General Governance Research Articles

The essence of governance in health development.

BackgroundGovernance and leadership in health development are critically important for the achievement of the health Millennium Development Goals (MDGs) and other national health goals. Those two factors might explain why many countries in Africa are not on track to attain the health MDGs by 2015. This paper debates the meaning of 'governance in health development', reviews briefly existing governance frameworks, proposes a modified framework on health development governance (HDG), and develops a HDG index.DiscussionWe argue that unlike 'leadership in health development', 'governance in health development' is the sole prerogative of the Government through the Ministry of Health, which can choose to delegate (but not abrogate) some of the governance tasks. The general governance domains of the UNDP and the World Bank are very pertinent but not sufficient for assessment of health development governance. The WHO six domains of governance do not include effective external partnerships for health, equity in health development, efficiency in resource allocation and use, ethical practises in health research and service provision, and macroeconomic and political stability. The framework for assessing health systems governance developed by Siddiqi et al also does not include macroeconomic and political stability as a separate principle. The Siddiqi et al framework does not propose a way of scoring the various governance domains to facilitate aggregation, inter-country comparisons and health development governance tracking over time.This paper argues for a broader health development governance framework because other sectors that assure human rights to education, employment, food, housing, political participation, and security combined have greater impact on health development than the health systems. It also suggests some amendments to Siddigi et al's framework to make it more relevant to the broader concept of 'governance in health development' and to the WHO African Region context.SummaryA strong case for broader health development governance framework has been made. A health development governance index with 10 functions and 42 sub-functions has been proposed to facilitate inter-country comparisons. Potential sources of data for estimating HDGI have been suggested. The Governance indices for individual sub-functions can aid policy-makers to establish the sources of weak health governance and subsequently develop appropriate interventions for ameliorating the situation.

Molecular coupling of Tsix regulation and pluripotency

The reprogramming of X-chromosome inactivation during the acquisition of pluripotency in vivo and in vitro is accompanied by the repression of Xist, the trigger of X-inactivation, and the upregulation of its antisense counterpart Tsix. We have shown that key factors supporting pluripotency-Nanog, Oct4 and Sox2-bind within Xist intron 1 in undifferentiated embryonic stem cells (ESC) to repress Xist transcription. However, the relationship between transcription factors of the pluripotency network and Tsix regulation has remained unclear. Here we show that Tsix upregulation in embryonic stem cells depends on the recruitment of the pluripotent marker Rex1, and of the reprogramming-associated factors Klf4 and c-Myc, by the DXPas34 minisatellite associated with the Tsix promoter. Upon deletion of DXPas34, binding of the three factors is abrogated and the transcriptional machinery is no longer efficiently recruited to the Tsix promoter. Additional analyses including knockdown experiments further demonstrate that Rex1 is critically important for efficient transcription elongation of Tsix. Hence, distinct embryonic-stem-cell-specific complexes couple X-inactivation reprogramming and pluripotency, with Nanog, Oct4 and Sox2 repressing Xist to facilitate the reactivation of the inactive X, and Klf4, c-Myc and Rex1 activating Tsix to remodel Xist chromatin and ensure random X-inactivation upon differentiation. The holistic pattern of Xist/Tsix regulation by pluripotent factors that we have identified suggests a general direct governance of complex epigenetic processes by the machinery dedicated to pluripotency.

The Transferability of Hong Kong's Public Housing Policy1

In response to the renewed emphasis on rental subsidy policy following the regional and global financial crises and the subsequent economic declines, this paper critically assesses the transferability of Hong Kong's public housing policy. It does so by evaluating the replicability of the policy environment of Hong Kong, and by identifying the structural, institutional and resource constraints on possible policy transfer. The paper argues that Hong Kong's public housing policy is primarily transferable to newer and growing cities, the governments of which have a strong commitment to improving the housing conditions of low income families for facilitating economic and social development. However, the finance factors are not easy to replicate as they are more significantly determined by historical circumstances than by policy design. Equally difficult in terms of transfer is the consultative approach adopted in the Hong Kong housing governance structure as this is embedded in its general political system and governance mode.

Behavioral Governance, Accountability and Corporate Governance Quality

The article explores the concepts of behavioral governance and behavioral accountability both of which look at the quality of the behavior of organizational members, especially directors, as the foundation for sound corporate achievement. This author posits that the effectiveness of governance in general and corporate governance in particular is dependent on the behavioral effectiveness of those who govern and manage. That governance fails is often because more effort is devoted at creating and sustaining structures and processes while almost no meaningful attention is given to genuine institutionalization of behavioral and ethical accountability which are accomplished by the hands of genuine integrity. The quality of corporate performance is hinged on the quality of behavioral performance and accountability with which members of the organization are associated. But given that the elevation of human animality in our organizations has tended to diminish the moral value of organizations, directors should adopt the concept of behavioral governance and behavioral accountability to raise the quality of behavior and accountability in our organizations as the route to genuinely raising the quality of performance in their organization.

The “aid contract” and its compensation scheme: A case study of the performance of the Ugandan health sector

Current literature on aid effectiveness describes increasing use of a more contractual approach to the relationship between donor and recipient government in which a system of rewards and penalties for good and bad performance operates. The purpose of this case study of the Ugandan health sector was to understand the extent to which this approach is influencing processes and effectiveness. This qualitative study used a conceptual framework based on agency theory and 'realistic evaluation'. Our results showed that the main official mechanism to assess and reward performance established through the Sector Wide Approach lacked objective criteria and was based on an unstructured system of discussions and agreements among donors. The achievement of a satisfactory performance rating was facilitated by the agreeing to undertakings that were under-demanding, vaguely formulated and lacking quantitative benchmarks against which progress could be measured. However, even when poor performance was readily observable, penalties failed to be applied by donors. This was always the case in relation to health sector performance and mostly so in relation to general governance and accountability. Funds continued to be disbursed despite the lack of progress made in achieving targets and undertakings and other evident performance problems (e.g. in the area of governance). A series of explanations of the failure to penalise were put forward by donor representatives in relation to this behaviour including the need to maintain long-term relationships based on trust and not to undermine health sector performance by withdrawing aid. Thus there are likely to be incentives to disburse funds and report success, irrespective of the realities of aid programmes in the context of large foreign aid volumes associated with increased political visibility of aid in donor countries.

Hybrid Capital Structures and the Governance of State-Owned Companies: The Case of SABESP

This paper develops a case study about a Brazilian company with a very interesting governance and capital structure that mixes public and private elements: SABESP, a monopolist water supplier controlled by the state of Sao Paulo that is now listed and traded in the Sao Paulo Stock Exchange. With a reputation for efficiency, it is considered a corporate benchmark for efficiency and a success story. It was the first Brazilian state-controlled company to be listed in the Novo Mercado segment of the Sao Paulo Stock Exchange (BOVESPA). The decision to go public and abide by more strict corporate governance rules without, however, being privatized led to a very interesting case of a company with hybrid ownership structure that, albeit being a colossus that deals with huge sums of money and implements very sensitive public policies, has been kept relatively well isolated from negative incentives, is turning profits, and has had a good performance in the stock exchange. To present the analysis, the paper will also try to provide a theoretical framework that would allow one to understand how state ownership and hybrid ownership forms can help to solve more general governance problems. The claim the study advances is that, since private ownership and state ownership lead to different governance arrangements that are more or less efficient and generate more or less surplus for the actors involved, there may be governance problems that would be easier to overcome if the state owned the firm or, at least, if it places itself amongst the residual claimants. Thus hybrid forms of ownership may appear or be adopted as a response to the environment under which a corporation operates, which means that they may not necessarily be inefficient. The proposed analytical framework will blur two traditional dichotomies. First, it will dissolve the strict separation between state-owned and private-owned companies. The intuition behind this is that governance forms are more flexible and varied than this pair of opposite classifications may imply. On the one hand governments can control private assets and private organizations in many degrees, whether they own directly such corporations or not. On the other hand, corporations that are supposedly state-owned may be at the mercy of private interests, or they may be dependent on external shareholders. In consequence, finding an optimal ownership structure for the firm becomes a problem of institutional design. The second one is that the framework to be proposed will soften the separation between “inside” and “outside” the company. In this sense, instead of seeing the firm as a dark monolith, the paper will identify it with a governance structure composed by public and private relationships.

Investigating the Two Faces of Governance: the case of the Euro-Mediterranean Development Bank

The literature on governance has recently witnessed a growing tension between a techno-managerial account of governance and a power-sensitive approach. This article argues that the downgrading of power relations by the techno-managerial approach is significantly problematic and counterproductive. Building on the case of the Euro-Mediterranean Development Bank, the article shows how the EU's articulation of the techno-managerial approach has had serious negative implications. On the one hand, it re-emphasised the embedded long-term power asymmetries that have characterised the EU's general governance attitude relationship with its Mediterranean partners. On the other hand, it compromised the credibility of EU policies in addressing and pressing for further reforms in the Mediterranean region.

Regulatory reform and governance: A survey of selected developing and transition economies

AbstractRegulation is now considered an integral instrument in developing policy toolkit to support market‐led, pro‐poor growth in developing and transition economies. Institutional environment in general and regulatory governance in particular have increasingly been viewed as a factor of competitiveness. In search for better governance, regulatory reform is critical. This article assesses regulatory reform in selected developing and transition economies by reporting the results of a survey on the application of regulatory governance policies, tools and institutions. It is found that in these countries regulatory reform has not shifted in approaches and objectives to taking a systematic view of regulatory governance and the means of promoting and enhancing it. It is suggested that, in order to improve regulatory governance, focus should be put on each of the three elements: regulatory policies, tools and institutions, and that centralised and concerted efforts are needed to integrate the elements. Copyright © 2009 John Wiley & Sons, Ltd.

A Governance Indicator for Small and Medium-Sized Enterprises

A governance indicator for Small and Medium-Sized Enterprises (SMEs) is presented. The indicator adopts stakeholder theory in selecting its elements, which also include a few general governance principles as well as board features. The paper reviews main governance indicators treated in the literature, which are mostly applied to publicly traded firms. It then proposes a specific indicator for SMEs which, in general, are private. The indicator takes into account - in its structure - the evaluation style of National Quality Awards, as a pattern to measure, by assigning points, a great number of variables. Governance variables included in the indicator are grouped into areas, themes, dimensions and elements, in order to make them operative and measurable. Measurement is performed by means of a questionnaire - reproduced as an appendix - with nominal and interval scales. Maximum scores for each question are assigned following multiple attribute decision theory. The article concludes with reflections on the measurement problem in the social sciences and final thoughts on the characteristics of the proposed indicator. The paper, based on Yacuzzi (2007), is part of an on-going research project. In this new version, several sections of the original work have been improved, others have been deleted, and the questionnaire has been modified in order to incorporate the experience of different users.

The Evolution of the Corporation: Organization, Finance, Knowledge and Corporate Social Responsibility

This paper, which selectively focuses on the contested concept of Corporate Social Responsibility [CSR], forms part of a larger research project on the evolution of corporate governance. This research posits the evolution of corporate governance along three historical paradigms: first, the economic/industrial organization paradigm, second, the financial paradigm, and third, the knowledge paradigm. With regard to CSR, the paper explores the promises and shortcomings of the concept against the background of an evolutionary theory of corporate governance. The identification of three historical-conceptual paradigms allows us to trace the development of the relation between a general discourse on corporate governance regulation [CGR] on the one hand and a more specialized, often polemic debate over corporate (social, environmental, human rights) responsibilities on the other. On the basis of the review of the three paradigms of CSR over the course of more than one hundred years, the paper concludes that there is no convincing justification to separate the general Corporate Governance from the more specific CSR discourse when assessing the nature of the corporation. Instead, it is argued that a more adequate understanding of what defines a corporation is gained when capturing its embedded nature in a continuously changing domestic, global and functional environment. Besides being both a legal fiction and an economic actor, the business corporation is assuming a host of other roles in a functionally differentiated global society. The paper suggests that the generation and dissemination of knowledge, both internally and externally, has become the defining feature of the firm. The corporation as a knowledge actor succeeds the prior stages of assessing it as a private, political or financial actor, without however erasing these dimensions of the firm. In that, the history of the corporation - as concept and reality - shares important features with that of the state - as concept and as fact.

Private actors and public accountability: the role of actuaries and auditors in UK life insurance regulation

The establishment of the Financial Services Authority (FSA) as the new unified regulator heralded fundamental change for UK financial services regulation. The FSA has developed detailed general corporate governance arrangements applicable to firms, individuals and systems. The FSA has also developed specific governance arrangements in the insurance sector which enrol private actors, actuaries and auditors in regulation. Together, the arrangements form a multilayered governance and accountability network involving a wide range of actors and stakeholders. This paper examines the changing public accountability role of two key groups of private actors in the governance arrangements of life insurers by using empirical evidence gathered from actuaries and auditors. The paper concludes that the FSA, as a key government regulator acting on behalf of the public, carries out its public accountability function in part by the enrolment of private actors, involving a decentred, fragmented and hybridised approach to financial services regulation.

Leadership, governance and management in dental education – new societal challenges

Dental schools around the world face new challenges that raise issues with regard to how they are governed, led and managed. With rapid societal changes, including globalization and consumerism, the roles of universities and their funding have become intensely debated topics. When financial burdens on universities increase, so does the pressure on dental schools. This is exacerbated by the relative expense of running dental schools and also by the limited understanding of both university managers and the public of the nature and scope of dentistry as a profession. In these circumstances, it is essential for dental schools to have good systems of leadership and management in place so that they can not only survive in difficult times, but flourish in the longer term. This paper discusses the concept of governance and how it relates to leadership, management and administration in dental schools and hospitals. Various approaches to governance and management in dental schools on different continents and regions are summarized and contrasted. A number of general governance and leadership issues are addressed. For example, a basic principle supported by the Working Group is that an effective governance structure must link authority and responsibility to performance and review, i.e. accountability, and that the mechanism for achieving this should be transparent. The paper also addresses issues specific to governing, leading and managing dental schools. Being a dean of a modern dental school is a very demanding role and some issues relating to this role are raised, including: dilemmas facing deans, preparing to be dean and succession planning. The importance of establishing a shared vision and mission, and creating the right culture and climate within a dental school, are emphasized. The Working Group advocates establishing a culture of scholarship in dental schools for both teaching and research. The paper addresses the need for effective staff management, motivation and development, and highlights the salience of good communication. The Working Group suggests establishing an advisory board to the dean and school, including lay persons and other external stakeholders, as one way of separating governance and management to some extent and providing some checks and balances within a dental school. Several other suggestions and recommendations are made about governance, management and leadership issues, including the need for schools to promote an awareness of their roles by good communication and thereby influence perceptions of others about their roles and values.

Corporate governance: a paradigmatic look

PurposeThe purpose of this paper is to present a paradigmatic look at corporate governance.Design/methodology/approachThis paper starts with the premise that any worldview can be associated with one of the four basic paradigms: functionalist, interpretive, radical humanist, and radical structuralist. The paper looks at the current state of mainstream academic finance and notes that it is founded only on the functionalist paradigm. It argues that any view expressed with respect to corporate governance is based on one of the four paradigms or worldviews. It, therefore, discusses four views expressed with respect to the nature and role of corporate governance.FindingsThe paper emphasizes that the four views expressed are equally scientific and informative; they look at the nature and role of corporate governance from a certain paradigmatic viewpoint. Emphasizing this example in the area of corporate governance, the paper concludes that there are opportunities for mainstream academic finance, in general, and corporate governance, in particular, to benefit from contributions coming from the other three paradigms if they respect paradigm diversity.Originality/valueThe paper recommends a serious conscious thinking about the social philosophy upon which finance, in general, and corporate governance, in particular, is based and of the alternative avenues for development.

Community Competence to Regulate the Internal Market

The claim of the Court of Justice in the Tobacco Advertising case that the Community institutions lack a general competence to regulate the internal market does not withstand critical examination. The Tobacco Advertising case contained both competence restricting and competence enhancing elements. The principal competence restricting elements were (a) that obstacles to trade could be addressed by removal of the obstacles, but not by a ban on the subject matter of the trade; (b) that harmonisation could only be justified by distortions of competition if those distortions were appreciable; (c) that in principle all provisions of a contested internal market measure must contribute to the internal market aims of the measure in question. The principal competence enhancing element was the proposition that a measure which makes some contribution to the internal market may be adopted an internal market measure even if its main aim is public health protection; despite the fact that harmonisation of public health requirements is in principle ruled out by the Treaty. A further competence enhancing element was that the Court adopted an impressionistic approach to assessment of the requirement that distortions of competition must be appreciable if they were to justify harmonisation, leaving open the possibility that this requirement might be relaxed or sidestepped by the lawmaking institutions. The competence restricting elements of the Tobacco Advertising case have been contradicted or eroded by subsequent case law, such the British American Tobacco case, and the Swedish Match case. After the latter case, obstacles to trade can be addressed by simply banning the trade. After the British American Tobacco case, it seems that hypothetical obstacles to trade, resulting from disparities between national labelling rules, can be addressed by eliminating the disparities in question, even if this makes no contribution to cross border trade in the products in question. In the Leitner case, the Court confirms that its approach to the requirement adopted in Tobacco Advertising, that distortions of competition must be appreciable in order to justify harmonisation, will be an impressionistic one. And in Rundfunk the Court considers that long a measure makes a contribution to the internal market, it is legitimate for that measure to regulate situations which have no link at all with freedom of movement - something of a retreat from the Tobacco Advertising case, but in line with case law dating from the 1960s which gives wide reading to competence to coordinate national social security rules in order to provide freedom of movement for workers. More broadly, it is noted that Community competence has not in practice been confined to removing obstacles to trade and distortions of competition, but extended to harmonising national rules which facilitate freedom of movement and to removing differences between national rules which create uncertainty for those contemplating cross border transactions. This aspect of Community competence to regulate the internal market is potentially far reaching, and could lead to the use of such measures instruments of general governance. This does not seem consistent with a scheme of attributed competences, nor with a system in which decisions are to be taken as closely possible to the citizen, in accordance with the principle of subsidiarity.

Compliance in the Supply Chain: The Present and Future Implications of Sarbanes-Oxley for UK Businesses

Most recent research and press reports on Sarbanes-Oxley have focused on large, dual-listed companies and UK-based subsidiaries of US companies that have to comply with the regulation. Often, these companies have big compliance budgets and have been at the vanguard of Sarbanes-Oxley compliance in the UK. The key aims of this report are to estimate the current number of UK companies that have to be Sarbanes-Oxley compliant, but also how that number will grow over the coming decade, particularly given the impact of the supply chain. The wider impact of Sarbanes-Oxley through the supply chain is a key issue that many UK businesses will have to deal with, many of whom will not have realised the implications to date given their status as partners or suppliers of compliant companies. These supplier companies will need to reengineer their internal processes to provide data to meet the compliant companies' Sarbanes-Oxley reporting requirements. This report also examines UK organisations that will need to comply with Sarbanes-Oxley as a cost of doing business, raising capital or for general corporate governance best practice. The focus of this study is on UK companies, employing between 50 and 1000+ people. The research was informed by relevant studies and reports from the US, as well as conclusions drawn from telephone interviews with UK companies affected by Sarbanes-Oxley and a focus group of leading academics at Henley Management College.

The Role of Southern Actors in Global Governance: The Fight against HIV/AIDS

Dieser Beitrag analysiert die Rolle von Akteuren aus den Entwicklungslandern (dem Suden) in der globalen Politik und Governance. Zum Zwecke der systematischen Analyse der Einflusswege der sudlichen Akteure und der Interaktionen bei Global Governance wird ein Schnittstellenkonzept entwickelt, das zwischen organisationalen, diskursiven, rechtlichen und Ressourcentransfer-Schnittstellen differenziert. Als Beispiel erfolgt die Untersuchung eines spezifischen Bereiches Global Governance: des globalen Kampfes gegen HIV/AIDS. Der Beitrag analysiert die Rolle sudlicher Regierungen und nichtstaatlicher Akteure in den zentralen Organisation der globalen Gesundheitspolitik, deren Einflusse auf die Debatten und Diskurse uber die Strategien zur Bekampfung von HIV/AIDS in den Entwicklungslandern entwickelt wurden. Es wird gezeigt, dass - trotz einer generellen Dominanz von Akteuren aus den Industrielandern bei Global Governance - in bestimmten Bereichen grundsatzlich schwache Akteure wie zivilgesellschaftliche Organisationen und sudlichen Regierungen aufgrund des spezifischen aktuellen institutionellen Setting die Chance haben, Einfluss auf die Politiken und Handlungsstrategien auszuuben.

Law, Corporate Governance, and Corporate Scandal in an Emerging Economy: Insights from China

There is an astonishingly high incidence of scandal among firms in the Chinese emerging market. This paper empirically examines whether certain corporate governance mechanisms are related to the probability of a firm being associated with corporate scandal. Using a sample of Chinese listed firms convicted for fraud, we find that firm ownership is related to the probability of a firm committing fraud, whereas other corporate governance characteristics such as board size, board independence, and institutional ownership are not. These findings suggest that in general governance mechanisms have not helped avoid serious corporate scandals in China. Further analysis indicates that the level of development of a country's legal system is related to the probability of a firm committing fraud. Together, our results suggest that without effective legal enforcement, corporate governance mechanisms will not be able to protect minority shareholders and facilitate stock market development in emerging markets.

Whither Japan's Corporate Governance

This paper examines the cumulative effects of gradual changes taking place in Japan's corporate landscape in general and corporate governance in particular in the past decade or so and regards it as an instance of institutional change which has not been completed yet. In order to substantiate this view, it first documents essential features of the changes and then interprets them using a game-theoretic framework of comparative corporate governance analysis. It identifies corporate governance institutions as multiple equilbria of game played between investors, managers and employees, and interprets the changes taking place in Japan as the transition from the model of Contingent Governance to that of stock market monitoring of complementary linkages between the managerial model and specific human assets of the firm.

African elephants Loxodonta africana and human‐elephant interactions: implications for conservation

African elephants face an uncertain future. Politics, war, sustained media campaigns, corrupt, weak or absent institutions supporting conservation, land‐use planning or general governance, and greed are all bringing elephants into direct conflict with humans. Although elephant populations have declined considerably relative to their historical size and range, human populations have expanded to occupy and intensively use remaining elephant areas. Strategies to minimize perceptions of conflict and the implementation of land‐use planning with biodiversity protection as its goal could help to sustain at least some populations of elephants. Here, we review threats to elephants, with an emphasis on those resulting from human perceptions of conflict, and suggest some mechanisms for grappling with these threats.

Nothing seems to have changed, nothing seems to be changing and perhaps nothing will change in the NHS: doctors' response to clinical governance

PurposeThe purpose of this paper is to contribute to the debate on the response of doctors to health policy initiatives in general and clinical governance in particular.Design/methodology/approachA qualitative approach has been adopted where the empirical data collection and the analysis are influenced by a phenomenological case study approach. An instrumental case study is undertaken and a heterogeneous group of 33 persons with important responsibilities for clinical governance was interviewed using a semi‐structured format.FindingsThe results indicate that doctors are not enthusiastic about clinical governance and it is not receiving wholehearted support from doctors because they feel that clinical governance is a management‐led initiative imposed without adequate consultations. The real reasons for lack of enthusiasm, indifference and sometimes resistance of doctors to clinical governance are examined. This paper points out the tension between an organisation (wishing to bring clinical care within a management framework) and doctors (who are resisting managerial efforts to replace the old framework of bureau professionalism).Research limitations/implicationsFurther research is required to develop a better understanding of the influence of clinical governance on power and conflict in NHS organisations.Practical implicationsThis paper has practical implications for policy makers as well as NHS managers. Policy makers may consider suitable amendments in clinical governance to minimise resistance and seek the support of clinicians. A better understanding of this issue would perhaps enable NHS management to develop better management practices that will make it possible to seek the support of doctors for clinical governance.Originality/valueLimited attention has been paid to understanding the response of doctors to clinical governance. This empirical research makes a valuable contribution by focusing on this important aspect of clinical governance.