn order to enhance the equity and efficiency of resource allocation in county-level CDCs in Qingdao City. The government needs to adopt targeted policies, such as implementing flexible staffing adjustments, increasing the number of technical personnel and senior experts, and strengthening continuous training to enhance workforce capabilities. Also, fiscal efficiency should be enhanced by linking fund allocation with performance evaluation. Meanwhile, accelerating technological modernization and enhancing technological capabilities through digital tools and management innovation are crucial. Overall, these comprehensive measures aim to enhance resource utilization efficiency and strengthen the resilience of public health services.Clinical trial numberNot applicable.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12913-025-13478-y.

Public participation has become a basic requirement for good governance in democratic societies across the world. It is also instrumental in development practice, where it holds the promise of including the community in agenda-setting as well as decision-making in development planning, implementation and sharing of development benefits. In Kenya, both the national and county governments have been engaging the members of the public in participatory processes including budget making process with various degrees of success. For the goals of public participation to be realized, the forums for engaging citizens must be structured in a way that the desired outcomes are achievable. Participants preparation is critical for ensuring they give meaningful and quality input. This study sought to investigate the influence of participants preparation for citizen fora on equity in resource allocation by county governments in Kenya. The study surveyed targeted members of the public who had participated in the budget hearing forums organized by county governments in nine counties selected for the study using a multistage sampling procedure. A total of 491 respondents selected through systematic random sampling, as well as 27 county government officers who were interviewed as key informants. The resulting data, both quantitative and qualitive was cleaned, coded and analysed using descriptive and inferential statistics and content analysis respectively. The findings of the study show that sufficient publicity in planning for the forums and availing timely, comprehensive, and adequate information to the budget forum participants have a positive and significant influence on equity in resource allocation by county governments. Specifically, it showed that sending invitations to members of the public in a timely manner through channels that are widely accessible to the members of the public leads to a higher number of people attending which is important for decisions that promote equity outcomes. Furthermore, availing adequate budget information helps the participants to understand the entire budget process, the proposed projects and the amounts allocated which enables them to give proposals that engender equity in resource allocation. The study recommends that county governments should strengthen both the publicity and civic education to ensure that members of the public are sufficiently mobilized and empowered to give input that will enable the counties to allocate resources in an equitable way.

BackgroundThe demographical and geographical distributions of health resources are important aspects of healthcare access. Few studies have been published on health resource allocation in TCM hospitals in China despite public equity concerns.MethodsThis article uses the Gini coefficient and agglomeration degree to analyze the health resources of TCM hospitals in China according to demographic and geographic configuration conditions in order to study the equity of the health resources of TCM from 2009 to 2018.ResultsFrom 2009 to 2018, all regions of the TCM health resources per ten thousand people and per ten thousand square kilometers showed overall upward trends. The overall equity of the health resource allocations of TCM hospitals in China tended to improve year by year. However, there were still great differences among regions. Generally, the equity of physical resource allocation was better than the equity of human resource allocation. Additionally, the equity of health resources in TCM hospitals allocated by population was better than it was by geographic region.ConclusionsIt is necessary to further optimize the structure of TCM resource allocation, and enhance the equity of resource allocation among different regions.

BackgroundUganda is proposing introduction of the National Health Insurance scheme (NHIS) in a phased manner with the view to obtaining additional funding for the health sector and promoting financial risk protection. In this paper, we have assessed the proposed NHIS from an equity perspective, exploring the extent to which NHIS would improve existing disparities in the health sector.MethodsWe reviewed the proposed design and other relevant documents that enhanced our understanding of contextual issues. We used the Kutzin and fair financing frameworks to critically assess the impact of NHIS on overall equity in financing in Uganda.ResultsThe introduction of NHIS is being proposed against the backdrop of inequalities in the distribution of health system inputs between rural and urban areas, different levels of care and geographic areas. In this assessment, we find that gradual implementation of NHIS will result in low coverage initially, which might pose a challenge for effective management of the scheme. The process for accreditation of service providers during the first phase is not explicit on how it will ensure that a two-tier service provision arrangement does not emerge to cater for different types of patients. If the proposed fee-for-service mechanism of reimbursing providers is pursued, utilisation patterns will determine how resources are allocated. This implies that equity in resource allocation will be determined by the distribution of accredited providers, and checks put in place to prohibit frivolous use. The current design does not explicitly mention how these two issues will be tackled. Lastly, there is no clarity on how the NHIS will fit into, and integrate within existing financing mechanisms.ConclusionUnder the current NHIS design, the initial low coverage in the first years will inhibit optimal achievement of the important equity characteristics of pooling, cross-subsidisation and financial protection. Depending on the distribution of accredited providers and utilisation patterns, the NHIS could worsen existing disparities in access to services, given the fee-for-service reimbursement mechanisms currently proposed. Lastly, if equity in financing and resource allocation are not explicit objectives of the NHIS, it might inadvertently worsen the existing disparities in service provision.

Based on our review of several literatures—the general sociology literature, the sport sociology literature, and the gender literature—we find that there exists an important literature that demonstrates that great strides have been made in opportunities for participation for women at all stages of the athletic pipeline. However, there are few if any studies of gender equity in resource allocation in competitive intercollegiate sports. Framed through the lens provided by feminist theory, this paper analyzes data collected from the Equity in Athletics Disclosure Act (EADA) to examine the issue of gender equity in resource allocation in intercollegiate (NCAA) Division 1 sports. We find that there is significantly more gender equity in resource allocation in nonrevenue, gender neutral sports, particularly soccer, than in the high profile, revenue generating, masculinized sport of basketball. The use of this data as well as our analysis—which make "head to head" comparisons in resource allocations to men's and women's basketball and soccer—makes this paper unique. Theoretically we argue that the closer women get to encroaching on men's domain, specifically in basketball, the more gender differences are highlighted and gender boundaries are enforced. This paper makes a significant contribution and advancement in the sociological study of sport literature as well as in the gender studies literature.

This review aims to identify, assess and analyse the evidence on equity in the distribution of public health sector expenditure in low- and middle-income countries. Four bibliographic databases and five websites were searched to identify quantitative studies examining equity in the distribution of public health funding in individual countries or groups of countries. Two different types of studies were identified: benefit incidence analysis (BIA) and resource allocation comparison (RAC) studies. Quality appraisal and data synthesis were tailored to each study type to reflect differences in the methods used and in the information provided. We identified 39 studies focusing on African, Asian and Latin American countries. Of these, 31 were BIA studies that described the distribution, typically across socio-economic status, of individual monetary benefit derived from service utilization. The remaining eight were RAC studies that compared the actual expenditure across geographic areas to an ideal need-based distribution. Overall, the quality of the evidence from both types of study was relatively weak. Looking across studies, the evidence confirms that resource allocation formulae can enhance equity in resource allocation across geographic areas and that the poor benefits proportionally more from primary health care than from hospital expenditure. The lack of information on the distribution of benefit from utilization in RAC studies and on the countries' approaches to resource allocation in BIA studies prevents further policy analysis. Additional research that relates the type of resource allocation mechanism to service provision and to the benefit distribution is required for a better understanding of equity-enhancing resource allocation policies.

Equity in resource allocation in the Irish health service: A policy Delphi study

This paper highlights the need for equity in resource allocation in the Nigerian educational system and its implication for technology education. It observes that the secondary education level is a very important stage in the educational system and as such resources required to make the system functional should be put in place and adequately too. It further posits that for technology education to be relevant in the 21st century this level of education must be given a new direction. Nigerian Journal of Technology and Education in Nigeria Vol. 8(2) 2003: 87-95

Background Long-term care (LTC) is organized in a fragmented manner. Payer agencies (PA) receive LTC funds from the agency collecting funds, and commission services. Yet, distributional equity (DE) across PAs, a precondition to geographical equity of access to LTC, has received limited attention. We conceptualize that LTC systems promote DE when they are designed to set eligibility criteria nationally (vs. locally); and to distribute funds among PAs based on needs-formula (vs. past-budgets or government decisions). The objectives of this cross-country study is to highlight to what extent different LTC systems are designed to promote DE across PAs, and the parameters used in allocation formulae. Methods Qualitative data were collected through a questionnaire filled by experts from 17 OECD countries. Results 11 out of 25 LTC systems analyzed, fully meet DE as we defined. 5 systems which give high autonomy to PAs have designs with low levels of DE; while nine systems partially promote DE. Allocation formulae vary in their complexity as some systems use simple demographic parameters while others apply socio-economic status, disability, and LTC cost variations. Conclusions A minority of LTC systems fully meet DE, which is only one of the criteria in allocation of LTC resources. Some systems prefer local priority-setting and governance over DE. Countries that value DE should harmonize the eligibility criteria at the national level and allocate funds according to needs across regions. Key messages A minority of LTC systems in OECD countries fully meet distributional equity in allocation of resources across payer agencies. Countries that value distributional equity should harmonize the eligibility criteria to LTC at the national level and allocate funds according to needs across regions.

to understand and master the resource allocation of TCM hospitals in China from 2014 to 2018, analyze the main problems in resource allocation of TCM hospitals, and put forward suggestions for optimization measures. Methods: the basic allocation of institutions, actual beds, practicing (Assistant) doctors and registered nurses in 31 provinces of China from 2014 to 2018 were sorted out through the national statistical extract of traditional Chinese medicine. The equity of resource allocation in TCM hospitals was analyzed by using Gini coefficient and Lorenz curve according to population and geography, and Theil index was used to determine the main causes of unfair resource allocation Source. Results: the resource allocation of TCM hospitals increased rapidly, but the regional distribution was uneven. The fairness of population allocation was better than that of geographical distribution, and the unfairness mainly came from regional differences. Conclusion: the rational allocation of resources in TCM hospitals is a powerful guarantee to provide effective TCM medical services. In resource allocation, we should strengthen macro-control, optimize talent allocation and guide Reasonable flow, boost resource integration, and promote co-construction and sharing.

To investigate the relation between decentralization and equity of resource allocation in Colombia and Chile. The "decision space" approach and analysis of expenditures and utilization rates were used to provide a comparative analysis of decentralization of the health systems of Colombia and Chile. Evidence from Colombia and Chile suggests that decentralization, under certain conditions and with some specific policy mechanisms, can improve equity of resource allocation. In these countries, equitable levels of per capita financial allocations at the municipal level were achieved through different forms of decentralization--the use of allocation formulae, adequate local funding choices and horizontal equity funds. Findings on equity of utilization of services were less consistent, but they did show that increased levels of funding were associated with increased utilization. This suggests that improved equity of funding over time might reduce inequities of service utilization. Decentralization can contribute to, or at least maintain, equitable allocation of health resources among municipalities of different incomes.

Objective To measure the equity of resources allocation in obstetric healthcare in Zhejiang Province, and provide evidence for decision making by healthcare departments of the government. Methods Lorenz curve and Gini coefficient were used to measure the equity of obstetric healthcare resources. Results The investigation found such allocation as equitable as measured by the layout of the number of live births, as the Gini coefficient of the distribution of obstetric doctors, nurses and beds was 0.1697,0.1971 and 0.1497 respectively by total birth, failing within the equitable range. However, when measured by geographic distribution, such coefficient were 0.2701, 0.3216 and 0.3341 respectively in cities, which were less equitable yet still within equitable range. Conclusions The government and health bureaus are recommended to scientifically predict the number of immigrants and rationally deploy healthcare resources according to the service radius of healthcare resources;moreover, more gynecologic doctors and nurses should be trained to improve the human resource structure in gynecologic departments. These effort can cater to the growing healthcare demands of the society resulting from a growing population of immigrants. Key words: Equity; Healthcare resource allocation; Deployment; Obstetric; Gini coefficient

BackgroundHealth equity has persistently been a global concern. How to fairly and appropriately allocate health resources is a research hotspot. While Western China is relatively backward economically and presents difficulties for the allocation of health resources, little attention has been given to the equity of resource allocation there. This study analysed the equity of allocation of beds, physicians and nurses in Western China from 2014-2018 to provide targeted guidance for improving the equity of health resource allocation.MethodsData for 2014-2018 obtained from the Statistical Yearbook (2015-2019) of provinces (autonomous regions and municipalities) were used to analyse health resource allocation in terms of beds, physicians and nurses in Western China. The Lorenz curve and Gini coefficient were calculated to evaluate equity in the population dimension and geographic dimension. The Theil index was used to measure the inequity of the three indicators between minority and nonminority areas.ResultsThe number of beds, physicians and nurses in Western China showed an increasing trend from 2014-2018. The Lorenz curve had a smaller curvature in the population dimension than in the geographic dimension. The Gini coefficients for health resources in the population dimension ranged from 0.044 to 0.079, and in the geographic dimension, the Gini coefficients ranged between 0.614 and 0.647. The above results showed that the equity of health resource allocation was better in the population dimension than in the geographic dimension. The Theil index ranged from 0.000 to 0.004 in the population dimension and from 0.095 to 0.326 in the geographic dimension, indicating that the inequity in health resource allocation was higher in the geographic dimension. The intergroup contribution ratios of the Theil index in both the population and geographic dimensions were greater than 60%, indicating that the inequity in resource allocation was mainly caused by intergroup differences, namely, the allocation of health resources within the province. Among them, the inequity of physicians and nurses allocation was the most obvious.ConclusionsFrom 2014 to 2018, the total amount of health resources have improved in Western China. However, health resource allocation in Western China was still inequitable in the population and geographic dimensions, and the inequity of health resource allocation in the geographic dimension showed a tendency to worsen. Meanwhile, although the inequity of human recourse allocation was alleviated in 2018 compare with 2014, the inequity of human resource distribution within provinces was still obvious. The government can increase the number of health resources and improve the accessibility of health resources by increasing financial investment, strengthening humanistic care for health workers, and establishing internet hospitals.