Sector Budget Research Articles

Financing immunisation in Kenya: examining bottlenecks in health sector planning and budgeting at the decentralised level

BackgroundDecentralisation has increasingly been adopted by countries as an important health sector reform aimed at increasing community participation in decision making while enhancing swift response at decentralised levels, to accelerate the attainment of health system goals. Kenya adopted a devolved system of government where health services delivery became a function of the 47 semi-autonomous county governments with planning and budgeting functions practised at both levels of government. This study sought to explore challenges facing health sector planning and budgeting and how they affect immunisation service delivery at the county level.MethodsData were collected through 77 in-depth interviews of senior county department of health officials across 15 counties in Kenya. We applied an inductive thematic approach in analysing the qualitative data using NVIVO software.FindingsThe study found a lack of alignment between planning and budgeting processes, with planning being more inclusive compared to budgeting. Inadequate capacity in conducting planning and budgeting and political interference were reported to hinder the processes. Limited budget allocations and delayed and untimely disbursement of funds were reported to affect execution of health and immunisation budgets. Low prioritisation of preventive health interventions like immunisation due to their perceived intangibility influenced resource allocation to the programs.ConclusionThe findings highlight the need for effective strategies to align planning and budgeting processes, increased technical support to counties to enhance the requisite capacity, and efforts to improve budget execution to improve budget credibility. Counties should plan to increase their funding commitment toward immunisation to ensure sustainability of the program as Kenya transitions from GAVI support.

Culture, tradition and healthcare: exploring the Kisiizi Community Health Insurance scheme

In southwestern Uganda, a custom of health and social support has been managed through collective organizations known as engozi for centuries. Subscribers advanced help for those who were not able to provide for themselves and their households. Participants pooled financial and food resources, offered emotional assistance, and aided in transporting patients to hospitals. The institution of “free government health amenities” caused the decline of the engozi custom. However, with an insufficient annual health sector budget allocation, the state health services cannot satisfactorily meet the needs. The Kisiizi neighborhood, while depending on the engozi practice, arrived at a CHI system in 1996 as a self-help innovation to eliminate financial obstacles and enhance access to quality health amenities. Numerous studies on CHI have examined the structure, registration and memberships, health-related advantages, and monetary-related benefits, but little has been documented on how cultural beliefs and customs have affected its application. This study aimed to identify the role of culture and customs in tackling healthcare disparities via a CHI strategy. This study adopted a case study methodology and qualitative methods. The study utilizes Woolcock’s social capital theory and Cultural competence theory as the analytical framework. It identifies Brotherhood, Solidarity, Belonging, Cooperation, Volunteering, Reciprocity, and Respect for Authority and Leaders as key values upheld by the engozi tradition, strengthening social capital and laying a solid foundation for successful CHI. This study also identified that societal values and traditions have significantly impacted the implementation of the Kisiizi CHI scheme, as evidenced by the influence on CHI leadership and governance, collecting premium fees from subscribers, mobilization and registration of participants, and information dissemination. Lastly, the study identified that CHI has positively affected healthcare challenges within the community, evidenced by increased utilization of healthcare services, improved access to antenatal care, health promotion and disease prevention initiatives, and improved quality of services due to user feedback.

The economic impact of COVID-19 on Syrian Refugees in Jordan: A review of existing evidence and policies

The global COVID-19 crisis has precipitated an economic downturn in many countries, subsequently raising concerns about the potential challenges faced by marginalized populations, such as refugees, in accessing essential healthcare, hygiene facilities, and critical health information and safety guidelines within the context of Jordan. Consequently, it is of paramount importance to investigate and evaluate the specific economic hurdles related to COVID-19 that refugees are encountering. This inquiry will serve as a valuable foundation for shaping public health interventions aimed at containing the virus’s spread and guiding policymakers on strategies to enhance the well-being of refugees in Jordan. This paper offers a comprehensive examination of Syrian refugees in Jordan, including an analysis of the policies implemented by Jordan concerning Syrian refugees in the context of the COVID-19 pandemic. Moreover, the report assesses whether international assistance, both through bilateral and multilateral channels, can mitigate the impact of COVID-19 on Jordan’s capacity to continue hosting Syrian refugees. It also delves into the economic consequences of COVID-19, covering aspects such as poverty, education, the health sector budget, healthcare accessibility, essential needs, livelihoods, the labor market, and food security among Syrian refugees in Jordan.

Mapping construction sector greenhouse gas emissions: a crucial step in sustainably meeting increasing housing demands

This paper examines the tension between needing to build more infrastructure and housing and simultaneously reduce greenhouse gas emissions (GHG) to avoid the most catastrophic impacts of climate change. This study uses an Environmentally Extended Input-Output approach to conduct a high-resolution top-down analysis of Canada’s national construction GHG emissions. Our findings highlight that Canada’s current construction practices cannot accommodate the construction required to restore housing affordability by 2030 without substantial environmental consequences. On a consumption life cycle basis, the construction sector was responsible for approximately 90 Mt CO2e in 2018, equivalent to over 8% of Canada’s total GHG emissions, while delivering less than a third of Canada’s annual housing needs. Residential construction was responsible for the largest share (42%) of total construction emissions. Overall, 84% of emissions are from material manufacturing and 35% of construction emissions are imported, underscoring the need for a comprehensive regulatory framework addressing both domestic and imported emissions. Under current construction practices (i.e. current material use patterns and emissions intensities), meeting Canada’s 2030 housing affordability and climate commitments requires an 83% reduction in GHG emissions per construction product (i.e. per home) compared to the 40% economy-wide reduction promised in Canada’s international reduction commitments. Mitigating the GHG gap between emission caps and housing demand calls for changes in the ratio of housing to other infrastructure (e.g. fewer roads, less fossil fuel infrastructure), new construction approaches (e.g. increasing material efficiency) and/or disproportionally allocating climate budget to construction. The implications of our study extend beyond Canada, offering valuable insights for other growing countries with climate goals. The results emphasize the urgency in considering and establishing sectoral GHG budgets for construction and for transformative changes in the construction sector to meet national GHG emission reduction commitments.

Budgeting Behavior: Indonesian Local Government Budget Predictions

Objective: The behaviors of overreaction and underreaction exhibited by public sector budget planners have an impact on the disparity between the initial budget set at the beginning of a period and the actual budget realization at the end of the period. This study aims to examine how budget planners in Indonesia predict budgets for local governments, specifically whether there is a difference in the overreaction or underreaction behavior of public sector budget planners among districts and cities in the South Sulawesi Province of Indonesia. Theoretical Framework: This study aims to elucidate the cognitive mechanisms of representativeness bias and the anchoring-adjustment heuristic, which may impact the behavior of individual budget planners in determining budget amounts for future periods and their reliance on past information. Method: This research employs a quantitative approach with a causal and explanatory study design. In this study, the independent variable is the behavior of public sector budget builders, while the accuracy of their predictions for the future budget of the public sector constitutes the dependent variable. The quantitative approach was selected because it aligns with the research's objective of discerning potential misestimations in the behavior of budgeting teams when determining the budgetary allocations for the upcoming year in various patterns or conditions. The research's respondents are the budgeting teams from various districts and cities in the South Sulawesi Province. To test the research subjects, a heuristic of representativeness and anchoring-adjustment is followed when utilizing patterns of revenue realization from previous years (time series). Results and Discussion: This study found that the average Uncertainty in Budget Planner Predictions for Local Governments in each district and city in South Sulawesi, Indonesia, is consistent and does not exhibit significant differences. This research is highly significant as it can provide a valuable contribution to public sector budget planners in Indonesia when establishing budget amounts for the forthcoming period. Research Implications: This study seeks to contribute to advancing research in the realm of public sector budgeting in South Sulawesi, particularly by providing an overview of the occurrence of overreaction and underreaction behaviors among the planners of Local Own-Source Revenue (PAD) budgets in South Sulawesi Province. Originality/Value: The novelty of this study lies in the empirical validation of the utilization of the concepts of representativeness and anchoring-adjustment in the behavior of public sector budget planners when determining the budget amounts for the upcoming period.

Evaluating Budget Functions for Effective Revenue and Expenditure Planning in Hulu River South District

The public sector budget has a function as a local financial management planning tool. BPKPD district of Hulu River South is an institution that carries out the duties of the local government in the planning of the regional budget. This study is aimed at finding out the application of budget functions as a tool for planning income and expenditure in the BPKPD district of Hulu River South. This study uses a method of quantitative research using a descriptive approach. The study uses three types of measurement analysis to find out the use of budget function as a planning tool, namely, the process of budgeting, the level of effectiveness of budget income, and the degree of efficiency as well as deviations in budget expenditures. The income budget effectiveness rate for 2022 reached 118.60% (more than 100%) with the category of highly effective, coming from three types of regional income. First, Regional Real Income with an efficiency ratio of 87.51% belongs to the effective category. Second, Transfer income with an effectiveness rate of 119.82% belonging to the highly efficient category. The calculation of the expenditure efficiency ratio showed less efficient access, with a ratio of 93.06%. Operations purchases obtained a rate of 75.92% in the efficient category. Capital purchases gained access to efficiency ratios of 91.41%, including the less effective category. Unexpected expenditures reached the rate of efficiency of 17.92%, in the highly efficient categories. Lastly, the transfer spending sector has an efficiency rate of 99.81% in the less efficient category. Secondly, the calculation of the variance analysis in the regional spending sector shows that the entire account in the local spending area has more variance. No spending account has a budget deficit as a result of the realization or achievement of greater income than estimated. The deviation that occurs on the entire account of the shopping sector is favorable.

The Influence of Government Expenditures in the Education and Health Sectors on the Human Development Index and Its Impact on the Open Unemployment Rate in Pontianak City for the 2010-2022 Period

This research was conducted with the aim of analyzing the influence of the government budget in the education and health sectors on the Pontianak City Human Development Index (HDI), as well as the influence of the Pontianak City government budget in the education, health and Human Development Index (HDI) sectors on unemployment in Pontianak City in 2010 – 2022. The analytical method used is path analysis using secondary data sourced from the Directorate General of Financial Balance (DJPK) and the Pontianak City Central Statistics Agency. The results of this study found that the education and health sector budgets had an influence and significance on the Human Development Index (HDI) of Pontianak City, and the Pontianak City government budget for the education and health sectors had an influence but was not significant on the level of open unemployment in Pontianak City, as well as the HDI ( Human Development Index) has an effect but is not significant on the level of open unemployment. The results of the F test found that together the education and health sector budgets had a significant influence on the Human Development Index and together the Pontianak City government budget for the education, health sectors and the Human Development Index (HDI) had a significant influence on the level of open unemployment.

Public Sector Budgeting in Poland: Challenges and Opportunities in a Changing Economy

This paper examines the challenges faced by Poland's public sector enterprises and organizations as they manage budgets during the country's transition to a market economy. It investigates how traditional budgetary principles interact with new economic development concepts, drawing on development economics to understand the unique context of Poland's systemic shift. The study analyzes empirical data and public finance trends, arguing that maximizing tax revenue through higher burdens is counterproductive. Specifically, the paper explores how escalating tax burdens on public sector units can stifle economic growth and contribute to the expansion of the shadow economy. Instead, the paper proposes a focus on rational and efficient resource allocation within the public sector as a means to bolster budgetary revenues without hindering overall economic development. This study offers valuable insights for policymakers and researchers interested in understanding the complexities of public finance management within transitional economies.

Analysis of the Ratio of Growth, Effectiveness and Budget Efficiency at the Ministry of Religious Affairs of the Republic of Indonesia in 2017 – 2022

A budget is a written plan regarding the activities of an organization which is expressed quantitatively for a certain period or period and is generally expressed in units of money. The Ministry of Religion of the Republic of Indonesia is one of the ministries that has authority over the State revenue and expenditure budget. The Ministry of Religion is ranked 2nd with the largest APBN ceiling after the Police of the Republic of Indonesia. The ratios for assessing financial performance in the Ministry of Religion used in this research include: Growth Ratio, Effectiveness and Efficiency Ratio. This research aims to analyze the level of Growth, Effectiveness and Efficiency Ratios during the 2017-2022 period to see the financial performance of the Ministry of Religion of the Republic of Indonesia. In writing this journal, a quantitative descriptive analysis method was used. The results of this research show that the financial performance of the Ministry of Religion using the Growth Ratio or the Ministry of Religion's budget growth ratio is around 4.39% every year. The Ministry of Religion's budget effectiveness ratio is relatively high at an average level of 112%, which means that budget realization is able to exceed the set targets. The highest achievement of 121% was recorded in 2017. The Ministry of Religion's budget efficiency ratio for 2017-2022 is at an average of 0.97%, which is very efficient considering the nature of the public sector budget, the smaller the efficiency ratio, the better the government's performance.

Social Decision-Making Analysis: A General Approach to Inform Decisions on Resources in the Public Sector

ObjectivesPublic expenditure aims to achieve social objectives by improving a range of socially valuable attributes of benefit (arguments in a social welfare function). Public expenditure is typically allocated to public sector budgets, where budget holders are tasked with meeting a subset of social objectives. MethodsDecision makers require an evidence-based assessment of whether a proposed investment is likely to be worthwhile given existing levels of public expenditure. However, others also require some assessment of whether the overall level and allocation of public expenditure are appropriate. This article proposes a more general theoretical framework for economic evaluation that addresses both these questions. ResultsUsing a stylized example of the economic evaluation of a new intervention in a simplified UK context, we show that this more general framework can support decisions beyond the approval or rejection of single projects. It shows that broader considerations about the level and allocation of public expenditure are possible and necessary when evaluating specific investments, which requires evidence of the range of benefits offered by marginal changes in different types of public expenditure and normative choices of how the attributes of benefit gained and forgone are valued. ConclusionsThe proposed framework shows how to assess the value of a proposed investment and whether and how the overall level of public expenditure and its allocation across public sector budgets might be changed. It highlights that cost-benefit analysis and cost-effectiveness analysis can be viewed as special cases of this framework, identifying the weakness with each.

Health managers' perspectives of community health committees' participation in the annual health sector planning and budgeting process in a devolved unit in Kenya: a cross-sectional study

Health managers' perspectives of community health committees' participation in the annual health sector planning and budgeting process in a devolved unit in Kenya: a cross-sectional study

Adapting Economic Evaluation Methods to Shifting Global Health Priorities: Assessing the Value of Health System Inputs

ObjectivesWe highlight the importance of undertaking value assessments for health system inputs if allocative efficiency is to be achieve with health sector resources, with a focus on low- and middle-income countries. However, methodological challenges complicated the application of current economic evaluation techniques to health system input investments. MethodsWe undertake a review of the literature to examine how assessments of investments in health system inputs have been considered to date, highlighting several studies that have suggested ways to address the methodological issues. Additionally, we surveyed how empirical economic evaluations of health system inputs have approached these issues. Finally, we highlight the steps required to move toward a comprehensive standardized framework for undertaking economic evaluations to make value assessments for investments in health systems. ResultsAlthough the methodological challenges have been illustrated, a comprehensive framework for value assessments of health system inputs, guiding the evidence required, does not exist. The applied literature of economic evaluations of health system inputs has largely ignored the issues, likely resulting in inaccurate assessments of cost-effectiveness. ConclusionsA majority of health sector budgets are spent on health system inputs, facilitating the provision of healthcare interventions. Although economic evaluation methods are a key component in priority setting for healthcare interventions, such methods are less commonly applied to decision making for investments in health system inputs. Given the growing agenda for investments in health systems, a framework will be increasingly required to guide governments and development partners in prioritizing investments in scarce health sector budgets.

What steps can improve and promote investment in the health and care workforce in Europe?

Abstract Background Recent experiences from Ireland and elsewhere have shown the urgent need for countries and international actors to prioritize investment in the health and care workforce (HCWF) and ensure funding is used well. This research, based on a European Observatory on Health Systems and Policies policy brief, explores: i) areas for strategic investments in the HCWF; and ii) how greater funding from domestic and international sources can be secured. Methods A scoping review of English-language peer reviewed and grey literature was conducted across databases and online repositories including PubMed, Scopus, Web of Science, Google Scholar, WHO data collections. The literature search focused on two areas: 1) areas for strategic investments in the organization, training, deployment and management of the HCWF; 2) actions that can help scale-up investment from domestic and international financing sources. Findings Strategic investments to effectively enhance the sustainability of the HCWF can be grouped into strategies that aim to: 1) increase the quantity, quality and diversity of available HCWs through education investments; 2) reskill and optimize use of the HCWF through investments in preventative and primary care, skill mix reforms and digital technologies; 3) improve employment and retention through labour market interventions and protecting, supporting and managing the HCWF. Ministries of Health must be able to share the measurable benefits of workforce development to secure greater investment, which requires: evidence on the socioeconomic benefits of HCWF investments; strong leadership and capacity; improved intersectoral governance processes; and more efficient and transparent health sector budget cycle processes. Conclusions Education, employment and retention of HCWs needs to be a priority in public expenditure to increase supply, protect the existing workforce and plan ahead to address future challenges.

Infrastructure Development in the UK: Key Drivers and Implementation Challenges.

Infrastructure is a critical factor in fostering strong and sustained economic growth, hence, sufficient attention should be given to the allocation of investment. Although UK infrastructure investment have risen in line with the global trend, the level of investment remains in the lower percentile when compared to other leading countries such as Singapore and China. The study examines the challenges of infrastructure development in the UK and explored the policies required to stimulate investment. Using semi-structured interviews, the views of key stakeholders involved in infrastructure operating across key sectors of transport and energy were captured to gain an insight into the key policy drivers of infrastructure investment. Findings from the research suggests that policy changes are required to stimulate significant investment if the UK is to become a world leader in infrastructure. Key criticisms of UK infrastructure policy focussed on comparatively low level of investment, inadequate collaboration between key stakeholders, and the regional bias of investment in favour of London which disproportionately affects the Northern regions. To facilitate economic growth, the identification of future investible pipeline of infrastructure projects, increasing collaboration with local stakeholders and addressing the regional biases will be critical to ensure synergy and ownership and to scale up the implementation of UK future infrastructure development plans. Considerations should also be given to the need to set up infrastructure banks similar to what is in operation in other countries such as China and Singapore to stimulate private investment and to complement public sector budget allocations. Improving infrastructure project implementation through institutional coordination will boost economic growth post Brexit, support the development of new trading agreements and enhance the country’s economic performance after the pandemic.

Public Sector Budget Implementation and Performance: A Comparative Analysis of Southwestern States in Nigeria

The study investigated the effect of budget implementation on performance: a comparative analysis of six Southwest states in Nigeria over the period of 10 years spanning from 2012- 2021. This is done specifically to explore the effect of capital expenditure, recurrent expenditure, statutory allocation and intervention fund on per-capita income in Nigeria. Ex-post-facto research design was employed in the study because the data were obtained secondarily from National Bureau of Statistics. Data collected were analysed using descriptive statistics and regression analysis. Finding revealed that capital expenditure, recurrent expenditure, statutory allocation and intervention fund have positive and significant effect on performance in Oyo, Ogun and Lagos states respectively. It however revealed that capital expenditure and statutory allocation have positive and significant effect in Osun state, while capital expenditure and intervention fund was discovered to portrayed a positive and significant effect on performance in Ondo state, and the study further showed that statutory allocation and intervention fund have positive and significant effect on performance in Ekiti state. The implication of this result is that Lagos state as well as Ogun state and Oyo state have shown an exemplary example in its budget implementation which significantly affected performance, the role statutory allocation and intervention have been judiciously used and channeled to respective quarters in the case of Lagos, Ogun and Oyo states whereas, the reverse is the same in Ondo, Osun and Ekiti States, as such, statutory allocation and

South Sudan Doctors’ Union calls for increased health sector budget

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Knowledge and Attitude of Health Managers Towards the Annual Health Sector Planning and Budgeting Process in Bungoma County, Kenya

The focus of health planning and budgeting is to identify priorities that, in turn, guide budgetary allocations aimed at improving health outcomes. The shift towards decentralization has necessitated reforms in the planning and budgeting processes. These reforms encompass the enactment of legislation, the formulation of process guidelines, and the utilization of program-based budgeting (PBB). Despite the institutionalization of these reforms, healthcare administrators continue to encounter the challenge of insufficient technical capacity and motivation, which hinders their effective participation in the process. Therefore, this study aimed to examine the knowledge and attitudes of health managers toward the annual health sector planning and budgeting process. A descriptive cross-sectional study design was employed, utilizing both quantitative and qualitative methods. Quantitative data were collected from 170 health managers drawn from all levels of the county health system, while qualitative data were collected from 3 county health executives. Quantitative data were analyzed using the Statistical Package for the Social Sciences (SPSS v. 29.0), while qualitative data were thematically analyzed. Fifty-eight percent of the health managers had not received training on the annual planning process, and 81% had not been trained on PBB. Only 41% were oriented on MoH planning guidelines and 40.5% on legal frameworks. Just 42% of health managers were knowledgeable about the planning and budgeting process. Chi-square tests indicated a significant association between training and the knowledge level of health managers, χ2 (1, N = 170) = 94.76, p < 0.001, as well as between the knowledge level and the use of legal frameworks, χ2 (1, N = 170) = 53.67, p < 0.001. Trained health managers displayed higher knowledge and utilization of legal frameworks. Although 93% of health managers acknowledged the process is essential for their units, only 40% affirmed their motivation to participate, and 78% disagreed with having a positive attitude toward the process. Top of Form To enhance the knowledge and attitude of health managers towards planning and budgeting, the county health department should allocate funds for training in the annual planning and budgeting process—including PBB. Additionally, the county health department should implement comprehensive orientation programs for health managers, encompassing the Ministry of Health's planning and budgeting guidelines along with the relevant legal frameworks.

Health Managers’ Utilization of Evidence to Inform Annual Health Sector Planning and Budgeting Process in Bungoma County, Kenya

Evidence-based planning and budgeting within the health sector are essential in strengthening the health system building blocks. Decentralization has presented opportunities for collecting local and reliable data to facilitate evidence-based planning and budgeting. Despite the increasing availability of routine health information at all levels of the health system, its effective utilization among health managers in lower and middle-income countries remains inadequate. This study, therefore, aimed to assess the health managers’ utilization of evidence to inform the annual planning and budgeting process. The study utilized a descriptive cross-sectional design, incorporating quantitative and qualitative research methods. Quantitative data were collected from 170 health managers, while qualitative data were gathered from three county department of health executives and 83 community health committee members across eight functional community health units. Statistical Package for the Social Sciences (SPSS v. 29.0) was employed for analyzing the quantitative data, while thematic analysis was used for the qualitative data. Only 42.4% of health managers received training in planning, budgeting, and annual performance reviews (APRs). Among the 45.9% who conduct APRs, only 47.4% use the findings to inform the process. A significant association was found between training and conducting of APRs, χ2 (1, N = 170) = 21.73, p < .001, and between training and the utilization of APR findings in decision-making, χ2 (1, N = 78) = 14.72, p < .001. Although 75% of health managers acknowledged the availability of health information, 71% disagreed that they have skills in data use for planning and budgeting and 54% disagreed regarding the reliability of the available data. The health managers who were trained in health sector planning, budgeting, and APRs were more likely to use findings to inform the process. To improve evidence-based planning and budgeting, the county health department should allocate additional funding towards conducting APRs as a critical first step in guiding the identification of priorities. Additionally, there is a need to implement capacity-building initiatives targeting health managers across all tiers of the county health system, focusing on data management and its effective utilization in planning and budgeting.

PRIVATE FINANCE INITIATIVE AS A TOOL FOR BRIDGING THE INFRASTRUCTURAL DEFICIT IN DEVELOPING ECONOMIES

A critical factor in the economic growth of any nation is its infrastructural development. For most developing countries, such as South Africa, the infrastructural deficit has been experienced over the years mainly due to low gross domestic savings. A viable tool in shoring up for the shortfalls of infrastructural investment is the private finance initiative (PFI), as it makes provision for private sector financing of construction projects. On this basis, this study seeks to assess the drivers of PFIs in the South African construction industry. Using a quantitative approach, the study elicited data from relevant stakeholders in the built environment. Retrieved data were subjected to data analysis methods such as mean item score, Kruskal Wallis h-test, and SNK post-hoc test. The analysis findings show that the most significant propelling measure for PFIs in the South African construction industry is overcoming public sector budget constraints, timely project completion, and improved service delivery. Based on the study’s conclusion, recommendations were made to help propagate the inclusion of PFI as an alternative for project financing in South Africa.

REFORM OF PUBLIC SERVICE PROVISION SYSTEMS: WORLDWIDE EXPERIENCE

Ukraine's orientation towards European and Euro-Atlantic integration, effective operations, and the recovery of Ukraine during wartime and the post-war period require reforms aimed at providing public services in modern conditions, aligning their provision with relevant standards, and improving their quality. This publication addresses the necessity of studying global practices in public service delivery to develop recommendations for enhancing their quality under contemporary circumstances in Ukraine. The analysis conducted in the publication can be summarized from several perspectives: Decentralization: the degree of decentralization was different. Where governments were concerned with maintaining same and equal access to services, such as in education services in France and Austria, strong central control was maintained, and local authority was limited. Accountability: N. Flynn and L. Strehl expressed serious concern in their work about the confusion regarding who is accountable to whom, for what, and when. In the Netherlands, for example, it was unclear who would be responsible for the deterioration of the quality of public services at the municipal level if budgetary funds proved to be insufficient. Personnel Management: In all the countries considered at that time, there was an increase in investments in the development and training of public service providers. A growing customer-oriented approach was identified. However, not all training programs focused on service management and customer orientation. For instance, training to promote the development of an active citizenship formation was widespread, which was considered important for ensuring the provision of quality public services. Financial Management: Budgeting was a common practice, and there was a departure from traditional approaches to public sector budgeting. Overall, changes in financial management in all countries highlighted the importance of business planning and measuring the effectiveness of public authorities' activities. Interaction with the Private Sector: The authors found evidence that public services in many countries were disillusioned with market forces and market competition, often associated with the inability of markets to deliver promised improvements. As a result, in countries such as New Zealand, the Netherlands, and Sweden, policies began to emphasize non-competitive ways of enhancing the efficiency of public service organizations. Different reasons are cited from country to country. In the UK, for instance, a high level of expenses related to contracting and administering public service delivery contracts by private organizations was noted. Despite many changes aimed at improving the quality of public services, which were initially made to achieve specific political goals, there were also entirely objective grounds for implementing these changes. Factors driving and continuing to drive the necessity of introducing changes both to the public services themselves and to the management systems of their provision including: reduction of government expenditures in some areas and their increase in others; emphasis on the public as a client and customer choice; replacement of administrators with managers in the public service; blurring the lines between private and public sectors; demographic changes such as aging; introduction of performance management in public authority activities; adoption of information technologies in public authority activities; increased citizen discernment regarding public services; the influence of globalization on domestic markets; extensive privatization of state and municipal property.