Browsing by Subject "Governance"
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- ItemOpen AccessBook review of Shaping the African Savanna by Michael Bollig(2022-03-01) Hoffman, M TBook details Bollig, M, Shaping the African Savannah: from Capitalist frontier to Arid Eden in Namibia. Cambridge: Cambridge University Press; 2020. 404 pages, hardback, ISBN 9781108488488
- ItemOpen AccessA call to advance and translate research into policy on governance, ethics, and conflicts of interest in public health: the GECI-PH network(2021-01-25) Nakkash, Rima; Mialon, Melissa; Makhoul, Jihad; Arora, Monika; Afifi, Rima; Al Halabi, Abeer; London, LeslieEfforts to adopt public health policies that would limit the consumption of unhealthy commodities, such as tobacco, alcohol and ultra-processed food products, are often undermined by private sector actors whose profits depend on the sales of such products. There is ample evidence showing that these corporations not only try to influence public health policy; they also shape research, practice and public opinion. Globalization, trade and investment agreements, and privatization, amongst other factors, have facilitated the growing influence of private sector actors on public health at both national and global levels. Protecting and promoting public health from the undue influence of private sector actors is thus an urgent task. With this backdrop in mind, we launched the “Governance, Ethics, and Conflicts of Interest in Public Health” Network (GECI-PH Network) in 2018. Our network seeks to share, collate, promote and foster knowledge on governance, ethical, and conflicts of interest that arise in the interactions between private sectors actors and those in public health, and within multi-stakeholder mechanisms where dividing lines between different actors are often blurred. We call for strong guidance to address and manage the influence of private sector actors on public health policy, research and practice, and for dialogue on this important topic. Our network recently reached 119 members. Membership is diverse in composition and expertise, location, and institutions. We invite colleagues with a common interest to join our network.
- ItemOpen AccessDevolution and its effects on health workforce and commodities management – early implementation experiences in Kilifi County, Kenya(BioMed Central, 2017-09-15) Tsofa, Benjamin; Goodman, Catherine; Gilson, Lucy; Molyneux, SassyBackground: Decentralisation is argued to promote community participation, accountability, technical efficiency, and equity in the management of resources, and has been a recurring theme in health system reforms for several decades. In 2010, Kenya passed a new constitution that introduced 47 semi-autonomous county governments, with substantial transfer of responsibility for health service delivery from the central government to these counties. Focusing on two key elements of the health system, Human Resources for Health (HRH) and Essential Medicines and Medical Supplies (EMMS) management, we analysed the early implementation experiences of this major governance reform at county level. Methods: We employed a qualitative case study design, focusing on Kilifi County, and adapted the decision space framework developed by Bossert et al., to guide our inquiry and analysis. Data were collected through document reviews, key informant interviews, and participant and non-participant observations between December 2012 and December 2014. Results: As with other county level functions, HRH and EMMS management functions were rapidly transferred to counties before appropriate county-level structures and adequate capacity to undertake these functions were in place. For HRH, this led to major disruptions in staff salary payments, political interference with HRH management functions and confusion over HRH management roles. There was also lack of clarity over specific roles and responsibilities at county and national government, and of key players at each level. Subsequently health worker strikes and mass resignations were witnessed. With EMMS, significant delays in procurement led to long stock-outs of essential drugs in health facilities. However, when the county finally managed to procure drugs, health facilities reported a better order fill-rate compared to the period prior to devolution. Conclusion: The devolved government system in Kenya has significantly increased county level decision-space for HRH and EMMS management functions. However, harnessing the full potential benefits of this increased autonomy requires targeted interventions to clarify the roles and responsibilities of different actors at all levels of the new system, and to build capacity of the counties to undertake certain specific HRH and EMMS management tasks. Capacity considerations should always be central when designing health sector decentralisation policies.
- ItemOpen AccessDevolution and its effects on health workforce and commodities management – early implementation experiences in Kilifi County, Kenya(2017) Tsofa, Benjamin; Goodman, Catherine; Gilson, Lucy; Molyneux, SassyBACKGROUND: Decentralisation is argued to promote community participation, accountability, technical efficiency, and equity in the management of resources, and has been a recurring theme in health system reforms for several decades. In 2010, Kenya passed a new constitution that introduced 47 semi-autonomous county governments, with substantial transfer of responsibility for health service delivery from the central government to these counties. Focusing on two key elements of the health system, Human Resources for Health (HRH) and Essential Medicines and Medical Supplies (EMMS) management, we analysed the early implementation experiences of this major governance reform at county level. METHODS: We employed a qualitative case study design, focusing on Kilifi County, and adapted the decision space framework developed by Bossert et al., to guide our inquiry and analysis. Data were collected through document reviews, key informant interviews, and participant and non-participant observations between December 2012 and December 2014. RESULTS: As with other county level functions, HRH and EMMS management functions were rapidly transferred to counties before appropriate county-level structures and adequate capacity to undertake these functions were in place. For HRH, this led to major disruptions in staff salary payments, political interference with HRH management functions and confusion over HRH management roles. There was also lack of clarity over specific roles and responsibilities at county and national government, and of key players at each level. Subsequently health worker strikes and mass resignations were witnessed. With EMMS, significant delays in procurement led to long stock-outs of essential drugs in health facilities. However, when the county finally managed to procure drugs, health facilities reported a better order fill-rate compared to the period prior to devolution. CONCLUSION: The devolved government system in Kenya has significantly increased county level decision-space for HRH and EMMS management functions. However, harnessing the full potential benefits of this increased autonomy requires targeted interventions to clarify the roles and responsibilities of different actors at all levels of the new system, and to build capacity of the counties to undertake certain specific HRH and EMMS management tasks. Capacity considerations should always be central when designing health sector decentralisation policies.
- ItemOpen AccessA global theory of justice for new governance : from process to substance with 'parity of participation'(2014) Hermann, Martin; Von Broembsen, MarleseThis thesis proposes a new counter-narrative to the neo-liberal agenda that combines two seemingly disparate bodies of work: New Governance and Nancy Fraser’s theory of justice. New Governance is a new and rapidly growing strand of legal thought and practi ce that has simultaneously developed a following in Europe and the United States. In short, legal scholars in this field of research are advocating a shift away from long-standing command-style, fixed-rule regulation toward more collaborative, bottom-up, and flexible modes of regulation.
- ItemOpen AccessPracticing governance towards equity in health systems: LMIC perspectives and experience(BioMed Central, 2017-09-15) Gilson, Lucy; Lehmann, Uta; Schneider, HelenThe unifying theme of the papers in this series is a concern for understanding the everyday practice of governance in low- and middle-income country (LMIC) health systems. Rather than seeing governance as a normative health system goal addressed through the architecture and design of accountability and regulatory frameworks, these papers provide insights into the real-world decision-making of health policy and system actors. Their multiple, routine decisions translate policy intentions into practice – and are filtered through relationships, underpinned by values and norms, influenced by organizational structures and resources, and embedded in historical and socio-political contexts. These decisions are also political acts – in that they influence who accesses benefits and whose voices are heard in decision-making, reinforcing or challenging existing institutional exclusion and power inequalities. In other words, the everyday practice of governance has direct impacts on health system equity. The papers in the series address governance through diverse health policy and system issues, consider actors located at multiple levels of the system and draw on multi-disciplinary perspectives. They present detailed examination of experiences in a range of African and Indian settings, led by authors who live and work in these settings. The overall purpose of the papers in this series is thus to provide an empirical and embedded research perspective on governance and equity in health systems.
- ItemOpen AccessResources, attitudes and culture: an understanding of the factors that influence the functioning of accountability mechanisms in primary health care settings(BioMed Central Ltd, 2013) Cleary, Susan; Molyneux, Sassy; Gilson, LucyBACKGROUND: District level health system governance is recognised as an important but challenging element of health system development in low and middle-income countries. Accountability is a more recent focus in health system debates. Accountability mechanisms are governance tools that seek to regulate answerability between the health system and the community (external accountability) and/or between different levels of the health system (bureaucratic accountability). External accountability has attracted significant attention in recent years, but bureaucratic accountability mechanisms, and the interactions between the two forms of accountability, have been relatively neglected. This is an important gap given that webs of accountability relationships exist within every health system. There is a need to strike a balance between achieving accountability upwards within the health system (for example through information reporting arrangements) while at the same time allowing for the local level innovation that could improve quality of care and patient responsiveness. METHODS: Using a descriptive literature review, this paper examines the factors that influence the functioning of accountability mechanisms and relationships within the district health system, and draws out the implications for responsiveness to patients and communities. We also seek to understand the practices that might strengthen accountability in ways that improve responsiveness - of the health system to citizens' needs and rights, and of providers to patients. RESULTS: The review highlights the ways in which bureaucratic accountability mechanisms often constrain the functioning of external accountability mechanisms. For example, meeting the expectations of relatively powerful managers further up the system may crowd out efforts to respond to citizens and patients. Organisational cultures characterized by supervision and management systems focused on compliance to centrally defined outputs and targets can constrain front line managers and providers from responding to patient and population priorities. CONCLUSION: Findings suggest that it is important to limit the potential negative impacts on responsiveness of new bureaucratic accountability mechanisms, and identify how these or other interventions might leverage the shifts in organizational culture necessary to encourage innovation and patient-centered care.
- ItemOpen AccessStrategies to overcome challenges when implementing an Enterprise Engineering Innovation Life-cycle(2018) Du Toit Francois; Tanner MaureenThe delivery of innovative IT solutions that support business strategy is an increasing, growing competitive aspect of organisations in the financial sector. Previous research has shown the need to follow an innovative or a more agile and flexible methodology when delivering IT solutions to save cost and enable the solutions to reach the consumer market as soon as possible. To apply agile/innovative methodologies across large organisations requires more alternative approaches than to implement them in small enterprises. The organisation used in the case study, implemented an enterprise engineering innovative lifecycle (EEILC). Limited research has been done concerning the challenges and strategies during implementation of an EEILC. The purpose of this study was to investigate the strategies to overcome the challenges when implementing an EEILC. The research was inductive qualitative following an in-depth case study approach. The researcher conducted a case study using documentation analysis, informal interviews, in-depth interviews and observations with multiple stakeholders who are experts in their fields of software design and development. An inductive grounded theory approach was followed using a case study within an organisation in the financial sector in South Africa. Results show there are seven core category challenges when implementing an innovation life cycle. Each of these core challenges has a core enterprise strategy to address the challenges occurring in the applicable domain. The core challenges are: (1) innovation process challenges (addressed by an agile product delivery innovation strategy) (2) invention challenges (addressed by an idea management strategy) (3) business model challenges (addressed by a client’s value proposition strategy), (4) commercialization challenges, which include implementation and operations challenges, (addressed by a product portfolio management strategy), (5) culture challenges (addressed by an innovation culture strategy) and (6) knowledge management challenges and strategy, and (7) innovation management related challenges and strategy An innovation management strategy will manage all these challenges. Most prominent is the innovation management strategy which has links to all other categories in other domains. The relationship between enterprise client value proposition strategy show that enterprise client value proposition serves as a coherent link between how the innovation life cycle is adopted or changed to address the enterprise client value chain. This is driven by demand management to align between business and IT regarding the business model and application portfolio alignment. Thereafter, the alignment between the demand for enterprise application capabilities and the business service portfolio is shown. This is supported by service-oriented architecture (SOA) services. The resource management has to make sure the right resources, competencies and skills are available to deliver the product portfolio. During innovation and life-cycle's execution, there is a lot of interaction between individuals and teams. Therefore, communication and culture play a vital role to create synergies by collaboration of work practice and living the values of the organization. Through grounded theory analysis, a practical theory was developed, to show how challenges that occur during implementation of an innovation life-cycle, based upon enterprise engineering principles, can be addressed by best by putting the right strategies in place. This theory contributes to the body of knowledge by providing data and analysis from practical insight into how an innovation life cycle can be implemented. The challenges thereof and the mitigating strategies make it work. This study also suggested the key re best practices for enterprise architecture driving such an implementation. The research is an area of interest for development or customizing an Innovation Life-cycle using an Enterprise Engineering Framework.