Service Delivery Agencies Research Articles

Health workforce strategies during COVID-19 response: insights from 15 countries in the WHO Africa Region

IntroductionThe COVID-19 pandemic unveiled huge challenges in health workforce governance in the context of public health emergencies in Africa. Several countries applied several measures to ensure access to qualified and skilled health workers to respond to the pandemic and provide essential health services. However, there has been limited documentation of these measures. This study was undertaken to examine the health workforce governance strategies applied by 15 countries in the World Health Organization (WHO) Africa Region in responding to the COVID-19 pandemic.MethodsWe extracted data from country case studies developed from national policy documents, reports and grey literature obtained from the Ministries of Health and other service delivery agencies. This study was conducted from October 2020 to January 2021 in 15 countries - Angola, Burkina Faso, Chad, Eswatini, Ghana, Guinea, Guinea Bissau, Ivory Coast, Liberia, Mali, Mauritania, Niger, Nigeria, Senegal and Togo.ResultsAll 15 countries had national multi-sectoral bodies to manage the COVID-19 response and a costed national COVID-19 response plan. All the countries also reflected human resources for health (HRH) activities along the different response pillars. These activities included training for health workers, and budget for the recruitment or mobilization of additional health workers to support the response, and for provision of financial and non-financial incentives for health workers. Nine countries recruited additional 35,812 health workers either on a permanent or temporary basis to respond to the COVID-19 with an abridged process of recruitment implemented to ensure needed health workers are in place on time. Six countries redeployed 3671 health workers to respond to the COVID-19. The redeployment of existing health workers was reported to have impacted negatively on essential health service provision.ConclusionStrengthening multi-sector engagement in the development of public health emergency plans is critical as this promotes the development of holistic interventions needed to improve health workforce availability, retention, incentivization, and coordination. It also ensures optimized utilization based on competencies, especially for the existing health workers.

Electronic public service delivery: progress and challenges in Bangladesh

PurposeThe paper aims to examine the state of electronic service delivery in Bangladesh. It reviews the structure and operation of the “e-service” centers at the district, sub-district (upazila), and union levels by taking an inventory and assessing their contributions.Design/methodology/approachThe paper is based on a review of the functions and operations of the service delivery agencies with reference to the claims made by the government. It is based on secondary materials obtained from academic studies, government documents, relevant websites, and media reports.FindingsElectronic delivery of public services in Bangladesh has not been effective as planned. There are issues regarding channels of communication, the competence of public officials, human and financial resources, and political will to support the agencies delivering public services.Originality/valueThe paper examines the arrangements, practices, and problems of delivery of public services in Bangladesh through e-service centers at the local levels to determine the progress and potentials of employing digital technology for addressing problems. It proposes the strategy for public service delivery by using digital technology in the country.

Examining organisational subcultures: Machinery of Government mergers and emerging organisational microcultures

AbstractMachinery of Government restructures—transformations that create or abolish departments or move functions between agencies—often result in the misalignment of cultures and subcultures that impact business operations and customer service levels. An understanding of how subcultures are impacted during restructures is vital as they can reveal diffused microcultural boundaries that reflect highly problematic cultural tensions. This study provides rare ethnographic insights into how Machinery of Government restructures destabilise the delivery of optimal customer service by disrupting Business as Usual operations. Based on 74 interviews and ethnographic methods, the integrationist ‘DNA’ culture, subcultures, and emerging microcultures within Service NSW, a public sector agency in New South Wales (Australia), were examined during and after its merger with the Department of Customer Service. Microcultures were shown to function in a way that preserved Business as Usual activities and responsibilities to secure task independence, highlighting the importance of developing a conceptual framework for the detection and resolution of cultural resistance. Scholars and practitioners may adopt the framework used in this study to determine how, when, and where cultural resistance is likely to emerge.Points for practitioners This study critically analyses the ‘DNA’ culture of a service delivery agency in New South Wales during and after its merger with the Department of Customer Service. Service NSW's ‘DNA’ integrationist culture, the broader subculture of its ‘Support Office’, and various microcultures were detected. Microcultures were shown to preserve Business as Usual activities and secure task independence as reflected in backstage sites of enactment. The degree of intra‐ and interpersonal tensions experienced by Service NSW employees was opaque to senior leaders responsible for the restructure. Leaders and practitioners responsible for mergers should fully understand the changing nature of employee language and behaviour. It is advisable they act on the assumption that employees are experiencing tensions resulting from the organisation's disturbed social reality. Scholars and practitioners may adopt the conceptual framework and this case study's methodological approach to analyse a public service agency's various cultures, before, during, and after Machinery of Government (MoG) mergers or restructures, to pre‐empt, identify, and reduce cultural tensions, and should consider the feasibility of appointing a Workplace Change Committee. Workplace Change Committee Members act like first responders across impacted departments and divisions within subcultures. Workplace Change Committee Members manage emerging issues, specifically cultural disparities to ensure both the intra‐ and interpersonal safety of employees impacted by MoG mergers.

The ‘mutualisation’ of public services in Britain: A critical commentary

This article provides a critical commentary on the ‘new mutualism’, an intellectual current in the recent debate about public services in Britain that argues for the ‘mutualisation’ of service delivery agencies. First, it defines a mutual, and identifies important ways in which the new mutuals diverge from this definition. It traces the genesis of the idea in the ‘old mutualism’ of pre-welfare state Britain, explaining how mutuals were rejected in the setting up of the post-war welfare state. It describes how foundation hospitals and other recent developments have been influenced by a new appreciation of the idea of mutuality that has been used to help shape New Labour’s modernisation of public services. It shows how mutuals fit with other new forms such as the public interest company and social enterprise, and with a broader ‘script’ provided by communitarianism and the ‘third way’. It considers potential weaknesses in the argument, and then reviews criticisms concerning inequality and lack of participation. Finally, it asks whether the concept will remain as influential in the future, and whether it will deliver the improvements in public services that its advocates have promised.

결혼이주여성의 공적 지원서비스 초기 이용 유형과 관련 요인

This study adopted a person-centered approach using latent class analysis to construct typologies of public service use among 2,455 migrant women, examining migrant women’s distinct socio-demographic characteristics and whether there are differences according to their patterns of service use. Data were drawn from the National Survey on Multi-Cultural Families in 2018. Five classes were identified and were labeled Active Use in Individual Empowerment Service (10.4%), Active Use in All Services (6.7%), Passive Use in All Services (51.2%), Active Use in Child Related Services (13.3%), and Active Use in Early Adaptation Support Services (18.3%). The patterns of public service use differed depending on the socio-demographic characteristics of migrant women such as age, place of residence, employment status, presence of children under age five, household income, marriage duration, and residency period. The results suggest that service delivery agencies should provide customized services in consideration of the characteristics of service users in the future.

Achieving Resilience in Primary Care during the COVID-19 Pandemic: Competing Visions and Lessons from Alberta.

The COVID-19 pandemic has tested the resilience of health systems broadly and primary care (PC) specifically. This paper begins by distinguishing the technical and political aspects of resilience and then draws on a documentary analysis and qualitative interviews with health system and PC stakeholders to examine competing resilience-focused responses to the pandemic in Alberta, Canada. We describe the pre-existing linkages between the province's central service delivery agency and its independent PC clinics. Together, these central and independent elements make up Alberta's broader health system, with the focus of this paper being on PC's particular vision of how resilience ought to be achieved. We describe two specific, pandemic-affected areas of activity by showing how competing visions of resilience emerged in the central service delivery agency and independent PC responses as they met at the system's points of linkage. At the first point of linkage, we describe the centralized activation of an incident management system and the replies made by independent PC stakeholders. At the second point of linkage, we describe central efforts to disseminate infection prevention and control guidance to PC clinics and the improvisational efforts of staff at those independent clinics to operationalize the guidance and ensure continuity of operations. We identify gaps between the resilience visions of the central agency and independent PC, drawing broadly applicable policy lessons for improving responses in present and future public health emergencies. Finding ways to include PC in centralized resilience policy planning is a priority.

Are policy tools and governance modes coupled? Analysing welfare-to-work reform at the frontline

ABSTRACT This paper considers the link between policy tools and governance modes – the characteristic ways frontline staff are meta-governed. It asks: Are substantive policy tools coupled to procedural tools (governance modes) that can guide local service delivery agencies and the work of individuals delivering welfare services? The substantive policy tools in this case are those typically utilised to reform welfare-to-work services: contracting-out of services and competitive tendering, and the regulation of quasi-markets. These are hypothesised to flow through to procedural policy tools in the form of corporate and market incentives and regulatory (bureaucratic) methods that shape how work is done (governance modes), privileging certain practice orientations at the frontline. Policy makers seek to shape these meta-level governance modes because they should result in systemic change, based on a reconfiguration of policy actors and their interrelationships, for both service delivery agencies and the individuals working in them. We identified four ideal-type governance modes (bureaucratic, corporate, market and network) and tracked which of these were dominant in-practice at the frontline in Australia and the UK at two levels: office and personal, at four points in time (1998, 2008, 2012 and 2016). We found that the dominant mode of organisation at the office level was corporate, followed by bureaucratic in both nations. But the bureaucratic mode had grown in strength over time, particularly in Australia, and as a personal priority for staff, as re-regulation occurred. The results indicate a coupling between substantive policy tools and governance modes at the frontline of welfare-to-work.

Administrative Responsiveness in Ease of Doing Business

Ease of doing business is an integrated approach to improve delivery of various services for running an enterprise through regulatory reforms. Several parameters have been identified by the World Bank, which ranks 190 countries, including India, based on the reform initiatives undertaken by them. India has made significant progress in the rankings. However, there are still areas where there is huge scope for improvement. Despite the political push, it is the responsiveness of the administrative system that holds the key. Indian bureaucracy is often blamed for its ‘personnel, paperwork, and process’ orientation. This article is an attempt to analyse the response of the bureaucracy in four select parameters: (a) starting a business, (b) getting electricity, (c) registering property and (d) getting credit. The rationale behind their selection is that, though all businesses have to negotiate the processes, these four have direct interface with the service delivery agencies, and there is greater measurability of their responsiveness in general.

Checklists in community care: reducing differences in care delivery between regular and relief staff to improve consistency and client experience

BackgroundToday, healthcare is more complex than just ensuring clients receive quality care; it also involves consistently delivering excellent client experience. A non-profit community support services agency conducted an extensive diagnostic...

THE CONCEPT OF CULTURAL COMPETENCE OF THE DIGITAL GOVERNANCE SPECIALISTS WITHIN PUBLIC ADMINISTRATION

The purpose of this article is to define and analyze the concept of cultural competence of the digital governance specialists in the public administration science. The methodological bases of the research are the methods of observation and comparative analysis that allow to systematize important factors of cultural competence assessment of digital governance specialists. Scientific novelty of the article consists of the identification of the digital governance specialists’ cultural competence concept in public administration and defining the elements of its assessment. Conclusions. Cultural competence based on developed communication skills makes digital governance more effective, because corresponding knowledge and communication skills help service delivery agencies to solve the majority of internal and external conflicts within the public administration system. The main advantage of intercultural communication skills development is the improvement of services delivery process and the increase in efficiency of interactions between citizens and public administration institutes via mechanisms of digital governance. Considering global experience in digital governance implementation, conclusions and recommendations for Ukraine were made.

A Correlational Analysis of Public Procurement Policy and Utilisation of Public Funds for Service Delivery in Ondo State (2007-2013)

This paper investigated public procurement policy vis-à-vis effective and efficient utilization of public fund for service delivery using Ondo State as a case study. Primary and secondary data were utilised for this study. The study universe 1,422 respondents comprised senior officials from selected service delivery ministries, agencies and civil society groups. 284 respondents were selected from sample groups using stratified sampling technique with a sample fraction of 20%. Interviews were conducted to complement the data gathered through questionnaire administration. The results showed that there is about thirty three percent (33%) positive relationship between the application of procurement policy and effective and efficient utilization of public fund for service delivery in Ondo State (r = +0.332, p < 0.01). This paper concluded that public procurement policy had a minor influence on effective and efficient utilization of public fund for service delivery in Ondo State.

Organising and Representing the Poor in a Clientelistic Democracy: the Decline of Radical NGOs in Bangladesh

This paper examines the political role of radical development NGOs that emerged in Bangladesh to challenge the marginalisation of subordinate groups and strengthen democratic processes. After briefly introducing the political context of Bangladesh and its NGOs, the paper identifies and defines a radical NGO sub-sector. It then reviews the activities of these organisations during the pre-1990 military government era and during the subsequent period of electoral democracy. Some important achievements are identified, but also many failures that have led to decline, leaving behind an NGO sector dominated by credit and service delivery organisations. The paper then explains this decline by focusing on three inter-related factors: (i) an institutional setting dominated by clientelistic structures that have undermined efforts to build horizontal alliances among excluded groups in civil society, or links between NGOs and political parties; (ii) a shift in donor support from mobilisation to market-based service delivery agencies; and (iii) internal structures that have generated legitimacy and accountability problems by encouraging elite capture, co-option and personalised leadership in the radical sub-sector. It concludes with some brief reflections on the main implications of these failures.

A Trusted Source of Information: How Systematic Reviews Can Support User Decisions About Adopting Evidence-Based Programs.

Systematic reviews sponsored by federal departments or agencies play an increasingly important role in disseminating information about evidence-based programs and have become a trusted source of information for administrators and practitioners seeking evidence-based programs to implement. These users vary in their knowledge of evaluation methods and their ability to interpret systematic review findings. They must consider factors beyond program effectiveness when selecting an intervention, such as the relevance of the intervention to their target population, community context, and service delivery system; readiness for replication and scale-up; and the ability of their service delivery system or agency to implement the intervention. To support user decisions about adopting evidence-based practices, this article discusses current systematic review practices and alternative approaches to synthesizing and presenting findings and providing information. We reviewed the publicly available information on review methodology and findings for eight federally funded systematic reviews in the labor, education, early childhood, mental health/substance abuse, family support, and criminal justice topic areas. The eight federally sponsored evidence reviews we examined all provide information that can help users to interpret findings on evidence of effectiveness and to make adoption decisions. However, they are uneven in the amount, accessibility, and consistency of information they report. For all eight reviews, there is room for improvement in supporting users' adoption decisions through more detailed, accessible, and consistent information in these areas.

Autonomy of Public Service Delivery Agencies in Vietnam and OECD: A Comparative Institutional Perspective

This paper analyses the underpinning institutional foundations of autonomy in public service delivery in Vietnam compared to the OECD countries. These include formal institutions such as governance structures, and informal institutions such as norms and values. Vietnam embarked on autonomization to enhance efficiency and flexibility, in line with the OECD countries, as part of a broader reform in response to a critical socio-economic crisis in the 1980s. Paradoxically, Vietnam’s autonomization goes against the official ‘socialist’ ideology, and is predominantly promoted to mobilize social resources, and to cut back on government expenditure. While autonomous agencies in the OECD countries have been established within institutionalized performance management and accountability backdrops, autonomization in Vietnam is implemented against weak institutional foundation. Considering the wide gap in autonomization outcomes between these jurisdictions, the paper seeks to prescribe some policy advice for Vietnam’s future autonomy reforms in terms of building institutions.

Regulating and Monitoring Public–Private Partnership in Infrastructure Development in the State of Punjab (India): A Case Study of Bus Terminal Project, Jalandhar

The traditional forms of governance had undergone paradigm shift from traditional welfare state towards effective, efficient, accountable and time bound service delivery agency. Public Private Partnership in service delivery is relatively a new experience in India and many State governments have considered various steps to promote PPPs in their respective States.

Responsive Change: Agency Output Response to Reputational Threats

AbsTRACT How do reputational threats affect agency outputs? We undertake quantitative and qualita-tive analyses of reputation and outputs data regarding the fight against welfare fraud by the main service delivery agency for the Australian government in the field of social policy. We find that an agency’s response to reputational threats is endogenously differential both within the set of agency outputs and between agency outputs and other activities (a pat-tern we termed responsive change ). For the former, we find that when an agency output is below average, negative media coverage leads to an increase in output in the following year. However, this relationship is nullified for agency outputs that are about average and is reversed for outputs that are above average, that is, these outputs tend to decrease fol-lowing negative media coverage. For the latter, we find that when a reputational threat is joined by a general above average level of outputs, the agency’s drive for change is likely to be channeled into activities other than the number of units of service delivered (e.g., public relations, community engagements, stakeholder consultations, etc.).How do reputational threats affect agency outputs?

Immigration Reform and Administrative Relief for 2014 and Beyond: A Report on Behalf of the Committee for Immigration Reform Implementation (CIRI), Human Resources Working Group

Successful implementation of any broad-scale immigrant legalization program requires an adequately funded infrastructure of immigrant-serving organizations. In 2014, President Obama announced an expanded Deferred Action for Childhood Arrivals (DACA) program, as well as the Deferred Action for Parents of Citizens and Lawful Permanent Residents (DAPA) program, which would make it possible for approximately five million people to attain lawful, albeit temporary, status and employment authorization. As the initial DACA program instituted in 2012 has already stretched the capacity of immigrant-serving organizations to their limits or even beyond them, the possibility of full implementation of DAPA and the expanded DACA programs presents a formidable challenge for these organizations. In this paper, the Human Resources Working Group of the Committee for Immigration Reform Implementation (CIRI) draws on the lessons of the Immigrant Reform and Control Act of 1986 (IRCA), DACA, and other initiatives to provide a roadmap for immigrant service delivery agencies and their partners in planning for implementation of the expanded DACA and the DAPA programs, with an eye (ultimately) to broad legislative reform. In particular, this paper focuses on the funding and human resources that the immigrant service delivery field, writ large, would require to implement these programs. If expanded DACA and DAPA were implemented, the CIRI Working Group estimates that, of the total of five million that may be eligible, 1.08 million individuals will require extensive application assistance, generating the need for approximately three times more full-time staff than are currently in the field. Moreover, without additional funding and staff, agencies will likely not be able to shift a portion of staff time to accommodate any new program, even taking the typical fee-for-service model into account. Thus, the paper identifies a pressing need for “upfront” funding as early in the program as possible for outreach, public education, combating notario fraud, advocacy, and assistance to self-filers. In terms of the financial resources needed, the Working Group’s analysis shows that about $83 million, net after collection of fees, is a reasonable estimate for the potential nonprofit sector “funding gap” required to assure effective application assistance services to the eligible low-income people likely to apply for the expanded DACA and DAPA programs. Wise front-loaded investments can help to maximize coordination and minimize duplication, ensure education and outreach, and channel applicants to the most appropriate sources of assistance. While investments required to build the necessary infrastructure are significant, the costs will be far outweighed by the benefits, not just to the DACA/DAPA population but to the society at large.

State Mental Health Policy: Back to the Future: New Mexico Returns to the Early Days of Medicaid Managed Care

Gubernatorial administrations in New Mexico have initiated four overhauls of the publicly funded behavioral health care system over the past two decades. The most recent effort, Centennial Care, was implemented under a Section 1115 Medicaid waiver in January 2014. The authors describe Centennial Care, which closely resembles the now defunct restructuring of the public system that introduced Medicaid managed behavioral health care to the state in 1997. They also note disruptions in services to clients and hardships for providers, described locally as a "behavioral health crisis," that resulted from actions taken in 2013 by the current gubernatorial administration to force the takeover of 15 nonprofit service delivery agencies by five Arizona companies. These actions led to an onsite investigation by the Centers for Medicare and Medicaid Services.

Differential Performance Response: The Effect of Reputational Threats on Public Agency Outputs

How do reputational threats affect the performance of public agencies? Based on a quantitative and qualitative analyses of reputation and outputs data related to the main service delivery agency for the Australian Government in the field of social policy and administration, we find that the effect of negative media coverage on agency performance is moderated by the level of its previous year performance, i.e., negative coverage is followed by an increase in agency outputs when previous year performance is below average, and a decrease in agency outputs when it is above average. The two types of performance response to reputational threats appear to be the result of the agency's increased interest in change following reputational threats, which is channeled to activities that are internally identified as lagging. Our findings suggest that an agency's response to reputational threats is endogenously differential, among others, through changes in its organizational outputs or other activities. These findings also empirically demonstrate stable relationships between organizational memory, with reputation management and performance.

We Can See There's a Light at the End of the Tunnel Now': Demonstrating and Ensuring Quality Service to Clients

This Report details research undertaken by Dr Liz Curran on behalf of Legal Aid ACT. The research looked at Legal Aid ACT and the quality of its legal services to clients.The study, after it was commissioned, ended up coinciding with indications by the Commonwealth Attorney General’s Office that it is to review and measure the outcomes of legal assistance services under a recent National Partnership Agreement (NPA) between the Commonwealth, State and Territory Governments. The research for this report anticipates this review by trying to provide a definition and approach to the measurement of ‘successful outcomes’ in a legal aid services context, as referred to in the NPA. Service delivery and humanitarian agencies world-wide are increasingly being asked to report and measure results-based outcomes. Although there has been surprisingly little outcome measurement undertaken internationally or domestically, there is some literature detailing how it might be done. The literature overwhelmingly concludes that results-based outcomes are difficult and challenging areas to measure. Therefore, while the main purpose of this project is to measure and enhance the quality of legal aid services delivered by Legal Aid ACT, this Report has wider importance and broader implications for other agencies. Legal Aid ACT has demonstrated foresight in commissioning this research early, somewhat in anticipation of the need to define outcomes for legal aid services.It is hoped that this Report will both assist Legal Aid ACT and inform public debate, helping shape realistic accountabilities, policy development and – most importantly – good and effective service delivery on behalf legal aid service sector clients and the wider community.