District Management Research Articles

Community perception regarding diarrhoea management practices in a tribal predominant aspirational district of Odisha: A mixed-method study.

Context:Childhood diarrhea is still a major problem in developing countries, and the condition is worse in tribal areas.Aims:The study aims to assess the community perception related to diarrhea management in an aspirational district of Odisha, India.Subjects and Methods:A mixed-method study was conducted in Kandhamal, an aspirational district of Odisha, Eastern India, from June to October 2018. An in-depth interview was conducted among community health workers, and a cross-sectional survey was done for the household interview. The data were collected in a mobile-based application, Epicollect5, and in-depth interviews were recorded digitally.Statistical Analysis Used:The data were analyzed in the Statistical Package for Social Sciences (SPSS) version 22.0. Categorical variables are presented in proportions. Force-field analysis was conducted to assess the driving and restraining forces of diarrhea. Content analysis was done for the digitally recorded data.Results:Nine out of ten people were aware of the benefit of breastfeeding during diarrheal episodes in children aged under 5 years, and <50% were aware of zinc benefit. Poor sanitation, lack of safe water, poor hygiene practices, socioeconomic status, and illiteracy are the major challenges in diarrheal control in the tribal area.Conclusions:Improving the demand by creating community awareness regarding management of diarrhea, availability of essential drugs (ORS and zinc) at the community level, and capacity building of community health workers for management of diarrhea can reduce diarrhea-related morbidity and mortality in tribal areas of India. Handwashing, hygiene practices, and availability of safe water need to be promoted in the tribal region. In the long term, the socioeconomic determinants have to be addressed.

Implementation of the Gayo Lues Regent's Regulation Policy Number 12 of 2016 concerning the Management of Property of Gayo Lues Regency (Four Wheel Service Vehicle Auction Study)

The aims of this study is to find out the Implementation of the Gayo Lues Regent's Regulation Policy Number 12 of 2016 concerning the Management of Property of Gayo Lues Regency. This study used a qualitative approach. The result show that The implementation of the Gayo Lues Regent's Regulation Number 12 of 2016 concerning the Management of Gayo Lues Regency Property (Four Wheel Service Vehicle Auction Study) has been carried out well but has not run perfectly. This can be seen from the results of the analysis of George Edward III's Theory as follows: Communication. The auction of four-wheeled official vehicles carried out by the Financial Management Agency of Gayo Lues Regency has been carried out through auction announcements through print and electronic mass media as well as providing direct information for the people who come and for goods to be auctioned which are still controlled by the head of the SKPK, a correspondence has been made written by Mr. Sekda as district property manager.

Implementation of an organizational intervention to improve low-wage food service workers\u2019 safety, health and wellbeing: findings from the Workplace Organizational Health Study

BackgroundMany organizational interventions aim to improve working conditions to promote and protect worker safety, health, and well-being. The Workplace Organizational Health Study used process evaluation to examine factors influencing implementation of an organizational intervention. This paper examines the extent to which the intervention was implemented as planned, the dose of intervention implemented, and ways the organizational context hindered or facilitated the implementation of the intervention.MethodsThis proof-of-concept trial was conducted with a large, multinational company that provides food service through contractual arrangements with corporate clients. The 13-month intervention was launched in five intervention sites in October 2018. We report findings on intervention implementation based on process tracking and qualitative data. Qualitative data from 25 post-intervention interviews and 89 process tracking documents were coded and thematically analyzed.ResultsOver the 13-month intervention, research team representatives met with site managers monthly to provide consultation and technical assistance on safety and ergonomics, work intensity, and job enrichment. Approximately two-thirds of the planned in-person or phone contacts occurred. We tailored the intervention to each site as we learned more about context, work demands, and relationships. The research team additionally met regularly with senior leadership and district managers, who provided corporate resources and guidance. By assessing the context of the food service setting in which the intervention was situated, we explored factors hindering and facilitating the implementation of the intervention. The financial pressures, competing priorities and the fast-paced work environment placed constraints on site managers’ availability and limited the full implementation of the intervention.ConclusionsDespite strong support from corporate senior leadership, we encountered barriers in the implementation of the planned intervention at the worksite and district levels. These included financial demands that drove work intensity; turnover of site and district managers disrupting continuity in the implementation of the intervention; and staffing constraints that further increased the work load and pace. Findings underscore the need for ongoing commitment and support from both the parent employer and the host client.Trial registrationThis study was retrospectively registered with the Clinical Trials. Gov Protocol and Results System on June 2, 2021 with assigned registration number NCT04913168.

Optimal Operation Model of Drainage Works for Minimizing Waterlogging Loss in Paddy Fields

The risk of flood or waterlogging in irrigation districts has increased due to global climate change and intensive human activities. A Model of Optimal Operation of Drainage Works (MOODW) for flat irrigation district was established by incorporating the hydrological model of waterlogging process and waterlogging loss estimation, which was solved by an optimization method of genetic algorithm. The model of waterlogging process was built based on a modified Tank model and hydrodynamic model for the ditch-river system. The waterlogging loss is calculated under the condition of inconstant inundated depth by linear interpolation. The adaptive genetic algorithm with the global optimization function was selected to solve the model. With an extreme rainfall events in Gaoyou irrigation district as cases, results showed that operation time and numbers of pumps increased; thus, operating costs were 1.4 times higher than before, but the yield loss of rice decreased by 35.4% observably. Finally, the total waterlogging loss was reduced by 33.8% compared with the traditional operation of waterlogging work. The most significant improvement was found in units with high waterlogging vulnerability. The MOODW can provide the waterlogging information visually and assist the district manager in making a reasonable decision.

Dimensions of interprofessional collaboration in the dynamics of the expanded family health and primary care centers: A qualitative study

ABSTRACT Primary health care (PHC) in Brazil is based on Family Health Strategy (FHS) teams. These teams are supported by Expanded Family Health and Primary Care Centers (Nuclei) (NASF-AB) whose services are backbone elements for comprehensive health care within PHC. NASF-AB encompass several professional groups that aim to increase the responsiveness and scope of actions of the FHS teams. The objective of this study was to identify the dimensions of collaboration in the work dynamics of NASF-AB in the capital of Northeast Brazil. The study was a descriptive and exploratory research using a qualitative approach through semi-structured interviews with nine NASF-AB workers and three district health managers. Three analytical categories were identified following content analysis: “Interprofessional and inter-organizational collaboration,” “Mainstays of collaboration in the relationship between NASF-AB and FHS,” and “Challenges for a culture of collaboration in health care work.” The results revealed important characteristics for interprofessional collaboration, including recognition of the attributions of the different teams and the key role of communication and planning. Participants highlighted roadblocks for interprofessional collaboration that hampered comprehensive care, such as the shortage of manpower and material resources, work overload, and lack of availability of professionals for effective teamwork.

Evaluation of the Impact of Immunization Second Year of Life Training Interventions on Health Care Workers in Ghana.

As part of a suite of training interventions to improve the knowledge and practice of immunization in the second year of life (2YL), training of trainers workshops were conducted with regional and district health management teams (DHMTs) in 15 districts in 3 regions of Ghana. Using adult learning principles, DHMTs implemented several capacity-building activities at the subdistrict and health facility levels, including health facility visits, on-the-job training, and review meetings. The current evaluation investigated whether frontline health care workers (HCWs) reported or demonstrated improvements in knowledge, attitudes, and practices after training interventions. Quantitative and qualitative methods with a utilization-focused approach guided the framework for this evaluation. A systematic random sample of 115 HCWs in 3 regions of Ghana was selected to complete a competency survey before and after training, which focused on 3 core competency areas-Expanded Programme on Immunization (EPI) policy; communication with caregivers; and immunization data management, recording, and use. Interviews and direct observations by data collectors were done to assess HCWs' knowledge, self-reported attitude, and behavior changes in practices. Of 115 HCWs, 102 were surveyed before and 4 months after receiving capacity-building interventions. Modest but not statistically significant improvements were found in knowledge on EPI policy, immunization data management, and communication skills with caregivers. HCWs reported that they had improved several attitudes and practices after the 2YL training. The most improved practice reported by HCWs and observed in all 3 regions was the creation of a defaulter list. Findings of this evaluation provide encouraging evidence in taking the first step toward improving HCW knowledge, attitudes, and practices for 3 core immunization competency areas. The use of learner-focused teaching methods combined with adult learning principles is helpful in solving specific performance problems (such as lack of knowledge of EPI policy).

The views of public service managers on the implementation of National Health Insurance in primary care: a case of Johannesburg Health District, Gauteng Province, Republic of South Africa

BackgroundThe South African government is implementing National Health Insurance (NHI) as a monopsony health care financing mechanism to drive the country towards Universal Health Coverage (UHC). Strategic purchasing, with separation of funder, purchaser and provider, underpins this initiative. The NHI plans Contracting Units for Primary healthcare (PHC) Services (CUPS) to function as either independent sub-district purchasers or public providers and District Health Management Offices (DHMOs) to support and monitor these CUPS. This decentralised operational unit of PHC, the heartbeat of NHI, is critical to the success of NHI. The views of district-level managers, who are responsible for these units, are fundamental to this NHI implementation. This qualitative study aimed to explore district and sub-district managerial views on NHI and their role in its implementation.MethodsPurposive sampling was used to identify key respondents from a major urban district in Gauteng, South Africa, for participation in in-depth interviews. This study used framework analysis methodology within MaxQDA software.ResultsThree main themes were identified: managerial engagement in NHI policy development (with two sub-themes), managerial views on NHI (with three sub-themes) and perceptions of current NHI implementation (with six sub-themes). The managers viewed NHI as a social and moral imperative but lacked clarity and insight into the NHI Bill as well as the associated implementation strategies. The majority of respondents had not had the opportunity to engage in NHI policy formulation. Managers cited several pitfalls in current organisational operations. The respondents felt that national and provincial governments continue to function in a detached and rigid top-down hierarchy. Managers highlighted the need for their inclusion in NHI policy formulation and training and development for them to oversee the implementation strategies.ConclusionsIt appears that strategic purchasing is not being operationalised in PHC. NHI policy implementation appears to function in a rigid top-down hierarchy that excludes key stakeholders in the NHI implementation strategy. The findings of this study suggest an inadequate decentralisation of healthcare governance within the public sector necessary to attain UHC. District managers need to be engaged and capacitated to operationalise the planned decentralised purchasing-provision function of the DHS within the NHI Bill.

Strengthening African health systems through outreach and support and values-driven leadership.

Healthcare systems are complex adaptive systems, requiring a change in leadership style, from the traditional model to collaborative, values-driven leadership (VDL). Family physicians are well positioned to facilitate integration and coordination between levels of care, across specialties and within teams, in partnership with local and district management team members. This short report describes a leadership innovation experience in a rural South African district, where a VDL course was introduced in a district health context to build on a strong tradition of relationship-centred outreach and support aimed at creating a learning health system. The authors reflect on the contribution of family physicians to strengthen team-based capacity building, care coordination and a learning culture aimed at quality improvement from the perspectives of the regional and district hospital environments. A values-based leadership style will enable family physicians to strengthen team-relationships and create organisational environments, which support shared learning and quality improvement approaches. Ultimately this approach should lead to improved health systems.

Integrated model concept for district energy management optimisation platforms

• District management platform to enable evolution to model predictive control. • Integrated district mode developed through co-simulation techniques and FMI. • Demand-side modelling through the combined use of physical and data-driven models. • New Modelica library for DH infrastructure modelling. • Energy input reduction of 21% in the Stepa Stepanovic subnetwork. District heating systems play a key role in reducing the aggregated heating and domestic hot water production energy consumption of European building stock. However, the operational strategies of these systems present further optimisation potential, as most of them are still operated according to reactive control strategies. To fully exploit the optimisation potential of these systems, their operations should instead be based on model predictive control strategies implemented through dedicated district energy management platforms. This paper describes a multiscale and multidomain integrated district model concept conceived to serve as the basis of an energy prediction engine for the district energy management platform developed in the framework of the MOEEBIUS project. The integrated district model is produced by taking advantage of co-simulation techniques to couple building (EnergyPlus) and district heating system (Modelica) physics-based models, while exploiting the potential provided by the functional mock-up interface standard. The district demand side is modelled through the combined use of physical building models and data-driven models developed through supervised machine learning techniques. Additionally, district production-side infrastructure modelling is simplified through a new Modelica library designed to allow a subsystem-based district model composition, reducing the time required for model development. The integrated district model and new Modelica library are successfully tested in the Stepa Stepanovic subnetwork of the city of Belgrade, demonstrating their capacity for evaluating the energy savings potential available in existing district heating systems, with a reduction of up to 21% of the aggregated subnetwork energy input and peak load reduction of 24.6%.

The effect of organizational factors and culture to organizational commitment in agency Financial Management, Income, and regional assets of Karo District

This research was conducted at the Agency Financial Management, Income and Regional Assets of Karo District with 41 employees as a sample which aims to determine: (1) significant influence of organizational on organizational commitments, (2) significant influence of organizational culture on organizational commitments and (3) influence organizational and organizational culture significantly to organizational commotments. The results showed that there was an influence of organizational on organizational commitments which was marked in the variable X1 with a value of tcount &gt; ttable and there was also the influence of the organizational culture on organizational commitments marked in variable X2 with a value of tcount &gt; ttable. The value of Fcount &gt; Ftable shows that there is an influence of organizational and organizational culture on organizational commitments. The results of the calculation show that where rcount &gt; rtable, all respondents' answers are valid. The Cronbach Alpha value is greater than 0.60, so the variable is reliable. In this study, there was no multicollinearity and heteroscedasticity neither. The multiple linear regression test is written in the regression equation Y=0,240+0,672X1+0,148X2. From the tests conducted, it was found that the samples were normally distributed. Based on the results of hypothesis testing, it was obtained that the value of tcount &gt; ttable (6.600&gt;2.022) for the organizational variable and (3,202&gt;2.022) for the organizational culture variable; Fcount &gt; Ftable (70,235&gt;3,24); and the coefficient of determination obtained 80,7% while the remaining 19,3% is influenced by other variables outside of this study that must be considered in order to achieve better employee performance in the future. So Ha is accepted and Ho is rejected, so it can be concluded that there is an influence of motivation and work environment on employee performance.

Degree of Practicing Administrative Creativity by Education District Managers as Perceived by Department Heads and Administrators in the Districts of Mafraq Governorate

The study aimed to assess the perceptions of department heads and administrators regarding the degree to which Educational District Managers practice administrative creativity in the districts of Mafraq governorate. To achieve this objective, the study followed the descriptive survey method, and used a questionnaire to collect data from the study sample which was selected from a population of 240 male and female employees (40 heads and 200 employees in education districts of Mafraq governorate). The sample consisted of (150) participants (25 department heads and 125 male and female employees). The data was analyzed by the use of statistical methods, such as means, standard deviations, the analysis of multiple variance and the method of Scheffe. The study findings revealed that the participants' degree of perception was moderate, and that there were differences in their perceptions according to their different demographic variables. The study recommended preparing and designing training programs to develop the performance of educational leaders in education districts to implement the requirements of administrative innovation and creativity.

Degree of Practicing Administrative Creativity by Education District Managers as Perceived by Department Heads and Administrators in the Districts of Mafraq Governorate

The study aimed to assess the perceptions of department heads and administrators regarding the degree to which Educational District Managers practice administrative creativity in the districts of Mafraq governorate. To achieve this objective, the study followed the descriptive survey method, and used a questionnaire to collect data from the study sample which was selected from a population of 240 male and female employees (40 heads and 200 employees in education districts of Mafraq governorate). The sample consisted of (150) participants (25 department heads and 125 male and female employees). The data was analyzed by the use of statistical methods, such as means, standard deviations, the analysis of multiple variance and the method of Scheffe. The study findings revealed that the participants' degree of perception was moderate, and that there were differences in their perceptions according to their different demographic variables. The study recommended preparing and designing training programs to develop the performance of educational leaders in education districts to implement the requirements of administrative innovation and creativity.

How pharmacy can start to solve the inequity puzzle

How pharmacy can start to solve the inequity puzzle

Analysis of Socio-Cultural Challenges Facing Local Managers in the Process of Rural Development (Case Study: Central District of Rasht County)

Design/Methodology/Approach- This is an applied research in which a descriptive-analytical method has been adopted for data collection and analysis. The study data was obtained through documentary analysis and field studies. The statistical population of this study includes 63 villages in the central district of Rasht County. All Dehyars and members of the Islamic Council of these villages (n=284) were interviewed and filled out the questionnaire. Data analysis was performed using statistical methods (t-test and weighted mean). The social challenges facing local managers with 18 items and cultural challenges with 8 items were subjected to analysis at three levels.Findings- The results suggested that local managers of villages in the central district of Rasht County confront serious social and cultural challenges in the process of rural development. Poor collaboration of villagers with local village managers in rural development plans and projects with a mean of 4.42, reverse migration and social problems caused by the construction of second houses with a mean of 4.41 and migration of youths from villages to the city and non-participation in Council elections with a mean of 4.40 were the major social and ethnic challenges. Also, tribal differences in the villages with a mean of 4.35, lack of solidarity between local managers and people in tackling rural problems with a mean of 4.34 and poor work culture with a mean of 4.13 were also the most important cultural challenges facing local managers in the villages at the central district of Rasht County.Research Limitations/Implications- The disagreements between local managers, reluctance to provide information on research topic and the difficulty of reaching managers in the villages were the main limitations of the present study. Appointing a member of the village management body as a spokesperson and setting the criterion of permanent residence in the village as a precondition for the nomination of the executive director were among executive strategies offered in the present study.Practical Implications- Changing the management style from person-centered to participatory management in the administration of rural affairs, monitoring the inflow of non-indigenous people into the village in order to safeguard its social and cultural structure, building a suitable infrastructure to keep young and active forces in rural areas and encouraging them to study in the fields pertained to planning and rural development, participating in the decision-making structure of local management, fostering interaction between local managers and villagers through a management system based on law obedience and transparency and ultimately stimulating villagers to engage in teamwork and its effective results in the process of achieving comprehensive rural development.Originality/value- Recognizing the main challenges facing local managers in a district of ​​Guilan province can play a prominent role in improving their efficiency in the process of achieving rural development. The results of this research can be useful for district and county managers.

Understanding the maternal and child health system response to payment for performance in Tanzania using a causal loop diagram approach

Payment for performance (P4P) has been employed in low and middle-income (LMIC) countries to improve quality and coverage of maternal and child health (MCH) services. However, there is a lack of consensus on how P4P affects health systems. There is a need to evaluate P4P effects on health systems using methods suitable for evaluating complex systems. We developed a causal loop diagram (CLD) to further understand the pathways to impact of P4P on delivery and uptake of MCH services in Tanzania. The CLD was developed and validated using qualitative data from a process evaluation of a P4P scheme in Tanzania, with additional stakeholder dialogue sought to strengthen confidence in the diagram. The CLD maps the interacting mechanisms involved in provider achievement of targets, reporting of health information, and population care seeking, and identifies those mechanisms affected by P4P. For example, the availability of drugs and medical commodities impacts not only provider achievement of P4P targets but also demand of services and is impacted by P4P through the availability of additional facility resources and the incentivisation of district managers to reduce drug stock outs. The CLD also identifies mechanisms key to facility achievement of targets but are not within the scope of the programme; the activities of health facility governing committees and community health workers, for example, are key to demand stimulation and effective resource use at the facility level but both groups were omitted from the incentive system. P4P design considerations generated from this work include appropriately incentivising the availability of drugs and staffing in facilities and those responsible for demand creation in communities. Further research using CLDs to study heath systems in LMIC is urgently needed to further our understanding of how systems respond to interventions and how to strengthen systems to deliver better coverage and quality of care.

Use of Immunostimulants for Fish Health Management in Mymensingh District Of Bangladesh

Immunostimulants have been used as a prospective substance against several disease events in aquaculture, although subsequent impact is not clearly explored yet. The present study was conducted to investigate the use of immunostimulants for fish health management in Mymensingh district of Bangladesh. Questionnaire survey was performed with a total of 40 fish farmers and 20 chemical and drug retailers. Altogether, 41 immunostimulants under 7 different categories including glucans and polysaccharides, vitamins, minerals, vitamin-mineral premixes, enzymes, nucleic acids and plant extracts were reported. ACI, Eon, Acme, Square, Renata and SK+F were noticed as the prominent sources among 24 listed companies in this study. The most frequently used immunostimulants were recorded as Megavit-aqua (88.75%), Multivitamin (87.5%), Aqua-boost (87.25%), Eskalina (83.25%) and Eon fish grower (82.5%). Farmers in this study mentioned about improved health condition with lower average disease incidence (29.3%) and reduced mortality (65.35%) in fish after application of immunostimulant. The findings of this study will be useful to perform further research regarding the efficacy and impacts of a wide range of immunostimulants used in aquaculture of Bangladesh. SAARC J. Agric., 19(1): 237-248 (2021)

Adoption of Coffee Shade Agroforestry Technology and Shade Tree Management in Gobu Seyo District, East Wollega, Oromia

Coffee production in the form of agroforestry practices is the most important management approach to improve the livelihoods of the farming community. This study was conducted to assess factors affecting the adoption of the technology, its socioeconomic and environmental benefits, and the management practices related to the technology. Out of eight kebeles in the district, two kebeles were selected purposively based on the existing and extensive agroforestry practices. Four villages were selected randomly. Based on the preidentified criteria as coffee growers and nongrowers, coffee growers were selected purposively. Then a total of 120 households were selected by Simple Random Sampling Method. Data were collected by using structured interview and field observation. The data were analyzed by using descriptive statistics analysis. The logit model was used to identify the factors affecting the adoption of coffee shade agroforestry technology. The results of this study showed that adoption of coffee shade agroforestry technology had a positive relationship and was statistically significant at 1% level with age and area covered by coffee production, while household composition and training were at 5% level. Education level, land holding, and extension services also had positive relationship, but it was not statistically significant. The farmers in the study area mentioned other benefits of these technologies such as for animal feed, firewood and construction materials, medicinal purpose, erosion control, honey bee production, and soil fertility enhancement. Different management activities were also identified in the area (such as composting, pruning, watering, and weeding). Coffee shade agroforestry technology was important to diversify the agricultural products, to solve the problem of livelihood, and adds economic and environmental benefits.

Rural –Urban Migration and Subsequent Land Management Practices in Moshi Rural District, Tanzania

This paper examined the impact of rural urban migration on land restoration and management in Moshi rural District. The paper is based on the study carried out in Mkolowonyi, Tema and Otaruni villages. Both qualitative and quantitative techniques were employed in collecting, managing and analysing data. Questionnaire were used to collect quantitative data while focus group discussion, indepth interviews and direct observation were employed to collect qualitative data. A total number of 100 householdswhich representing 5% of 1819 household swere was selected as a sample. Also 5 key informants and about 17 members were purposefully selected for 3 focus group discussions. Descriptive and thematic data analysis techniques were employed. Findings show that rural urban migration has both positive and negative impacts on land management. It reduces pressure on land resource, and improves land management practises through funds provided by the migrants, employing temporary labourers and introducing new crop varieties. The study recommends that rural - urban migration should be seen as an opportunity instead of a problem. Thus there is a need to encourage positive linkage between rural migrants and counterparts in rural areas in order to boost community development.

Empowerment key factors in shaping women's awareness of household waste management

BACKGROUND AND OBJECTIVES: Empowering activities is the key in building awareness and individual capacity of household waste management, especially for women as the main actors. This study aimed to explore empowering activities as the key factor in shaping women's awareness of household waste management.METHODS:This study was conducted using quantitative methods. The data collection technique used was survey. The sampling was carried out by purposive sampling technique. The criteria for sampling were those women who attended training in waste management in Jagakarsa Sub District, South Jakarta, Indonesia. The analytical technique used was Ordinary Least Square regression.FINDINGS: Based on the findings of this study, it was known that women who had good adaptability to technology were likely to have a greater chance score of 0.908. Education in schools was also found to have a positive impact on the opportunity score to earn good living environment. It was found that an increase in 1 year of schooling will increase the score of chance by 0.0755 (estimation 5). This is not significantly different from estimation 4 which would increase the chance by 0.0745. In waste management training, The womens’ participation are likely to increase the score chance of having a good environment by 0.944 points (estimation 5). Besides, the womens’ participation were found to be statistically significant at 95% confidence level in all estimations, particularly in the waste management training. Based on the comparison of the participation coefficient parameters in waste management training, it was found that there were no significant differences or signs (+ and -) between the estimations. All coefficient parameters ranged from 0.83 to 0.94.CONCLUSION: Empowerment activities that utilize access to education and easily adapt to a technology might have a significant correlation with women's involvement in waste management training. This is the basis for building awareness to carry out more sustainable household waste management and achieve change to get a good living environment.

Taxes for public libraries: Arguments about library district management from the perspective of residents

Economic pressure on public library budgets has risen since the late-20th century as government funding has declined. Under increasing financial pressure, creating a procedure for how public libraries can provide fulfilling services to residents is one of the essential issues in public library management. As a result, library districts are receiving much attention as a management model in response to financial deterioration of public sectors in the United States. Library districts are special-purpose local governments that have a tax levy and bond authority for library management. Recent studies have demonstrated that library districts’ revenues are more stable over the long term than those of other legal bases, such as general-purpose local governments and non-profit organizations in the United States. However, it is not easy to form a library district because it involves a tax increase for residents. Nevertheless, the number of library districts has increased since the late-20th century. Why do voters allow a tax levy for library management? In this study, we examined the opinions of residents through a qualitative content analysis, using the voters’ pamphlets distributed to residents at the time of the referendum for forming the library district. Specifically, we analyzed opinions of both voters in favor and opposed to creating a library district and identified their preferences. Our research results showed that residents held a common understanding of the significance of public libraries in the community. The debate revolved around how much burden the residents were willing to accept to provide library services.