1,720,979 research outputs found
Institutional pluralism and interorganisational relations in local health care provision in Uganda: Institutionalised pathologies or healing organisations?
No full textThis thesis is an examination of health care provision in Uganda by means of a case study in Kamuli District. In Uganda, the response to political and economic breakdown in the 1970s has been the spontaneous, decentralised emergence of a pluralist, but fragmented system made up of public, private and voluntary sector providers. While theorists and policy-makers previously placed almost exclusive emphasis on state health care provision, they now favour a system of institutional pluralism. This approach attempts to use the particular advantages attributed to each type of provider to meet diverse needs and conditions. The thesis undertakes a comparative performance analysis of each sector in relation to access, efficient use of resources and quality of care to determine each provider's relative strengths. While the public sector performs worst, the other two sectors also suffer from performance gaps. An institutional analysis is used to explain the differences in (mal-)performance. First, the thesis assesses the intraorganisational institutional mechanisms of each provider type and their ability of ensuring accountability, financial responsibility and appropriate staff incentives. Secondly, it examines the nature of interorganisational interactions and the effectiveness of the governance mechanisms for the co-ordination and regulation of the system as a whole and illuminates how these affect organisational performance. The study demonstrates that the intraorganisational institutional set-up, the governance mechanisms and the interorganisational interactions are characterised by a lack of accountability and therefore are constantly distorted through the operation of perversive incentives. These institutionalised pathologies, especially in the public sector, affect performance negatively. It is argued that a system characterised by institutional pluralism is superior. However, to benefit from its full potential and to heal organisations and put them in a position to heal, it is necessary to manage the intraorganisational and interorganisational dimensions simultaneously and to strengthen accountability mechanisms and the actors' capacities and willingness to co-operate
Institutional pluralism and interorganisational relations in local health care provision in Uganda: Institutionalised pathologies or healing organisations?
Full text linkThis thesis is an examination of health care provision in Uganda by means of a case study in Kamuli District. In Uganda, the response to political and economic breakdown in the 1970s has been the spontaneous, decentralised emergence of a pluralist, but fragmented system made up of public, private and voluntary sector providers. While theorists and policy-makers previously placed almost exclusive emphasis on state health care provision, they now favour a system of institutional pluralism. This approach attempts to use the particular advantages attributed to each type of provider to meet diverse needs and conditions. The thesis undertakes a comparative performance analysis of each sector in relation to access, efficient use of resources and quality of care to determine each provider's relative strengths. While the public sector performs worst, the other two sectors also suffer from performance gaps. An institutional analysis is used to explain the differences in (mal-)performance. First, the thesis assesses the intraorganisational institutional mechanisms of each provider type and their ability of ensuring accountability, financial responsibility and appropriate staff incentives. Secondly, it examines the nature of interorganisational interactions and the effectiveness of the governance mechanisms for the co-ordination and regulation of the system as a whole and illuminates how these affect organisational performance. The study demonstrates that the intraorganisational institutional set-up, the governance mechanisms and the interorganisational interactions are characterised by a lack of accountability and therefore are constantly distorted through the operation of perversive incentives. These institutionalised pathologies, especially in the public sector, affect performance negatively. It is argued that a system characterised by institutional pluralism is superior. However, to benefit from its full potential and to heal organisations and put them in a position to heal, it is necessary to manage the intraorganisational and interorganisational dimensions simultaneously and to strengthen accountability mechanisms and the actors' capacities and willingness to co-operate
The role of institutional design and organizational practice for health financing performance and universal coverage
No full textMany low- and middle income countries heavily rely on out-of-pocket health care expenditure. The challenge for these countries is how to modify their health financing system in order to achieve universal coverage. This paper proposes an analytical framework for undertaking a systematic review of a health financing system and its performance on the basis of which to identify adequate changes to enhance the move towards universal coverage. The distinctive characteristic of this framework is the focus on institutional design and organizational practice of health financing, on which health financing performance is contingent. Institutional design is understood as formal rules, namely legal and regulatory provisions relating to health financing; organizational practice refers to the way organizational actors implement and comply with these rules. Health financing performance is operationalized into nine generic health financing performance indicators. Inadequate performance can be caused by six types of bottlenecks in institutional design and organizational practice. Accordingly, six types of improvement measures are proposed to address these bottlenecks. The institutional design and organizational practice of a health financing system can be actively developed, modified or strengthened. By understanding the incentive environment within a health financing system, the potential impacts of the proposed changes can be anticipated.Health financing system assessment Institutional and organizational analysis Health financing performance
The role of institutional design and organizational practice for health financing performance and universal coverage
No full textAbstract: Many low- and middle income countries heavily rely on out-of-pocket health care expenditure. The challenge for these countries is how to modify their health financing system in order to achieve universal coverage. This paper proposes an analytical framework for undertaking a systematic review of a health financing system and its performance on the basis of which to identify adequate changes to enhance the move towards universal coverage. The distinctive characteristic of this framework is the focus on institutional design and organizational practice of health financing, on which health financing performance is contingent. Institutional design is understood as formal rules, namely legal and regulatory provisions relating to health financing; organizational practice refers to the way organizational actors implement and comply with these rules. Health financing performance is operationalized into nine generic health financing performance indicators. Inadequate performance can be caused by six types of bottlenecks in institutional design and organizational practice. Accordingly, six types of improvement measures are proposed to address these bottlenecks. The institutional design and organizational practice of a health financing system can be actively developed, modified or strengthened. By understanding the incentive environment within a health financing system, the potential impacts of the proposed changes can be anticipated
Feasibility assessment and financial projection results for a social health insurance scheme in Lesotho: exploring possible options
No full textCoûts de l'administration dans les systèmes d'assurance maladie (caractérisation des difficultés limitant leur analyse et les comparaisons internationales)
No full textSTRASBOURG-Medecine (674822101) / SudocSudocFranceF
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
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