Financial Input Research Articles

No Magic Bullets: Insights on Drivers of Stunting Decline from an Analysis of Subnational Success Cases in India

Abstract Objectives Global attention to reducing childhood stunting has increased the demand for guidance on translating policies into impact. Evidence from national-level success cases is emerging but little is known about how subnational entities can accelerate change. In India, despite a common national framework of programs/policies targeting many determinants of child growth, stunting reduction has varied across states. We aimed to understand drivers of change in stunting at state-level and to identify programmatic, social and political factors that contributed to these changes. Methods We studied three states that had achieved substantial stunting declines between 2005 and 2016 [Chhattisgarh (CG) 14 percentage points (pp); Gujarat (GJ) 13pp; Odisha (OD) 11 pp]. We used regression-decomposition analysis to assess contributions of various determinants of height-for-age Z-score (HAZ) using two rounds of national data. We reviewed nutrition-relevant policies and programs linked to these drivers of change and interviewed stakeholders in government, development partners (DPs), academia and civil society (n = 61) to understand how change occurred. Results Main contributors to gains in HAZ were coverage of health and nutrition interventions (21% CG; 11% GJ; 25% OD), household assets (10% CG; 13% GJ; 18% OD), and sanitation (7% CG; 6% GJ; 5% OD). Maternal education, age at marriage, community-level hygiene, and electrification also contributed. Political leadership and an outcome-focused vision were crucial for action. Although vision varied, capable administrators were able to secure adequate finances, strengthen implementation systems, and invest in state-specific innovations, creating an enabling environment for change. Varied actors, including civil society and DPs, played a catalytic role in spurring action through advocacy, technical and financial inputs, and vigilance. Conclusions Similar drivers were responsible for stunting reduction in 3 states. Ingredients for success highlight the importance of political leadership, targeting multiple determinants and improving implementation systems. Supportive civil society, political and bureaucratic leadership motivated by the well-being of communities remain crucial. Funding Sources Bill & Melinda Gates Foundation through POSHAN, led by IFPRI.

An Evaluation of Quality Aspects of Primary Health Centre (PHCs) Laboratory Using National Quality Assurance Standards (NQAS) Tool in Hassan District, Karnataka

The Primary Health Centre (PHC) is the nearest point of contact that should be accessible to the public for availing health care services. The ability of a PHC to provide quality healthcare is determined by the laboratory support along with the infrastructure attached to them. Objectives: To determine various shortcomings in the PHCs laboratory services utilizing National Quality Assurance Standards (NQAS) tool. Method: For the same, National Quality Assurance Standards (NQAS) tool is used in this study. 24 PHCs laboratory (from 134) in Hassan district were selected from 8 taluk as which formed a study population. Various quality factors among 7 domains were subjected to reliability testing and principal component analysis (PCA). Results: The dengue serology was not done in more than 45% of laboratories. Referral pattern was inadequate in more than 90%. Only 37.5% followed SOPs. With reference to testing procedure and charts for biological reference range (0.723) and reporting of tests within given duration was (0.677). Kaiser-Meyer-Olkin measure of sampling adequacy value was 0.417 (P<0.001.). Also, for support service component, three factors yields Cronbach’s alpha=0.712 Conclusion: Recruitment of qualified laboratory technician and training them to quality work is very important. Not only that, financial input with maintenance of equipment and work ethics towards quality in diagnostics is imperative for case management in primary health care.

Health system quality in the time of COVID-19

Health system quality in the time of COVID-19

Creating an Outpatient, Local Anesthetic Hand Operating Room in a Resource-Constrained Ghanaian Hospital Builds Surgical Capacity and Financial Stability.

Expanding surgical capacity is very difficult in resource-constrained countries. Financial input and additional physical operating room space are needed. The surgical patient volume exists, but the lack of operating room time causes postponement of cases. Hand surgery is particularly important as it improves patient function and allows for a timely return to the workforce after injury. Some hand surgery cases may be performed under local anesthesia with a very basic instrument set in a procedure room. This arrangement eliminates the need and financial burden of an equipped operating room and the need for an anesthesiologist. We hypothesized that performing hand surgery in a simple procedure room by a surgeon with knowledge of adequate local anesthesia could increase hand surgery capacity significantly in a low-income country. This technique has been instituted at Komfo Anokye Teaching Hospital in Kumasi, Ghana, with the use of a single procedure room that was previously used for storage. A surgeon trained in performing wide-awake local anesthesia no tourniquet technique visited Komfo Anokye Teaching Hospital and provided lectures about hand surgery under local anesthesia and evidence-based sterility for 6 years. The number and type of cases performed in the procedure room were recorded for the first 11 months after it opened in 2017. For 11 months, use of this room had increased surgical capacity by 33 cases per month. Patient ages ranged from 2 months to 65 years. There have been 358 total cases performed, 240 of which were hand cases. This included washout of hand wounds (n = 87), tendon repair (n = 54) including a single tendon transfer, fracture pinning (n = 33), amputations (n = 24), trigger finger repair (n = 10), nerve repair (n = 6), congenital hand surgery (n = 4), and other (n = 22). Cost savings per case in the procedure room ranges from 500 cedis (US $100) to 2000 cedis (US $400). The simple procedure room runs more efficiently and is less costly compared with the main operating rooms. Although the case volume has increased surgical capacity significantly, costs to the hospital and patient have decreased. The hospital is reimbursed in a timely fashion for the procedures directly by the patient using this technique. The creation of a single procedure room for wide-awake local anesthesia no tourniquet hand surgery has helped address the issues of inadequate operating room space, time, and expense in resource-constrained Ghana.

Evaluation of the old residential area modification by applying improved fuzzy comprehensive evaluation

In order to make a global assessment on the modification effect of existing old residential areas in hot summer and warmer winter zone, an improved fuzzy comprehensive evaluation (FCE) model of old residential building modification is established based on the aspects of structural safety and architectural appearance, indoor comfort system, outdoor environment, public service facilities, building equipment efficiency and operation management, etc. Analytic hierarchy process is used to determine the weights of evaluation factors at all levels. And the model is used to evaluate the modification effect of the old residential buildings in Xiamen city. The evaluation result shows feasibility of this modification method on the old residential building. The evaluation grade of this area’s modification can be assessed as “Good”, which can provide a reference for the modification of the old residential areas with hot summer and warm winter. Measures, such as increasing government financial input, institutionalized ways to tracking energy consumption, popularization of energy-saving awareness, should be taken for the modification.

An Economic Study of a Wind Energy Project Using Different Sources of Wind Data

In this study, a preliminary economic feasibility study of the project of wind power at the site of Al-Shehabi (Wasit-Iraq) was conducted using measured wind data at altitudes of 10, 30, 50 and 52 m per 10 minutes. For the purpose of comparison, data from NASA were used at the same location at 50 m height. The lowest unit cost of electricity from wind energy was found to be 0.028 $/Kwh and 0.0399 $/Kwh by using the standard methodologies of Levelized Cost of Energy (LCOE) equation and Net Present Value (NPV) procedure, respectively. Furthermore, RETScreen software was used to perform the economic prefeasibility study of a proposed wind farm. The study concludes that this site is economically feasible if a wind farm with 5.0 MW of ten wind turbines (EWT DW54) was established, with an NPV of $11,309,956, after-tax IRR of 24.7%, a simple payback period of 6.1 years, and a capacity factor of 38.34%. Finally, this wind farm development will result in a reduction in greenhouse gases of 31876 tCO2 per year. The sensitivity and risk analysis were performed and guarantee the safety of specified financial input parameters values.

Contributions of financial, social and natural capital to food security around Kanha National Park in central India

The well-being of people living around protected areas is critical in its own right as well as for effective conservation, particularly in human-dominated landscapes. We examine the contributions of financial, social, and natural capital to household food access of 883 households around Kanha National Park (KNP) in central India over three seasons. We use regression trees and mixed effects models to identify associations between natural, social, and financial capital indicators and household food access (an indicator of well-being). We find that food access is low in the KNP landscape with over 80% of households indicating lower than acceptable food consumption scores, with a further worsening in monsoon season. Financial capital (e.g., salaried jobs and proximity to towns for all seasons) is most prominently associated with higher food consumption scores. Moreover, households supplement incomes by converting social capital (e.g., 28% of surveyed households access “food in lieu of work or credit” in monsoon) and natural capital (e.g., 14% of surveyed households sold forest products in summer) to financial capital seasonally. Financial capital dwarfs contributions of social and natural capital around KNP, in contrast to other studies, which suggest that gains from natural capital are essential for well-being of people around protected areas. Management interventions, such as kitchen gardens (borne from human capital) to supplement market-bought produce, could contribute to food security without high financial inputs. However, food insecurity in the KNP landscape primarily relates to the lack of financial capital. Food security of people around protected areas in other human-dominated landscapes is likely to be context-specific and counter to frequent assumptions particularly as livelihood strategies change with increasing economic opportunities.

Study on the driving factors and forming mechanism of the willingness for primary doctors to make initial diagnosis

Objective Based on the KAP and Prospect theory, to explore, construct and verify the theoretical model and formation mechanism of driving factors of primary care doctors′ willingness to carry out the primary diagnosis. Methods Using the random cluster sampling method, from April to May 2019, a questionnaire survey was conducted among doctors at 20 primary medical and health service institutions in Hangzhou. The survey covered the primary care doctors′ cognition level of primary diagnosis, their self-evaluation of primary medical care capabilities, evaluation of policies and systems, expectation of primary medical care, and their job satisfaction. Descriptive statistic, multiple linear regression and structural equation model were used to analyze and explore the driving factors and formation mechanism of their willingness to carry out the primary diagnosis. Results Primary care doctors′ willingness rate for primary diagnosis was 76.4%(308/403). Positive expectation(beta=0.309), cognition level(beta=0.216), evaluation of policies and systems(beta=0.184), and self-evaluation of primary diagnosis capability(beta=0.170), all of which directly affect the said willingness. The total effect of the five types of driving factors on the willingness of the primary diagnosis was as follows: cognitive level of the primary diagnosis(0.536), evaluation of the policy system(0.494), self-evaluation of the primary diagnosis capability(0.436), positive expectations of the primary diagnosis work(0.186), job satisfaction(0.146). Conclusions The cognition of the primary diagnosis, the capability of the primary diagnosis, the policy system and the positive expectation are the important premises, key driving forces, and a strong guarantee and motivation to drive primary care doctors to carry out the primary diagnosis. It is suggested that the government and medical institutions should further improve the cognition level of primary care doctors, focusing on systematically improving the service capability of primary care doctors′ primary consultation, coordinating to improve policy guidance measures such as financial input, medical insurance reimbursement and referral system, establishing and improving incentive measures such as career development, performance appraisal, salary and welfare of primary care doctors. Key words: Initial diagnosis at primary level; Intention of initial diagnosis; Driving factors; Mechanism; Structural equation model

PTT'NİN POSTA KATILIM BANKACILIĞI SENARYOSUNUN SWOT ANALİZİ İLE DEĞERLENDİRMESİ

Participation banking is a banking method that has increased in recent conditions and is an alternative to deposit banks. In participation banking, interest is replaced by profit and loss as a financial input. Participation banks are not required in economic use with the principle of interest-free relationship, and the values expressed in money or money, which are called as under-pillow (claim) in economics, which remain idle for various reasons, and are intended to be used as a fund for those in need. Islamic belief describes interest as an unfair gain that does not correspond. These entry participation banks can be preferred for the binding of the officials who are sensitive to interest. In this research, participation banking function has been added to PTT services and an attempt has been made to analyze the possible scenario. In the literature of the research, the Postal Telegraph Organization, which operates agency banking through mail branches and plans to take its place among participation banks with its vision of postal participation banking. Strengths and Weaknesses, Opportunities and Threats of Mail Participation Banking application were evaluated by SWOT analysis. It turns out that the benefits of transforming PTTBank into a participation bank to be socio-economic efficient are high and there are possible scenarios.

Feasibility Study of Hybrid Power Systems for Remote Dwellings in Tamil Nadu, India

Hybrid power systems are technically suitable for providing continuous and quality power to remotely located dwellings and have the potential of reducing the greenhouse gases emissions. The present study aims at finding an optimal hybrid power system based on wind, solar, diesel, and battery backup, which can address the load requirements of a village (Muhavoor, India). The present study utilizes the HOMER software for sizing the major power components, performing economic analysis and estimating greenhouse gas emission. It uses the minimum cost of energy as the basis for optimum system selection. Local load, wind speed, and solar radiation data along with technical and financial input of wind turbines, solar photovoltaic panels, diesel generators, inverters, and fuel are considered in the simulation. Several options have been considered in the study including: diesel, PV/diesel/battery, wind/diesel, and PV/wind/diesel/battery hybrid power systems. Based on the simulation results and analysis, the PV/diesel/battery system with 53MW capacity of PV, 16.55MW diesel generator capacity, 3,520MWh of battery backup, and 15.5MW of converter is recommended as the best option for the concerned village. This system is capable of meeting the entire load of the village with annual energy yield of 92,549MWh with an excess energy of 7,262MWh. Of the total electricity produced, PV panels generate 92.71% with a renewable fraction of 89.2% at an energy cost of 0.117US$/kWh. The total cost of the proposed hybrid power system can be recovered in 11 or 8 years with positive cash flows at the end of year 12 or 9 based on sale of electricity alone or with additional income from fuel savings and greenhouse gases credit incentive.

Stochastic Valuation of Revenue-Collecting Tokens in Cryptoeconomic Organizations

Cryptoeconomic systems are an emerging type of complex systems that are viewed as a way to steer economic systems and organizations through agents coordination and incentives. However, very little is known about the inherent economic flows of such systems. In this paper, in order to provide intuition on the incentive structures, we draw a first sketch of financial streams in cryptoeconomic organizations. We then present a formal stochastic model of revenue-collecting tokens valuation. With the aim to account for the stochastic nature of this revenue, the financial input of such an organization is assumed to follow a geometric Brownian motion.

An Empirical Study on the Construction of a Higher-Education Performance Allocation Model

China’s financial input mechanism reform’s current development trend involves fully implementing budget performance management and constructing a performance-oriented financial allocation model. These are also essential measures in promoting the modernization of the national governance system and governance capacity. The current financial allocation method for higher education entails a financial supply policy based on per-student appropriation. A new performance-oriented system of higher- education financial allocation system is necessary to upgrade the per-student appropriation of a single flow, construct a close loop of financial allocation “fund flow,” optimize the allocation of financial resources for higher education, and guide higher-education institutions to deepen comprehensive reform and achieve high- quality development. Based on the actual situation and relevant data of 26 undergraduate universities in Jiangsu of China, this paper proposes a “double dimension” higher-education performance funding index system, conducts an empirical study with the data envelopment analysis model, and suggests policies on the construction, organization, and implementation of higher-education performance allocation models.

The Redescription of the Full Coverage of “Lawyer’s Defense” in Criminal Cases

In October 2017, since China has implemented full coverage of lawyers’ defense in criminal cases on a pilot basis in eight provinces and cities, the term for full coverage of lawyer defense in criminal cases has become a high-frequency word. However, if carefully studying the two paths proposed by the Chinese Supreme People’s court, one would find that the full coverage of lawyer’s defense in criminal cases is not real “full coverage of lawyer’s defense”, because the “legal assistance” of lawyers on duty is not “lawyer’s defense”. Restricted by the number of lawyers and the growth limit of the financial input in criminal legal aid, and considering the applicable conditions and the court trial mode of the rapid judgment procedure, China has neither the conditions nor the necessity to implement the full coverage of “lawyer defense” in the trial stage. So we should replace “full coverage of lawyers’ defense” with “full coverage of legal aid”.

The Demography and Practice of Australians Caring for Native Wildlife and the Psychological, Physical and Financial Effects of Rescue, Rehabilitation and Release of Wildlife on the Welfare of Carers.

Simple SummaryLittle is known about the physical, financial and emotional effects on the 20,000 volunteers who rescue, rehabilitate and release injured and/or orphaned Australian wildlife. A survey for wildlife carers was instigated to address this knowledge gap. Collated survey responses from the wildlife carers suggested that their physical workload is on average 32 h per week but can be up to 100 h, their financial input is on average AUD5300 per year and over a lifetime of caring can go up to AUD800,000. The emotional input is such that 28% of the respondents were experiencing moderate to severe grief. Grief increases as more joeys die in care and as expenditure rises, and is age dependent. Burnout and compassion fatigue are likely outcomes. Over 65% of respondents felt that their welfare, and that of the animals for whom they care, is neglected and unappreciated by government agencies. Unless these deficiencies are corrected by financial and emotional support and workload is reduced for carers, animal and wildlife carer welfare will be compromised.The rescue, rehabilitation and release of injured and orphaned Australian wildlife is managed by over 20,000 carers, mostly voluntarily. These volunteers experience mental, physical and financial challenges that have not been researched adequately. This study collated the responses (n = 316) to a survey conducted among Australian wildlife carers who actively foster orphaned joeys for hand-raising and injured adult mammals for rehabilitation and release. It confirmed 86% of rehabilitators are female, 70% are over the age of 46 years and their prime motivation is an affinity with animals. The average time spent in the sector is 11.5 years, and the work week is 31.6 h, caring for 15 animals per year, with an average of 2.6 dying. The average financial commitment is AUD5300 annually and up to AUD800,000 over a lifetime. Regarding the grief experienced by carers, the lower the age, the longer the time spent, the greater the financial input and the more joeys that died, the more severe is the grief experienced. Moderate to severe grief is experienced by 28% of carers, which, coupled with other factors, could lead to burnout or compassion fatigue. Soon, wildlife carer welfare will likely be compromised unless financial and mental support is provided and their workload reduced.

Mapping essential urban land use categories in China (EULUC-China): preliminary results for 2018

Land use reflects human activities on land. Urban land use is the highest level human alteration on Earth, and it is rapidly changing due to population increase and urbanization. Urban areas have widespread effects on local hydrology, climate, biodiversity, and food production. However, maps, that contain knowledge on the distribution, pattern and composition of various land use types in urban areas, are limited to city level. The mapping standard on data sources, methods, land use classification schemes varies from city to city, due to differences in financial input and skills of mapping personnel. To address various national and global environmental challenges caused by urbanization, it is important to have urban land uses at the national and global scales that are derived from the same or consistent data sources with the same or compatible classification systems and mapping methods. This is because, only with urban land use maps produced with similar criteria, consistent environmental policies can be made, and action efforts can be compared and assessed for large scale environmental administration. However, despite of the fact that a number of urban-extent maps exist at global scales [3,4], more detailed urban land use maps do not exist at the same scale. Even at big country or regional levels such as for the United States, China and European Union, consistent land use mapping efforts are rare.

Financial liberalization, political institutions, and income inequality

Rising income inequality coinciding with financial liberalization has stimulated extensive studies on the possible links between income inequality and different forms of financial liberalization, both inputs and outputs, since the 1990s. Nonetheless, empirical investigations remain inconclusive. To provide new and robust evidence, this study investigates the distributional repercussions of financial liberalization and the role played by democratization in this process. Focusing on the outcome measures of financial liberalization, we find, in a panel of developing and developed countries for 1989–2011, that (1) financial openness alleviates income inequality, particularly for less democratic countries; (2) stock market development mitigates income inequality, whereas its volatility exacerbates it, with both effects decreasing with democratization; (3) banking development strengthens income inequality, whereas its volatility alleviates it, with both effects again moderating with democratization; and (4) these effects are mediated by human capital accumulation and entrepreneurship development. The data thus suggest that financial reforms toward capital account openness and more liquid, stable stock markets are beneficial to income distribution, as such reforms allow more previously excluded households and firms to access financial funds and services, thereby increasing human capital and entrepreneurship, especially in less democratic countries.

China’s poverty alleviation over the last 40 years: successes and challenges

Over the past 40 years, China has made significant progress towards its poverty alleviation goals. The rural population under the current poverty line has decreased by 739.9 million. China has contributed to more than 70 per cent of world poverty reduction. To better promote the new anti‐poverty strategy and to serve as a reference for poverty alleviation in other developing countries, this paper summarises the main experiences of China’s poverty alleviation over the past 40 years and then discusses the challenges associated with implementing the targeted poverty alleviation policy in the new era. China’s experience with poverty alleviation includes development‐oriented poverty alleviation, improving self‐development capabilities of the poor population, encouraging multiple subjects to participate in poverty alleviation and focusing on innovation and ways to improve poverty alleviation. Although China’s poverty alleviation initiatives have achieved significant successes, there are still several challenges that should be of concern in the coming years, such as the diminishing marginal effect of financial inputs on poverty alleviation, the resulting negative incentives for the poor to improve their internal motivations and the insufficient participation of markets and social forces in poverty alleviation. Given these challenges, this paper provides suggestions for anti‐poverty policies beyond 2020.

Poor health workforce planning is costly, risky and inequitable.

KEY POINTS Planning for the right number and mix of health workers — in the right place, at the right time — is an ongoing struggle in Canada’s health care systems. Health workers represent these systems’ greatest financial input, accounting for more than 70% of direct health care costs in

Measurement of financial efficiency and productivity of Turkish Public Universities by using non-parametric methods

Purpose The purpose of this paper is to measure the financial efficiency and productivity of 23 public universities founded in 1992 in Turkey over the period between 2004 and 2013. The results obtained will provide managerial information and act as a guide to public universities’ administrations, in using their resources more effectively. Design/methodology/approach Data envelopment analysis is applied to assess the relative financial efficiency of these universities, while Malmquist total factor productivity index is used to measure the total factor productivity change concerning financial inputs of the universities. Findings The number of financially efficient universities and the number of universities showing an increase in their productivity according to their financial inputs change annually and both of them display a rough trend over the years. A decrease of about 5 percent in the financial productivity of the universities is observed which stems from a technological recession. Therefore, public universities in Turkey are not able to develop effective policies to diversify, increase and use their financial resources. Originality/value When the lack of studies within the literature measuring the financial efficiency of higher education institutions is taken into account, this study can fill a gap in this area. The analyses conducted here distinguish from existing studies on this subject with regards to the extent and diversity of financial data set and the measurement of both efficiency and productivity change of universities considering financial inputs concurrently.

‘Ownership Hypothesis’ on Development Projects and Project Duration Analysis

원조자금으로 수행되는 개발프로젝트의 위험 중 하나는 수원국의 주인의식 결여로 사업이 부실해지거나 지연되는 것이다. 본 논문은 유상원조 사업에서 수원국이 투입하는 내부자금 비중이 사업기간에 미치는 영향을 분석한다. ‘주인의식 가설’에 따르면, 내부자금 비중이 높은 경우 수원국의 주인의식도 강해져 사업 효율성 제고와 사업기간 단축이 기대된다. 이 가설을 검증하기 위해 세계은행이 주도하여 2010~2014년에 완료된 600개 이상 프로젝트를 분석한다. 분석결과 내부자금 비중과 사업기간 사이에는 단순한 선형 관계가 확인되지 않는다. 하지만 수원국의 거버넌스가 양호하거나 세계은행 외에 다수의 자금제공 기관이 참여하는 상황에서는 주인의식 효과가 작동하는 것으로 나타났다. 결국 주인의식 효과는 조건부로 작용하므로, 수원국 거버넌스가 양호하고 다수의 자금제공기관이 참여하는 경우에는 수원국 내부자금을 많이 투입하도록 하는 것이 사업수행 효율성에 도움이 된다는 정책 함의를 얻을 수 있다.Aid-funded development projects involve a risk of poor management or schedule overruns. This study examines how the local investment by recipient governments affects the duration of projects. The Ownership Hypothesis predicts that a higher ratio of local investment improves the efficiency of project implementation and shortens the duration by reinforcing the recipient s ownership. This hypothesis is tested by the analysis of over 600 World Bank projects completed in 2010~2014. The results find no simple linear relationship between local investment ratio and project duration. However, they show that the ownership effect works on the condition of good governance in a recipient country and the participation of multiple financiers in a project. These findings suggest that only when these conditions are met, local financial input is recommendable for efficient project implementation.