Browsing by Subject "Public-private partnership"

Background: Healthcare systems such as that of Rwanda face barriers in terms of infrastructural, financial, human, and technical resources. The value-based care framework offers an approach to examining health delivery systems facing resource-constraints and to highlight areas for greater progression towards maximizing impact on health outcomes given resource limitations. Methods: A qualitative approach was used to explore One Family Health’s care delivery model and its challenges and successes using value-based care as an underlying analytic framework. Primary data in the form of 8 qualitative semi-structured interviews were combined with secondary data from 14 previously conducted semi-structured interviews. Thematic analysis was applied to analyze the data. Results: Successes indicate OFH contribution to expanding access to care in Rwanda and challenges of the OFH health post model point to financing model and its relation to Rwanda’s recent financing changes. Quality of service delivery at the OFH health post approximately indicate strengths in patient-centeredness and equity and weaknesses in safety and efficiency. An anecdotal exploration of health outcomes suggest that individual patients improve as a result of visiting the health post and that the health post contributes to community wellbeing particularly in terms of health education and reducing the burden on health centers. Barring a small and biased sample, OFH nurses seem to be satisfied with the health post model, though their experience could be improved with routine training and increased supervision. Insights in integration and alignment in the context of the public-private partnership were also discussed. Conclusions: The One Family Health qualitative case study utilizing the value-based care framework offers several lessons for One Family Health, Rwanda Ministry of Health as it continues to contract with private sector entrepreneurs, and for further research that involves the application of the value-based care framework. These lessons include aligning its financial model with the aims of government financing initiatives, providing infrastructural and financial supports, and routine monitoring of health outcomes centered on patients as well as provider satisfaction and support.

The global diffusion of neoliberal economic policies is one of the most significant events in modern history. This research applies current knowledge on policy diffusion to the analysis of the diffusion of two major neoliberal urban policies among Chinese cities, namely land banking and privatization of urban infrastructures. Both policies are believed to have contributed greatly to the rapid growth of China's urban economy, and reflect the idea of capitalizing a city's tangible assets and utilizing market institutions to manage them so as to achieve economic gains.

Borrowing insights from existing diffusion theories developed by scholars from different background, this research explores the determinants of the policy innovation decisions by utilizing three theoretical models: (1) The internal determinants model, which presumes that the factors causing a local state to adopt a new policy are political, economic, and social characteristics of the local state. (2) The regional diffusion model, which posits that the geographical proximity affects diffusion by encouraging emulation and competition among neighboring states. (3) Institutional diffusion model, which proposes that a new policy may be adopted to prove the legitimacy of the organization, to cope with environment uncertainties by modeling others, to conform to the will of other organizations on which the adopters depend.

This study emphasizes the role of the Chinese states, both at the central and local levels, in building neoliberal market institutions. It pays particular attention to the effects of provincial governments' pressure, and shows that local states' dependency on higher level authorities has limited the effectiveness of such interventions. Moreover, I highlight the influence of horizontal intergovernmental relations, such as competition and emulation, on the diffusion processes, and argue that it is an important factor that has promoted the national-wide expansion of neoliberal policies. The results of this study enrich our understanding on how local policy makings are influenced by complex intergovernmental relations, and how do local states balance between local economic interests and political loyalty to higher levels when they formulate local development agenda.

Background: Outbreaks of infectious diseases such as Ebola have dramatic economic impacts on affected nations due to significant direct costs and indirect costs, as well as increased expenditure by the government to meet the health and security crisis. Despite its dense population, Nigeria was able to contain the outbreak swiftly and was declared Ebola free on 13th October 2014. Although Nigeria’s Ebola containment success was multifaceted, the private sector played a key role in Nigeria’s fight against Ebola. An epidemic of a disease like Ebola, not only consumes health resources but also detrimentally disrupts trade and travel to impact both public and private sector resulting in the ‘fearonomic’ effect of the contagion. In this thesis, I have defined ‘fearonomics’ or the ‘fearonomic effects’ of a disease as the intangible and intangible economic effects of both informed and misinformed aversion behavior exhibited by individuals, organizations, or countries during an outbreak. During an infectious disease outbreak, there is a significant potential for public-private sector collaborations that can help offset some of the government’s cost of controlling the epidemic.

Objective: The main objective of this study is to understand the ‘fearonomics’ of Ebola in Nigeria and to evaluate the role of the key private sector stakeholders in Nigeria’s Ebola response.

Methods: This retrospective qualitative study was conducted in Nigeria and utilizes grounded theory to look across different economic sectors in Nigeria to understand the impact of Ebola on Nigeria’s private sector and how it dealt with the various challenges posed by the disease and its ‘fearonomic effects'.

Results: Due to swift containment of Ebola in Nigeria, the economic impact of the disease was limited especially in comparison to the other Ebola-infected countries such as Liberia, Sierra Leone, and Guinea. However, the 2014 Ebola outbreak had more than a just direct impact on the country’s economy and despite the swift containment, no economic sector was immune to the disease’s fearonomic impact. The potential scale of the fearonomic impact of a disease like Ebola was one of the key motivators for the private sector engagement in the Ebola response.

The private sector in Nigeria played an essential role in facilitating the country’s response to Ebola. The private sector not only provided in-cash donations but significant in-kind support to both the Federal and State governments during the outbreak. Swift establishment of an Ebola Emergency Operation Centre (EEOC) was essential to the country’s response and was greatly facilitated by the private sector, showcasing the crucial role of private sector in the initial phase of an outbreak. The private sector contributed to Nigeria’s fight against Ebola not only by donating material assets but by continuing operations and partaking in knowledge sharing and advocacy. Some sector such as the private health sector, telecom sector, financial sector, oil and gas sector played a unique role in orchestrating the Nigerian Ebola response and were among the first movers during the outbreak.

This paper utilizes the lessons from Nigeria’s containment of Ebola to highlight the potential of public-private partnerships in preparedness, response, and recovery during an outbreak.