Early Years Of Operation Research Articles

Innovation, asymmetric information and the capital structure of new firms

ABSTRACT Start-ups are essential contributors to economic development, but they often face several barriers to growth, including access to finance. We study their capital structure in their early years of operation through the lens of Pecking Order Theory, exploring how the pursuit of innovation influences firms’ reliance on different types of finance. Panel analyses of 8273 German start-ups show that innovation activities are relevant predict start-ups’ revealed preferences for finance. Effects on the type and order of financing sources depend on the degree of information asymmetries specific to research and development activities, human capital endowments, and the market introduction of new products and processes. New firms focused on research and development activities and with better human capital are less likely to receive informationally complex finance such as debt and will rely relatively more on owner and equity finance. Mixed evidence is found, instead, on the role of new products or processes. Our results suggest that the traditional pecking order theory does not hold for new firms, implying that owner and external equity play a much more prominent role for such firms. Then, managers and entrepreneurs should consider specific sources of finance and financial instruments in light of their innovative activities.

The judicialisation of discrimination in the Indonesian constitutional court

Following the post-Soeharto constitutional reform from 1999 to 2002, the Indonesian Constitutional Court was established with powers, inter alia, to review the constitutionality of national legislation. The constitutional amendments also incorporated a constitutional Bill of Rights, which includes the right to be free from discrimination on any ground and the right to protection against discrimination under Article 28I(2) and the right to equality before the law under Article 28D(1). However, the Constitution does not specify an enumerated list of grounds against which discrimination is prohibited. This article examines a body of constitutional jurisprudence in Indonesia, an Asian civil law country with no formal system of precedent. It seeks to determine the extent to which the Indonesian Constitutional Court has protected the citizens' fundamental rights of equality and against discrimination. Through describing and analysing three court decisions on the principles of equality and non-discrimination, this article argues that the Indonesian Constitutional Court, in its early years of operation, took these principles seriously. Nevertheless, in its later decisions, the Court departed, albeit not explicitly, from its earlier ruling by relying on ‘the belief in One God’ and ‘the religious values consideration’ under Articles 29(1) and 28J of the Constitution to restrict the fundamental rights of equality and non-discrimination. Consequently, the Court has unjustifiably held that discrimination is not prohibited insofar as it is in accord with religious orthodoxy.

Survival After Intervention for Single-Ventricle Heart Disease Over 15 Years at a Single Institution

BackgroundChildren with single-ventricle (SV) heart disease possess a spectrum of heart malformations, yet progress through similar hemodynamic states, suggesting differences in outcomes are related to fundamental morphologic differences, patient characteristics, or procedural pathways. We sought to provide a holistic overview of survival after intervention for SV heart disease at our institution. MethodsSV heart disease was defined as patients born with a hypoplastic or dysfunctional ventricle with uncertain or unacceptable candidacy for a 2-ventricle circulation. Patients were stratified into 8 diagnostic groups and 11 procedural categories based on the initial interventional procedure. ResultsBetween 2005 and 2020, 381 patients born with SV heart disease underwent intervention at our institution. Ten-year survival was highest for patients with double inlet left ventricle (89% ± 7%) and lowest for patients with hypoplastic left heart syndrome (55% ± 5%). Initial palliation with less invasive procedures, such as ductal stent (4-year: 100%) or pulmonary artery banding (10-year: 95% ± 5%), demonstrated superior survival compared with more invasive procedures such as the Norwood procedure (10-year: 59% ± 4%). Survival of patients who achieved a biventricular circulation was superior to patients who remained with SV physiology (10-year: 87% ± 5% vs 63% ± 3%, P = .04). In a multivariable analysis, chromosomal/syndromic abnormality, lower weight, hybrid Norwood procedure, nonleft ventricular dominance, and earlier year of operation were risk factors for death. ConclusionsSurvival differences in patients with SV heart disease were related primarily to underlying cardiac anatomy, patient characteristics, and procedural complexity. Left ventricular dominance, more recent intervention, and attainment of a 2-ventricle circulation were associated with improved survival.

Overview of epidemiological studies of nuclear workers: opportunities, expectations, and limitations ∗ ∗ Based upon an invited presentation in Special Session 9 of the IRPA15 Virtual Congress, January–February 2021.

Epidemiological studies of those exposed occupationally to ionising radiation offer an important opportunity to directly check the assumptions underlying the international system of radiological protection against low-level radiation exposures. Recent nuclear worker studies, notably the International Nuclear Workers Study (INWORKS) and studies of the Mayak workforce in Russia, provide powerful investigations of a wide range of cumulative photon doses received at a low dose-rate over protracted periods, and broadly confirm radiation-related excess risks of leukaemia and solid cancers at around the levels predicted by standard risk models derived mainly from the experience of the Japanese atomic-bomb survivors acutely exposed principally to gamma radiation. However, the slope of the dose-response for solid cancers expressed in terms of the excess relative risk per unit dose, ERR/Gy, differs between INWORKS and Mayak, such that when compared with the slope derived from the atomic-bomb survivors, INWORKS does not provide obvious support for the use in radiological protection of a dose and dose-rate effectiveness factor greater than one whereas the Mayak workforce apparently does. This difference could be a chance effect, but it could also point to potential problems with these worker studies. Of particular concern is the adequacy of recorded doses received in the early years of operations at older nuclear installations, such as the potential for ‘missed’ photon doses. A further issue is how baseline cancer rates may influence radiation-related excess risks. There is scope for a considerable increase in the statistical power of worker studies, with longer follow-up capturing more deaths and incident cases of cancer, and further workforces being included in collaborative studies, but the difficulties posed by dosimetry questions should not be ignored and need to be the subject of detailed scrutiny.

Evaluation of long-term phosphorus uptake by Schoenoplectus californicus and Phragmites australis plants in pilot-scale constructed wetlands

The aim of this study was to evaluate long-term phosphorus (P) retention in a pilot-scale system made of four horizontal subsurface flow (HSSF) constructed wetlands for wastewater treatment. Each wetland had an area of 4.5 m2 and was operated for nearly 8 years (2833 days). Two wetlands with Schoenoplectus californicus (HSSF-Sch) and the other two with Phragmites australis (HSSF-Phr) were planted. The P removal efficiency was 18% for both types of HSSF wetlands. The primary factors that correlated with long-term P retention efficiency in HSSF were phosphorus loading rate (PLR), hydraulic loading rate (HLR) and dissolved oxygen (DO). Average biomass production of HSSF-Phr and HSSF-Sch was 4.8 and 12.1 kg dry weight (DW)/m2, respectively. The P uptake by the plant increased over the years of operation from 1.8 gP/m2 to 7.1 gP/m2 for Phragmites and from 3.2 to 7.4 gP/m2 for Schoenoplectus over the same periods. Moreover, the warm season (S/Sm) was more efficient reaching 14% P uptake than the cold season (F/W) with 9%. These results suggest that both plants' P retention capacity in HSSF systems represents a sustainable treatment in the long term. Novelty statement Long-term (8 years) phosphorus uptake by Schoenoplectus californicus and Phragmites australis and retention in pilot-scale constructed wetlands are evaluated. Schoenoplectus californicus is an uncommon species that has been less studied for phosphorus uptake compared to Phragmites australis, a globally known species in constructed wetlands. Moreover, some studies evaluating the performance of constructed wetland systems for domestic wastewater treatment are usually limited in time (1–3 years). Therefore, this long-term study demonstrates that the plant plays an important role in phosphorus retention, especially the species Schoenoplectus californicus. So, the phosphorus uptake by plants can contribute between 9 and 14% of the phosphorus load of constructed wetland systems in early years of operation.

Understanding China's role in recent debt relief operations: A case study analysis

China has been increasingly involved in debt restructurings for low- and middle-income countries. This paper presents case studies of China's debt relief actions overseas: Iraq (2003), Cuba (2010), Seychelles (2011), Chad (2017), Zambia (2018), Mozambique (2018), Cameroon (2019), Republic of Congo (2019) and Venezuela (in progress). These cases shed light on the commonalities and particularities of China's actions, and underline the evolution of its restructuring terms. We highlight the lack of formal coordination between China and other creditors. China almost exclusively made its own decision on providing restructurings and restructuring terms. The magnitude of China's debt relief actions remains generally limited and varies across countries, depending on whether other creditors have also provided debt restructurings. China seems to have a growing preference for cancellation of accumulated arrears to nominal debt principal reduction. The debt rescheduling cases have significantly increased in recent years as well. This evolution brings China closer to the flow treatment that the Paris Club privileged in its early years of operations and the prevailing practices among private creditors.

Public-Private Partnership (PPP) as an Alternative Model to Public Infrastructure Development and Service Delivery: The Case of PPP-Public Markets in the Philippines

The study examined the internalization of core-values of New Public Management (NPM) among Local Government Units (LGUs) in the Philippines in their effort to reform the management and operation of public markets. Using Public-Private Partnership (PPP) as a framework of NPM for infrastructure development and service delivery, the study assessed the performance of PPP/BOT Public Markets in addressing the perennial problems of public markets in the Philippines. It inquired whether or not PPP as an instrument of reform has improved the management and operation of public markets.To substantiate the assessment, five pioneering PPP public markets in the country were examined, namely; Mandaluyong Public Market in Mandaluyong City, Carmen and Cogon Public Markets in Cagayan de Oro City, Suki Market in Quezon City, and Bocaue Public Market in Bocaue, Bulacan. It used organization and management, the scope of facilities and services, LGU-revenue income and expenditures, and income of market vendors, and client satisfaction on the quality of facilities and services as performance indicators. The data of the study were obtained through combined research methodologies such as case study, content analysis, ocular inspection, and interviews with the city and municipal administrators, market administrators, market vendors, and officers of market vendors associations.The study shows that while PPP has improved the performance of public markets during the early years of operation, these gains and all advances were not sustained by the LGUs when management and operation of public markets were turned over to them from the private project proponent-operators. The study argued that in order to sustain public-private partnerships in the operation of the public market, it is imperative to institutionalize reforms in the structure, processes, mindsets of the leaders, and stakeholders. The institutionalization of NPM’s core values can be carried out effectively through localization of PPP as a policy so that the necessary legal and institutional frameworks for PPP will be anchored based on the need, strength, and weaknesses of the LGU concerned.The study makes a positive contribution to the on-going discourse on public sector reform in the Philippines particularly at the local level using PPP as a model. It enriches not only the literature of Public Administration but also provides valuable lessons in the praxis of governance.

Cholecystectomy Outcomes in the Veterans Affairs Surgical Quality Improvement Program (2006-2017).

Background: Cholecystectomy trends and outcomes have been reported extensively in the private sector. Despite being one of the most common procedures performed in the United States, there is a paucity of reports on the trends and outcomes of laparoscopic and open cholecystectomy in the veteran population. Materials and Methods: Veterans who underwent laparoscopic or open cholecystectomy from 2006 to 2017 were identified using current procedural terminology codes from the Veterans Affairs Surgical Quality Improvement Program (VASQIP) database. Multivariable analyses were used to compare laparoscopic and open outcomes. The primary outcome was mortality, and secondary outcomes were postoperative complications and length of stay (LOS). Results: In the VASQIP database, 53,901 patients underwent laparoscopic cholecystectomy and 8011 patients underwent open cholecystectomy during the study period. The laparoscopic approach increased from 82.0% (2006-2008) to 91.9% (2015-2017). Postoperatively, the open group had a significantly higher morbidity rate (15.4% versus 3.8%, P < .001). The 30-day mortality rate and mean LOS were also significantly higher in the open cholecystectomy group (P < .001). Earlier year of operation, diabetes diagnosis, and open approach significantly increased the likelihood of postoperative morbidity (P < .05). Conclusions: Similar to the private sector, minimally invasive cholecystectomy in the Veterans Health Administration (VHA) has increased over the last two decades. Diabetes was present in a significant percentage of the veteran population and was a predictor of all postoperative complications. Finally, the clinical outcomes in the VHA are comparable with those documented in the private sector.

CEO TENURE AND EARNING MANAGEMENT

The action raises earnings management accounting reporting scandal in the business world. Research on management of profit made by the CEO at the beginning of the year working period and at the end of his tenure is comprehensive regarding the CEO incentive to undertake earnings management. Several previous studies have focused on the accrual-based earnings management techniques. But in this study earnings management is also measured by the real earnings management to get more comprehensive results. This study predicts that the CEO in the early years of operation will increase the earnings management earnings (income-increasing) which can be explained by the theory of career concerns.

Regional and Temporal Trends in the Outcomes of Repairs for Acute Type A Aortic Dissections

Little information exists regarding the use of arch operations for repair of acute type A aortic dissections (AADs) despite increasing interest in this strategy and its potential impact on outcomes. We aimed to determine the relationship between extent of aortic repair, US geographic regions, and outcome. We queried The Society of Thoracic Surgeons database for patients who underwent AAD repair from January 1, 2004 to December 31, 2016 and grouped patients by ascending-only operations and operations involving the arch. We identified 25,462 patients (mean age, 59.8 ± 14.2; 66.7% men) who underwent AAD repair. Operations involving the ascending aorta only were performed in 54% of patients; 46% had repair additionally involving the arch. The 30-day mortality was 18.9% for patients who underwent ascending-only operations vs 19.8% for patients who underwent arch operations (P= .09). In multivariable analysis older age (P < .001), earlier year of operation (P < .001), diabetes mellitus (P < .001), severe chronic lung disease (P < .001), prior cerebrovascular disease (P < .001), and longer bypass time (P < .001) were independently associated with 30-day mortality. There was regional variation in 30-day mortality (P < .001), and incidence of arch repair varied from 38.6% to 52.6% in 9 geographic regions (P < .001). In this analysis of cardiac surgical practice in the United States, repair of AADs included a portion of the aortic arch in 46% of patients. Early mortality remained high throughout the current era regardless of extent of aortic resection. Regional variation in perioperative mortality may signal an opportunity for practice improvement.

Measured Performance of a Mixed-Use Commercial-Building Ground Source Heat Pump System in Sweden

When the new student center at Stockholm University in Sweden was completed in the fall of 2013 it was thoroughly instrumented. The 6300 m2 four-story building with offices, a restaurant, study lounges, and meeting rooms was designed to be energy efficient with a planned total energy use of 25 kWh/m2/year. Space heating and hot water are provided by a ground source heat pump (GSHP) system consisting of five 40 kW off-the-shelf water-to-water heat pumps connected to 20 boreholes in hard rock, drilled to a depth of 200 m. Space cooling is provided by direct cooling from the boreholes. This paper uses measured performance data from Studenthuset to calculate the actual thermal performance of the GSHP system during one of its early years of operation. Monthly system coefficients-of-performance and coefficients-of-performance for both heating and cooling operation are presented. In the first months of operation, several problems were corrected, leading to improved performance. This paper provides long-term measured system performance data from a recently installed GSHP system, shows how the various system components affect the performance, presents an uncertainty analysis, and describes how some unanticipated consequences of the design may be ameliorated. Seasonal performance factors (SPF) are evaluated based on the SEPEMO (“SEasonal PErformance factor and MOnitoring for heat pump systems”) boundary schema. For heating (“H”), SPFs of 3.7 ± 0.2 and 2.7 ± 0.13 were obtained for boundaries H2 and H3, respectively. For cooling (“C”), a C2 SPF of 27 ± 5 was obtained. Results are compared to measured performance data from 55 GSHP systems serving commercial buildings that are reported in the literature.

Identification of the factors influencing the profitability of the Hungarian beer industry

Beer consumption and beer industry is an important beverage sector in Hungary because the beer is the most consumed alcoholic beverage in the country according to WHO studies. During history, breweries developed in different size and different values. The Hungarian beer industry can be divided into three groups of breweries: old large scale breweries, old microbreweries and new wave microbreweries. In this paper, we examine the factors influencing the economic performance of the Hungarian beer industry based on panel data of all active Hungarian breweries in 2018 (121 breweries), for the period of 2009-2017. The study applied panel-data linear models by using feasible generalized least squares with error structure with no cross-sectional correlation option. The economic performance is measured by companies’ turnover, EBIT and profit, which were used as dependent variables. The following explanatory variables were applied in the model: age of brewery (number of closed business years), Social Media activity (FB likes of company page), geographical location (distance from Budapest in km), direct sales (represent own pub/direct sales channel), impact of tax reduction (small beer companies pay 50% less tax since 2012). Regression results have shown a number of determinants of the economic performance of Hungarian breweries, and the estimations are valid for all profitability indicators included (turnover, EBIT and profit). As in previous research, we have come to the conclusion that if the company survives the early years of operation, we can expect profitable activity. Since the ratio of early bankruptcy among Hungarian brewers is still very high, the fluctuation between smaller breweries strongly determines the industry.The benefits of short food supply chains (both physical distance and number of intermediaries) are also prevalent in the beer industry. Breweries with direct sales channels (mostly their own pubs) showed significantly higher sales, EBIT and profits compared to those selling their products by third parties. Breweries situated in Budapest are the most profitable, because the capital city provides a higher demand for high-quality beer, in contrast, the distance from the capital city has a negative impact on the firm’s success.The Social Media activity, often used as the only promotion channel for the microbreweries, has a positive impact on the brewery’s profitability. Finally, tax reduction for small breweries introduced in 2012 by the Hungarian government had the most important positive impact on industrial profitability, especially in the case of microbreweries. It seems the government aim to support small scale beer production has been successful because it helped the survival of the Hungarian microbreweries.

Business incubators and green technology: The Gauteng Climate Innovation Centre, South Africa

Business incubators are a vehicle to assist the survival prospects of start-up enterprises, many of which fail in their early years of operation. One special form of business incubator is the Climate Innovation Centre (CIC) which is part of international debates around green economies and appropriate technologies for climatecompatible development. CICs are an intervention to build innovation sites to ameliorate climate change and a highly distinctive form of business incubator in which the explicit focus is upon supporting small business startups allied to the application of green technologies. Using a qualitative approach the article analyses the establishment and operations of the Gauteng Climate Innovation Centre in South Africa. The CICSA in its first five years of operations has been ‘learning through experience’ and introduced a number of changes since its launch in 2012, including an extension of the business incubation programme and an adjusted focus to South Africa’s climate change related ‘green’ issues around energy, water and waste. Although 5 years is too short for a conclusive evaluation of CIC operations the evidence from this research with South African clean-tech enterprises is largely positive and suggests that the assistance provided by the CIC has contributed towards enterprise development.

Do Clean Development Mechanism Projects Generate Local Employment? Testing for Sectoral Effects across Brazilian Municipalities

Clean Development Mechanism (CDM) projects have a two-fold objective: reducing greenhouse gas emissions and contributing to sustainable development. But while the contribution to mitigation has been analyzed extensively in the literature, the impact on development has seldomly been quantified empirically. This paper addresses this gap by investigating the impacts of CDM projects on local employment. We use a dynamic panel regression model across Brazilian municipalities for the period 2004–2014 to estimate cross-sectoral employment effects of two project types: hydro projects and methane avoidance projects. We find that CDM projects have mixed effects on sectoral employment. Municipalities with hydro projects show a positive impact on commerce and a negative on agricultural employment. In a similar way, these effects have also been identified in municipalities with methane avoidance projects, as well as positive effects in the service and the construction sector. Regardless of project type, the sectoral employment effects are found to be small and transitory, i.e. these took place immediately or within the first, second or third year after the registration of the project, corresponding to the construction phase and early years of operation. Revenues from Certified Emission Reductions (CER) seem to have no or a very small positive impact on sectoral employment, and no significant impact is found for the CER price fall in 2012.

An Integrated Analysis of the Eutrophication Process in the Enxoé Reservoir within the DPSIR Framework

The Enxoé reservoir in southern Portugal has been exhibiting the highest trophic state in the country since its early years of operation. The problem has attracted water managers’ and researchers’ attention as the reservoir is the water supply for two municipalities. Extensive research was thus conducted over the last few years, including field monitoring and modelling at the plot, catchment, and reservoir scales. This study now frames all partial findings within the Driver-Pressure-State-Impact-Response (DPSIR) framework to better understand the eutrophication process in the Enxoé reservoir. Agriculture and grazing were found to have a reduced role in the eutrophication of the reservoir, with annual sediment and nutrient loads being comparably smaller or similar to those reported for other Mediterranean catchments. Flash floods were the main mechanism for transporting particle elements to the reservoir, being in some cases able to carry up three times the average annual load. However, the main eutrophication mechanisms in the reservoir were P release from deposited sediment under anoxic conditions and the process of internal recycling of organic matter and nutrients. Reducing the P load from the catchment and deposited sediment could lead to a mesotrophic state level in the reservoir. However, this level would only be sustainable by limiting the P internal load ability to reach the photic zone.

Nitrogen Removal in Greywater Living Walls: Insights into the Governing Mechanisms

Nitrogen is a pollutant of great concern when present in excess in surface waters. Living wall biofiltration systems that employ ornamentals and climbing plants are an emerging green technology that has recently demonstrated significant potential to reduce nitrogen concentrations from greywater before outdoor domestic re-use. However, there still exists a paucity of knowledge around the mechanisms governing this removal, particularly in regards to the fate of dissolved organic nitrogen (DON) within these systems. Understanding the fate of nitrogen in living wall treatment systems is imperative both to optimise designs and to predict the long-term viability of these systems, more so given the growing interest in adopting green infrastructure within urban cities. A laboratory study was undertaken to investigate the transformation and fate of nitrogen in biofilters planted with different climbing plants and ornamental species. An isotropic tracer (15N-urea) was applied to quantify the amount removed through coupled nitrification-denitrification. The results found that nitrification-denitrification formed a minor removal pathway in planted systems, comprising only 0–15% of added 15N. DON and ammonium were effectively reduced by all biofilter designs, indicating effective mineralisation and nitrification rates. However, in designs with poor nitrogen removal, the effluent was enriched with nitrate, suggesting limited denitrification rates. Given the likely dominance of plant assimilation in removal, this indicates that plant selection is a critical design parameter, as is maintaining healthy plant growth for optimal nitrogen removal in greywater living wall biofilters in their early years of operation.

Designing terminals that offer the flexibility to adapt quickly and cost-effectively to evolving processes

This paper looks at the use of a public private partnership (PPP or P3) structure to enable foreign investment to develop US$273 m of new facilities in a highly collaborative deal structure. The selected P3 partner was required to ensure that the government’s requirements and mandatory project features would be collaboratively formulated, developed and created as a balanced project between Bermuda’s public policy requirements and international investor expectations and requirements. Prior to presenting the scheme to lenders, stakeholder collaboration produced a scope that met the expectations of all parties; one of the real benefits of a negotiated concession, in particular where financing is marginal. With the priority of cutting unnecessary expenditure there was a constant challenge to the scale of the facilities and the operational performance. As the forecast growth was relatively modest it was agreed that the facilities should be sized and future proofed for 10 years after opening to avoid disruption during the early years of operation. Opportunities for increased collaborative decision making were revealed throughout the engagement process. Future airport development projects can learn from some of the missed opportunities such as further alignment on the cost/benefit model that this type of early collaboration during the project definition process could produce.

Favourable long-term outcome after coronary artery bypass grafting in a nationwide cohort

Objectives. In a nationwide cohort, we analyzed long-term outcome following coronary artery bypass grafting, using the combined strategy of left internal mammary artery to the left anterior descending artery and saphenous vein as secondary graft to other coronary targets. Methods. 1,507 consecutive patients that underwent myocardial revascularization during 2001–2012 in Iceland. Mean follow-up was 6.8 years. Major adverse cardiac and cerebrovascular events were depicted using the Kaplan-Meier method. Cox-regression was used to define risk factors. Relative survival was estimated by comparing overall survival to the survival of Icelanders of the same age and gender. Results. Mean age was 66 years, 83% were males, mean EuroSCOREst was 4.5, and 23% of the procedures were performed off-pump. At 5 years, 19.7% had suffered a major adverse cardiac or cerebrovascular event, 4.5% a stroke, 2.2% myocardial infarction, and 6.2% needed repeat revascularization. Overall 5-year survival was 89.9%, with a relative survival of 0.990. Independent predictors of major adverse cardiac and cerebrovascular events were left ventricular ejection fraction ≤30%, a previous history of percutaneous coronary intervention, chronic obstructive lung disease, chronic kidney disease, diabetes, and old age. The same variables and an earlier year of operation were predictors of long-term mortality. Conclusions. The long-term outcome following myocardial revascularization, using the left internal mammary artery and the great saphenous vein as conduits, is favourable and improving. This is reflected by the 5-year survival of 89.9%, deviating minimally from the survival rate of the general Icelandic population, together with a freedom from major adverse cardiac and cerebrovascular events of 80.3%.

An in-depth investigation of the causes of persistent low membership of community-based health insurance: a case study of the mutual health organisation of Dar Na\xefm, Mauritania

BackgroundPersistent low membership is observed in many community-based health insurance (CBHI) schemes in Africa. Causes for low membership have been identified and solutions suggested, but this did not result in increased membership. In this case study of the mutual health organisation of Dar Naïm in Mauritania we explore the underlying drivers that may explain why membership continued to stagnate although several plans for change had been designed.MethodsWe used a systems approach focussed on processes, underlying dynamics and complex interactions that produce the outcomes, to delve into 10 years of data collected between 2003 and 2012. We used qualitative research methods to analyse the data and interpret patterns.ResultsDirect causes of stagnation and possible solutions had been identified in the early years of operations, but most of the possible solutions were not implemented. A combination of reasons explains why consecutive action plans were not put into practice, showing the complexity of implementation and the considerable management capacity required, as well as the challenges of integrating a novel organisational structure into exiting social structures.ConclusionsFor any CBHI project aiming at high membership, skilled professional management seems essential, with capacity to question and adapt routine procedures and interpret interactions within the wider society. Countries that include community-based health insurance in their strategic plan towards universal coverage will have to pay more attention to management capacity and the minutiae of implementation.

The Korean emissions trading scheme: business perspectives on the early years of operations

ABSTRACTKorea’s domestic emissions trading scheme commenced in January 2015. It targeted mainly industrial and power sectors, and compelled companies to transform how they manage energy efficiency and mitigate GHGs. This study sets out to explore how Korean companies evaluated their allocation position and engaged in emissions trading in the first compliance period, and to identify their views on trading barriers and policy expectations at the start of emissions trading. Questionnaire surveys and on-site interviews targeting Korean companies under the Korean emissions trading scheme were conducted at the start of operations (February to March 2015) and after the first compliance year (May 2016), respectively. Actual operation results are observed and compared with the survey findings. This study extrapolates implications for policy and presents suggestions for the government and the target companies in terms of how to improve the current emissions trading scheme in order to further stimulate emissions trading.POLICY RELEVANCEThis study attempts to bridge the gap between companies and government policy in operating the domestic emission trading scheme in Korea. Empirical results, based on analysis of company-level data, reveal how businesses perceive K-ETS and how this relates to the operating results, which saw only limited trading of surplus emissions taking place in the early phase. Key barriers to active trading identified in the study include supply–demand imbalance, policy uncertainty and lack of preparedness of companies over carbon pricing. These barriers could be addressed by improved transparency of allowance allocation methods, possibly restricting carry-over of surplus allowances, ending policy uncertainty and providing more information to companies that can support companies’ policy understanding of the carbon pricing based on the market mechanism. Targeted companies should proactively participate in emissions trading in the early phase, in order to learn from it and prepare for the future introduction of auctioning.