Publication:
New Trends in Public Sector Management in Health : Applications in Developed and Developing Countries

Loading...
Thumbnail Image
Files in English
English PDF (1.43 MB)
528 downloads
English Text (263.18 KB)
95 downloads
Published
2004-09
ISSN
Date
2013-06-04
Editor(s)
Abstract
This paper begins with a review of the broad motivations behind the New Public Sector Management (NPSM), including intrinsic differences between public and private organizations that appear to impact on incentives and performance. The experience in selected OECD countries is reviewed where the financing and delivery of health and other social services is heavily socialized with a strong public sector role, taxpayers have expressed dissatisfaction with traditional modes of public sector management, and NPSM reforms have been hotly debated. Part II of the paper then describes the NPSM paradigm in terms of three building blocks that influence the performance of public agencies and the behaviors of employees who work for them. It explains how leverage points within the NPSM paradigm are expected to create incentives for improved performance. It is when all three building blocks of the NPSM paradigm work together that synergies are expected to take place, and that continuous improvements in the performance of public agencies are expected to be generated over time. Part III illustrates five organizational strategies that can be used to introduce NPSM into public agencies in the national health system. Much of Part III refers to developing country applications.
Link to Data Set
Citation
Shaw, R. Paul. 2004. New Trends in Public Sector Management in Health : Applications in Developed and Developing Countries. Health, Nutrition and Population (HNP) discussion paper;. © World Bank. http://hdl.handle.net/10986/13752 License: CC BY 3.0 IGO.
Associated URLs
Associated content
Report Series
Other publications in this report series
Journal
Journal Volume
Journal Issue

Related items

Showing items related by metadata.

  • Publication
    Background Study for the National Strategy on Social Inclusion and Poverty Reduction, 2015-2020
    (World Bank, Bucharest, 2015-10-15) Tesliuc, Emil; Grigoras, Vlad; Stanculescu, Manuela
    The background study for the national strategy on social inclusion and poverty reduction 2015-2020 was produced under a RAS agreement with the Ministry of Labor, Family, Social Protection, and Elderly of Romania. The report is a companion volume of the strategy, adopted by the Romanian Government in May 2015, and summarizes the diagnostics and analyses carried out by the World Bank team to provide a sound empirical base for the strategy. Given the multi-dimensional nature of poverty, the report includes diagnostics and policy recommendations on employment, social protection, education, health, housing, social participation, as well as regional and rural development policies. The document is based on a combination of desk research, qualitative data analysis, new data collected by the World Bank team and analyses of administrative, census, and survey data. This included qualitative research (for example, case-studies in two counties, interviews with representatives of central governmental bodies, interviews with recipients and eligible potential beneficiaries of means-tested benefits and with social workers), and quantitative data collection and analysis (a census on social housing stock; census of frontline social workers; a consolidated database of physicians, representatives of the pharmacies, community nurses, and health mediators; administrative dataset with social services for elderly, social services for people with disabilities and specialized child protection services; analysis of poverty. The book is organized in four parts. The first part starts with an analysis of the trends in poverty and social exclusion over the past few years and with a poverty forecast for the next five years (2015 to 2020). The second part analyzes the sectoral policies that must be implemented to tackle the problems identified in the first part of the volume. The third part turns its focus to area-based policies and discusses regional disparities, urban-rural differences, and specific problems in small towns and villages, rural, and urban marginalized areas, and Roma and non-Roma communities. The fourth part discusses the actions needed to strengthen the capacity of the public system to reduce poverty and increase social inclusion.
  • Publication
    Political Economy of Infrastructure Spending in India
    (2010-09-01) Khemani, Stuti
    This paper examines a puzzle in the political economy of infrastructure in India -- the co-existence of relatively low shares of capital spending in public budgets alongside evidence of large demand for village infrastructure from poor voters. It argues that this pattern is due to infrastructure projects being used at the margin for political rent-seeking, while spending on employment and welfare transfers are the preferred vehicles to win votes for re-election. New suggestive evidence on the variation of public spending composition across states, and within states over time is offered that is consistent with this argument. This evidence underscores a growing argument in the development literature that the level and composition of public spending per se may not be sufficient metrics to assess the quality of public goods policies -- greater infrastructure spending in some contexts may go to political rents rather than to the actual delivery of broad public goods for growth and poverty reduction.
  • Publication
    Health Financing Reform in Thailand : Toward Universal Coverage under Fiscal Constraints
    (World Bank,Washington DC, 2013-01) Hanvoravongchai, Piya
    Thailand's model of health financing and its ability to rapidly expand health insurance coverage to its entire population presents an interesting case study. Even though it is still a middle-income country with limited fiscal resources, the country managed to reach universal health insurance coverage through three main public schemes: the Universal Coverage Scheme (UCS), the Social Security Scheme (SSS), and the Civil Servant Medical Benefit Scheme (CSMBS). The UCS, which is the largest and most instrumental scheme in the expansion of coverage to the poor and to those in the informal sector, is the focus of this report. It describes the nuts and bolts of the UCS as a key component of the health financing system in Thailand. It analyzes Thailand's experience in health insurance coverage expansion within limited fiscal constraints through various mechanisms to contain costs. It also explores the two commonly discussed approaches for the universal coverage movement: the expansion model (starting from covering the poor and formal sector to universal coverage) and the comprehensive approach (covering the entire population at the same time).
  • Publication
    Democratic Republic of the Congo Poverty and Social Impact Analysis : Mine Sector Reform
    (Washington, DC, 2007-06) World Bank
    Although the initial impetus for this poverty and social impact analysis (PSIA) was to inform the Gecamines retrenchment program, it quickly became evident during the scoping that the policy issues fell into two broad categories: a) Short term which involved the key issues of inquiry focusing on what the impact of this program might be, how to mitigate negative effects, and, according to the standard methodology for PSIA, whether the alternatives to restructuring were better or worse than the reform itself. Accordingly, a central question concerned the degree to which Gecamines' degradation had already caused adjustments in income and services and whether the alternative of not restructuring would have been preferable; and b) Medium term which stressed plans to restructure the sector included re-centering on the company's core activity and competency (ore extraction and production of copper and cobalt metal), and minimizing its role as a social service provider. The DRC Government had set a timetable of 2 years for this transfer, but viable options for the future provision of these services still had yet to be defined. Upstream work on the degree to which Gecamines' financial collapse has affected the provision of these ancillary services (and therefore the degree of impact from such a shift), as well as the design of mitigatory mechanisms and institutional options was essential as part of the PSIA.
  • Publication
    Local Governance in Industrial Countries
    (Washington, DC: World Bank, 2006) Shah, Anwar
    Local government refers to specific institutions or entities created by national constitutions (Brazil, Denmark, France, India, Italy, Japan, Sweden), by state constitutions (Australia, the United States), by ordinary legislation of a higher level of central government (New Zealand, the United Kingdom, most countries), by provincial or state legislation (Canada, Pakistan), or by executive order (China) to deliver a range of specified services to a relatively small geographically delineated area. Local governance is a broader concept and is defined as the formulation and execution of collective action at the local level. Thus, it encompasses the direct and indirect roles of formal institutions of local government and government hierarchies, as well as the roles of informal norms, networks, community organizations, and neighborhood associations in pursuing collective action by defining the framework for citizen-citizen and citizen-state interactions, collective decision making, and delivery of local public services.

Users also downloaded

Showing related downloaded files

  • Publication
    Returns to Soft Skills Training in Rwanda
    (World Bank, Washington, DC, 2023-07-11) Brudevold-Newman, Andrew; Ubfal, Diego Javier
    Young adults seeking to enter the labor market often confront a skills mismatch with firms reporting difficulty finding new entrants with appropriate levels of soft skills. This paper reports findings from a randomized controlled trial in Rwanda in which recent graduates from tertiary education were randomly assigned to a two-week intensive soft skills training program developed and delivered by staff of the University of Rwanda. Results indicate that the program facilitated accelerated entry into the labor market in a period characterized by COVID-19-related disruptions. These effects dissipated over the following year as more jobs became available in the economy and the control group's employment caught up with that of the treatment group. The paper finds evidence of significant job network expansion for participants of the training, which could have led to faster labor market entry for the treated youth.
  • Publication
    World Bank East Asia and Pacific Economic Update, October 2025: Jobs
    (Washington, DC: World Bank, 2025-10-07) World Bank
    GDP growth in the East Asia and Pacific (EAP) region remains above the global average but is projected to slow down in 2025 and even further in 2026. The sluggishness is due to a less favorable external environment—rising trade restrictions, easing but still elevated global uncertainty, and slowing global growth—as well as persistent domestic difficulties. Today, many people are in low-productivity or informal jobs, and many of the young cannot find any jobs. The class of people vulnerable to falling into poverty is now larger than the middle class in most countries. In a region that thrived because export-oriented, labor-intensive growth created more productive jobs, firms must deal with higher tariffs and workers must contend with the growing use of robots, AI and digital platforms. More productive jobs would be created by reforms to enhance economic opportunity, human capacity and their virtuous interplay.
  • Publication
    Procuring Infrastructure Public-Private Partnerships Report 2018
    (World Bank, Washington, DC, 2018-04) World Bank
    Procuring Infrastructure PPPs 2018 assesses the regulatory frameworks and recognized good practices that govern PPP procurement across 135 economies, with the aim of helping countries improve the governance and quality of PPP projects. It also helps fill the private sector’s need for high-quality information to become a partner in a PPP project and finance infrastructure. Procuring Infrastructure PPPs 2018 builds on the success of the previous edition, Benchmarking PPP Procurement 2017, refining the methodology and scope based on guidance from experts around the world, as well as expanding its geographical coverage.
  • Publication
    Digital Africa
    (Washington, DC: World Bank, 2023-03-13) Begazo, Tania; Dutz, Mark Andrew; Blimpo, Moussa
    All African countries need better and more jobs for their growing populations. "Digital Africa: Technological Transformation for Jobs" shows that broader use of productivity-enhancing, digital technologies by enterprises and households is imperative to generate such jobs, including for lower-skilled people. At the same time, it can support not only countries’ short-term objective of postpandemic economic recovery but also their vision of economic transformation with more inclusive growth. These outcomes are not automatic, however. Mobile internet availability has increased throughout the continent in recent years, but Africa’s uptake gap is the highest in the world. Areas with at least 3G mobile internet service now cover 84 percent of Africa’s population, but only 22 percent uses such services. And the average African business lags in the use of smartphones and computers as well as more sophisticated digital technologies that catalyze further productivity gains. Two issues explain the usage gap: affordability of these new technologies and willingness to use them. For the 40 percent of Africans below the extreme poverty line, mobile data plans alone would cost one-third of their incomes—in addition to the price of access devices, apps, and electricity. Data plans for small- and medium-size businesses are also more expensive than in other regions. Moreover, shortcomings in the quality of internet services—and in the supply of attractive, skills-appropriate apps that promote entrepreneurship and raise earnings—dampen people’s willingness to use them. For those countries already using these technologies, the development payoffs are significant. New empirical studies for this report add to the rapidly growing evidence that mobile internet availability directly raises enterprise productivity, increases jobs, and reduces poverty throughout Africa. To realize these and other benefits more widely, Africa’s countries must implement complementary and mutually reinforcing policies to strengthen both consumers’ ability to pay and willingness to use digital technologies. These interventions must prioritize productive use to generate large numbers of inclusive jobs in a region poised to benefit from a massive, youthful workforce—one projected to become the world’s largest by the end of this century.
  • Publication
    Long-Run Impacts of China's WTO Accession on Farm-Nonfarm Income Inequality and Rural Poverty
    (World Bank, Washington, DC, 2003-05) Huang, Jikun; Anderson, Kym; Ianchovichina, Elena
    Many fear China's accession to the World Trade Organization (WTO) will impoverish its rural people by way of greater import competition in its agricultural markets. Anderson, Huang, and Ianchovichina explore that possibility bearing in mind that, even if producer prices of some (land-intensive) farm products fall, prices of other (labor-intensive) farm products could rise. Also, the removal of restrictions on exports of textiles and clothing could boost town and village enterprises, so demand for unskilled labor for nonfarm work in rural areas may grow even if demand for farm labor in aggregate falls. New estimates, from the global economywide numerical simulation model known as GTAP, of the likely changes in agricultural and other product prices as a result of WTO accession are drawn on to examine empirically the factor reward implications of China's WTO accession. The results suggest farm-nonfarm and Western-Eastern income inequality may well rise in China but rural-urban income inequality need not. The authors conclude with some policy suggestions for alleviating any pockets of farm household poverty that may emerge as a result of WTO accession.