Browsing by Subject "GOVERNMENT"

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  • Mozumder, Mohammad; Pyhälä, Aili; Wahab, Md. Abdul; Sarkki, Simo; Schneider, Petra; Islam, A.A. (2020)
    This paper considers the hilsa shad (Tenualosa ilisha) fishery of southern Bangladesh as a case study regarding governance and power dynamics at play in a small-scale fishery, and the relevance of these for the sustainable management of coastal fisheries. Qualitative methods, involving in-depth individual interviews (n = 128) and focus group discussions (n = 8) with key stakeholders in the hilsa fishery, were used to capture multiple perspectives on governance from those in different positions in the relative power structures studied, while facilitating insightful discussions and reflections. The analysis here is based on a power cube framework along three power dimensions (levels, spaces, and forms) in Bangladesh's hilsa fishery. The study displays an imbalance in the present hilsa governance structure, with some stakeholders exercising more power than others, sidelining small-scale fishers, and encouraging increasing illegal fishing levels that ultimately harm both the fisheries and those dependent on them. To overcome this, we propose a co-management system that can play a vital role in equalizing power asymmetry among hilsa fishery stakeholders and ensure effective hilsa fishery governance. Our results suggest that recognizing analyzed power dynamics has substantial implications for the planning and implementation of such co-management and the long-term sustainability of the hilsa fishery.
  • Marionneau, Virve; Egerer, Michael; Nikkinen, Janne (2021)
    Purpose of Review: This systematic literature review evaluates the potential of gambling monopolies to affect gambling harms. It compares the occurrence of gambling harms in jurisdictions with gambling monopolies to jurisdictions with license-based regimes. Recent Findings: The review identified 21 publications concerning three gambling-related harm indicators: problem gambling prevalence, total consumption, and the appearance of conflicts of interest. Due to the dearth of literature, concept papers and older publications were also included. Summary: Results show that there is a paucity of empirical research on the effectiveness of different regulatory regimes in affecting gambling harms. Available research demonstrates that monopolistic regimes appear to perform somewhat better in terms of problem gambling prevalence and total consumption but may also be more prone to conflicts of interest than license-based regimes. Monopolistic configurations also differ between themselves, and issues such as availability, accessibility, product range, scope of preventive work, monitoring, as well as the recognition of the public health approach may better predict the levels of harm in society than the existence of a monopoly.
  • Mattila, Vesa Mikko; Rapeli, Lauri (2018)
    This article explores two theoretical possibilities for why personal health may affect political trust: the psychological-democratic contract theory, and the role of personal experience in opinion formation. It argues that citizens with health impairments are more likely to experience the direct effects of political decisions as they are more dependent on public health services. Negative subjective evaluations of public services can lower trust levels, especially if people's expectations are high. Using European Social Survey data, the association between health and trust in 19 Western European states is analysed. The results indicate that people in poor health exhibit lower levels of trust towards the political system than people in good health. The differences in trust between those in good and poor health are accentuated among citizens with left-leaning ideological values. The results suggest that welfare issues may constitute a rare context in which personal, rather than collective, experiences affect opinion formation.
  • Fullman, Nancy; Barber, Ryan M.; Abajobir, Amanuel Alemu; Abate, Kalkidan Hassen; Abbafati, Cristiana; Abbas, Kaja M.; Abd-Allah, Foad; Abdulle, Abdishakur M.; Abera, Semaw Ferede; Aboyans, Victor; Abu-Raddad, Laith J.; Abu-Rmeileh, Niveen M. E.; Adedeji, Isaac Akinkunmi; Adetokunboh, Olatunji; Afshin, Ashkan; Agrawal, Anurag; Agrawal, Sutapa; Kiadaliri, Aliasghar Ahmad; Ahmadieh, Hamid; Ahmed, Muktar Beshir; Aichour, Amani Nidhal; Aichour, Ibtihel; Aichour, Miloud Taki Eddine; Aiyar, Sneha; Akinyemi, Rufus Olusola; Akseer, Nadia; Al-Aly, Ziyad; Alam, Khurshid; Alam, Noore; Alasfoor, Deena; Alene, Kefyalew Addis; Alizadeh-Navaei, Reza; Alkerwi, Ala'a; Alla, Francois; Allebeck, Peter; Allen, Christine; Al-Raddadi, Rajaa; Alsharif, Ubai; Altirkawi, Khalid A.; Alvis-Guzman, Nelson; Amare, Azmeraw T.; Amini, Erfan; Ammar, Walid; Antonio, Carl Abelardo T.; Ansari, Hossein; Anwari, Palwasha; Kivimaki, Mika; Meretoja, Atte; Meretoja, Tuomo J.; Weiderpass, Elisabete; GBD 2016 SDG Collaborators (2017)
    Background The UN's Sustainable Development Goals (SDGs) are grounded in the global ambition of "leaving no one behind". Understanding today's gains and gaps for the health-related SDGs is essential for decision makers as they aim to improve the health of populations. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016), we measured 37 of the 50 health-related SDG indicators over the period 1990-2016 for 188 countries, and then on the basis of these past trends, we projected indicators to 2030. Methods We used standardised GBD 2016 methods to measure 37 health-related indicators from 1990 to 2016, an increase of four indicators since GBD 2015. We substantially revised the universal health coverage (UHC) measure, which focuses on coverage of essential health services, to also represent personal health-care access and quality for several non-communicable diseases. We transformed each indicator on a scale of 0-100, with 0 as the 2.5th percentile estimated between 1990 and 2030, and 100 as the 97.5th percentile during that time. An index representing all 37 health-related SDG indicators was constructed by taking the geometric mean of scaled indicators by target. On the basis of past trends, we produced projections of indicator values, using a weighted average of the indicator and country-specific annualised rates of change from 1990 to 2016 with weights for each annual rate of change based on out-of-sample validity. 24 of the currently measured health-related SDG indicators have defined SDG targets, against which we assessed attainment. Findings Globally, the median health-related SDG index was 56.7 (IQR 31.9-66.8) in 2016 and country-level performance markedly varied, with Singapore (86.8, 95% uncertainty interval 84.6-88.9), Iceland (86.0, 84.1-87.6), and Sweden (85.6, 81.8-87.8) having the highest levels in 2016 and Afghanistan (10.9, 9.6-11.9), the Central African Republic (11.0, 8.8-13.8), and Somalia (11.3, 9.5-13.1) recording the lowest. Between 2000 and 2016, notable improvements in the UHC index were achieved by several countries, including Cambodia, Rwanda, Equatorial Guinea, Laos, Turkey, and China; however, a number of countries, such as Lesotho and the Central African Republic, but also high-income countries, such as the USA, showed minimal gains. Based on projections of past trends, the median number of SDG targets attained in 2030 was five (IQR 2-8) of the 24 defined targets currently measured. Globally, projected target attainment considerably varied by SDG indicator, ranging from more than 60% of countries projected to reach targets for under-5 mortality, neonatal mortality, maternal mortality ratio, and malaria, to less than 5% of countries projected to achieve targets linked to 11 indicator targets, including those for childhood overweight, tuberculosis, and road injury mortality. For several of the health-related SDGs, meeting defined targets hinges upon substantially faster progress than what most countries have achieved in the past. Interpretation GBD 2016 provides an updated and expanded evidence base on where the world currently stands in terms of the health-related SDGs. Our improved measure of UHC offers a basis to monitor the expansion of health services necessary to meet the SDGs. Based on past rates of progress, many places are facing challenges in meeting defined health-related SDG targets, particularly among countries that are the worst off. In view of the early stages of SDG implementation, however, opportunity remains to take actions to accelerate progress, as shown by the catalytic effects of adopting the Millennium Development Goals after 2000. With the SDGs' broader, bolder development agenda, multisectoral commitments and investments are vital to make the health-related SDGs within reach of all populations. Copyright The Authors. Published by Elsevier Ltd. This is an Open Access article published under the CC BY 4.0 license.
  • Global Burden Dis Hlth Financing (2018)
    Background Comparable estimates of health spending are crucial for the assessment of health systems and to optimally deploy health resources. The methods used to track health spending continue to evolve, but little is known about the distribution of spending across diseases. We developed improved estimates of health spending by source, including development assistance for health, and, for the first time, estimated HIV/AIDS spending on prevention and treatment and by source of funding, for 188 countries. Methods We collected published data on domestic health spending, from 1995 to 2015, from a diverse set of international agencies. We tracked development assistance for health from 1990 to 2017. We also extracted 5385 datapoints about HIV/AIDS spending, between 2000 and 2015, from online databases, country reports, and proposals submitted to multilateral organisations. We used spatiotemporal Gaussian process regression to generate complete and comparable estimates for health and HIV/AIDS spending. We report most estimates in 2017 purchasing-power parity-adjusted dollars and adjust all estimates for the effect of inflation. Findings Between 1995 and 2015, global health spending per capita grew at an annualised rate of 3.1% (95% uncertainty interval [UI] 3.1 to 3.2), with growth being largest in upper-middle-income countries (5.4% per capita [UI 5.3-5.5]) and lower-middle-income countries (4.2% per capita [4.2-4.3]). In 2015, $9.7 trillion (9.7 trillion to 9.8 trillion) was spent on health worldwide. High-income countries spent $6.5 trillion (6.4 trillion to 6.5 trillion) or 66.3% (66.0 to 66.5) of the total in 2015, whereas low-income countries spent $70.3 billion (69.3 billion to 71.3 billion) or 0.7% (0.7 to 0.7). Between 1990 and 2017, development assistance for health increased by 394.7% ($29.9 billion), with an estimated $37.4 billion of development assistance being disbursed for health in 2017, of which $9.1 billion (24.2%) targeted HIV/AIDS. Between 2000 and 2015, $562.6 billion (531.1 billion to 621.9 billion) was spent on HIV/AIDS worldwide. Governments financed 57.6% (52.0 to 60.8) of that total. Global HIV/AIDS spending peaked at 49.7 billion (46.2-54.7) in 2013, decreasing to $48.9 billion (45.2 billion to 54.2 billion) in 2015. That year, low-income and lower-middle-income countries represented 74.6% of all HIV/AIDS disability-adjusted life-years, but just 36.6% (34.4 to 38.7) of total HIV/AIDS spending. In 2015, $9.3 billion (8.5 billion to 10.4 billion) or 19.0% (17.6 to 20.6) of HIV/AIDS financing was spent on prevention, and $27.3 billion (24.5 billion to 31.1 billion) or 55.8% (53.3 to 57.9) was dedicated to care and treatment. Interpretation From 1995 to 2015, total health spending increased worldwide, with the fastest per capita growth in middle-income countries. While these national disparities are relatively well known, low-income countries spent less per person on health and HIV/AIDS than did high-income and middle-income countries. Furthermore, declines in development assistance for health continue, including for HIV/AIDS. Additional cuts to development assistance could hasten this decline, and risk slowing progress towards global and national goals. Copyright (c) 2018 The Author(s). Published by Elsevier Ltd.
  • Godenhjelm, Sebastian; Johanson, Jan-Erik (2018)
    The delivery of public services in collaborative agency networks has given rise to an increasing use of projects in administering policy and service delivery. Projects are assumed to provide mechanisms by which flexibility can be achieved and innovative solutions produced. The aim of the article is to advance the understanding of collaboration between stakeholders and its effect on innovation. It analyses stakeholders' influence on the creation of project innovations in 275 European Union-funded projects by using content analyses and logistic regression analyses. The results show that projects can act as hubs where valuable information is produced but that few projects produce innovations. Project stakeholder network, knowledge dissemination and project influence, as well as sources of advice, play a role in predicting project innovations. The article concludes that the overly optimistic view of collaboration as a remedy for a lack of innovation in the public sector can be questioned. Points for practitioners The results of the article help practitioners to compose public sector development projects that foster innovation. The results suggest that it pays to include representatives of research and education facilities among project staff as their inclusion predicts the possibilities of achieving innovations. The empirical findings provide insight into project innovation and indicate which practices to avoid. It is suggested that when managed correctly, stakeholder inclusion has an effect on public sector project innovation.
  • Global Burden Dis Hlth Financing (2018)
    Background Achieving universal health coverage (UHC) requires health financing systems that provide prepaid pooled resources for key health services without placing undue financial stress on households. Understanding current and future trajectories of health financing is vital for progress towards UHC. We used historical health financing data for 188 countries from 1995 to 2015 to estimate future scenarios of health spending and pooled health spending through to 2040. Methods We extracted historical data on gross domestic product (GDP) and health spending for 188 countries from 1995 to 2015, and projected annual GDP, development assistance for health, and government, out-of-pocket, and prepaid private health spending from 2015 through to 2040 as a reference scenario. These estimates were generated using an ensemble of models that varied key demographic and socioeconomic determinants. We generated better and worse alternative future scenarios based on the global distribution of historic health spending growth rates. Last, we used stochastic frontier analysis to investigate the association between pooled health resources and UHC index, a measure of a country's UHC service coverage. Finally, we estimated future UHC performance and the number of people covered under the three future scenarios. Findings In the reference scenario, global health spending was projected to increase from US$10 trillion (95% uncertainty interval 10 trillion to 10 trillion) in 2015 to $20 trillion (18 trillion to 22 trillion) in 2040. Per capita health spending was projected to increase fastest in upper-middle-income countries, at 4.2% (3.4-5.1) per year, followed by lower-middle-income countries (4.0%, 3.6-4.5) and low-income countries (2.2%, 1.7-2.8). Despite global growth, per capita health spending was projected to range from only $40 (24-65) to $413 (263-668) in 2040 in low-income countries, and from $140 (90-200) to $1699 (711-3423) in lower-middle-income countries. Globally, the share of health spending covered by pooled resources would range widely, from 19.8% (10.3-38.6) in Nigeria to 97.9% (96.4-98.5) in Seychelles. Historical performance on the UHC index was significantly associated with pooled resources per capita. Across the alternative scenarios, we estimate UHC reaching between 5.1 billion (4.9 billion to 5.3 billion) and 5.6 billion (5.3 billion to 5.8 billion) lives in 2030. Interpretation We chart future scenarios for health spending and its relationship with UHC. Ensuring that all countries have sustainable pooled health resources is crucial to the achievement of UHC. Copyright (c) 2018 The Author(s). Published by Elsevier Ltd.