Municipal Setting Research Articles

Exploring the Influence of Supplier Relationship Quality on South African Municipalities’ Service Delivery Performance

Most South African municipalities are yet to perform at the desired level. Service delivery protests have been a permanent feature in the South African media for years. Apprehending the factors influencing relationship quality may help municipalities enhance their performance and reduce service delivery problems. The study adopted a quantitative approach within the South African municipality setting. The respondents were sampled using stratified random sampling and snowball sampling. Data were collected from 205 respondents using a structured 5-point Likert scale questionnaire. The data were coded and analyzed using descriptive statistics, SPSS, and AMOS statistical software. The main finding was that relationship quality influenced service delivery performance from the management’s perspective. The composite relationship quality variables (cooperation, trust, commitment, and satisfaction) significantly influenced the relationship quality. The implication is that the quality of the relational interactions between the municipalities and their suppliers significantly impacted the quality-of-service delivery performance.

Monetary valuation of unsorted waste: A shadow price approach

Improving the management of municipal solid waste (MSW) is fundamental to promote circular economy and sustainability. Unsorted waste involves negative environmental impacts which often are ignored in economic feasibility studies due to its difficult valuation. In this study the shadow price of unsorted waste using the directional distance function was estimated. This methodological approach also allowed us to compute eco-efficiency scores of a set of municipalities in the provision of MSW services. The empirical application focused on a sample of 119 Chilean municipalities. The results showed that the average shadow price of unsorted waste was 297.66 €/ton which means that the environmental cost of left waste as unsorted was 297.66 € per ton. A regression tree model illustrated that population density, tourism intensity and the generation of waste per capita significantly influenced the shadow price of unsorted waste. Moreover, it was illustrated that Chilean municipalities were very inefficient in the management of MSW since the average eco-efficiency score was 0.272. The findings from this study reveal that additional and alternative policies should be adopted to improve the management of MSW and increase its recycling rate.

Interdisciplinary intervention (GAIN) for adults with post-concussion symptoms: a study protocol for a stepped-wedge cluster randomised trial

BackgroundPersistent post-concussion symptoms (PCS) are associated with prolonged disability, reduced health-related quality of life and reduced workability. At present, no strong evidence for treatments for people with persistent PCS exists. Our research group developed a novel intervention, “Get going After concussIoN (GAIN)”, that incorporates multiple evidence-based strategies including prescribed exercise, cognitive behavioural therapy, and gradual return to activity advice. In a previous randomised trial, GAIN provided in a hospital setting was effective in reducing symptoms in 15–30-year-olds with PCS 2–6 months post-injury. In the current study, we describe the protocol for a trial designed to test the effectiveness of GAIN in a larger municipality setting. Additionally, we test the intervention within a broader age group and evaluate a broader range of outcomes. The primary hypothesis is that participants allocated to enhanced usual care plus GAIN report a higher reduction in PCS 3 months post-intervention compared to participants allocated to enhanced usual care only.MethodsThe study is a stepped-wedge cluster-randomised trial with five clusters. The 8-week interdisciplinary GAIN program will be rolled out to clusters in 3-month intervals. Power calculation yield at least 180 participants to be enrolled. Primary outcome is mean change in PCS measured by the Rivermead Post-Concussion Symptoms Questionnaire from enrolment to 3 months after end of treatment. Secondary outcomes include participation in and satisfaction with everyday activities, labour market attachment and other behavioural measures. Self-reported outcomes are measured at baseline, by end of treatment and at 3, 6, and 18 months after end of treatment. Registry-based outcomes are measured up to 36 months after concussion.DiscussionThe trial will provide important information concerning the effectiveness of the GAIN intervention in a municipality setting. Furthermore, it will provide knowledge of possible barriers and facilitators that may be relevant for future implementation of GAIN in different settings.Trial registrationThe current GAIN trial is registered in ClinicalTrials.gov (study identifier: NCT04798885) on 20 October 2020.

Healthcare waste management protocols challenged by Covid-19: a case study

The resilience of a new national healthcare waste management protocol was compared in hospital and community settings in Ethiopia during the coronavirus disease 2019 (Covid-19) pandemic. The aim was also to evaluate the flexibility and implementation status of the guidelines for healthcare waste management in the context of a pandemic. The study was performed in a cross-sectional design by using a structured questionnaire and checklists and through a systematic review. Primary and secondary data were collected, including those from municipal sites, Yekatit 12 Hospital and other relevant stakeholders. Furthermore, the data were analysed and compared to the global practices and standards. The study revealed there was a comparable difference in the level of care taken in healthcare waste management between healthcare institutions and in the community in Addis Ababa city. The provision of awareness training to waste handlers in both the clinical and municipal setting was significantly deficient, which has to be addressed together with many other variables, starting with the formulation of a resilient waste management protocol. Furthermore, waste management protocols have to be expert-revised periodically.

Portable wide-field digital imaging for screening of neonatal visual impairment causes in Rio de Janeiro, Brazil: a budget impact analysis

ObjectiveTo estimate the budget impact of portable wide-field digital imaging incorporation on screening neonatal causes of childhood blindness and visual impairment in Rio de Janeiro, Brazil.DesignBudget impact analysis.SettingRio de Janeiro,...

Daily life coping—Helping stress-afflicted people manage everyday activities

Background Symptoms of stress are widespread in the working population and associated with long-term sickness absence and poor work functioning. Occupational therapy (OT)-based interventions are effective in improving return-to-work (RTW)-rates in stress-afflicted long-term sickness benefit beneficiaries (SBBs). No Danish standard on OT-RTW for stress-afflicted SSBs exists. Aims To describe and evaluate the feasibility of a seven-week OT-RTW intervention for stress-afflicted SBBs. Materials and methods Daily Life Coping (DLC) utilizes peer-learning and salutogenetic perspectives to address occupational imbalances experienced by long-term SBBs. Stress-afflicted SBBs (n = 54) in the municipality of Hilleroed were enrolled. Self-efficacy and well-being were measured before and after intervention using the general self-efficacy (GSE) scale and WHO-5 Well-Being Index (WHO-5). RTW-rates were measured at one-year follow-up. Participant feedback was collected using standardized evaluation forms. Results Following the intervention, WHO-5 improved by 13.7 ± 16.5 points and GSE improved by 4.3 ± 4.8 points. Participant feedback was positive. At one-year follow-up, employment status data were available for 51 SSBs of these 58.8% achieved employment. High post-test GSE and WHO-5 scores were associated with employment at follow-up. Conclusion DLC led to significant improvements in self-efficacy and well-being. Preliminary results indicate benefits on RTW-rates. Significance This study provides evidence of the feasibility of DLC in a municipal setting.

Physical Activity for Children and Youth with Physical Disabilities: A Case Study on Implementation in the Municipality Setting.

Children and youth with disabilities participate less in physical activity (PA) than their peers. This qualitative multiple-case study aimed to assess how municipal practices support PA implementation for these children and youth. A total of 23 interviews were conducted, which covered participants from different departments and professional positions in two municipalities. Local policy documents were included. A thematic analysis was performed, which was based on Winter’s integrated implementation model and Gittell’s theory on relational coordination. The study findings indicate how PA implementation for children and youth with disabilities is a complex challenge that involves several departments and agents. The study demonstrates that having an explicit policy that focuses on parasport can positively influence organisational and interorganisational behaviour, and that coordinating consultants seem to play an essential role in PA implementation. However, there is room for improvement at the municipal level in order to promote a better overall performance in terms of the support for PA participation of children and youth with disabilities.

Registered nurses’ experiences of challenging situations in their psychosocial working environment in home care of patients with functional and/or intellectual disability: a qualitative study

Around 15% of the world's population lives with some form of functional and/or intellectual disability (FID). Nursing staff often face threats and violence in the care of patients with FID. This study aimed to illuminate registered nurses’ experiences of challenging situations in their psychosocial working environment in home care of patients with functional and/or intellectual disabilities. Nine registered nurses/district nurses working in municipal settings were interviewed using a qualitative approach. COREQ was used for explicit and comprehensive reporting of qualitative studies. Three categories were revealed: To face challenging behaviour, To face emotional burden and To face communication difficulties. Nurses need continuous training and support to cope with work-related stress to meet a person with FID in a calm and relaxed mood and to be prepared for critical situations in their psychosocial environment. Training and support may enable nurses to be in a state of harmony and to be present in order to build caring relationships.

English

Globalization puts extra pressure on local governments to be more responsive and accountable. The belief from theory is that with high levels of fiscal autonomy, the elected public officials would be more responsive to allocate resources to the local priority areas determined by citizen interests and preferences. On the face of it, responsiveness reads like the normative outcome of fiscal autonomy in the developing and emerging economies. However, an empirical comparative analysis of responsiveness for Uganda and Thai municipal governments provides reasons for both optimism and pessimism. The findings challenge the traditional theory for responsiveness being an outcome of a coherent fiscal decentralization system that follows specific and predetermined rational logic of consequentiality. The paper concluded that responsiveness facilitated fiscal autonomy not the other way round in municipal governments. The paper therefore recommended country and circumstance specific conditions under which responsiveness would more likely happen in municipal settings. The perceived conditions for responsiveness to happen is included but not limited to  spending according to the source; more involving system of selecting representatives to assemblies; renewed national government commitment to empower municipal institutions and the citizens; and more incorporation of civil society to play a more participative role in municipal governance.   Key words: Reframing, convergence, fiscal autonomy, responsiveness, municipalities.

Registered nurses’ experiences of barriers in providing care for older patients with low mood in Swedish municipal settings: A qualitative study

Low mood and depression are common mental states among older people, and are difficult to diagnose and treat, causing suffering and declining functions. The aim of the study was to describe registered nurses’ experiences of barriers in providing care for older persons with low mood in Swedish municipal settings. Ten registered nurses working in municipal settings were interviewed using a qualitative approach. The analysis resulted in two main categories, ‘Professional barriers in the care of older persons with low mood’ and ‘Organisational barriers in the care of older persons with low mood’, and four subcategories. Improvements regarding increased knowledge about the use of assessments tools are suggested. Registered nurses should strive to listen to the older person's desires and needs. Furthermore, suggestions about improved collaboration within the organisation as well as with other caregivers in order to provide quality care to older persons with low mood, are made. COREQ was used as criteria to report qualitative data.

Indiana University’s Woodland Campus: A Case Study of Urban Forest Patch Sustainability

Background: Urban green spaces are increasingly seen as vital resources contributing to ecological and social health. The ecological concept of patch dynamics over space, scale, and time applies to patches in urban settings and is important in understanding the complexity of relationships between and within the ecological and social spheres interacting in urban settings. Methods: This case study investigates forested and natural patches on Indiana University’s Bloomington (IUB) campus. Data gathered through university archives includes historical maps and campus plans for a study period beginning in 1884 with the university’s relocation to its current area. Documents were reviewed forevidence of patches being labeled or left blank. Historic aerial photos were compared with present satellite imagery using geographic information system (GIS) software. Results: Findings include patterns where patches were indicated on maps (1902 to early 1940s), followed by a period where natural/forested areas were unindicated on maps (post-World War II to 1960s), followed by patches reappearing on maps and being suggested for preservation (1960s to present). Although some natural patches were “lost” during the study period, others persisted. Patches that endured may be defined as Commons: shared resources protected by formal/informal rule processes. Conclusions: This novel framework for the IUB patch project serves as a template for use in investigating green patches in the city of Bloomington. The Bloomington project builds upon the IUB framework, expanding GIS analysis of current patches and historical imagery, and assessing current ecological patch condition. Additional considerations reflect complexity of municipal settings and include patch ownership, socio-demographics, and equitability in access.

Changes of Physical Function and Quality of Life in Patients with Type 2 Diabetes after Exercise Training in a Municipality or a Hospital Setting.

Introduction The aim was to compare changes in physical function and quality of life (QOL) after an exercise training programme to patients with type 2 diabetes mellitus (T2DM) in a municipality and a hospital setting and to compare the patients' physical function and QOL with an age- and sex-matched general population. Methods Patients with T2DM were stratified to exercise training in a municipality (n = 26) or a hospital (n = 46), respectively. The training was one hour twice weekly for 12 weeks. The outcomes were physical function (30 sec chair stand test (CST)) and QOL (using the SF-36). The data for the general population were collected from previous reference studies. Results Fifty-one (71%) participants completed the intervention. The CST results improved in both groups with no difference between the municipality and hospital groups (1.6 [0.1; 3.1] vs. 3.5 [2.3; 4.8] no., respectively, p = 0.062). The QOL scales physical function and general health increased more in the municipality group than in the hospital group (10.5 [2.8; 18.2] vs. -1.2 [-7.9; 5.5], respectively, p = 0.031, and 8.3 [2.3; 14.4] vs. -0.2 [-5.6; 5.1], respectively, p = 0.042). Dropout (n = 21) during the intervention was associated with reduced QOL at baseline. The patients' CST results at baseline were reduced compared to the general population (11.8 ± 3.5vs.18.9 ± 3.3, respectively, p < 0.001). All QOL scales apart from social function were reduced in the patients compared to the general population. Conclusion Patients in a 12-week exercise training programme in a hospital or a municipality setting had significantly lower QOL compared to an age- and sex-matched population sample. Similar improvements in physical function were observed in patients after completion of the exercise programme irrespective of exercise setting, whereas patient exercising in a municipality setting had higher positive changes in QOL than patients undergoing the same exercise programme in a hospital setting.

The experiences of community-dwelling individuals with newly diagnosed type-2 diabetes in using patient-reported outcomes in a municipal setting.

ObjectiveThe aim of this study was to examine the experiences of citizens with newly diagnosed type-2 diabetes when using a newly developed and implemented patient-reported outcome (PRO) questionnaire as part of clinical practice in a municipal setting. Specifically, the citizens’ experiences in completing the PRO questionnaire and using the PRO data in consultations were examined.MethodsThe study was based on participant observations and semi-structured interviews and conducted at the Centre for Diabetes in Copenhagen and online. Participants were recruited deliberately to represent different cases of citizens with type-2 diabetes. Ten citizens were observed during consultation with an healthcare professional (HCP) and subsequently interviewed. The interviews were recorded as audio or video and transcribed verbatim. A thematic analysis was performed on the basis of previously described guidelines.ResultsThe PRO instigated reflections and enlightened citizens on disease-specific matters and motivated citizens to engage in self-management activities. During the citizen-HCP consultations, the PRO data prepared the actors before the meeting and enabled structured, effective and relevant conversations. However, the PRO questionnaire lacked response options, triggered citizen concerns about future health conditions and made them unsure if their answers were correct and aware that they lacked disease-specific knowledge. The experiences were linked to the citizens' situation as newly diagnosed with type-2 diabetes.ConclusionThe informants found the PRO questionnaire and data meaningful and useful. However, adjustments are needed if the PRO instrument is to resemble the disease situation of citizens with newly diagnosed type-2 diabetes.

Using “Live” Public Sector Projects in Design Teaching to Transform Urban Green Infrastructure in South Africa

Urban green infrastructure is not acknowledged in the Global South for the critical social and ecological functions it can provide. Contextual design solutions and innovative approaches are urgently needed to transform the status quo. University-local government collaboration could be a way to encourage new thinking, new roles and design skills to develop solutions to these complex problems. This paper presents a case study analysis of such a collaboration. Qualitative research was conducted to establish the degree to which the exposure to real-life projects stimulates postgraduate design students’ transformative learning. The researchers also inquired into the benefits of the collaboration for the municipality. The participants’ reflections were recorded by means of anonymous questionnaires. The findings show that the live project created a municipal setting for seeking alternative solutions in design processes and outcomes. For the students, the project created rich social dynamics and an interplay of familiarity and uncertainty, which aided transformative learning. The students’ deeper learning indicates greater social empathy, reconsidering the role of the profession, greater design process flexibility, and learning and valuing skills across disciplines. The findings hold promise for a more just and sustainable future built environment through collaborations that transform the design professionals involved, the outcomes they pursue, and the processes they follow.

Exploring motivations behind the introduction of tourist accommodation taxes: The case of the Marche region in Italy

The accommodation tax is one of the most common forms of tourism taxation to tackle tourism-related negative externalities, usually administered at sub-national level by municipalities. Although widely applied, the accommodation tax is not unanimously adopted, which makes it particularly interesting to investigate what encourages municipalities to rely on it. By using random effects panel logit and probit regression models on a set of Italian municipalities, this paper contributes to the scant literature that explores the issue and shows differences from similar studies. Specifically, our findings suggest that the probability of introducing a tourist accommodation tax is related to the size and fiscal conditions of the municipality, occupancy of tourist accommodation establishments, and electoral disproportionality. Furthermore, as our results reveal that strategic interactions among municipalities within the same province play a role, the paper suggests to consider the accommodation tax as a strategic tool in competition among tourist destinations.

The Intertwined Functions of Advanced Information Systems and Management Control Practice in a Municipal Context

Abstract Background: Advanced, integrated information systems such as an enterprise resource planning (ERP) system have nowadays come to play such a crucial role for organizations and functions such as management accounting and control that in many cases, they would not function without the support of these systems. Public sector operations in general and municipal operations, in particular, are complex and require a lot of resources. Because of this, the managers working within this context need the support of advanced information systems to a large extent. Objectives: This paper aims at understanding how these new systems and their users, accountants, and controllers, perceive the opportunities they bring in a municipal setting. Methods/Approach: Out of 290 Swedish municipalities, 97 participated in the survey. Results: The results show that these systems have come to play an important part in working with management accounting and control issues. Conclusions: One conclusion that could be drawn from this study is that information supported by advanced information systems has become such an important necessity that management accounting as a function or phenomenon would not work without it. Therefore, the interdependency between information systems and management accounting and control practice could be described as intertwined.

The development of a quality-assured action model for municipal health promotion

Abstract Background The creation of health-promoting living environments is a key strategy in order to minimise health inequalities, which have been increasing recently. Health promotion in municipalities offers many approaches in this context and is gaining importance on an international level. To structure the process of municipal health promotion, the aim of this research was to create a basis for action and to define requirements in the process. Methods A systematic literature research on models, approaches and tasks for health promotion in municipal settings was conducted in five databases such as Web of Science and EBSCOhost, and was supplemented by a manual search. All hits were filtered using inclusion and exclusion criteria. The design and presentation of the results were prepared based on the method of the Integrative Review. Results 262 publications were screened, sixteen of which were considered for analysis. On this basis, an action model for municipal health promotion was developed. It consists of four phases: Network Planning and Modification, Municipal Profiling, Municipal Strategy Development, Implementation and Evaluation. Other important identified aspects during the process are participation, project and network management, communication, evaluation and quality assurance. Conclusions The action model structures tasks and requirements in the process of municipal health promotion. The evidence also shows the importance of central coordination in municipal health promotion, which can be structured by the action model. The created model provides a new framework for a quality-assured and sustainable process and for a central coordinated municipal health promotion. Key messages Municipal health promotion should increasingly be established. Thereby, the adherence to a systematic, quality-assured process is important.

Socioeconomic potential for rainwater harvesting systems in southern Brazilian municipalities

Abstract The implementation of rainwater harvesting (RWH) systems depends on technical and socioeconomic assessments. However, most studies do not consider socioeconomic aspects, which could lead to different degrees of RWH implementation and technology selection due to economic constraints and local regulations. We evaluated the socioeconomic potential for RWH as an alternative for the water supply of 24 southern Brazilian municipalities with less than 50,000 inhabitants. A total of 10,080 RWH configurations were assessed and a reliability analysis was carried out to define the RWH system configurations potentially implementable (RWH+) in each municipality. RWH economic benefits were estimated from a social point of view, based on the reduction of the monthly water payment. Overall, RWH+ supplying higher demands with higher economics savings were feasible, as expected. However, several municipalities that showed RWH+ supplying 100% of the domestic water demands obtained lower economic savings, due to low water tariff and water consumption. Still, a set of municipalities presented RWH+ for rainwater demand replacing 50% to 60% of the residential demand, for which the high water tariffs were reflected in higher economic savings. The advantages of using the RWH systems stand out even more when the investments at Federal and Local levels are considered.

Комплексное зонирование региона для целей государственной кадастровой оценки

The article analyses the issue of development a methodology for the effective evaluation zoning of rural and urban land for tax purposes. The final result of such zoning was a set of municipalities in the region, for which the factors in price formation are established and unified models for the cadastral value calculation are applied. The analysis of existing methods showed that zoning may be based on the average specific market price of a typical object of evaluation per 1 sq. m., the size of municipalities. The interpolation method of weighted inverse distances can also be applied. Consequently, it was found that the well-known grouping methods can be conditionally divided into three types: expert (subjective), economic-statistical and cartographic zoning methods. The article suggests the author’s approach to the evaluation zoning, which consists in the analysis of factors of administrative and territorial division, forms of territorial development of cities, natural and climatic factors, economic, production and social factors. Using as the example Krasnodar Krai, the agglomeration core, coastal cities with a semicircular and striped structure, coastal small towns and rural municipalities along the Black and Azov Seas, municipal districts with an actively developing economy and a favorable investment climate, areas with a stable economic situation, moderately developing areas and areas with a difficult economic situation were identified. As a result of the evaluation zoning, eleven zones were identified, within the boundaries of which it is possible to analyze the situation on the real estate market, assess its dynamics and implement correlation and regression modeling.

Conservation or disappearance? The public provider of home care services in a system of choice

ABSTRACT This article aims to analyse the position of the public provider (i.e. share of recipients) of home-care services in Swedish municipalities with marketization: a system of choice. Following the literature, an assumption is that the public provider has difficulties in surviving the competition with private home-care providers. In addition, the relevancy of this assumption could differ between different municipal settings. To test this assumption, we use statistical analysis. The main result is that the public provider is a ‘strong player’ in most municipalities experiencing marketization. However, there exists a variation in this respect – the position varies between municipalities.