Public Sector Research Articles

Healthcare Disparities in the Treatment and Outcomes of Hepatocellular Carcinoma in South Africa.

The impact of healthcare disparities on the outcomes for hepatocellular carcinoma (HCC) has not been explored in South Africa. This study aims to evaluate and compare the presentation, treatment, and outcomes of HCC in a cohort of patients treated in the public and private sectors. The records of 551 consecutive patients treated at a public hospital compared to those of 51 treated in the private sector from 1 December 2001 to 29 February 2024 were retrospectively reviewed. Patients managed in the public sector were significantly younger (mean age: 49.6±14.8 vs. 59.6±14.3years, p<0.00001) and more likely to have hepatitis B virus (HBV)-related HCC (62.1% vs. 17.6%, p<0.00001). The prevalence of multifocal disease (59.2% vs. 15.7%, p<0.00001), portal vein tumor thrombosis (44.6% vs. 5.9%, p<0.00001), and pulmonary metastases (16.2% vs. 3.9%, p=0.0143) was significantly higher in public sector patients. A significantly higher number of public sector patients received best supportive care as their only treatment (69.7% vs. 15.7%, p<0.00001). A higher proportion of private sector patients were treated with curative-intended therapies (ablation, liver resection, and liver transplantation) and transarterial modalities. Median survival was lower in public sector patients (68 [IQR: 25-232] vs. 703 [IQR: 388-1327] days, p<0.001). There was no difference in survival between public and private sector patients treated with curative-intended therapies. In the public sector, patients present with more advanced HCC, which limits their access to curative-intendedtherapies, resulting in lower survival. Patients treated with curative-intended therapies have similar survival rates in the public and private sectors. With the introduction of universal health coverage through the National Health Insurance program in South Africa, these data highlight the gaps in HCC care in the public sector, where health initiativessuch as HBV vaccination, early treatment of HBV, patient education, and screening of at-risk patients should be prioritized.

Effects of work-related digital technology on occupational health in the public sector: A scoping review.

BackgroundDespite a growing literature on how digitalisation affects service quality, justice, and accountability in the public sector, research on the effects on the work and work environment of public employees is scarce.ObjectiveTo present and discuss existing evidence and identify knowledge gaps related to how digitalization affects the work and work environment of public sector employees.MethodsThis scoping review is based on peer reviewed academic journal articles in English found in PubMed, PsycINFO, Business Source Premier (EBSCO) and Scopus.ResultsThe review included 52 studies, of which most focused on office or care workers. An increase in studies since 2020 indicates growing interest in the topic. Challenges among screen-level bureaucrats included work-life balance problems, technostress and fear of job loss. Among street-level bureaucrats, reported challenges included curtailed discretion, lack of user involvement and ethical stress. Identified knowledge gaps include the small number of studies with a work environment focus in general and on sectors beyond office and health settings in particular, few studies set outside of Europe and absence of studies on recent phenomena such as AI or algorithmic management.ConclusionsIn view of the presented scarcity of research, we suggest that relevant questions are included in national and local surveys to enable more research, that more studies are conducted in occupational sectors, countries and regions lacking this type of research, and that comparative research is stimulated to uncover differences between the effects of digitalisation on occupational health in private and public sector work settings.

Navigating HIV care in a mobile society: case studies of clinic transfers in South Africa's public health sector

ABSTRACT In South Africa, people living with HIV (PWH) often relocate for work and family obligations, which creates unique challenges for continuous HIV care. We explored the experiences of mobile individuals living with HIV navigating clinic transfers without formal letters. A qualitative study was conducted with PWH on antiretroviral therapy (ART) from two clinics in KwaZulu-Natal. Participants, who had not disclosed their HIV treatment history at registration, were interviewed in-depth between March and October 2023. Content and thematic analyses, informed by Andersen’s behavioral model and self-management domains, were used. This study presents two case studies of individuals who faced challenges with accessing ART after relocating to new areas: a 37-year-old female worker and a 47-year-old male construction worker. Both faced difficulties accessing ART after relocation. When they presented at new clinics, they were told they could not access care without transfer letters. Unable to return to previous clinics, they sought treatment at a third clinic as treatment-naive, changing their names to avoid detection. To cover ART gaps, they also purchased or borrowed ART from others. These individuals developed strategies to overcome barriers. Educating clinic staff on the challenges faced by migrants could help improve transfers.

What drives usability of public sector online reporting?

IMPACT Whereas digital reporting has become more popular, insight is missing into the drivers of the usability of public sector online reporting. Based on prior literature, this article provides an overview of these drivers, as well as the advantages and disadvantages of the PDF format vis-á-vis the website format of financial reporting. Furthermore it explores the relevance of these drivers by conducting an empirical study. These insights can be used for increasing the usability of public sector online reports.

Invitation to exclusion: The continuing experience of Black women in higher education (HE) in the United Kingdom

Black women exist in a contested space in higher education (HE) in the United Kingdom where they can be used in a tokenistic way as visible confirmation of how well an organisation is realising its organisational aims of equality as required under the Public Sector Duty, while at the same time often being denied opportunities which are routinely allocated to their White counterparts (Bernard, 2007; Wilson, 2007). While the Commission on Race and Ethnic Disparities (2021) reported the crude racist expressions were now, mostly, features of the past, the findings of this research indicated that Black women could not necessarily expect support from within their organisation nor could they rely on internal systems to either provide them with the protection they needed or opportunities to progress in their careers. Instead, more often, Black women needed to build their own support networks and plot their own paths for progression.

The Debilitating Impact of Transphobia on Health Care Services: The Moderated Mediation Model of Transphobia, Minority Stress, Social Exclusion, and Access to Health Care among People Who Are Transgender.

Drawing on the perspective of minority stress theory, an elaboration of social stress theory, and the Social Exclusion Knowledge Network model, this study's aim is to develop and test the feasibility of a moderated mediation model in the context of Pakistan. This model investigates the roles that transphobia, minority stress, and social exclusion play in the transgender population's access to health care services by the individual's communities in Pakistan. By applying a time-lagged research design and collecting multisource data from public sector hospitals in the capital city of Pakistan, alongside conducting a single-source survey over 30 consecutive working days (N = 206), we explore these relationships in depth. The results reveal that transphobia is negatively related to health care access, with minority stress mediating this negative relationship. Furthermore, social exclusion not only moderates the connection between transphobia and minority stress but also amplifies the indirect association between leader transphobia and health care access via minority stress. This moderated mediation framework underscores the critical impact of transphobia on health care access and highlights the amplifying role of social exclusion. The findings from this study offer invaluable insights for future researchers and practitioners focused on mitigating transphobia's impact on health care access within transgender contexts.

Master or Escape: Digitization-Oriented Job Demands and Crafting and Withdrawal of Chinese Public Sector Employees

Master or Escape: Digitization-Oriented Job Demands and Crafting and Withdrawal of Chinese Public Sector Employees

Correction: To what extent do CEO characteristics explain CSR practices in public sector organisations? Evidence from Nigeria

Correction: To what extent do CEO characteristics explain CSR practices in public sector organisations? Evidence from Nigeria

The inclusion of CO2 accounting in the IPSAS accounting standard

Accounting and reporting for the CO2 footprint has become standard procedure for capital market-oriented companies since the IFRS S2 standard was released in 2023. However, the IPSAS Board have already committed themselves to: (i) include CO2 Accounting in the standard; and (ii) to orient themselves towards IFRS S2. The contribution will show what this means for public sector entities in terms of facility and energy management, procurement of capital goods, materials and services as well as waste management. It will also show how the resulting requirements can be included in ERP systems that are already in place for public sector administration.

Investigating the impact of ethical standards on enhancing accounting practices: A comparative analysis of public and private sectors in Oman

This research examines how ethical standards contribute to improving accounting practices in both the public and private sectors of Oman, concentrating on the importance of professional ethics and its effect on accountants’ performance and quality. The objective of the study is to investigate the connection between adherence to ethical standards and the quality of financial reporting while noting differences in ethical compliance across sectors. A questionnaire using a Likert scale was utilized to gather primary data from accounting professionals in various organizations. Statistical techniques were applied to evaluate the relationship between ethical compliance and the integrity of financial reporting. The findings reveal a significant positive correlation between ethical conduct and enhanced financial reporting quality. Public sector organizations demonstrate higher levels of ethical compliance due to more rigorous regulatory oversight, while ethical training and governance are essential for ensuring compliance, especially among less experienced accountants. The study concludes that ethical conduct enhances transparency, builds trust, and reduces financial risk, underscoring the importance of maintaining strict ethical standards. For practical implications, the study advocates for ongoing ethical training, strong governance frameworks, and a workplace culture that emphasizes ethics to improve financial integrity. These insights are beneficial for policymakers and organizations aiming to strengthen ethical accounting practices and uphold stakeholder trust.

Development of an Energy-Efficient Electrical Load Model for Optimizing Electricity Consumption in the Headquarters Building of PT Semen Padang Using the PDCA Approach

The increasing electricity consumption in the public building sector has a significant impact on greenhouse gas (CO2) emissions, which is proportional to the volume of energy used. This study aims to develop an energy-efficient electrical load model to optimize electricity consumption in the headquarters building of PT Semen Padang using the Plan-Do-Check-Action (PDCA) approach. In the Plan stage, problem identification was conducted through a Pareto diagram and root cause analysis using a fishbone diagram. The dominant issue identified was energy waste in the lighting system. The solution implemented included the installation of motion sensor-based switch control devices to regulate lighting use automatically. In the Do phase, the devices were installed and tested, while in the Check phase, the evaluation showed a reduction in electricity consumption from over 85,000 kWh per month to below 80,000 kWh per month, resulting in an electricity cost savings of IDR 31 million per month. The Action phase established standards for inputs, processes, and outputs to ensure the sustainability of the improvements made. This study not only provides financial benefits but also supports the company's Energy Management System policy. With the PDCA approach, improvement processes can be carried out systematically and continuously, making a tangible contribution to energy efficiency in the public building sector.

The Good or The Bad: Implications of Ethnic Diversity in Interpersonal Conflicts at Work

Aim of the Study: The objective of this study is to investigate the relationship between ethnic diversity and Interpersonal Conflicts at Work (IPCW) among staff of universities located in Rawalpindi and Islamabad, Pakistan. Particularly, it explores the dynamics of ethnic diversity and how these dynamics affects interpersonal conflicts at work. Methodology: Data were collected from administrative and academic staff of the universities using a structured questionnaire. The independent variable, ethnic diversity and dependent variable, IPCW, were measured by adopting established measures developed by Phinney, J. (1992) and Spector &amp; Jex (1998), respectively. A total of 200 samples were collected by using in person and online data collection approaches. The proposed study model was tested using correlation and hierarchical multiple regression tests carried out in SPSS software. Findings: The study results point out that ethnic diversity has a significant impact on interpersonal conflicts in the workplace among employees of the universities. This significant relationship between ethnic diversity and IPCW indicates the challenges that ethnic diversity can pose in the workplace. Furthermore, male employees with diverse ethnic background are more prone to IPCW as compared to their female counterparts. Whereas employees from different age groups and levels of work experience remained consistent regardless of variations in age or work experience. Implications: The study finding has significant implications for public and private sector managers and policy makers. To counter the adverse effects of ethnic diversity and to bring inclusiveness and harmony to the workplace, managers must have training, awareness and intercultural competence. The organizational culture of Pakistani organizations required to be more sensitive towards ethnic diversity by embracing, valuing and leveraging it vis-à-vis open communication.

Contribution of cardiac surgeons in transcatheter aortic valve replacement activity in France.

This study provides a thorough analysis of cardiac surgeons' involvement in transcatheter aortic valve replacement (TAVR) activities in France, covering decision-making, procedural roles, training, and outcome analysis. A nationwide survey was sent to all cardiac surgeons and all cardiac surgery trainees in France. Subgroup analysis was performed for age, status (established versus in-training), and type of practice facility. A total of 172 surgeons from both private and public sectors responded to the survey. Most respondents, 71%, had TAVR activity, and there were no significant differences between subgroups. Most respondents with TAVR activities, 30%, had average access (once per week). Almost one-third of centers had >3 established surgeons with TAVR activity, whereas 19% had no in-training surgeons with TAVR activity. TAVR was the only structural practice for 67% of surgeons, while 33% practiced other structural procedures. When asked, 82% of surgeons were against establishing TAVR programs in centers without a cardiac surgery program. Most TAVR patients, 72%, were discussed by the Heart Team, and only 9% of surgeons said their relationship with the interventional cardiologist was disrupted. Two-thirds of vascular complications were managed by cardiac surgery, and only 6% of cardiac surgeons admitted were unfit to handle any vascular complications. In France, cardiac surgeons are becoming increasingly involved in TAVR procedures as an integral part of the Heart Team.

Exploring the influences of contracting management capacity in realizing the promised benefits of government outsourcing: evidence from the U.S. federal bureaucracy

ABSTRACT The new public management (NPM)-oriented administrative reforms have been medicine for many governments to improve public sector performance since the 1980s. However, while empirical results on the effects of outsourcing on organizational performance have been contested for decades, scholars highlight the crucial role of an agency’s capacity to manage contracting processes and practices effectively, put simply contracting management capacity, in realizing the benefits of the practices. Considering the increasing importance of government outsourcing, it is meaningful to identify the role of contracting management capacity in terms of organizational performance as it can help public agencies derive practical implications for improving their performance. The panel data analyses of the U.S. federal bureaucracy show that contracting management capacity determines the relationship between outsourcing spending and organizational performance. This finding supports theoretical perspectives highlighting the critical roles of agency capacity in mitigating principal–agent problems through effective management and monitoring of contracts/contractors.

Strengthening the functional capacity of public sector banks in the economic recovery of Ukraine

Strengthening the functional capacity of public sector banks in the economic recovery of Ukraine

Action intersectorielle locale pendant la pandémie de COVID-19: une démarche de développement territorial en milieu rural.

The COVID-19 pandemic affected the action of collaborative networks, connecting organizations from the public, community, and private sectors. Intersectoral action is a recognized strategy for tackling complex problems and reducing social inequalities. This study aims to understand how the COVID-19 pandemic modified local intersectoral action to improve the living conditions of rural populations. Data for this qualitative, case study were collected through semi-structured individual interviews, observation sessions, and documentary analysis. Actor-network theory was used as the theoretical framework. Data collection took place from March 2021 to June 2022. The data were processed using a thematic analysis inspired by the analytical framework. The pandemic disrupted local intersectoral action, hampering networking operations and promoting a sectoral approach. Strategies favouring networking (use of technology and the liaison work of collective stakeholders) made it possible to create spaces for negotiating shared interests, identifying common causes, committing players to new roles, and sharing resources. When faced with disruptions, networks can be flexible, testifying to the relevance of intersectoral action to meet the needs of the population. Even if the network was in a state of near-fragmentation before the pandemic, its reconstitution and remobilization were relatively easy for the community organizers.

The Effectiveness of Good Governance Laws in Public Administration

Good governance laws play a critical role in ensuring transparency, accountability, and public participation in public administration. However, their implementation often encounters challenges related to bureaucratic inefficiencies, limited public awareness, and resource constraints. This research aims to assess the effectiveness of good governance laws in enhancing public administration performance and citizen satisfaction. Adopting a qualitative research approach, data were collected through in-depth interviews, surveys, and document analysis involving various government institutions and stakeholders. The findings indicate that while certain sectors exhibit high compliance with governance laws, others face difficulties due to financial limitations, a shortage of skilled personnel, and weak enforcement mechanisms. Additionally, a strong correlation was identified between governance compliance and public satisfaction, suggesting that institutions with greater transparency and accountability tend to receive higher public approval. Despite these positive associations, challenges such as budget constraints and inadequate digital infrastructure continue to hinder the full realization of governance principles. To address these issues, it is recommended that governments reinforce regulatory enforcement, invest in digital governance platforms, and enhance public engagement initiatives. Furthermore, bureaucratic reform is essential to equip civil servants with the necessary competencies to uphold governance standards effectively. Strengthening independent oversight bodies can also help ensure consistent adherence to governance laws across various administrative sectors. By overcoming these challenges, public administration can become more transparent, accountable, and responsive to citizens’ needs, ultimately fostering greater trust in government institutions. Future research should consider longitudinal studies to evaluate the long-term impact of governance laws and examine the evolving role of digital transformation in enhancing public sector performance.

Middle managers matter! Unpacking the deployment and adaptation of organization-level dynamic capabilities

ABSTRACT How do public sector organizations (PSO) adapt established dynamic capabilities (DC)? Our longitudinal study of two Norwegian municipalities reveals that public middle managers leverage their distinct dynamic managerial capabilities (DMC) to deploy and adapt organization-level DC through specific meso-level mechanisms. Our study makes two significant contributions. First, we introduce a multilevel model for the deployment and adaptation of organization-level DC in PSO. Second, we challenge the prevailing upper-echelons perspective by extending the concept of DMC to include public middle managers. We demonstrate how their DMC differ from those of top public managers and contribute to shaping and operating organization-level DC.

Assessing Software Practitioners’ Work Engagement and Job Satisfaction in a Large Software Company—What We Have Learned

Social aspects of software practitioners strongly influence software engineering outcomes. For instance, software companies seek to measure how factors like work engagement and job satisfaction impact employee productivity and software quality. Work engagement represents a positive, fulfilling, work-related mental state, while job satisfaction reflects how content professionals are with their roles. Our study aims to highlight the social aspects of software practitioners considering a large organization. We investigate the work engagement and job satisfaction of software practitioners working remotely at a large software organization in the public sector. We surveyed 891 software practitioners and analyzed their responses qualitatively and quantitatively. The survey participants indicated strong work engagement. They perceived their teams as effective, but there is room for improving social aspects, such as communication within the teams, promoting discussions about career development, and consistent feedback. Most professionals are satisfied with their teams, though a small minority expressed concerns that may influence their willingness to recommend their teams. Our findings provide relevant information about the engagement and satisfaction of employees within this particular type of organization and expand the knowledge base on the subject, supporting new research efforts in the area.

A Comparative Analysis of Two Data-Driven Mechanisms for Behavioral Change: Nudging and the Chinese Social Credit System

Nudging and the Chinese social credit system (SCS) are two widely discussed measures that utilize digital technology and behavioral science to shape and modify people’s behavior. But these two approaches differ in many perspectives. Nudging is envisioned to address challenging policy issues and lauded for its effectiveness. In contrast, the SCS is seen as highly controversial and regarded as an instance of social surveillance. With reference to the Fogg Behavior Model (FBM), this paper aims to examine how nudging and the SCS are strategically designed in different ways to influence individuals’ behavior in the public sector. Our analysis draws upon comprehensive interviews conducted with a sample of 30 university students and researchers from Germany and China. We employed a scenario-based approach involving digital nudges and SCS measures in domains of law enforcement and prosocial conduct. Our interviews reveal how people think conceptually about these two data-driven intervention methods. For Chinese citizens, who are supposed to be more familiar with the SCS, we also explore whether they see a difference between the two approaches and how they understand the fundamental differences. The application of the FBM analysis uncovers disparities in behavioral influence mechanisms between these two approaches for behavioral change.