International Journal of Public Policy and Administration Research

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No. 2

The Promise and Reality of Public Sector Reform – A Case Study of the Implementation of Trinidad and Tobagos Health Sector Reform

Pages: 94-111
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The Promise and Reality of Public Sector Reform – A Case Study of the Implementation of Trinidad and Tobagos Health Sector Reform

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DOI: 10.18488/journal.74.2020.72.94.111

Jochelle Greaves Siew

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Jochelle Greaves Siew (2020). The Promise and Reality of Public Sector Reform – A Case Study of the Implementation of Trinidad and Tobagos Health Sector Reform. International Journal of Public Policy and Administration Research, 7(2): 94-111. DOI: 10.18488/journal.74.2020.72.94.111
This research examines the relationship between control mechanisms selected for use by central governments during the implementation of public sector reform and the successful implementation of said reform. This investigation is carried out in light of a case study, namely Trinidad and Tobago’s health sector reform. Previous research either offers a descriptive account of what conditions are necessary for perfect implementation or focuses on the debate between top-down and bottom-up approach supporters in terms of controlling implementation. Drawing on both sets of literature, this study goes further by offering insights into the importance of government control over public sector reform implementation by contributing a fresh perspective to existing research – recognition that the actions of the central government can constitute more important explanations for the outcome of public sector reform than those of the implementers. This paper presents relevant interdependent elements needed for determining what type of control mechanisms should be used to control implementing bodies, which include central acceptance of delegated tasks, balance between control and discretion, clear roles and performance goals that accurately reflect policy intent, objective measurement and effective monitoring, and a simple implementation structure. It is found that control mechanisms need to be planned and performed in light of the intent and performance goals of the reform in order for said reform to be successful. These findings provide policymakers with knowledge on how control mechanisms can be better employed in order to improve the performance of the public sector under the reform.
Contribution/ Originality
This study provides an original investigation into how governments can better select and employ control mechanisms during policy implementation to improve the performance of public sectors under reform. It further demonstrates that central governments actions constitute more significant explanations for outcomes of public sector reform than those of its implementers.

Assessing Access to Comprehensive HIV Treatment Services for Men Who Have Sex with Men and Female Sex Workers in the Bamenda Health District

Pages: 79-93
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Assessing Access to Comprehensive HIV Treatment Services for Men Who Have Sex with Men and Female Sex Workers in the Bamenda Health District

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DOI: 10.18488/journal.74.2020.72.79.93

Sundjo Fabien , Fokam Ijang Pamella

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Adedotum, O. (2016). Barriers, motivators, facilitators related to engagement in HIV care among Ghanian men who have sex with men(MSM) living with HIV:A qualitative study. Public Health Theses, 1215.Available at: https://elischolar.library.yale.edu/ysphtdl/1215.

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Sundjo Fabien , Fokam Ijang Pamella (2020). Assessing Access to Comprehensive HIV Treatment Services for Men Who Have Sex with Men and Female Sex Workers in the Bamenda Health District. International Journal of Public Policy and Administration Research, 7(2): 79-93. DOI: 10.18488/journal.74.2020.72.79.93
Having access to quality health and specifically access to comprehensive HIV treatment services is a human right for everyone irrespective of age, sex, gender and sexual orientation. The main objective of this research was to investigate the determinants of access to HIV treatment for Female Sex Workers and Men Having sex with Men in the Bamenda Health district. Specifically, the study aimed at investigating the drivers of non-accessibility to HIV treatment services for Men having sex with Men and Female sex workers and also to scrutinize the drivers of non-accessibility to HIV treatment services for Men having sex with Men and Female sex workers in the Bamenda Health district. To assess treatment access, 20 and 25 questionnaires were administered to HIV positive FSW and MSM respectively. Data was analyzed using descriptive statistics, Chi-square, Bivariate and Multivariate regressions. The descriptive analysis showed that 44.0% and 65% of MSM and FSW respectively have access to HIV treatment services. MSM and FSW with lower incomes face economic barriers though higher incomes at some point for the VIP FSW are instead a barrier to access CBOs for services. Another barrier to treatment is long distance to health facility for MSM as those who live further away are less likely to access HIV treatment services. Long waiting time at health facility was also found to be significant and hence a barrier to treatment access. None of the demographic factors were significant for FSW and MSM. Thus for access to be effective, actors should take these key issues into consideration.
Contribution/ Originality
This study is one of very few studies which have investigated the determinants of access to HIV treatment for Female Sex Workers and Men Having sex with Men in Cameroon while employing descriptive statistics, Chi-square, Bivariate and Multivariate regressions.

The Reasons Behind the Shift of Patients from Public to Private Hospitals: Evidence from Public Hospitals in Cumilla City Corporation

Pages: 69-78
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The Reasons Behind the Shift of Patients from Public to Private Hospitals: Evidence from Public Hospitals in Cumilla City Corporation

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DOI: 10.18488/journal.74.2020.72.69.78

Md. Hasanur Rahman , Shapan Chandra Majumder , Md. Zuwel Rana

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Md. Hasanur Rahman , Shapan Chandra Majumder , Md. Zuwel Rana (2020). The Reasons Behind the Shift of Patients from Public to Private Hospitals: Evidence from Public Hospitals in Cumilla City Corporation. International Journal of Public Policy and Administration Research, 7(2): 69-78. DOI: 10.18488/journal.74.2020.72.69.78
Health care services involve improving our health necessities. Public hospitals play a vital role to provide health services to the people. The private sector also comes forward and working with hand to hand with the government. This study investigates the reasons behind the patient's shift from public to private hospitals at Cumilla City Corporation (CuCC) in Bangladesh. This study has found that the total numbers of physicians are very few compared to demand in government hospitals which are why the time consideration to prescribe a patient is quite poor. The behavior of physicians, nurses and other staff accelerates the patient shift in private hospitals. The environmental quality of the public hospital is also an important reason for the patient's shift to private hospitals. Distance between household and public hospitals also a major barrier to adequate services of the public hospital. The current study contributes to assures the importance of public health care services to the stakeholders of the study.
Contribution/ Originality
This study is the first attempt to contribute in the literature by investigating the reasons behind the patient's shift from public to private hospitals at Cumilla City Corporation (CuCC) in Bangladesh.

Fiscal Decentralization and Economic Growth: Assessing Public Policy in Ukraine

Pages: 58-68
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Fiscal Decentralization and Economic Growth: Assessing Public Policy in Ukraine

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DOI: 10.18488/journal.74.2020.72.58.68

Kovalchuk Anna , Zhang Donghui

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Kovalchuk Anna , Zhang Donghui (2020). Fiscal Decentralization and Economic Growth: Assessing Public Policy in Ukraine. International Journal of Public Policy and Administration Research, 7(2): 58-68. DOI: 10.18488/journal.74.2020.72.58.68
The purpose of the study is to attempt to ascertain the primary influences affecting the regional economic growth in developing countries. The research took place on the data panel of 24 provinces in Ukraine over four years under a non-linear fixed effect framework. The paper shows that population growth fosters economic efficiency. Revenue decentralization is negatively related to per capita gross regional product (per cap GRP). By so, produces a relatively high, positive, but not-significant effect under non-linear specifications; on the contrary, per capita GRP growth declines as local revenue increases under fixed-effects. As such, the research proves that findings directly rely on the model selected; however, institutional conditions matter. The business environment reforms, surprisingly, detrimentally influence regional economic growth. The economic conditions in Ukraine are hard to specify as a direct result of fiscal decentralization (FD). Hence, various impacts of non-economic considerations can contribute to regional economic growth degrees, as well. Finally, the results are by no means as satisfactory as would be expected, and additional work is clearly desirable.
Contribution/ Originality
This study contributes to the existing literature on fiscal decentralization (FD) based on its relations with regional economic growth in developing countries. The paper contributes the first logical analysis on the data-set that covers the period from the launching FD up to now considering economic and social crisis. The paper's primary contribution is empirical confirmation revenue decentralization detrimentally impacts per capita GRP in Ukraine.