Stewardship Function Research Articles

Iran’s health insurance ecosystem: challenges and strategies

IntroductionIdentifying and exploiting stewardship and financing challenges in Iran’s health insurance system as an ecosystem is essential to achieving predetermined goals. This study aimed to determine the challenges and strategies in the Iranian health insurance ecosystem to provide relevant evidence to healthcare managers and policymakers to improve its functions and perform necessary reforms.MethodThis qualitative study was conducted at the national level in Iran. Data were collected using semi-structured interviews and analyzed using the directed content analysis method. The study participants included managers and experts in health insurance and faculty of universities of medical sciences, who were selected by purposive sampling.ResultsThe challenges and strategies expressed by participants were categorized into two functions: stewardship and financing. Four main themes, ten subthemes, 22 challenges, and 24 strategies were identified in the stewardship function, along with three main themes, 12 subthemes, 17 challenges, and 16 strategies in the financing function. The major challenge in the Iranian health insurance ecosystem was the complexity and conflict of interests between multiple actors with different roles, which led to fragmentation, diverse structures, and a gap between other functions and objectives, hindering the effective functioning of the ecosystem.ConclusionIn order to deal with the challenges of the health insurance ecosystem, it is suggested to create a coherent insurance system through a single utility system, and by paying more attention to health-oriented services, the health insurance ecosystem becomes a health-oriented system instead of being treatment-oriented. In addition, in order to strengthen the governance of the country’s health insurance ecosystem, the number of actors with multiple roles should be reduced and the roles of the actors should be clarified and separated in order to prevent conflicts of interest and structural corruption in this ecosystem.

Implementasi Akuntansi Dalam Rangka Meningkatkan Kualitas Laporan Keuangan UMKM

Micro, small, and medium enterprises (MSMEs) have an important position and function that, together with state-owned or private enterprises, carry out various businesses to achieve prosperity for the community. The function of MSMEs is to unite, direct, and develop the creative power and business power of the people, especially those with limited economic capacity so that they can participate in economic activities. Accounting information is used to assess management activities in managing assets entrusted to them (the stewardship function) and is also used as a decision-making tool by those who use it. MSMEs experience problems understanding the application of accounting in their business operations. The efforts they make are to improve the ability of their accounting personnel through training that is carried out incidentally both by related agencies and through activities carried out by universities. However, their efforts have not produced optimal results, coupled with a fairly high level of employee mutation, where employees who have been trained sometimes change workplaces. This problem is latent and occurs repeatedly, so it greatly disrupts the daily operations of MSMEs. To be able to achieve the objectives of the activity, the method used was in the form of assistance to 20 MSMEs. This assistance is carried out by providing a multimedia-based accounting simulation device to MSMEs and then explaining how to use it. This mentoring activity begins with a briefing on the use of the device. After that, monitoring the simulation device's utilization was carried out. The final activity carried out was an evaluation of the usefulness of the device in improving the ability of MSMEs to prepare financial reports.

Information provision by non‐government actors in the Australian National Disability Insurance Scheme: A key market stewardship function in social care quasi‐markets

AbstractThe use of quasi‐markets for the delivery of social care continues to grow internationally. This has presented considerable challenges regarding governance and stewardship of these markets, to ensure they meet policy goals. To date, both scholarship and practice on quasi‐market stewardship have mainly focused on the role of government. However, non‐government actors can also play important stewardship roles. For effective stewardship, there needs to be integration between government and non‐government actors in the system, not just a top‐down approach. This paper explores the stewardship role of non‐government actors in the Australian National Disability Insurance Scheme (NDIS) with a focus on the role of information provision as a key market stewardship function. Findings show non‐government information providers play important stewardship roles that increase choice and control for citizens, enhance market sufficiency, diversity, and innovation, and support other actors in the system. We argue for a shift in the conception of market stewardship as primarily a government activity and recommend the market stewardship actions of non‐government actors be better acknowledged, funded, and ‘joined up’ with the market stewardship role of government to enable social care quasi‐markets to operate more effectively.Points for practitioners Information provision by non‐government actors is a key market stewardship function in social care quasi‐markets. Market stewardship needs to be the responsibility of a much greater range of actors than government alone. A framework for ‘distributed stewardship’ can help join up the stewardship actions of non‐government actors with those of government to support information flows for more effective stewardship.

Accounting and religious influence in the seventh day Adventist church in the Pacific islands

PurposeThis paper aims to investigate the practice of accounting in the Seventh-day Adventist church of the Pacific Islands and pays particular attention to the coexisting of two control devices: accounting and religion.Design/methodology/approachThis paper implemented a qualitative field study design collecting interview data from church members from the Solomon Islands, Tonga and Fiji. Data were also collected through focus group discussions, document reviews, website analysis and participant observations. Pierre Bourdieu’s thinking on symbolic violence, doxa and capital are used to interpret the findings.FindingsThis paper’s main contribution shows that while there is a divine and profane divide, social agents, given their agency, can move back and forth from one side of the divide to the other. Accounting as a control device does not include features such as faith, which is helpful for decision-making; accordingly, religion is relied upon when it comes to decision-making. In contrast, accounting has features that are useful for stewardship purposes. Accordingly, when it comes to the church’s stewardship function accounting in the form of financial reports is relied upon.Research limitations/implicationsPacific Island culture almost permeates all facets of life, including church life; however, this study did not clarify this. Later studies can explore the implications of culture on the deployment of accounting in a religious setting.Practical implicationsThis rich empirical study describes the control dynamics and the tension between accounting and religion in a religious organisation. Accounting needs to adapt to churches’ unique characteristics, whereby religious/doctrinal beliefs must be accounted for and respected. Unlike in the corporate world, accountants in churches cannot fully practice their training or exercise the kind of influence they usually hold in organisations due to their religious belief systems.Originality/valueTo the best of the authors’ knowledge, this research is one of a few studies on the religion-accounting relationship. While the focus of earlier studies was generally on a secular and sacred divide, this study looks at coexisting of accounting and religion. This study adds to the sparse literature on accounting and religion and their controlling influence.

The challenges of urban family physician program over the past decade in Iran: a scoping review and qualitative study with policy-makers.

Despite all the advantages of urban family physician program (UFPP), there is still a gap between UFPP and what is actually achieved by the community after its implementation in Iran. In response, this study attempted to review published studies related to the barriers to the implementation of the UFPP in Iran as well as potential solutions to improve it. Further, a qualitative study was conducted to learn the perspectives of experts at the national level and in the Fars province in order to better understand the program's challenges. This study was conducted in two phases. First, a scoping review was done, aiming to identify the common barriers and potential solutions to implementing UFPP in Iran. Second, a qualitative study using semi-structured interviews was conducted to investigate the views of decision- and policy-makers regarding barriers to and solutions for implementing the UFPP in the Fars province over the last decade. The findings were classified using the five control knobs framework (organization, financing, payment, regulation, and behavior). The most common barriers to UFPP were: 1) organization (ununited stewardship function of the Ministry of Health, weak management and planning, inadequate training of human resources, and a weak referral system); 2) financing (fragmented insurance funds, insufficient financial resources, and instability of financial resources); 3) payment (inappropriate payment mechanisms and delay in payments); 4) regulation (cumbersome laws and unclear laws); and 5) behavior (cultural problems and conflict of interests). On the other hand, several solutions were identified to improve the implementation of UFPP, including: enhancing the role of government; improving the referral system; providing comprehensive training for UFPP providers; considering sustainable financial resources; moving towards mixed-payment mechanisms; employing appropriate legal and regulatory frameworks; enhancing community awareness; and elevating incentive mechanisms. Our research found that, despite the UFPP having been in place for a decade in Iran, there are still significant challenges in all five components. Therefore, the promotion of this program requires solving the existing implementation challenges in order to achieve the predetermined goals. The ideas in this study can be used to improve the current program in Fars Province and bring it to other cities in Iran.

English

This paper reviews the existing and emerging perspectives on fair value accounting (FVA) in the context of the stewardship function of financial reporting. This study draws on diverse research threads and theoretical notions to advance a comprehensive assessment of existing FVA research in the context of the trade-off between decision-usefulness and the stewardship objective. By conducting a narrative literature review, the authors identify two distinct domains of literature: FVA- a result of a conceptual shift in financial reporting; and FVA- an enhancement of decision-usefulness in general-purpose financial reporting. This study posits that FVA can be considered as an evolutionary, rather than revolutionary, development in financial reporting measurement which emerged from financialisation and globalisation of economies. It is further suggested that the ability of FVA to provide stewardship-relevant information may be reduced due to the emphasis it places on the provision of decision-useful information for investment purposes. Therefore, the authors call for a greater engagement between policy-setters and researchers when choosing conceptual underpinnings for financial measurement objectives.   Key words: Fair value accounting, stewardship function, decision usefulness, IFRS 13.

Business in times of crisis

Government bailouts of corporate sectors in the COVID-19 crisis are part of a tripartite arrangement between government, business and institutional investors. Business should respond to the changing preferences of customers, employees and societies by identifying value propositions that justify the provision of risk capital by institutional investors. Critical to this is the determination and implementation of corporate purposes by owners and board directors that focus on inter-generational horizons. Family owners are particularly well placed to do this, but institutional investors need to make it part of their stewardship function as well. Measurement is key and significant reforms are required in the areas of accounting, valuation and reporting. Consistent with these observations, companies that had strong environmental, social and governance records performed better during the initial stages of the crisis, as did family owned firms and those that avoided high levels of leverage prior to the crisis.

Quo vadis development: assessing the livelihood of indigenous people’s communities in Malaysia and the potential for community-based conservation effort

New development activity brings its various impacts for indigenous people often prompting their relocation to a new area. The 1977’s relocation of indigenous people in Royal Belum, Perak State, Malaysia, as part of its rural spatial development, questions on their livelihood in a new resettlement area and their relationship with nature within the current context of development. Despite the provision of basic facilities and infrastructure and the introduction of mono-crop cultivation and agriculture for the indigenous people, they are still practicing the ‘slash and burn’ method and performing their nomadic forest-based lifestyle. This contributes to their living below the poverty line. This present study explains the coexistence of indigenous people in the context of physical development vis-a-vis conservation effort in the Royal Belum. As neglected issue of interactions and conflicts between indigenous peoples and biodiversity conservation, this study outlined the potential of indigenous people’s community-based practices based on the factors: (1) self-belonging of Royal Belum Forest; (2) biodiversity conservation concerns; (3) sustainable development supporter; and (4) wildlife concerns. The indigenous people close relationship with the nature offers a unique stewardship function for co-creation and co-management practices of community-based sustainable ecotourism and agriculture for further enhancement of their livelihood. This effort will support the socio-economic of national physical spatial plan as well as the co-development of conservation of Royal Belum world natural heritage.

The Issues of Arts Governance in Australia and Implications - Focusing on Conflicts of Interests and Diversity

본 연구는 이해관계의 충돌 방지와 다양성의 이슈들을 중심으로 호주의 비영리 예술기관의 거버넌스와 리더십의 발전 과정을 살펴본다. 1980년대 중반부터 이루어진 호주의 공공부문 혁신과 예술기관의 전문화는 지역사회의 청지기로부터 에이전시, 자원 의존, 이해관계자의 혼합된 기능으로 예술 거버넌스의 역할에 변화를 가져왔다. 개인의 이익과 기관의 이익 간의 충돌은 기관을 위험에 빠트릴 수 있는 거버넌스의 일부로, 거버넌스에 있어 성과(performance)와 규율 부합성(conformance)에 대한 집중 외에도, 예술기관에 특수한 감성과 열정이 제어되어야 함을 시사한다. 예술기관이 관계를 맺는 지역사회를 반영하여야 하는 필요성에서 출발한 거버넌스의 다양성 구현은 이해관계자의 신뢰를 얻음으로써 기관의 평판을 구축하고 투자를 유치하는 데 핵심적인 조건이 되고 있으나, 거버넌스의 장애로 작용할 위험도 내포한다. 향후 예술 거버넌스의 구조와 구성, 규제 뿐 아니라 거버넌스의 실제 과정과 역동(dynamics)을 연구함으로써 국내 예술기관 거버넌스의 취약한 저변을 강화시킬 수 있을 것으로 기대된다.This study examines the development of nonprofit arts organizations’ governance and leadership in Australia, focusing on the issues of conflicts of interests and diversity. The Australian government reform and professionalization of the arts during the mid-eighties brought about the shift in arts governance, from a stewardship function of community leaders to a mix of agency, resource-dependency and stakeholder functions. The conflicts of individual interests and organizational interests constitute a part of governance, implying that passion in arts governance should be harnessed on top of the focus on the performance and conformance. Starting from the need to reflect the communities to which art institutions relate, the realization of diversity in governance is a key condition for building an institution s reputation and attracting investment by garnering stakeholders’ trust, while running a risk of being a barrier to governance. The future study on processes and dynamics of arts boards – board strategy, performance and behavior - in addition to the analyses on the structure and composition, and regulations of the boards will contribute to strengthening the fundamentals of arts governance in Korea.

Status of Human resources management in Iran's health sector and the path to development: A qualitative study.

Background: Resource generation, stewardship, financing, and provision of health care services are 4 major functions of the health system. In this study, human resource management, as a vital aspect of resource generation, was studied and some interventions have been suggested for Iran. Methods: This was a mixed method study. Data were collected through the review of the relevant articles and government documents, interviews with human resources managers and experts in the health sector, and focus group discussions with selected authorities. The interview questions were based on a model proposed by the WHO. Results: The collected data were categorized into 3 broad sets: description of the current status, factors contributing to the current status, and suggested interventions for improvement. Lack of a comprehensive human resources management policy and inattention to the human resources management in the developmental plans are some of the most common problems in Iran’s health sector. Also, unequal distribution, unemployment, migration of graduates, and inadequate and ineffective participation of faculty members in universities are some other problems referred to as lack of a unified stewardship and dearth of a comprehensive human resources planning. Suggested interventions have focused on stewardship function of the health care system. Conclusion: A policy brief on the human resources for health needs should be developed and added as a separate article to the upstream documents of the country (eg, Iran’s 20-year outlook plan). Implementing and monitoring operational plans for policy execution at Ministry of health has a major role in executing the adopted strategies.

Take Stock Bali Island as the Potential of Biosphere Reserve Site

Adopting biosphere reserves, BRs in the area with local protected area and international designated area will embrace the community involvement to support its biosphere stewardship function. It is argued that the community with a strong social capital as well as strong traditional ecological knowledge and culture will contribute to strengthen the conservation efforts by providing more opportunity at the local level through the specific zonation of the UNESCO Man And Biosphere, MAB program. By using the Bali Island as a case study, the study analyses to what extent the potential of Bali island as a Biosphere Reserves, BRs site by take stock the natural resources, governance of the conservation park as well as the human cultural and social capital aspect. The latest has been recognised as crucial element to develop social enterprise and entrepreneurs as stated in the Lima Action plan to deliver Sustainable Development Goals, SDGs 2030 in BRs site. Hence, the paper found out the three sites in Bali island, the two are the important international designated sites; the Bali island cultural landscape as a manifestation of Tri Hita Karana in Subak system by United Nations Educational, Scientific and Cultural Organization, UNESCO World Heritage Site and the West Bali National Park protected area category II by the International Union for Conservation Nature, IUCN and the last is the national park of Monkey Forest in Ubud as the initial assessment of take stock Bali BRs. Nevertheless, the study found the manifestation of Balinese philosophy, Tri Hita Karana or ‘Three Sources of Wellbeing’ which represents the existence pluralistic collectivism actions at the local level has potential to accommodate the adaptive governance crucial to manage the commons in biosphere reserve. Finally, the paper came up with the conceptual model of proposed Bali BRs that accommodate the natural capital as well as the social capital in zonation concept of BRs. However, further detail study on the ecosystem services functions and sustainable livelihood need to be conducted to support the nomination of Bali Island as the future biosphere reserve.

Public involvement in health research systems: a governance framework

BackgroundGrowing interest in public involvement in health research has led to organisational and policy change. Additionally, an emerging body of policy-oriented scholarship has begun to identify the organisational and network arrangements that shape public involvement activity. Such developments suggest the need to clearly conceptualise and characterise public involvement in health research in terms of governance.MethodsWe drew on an established health research system framework to analyse governance functions related to public involvement, adapting scoping review methods to identify evidence from a corpus of journal papers and policy reports. We drew on the logics of aggregation and top down configuration, using a qualitative interpretive approach to combine and link findings from different studies into framework categories.ResultsWe identified a total of 32 scholarly papers and 13 policy reports (n = 45 included papers) with relevance to governance for public involvement. Included papers were broadly consonant in identifying the need for activity to specify and support public involvement across all four governance functions of stewardship, financing, creating and sustaining resources, and research production and use. However, different visions for public involvement, and the activity required to implement it and achieve impact, were particularly evident with respect to the stewardship function, which seeks to set overall directions for research while addressing the potentially competing demands of a system’s many constituents.ConclusionsA governance perspective has considerable value for public involvement in health research systems, supporting efforts to coordinate and institutionalise the burgeoning public involvement enterprise. Furthermore, it highlights challenges for what is, ultimately, a highly political intervention, suggesting that diverse publics must be both involved within health research systems and enrolled as governors of them.

Accounting for the male domination through legislative empowerment of upper-middle class women in the early nineteenth century Spain

PurposeThe purpose of this paper is to address both the neglect of non-Anglo-centric accounting gendered practices beyond the predominant professional setting and the controversial roles of women and accounting in power relationships inside the household. Analyzing a Spanish upper-middle class Catholic family in the early nineteenth century, the research focuses on the reciprocal interaction of accounting with practices and processes of daily life in a rigid patriarchal socio-cultural and juridical context.Design/methodology/approachThis microhistory draws upon several archives, including in Spain the Archivo Histórico Provincial de Cádiz. In England, the Bath Record Office has preserved documents and correspondence, both personal and business related, and the Worcester Record Office preserved notarial documents concerning the family. The large number of letters which have survived has facilitated an in-depth study of the people who were affected by accounting calculations.FindingsIn a juridical context where women were conceived as merely the means for the circulation of property between two families, the evidence shows that accounting provided the proof of women’s patrimony value and the means to facilitate their recovery in this cosification process. Although women had a little involvement in the household’s accounting and management, they demonstrated confidence in accounting, fulfilling a stewardship function for the resources received. Also, evidence shows that by using accounting practices to shield supposedly defenseless women, this reinforced male domination over women and promoted the view that the role of women was as an ornament and in need of a good husband.Originality/valueContrasting with the Anglo-Saxon contemporary context, the Spanish law preserved a woman’s property rights, guaranteeing recovery of properties owned by her before marriage should the marriage be legally annulled or be dissolved because one of the spouses’ death. This required a detailed accounting of the wife’s properties brought to her marriage, most especially regarding the dowry provided by her family.

Pharmacists\u2019 views and reported practices in relation to a new generic drug substitution policy in Lebanon: a mixed methods study

BackgroundGovernments in both developed and developing countries have adopted generic drug substitution policies to decrease pharmaceutical expenditures and improve access to medicine. In August 2015, the Ministry of Public Health (MOPH) in Lebanon introduced generic drug substitution and a unified medical prescription form as policy instruments to promote generic drug use. The objective of this exploratory study was to examine the attitudes of community pharmacists and the reported practices in relation to the implementation of the new generic drug substitution policy.MethodsWe used a cross-sectional mixed methods approach composed of self-administered questionnaires and semi-structured interviews. The study population consisted of community pharmacists in Lebanon. We randomly approached one pharmacy personnel from each selected community pharmacy. We conducted descriptive analyses to assess responses to questionnaire and regression analyses to understand associations between responses and respondent demographics. We analyzed qualitative data thematically.ResultsOut of 204 invited community pharmacies, 153 pharmacies participated (75% response rate). The majority of respondents (64%) were in favor of generic drug substitution; however, less than half (40%) indicated they have substituted brand drugs for generic equivalents. Moreover, 57% indicated that the existing pricing system discourages them from performing generic drug substitution. Most respondents indicated that physicians are overusing the “non-substitutable” option (84%) and that there are technical problems with processing the new prescription form (78%). Less than half (47%) reported that the MOPH is performing regular audits on the forms collected by the pharmacy. While 45% of the respondents indicated that consumers have accepted most of the generic substitutions, 21% perceived the increase in generic drug dispensing to be significant. Findings suggested a potentially significant association between being informed about generic drugs and respondents’ support of the policy. Suggested strategies to address implementation challenges included strengthening stewardship function of MOPH, securing full commitment of health care providers, conducting educational and awareness campaigns about generic drugs and generic drug substitution, and aligning incentive systems of the key stakeholders.ConclusionsThe majority of community pharmacists were supportive of generic drug substitution in general but not of the current implementation of the policy in Lebanon. Findings revealed implementation challenges at the provider, patient, and system level which are hindering attainment of the policy objectives. The key lessons derived from this study can be used for continuous improvement of the policy and its implementation.

Le programme national de lutte contre le VIH/sida renforce-t-il les hôpitaux de district au Cameroun ?

The aim of this study was to investigate the effects of the national HIV/AIDS control programme on district hospitals in Cameroon. A multiple case study was conducted in two district hospitals- one public and one faith-based. Data were collected by document review, semi-structured interviews and observation of managerial processes and health care delivery. Programme interventions result in a series of positive and negative effects on the functioning of district hospitals and local health systems. High input and support of staff skills were observed for antiretroviral therapy and the management of opportunistic infections. However, the impact of the programme on the stewardship function is problematic. The low implication of district management teams in the implementation of HIV /AIDS activities reduces their structural capacity to run the local health systems. Programme and health system managers failed to take advantage of opportunities to develop synergies between the HIV/AIDS programme and local health systems. The HIV/AIDS programme weakens the systemic and structural capacity of local health systems. Managers of both programmes and general health systems should analyse and adapt their interventions in order to effective' strengthen health systems. One of the research questions is to understand why health system stakeholders do not seize opportunities to develop synergies between programmes and the general system and to strengthen health systems.

Health Care Inequalities between Italy and Germany: An Econometric Analysis

The phenomenon that life expectancy and health status could differ across socioeconomic groups is called 'health inequalities' and is evident in today's societies. Reasons for their existence could be that there are, inter alia, obstacles in access to medical services and that patients' actual need in lower classes remains unmet. Therefore, the institutional design of the health care system could be decisive in reducing health care inequalities and thus also in reducing health inequalities in general. This paper aims at contributing to the historical question which health system is best in reducing health disparities, a national health system (NHS) or a social health insurance system (SHI), in short: Beveridge or Bismarck? Italy and Germany are chosen as objects of comparison. The literature analysis will find that Italy has a strong gatekeeping system, while Germany has not yet achieved the goal of universal coverage. Furthermore, both systems do not fully correspond to the model system described in the literature and carry traits of the respective other system and are thus assimilating. From the econometric analysis in section 5 the conclusion can be drawn that there are no differences in health outcomes between both countries. This does not mean that there are no disparities in health care utilization within respective socioeconomic groups. By analogy, section 4 examines health inequalities in Italy and Germany revealing disparities related to socioeconomic status within both countries. In order to tackle the existing inequalities, a universal strategy should be adopted, that includes also family, environmental, labor market and economic policy, following the stewardship function of the health system.

Framework for assessing stewardship of the oral health system in Islamic Republic of Iran

This study designed a framework for assessing the stewardship function of the oral health system in Islamic Republic of Iran. The modified RAND Corporation/University of California Los Angeles (RAND-UCLA) Appropriateness Method was used in a 2-step process that combined literature evidence and the collective judgement of experts. After a comprehensive literature review, policy instruments related to stewardship components were extracted as candidate standards and categorized according to the 6 sub-functions of stewardship (accountability; defining strategic direction; alignment of policy objectives and organizational structure; regulation; intersectoral leadership; and generation of intelligence). Five key informants then rated the appropriateness of the 85 standards on a 5-point Likert scale. The 38 highest ranked standards, including at least 2 standards in each of the 6 sub-functions, formed a set of proposed standards for evaluating the current stewardship of oral health system. Piloting of the instrument will be reported separately.

Blue Ocean Strategy: A Panacea to the Menace of Bureaucratic Corruption in Nigeria

The misplacement of official interest for personal benefit that has characterized the Nigeria bureaucratic settings has in no small way curtailed the extent to which national development is achieved. Blue ocean strategy represents an alternative approach to the conduct of public business in such a way it blocks all the major avenues for looting public treasury as well as the enhancement of effective and efficient service delivery. Exploring the current failures in our health institutions it appears that numerous factors have continued to militate against their effective service quality. Despite the huge amount of money voted yearly for the development of the health sector in the national budget, the sector has remained a mere shadow of itself. This paper adopts a stratified sampling technique and use questionnaire to extract response from the respondents. The result of the analysis reveals that the level of corrupt practices in the health sector has led to the diversion of fund from the procurement of medical equipment to private pockets, hence the inadequacies of medical equipment in the various public health institutions.). It is therefore recommended that stewardship function and improved management support system should be incorporated in the activities of the public service.

Strategies for Private Sector Participation in Child Healthcare: A Meta Analysis of Empirical Findings

A large number of households in developing countries seeks child health care services from the private sector. Despite this, policy makers have largely ignored it while developing health policies. Without an effective stewardship of government, the technical quality of child healthcare services provided by the private sector has generally remained poor. In this context, there is a growing consensus that a better match between the role of public and private sectors and their respective capabilities needs to be established. In such a redefined role, the public sector would largely perform a stewardship function and create an environment in which the private sector can help the state achieve its goals in the health sector. This raises a number of policy issues: how governments can fulfill their stewardship function in the context of child health, how they can work with the existing private sector to improve the effectiveness of child health services, and how they can encourage further private sector participation in the delivery of child health care services. Policy makers and analysts usually possess little knowledge or understanding of the private sector. In addition, the strategies and instruments to harness and grow the private sector for the achievement of child health objectives are not widely studied, or understood. This paper provides an overview of reform strategies and instruments being utilized in developing countries to enhance the contribution of the private sector to child health care. 1.1 Objectives The paper uses an analytical framework to gather and analyze information about public-private partnership programs, the effectiveness of these programs, and to identify the areas for future work on public-private issues in child health care. The paper is based on a review of 130 relevant studies, both published and unpublished. 1.2 Analytical Framework The paper uses an analytical framework to help health policy makers and planners identify policies to: Work with the private sector to ensure that the services it provides meet health sector goals (harnessing the private sector); Create an environment that supports private sector growth consistent with child health goals (growing the private sector). Certain principles of public finance and institutional economics guide the public-private division of labor. These principles also set out the stewardship role of the public sector in guiding (the often much larger) private sector in financing and provision of child health services. These principles help clarify the rationale for effective mix of public and private sectors in health care goods and services and marking out their specific domains. According to these principles, a desirable division of labor between public and private sectors in health depends on whether markets can work properly (contestability), so that the private sector will produce positive results, and whether information is sufficiently available (measurability) to permit assessment of the effectiveness of services. When markets and information fail, governments must play a corrective role. When markets and information succeed, government can open space for private response to consumer demand. As these conditions differ from time to time and place to place, the relative roles and relations of private and public sectors must evolve as well (For detailed description of the framework and the associated principles see, Chakraborty and Harding, 2001 pp.5-8).

Capacity Development and Sustainable Development in Nigeria: Advancing the Resource-Based Argument.

The efficiency or otherwise of an organization and the competitive operations of getting thing done in the way and manner in which they were designed for the achievement of a set objective cannot be achieved without effective capacity development. Human capital development gives hope for the transformation of our institutional and individual components as well as the society in general from what it was to what it should be. The human capital is hereby entrusted with more challenging responsibilities and in it lies the centrality of the process of development, its capacity must be built on constant basis. This paper used survey research as a grand design, examined the human quality response to capacity building techniques in Nigeria, and used questionnaire to extract response from the respondents. The result of the analysis reveals that, the process of human capital development and capacity building in Nigeria faces allot of challenges ranging from institutional to environmental ones among others and concludes that improvement of human capital as a strategy of improving service quality or delivery of same, requires very solid institutional, statutory and economic base(s). It is therefore recommended that stewardship function and improved management support system should be incorporated in the activities of organizations through which human capital development, effective capacity building will combine to expedite positive adjustment in the character of services delivered as well as nature of clients and stakeholders satisfaction.