Administrative Efforts Research Articles

THE ROLE OF LOCAL REPRESENTATIVE AND EXECUTIVE BODIES IN UZBEKISTAN'S POLITICAL SYSTEM: LEGAL AND INSTITUTIONAL ASPECTS

This article explores the evolving role of local representative and executive bodies in Uzbekistan’s political system, with a particular focus on the increased participation of political parties in local governance. It examines the expansion of the powers of the Councils of People's Deputies, especially in relation to monitoring local executive authorities and ensuring the implementation of laws and governmental decrees. The study highlights the need for enhanced parliamentary oversight at the local level and discusses the potential impact of party groups in strengthening the socio-political framework of the regions. The article also addresses the challenges faced by local authorities in ensuring efficient governance, including insufficient use of the powers granted to political parties and the lack of a unified approach to solving socio-economic problems. Drawing on recent reforms, including experimental governance models in Tashkent, the article argues for a more robust legal framework to support local political oversight and promote greater accountability among local executive bodies. The findings underscore the importance of legal reforms aimed at enhancing the autonomy and effectiveness of local governance as a key component of Uzbekistan’s broader political and administrative modernization efforts.

Legal Certainty The Obligation To Make Administrative Efforts Before Filing A Lawsuit In The Administrative Court

In accordance with the provisions of Article 48 of Law Number 5 of 1986 concerning the State Administrative Court which has been last amended by Law Number 51 of 2009 concerning the Second Amendment of Law Number 5 of 1986 concerning the State Administrative Court ("Peratun Law") which states that not every State Administrative Decision (beschikking) as the object of the State Administrative dispute can be directly sued through the State Administrative Court, because if there are administrative remedies, the state administrative dispute must be resolved first through administrative efforts before being resolved through the State Administrative Court. This research uses a qualitative normative method, which is a process to find a legal rule, legal principles, and legal doctrines to answer the legal issues faced. The result of this study is that Sema No. 1 of 2017 has been affirmed through Perma No. 6 of 2018, thus according to the Court, as long as the administrative effort is intended to file a lawsuit to the PTUN or at least related to the procedural law of the PTUN, the word "can" must be interpreted as "mandatory" to take administrative efforts first. Then the PTUN plays a role in ensuring that law enforcement occurs effectively, by paying attention to the principles of justice and legal certainty that are the basis for every decision taken, and the PTUN plays the role of a court that has the authority to resolve state administrative disputes after the administrative efforts have been passed, in accordance with applicable regulations.

A national-wide survey on clinical implementation of PGx testing into precision therapeutics for Chinese children: a long way before standard clinical practice

BackgroundPharmacogenetics/pharmacogenomics (PGx) focuses on the genetic variation that causes the heterogeneity of pharmacokinetics and drug response among individuals and has the potential to predict individual efficacy and/or side effects. This study aims to investigate and understand the implementation of genetic testing for the personalized medication (GTPM) in children's hospitals in Mainland China.MethodsA survey was conducted on 50 children's hospitals from 31 provinces, municipalities, and autonomous regions across Mainland China, and statistical analysis and recommendations were made.ResultsQuestionnaire response was rate of 76.0% (38/50). Data from 15 hospitals conducting GTPM were included in this study, but only 6 hospitals had offered PGx tests for no less than five drug-related genes, and only 5 hospitals had covered more than ten drugs, which was a small scale overall. 20.0% of the laboratories did not conduct internal quality control, and 33.3% did not participate in inter-laboratory quality assessment. 46.7% of the practitioners did not receive external training. The primary goal for GTPM was to optimize drug dosage in the 15 hospitals, while the main challenge for GTPM was the implementation cost.ConclusionAlthough GTPM in pediatrics has made major progress in Mainland China in recent years, there were still various problems in terms of software, hardware configuration, personnel allocation, business scale, quality control, and result interpretation. This requires joint efforts of health administration, medical insurance departments, researchers, and hospitals to promote and improve GTPM.

Street Lighting in Brazilian Cities: From Comfort to Safety at Nighttime

Objective: The objective of this work is to carry out a qualitative literature review, with the aim of exploring the multidisciplinary nature of the topic discussed here. Bibliographic exploration was consulted in order to establish a historical narrative regarding the impact of the emergence of public lighting in Brazilian cities. It is also the intention to raise the discussion regarding the multifactors that public lighting can address in improving the lives of those who enjoy the city at night. This context, which presents itself as a fruit of human development, raises the need for work, since progress should not negatively affect the reality, health and sociability of the human species. As a secondary objective, the proposal arises to raise the collective notion of the importance of establishing administrative and technical efforts, so that Brazilian cities remain sufficiently illuminated during the night, since the technological development of lighting resources is constantly updated. Such understanding is fundamental to enhancing the role of urban settlements in the lives of the citizens who live there and have, at night, the possibility of leisure, work and sociability. As a consequence, an improvement in the safety, health and well-being of the population can be achieved. Theoretical Framework: The primary database used in the development of this study was the analysis of historical and technical data on the implementation of the public lighting system in Brazil, as well as its benefits, obtained from the bibliography of authors capable of discussing the subject. Method: The methodology adopted for this research comprises the process of integrative bibliographic review, with the objective of fostering the multidisciplinary nature of the topic regarding public lighting in Brazilian cities. Data collection was carried out through the exploration of digital academic databases. Results and Discussion: The results obtained reinforced the crucial role of public lighting for the well-being of the population. Furthermore, they revealed that the central subject explored in the research demands a broad and integrated study, given the complexity of its nature. Public lighting in Brazilian cities needs to be analyzed from the perspective of various fields of knowledge. Research Implications: The practical and theoretical implications of this research are discussed, providing insights on how the results can be applied or influence practices in the fields of electrical engineering, urban planning, statistics, architecture, public administration, and the joint work between these fields. Originality/Value: This study contributes to the literature by presenting an innovative, theoretical and integrative essay on the topic of public lighting in Brazilian cities. The work also acts as a promoter for future studies that seek to unite in a complex way the multifactors treated, and, possibly, factors external to the topic.

The role of community policing in the Addis Ababa City Administration's efforts to maintain community safety and security

This study aimed to assess the role of community policing in maintaining community safety and security in the Addis Ababa city administration and to assess the role of community policing in maintaining community safety and security community policing initiatives, information sharing, and attitudes toward community policing among community members on local security management practices. A descriptive case study was adopted, in which the target population of 328 respondents was stratified randomly into three sub-cities: Arada, Kirkos, and Addis Ketema. A structure questionnaire was used as the research instrument. Quantitative data were analyzed using descriptive and inferential statistics. The findings revealed that the role of community polices included paper initiatives among members, information sharing on community policing, and community policing among community members because there were no local security management practices affecting security practices. It was recommended that the community be made aware of their role in community policing and that the police should ensure that they interact well with the community so that the members of the community will willingly provide information to the police, which may help prevent crime.

PERLINDUNGAN HAK ANAK DALAM KONFLIK BERSENJATA DI KONGO BERDASARKAN CONVENTION ON THE RIGHTS OF THE CHILD 1989

The armed conflict, particularly in the Eastern Congo regions of North Kivu, South Kivu and Ituri, has led to many violations of children's rights. 14.9 million children have been most severely affected by this conflict. There are violations in terms of recruitment, use, detention, abduction, physical and sexual violence, attacks on schools and health facilities. The formulation of the problem of this article is what forms of violations of children's rights in the armed conflict that occurred in Congo based on the UNCRC 1989 and how efforts should be made by Congo in protecting children's rights based on the UNCRC 1989. This article uses normative research methods, descriptive-analytical in nature, drawing conclusions with deductive methods. The results of the research are the form of violations of children's rights committed by Congo, namely the right to survival, the right to protection, the right to growth and development and violating the principle of non-discrimination, the principle of state responsibility, the principle of the right to life and development to the fullest. The conclusion is that Congo should take the best measures to protect children's rights, especially in armed conflict, such as legislative, administrative, social and educational efforts to protect children's rights

Implementing a multidimensional faculty promotion matrix at Saint George University of Beirut Faculty of Medicine

This paper outlines the development and implementation of a multidimensional faculty promotion matrix at Saint George University of Beirut Faculty of Medicine (SGUB FM). The matrix, designed to provide a comprehensive and equitable evaluation of faculty across multiple dimensions, is anchored in six pillars: Research, Clinical Practice, Teaching Effort, Administrative Effort, Community Work, and Extra Degrees and Awards. These pillars encompass diverse components, including publication output, clinical activities, teaching responsibilities, administrative roles, community engagement, and additional qualifications, with each metric normalized using z-scores for fair comparison. This matrix analyzed the CVs and relevant documents of 112 faculty members, demonstrating its efficacy in providing equitable evaluation regardless of gender or rank. The results showed no significant differences in promotion rates among various faculty ranks, highlighting the matrix’s fairness and impartiality. The study also explores the relationship between faculty ranks and various performance metrics, revealing patterns in research productivity, clinical practice, and community engagement that escalate with higher academic ranks. SGUB FM's approach aligns its curricular designs and instructional implementations with international benchmarks, particularly those set by the Association of American Medical Colleges (AAMC), ensuring global standard compliance while catering to the institution's unique context. The matrix serves not only as an evaluation tool but also as a catalyst for faculty excellence and professional development. This case study offers valuable insights for medical institutions developing inclusive promotion criteria and emphasizes the importance of holistic evaluation frameworks in fostering academic excellence and professional growth.

Introduction of a New Satellite Model for Participation in Clinical Trials in a Consortial Comprehensive Cancer Center with Four University Hospitals in Germany

Introduction: The trend toward personalized medicine leads to very small study cohorts for clinical trials, which makes it difficult to recruit patients in a single study center. On the other hand, the administrative effort required to initiate a clinical trial is very high. As a result, Germany runs the risk of falling behind other countries as a trial location. For this reason, the Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) has been working on the challenge of a new satellite model in which the main trial center is the only one to conclude a trial center contract with the sponsor and also handles all formalities with it. The remaining sites constitute the satellites. In contrast to former satellite models, the entire study-related interventions are carried out at each site in the present model. Methods: In order to evaluate the approvability of the model, contact was made with both higher federal authorities and the responsible inspectorate, and none of them declared themselves responsible for a possible basic approval. The four ethics committees contacted agreed to the model subject to certain framework conditions. In addition, the model was validated by the preparation of several legal opinions on various issues (medical, labor, antitrust law). Conclusion: Study participation close to home is a decisive advantage for multimorbid patients. As up to four locations form a trial site in the model, a large catchment area can be covered with reduced administrative costs. The satellite model developed is intended to give patients broader access to medical innovations in cancer therapy.

Galaxy Helm chart: a standardized method for deploying production Galaxy servers.

The Galaxy application is a popular open-source framework for data intensive sciences, counting thousands of monthly users across more than 100 public servers. To support a growing number of users and a greater variety of use cases, the complexity of a production-grade Galaxy installation has also grown, requiring more administration effort. There is a need for a rapid and reproducible Galaxy deployment method that can be maintained at high-availability with minimal maintenance. We describe the Galaxy Helm chart that codifies all elements of a production-grade Galaxy installation into a single package. Deployable on Kubernetes clusters, the chart encapsulates supporting software services and implements the best-practices model for running Galaxy. It is also the most rapid method available for deploying a scalable, production-grade Galaxy instance on one's own infrastructure. The chart is highly configurable, allowing systems administrators to swap dependent services if desired. Notable uses of the chart include on-demand, fully-automated deployments on AnVIL, providing training infrastructure for the Bioconductor project, and as the AWS-recommended solution for running Galaxy on the Amazon cloud. The source code for Galaxy Helm is available at https://github.com/galaxyproject/galaxy-helm, the corresponding Helm package at https://github.com/CloudVE/helm-charts, and the required Galaxy container image https://github.com/galaxyproject/galaxy-docker-k8s.

Workplace support for physicians during the COVID-19 Pandemic: Did it affect burnout?

BackgroundA concern before 2020, physician burnout worsened during the COVID-19 pandemic. Little empirical data are available on pandemic workplace support interventions or their influence on burnout. We surveyed a national sample of frontline physicians on burnout and workplace support during the pandemic.MethodsWe surveyed a stratified random sample of 12,833 US physicians most likely to care for adult COVID-19 patients from the comprehensive AMA Physician Professional Data ™ file. The sample included 6722 primary care physicians (3331 family physicians, 3391 internists), 880 hospitalists, 1783 critical care physicians (894 critical care physicians, 889 pulmonary intensivists), 2548 emergency medicine physicians, and 900 infectious disease physicians. The emailed survey elicited physicians’ perceptions of organizational interventions to provide workplace support and/or to address burnout. Burnout was assessed with the Professional Fulfillment Index Burnout Composite scale (PFI-BC). Proportional specialty representation and response bias were addressed by survey weighting. Logistic regression assessed the association of physician characteristics and workplace interventions with burnout.ResultsAfter weighting, respondents were representative of the total sample. Overall physician burnout was 45.4%, significantly higher than in our previous survey. Open-ended responses mentioned that staffing shortages (physician, nursing, and other staff) combined with the increased volume, complexity, and acuity of patients during the pandemic increased job demands. The most frequent workplace support interventions were direct pandemic control measures (increased access to personal protective equipment, 70.0%); improved telehealth functionality (43.4%); and individual resiliency tools (yoga, meditation, 30.7%). Respondents placed highest priority on workplace interventions to increase financial support and increase nursing and clinician staffing. Factors significantly associated with lower odds of burnout were practicing critical care (compared with emergency medicine) OR 0.33 (95% CI 0.12 – 0.93), improved telehealth functionality OR 0.47 (95% CI 0.23 – 0.97) and being in practice for 11 years or longer OR 0.44 (95% CI 0.19–0.99).ConclusionsBurnout across frontline specialties increased during the pandemic. Physician respondents focused on inadequate staffing in the context of caring for more and sicker patients, combined with the lack of administrative efforts to mitigate problems. Burnout mitigation requires system-level interventions beyond individual-focused stress reduction programs to improve staffing, increase compensation, and build effective teams.

The effect of organisational factors on adopting big data analytics in supply chain operation among companies in Saudi Arabia: The moderating role of resistance to change

Background: Big data analytics (BDA) is vital for modern supply chain operations. However, implementing BDA requires significant administrative effort to ensure success, as managers and employees may resist change. A study was conducted on large and medium-sized companies in Saudi Arabia to investigate the impact of organisational factors on BDA adoption and identify potential resistance. (hereafter Saudi Arabia).Objectives: This study investigate how organisational factors influence the adoption of BDA in medium and large supply chain companies in Saudi Arabia. It also explores the moderating role of resistance to change (RTC) in this relationship.Method: A survey questionnaire was given to 402 supply chain practitioners working in medium and large enterprises (MLEs) in Saudi Arabia as part of a quantitative study. The collected data were analysed using the Statistical Package for Social Science (SPSS29.0) and SMART PLS (version 4.0).Results: The findings indicated that organisational factors (top management support, IT expertise, and organisational resources) insignificantly influenced BDA adoption (p 0.05). Furthermore, RTC did not moderate the relationship between organisational factors and technology adoption (p 0.05).Conclusion: The successful use of BDA is crucial for improving Saudi supply chain operations, with a positive impact on customers, companies, and the country.Contribution: This study is important for medium and large companies in the Saudi Arabian supply chain. It provides scope for developing innovations in adopting BDA by understanding organisational factors that influence adoption. The results will help push Saudi companies forward in trusting BDA in supply chain operations.

Cyber Diplomacy during the Biden Administration and Future Prospects

The Biden administration has placed a high priority on cybersecurity and cyber diplomacy during its tenure. This paper delves deeply into the Biden administration's various efforts in the realm of cyber diplomacy, aiming to forge cyber alliances guided by cybersecurity strategy and the concept of small multilateralism. The Biden administration seeks to leverage cyber diplomacy to repair relationships with traditional allies while also strengthening cooperation with emerging market countries, thereby maintaining and enhancing the United States' leadership in global cyber policy. The paper also analyzes the main challenges faced by the Biden administration, including rapidly advancing technology, domestic and international political factors, and competition with global adversaries. Finally, the paper evaluates the current effectiveness of the Biden administration's cyber diplomacy, noting some achievements while arguing that the U.S. cyber diplomacy strategy will need further adjustments and optimizations to address the continuously changing global political and economic landscape.

A descriptive study of poisoners and users of other indiscriminate means to illegally control wildlife in Spain

AbstractPoison and other indiscriminate means are used illegally for wildlife control worldwide. This pervasive phenomenon can significantly damage ecosystems overall and be particularly harmful to certain species (endangered or otherwise) that are susceptible to poisoned baits. Poisoning (and co‐occurring poaching) jeopardizes public administration efforts to reintroduce or support the populations of certain species, while the favored toxic substances used pose a major threat not only to the biodiversity of habitats but also to human health. Both alleged and actual harm to crops and hunting resources are the main driver of illegal vermin and predator control. Previous studies on poisons and other nonselective methods of wildlife elimination have focused on the means used and the species affected. We have instead taken a global empirical approach, also analyzing contextual aspects, what motivates perpetrators and, eventually, the characteristics of the poisoners and users of various indiscriminate means for illegal wildlife control in Spain. This analysis is derived from a thorough examination of incidents based on the investigation of perpetrator by police and judicial records. Furthermore, this work provides a methodological framework that serves as first approach to this issue, gaining insight into the formulation of preventive policies and improving decision taking by law enforcement agencies.

Trends of liver transplantation in Asia.

Liver transplantation (LT) in Asia started comparatively early in 1964, just 1year after Starzl's trail-blazing first attempt. Despite the quick start, LT was slow to develop in this region. Limited access to universal healthcare, lack of public understanding and support as well as the absence of strong legislation, on a backdrop of a wide range of diverse social, religious, economic and cultural background are all contributory factors. Through strong administrative efforts, the number of DDLTs in selected Asian countries has been slowly rising in recent years. However, Asians are generally still less likely to donate organs than Caucasians after death. The strong demand for LT with limited access to deceased organs has, therefore, led to constant need for innovation in LT this region, with the pioneering of various LDLT techniques and safe expansion of donor pool being driven primarily by Asian centers. Familiarity and the development of technical expertise in donor surgery have also resulted in Asian centers repeatedly pushing the boundaries on minimally invasive donor and recipient surgery. In this article, we focus on the past and present states of LT in Asia and explore the future trends of LT in this region.

Current status of implementation of trauma registries' in LMICs & facilitators to implementation barriers: A literature review & consultation.

Background & objectives Many low- and middle- income countries (LMICs) have attempted to implement trauma registries with varying degrees of success. This study aimed to understand the registry implementation mechanism in LMICs better. Study objectives include assessment of the current use of trauma registries in LMICs, identification of barriers to the process and potential areas for intervention, and investigation of the registry implementation experience of key stakeholders in LMICs. Methods An initial narrative review of articles on trauma registry use in LMICs published in English between January 2017 and September 2023 was conducted. Key findings identified in this review were used to establish a theoretical framework from which an interview guide was subsequently developed. Expert consultation with key stakeholders in trauma registry implementation in two LMICs was conducted to assess the experience of registry implementation further. Results The presence of trauma registries in LMICs is limited. Key implementation barriers include funding concerns, uncoordinated administrative efforts, lack of human and physical resources (i.e., technology, equipment), and challenges in data management, analysis, and quality. Stakeholder interviews highlighted the importance of trauma registry development but echoed some obstacles, notably funding and data collection barriers. Interpretation & conclusions Barriers to registry implementation are ubiquitous and may contribute to the low uptake of registries in LMICs. One potential solution to these challenges is the application of the WHO International Registry for Trauma and Emergency Care. Future studies examining context-specific challenges to registry implementation and sustained utilization are required.

Student involvement and leadership: A commitment to active citizenship

Assuming leadership from an ethical stance with responsibility for action proposes a complex challenge to achieve, because of the many aspects inherent to human beings and their evolutionary processes. It is necessary to undertake ways and ventures to weave forms and experiences that lead to it. The School of Nursing at Universidad del Valle, interpreting the university mission and based on its 2005-2015 Strategic Plan, assumes the responsibility of promoting opportunities and initiatives that foster leadership in students through the development of two strategies: promotion of Leadership and Training, through accompanying initiatives and representations of the Nursing Program students. This article describes different voices of students who have been participating in initiatives generated from the Leadership Project and the development of their strategies to recover and reveal the richness of its possibilities, as well as the difficulties of mobilizing a proposal involving democratic and humanist views on various forms of individual life and projected onto the horizon of the collective.Final reflection: The experience at the School of Nursing at Universidad del Valle about leadership and student participation provides the necessity to promote leadership based on the collective, but focusing on individual potential, as well as the personal and professional growth of students and teachers, which requires the conjunction of human, economic, academic and administrative efforts.

Incorporating genetic testing into a routine kidney clinic.

Incorporating genetic testing in routine outpatient nephrology clinic can improve on chronic kidney disease (CKD) diagnosis and utilization of precision medicine. We sent a genetic test on patients with atypical presentation of common kidney diseases, electrolytes derangements, and cystic kidney diseases. We were able to identify a gene variant contributing to patients' kidney disease in more than half of our cohort. We then showed that patients with ApoL1 risk allele have likely worse kidney disease, and we were able to confirm genetic focal segmental glomerulosclerosis (FSGS) in 2 patients and avoid unnecessary immunosuppression. Genetic testing has also improved our operation to establish a polycystic kidney disease excellence center by confirming our diagnosis, especially in patients without a well-defined family history. In conclusion, utilizing genetic testing in a routine outpatient renal clinic did not cause any burden to either patients or nephrologists, with minimal administrative effort and no financial cost to our patients. We expect that genetic testing in the right setting should become routine in nephrology to achieve a patient-centered precision medicine with less invasive means of kidney disease diagnosis.

Moral foundations, moral emotions, and moral distress in NICU nurses.

Background: Moral distress is common in neonatal intensive care unit (NICU) nurses. Purpose: The purpose of this study was to evaluate the relationships between NICU nurses' moral foundations, moral emotions, and moral distress. Research design and method: This is an observational cross-sectional self-report questionnaire study. Participants and research context: One hundred and forty-two (24%) of 585 Level 3-4 NICU nurses completed pen-and-paper self-report measures of moral foundations (harm, fairness, ingroup, authority, and purity) (Moral Foundations Questionnaire-20), proneness to self-conscious moral emotions (guilt and shame) (modified Personal Feelings Questionnaire-2), and moral distress (futile care, compromised care, and untruthful care) (modified Revised Moral Distress Scale). Ethical considerations: Participation was voluntary and anonymous. The ethics committees of the participating hospitals approved the study protocol (HREC Reference: LNR/18/SCHN/316). Results: Non-parametric statistical analyses showed medium to large correlations between moral foundations and moral emotions. Moral foundations and moral emotions had trivial to small correlations with moral distress. Using a liberal p-value of <.10 for statistical significance because of the small sample size, harm (rs = 0.22) and fairness (rs = 0.16) predicted futile care, ingroup predicted compromised care (rs = 0.19) and untruthful care (rs = 0.15), and purity predicted untruthful care (rs = 0.15). Guilt-proneness predicted futile care (rs = 0.15). Shame-proneness did not predict moral distress. Conclusion: The correlations between moral foundations and moral emotions were significant. Moral foundations and guilt-proneness predicted one or more dimensions of moral distress. The smaller than expected effect sizes may have been owing to how moral foundations, moral emotions, and moral distress were conceptualized and measured, or to moral disengagement, including NICU nurses' possible reluctance to countenance aversive but morally warranted feelings of guilt and especially shame. Understanding the nature of these relationships may complement the efforts of NICU administrators, educators, counsellors, and nurses themselves to mitigate moral distress.

Tanggung Jawab Hukum Bagi Produsen Obat Sirup Anak yang Berbahan Zat Berbahaya Berdasarkan Undang-Undang No 17 Tahun 2023 Tentang Kesehatan

The case shows that some children's syrup drug products contain hazardous substances that can endanger the health of children. As a producer of children's syrup, their legal responsibility is very important in ensuring consumer safety. Law No. 17 of 2023 concerning Health provides a legal framework that regulates the responsibility of producers in this regard. This thesis discusses the legal responsibility of producers of children's syrup containing dangerous substances based on the law. The research reviews legal aspects related to producer responsibility, including legal sanctions that can be given to producers if they are found to have violated regulations, as well as what efforts producers can take to minimize legal risks and meet product safety and quality standards. The results of the study show that manufacturers of syrup for children must pay attention to various regulations and safety and quality standards stipulated by Law No. 17 of 2023 concerning Health and related institutions, and conduct product trials periodically to ensure safety and quality. In addition, producers must also be prepared to face legal sanctions if they violate existing regulations, such as fines and revocation of business licenses. The legal responsibility of the producer, then legal liability, namely civil, criminal and administrative responsibility Legal efforts that can be carried out Mediation efforts with the business actor/manufacturer of children's syrup medicine, if this fails, then the process can be carried out through the Consumer Dispute Protection Agency (BPSK), if the decision is not satisfactory, further legal action can be taken through the general court. The Ministry of Health and BPOM should be able to mitigate risks at the outset, regarding the distribution of drugs in Indonesia

Building integrated primary health care: the role of the government in China and Thailand

ABSTRACT While the importance of primary health care (PHC) as a foundation for a strong healthcare system is widely accepted, the policies needed to achieve it remain deeply controversial. Some proponents call for a greater role for market and user choice in expanding and strengthening PHC, whereas others recommend a greater role for the government in directing its development. The objective of this paper is to assess these arguments by comparing the experience of China and Thailand in strengthening PHC. We find that tight government steering of the healthcare system in Thailand has produced better integration and eventually outcomes than the more decentralized and competitive system in China. The Chinese government’s massive administrative and fiscal efforts to strengthen PHC have been undermined by systemic barriers in the wider health system, notably fee-for-service and out-of-pocket financing that distort the incentives of healthcare providers. A key conclusion to emerge from the analysis is that central stewardship and steering accompanied by appropriate incentives to promote integration are critical to building effective primary health care.