Budget Lines Research Articles

An Assessment of Waste Management in Slum Communities in Freetown. It’s Implications on the Health and Safety of Inhabitants

Purpose: The study objective is to assess the state of Solid Waste Management (SWM) in slum communities in Freetown, its factors and effects on the safety and wellbeing of slum dwellers together with the challenges faced by authorities in combatting inadequate SWM system in slum and to provide recommendations with regards to interventions to promote adequate waste management in slums.
 Materials and Methods: The study took place in three slum areas around Freetown in Sierra Leone. A total sample size of 400 respondents comprising of household heads were selected. A self-administered structured questionnaire was given to a total of 400 respondents of household heads above eighteen years old. Only 392 of the 400 respondents that were initially targeted for the study completed their questionnaires at the end of the survey. The data collected was presented in tables and statistical analytical techniques or methods such as percentages and graphs were used to analyse the data and to find out the factors, effects and challenges associated with inappropriate solid waste management services in slum areas in Freetown.
 Findings: According to the study, it was found that the major categories of waste generated in households were biodegradable and food (39%) while plastic remains (31%). Most households stored their wastes in polythene bags (59.1%) and sacks (20.2%) before disposal and 10.3% of the households did not have waste storage containers and kept their wastes outside the house in the open. Poor knowledge in waste segregation practices with very minimal recycling, reuse of wastes and a resultant poor waste management system were observed in slum communities. The study helps provide a much-needed data on solid waste management (SWM) in Freetown for authorities and other stakeholders as there are limited sources of data on waste management in Sierra Leone. It also provides further literature on waste management issues for further research, policy development by the authorities and recommendations for best practice by communities and stakeholders.
 Implications to Practice and Policy: It was recommended that waste management should be prioritized as a social service, with adequate budget lines. Engage several stakeholders in the management of waste to generate a sense of responsibility and interest from all stakeholders.

The Epidemiology of Chronic Hepatitis C: Where We Are Now

One of the main objectives of the World Health Organization is the eradication of viral hepatitis by 2030 by identifying subjects before disease progression. In 2019, only 21% of the 58 million people chronically infected with hepatitis C virus (HCV) had been diagnosed, while overall 13% had been treated. The key recommendation of international screening programs is to reach the people at major risk of viral hepatitis and the general population. National plans, including that in Italy, have dedicated budget lines to support efforts to achieve the objective of elimination. The Italian program involves free screening for HCV in the general population born between 1969 and 1989 and also for all persons in the care of addiction services (Ser.D) and prisoners. The screening programs differed slightly among regions in Italy. In particular, referring to the screening for people born in the period of 1969–1989, in Tuscany, these people received an invitation by SMS to undergo a HCV antibody test. If the test results were positive, the subject was registered on a regional platform and required to undergo HCV RNA testing, prescribed by their GP. In the case of testing positive for HCV RNA, the linkage to care (i.e., patient entry into specialist care after diagnosis) is guaranteed. A strong effort is currently required to eliminate HCV effectively. This review highlights the most recent changes to the epidemiological scenario at the global, European, Italian, and regional (Tuscany) levels.

Sahel terrorist crisis and development priorities: case of financial allocations for the control of non-communicable diseases in Burkina Faso.

In Africa, nearly 46% of all mortality will be attributed to non-communicable diseases (NCDs) by 2030. While the cost of inaction far exceeds the cost of action against NCDs, global funding for the prevention and control of NCDs is minimal. The objective of this was to explore the Ministry of Health budget allocations for NCDs from 2010 to 2020 as well as the effect of the terrorism crisis on these allocations. The methodology was based on the budget tracking tool developed by the Scaling Up Nutrition Movement. Twenty-nine budget lines related to the prevention and/or control of NCDs have been identified. About 29.9 million USD were allocated to the fight against NCDs with an absorption rate of more than 98%.There is an upward trend of allocated budget characterized by an exponential increase from the development of the national integrated strategic plan for the fight against NCDs (2016-2020). In 2017, an increase of 184% compared to 2016 was observed. However, the efforts were challenged by the emergence of the terrorist threat which triggered in January 2016, leading to a drastic reduction in allocations for NCDs in favor likely of defense and security priorities as well as addressing the needs of internally displaced persons. A trend analysis suggests that the NCDs budget significantly decrease as the country global terrorist index increase. Further analysis is needed to better understand the implication on NCD incidence, and identify advocacy opportunities for mitigating the negative impact of the terrorist treat on NCDs and other development issues.

Does Dependence on External Resources Affect Community-Based organizations’ Efforts in Countering Violent Extremism? An Explorative Study of the Northeast Nigeria Experience

ABSTRACT This study examines the funding of community-based organizations (CBOs) as instruments for reducing the extreme behaviors of violent extremist organizations (VEOs). Evidence abounds that CBOs in industrialized nations like the USA and Canada have budget lines designated for government expenditures to deal with extremist behaviors in their local communities. This state-level effort to reduce violent extremism and VEOs behavior is absent throughout Africa, especially in Nigeria. This gap is the focal point of our investigation into how external resource dependence affects CBOs in northeast Nigeria. We triangulated our data sources using secondary data, in-depth interviews, and focus group discussions. However, this study discovered that in Nigeria, external donor agencies, NGOs, and organizations that support CBOs financially, logistically, materially, and in terms of training also tend to impact their programming selection, training content, and accountability.

Using return on investment and resiliency return on investment for preparedness

AbstractReturn on investment (ROI) has long been accepted as a primary tool for decision‐making for capital investments and even choices among competing operational budget lines. Applying ROI to investments intended to prevent or mitigate future risks and hazards can be very difficult, as benefits are typically arduous to define and calculate while risk probabilities can be very small. This paper uses examples from recent research concerning law enforcement, airport security, and airport resiliency to illustrate the feasibility of computing ROI and resiliency ROI (RROI) for such investments and to suggest methodology to approach these computations.

Government Budget for Nutrition-Sensitive Agriculture in Nigeria Increased Following Development of Related Strategy.

Financial resources that are commensurate with the magnitude of malnutrition problem are requisite for effective interventions to reduce malnutrition. Understanding the amount and nature of sectoral investments in nutrition is important for advocating and mobilizing increased government budgetary allocations and release. This study assessed trends in Nigeria's agriculture sector nutrition allocations and whether launch of nutrition-sensitive agriculture strategy and/or the COVID-19 pandemic may have affected these nutrition allocations. Agricultural budgets from 2009 to 2022 of Nigeria's federal government were analyzed. Nutrition-related budget lines were identified using a keyword search and were then classified as nutrition-specific, nutrition-sensitive, or potentially nutrition-sensitive, based on defined criteria. Potentially nutrition-sensitive items were further screened. Budget lines finally included as nutrition allocations directly targeted improvements in nutrition or intermediate outcomes in pathways between agriculture and nutrition. Budget lines were summed, and these nominal values were adjusted for inflation (using the consumer price index for each year) to obtain real values. Nutrition allocations in the agriculture budget increased considerably even after adjusting for inflation and went from 0.13% of agriculture capital budget in 2009 to 2.97% in 2022; while the real value of total government agricultural budget declined. Large budgetary increases coincided with the development/launch of costed strategies with nutrition-sensitive agriculture components. Still, there were some missed opportunities to increase nutrition allocations. Existence of nutrition-sensitive agriculture strategies has facilitated increased nutrition funding and improved the enabling environment. There is need to optimize existing nutrition allocations while advocating for additional funds.

Institutional roles, structures, funding and research partnerships towards evidence-informed policy-making: a multisector survey among policy-makers in Nigeria

BackgroundEvidence-informed policy-making aims to ensure that the best and most relevant evidence is systematically generated and used for policy-making. The aim of this study was to assess institutional structures, funding, policy-maker perspectives on researcher–policy-maker interactions and the use of research evidence in policy-making in five states in Nigeria.MethodsThis was a cross-sectional study carried out among 209 participants from two geopolitical zones in Nigeria. Study participants included programme officers/secretaries, managers/department/facility heads and state coordinators/directors/presidents/chairpersons in various ministries and the National Assembly. A pretested semi-structured self-administered questionnaire on a five-point Likert scale was used to collect information on institutional structures for policy and policy-making in participants’ organizations, the use of research evidence in policy and policy-making processes, and the status of funding for policy-relevant research in the participants’ organizations. Data were analysed using IBM SPSS version 20 software.ResultsThe majority of the respondents were older than 45 years (73.2%), were male (63.2) and had spent 5 years or less (74.6%) in their present position. The majority of the respondents’ organizations had a policy in place on research involving all key stakeholders (63.6%), integration of stakeholders’ views within the policy on research (58.9%) and a forum to coordinate the setting of research priorities (61.2%). A high mean score of 3.26 was found for the use of routine data generated from within the participants’ organizations. Funding for policy-relevant research was captured in the budget (mean = 3.47) but was inadequate (mean = 2.53) and mostly donor-driven (mean = 3.64). Funding approval and release/access processes were also reported to be cumbersome, with mean scores of 3.74 and 3.89, respectively. The results showed that capacity existed among career policy-makers and the Department of Planning, Research and Statistics to advocate for internal funds (mean = 3.55) and to attract external funds such as grants (3.76) for policy-relevant research. Interaction as part of the priority-setting process (mean = 3.01) was the most highly rated form of policy-maker–researcher interaction, while long-term partnerships with researchers (mean = 2.61) had the lower mean score. The agreement that involving policy-makers in the planning and execution of programmes could enhance the evidence-to-policy process had the highest score (mean = 4.40).ConclusionThe study revealed that although institutional structures such as institutional policies, fora and stakeholder engagement existed in the organizations studied, there was suboptimal use of evidence obtained from research initiated by both internal and external researchers. Organizations surveyed had budget lines for research, but this funding was depicted as inadequate. There was suboptimal actual participation of policy-makers in the co-creation, production and dissemination of evidence. The implementation of contextually relevant and sustained mutual institutional policy-maker–researcher engagement approaches is needed to promote evidence-informed policy-making. Thus there is a need for institutional prioritization and commitment to research evidence generation.

The Effect of Budget Control on Financial Performance among State-Owned Enterprises: Towards Enhancing A Budget Management Control Policy

Rwanda’s state-owned enterprises (SOEs) are suffering from poor financial performance. For instance, 60% of them are at a loss from 2016-to-date. For example, five companies, KTRWANDA NETWORKS, MARAPHONE RWANDA, and AFRICA OLLEH SERVICES LTD, which are 49%, 95%, and 49% respectively owned by the government of Rwanda, have accumulated US$5 million in losses each year for the last five years. Based on the above problem, the study intended to assess the link between budget control and the financial performance of SOEs in Rwanda. The study analyzed the seven objectives. The components of budget control understudy include budget planning, budget control, budget implementation, and budget review. The components of financial performance are Liquidity, Profitability, and Solvency. The research is descriptive research using both qualitative and quantitative approaches. It is also correlational research because it tested the relationship between budget control as an independent variable and financial performance as the dependent variable. The respondent of this study is 106 employees of seven selected SOEs. The researcher used the questionnaire to collect primary data and as an instrument of the study. And financial report for secondary data. Descriptive statistics like Frequency and Percentage and mean and inferential statistics Correlation and regression were used to analyze data. Findings showed that in general, the level of budget planning was high with a mean of 3.75. In the general, the level of budget implementation is high with a mean of 3.78. In general, the level of budget review is high with a mean of 3.67. In general, the level of liquidity in the companies was high with a mean of 3.66. In general, the level of profitability was moderate in the last five years, with a mean of 2.96. In general, the level of solvency was high with a mean of 3.59. Generally, there is a low significant relationship between Budget Control and financial performance with a coefficient of correlation of 0.384 with a P-value of 0.000. The multiple regressions showed R Square is 0.217 showing that the budget control contributes 22% to financial performance. The challenges related to budgeting control include unpredictable market, cash flows constraint, overspending versus planned, Rigid Decision-Making, Lack of trained and skilled labor, No clear budget lines in place and absence of regular budget control, limited is available to cash, Unbudgeted activities, Not complying to the rules and regulations of the budget, Insufficient cash to meet the budgeted costs, Unplanned activities due to government priorities, fluctuation in prices for commodities and Cash inflation. The challenges related to financial performance include the Lack of modern technology, High expenses and not achieved expected revenues, lack of a core system that can control all finance modules, Accuracy and timely arrival of monthly management reports, Lack of Ownership of finance performance by all staff, Recovery that may take longer than expected, Risks associated with worldwide inflation, Cost of importation, Poor marketing and reliance on public tenders. Good investment analysis, poorly managed subsidiaries. As recommendations, the management should strive to increase the profitability of their companies from a moderate level to a high level. The management should try to increase the effect of budget control on financial performance which was 22%. The management should make a deep analysis to check why their Budget planning is not affecting their financial performance when it is known that there should be a positive effect.

Gaps in the implementation of national core elements for sustainable antimicrobial use in the WHO-African region

BackgroundAntimicrobial resistance (AMR) has emerged as a leading global health and economic threat of the 21st century, with Africa bearing the greatest burden of mortality from drug-resistant infections. Optimization of the use of antimicrobials is a core strategic element of the response to AMR, addressing misuse and overuse as primary drivers. Effectively, this requires the whole society comprising not only healthcare professionals but also the public, as well as the government, to engage in a bottom-up and a top-down approach. We determined the progress of African national governments in optimizing antimicrobial drug use.MethodsFrom September 2021 to June 2022, all 47 member states of the World Health Organization African region (WHO AFRO) were invited to participate in a survey determining the implementation of strategies to optimize antimicrobial use (AMU). We used the WHO antimicrobial stewardship (AMS) assessment tool, National core elements—A checklist to guide the country in identifying existing national core elements for the implementation of AMS Programs, to obtain information from national AMR focal persons. The tool consists of four sections—national plans and strategies; regulations and guidelines; awareness, training, and education; and supporting technologies and data—with a total of 33 checklist items, each graded from 0 to 4. The responses were aggregated and analyzed using Microsoft Excel 2020®.ResultsThirty-one (66%) of the 47 countries returned completed forms. Only eight (25.8%) countries have developed a national AMS implementation policy incorporating defined goals, targets, and operational plans. There are no budget lines for AMS activities in 23 (74.2%) countries. The WHO Access, Watch, Reserve (AWaRe) classification of optimizing AMU has been integrated into the national essential medicines list or formulary in 19 (61.3%) countries, while the incorporation of the AMS principles and WHO AWaRe classification into national clinical guidelines for the management of infections is present in only 12 (38.7%) and 11 (34.5%) countries, respectively. Although regulations on the prescription-only sale/dispensing of antibiotics are present in 68% of countries, their enforcement is poor. Systems identifying pathogens and antibiotic susceptibility for optimal use of antibiotics are lacking in 38% of countries.ConclusionIn Africa, wide gaps exist in the governments’ implementation of the core elements of optimizing antimicrobial drug use. Responding to AMR constitutes a long journey, and technical and financial support needs to be deployed to optimize the use of antimicrobials.

Analysis of Public Health Centre Financing using the District Health Account (DHA) Model in Karangasem District, Bali, Indonesia

Background and purpose: Health financing aspects of the public health centres (PHC) may influence the achievement of PHC’s programs and its minimum service standards (SPM). The District Health Account (DHA) is a model used to describe and evaluate health financing at the PHC level. The purpose of this study was to analyze health financing mechanism from both the government and national health insurance in the Karangasem District using the DHA Model. Methods: This study was an evaluation research with a case study approach using the DHA Model. Evaluations were carried out at two PHC, Manggis II PHC and Abang I PHC, between March and April 2018. Data were collected from the Karangasem District Health Office and the PHCs. These include PHC realization data, report on program achievements and SPM. The research instrument used for the data collection and analysis was the DHA extraction form and pivot table which includes information on cost sources, financing managers, service providers, functions, programs, types of activities, budget lines, levels of activities and beneficiaries. Results: We found the source of budget in both PHC was dominated by the district budget (APBD) and the national budget (APBN). The institutions which manage the budget and provide service were predominantly the Health Office and PHC. The most frequent financing functions was for governance and administration, while the largest types of activities covered was the indirect activities. Budget spending for operational costs was higher than for maintenance and investment. Realization of the activity for community program efforts (UKM) and prevention program (UKP) was lower than for the capacity building program. Conclusion: The DHA model was able to identify patterns of health budget allocation by health agencies. The use of the DHA model to analyze health financing should be adopted routinely in order to provide evaluation reports for health agencies at the district level.

Expansion of Budgetary to Public Universities in Ghana Case: University of Development Studies

The success of the university as a whole depends heavily on the administration and upkeep of its facilities. When taking a closer look, however, it becomes clear that increasing financial resources at the University for Development Studies (UDS) is crucial but constrained, as there are only two budget lines that cover all university expenses. The university's budgetary allocation needs to be expanded, so it needs to look far afield for ways to involve other relevant stakeholders in the planning process. This paper assesses whether or not the government provides funding for university infrastructure projects, and whether or not individual schools receive funding for their own expansion. Research techniques, such as structured questionnaires, were used for data collection and analysis, and both qualitative and quantitative approaches were taken. According to the data, 67.5% of people feel that the government does not help with infrastructure. A total of 47.5% of the university's infrastructure needs were found to be within the purview of the Ministry of Finance, making it the most directly relevant governmental agency. It was also found that 77.5% of respondents disagreed that there are funds set aside for expansion projects within the health school. It was found that 77.5% of respondents from the school of applied economics agreed that funding should be made available for the growth of medical and health science schools. They should have a budgetary allocation from the government to improve upon infrastructure development and staff development, and it is recommended that the government initiate policies that are geared toward bringing support to the university in order to enhance and or support its infrastructure development, such as laboratories, the construction of new lecture halls, libraries, and information centres, and direct budgetary allocations from the government. Keywords : Budgetary allocation, expanding, government, development. DOI: 10.7176/RJFA/13-16-04 Publication date: August 31 st 2022

The fiscal costs of earthquakes in Japan

We quantify the fiscal impacts of earthquakes in Japan. In contrast with earlier research which examined national level aggregate spending in several countries, we are able to provide a detailed examination of separate budget categories within the local governments’ fiscal accounts. We do this using detailed line-budget expenditure data, and by comparing regions and towns affected and unaffected by the damage from earthquakes. Besides the obvious - that government spending increases in the short-term (one year) after a disaster event - we observe that the share of public spending on disaster relief, at the prefecture level, increases significantly, but with no corresponding change in the other budget lines. In contrast, at the lower administrative units, we observe a decrease in the share of spending going to finance other priorities. For the bigger cities, we observe a decrease in the share of spending targeting education, while for the smaller towns, we find that spending on construction and servicing public debt goes down. This evidence suggests that while at the prefecture level fiscal policy-making is robust enough to prevent presumably unwanted declines in public services, the same cannot be said for the city/town level.

Rationale and Proposed Design for a Mars Sample Return (MSR) Science Program.

Rationale and Proposed Design for a Mars Sample Return (MSR) Science Program.

ANALYSE DU BUDGET D’EXPLOITATION ET SON INCIDENCE SUR LA GESTION D’UN ETABLISSEMENT SCOLAIRE

The major concern that prompted us to carry out this research is to analyze the operating budgets of the Tuungane School Complex in order to identify its impact on management. Taking this concern into account, we formulated the following question: Are the operating budgets drawn up at the Tuungane School Complex managed in accordance with the budget lines provided for when they were drawn up? Thus, to carry out this research successfully, we resorted to descriptive, comparative and systemic methods. These were supported by documentary and free interview techniques for data collection as well as the statistical technique for processing these data. 
 From the analysis of the results resulting from the processing of our data, we noted that the decision-makers of this school establishment did not respect the budget lines planned during the three years retained for our analyses, because the commitments of expenditure for certain headings n were not executed as originally planned. This is the case for the ''Personnel'' heading, because during these three years, it is observed that the employees do not benefit from the remuneration of their services for the last month of each school year. The managers of this School Complex, justify this inconvenience by the insolvency of some students; and yet other headings are not well served, even partially.

National climate funds: a new dataset on national financing vehicles for climate change

ABSTRACT The Paris Agreement’s nationally driven structure puts the spotlight on financing strategies at the national level. The role of national funding vehicles in mobilizing climate finance, however, has not received extensive attention. This paper remedies this gap by introducing a novel dataset of national climate funds established in developing countries. The database creates an inventory of national financing vehicles and tracks their major attributes, including scope, legal form, and the host, among others. We show that 39 countries have established national climate funds. These funds seek to access and mobilize finance from various sources, domestic and international. Most of these funds have broad mandates to tackle climate change, while a smaller share has a more targeted, sectoral focus. Funding sources vary from taxes to international aid. The funds offer a limited range of financial instruments, primarily awarding grants. The funds also differ in how integrated they are with overarching climate plans and strategies. We also find that most developing countries use existing budget lines to target finance towards climate change objectives. Only five countries track public expenditure on the basis of dedicated budget codes. This paper contributes to the literature by providing an empirical basis to pursue questions regarding the role and effectiveness of national climate funds. For policymakers, the limited range of instruments at the disposal of many of these national climate funds also suggests a need to ensure that the national climate funds have the design features they need to support the implementation of national policy goals. Key policy insights Systematic data on public climate finance are scarce. Most governments do not use climate change codes to track their expenditures related to climate change. Policymakers should adopt practices that will help instil transparency in public expenditure on climate change. Policymakers have to revisit the design features of national climate funds such as legal form and areas of operation as the wider operating context changes. Funds accredited with multilateral climate funds are underutilized by fund contributors. The Green Climate Fund’s direct access modality offers one major avenue to foster synergies between national climate funds and multilateral climate funds. Policymakers have the opportunity to harvest lessons from existing funds and calibrate climate policies accordingly, especially as countries contemplate setting revenue-generating carbon prices.

Assessment of the core and support functions of the integrated disease surveillance and response system in Zanzibar, Tanzania

BackgroundDisease surveillance is a cornerstone of outbreak detection and control. Evaluation of a disease surveillance system is important to ensure its performance over time. The aim of this study was to assess the performance of the core and support functions of the Zanzibar integrated disease surveillance and response (IDSR) system to determine its capacity for early detection of and response to infectious disease outbreaks.MethodsThis cross-sectional descriptive study involved 10 districts of Zanzibar and 45 public and private health facilities. A mixed-methods approach was used to collect data. This included document review, observations and interviews with surveillance personnel using a modified World Health Organization generic questionnaire for assessing national disease surveillance systems.ResultsThe performance of the IDSR system in Zanzibar was suboptimal particularly with respect to early detection of epidemics. Weak laboratory capacity at all levels greatly hampered detection and confirmation of cases and outbreaks. None of the health facilities or laboratories could confirm all priority infectious diseases outlined in the Zanzibar IDSR guidelines. Data reporting was weakest at facility level, while data analysis was inadequate at all levels (facility, district and national). The performance of epidemic preparedness and response was generally unsatisfactory despite availability of rapid response teams and budget lines for epidemics in each district. The support functions (supervision, training, laboratory, communication and coordination, human resources, logistic support) were inadequate particularly at the facility level.ConclusionsThe IDSR system in Zanzibar is weak and inadequate for early detection and response to infectious disease epidemics. The performance of both core and support functions are hampered by several factors including inadequate human and material resources as well as lack of motivation for IDSR implementation within the healthcare delivery system. In the face of emerging epidemics, strengthening of the IDSR system, including allocation of adequate resources, should be a priority in order to safeguard human health and economic stability across the archipelago of Zanzibar.

Finance for nature: A global estimate of public biodiversity investments

Parties to the United Nations Convention on Biological Diversity (CBD) will meet at the 15th Conference of Parties (COP 15) to carve out a post-2020 framework for global biodiversity conservation. Finance will be among the priority concerns. No global estimates of public biodiversity investments are in the peer reviewed literature. The methodology developed by the Biodiversity Finance Initiative (BIOFIN) provides a means for countries to account systematically for their biodiversity expenditures. Importantly, budget lines that intentionally, but secondarily, affect biodiversity outcomes are assigned a percentage at which they can be attributed to biodiversity. A sample of thirty countries facilitated the construction of a panel to predict public biodiversity investments at a global level. Here we show that global public biodiversity investments have increased steadily to an average of US$121 billion invested annually from 2008–2017, or 0.19–0.25% of global GDP. Our data not only indicate an increasing trend in total biodiversity investment, but also an increase in the percentage of total public domestic investment dedicated to biodiversity.

Delivering \u2018tiny targets\u2019 in a remote region of southern Chad: a cost analysis of tsetse control in the Mandoul sleeping sickness focus

BackgroundSince 2012, the World Health Organisation and the countries affected by the Gambian form of human African trypanosomiasis (HAT) have been committed to eliminating the disease, primarily through active case-finding and treatment. To interrupt transmission of Trypanosoma brucei gambiense and move more rapidly towards elimination, it was decided to add vector control using ‘tiny targets’. Chad’s Mandoul HAT focus extends over 840 km2, with a human population of 39,000 as well as 14,000 cattle and 3000 pigs. Some 2700 tiny targets were deployed annually from 2014 onwards.MethodsA protocol was developed for the routine collection of tsetse control costs during all field missions. This was implemented throughout 2015 and 2016, and combined with the recorded costs of the preliminary survey and sensitisation activities. The objective was to calculate the full costs at local prices in Chad. Costs were adjusted to remove research components and to ensure that items outside the project budget lines were included, such as administrative overheads and a share of staff salaries.ResultsTargets were deployed at about 60 per linear km of riverine tsetse habitat. The average annual cost of the operation was USD 56,113, working out at USD 66.8 per km2 protected and USD 1.4 per person protected. Of this, 12.8% was an annual share of the initial tsetse survey, 40.6% for regular tsetse monitoring undertaken three times a year, 36.8% for target deployment and checking and 9.8% for sensitisation of local populations. Targets accounted for 8.3% of the cost, and the cost of delivering a target was USD 19.0 per target deployed.ConclusionsThis study has confirmed that tiny targets provide a consistently low cost option for controlling tsetse in gambiense HAT foci. Although the study area is remote with a tsetse habitat characterised by wide river marshes, the costs were similar to those of tiny target work in Uganda, with some differences, in particular a higher cost per target delivered. As was the case in Uganda, the cost was between a quarter and a third that of historical target operations using full size targets or traps.

The paradox of planning for transformation: the case of the integrated sustainable urban development strategy in Val\xe8ncia (Spain)

Urban transformation towards sustainability requires deep systemic change in economic, social, environmental, cultural, organisational, governmental, and physical terms. Considering this challenge, this paper aims to explore the potentials and limitations of urban planning to incorporate an urban transition management approach that strives to enable such deep transformation processes.Taking the Integrated Sustainable Urban Development (ISUD) Strategy for district regeneration in Valencia (Spain) as a case study, the analysis and discussion elaborate on the main barriers and enablers for urban planning to incorporate a transition perspective when tackling urban sustainability challenges. Four main fields of tension emerge as particularly relevant: 1) Democratic representation versus involvement of forerunner innovators, 2) Formal decision-making procedures versus reflexivity and social learning, 3) Standardised project formats versus open processes of searching and experimentation, and 4) Fragmented policy agendas and budget lines versus integrated and multi-sectoral interventions.The case study illustrates how urban planning struggles to align its rationale with requirements for managing complex sustainability transformations. The findings point to a paradox inherent in planning for transformation: although urban planning necessarily incorporates the values and rules of the currently dominant urban systems, it also has the potential to create windows of opportunity for niche innovations to emerge at district or even city level. Therefore, urban planning processes form an arena in which conflicts between niches and regimes are negotiated.

Analysis of Public Health Centre Financing using the District Health Account (DHA) Model in Karangasem District, Bali, Indonesia

Background and purpose: Health financing aspects of the public health centres (PHC) may influence the achievement of PHC’s programs and its minimum service standards (SPM). The District Health Account (DHA) is a model used to describe and evaluate health financing at the PHC level. The purpose of this study was to analyze health financing mechanism from both the government and national health insurance in the Karangasem District using the DHA Model.Methods: This study was an evaluation research with a case study approach using the DHA Model. Evaluations were carried out at two PHC, Manggis II PHC and Abang I PHC, between March and April 2018. Data were collected from the Karangasem District Health Office and the PHCs. These include PHC realization data, report on program achievements and SPM. The research instrument used for the data collection and analysis was the DHA extraction form and pivot table which includes information on cost sources, financing managers, service providers, functions, programs, types of activities, budget lines, levels of activities and beneficiaries.Results: We found the source of budget in both PHC was dominated by the district budget (APBD) and the national budget (APBN). The institutions which manage the budget and provide service were predominantly the Health Office and PHC. The most frequent financing functions was for governance and administration, while the largest types of activities covered was the indirect activities. Budget spending for operational costs was higher than for maintenance and investment. Realization of the activity for community program efforts (UKM) and prevention program (UKP) was lower than for the capacity building program.Conclusion: The DHA model was able to identify patterns of health budget allocation by health agencies. The use of the DHA model to analyze health financing should be adopted routinely in order to provide evaluation reports for health agencies at the district level.