Related items
Showing items related by title, author, creator and subject.
-
The Political Economy of the Middle
 Class in the Dominican Republic : Individualization of
 Public Goods, Lack of Institutional Trust and Weak
 Collective ActionThis paper tries to uncover some of the
 hidden factors behind poor public service delivery in the
 Dominican Republic. By looking at three sector cases,
 education, health and electricity, it is possible to observe
 that in this setting of low quality of public services the
 "middle class" is opting out from the system and
 adopting private solutions to collective problems. The
 combination of this opting out behavior with low levels of
 institutional trust, especially among "middle
 class" members, fragmented interests and clientelism,
 among other factors, results in weak collective action and
 lack of effective demand for improvements in service
 provision. Some of the tentative policy options to break
 this sub-optimal equilibrium are i) to build capacity in
 civil society organizations and help them forming a
 pro-reform coalition, ii) reduce the gap between the middle
 class and the poorer by trying to improve the provision of
 public goods and enlarging the welfare state, and (iii)
 increase transparency mechanisms and introduce e-government
 formulas in order to optimize the allocation of public resources.
-
Uzbekistan - Assessment of the Primary Health Care Reform :
 Transparency, Accountability and EfficiencyThe main purpose of this report is to
 assess the degree to which progress has been made by the
 Government of Uzbekistan in increasing the transparency,
 accountability, and efficiency of its primary health
 services, and to identify what further steps could be taken
 to improve the effectiveness of delivery, some of which may
 be applicable to other sectors as well. The report examines
 public spending, public financial management, and human
 resource management and remuneration in the primary health
 care sector at the local level. It draws lessons from the
 experience of Ferghana and Samarkand, two oblasts that have
 implemented reforms in primary health care, and incorporates
 the findings drawn from other sources, such as public
 expenditure data, the laws and regulations governing these
 systems, and the Service Quality Delivery Survey (SQDS)
 conducted in 2007. This report discusses the key governance
 issues related to improving service delivery in the primary
 health care area, and concludes with recommendations
 tailored to decision makers at the central and local
 government levels and those in local facilities.
-
The Nuts & Bolts of Jamkesmas, Indonesia’s Government-Financed Health Coverage Program for the Poor and Near-PoorThis case study describes and assesses Jamkesmas, Indonesia's government-financed health coverage program for the poor and near-poor. It provides a detailed description of the scope, depth, and breadth of coverage provided under Jamkesmas, and highlights ways in which the program interacts with the rest of Indonesia's health system. It also summarizes and discusses evidence on whether Jamkesmas is attaining its stated objectives of removing financial barriers and improving access to health care by the poor and near-poor, what could be improved, and what lessons can be learned from the experience of Jamkesmas that could help inform Indonesia's quest for universal coverage. The primary theme underlying the study is that supply-side constraints and supply-side subsidies have not been leveraged to increase the effectiveness of the Jamkesmas program. There are significant geographic deficiencies in the availability and quality of the basic benefits package, especially for those living in relatively remote and rural locations of the country, and this limits the effective availability of benefits for many Jamkesmas beneficiaries. The remainder of the case study is organized as follows. Section two provides general background and information on health system outcomes in Indonesia. Section three is an overview of health care financing and delivery. Section four describes the institutional architecture of Jamkesmas. Section five highlights the process of targeting, identification, and enrolment of beneficiaries under the program. Section six focuses on the role of public financing. Section seven outlines the basic benefits package. Section eight provides an overview of the information environment of Jamkesmas. Section nine discusses the special theme of supply-side constraints and supply-side subsidies that dilute the effectiveness of the Jamkesmas program. Section ten discusses the pending agenda around some of the architectural and operational features of Jamkesmas in the context of universal coverage.