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Wyss Kaspar - One of the best experts on this subject based on the ideXlab platform.
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Who should decide for Local health services? A mixed methods study of preferences for decision-making in the decentralized Philippine health system
'Springer Science and Business Media LLC', 2020Co-Authors: Liwanag, Harvy Joy, Wyss KasparAbstract:The Philippines decentralized government health services through devolution to Local governments in 1992. Over the years, opinions varied on the impact of devolved governance to decision-making for Local health services. The objective of this study was to analyze decision-makers' perspectives on who should be making decisions for Local health services and on their preferred structure of health service governance should they be able to change the situation.; We employed a mixed methods approach that included an online survey in one region and in-depth interviews with purposively-selected decision-makers in the Philippine health system. Study participants were asked about their perspectives on decision-making in the functions of planning, health financing, resource management, human resources for health, health service delivery, and data management and monitoring. Analysis of survey results through visualization of data on charts was complemented by the themes that emerged from the qualitative analysis of in-depth interviews based on the Framework Method.; We received 24 online survey responses and interviewed 27 other decision-makers. Survey respondents expressed a preference to shift decision-making away from the Local Politician in favor of the Local health officer in five functions. Most survey participants also preferred re-centralization. Analysis of the interviews suggested that the preferences expressed were likely driven by an expectation that re-centralization would provide a solution to the perceived politicization in decision-making and the reliance of Local governments on central support.; Rather than re-centralize the health system, one policy option for consideration for the Philippines would be to maintain devolution but with a revitalized role for the central level to maintain oversight over Local governments and regulate their decision-making for the functions. Decentralization, whether in the Philippines or elsewhere, must not only transfer decision-making responsibility to Local levels but also ensure that those granted with the decision space could perform decision-making with adequate capacities and could grasp the importance of health services
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Who should decide for Local health services? A mixed methods study of preferences for decision-making in the decentralized Philippine health system
'Springer Science and Business Media LLC', 2020Co-Authors: Liwanag, Harvy Joy, Wyss KasparAbstract:Background: The Philippines decentralized government health services through devolution to Local governments in 1992. Over the years, opinions varied on the impact of devolved governance to decision-making for Local health services. The objective of this study was to analyze decision-makers’ perspectives on who should be making decisions for Local health services and on their preferred structure of health service governance should they be able to change the situation. Methods: We employed a mixed methods approach that included an online survey in one region and in-depth interviews with purposively-selected decision-makers in the Philippine health system. Study participants were asked about their perspectives on decision-making in the functions of planning, health financing, resource management, human resources for health, health service delivery, and data management and monitoring. Analysis of survey results through visualization of data on charts was complemented by the themes that emerged from the qualitative analysis of in-depth interviews based on the Framework Method. Results: We received 24 online survey responses and interviewed 27 other decision-makers. Survey respondents expressed a preference to shift decision-making away from the Local Politician in favor of the Local health officer in five functions. Most survey participants also preferred re-centralization. Analysis of the interviews suggested that the preferences expressed were likely driven by an expectation that re-centralization would provide a solution to the perceived politicization in decision-making and the reliance of Local governments on central support. Conclusions: Rather than re-centralize the health system, one policy option for consideration for the Philippines would be to maintain devolution but with a revitalized role for the central level to maintain oversight over Local governments and regulate their decision-making for the functions. Decentralization, whether in the Philippines or elsewhere, must not only transfer decision-making responsibility to Local levels but also ensure that those granted with the decision space could perform decision-making with adequate capacities and could grasp the importance of health services
Liwanag, Harvy Joy - One of the best experts on this subject based on the ideXlab platform.
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Who should decide for Local health services? A mixed methods study of preferences for decision-making in the decentralized Philippine health system
'Springer Science and Business Media LLC', 2020Co-Authors: Liwanag, Harvy Joy, Wyss KasparAbstract:The Philippines decentralized government health services through devolution to Local governments in 1992. Over the years, opinions varied on the impact of devolved governance to decision-making for Local health services. The objective of this study was to analyze decision-makers' perspectives on who should be making decisions for Local health services and on their preferred structure of health service governance should they be able to change the situation.; We employed a mixed methods approach that included an online survey in one region and in-depth interviews with purposively-selected decision-makers in the Philippine health system. Study participants were asked about their perspectives on decision-making in the functions of planning, health financing, resource management, human resources for health, health service delivery, and data management and monitoring. Analysis of survey results through visualization of data on charts was complemented by the themes that emerged from the qualitative analysis of in-depth interviews based on the Framework Method.; We received 24 online survey responses and interviewed 27 other decision-makers. Survey respondents expressed a preference to shift decision-making away from the Local Politician in favor of the Local health officer in five functions. Most survey participants also preferred re-centralization. Analysis of the interviews suggested that the preferences expressed were likely driven by an expectation that re-centralization would provide a solution to the perceived politicization in decision-making and the reliance of Local governments on central support.; Rather than re-centralize the health system, one policy option for consideration for the Philippines would be to maintain devolution but with a revitalized role for the central level to maintain oversight over Local governments and regulate their decision-making for the functions. Decentralization, whether in the Philippines or elsewhere, must not only transfer decision-making responsibility to Local levels but also ensure that those granted with the decision space could perform decision-making with adequate capacities and could grasp the importance of health services
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Who should decide for Local health services? A mixed methods study of preferences for decision-making in the decentralized Philippine health system
'Springer Science and Business Media LLC', 2020Co-Authors: Liwanag, Harvy Joy, Wyss KasparAbstract:Background: The Philippines decentralized government health services through devolution to Local governments in 1992. Over the years, opinions varied on the impact of devolved governance to decision-making for Local health services. The objective of this study was to analyze decision-makers’ perspectives on who should be making decisions for Local health services and on their preferred structure of health service governance should they be able to change the situation. Methods: We employed a mixed methods approach that included an online survey in one region and in-depth interviews with purposively-selected decision-makers in the Philippine health system. Study participants were asked about their perspectives on decision-making in the functions of planning, health financing, resource management, human resources for health, health service delivery, and data management and monitoring. Analysis of survey results through visualization of data on charts was complemented by the themes that emerged from the qualitative analysis of in-depth interviews based on the Framework Method. Results: We received 24 online survey responses and interviewed 27 other decision-makers. Survey respondents expressed a preference to shift decision-making away from the Local Politician in favor of the Local health officer in five functions. Most survey participants also preferred re-centralization. Analysis of the interviews suggested that the preferences expressed were likely driven by an expectation that re-centralization would provide a solution to the perceived politicization in decision-making and the reliance of Local governments on central support. Conclusions: Rather than re-centralize the health system, one policy option for consideration for the Philippines would be to maintain devolution but with a revitalized role for the central level to maintain oversight over Local governments and regulate their decision-making for the functions. Decentralization, whether in the Philippines or elsewhere, must not only transfer decision-making responsibility to Local levels but also ensure that those granted with the decision space could perform decision-making with adequate capacities and could grasp the importance of health services
Signy Irene Vabo - One of the best experts on this subject based on the ideXlab platform.
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New Organisational Solutions in Norwegian Local Councils: Leaving a Puzzling Role for Local Politicians?
Scandinavian Political Studies, 2000Co-Authors: Signy Irene VaboAbstract:Inspired by the concept of New Public Management, recent organisational alterations in Norwegian Local councils have aimed to change the role of Local Politicians from a traditional to a strategic political one. Traditionally, Local Politicians have been involved in the day-to-day activities of the council, and have tended to address single issues and details. Strategic leadership implies, however, a withdrawal from close contact with the service departments and a primary focus on (preferably pivotal) issues of a general and/or principle nature, such as budgeting, goal setting, and planning. In addition, establishment of stronger coordinating bodies is emphasised. Drawing on evidence from a large body of research, it is concluded that so far, for the ordinary Local Politician, the new role is rather puzzling, that is, confusing and perplexing, thus creating a certain sense of uneasiness. Two theoretical reasons for this state of affairs are presented. First, it is demonstrated that some of the chosen organisational solutions simply cannot be assumed to work as intended. Second, it is argued that the concept of strategic political leadership represents such a challenge to the Local Politicians’ traditional behaviour that a certain amount of reluctance and prevarication is to be expected. The article concludes with a discussion of why the changes have taken place in several municipalities, despite the demonstrable weaknesses in the basic idea. One suggested reason is the improvements to the working conditions of the political and administrative elite as a result of the changes.
Adrián Lucardi - One of the best experts on this subject based on the ideXlab platform.
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Jumping Ship or Jumping on the Bandwagon: When Do Local Politicians Support National Candidates?
Political Science Research and Methods, 2019Co-Authors: Guillermo Rosas, Adrián LucardiAbstract:AbstractLocal Politicians are often expected to mobilize voters on behalf of copartisan candidates for national office. Yet this requirement is difficult to enforce because the effort of Local Politicians cannot be easily monitored and the promise of rewards in exchange for help is not fully credible. Using a formal model, we show that the incentives of Local Politicians to mobilize voters on behalf of their party depend on the proportion of copartisan officials in a district. Having many copartisan officials means that the party is more likely to capture the district, but the effort of each Local Politician is less likely either to be noticed by higher-level officials or to make a difference on the election outcome, thus discouraging lower-level officials from exerting effort. We validate these claims with data from federal elections in Mexico between 2000 and 2012. In line with the argument, the results show that political parties fail to draw great mobilization advantages from simultaneously controlling multiple offices.
Wester Teodor - One of the best experts on this subject based on the ideXlab platform.
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HJÄLP, vi krymper! En studie av anpassningsstrategier för en minskande befolkning i Strömsunds kommun
2020Co-Authors: Lundin Johanna, Wester TeodorAbstract:Samhällen som krymper demografiskt är ett globalt fenomen som medför en mängd utmaningar för kommunala beslutsfattare, inte minst ur en planeringsaspekt. Runt om i Europa kan partiella strategier för att hantera befolkningsminskning återfinnas – men finns det strategier som är generellt tillämpbara? För att besvara den frågan undersöks i den här studien hur en krympande kommun i Sverige hanterar och planerar för befolkningsminskningen. Detta görs genom en intervjustudie i kommunen Strömsund där individer på chef- och ledningsnivå i kommunen intervjuas. Resultatet visar att det för närvarande inte finns tillräckligt många - eller tillräckligt distinkta - strategier för varken Strömsund eller andra demografiskt krympande samhällen. En anledning till detta är att anpassning är politiskt svårt; demografisk minskning blir därför politiskt sett enklare att hantera än att aktivt planera för. Många av de befintliga strategierna föreföll platsspecifika och beroende av den lokala geografiska kontexten såväl som begränsade av nationella lagar och regler. Tänkbara framtida strategier kan därför vara avhängiga policyförändringar där lagar och regler - snarare än att vara unisona - baseras på territoriella och geografiska förutsättningar. Ett behov av mer kunskap identifierades, i synnerhet gällande hur strategier för ’smart krympning’ kan appliceras. En slutsats är att ett skifte verkar pågå i vilket tillväxt inte längre ses som den självklara lösningen för alla samhällen. Istället framhålls att en större utjämning av förutsättningar mellan det urbana och det rurala kan vara viktigare för utvecklingen i krympande samhällen. Detta då livskvalitet och hållbara livsstilar värderas allt högre och dessutom möjliggörs genom ytterligare digitalisering av samhället.The global phenomenon of demographically shrinking communities presents challenges for planning authorities. A few partial strategies trying to address this can be found throughout Europe, but are there more universally appliable ones? In this study, we aim to find that out by the means of an interview study in the shrinking municipality of Strömsund, where public servants are interviewed in order to understand how the municipality is tackling the challenge and plan for shrinkage. The results emphasize that this is a tricky question to address, especially as a Local Politician. As of now, there are not as many or as distinct strategies as potentially is needed in neither Strömsund nor for demographically shrinking communities in general, and one of the reasons is that demographic shrinkage is politically easier to manage reactively rather than to actively plan for. The interviewed public servants are all interested in how strategies for smart shrinkage can be applied and a need for more knowledge was apparent. Many strategies were found to be place specific and dependent on the Local geography as well as bound by laws and regulations. As a result, in this study we discuss conceivable strategies together with a need for laws based on territorial and geographical preconditions. We conclude that there appears to be a shift underway, where growth may not always be seen as the answer, but rather an equalization between urban and rural where quality of life and sustainable living are seen as increasingly important