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Public–private partnership (PPP) projects often end in early termination and the governments must compensate private-sector partners and take over project assets. Based on multicountry experience, this article proposes a systematic approach on when and how to compensate efficiently and fairly. A compensation model was first developed to quantify the amount paid to the private-sector partners when early termination occurs, and built upon that, an incentive model was proposed to analyze the incentives of both contracting parties. We then testified our propositions through two realistic cases. In line with the incomplete contract theory and the reference point theory, the findings demonstrate that the proposed compensation method increases the the private sector's incentives of relationship-specific investments, but discourages its efforts to prevent early termination in serious risk scenarios. This article not only contributes to the theoretical development of PPPs on contract design and incentive mechanisms, but also offers solutions for practitioners in the early termination of PPP projects.

Poor-quality remains a pervasive challenge for the delivery of large-scale transport infrastructure projects. Typically, it manifests as nonconformance and often requires rework. If, however, a nonconformance goes unidentified, then an asset's integrity can be jeopardized and put people's lives at risk. Hence, governments should shoulder the responsibility for quality. In practice, however, there has been a proclivity for governments to place fixed-price contracts and high-level quality risks on contractors. Yet, there is a dearth of research that has addressed the issue of poor-quality within large-scale transport infrastructure projects. In this article, we attempt to fill this gap and adopt an illustrative case-study approach to garner an understanding as to why poor-quality manifests during the construction of large-scale transport projects. We examine the issue of poor-quality in three high-profile rail transit projects using the gray literature: 1) Delhi Airport Metro Express (India); 2) Honolulu Rail Transit (United States); and 3) Sydney Skytrain (Australia). Then, drawing on empirical observations from two road projects, a highway corridor and a busway, we bring to the fore the poor-quality issue that pervades practice. To curb poor-quality, we suggest that the public and private sectors work collaboratively and share risks to ensure the benefits and value of an asset can be realized. To facilitate the process of collaboration and sharing of quality risks, we propose a Standard Life-cycle Quality Assessment system that can be used to ensure projects conform to standards and requirements.

Freight demand forecasting models used by federal, state, and local transportation agencies to predict future freight flows are often based on economic forecasts of industry growth and/or commodity production/consumption rates which are then used to estimate expected freight movement, e.g., truck volumes. Unfortunately, there is a lack of data connecting industry served and commodity carried to freight movements which limits the accuracy and usability of such models. While the private sector collects robust data on freight movements including commodity carried, when shared with the public sector, this data is anonymized to protect privacy. Thus, there is a critical need to re-identify industry served and commodity carried from anonymous freight movement data in ways that maintain privacy standards. To address this research gap, we developed a classification model using data mining and machine learning methods to predict industry served by a truck from daily activity patterns of trip and stop sequences extracted from truck Global Positioning System (GPS) data. A Weighted Random Forest (WRF) supervised machine learning model is used to predict five industry groups: farm products, mining materials, chemicals, manufactured goods, and miscellaneous mixed goods. The WRF model achieves 88% prediction accuracy and explicitly accounts for class imbalance. The model does not reveal fleet, driver, company, etc. and thus, we are able to provide necessary insight into the relationship between truck movement and economic (industry) forecasts without violating data privacy standards. Ultimately, our model allows large streams of truck movement data to be leveraged for freight travel demand forecasting.

In India, around 70% of health care services are offered by the private sector. National strategic plan (NSP) has emphasized private sector engagement to TB program. Public private mix strategy along with web based mandatory notification of TB cases were established in 2002. However, feasibility of consulting an informal provider first was seen to be associated with significant increases in total delay (absolute increase 22.8 days, 95%CI 6.2–39.5) and in the risk of prolonged delay >90 days. Study design A mixed method literature review, descriptive information and evaluative outcomes data extracted and analysed. Objective This review aimed to systematically review public private mix strategy in TB control in Indian tuberculosis disease burden and efforts towards elimination. Methods Available published literatures were searched with key words, articles related with objectives were selected, analysed and systematically synthesized. Overall 30 studies were reviewed. Result Available literatures were selected based on study objective and analysed. The modes of PPM strategy its success and problems of implementation and shortcomings were synthesized. Discussion After implementing PPM from 2002, case detection is seen to have significantly increased for smear positive cases and high detection rate and better treatment outcomes achieved. However, implementation of PPM has been challenged to fully deliver the intended services. Interestingly, seeking initial care from PPs is significant risk factor for diagnostic delay. Conclusion PPM is a proven and tested strategy to achieve End TB goal globally and even in India. However, studies indicated there is the need to strengthen and motivate public sector to engage private practitioners in specific districts and sync their activities into the mainstream programme. Conflict of interest and mistrust between private practitioners and public sector has to be well addressed to build sustainable relationship among the sectors. Routine and institutionalized systematic monitoring and evaluation of the system is required to meet the End TB goal by 2025.

This paper explores national strategies for emerging countries with ambitious policy targets for future offshore wind development. A scenario-based economic cost-benefit analysis of multiple approaches to the development of offshore wind projects is conducted based on (1) who takes the initiative on financing (public sector vs. private sector), (2) whether wind turbines are supplied locally or not, and (3) whether investment plans provide managerial flexibility to respond to changing circumstances or not (real options strategy vs. traditional investment decision-making). The analysis demonstrates that a real options strategy that allows flexibility regarding future uncertainties can significantly increase the economic value of a project regardless of the type of developer or dependence on foreign wind turbine technologies. The study concludes with a recommendation that late-mover countries focus on the combination of public-sector initiatives, a real options strategy, and the purchase of domestic turbines.

An exploratory research investigation into the creation of ‘privately owned publicly accessible spaces’ (POPS) in Toronto, Ontario and a critical review of the process used to secure these spaces and the subsequent agreements made. This paper seeks to answer if land use planners are able to better mediate the use of POPS as a means of providing open space to communities in high-density areas. This report includes the timeline illustrating the development of Toronto’s POPS program followed by a discussion on Toronto’s increase growth and development and the suitability of POPS as a contributing strategy for diminishing new park and open space assets and a high level breakdown of the legal mechanisms currently in place to help facilitate new POP spaces. Interviews with individuals from both the public and private sectors were conducted, which produced a generalized model outlining how POPS in Toronto are secured.

Introduction: In an era of increasing accountability throughout our society, it is not surprising that questions about the efficacy and efficiency of our health care system are also being raised. Both functional and technical qualities have to be monitored and managed effectively. Objectives: To enhance service effectiveness CHC/PHC health delivery systems. To evaluate the quality of care rendered by CHC, PHCs, Sub centres, AWCs by IPHS guidelines, Likert’s scale and WHO Assessment tool. To assess the health workforce in their capabilities. Patient satisfaction in the quality of care. Methodology: Out of the thirteen districts of Uttarakhand, the district of Dehradun has six blocks of which Doiwala is the largest block. A qualitative study design: One Community Health Centre namely CHC Doiwala, which has five Primary Health centres were studied using three different tools. (i) IPHS standards (ii) SARA (WHO) (iii) Likerts scale for patient satisfaction. However, in the COVID scenario some limitations have been considered in the study. Results: The quality of health care in the healthcare delivery system has been assessed as per scale and has been found that factors of patient satisfaction, infrastructure and outcomes for assessment of quality are strong contending variables. Conclusion: The PPP model has upgraded the healthcare system with substantial contribution from the private sector.

Unlike the rest of the state of Punjab in India, cotton remained the dominant monsoon crop in the southwest region till the 1990s. As it has been increasingly replaced by paddy in recent decades, this paper asks what this shift in cropping pattern reflects about the state’s agrarian capitalism. Towards an analysis of this question, it builds on James Scott’s idea of ‘political crops’ in the earliest states and places it in conversation with scholarship in critical agrarian studies, political ecology and commodity studies to account for relations of power under contemporary capitalism. Drawing on intensive primary research in the region, the paper contrasts the power relations generated by the production and circulation of the two crops. It shows that larger farmers are more likely to cultivate paddy due to better access to irrigation, and that the shift to paddy is threatening to make redundant the labour of landless Dalit women, who do cotton-picking, and increasing dependence on migrant male labour for paddy-transplanting. It also demonstrates how the different end uses of the two crops and the predominance of the private sector in the cotton markets versus the hitherto state-led nature of the paddy markets produce differential risks for farmers and traders. The paper concludes by suggesting that the shift from cotton to paddy represents capital intensification in response to Punjab’s mature capitalist conditions in agriculture but also results in new contradictions and axes of political struggle.

Nuclear power plant (NPP) is currently considered as one of the most reliable power sources. However, 182 of them are considered decommissioned and inactive including the one in Bataan, Philippines. The aim of this study was to investigate the acceptance of the reopening of Bataan Nuclear Power Plant (BNPP) by integrating the Theory of Planned Behavior and Protection Motivation Theory. A total of 815 Filipinos answered an online questionnaire which consisted of 37 questions. The Structural Equation Modeling (SEM) indicated that knowledge towards nuclear power plants was the key factor in determining people's acceptance towards NPP reopening. In addition, knowing the benefits would lead to positive perceived behavioral control (PBC) and attitude towards intention. Results showed that PBC and attitude are mediators towards the acceptance of people regarding the reopening of BNPP. If an individual's knowledge gravitates towards the perceived risk, then this can lead to the negative acceptance of the NPP reopening. On the other hand, if an individual's knowledge gravitates towards the perceived benefits, then this will lead to positive acceptance. This study is the first study that explored the acceptance of the reopening BNPP. Finally, the study's model construct would also be very beneficial for researchers, government, and even private sectors worldwide.

This article investigates the asymmetric effect of internet access (index of the internet) on economic growth in 42 sub-Saharan African (SSA) countries over the period 2008-2018.The estimation procedure is obtained following a dynamic panel threshold regression technique via 1000 bootstrap replications and the 400 grids search developed by Hansen (1996, 1999, 2000). The investigation first explores the presence of inflection points in the relationship between internet access and economic growth through the application of Hansen's threshold models. The finding from the nonlinearity threshold model revealed a significant internet threshold-effect of 3.55 percent for growth. The article also examines the linear short-run effect of internet access on economic growth while controlling for the effects of private sector credit, trade openness, government regulation, and tariff regimes. The marginal effect of internet access is evaluated at the minimum, and the maximum levels of government regulation and tariffs regime are positive. On the other hand, the minimum and maximum levels of private sector credit and trade openness are negative via the interaction terms. The article advances the literature by its nonlinear transformation of the relevance of internet access on economic growth by exploring interactive mechanisms of internet access versus financial resource, internet access versus trade, internet access versus government regulation, and internet access versus the tariff regimes from end-user subscriptions. In policy terms, the statistical significance of the joint impact of government regulations and tariff regimes is relevant in the operation of the telecommunication industry in SSA countries.

Problem definition: Because of a prolonged decline in public transit ridership over the last decade, transit agencies across the United States are in financial crisis. To entice commuters to travel by public transit instead of driving personal vehicles, municipal governments must address the “last-mile” problem by providing convenient and affordable transportation between a commuter’s home and a transit station. This challenge raises an important question: Is there a cost-effective mechanism that can improve public transit adoption by solving the last-mile problem? Academic/practical relevance: In this paper, we present and analyze two incentive mechanisms for increasing commuter adoption of public transit. In a direct mechanism, the government provides a subsidy to commuters who adopt a “mixed mode,” which involves combining public transit with hailing rides to/from a transit station. The government funds the subsidy by imposing congestion fees on personal vehicles entering the city center. In an indirect mechanism, instead of levying congestion fees, the government secures funding for the subsidy from the private sector. We examine the implications of both mechanisms on relevant stakeholders. These two mechanisms are especially relevant because several jurisdictions in the United States have begun piloting incentive programs, in which commuters receive subsidies for ride-hailing trips that begin or end at a transit station. Methodology: We present a game-theoretic model to capture the strategic interactions among five self-interested stakeholders (commuters, public transit agency, ride-hailing platform, municipal government, and local private enterprises). Results: By examining equilibrium outcomes, we obtain three key findings. First, we characterize how the optimal interventions associated with the direct or the indirect mechanism depend on: (a) the coverage level of the public transit network; (b) the public transit adoption target; and (c) the relative strength of commuter preferences between driving and taking public transit. Second, we show that the direct mechanism cannot be budget-neutral without undermining commuter welfare. However, when the public transit adoption target is not too aggressive, we find that the indirect mechanism can increase both commuter welfare and sales to the private-sector partner while remaining budget-neutral. Finally, we show that, although the indirect mechanism restricts the scope of government intervention (by eliminating the congestion fee), it can dominate the direct mechanism by leaving all stakeholders better off, especially when the adoption target is modest. Managerial implications: Our findings offer cost-effective prescriptions for improving urban mobility and public transit ridership.

Problem setting. Spatial development of Ukraine today is characterized by the presence of serious problems and negative trends, including inequalities of socio-economic development of some regions and settlements, inconsistency of social, economic, urban and environmental aspects of their development.State and local governments solve these problems by developing and implementing spatial development strategies. However, very few of such strategies met the real challenges and needs of local communities, were implemented or integrated.Recent research and publications analysis. Such Ukrainian scientists as O. Berdanova, B. Bezzubko, V. Vakulenko, G. Vasylchenko, Z. Gerasymchuk, O. Kary, V. Mamonova, O. Karlova, I. Parasyuk, A. Tkachuk and some others should be noted among the researchers of strategic planning and territorial development. Some national scientists devoted their research to relevant aspects of project management in territorial development, such as O. Amosha, V. Babayev, O. Bezugly, Z. Varnaliy, S. Vovkanych, S. Ghazaryan, A. Galchynsky, V. Geets, Z. Gerasymchuk, B. Danylyshyn, M. Dolishniy, T. Zayats, O. Kavtysh, I. Katsai, G. Litosh, O. Medvedeva, V. Molokanova, O. Novikova, O. Pidkuyko, S. Pisarenko, V. Rach, O. Rossoshanska, V. Seminozhenko, S. Chernov and some others.A number of methodological documents for spatial development planning have also been developed as part of EuropeAid technical assistance programs and projects.Highlighting previously unsettled parts of the general problem. Previous research has paid almost no attention to the identification of specific entities that are currently involved in the spatial development of Ukraine. The lack of clearly defined development “recipients” deprives the developed strategic documents of any specific vector of their implementation. This greatly complicates the functioning of the spatial development system in our country and reduces its efficiency. Therefore, the aim of the study is to propose a method of spatial development entities analysis in order to identify the actors who now provide implementation of measures in the field of spatial development in Ukraine.Paper main body. According to the proposed method, the first stage of the spatial development entities analysis is the establishment of landowners as potential assets users for the implementation of development measures. The next analyzed group of participants includes the subjects of urban planning, namely – customers of buildings construction and reconstruction, which are contained in the Unified Register of documents certifying the commissioning of completed facilities. The third group of spatial development entities studied includes investors who provide financing for spatial development activities. Statistical data on capital investments by sources of financing were obtained from the State Statistics Service of Ukraine.Certain spatial development entities are clearly divided into the public or private sphere, as project management approaches and methods in these areas have traditionally differed significantly. According to the developed method, the analysis of current entities in Ukrainian spatial development was carried out.Conclusions of the research and prospects for further studies. Obtained results of the analysis allow us to establish the representatives of the private sector as the main players in the spatial development in Ukraine. They own almost three quarters of Ukraine’s land. They are the most active participants in urban development, and they are the ones who provide more than 87% of capital investments with their own funds. That is, spatial development must be strategically attractive primarily for the private sector. Therefore, a topical area for further research may be the search of mechanisms for reconciling the strategic priorities established by the authorities in spatial development strategies with the strategic priorities of private structures as the main actors in spatial development.

В Україні і світі спостерігається швидке постаріння населення, поширення захворюваності і смертності від онкологічних і хронічних неінфекційних захворювань, низьку доступність паліативної та хоспісної допомоги (ПХД) для населення. Мета дослідження: наукове обґрунтування розвитку оптимальної організаційної моделі залучення лікарів загальної практики-сімейних лікарів (ЗП-СЛ) до надання паліативної і хоспісної допомоги пацієнтам геріатричного профілю, що сприятиме розробці та запровадженню в Україні сучасної доступної та ефективної системи ПХД. Матеріали, що були використані для виконання роботи: медико-статистичні та демографічні дані Державного комітету статистики України і ВООЗ, звіти МОЗ України і регіональних управлінь охорони здоров`я, міжнародні та вітчизняні нормативно-правові документи, вітчизняна та закордонна наукова література, експертні заключення. Методи дослідження: інформаційно-аналітичний, порівняльний контент-аналіз, статистичний, системного підходу. Результати досліджень та їх обговорення. Результати наших досліджень свідчать, що в Україні ще не забезпечена доступність ПХД для більшості населення. Досі навіть не в усіх обласних центрах і великих містах (не говорячи вже про сільську місцевість) створені хоспіси або центри ПХД, а більшість стаціонарних закладів ПХД вкрай обмежені в ресурсах. Обґрунтовується мультидисциплінарна та міжсекторальна модель ПХД і умови залучення лікарів ЗП-СЛ до надання якісної паліативної допомоги в амбулаторних умовах та вдома пацієнтам геріатричного профілю. Висновки. Запропонована організаційно-функціональна модель системи ПХД спрямована на підвищення доступності та якості медико-соціальної допомоги інкурабельним хворим з злоякісними новоутвореннями та іншими важкими хронічними прогресуючими захворюваннями у термінальній стадії. Важливою умовою ефективності роботи лікарів ЗП-СЛ щодо надання ПХД вдома є спеціальна підготовка з питань ПХД студентів, інтернів та лікарів, які одержують спеціалізацію з сімейної медицини, у вищих медичних закладах освіти до- та післядипломного рівнів. Умовою ефективності надання ПХД інкурабельним хворим, зокрема людям похилого і старечого віку, в амбулаторних умовах і вдома є робота в складі мультидисциплінарної команди для поєднання зусиль, координації та співпраці лікарів ЗП-СЛ та лікарів-спеціалістів, працівників установ соціального захисту населення, волонтерів, представників приватного сектору та громадських організацій, священнослужителів тощо.

Background The Government of India implemented mandatory TB notification policy since 2012. After that India's TB notifications from the private sector steadily increased; however, less is known about private practitioners' (PP's) experiences with TB notification. The present study aims to fulfil this gap. Methods We conducted a cross-sectional study during November 2019 to March 2020 in Pimpri-Chinchwad Municipal Corporation (PCMC) area of Maharashtra State. We used a mixed methods approach which involved a survey of 200 PPs and in-depth interviews (IDIs) with 7 PPs and 8 National TB Elimination Program (NTEP) staff. The data were presented in the form of frequencies and percentages and thematic analysis was performed on the qualitative data. Results The study revealed that most PPs (194 of 200; 97%) were aware of TB notification and 75% reported that they notify TB cases to the NTEP. Of those who notify, majority (129 of 145; 89%) reported that they use paper-based notification being the convenient method due to in-person visit and help by the NTEP staff. Only a third of PPs were aware of electronic notification methods. The main reasons behind low utilization of web based and mobile application were unfamiliarity and technical issues such as poor network connectivity. A third of PPs were aware about monetary incentives for notification and only 17% reported actual receipt of incentive at some point. Conclusions Our study identifies several areas where the NTEP can undertake interventions to strengthen the implementation of mandatory TB notification policy. Low awareness about electronic notification methods and preference for paper-based notification in this Study area suggest that more efforts are necessary for successful transitioning from paper-based to electronic notification system.

While the literature on corporate social innovation suggests that value is co-created by different parties at the individual, organizational, and societal level, there is little work focusing on how these levels interface with one another. This paper helps to fill that gap by using systems thinking to develop a general causal model that explains one pathway for how individual corporate social innovations can impact interorganizational dynamics, encouraging the co-creation of social value by multiple parties within an industry while reinforcing the economic case within the initiating firm. We ground this model in the existing literature, and present historical case studies supporting its viability in practice. Overall, we offer the model as a starting point for understanding how initiatives in the private sector might reverberate across organizations in both the private and public sector to create shared value.

The research seeks to activate the role of partnership between the public and private sectors by developing successful solutions and developing partnership methods in the field of infrastructure from the economic and developmental aspects, as this research focused on infrastructure financing through the best methods of partnership between the public and private sectors in the field of infrastructure The public sector has turned to other projects through which public services can be provided in a better and more efficient manner. The research addressed the problem of weak infrastructure in the port transport sector due to low absorptive capacity, which called for the development of new methods of rehabilitating and developing these infrastructures through systems and methods. Partnership, which led to the development of port infrastructure, the increase in annual capacity and the increase in competitiveness with other ports. Conclusions have been reached, including the weak infrastructure services provided due to the instability of the economic, political and security conditions, in addition to weak oversight, and the absence of a legislative and legal framework regulating relations between the contracting parties, and despite the presence of several obstacles, the Iraqi ports witnessed rapid development and that To meet the requirements of growth and the volume of global trade through the use of the best partnership systems, including the (BOT) system, where this system is one of the best financing methods adopted by the General Company for Ports of Iraq, which has proven its success through high capacity and increased financial returns.

Smart city promotes the unification of conventional urban infrastructure and information technology (IT) to improve the quality of living and sustainable urban services in the city. To accomplish this, smart cities necessitate collaboration among the public as well as private sectors to install IT platforms to collect and examinemassive quantities of data. At the same time, it is essential to design effective artificial intelligence (AI) based tools to handle healthcare crisis situations in smart cities. To offer proficient services to people during healthcare crisis time, the authorities need to look closer towards them. Sentiment analysis (SA) in social networking can provide valuable information regarding public opinion towards government actions. With this motivation, this paper presents a new AI based SA tool for healthcare crisis management (AISA-HCM) in smart cities. The AISA-HCM technique aims to determine the emotions of the people during the healthcare crisis time, such as COVID-19. The proposed AISA-HCM technique involves distinct operations such as pre-processing, feature extraction, and classification. Besides, brain stormoptimization (BSO) with deep belief network (DBN), called BSODBN model is employed for feature extraction. Moreover, beetle antenna search with extreme learning machine (BAS-ELM) method was utilized for classifying the sentiments as to various classes. The use of BSO and BAS algorithms helps to effectively modify the parameters involved in the DBN andELMmodels respectively. The performance validation of the AISA-HCM technique takes place using Twitter data and the outcomes are examined with respect to various measures. The experimental outcomes highlighted the enhanced performance of the AISA-HCM technique over the recent state of art SA approaches with the maximum precision of 0.89, recall of 0.88, Fmeasure of 0.89, and accuracy of 0.94. © 2022 Tech Science Press. All rights reserved.

Background:Rapidly growing coronavirus disease 2019 (COVID-19) pandemic has brought unprecedented challenges to the health system in Nepal. The main objective of this study was to explore the health system preparedness for COVID-19 and its impacts on frontline health-care workers in Nepal.Methods:Semi-structured interviews were conducted among 32 health-care workers who were involved in clinical care of COVID-19 patients and four policy-makers who were responsible for COVID-19 control and management at central and provincial level. Interviews were conducted through telephone or Internet-based tools such as Zoom and Skype. All interviews were audio-recorded, transcribed into English, and coded using inductive and deductive approaches.Results:Both health-care workers and policy-makers reported failure to initiate pre-emptive control measures at the early stages of the outbreak as the pivot in pandemic control. Although several measures were rolled out when cases started to appear, the overall health system preparedness was low. The poor governance, and coordination between three tiers of government was compounded by the inadequate personal protective equipment for health-care workers, insufficient isolation beds for patients, and poor engagement of the private sector. Frontline health-care workers experienced various degrees of stigma because of their profession and yet were able to maintain their motivation to continue serving patients.Conclusion:Preparedness for COVID-19 was affected by the poor coordination between three tiers of governance. Specifically, the lack of human resources, inadequate logistic chain management and laboratory facilities for testing COVID-19 appeared to have jeopardized the health system preparedness and escalated the pandemic in Nepal. Despite the poor preparedness, and health and safety concerns, health-care workers maintained their motivation. There is an urgent need for an effective coordination mechanism between various tiers of health structure (including private sector) in addition to incentivizing the health-care workers for the current and future pandemics.

Background: An increasing number of South Africans utilise primary healthcare services (either in the state or private sector) for mental health concerns; hence, there is a need to objectively assess these doctors’ attitudes and knowledge of mental illness. Aim: To investigate aspects of knowledge and attitudes towards mental illness of a group of private and state-employed non-specialist medical doctors. Method: Doctors in the state sector who were working at a primary healthcare level and who were not working towards, or did not hold, a specialist qualification were considered eligible for the study. Doctors in the private sector who were working as general practitioners and who did not hold a specialist qualification were considered eligible for the study. Data were collected by means of a self-administered questionnaire. A link to the study questionnaire, information about the study, details of the researcher and matters pertaining to informed consent were emailed to potential participants. Results: Of the 140 practitioners who responded to the survey, 51.4% (n = 72) worked in the state sector, 41.4% (n = 58) worked in the private sector and 7.1% (n = 10) worked in both the state and private sectors (χ2 1 = 45.31, p < 0.010). The majority (> 50%) of participants in all three groups had a positive attitude towards mental illness (χ2 2 = 1.52, p = 0.468). Although there were no significant associations between attitude and socio-demographic characteristics (p > 0.05), male SS doctors reported feeling less comfortable when dealing with mentally ill patients (p = 0.015); SS doctors who did not have family contact with mental illness were less likely to feel that mentally ill patients did not pose a risk to others (p = 0.007), and PS doctors under the age of 35 years were more likely to feel adequately trained to treat mental illness (p = 0.026). The majority (> 50%) of participants in all three groups had an adequate level of knowledge of mental illness (modal scores = 10). There were no significant associations between knowledge and socio-demographic characteristics (p > 0.05). Conclusion: Despite the findings of a positive attitude and adequate knowledge of mental illness amongst the participants of this study, it is recommended that more targeted interventions are established to further improve mental health awareness and knowledge of doctors at both undergraduate and postgraduate levels of study.

INTRODUCTIONSARS-CoV-2 testing is one of the options to combat COVID-19 in Kenya. In the first COVID-19 year there was limited tapping of the private sectors potential to scale up testing in Kenya. In April 2020, we initiated a unique public-private partnership (PPP) project in Kisumu County connecting the private sector to centralized testing supported by the ministry of health (MoH), COVID-Dx, to accelerate the local response to COVID-19. Within COVID-Dx, we aimed to demonstrate this PPPs performance as a replicable model for effective public-private collaboration in responding to the COVID-19 pandemic in similar settings. METHODSKEMRI, Department of Health Kisumu County, PharmAccess Foundation, and local faith-based and private healthcare facilities collaborated in COVID-Dx. COVID-Dx was implemented from June 01, 2020, to March 31, 2021, in Kisumu County, Kenya. Trained laboratory technologists in participating healthcare facilities collected nasopharyngeal and oropharyngeal samples from patients meeting the MoH COVID-19 case definition. Samples were tested at the central laboratory in KEMRI via SARS-CoV-2 RT-PCR. Healthcare workers in participating facilities collected data using the digitized MoH COVID-19 Case Identification Form. We shared aggregated results from these data via (semi-) live dashboard to all relevant stakeholders. We did descriptive statistical analyses using Stata 16 to inform project processes. RESULTSNine facilities participated in the project. A total of 4,324 PCR tests for SARS-CoV-2 were done, with 425 positives. We noted differences in positivity rates between the facilities. Healthcare workers were the largest group tested in the project, 1009, representing 43% of the Kisumu healthcare workforce. CONCLUSIONCOVID-Dx can serve as a model for PPPs scale-up testing, especially LMICs, and digitizing the MoH case report form improved reporting efficiency, demonstrating that digital is the way forward. The COVID-Dx PPP has led to another collaboration with Kisumu County aimed towards extending the COVID-Dx model to other counties. SUMMARY BOX O_TEXTBOXWhat is already known?O_LIIn sub-Saharan Africa, COVID-19 responses are mainly rolled out through the public healthcare sector, even though the private sector plays a significant role in health service delivery C_LIO_LIThe challenge is to combine private and public efforts in healthcare delivery in a mutually supportive and collaborative manner, especially during large outbreaks such as COVID-19. C_LI What are the new findings?O_LIThe development of a public-private partnership (COVID-Dx) at the start of a global pandemic - COVID-19 - is challenging, but PPPs are essential for epidemic preparedness. C_LIO_LIThe development of a digital app with a corresponding dashboard, ensures transparency and efficiency. It has shown to enable data-driven decision-making and provides insight into how to prioritize funding streams. C_LI What do the new findings imply?O_LIThis PPP model is replicable and can serve as an example of PPPs for epidemic preparedness in similar settings in LMICs. C_LIO_LIDigital is the way going forward when combatting large outbreaks in the future, especially in LMICs C_LI C_TEXTBOX

Assessment of food safety management systems is a verification activity with the objective of evaluating the compliance with set standards. While it cannot be relied upon for ensuring safety, it is important for verifying that stakeholders comply with safety and regulatory requirements. Assessment can be carried out by authorities or by the private sector itself. It can be comprehensive and cover the assessment of the entire food safety management system, or be partial and limited to some elements of the food safety management system, operations or products. This will depend on the purpose of the assessment. The validity of the assessment depends on a number of factors, in particular the competence of assessors. The frequency and scope must be based on the level of risk presented by the operation. Among different factors, the previous records of compliance are important criteria to be considered.

Problem setting. The level of ability of healthcare organizers and employees of healthcare facilities at various levels to provide medical care and their readiness for transition to autonomy was examined. It has been established that there is a low level of ability of healthcare organizers and employees of healthcare facilities at various levels to provide medical care for transition of healthcare facilities and their readiness for transition to autonomy. It was determined that current level of readiness of healthcare organizers and employees of financial and economic services will not allow for an efficient transition of healthcare facilities to autonomy. Recent research and publications analysis. The majority of healthcare facilities in Ukraine are a legacy of the post-Soviet era, starting from the condition of premises and equipment and ending with the level of provision of services by the staff. Taking into account that the market of health services in Ukraine holds much promise, over the last years we have seen an increase in the number of private healthcare facilities which have much better equipment and conditions for providing services. Under such conditions, state and municipal healthcare facilities find it very hard to compete with them. Such situation is unacceptable as it undermines confidence in the State as a guarantor of provision of high-quality medical care. Highlighting previously unsettled parts of the general problem. To analyse the status of readiness of healthcare facilities for implementation of state and private partnership by determining the stage of their transition to autonomy under conditions of the healthcare reform in Ukraine. Paper main body. Since 01 April 2020 in the course of healthcare reform these facilitieshave found themselves in a position when they are not ready for full transition to autonomy which is characterized by ability to tend to their own needs by themselves on account of payments for provision of healthcare services. On the one hand, they lack logistical support, while, on the other hand, there is poor-quality management from the perspective of provision of services. Considering that the State provides funding to the healthcare sector from payments for services according to the list of guaranteed healthcare services through the National Health Service of Ukraine and additional funding is not foreseen, except for funding from local budgets, state and private partnership is an effective way of resolving the matter of finances and the problem of management. The involvement of private sector will provide budgetary and municipal facilities with an opportunity to compete with private healthcare centres. Healthcare reform and namely its elements such as transfer of the state and municipal healthcare facilities to autonomy as well as transfer from funding of healthcare facilities based on the breakdown of estimated costs to payment for health services create preconditions for deepening the cooperation between the state and private sector in the field of healthcare. Nonetheless, providing respective healthcare facilities with proper logistical support has to be the next step directed towards deepening the processes of reforming the healthcare system and due to the limited nature of budgetary resources the involvement of private partners seems to be the best possible option. And specifically, joining the efforts of the state and private partners is desirable under conditions of an existing need for construction and equipment of cancer centres, rehabilitation centres, diagnostic centres, dialysis and perinatal centres etc., i.e. the objects of infrastructure, the appearance of which is critically important for developing the healthcare system and for which there exists an effective demand from the State (which is the largest customer for health services and is acting through the National Health Service of Ukraine which starting from 2020 carries the functions of the single national customer for health services under the programme of state guarantees of provision of health services to the population) as well as potential consumers (who will purchase corresponding health services above the volumes foreseen by the programme of medical guarantees) which ensures the interest in the implementation of corresponding projects for state and municipal healthcare facilities and their owners as well as for a private partner. The method of calculating the cost of a service for provision of healthcare became one of the most eagerly awaited subordinate acts because no one has ever made any calculations regarding these matters at the state level and it was successfully introduced only in private medical practice. Unfortunately, certain respective decrees are not prepared yet despite the established deadlines that it why this matter will be also attended by a subcommittee on matters of control of implementation of healthcare reform of the Committee. Conclusions of the research and prospects for further studies. In general, from the perspective of the Ministry of Health of Ukraine, the need for change in the legal status of a facility specifically to the municipal non-commercial enterprise consists in the following: – funds received under the programme of the state financial guarantees are the enterprise’s own revenues. The manager himself decides how to better organize primary medical care using these funds within the limits of the approved financial plan; – doctor’s pay is not limited by pay scale. The enterprise gets an opportunity to build a system of incentives according to the principle: the majority of employees must be satisfied. – the director general of the enterprise has greater freedom in the operational matters and the matters of improvement of primary medical care. It is necessary to take the legal mechanism of reorganization as basis specifically in the process of establishment of a municipal non-commercial enterprise. Further research prospects are related to the study of the process of preparations and implementation of transition of healthcare facilities to autonomy.

Problem setting. The active development of the service sector contributes to the growth of scientists’ attention to the concept of marketing relations, the center of which is a customer-oriented approach. This concept is especially relevant for the field of medical services, as the quality of these services not only forms aspects of patient satisfaction, but also determines their quality of life and longevity. The Ukrainian model of health care and the provision of medical services has recently been in the process of reform. The changes affect key elements of the functioning of the medical sector: transformation of the structure of the medical services market, aimed at increasing the share of the private sector, changing the principles and conditions of financing, improving the system of medical education and quality of health care. The insurance mechanism in the system of medical services is being reformed and the system of legal regulation of state medical institutions is being changed. One of the key tasks of the reform is to ensure the orientation of the health care system to meet the needs of patients in treatment. This necessitates scientific research in the interaction of two key aspects of medical service – the patient (recipient of medical services) and the medical worker (institution of medical services). Recent research and publications analysis. Ukrainian researchers have devoted their work to analyzing the needs of patients in the system of patient-medical institution and finding effective mechanisms for managing medical institutions to meet these needs. The analysis of patients’ opinions on the availability, satisfaction with the provision of medical services and health care reform was conducted by scientists Shkrobanets, V. Galkin researched the issue of improving outpatient therapeutic care as an urgent task of health care. English scientists S. Cavanagh and K. Chadwick identified the basic needs of public health. They analyzed the needs, aspirations and goals: welfare, quality of life and public policy in the field of medicine, and conducted applied research on the quality of life. However, given the realities of the development of the medical services market in Ukraine, patient orientation issues need to be explored in more depth. Highlighting previously unsettled parts of the general problem. Ukrainian patients face significant difficulties in obtaining medical services. In addition to physiological problems, there are psychological problems associated with the implementation of the choice among the complex processes of diagnosis and treatment. The greatest responsibility for health care processes lies with physicians, heads of health care facilities, and other health care providers who are aware of patients’ needs and are responsible for the functioning of the system. Their ability to identify problems and respond appropriately to public demand is fundamental to working in terms of their competencies. Thus, the competence of health professionals is a systemic factor that contributes to the patient’s receipt of high-level medical services. Paper main body. Modern market relations are subject to economic laws that are specific to management and are in conflict with the methods of administration. Medical care within market relations is a specific type of intangible production, filled with economic characteristics. In recent years, Ukraine’s medical sector has achieved significant results in overcoming the crisis that arose during the establishment of independence in all spheres of society, and, as a result of global social, political and economic changes, continues to be reformed. The essence of the current stage of health care reform in Ukraine is characterized by objective conditions under which medical services become a commodity, and the relationship between doctor and patient in its content begins to be defined as marketing with the predominant role of the patient. The introduction of economic criteria in the activities of the medical sector in modern market relations is determined by the need to develop the health care system. At the same time, the reform of health care delivery is being transformed into a system that regulates supply and demand in the health care market. Conclusions of the research and prospects for further studies. According to the results of the research, it is established that Ukrainian consumers average the patient’s focus on medical services. Among the key, unresolved issues that hinder the introduction of patient orientation are the insufficiently comfortable conditions of patients’ stay in inpatient facilities and treatment, insufficient effectiveness of treatment in general and the results obtained. Weaknesses include low awareness of health services in public health facilities, lack of focus on patient health, lack of psychological support for patients during treatment and rehabilitation, late delivery of services, and problems with non-compliance. This creates a field for new research to address the identified problems.

This study aims to determine the Renewable Energy Development Implementation in South Solok Regency. New and Renewable Energy is clean energy that is rich in diversity and quantity such as solar energy, wind, natural gas, ocean waves, garbage, wood, biomass, nuclear and water (microhydro). New and Renewable Energy was developed by the West Sumatra Provincial ESDM Office in the South Solok area since 2013, however, in implementing this development there were still some obstacles which was faced by the West Sumatra Provincial ESDM Office as the community which has not felt the impact of developing the benefits of PLTMH. It was because there were some PLTMH which were not functioning or have damaged caused by natural disasters such as floods and landslides, there was still a lack of technicians to repair the damage to the PLTMH, there was still a lack of costs obtained from PLTMH customers who aimed to repair damage to PLTMH generators and turbines. This study was a qualitative research which used descriptive method. The research respondents were selected by using a purposive sampling technique. For the data collection, this study used interview guidelines, observation, and documentation of the research as the instrumentation. The validation technique used the triangulation method. Furthermore, the data analysis technique was reducing data, displaying data, and drawing the conclusions of the study which has been conducted. The findings showed that the Renewable Energy Development implementation for Micro Hydro Power Plants (PLTMH) by the ESDM Office of West Sumatra Province in South Solok was still not running as it should be, because there were still some obstacles which were faced in developing of New Renewable Energy of PLTMH that the results was not being implemented properly. Supporting factors for the implementation of this PLTMH development were the data and information, communication, bureaucratic attitudes, and organizational structure. While communication, organizational characteristics, economic environment and human resources were the inhibiting factors. The Effort to overcome these obstacles was the government has signed several commitments related to the development of Renewable Energy. Beside that, to fill the conditions of the national electricity, the government has also involved the private sector

Bus operators in the public and private sector are increasingly subject to competitive tendering in many countries and a requirement to operate under a gross cost contract. This contract sets out in detail the requirements of the operator, including the levels of service as well as infrastructure required to deliver the contracted services. Buses acquired by operators in many jurisdictions have until very recently been essentially diesel fuelled and often available from a panel approved set of buses compliant with Euro 6 standards. The predictability of the cost profiles of vehicles and associated costs of maintenance and repairs is well known and used in tendered offers. With the growing requirement of switching to a green fleet with varying timetabled transition rates, the future costs of providing bus services are going to be subject to significant unknowns. These unknowns are associated not only with the fast changing vehicle technology associated with a range of fuel sources (notably standard battery and fuel cell battery (i.e., hydrogen)), but also the impact this will have of the top-to-bottom change in the operations of bus fleets affecting operating and capital expenditure including depot infrastructure, timetabling, maintenance, labour skills and access to efficient electricity charging or hydrogen facilities. With such great uncertainty, the challenge of how to structure future contracts to allow for such volatility in cost commitments becomes of paramount importance to both the regulator and the bus operator. In this paper, we promote way forward to ensure that the transition to a totally green fleet is achieved without throwing the industry into chaotic uncertainty.

Objective To determine the current state of Rheumatology in Catalonia and to update the information regarding previous studies. Material and methods Design Observational, descriptive and cross-sectional study. Data collection from January to June 2017. Sample Rheumatologists practising public healthcare activity in Catalonia. An online questionnaire was sent to gather individual data and data from rheumatology services/sections. Results Information was obtained on 109 rheumatologists: 39 men and 70 women; mean age: 47 ± 9 years. The number of rheumatologists has increased by 8% over the past 5 years. One hundred and one (92.7%) doctors qualified as rheumatologists through the MIR. Rheumatology practice was mostly in a hospital setting: 68 (62.4%) physicians. Ninety-six (88.1%) rheumatologists were full-time practitioners. Fifty-four (50%) rheumatologists also practiced in the private sector. Clinical practice was predominant: 76% of daily time was devoted to this area. Of note, it was found that most of the rheumatology services, 24 (705), were dependent hierarchically on other services, namely internal medicine and orthopaedic surgery. There are still 6 hospitals in Catalonia without a rheumatologist. Conclusions The number of rheumatologists in the public health sector of Catalonia has increased over the past 5 years. The mean age of rheumatologists is advanced and there is a clear predominance of female practitioners in the specialty. Many rheumatology services depend on other services. Rheumatology activity is primarily focussed in the city of Barcelona.

Background The rotator cuff surgery (RCS) incidence is rising rapidly in North America, Europe, Asia, and Australia. Despite this, multiple factors limit patients’ access to surgery. In Latin America, barriers to orthopedic surgery have been largely ignored. The purpose of this study was to calculate the rate of RCS in Chile between 2008 and 2018, investigating possible associated factors to access such as age, sex, and the health insurance. Methods An ecological study was carried out with nationwide data obtained from the Database of Hospital Discharges of the Department of Statistics. All Chilean inhabitants aged 25 years or more were included. We used the ICD-10 codes M751, M754, and S460. The annual incidence rate of surgeries and the incidence rate for the period studied per 100,000 inhabitants were calculated. Data were analyzed stratified by age, sex, year of study, and the health insurance. Negative binomial regression was used to compare rates. Statistical analyzes were performed with Stata v.14 software. Results 39,366 RCSs were performed, with a total rate for the period of 32.36 per 100,000 inhabitants. The annual rate of surgeries from 2008 to 2018 increased from 24.55 to 49.11 per 100,000/year. When adjusting for year, an annual increase in surgery rates of 8.19% (95% CI 6.7–9.6) and 101% growth between 2008 and 2018 (95% CI 90–109%, p < 0.001) was observed. When comparing the global rates according to the health insurance, the public system corresponds to 21.3 per 100,000 and the private system to 72 per 100,000, the latter being 3.4-times higher (95% CI 2.7–4.4; p < 0.001). Conclusion RCS rates are increasing in Chile concordantly with previous reports of other western countries. The most important factor associated with RCS rate found was the patients’ health insurance, with higher rates observed for the private sector.

On the Ground • There are three general stages of a well's life on US public land: 1) the permitting process to drill, 2) active extraction of fossil fuel resource, and 3) plugging and abandonment of well. • There is no national standard for oil and gas reclamation in the United States similar to mining and therefore current reclamation practices and standards fail to achieve long-term effectiveness across the western United States. • A reclaimed well pad's land potential is determined by 3 properties: static (e.g., climate), dynamic (e.g., soil stability), and process (e.g., water retention). • Understanding a reclaimed well pad's land potential enables federal land agencies to outline surface reclamation goals and requirements consistently and clearly. • Monitoring for land potential increases the capacity of the private industry to practice adaptive management by enabling companies to respond to plant community changes while maintaining long-term progress toward recovery.

Inclusive access to transport is an important determinant of health for older and disabled people. Despite transport policy increasingly focusing on wellbeing and equity outcomes, transport professionals’ understanding of and approaches to delivering accessible transport remain poorly understood. Transport professionals (N = 175) from a range of government and private sector organisations in Aotearoa/New Zealand completed a web survey. Questions covered respondents’ views on what might make inclusive access a more prominent transport policy objective; their approach to accessibility for older and disabled people in their work; and the extent to which they engage with older and disabled people in transport practice and design. Analyses suggest that inclusive access is a complex issue for transport professionals. There was a range of perspectives on why it is not more prominent in transport policy, or why outcomes are not better for older and disabled people using transport. In-person engagement between transport professionals and older and disabled people is infrequent. We argue that these findings are reflective of inclusive access being vaguely defined and poorly measured in transport. Consequently, compared with transport policies such as road safety which have clearly measurable outcomes, improved equity of mobility is reliant on design standards and transport professionals’ awareness and training. It is recommended that inclusive access in transport policy is improved with measures that link policy and design choices to outcomes, ultimately benefitting the health of all people, and that of older and disabled people in particular.

This paper examines three sites where diplomacy interacts with geoscience, international law, and military capabilities. These sites, invisible to the general public due to their subterranean character, are undersea long-distance telecommunications cables; submarine operations; and espionage operations. The paper uses these subterranean sites to shed light on the hidden dimensions of Australian statecraft. Taken as a whole, they illustrate the influence of elite economic interests in Australia's national security objectives. The covert instruments of statecraft are devoted not just to military security but to the power and interests of the private sector. These interests heavily influence the concept of “national interest” in Australia's external relations.

Background: Telehealth in the Military Health System (MHS) has long been an important tool for delivering care in deployed settings. However, the scope of nondeployed telehealth usage in the MHS has not previously been published, making full evaluation difficult. This study aims at addressing this gap by assessing trends over time, demographics, provider types, and diagnoses most associated with telehealth usage in the MHS. Methods: Secondary analysis was conducted on health care claims from the MHS Data Repository for all telehealth services provided from fiscal years 2006 to 2018. Telehealth services were identified by using Common Procedural Terminology (CPT) code modifiers GT, GQ, and 95. Patient demographics, provider type, and major diagnostic category were assessed for all telehealth services in both direct (military provided) and purchased (private sector) care. Results: Usage of telehealth services in the MHS rose ∼19-fold, from 2,549 to 48,667 occurrences, from 2006 to 2018. Physicians provided ∼60% of telehealth services overall, and the greatest usage was for mental health diagnoses. Purchased care (PC) showed differences from direct care (DC), including a greater level of expansion, greater inclusion of children and adolescents, and lower usage of telehealth for non-mental health services. Conclusions: Telehealth usage in the MHS has increased substantially from a total 2,549 occurrences in 2006 to 48,667 occurrences in 2018, demonstrating greater acceptance and usage by both DC and PC providers. Future directions include assessing provider types, diagnosis codes, and patient demographics associated with telehealth use, especially in the emerging COVID19 clinical practice environment.

This research aims at investigating the interrelationships between critical success factors (CSFs) in municipal solid waste management (MSWM) projects taken up in public–private partnership (PPP) mode in India and studies the extent to which they can affect project success. A three-step procedure was followed to identify the CSFs in MSWM. A conceptual structural equation model (SEM) was developed using cluster groupings of the identified CSFs to show their interrelationships. Data collection from the public sector and private sector waste management managers was done through a questionnaire survey. The respondents’ data were analysed in analysis of moment structures (AMOS) using structural equation modelling. The SEM analysis of the respondents’ data gives the most exemplary fitting measurement model with the 17 CSFs taken as components of five latent variables: external environment, financial characteristics, project planning and procurement, project operation and management and project stakeholders. The model shows the relationships between the constructs of CSFs for project success. This study contributes to current ideas by empirically identifying the interrelationships between the MSWM CSFs, which can help waste management professionals handle the CSFs rationally. Furthermore, the study shows that all the groups have a direct and positive impact on project success. The findings may only portray the opinion of solid waste management managers in India.

Private sector actors are taking on an increasingly prominent role in energy transitions, including in hydropower development and finance. Yet, there is little empirical research on the topic. This study covers private sector views on accelerating hydropower investment in Nepal, using Q methodology. Three main viewpoints were identified among 17 interviewed hydropower developers, planners, and investors based in Nepal: 1) Efforts need to be focused on reforming hydropower policies and administration at the national level; 2) Funds for hydropower development need to be increased and sought from a diversity of domestic and foreign private sources; 3) Nepal needs to integrate its energy grid with its South Asian neighbours, starting with India. Areas of strong disagreement include the role of political stability in enabling hydropower development, as well as modes of engagement with Indian, Chinese, and Western partners. Areas of consensus include the need to smoothen land acquisition procedures as well as discomfort with the state-owned Nepal Electricity Authority’s perceived monopolistic status in the sector. Overall, this study contributes to debates on private sector involvement in hydropower development with a nuanced empirical assessment of views which contain clear visions for an independent and domestically driven future of the country’s hydropower sector. Postprint

A pharmacy-based surveillance system in Kerala, India, has helped to improve TB patient notifications from the private sector, build better public-private partnerships, and improve the quality of TB diagnosis. Pharmacy-based surveillance has the potential to strengthen TB surveillance and facilitate standards of TB care., Key Findings Efforts to strengthen implementation of Schedule H1 regulation involved increasing advocacy efforts with the state government and local stakeholders, improving communication with stakeholders, educating chemists on data collection, and improving the quality of documentation of prescriptions.State program managers of the National TB Elimination Program used the information from Schedule H1 registers to identify missing TB cases and improve TB notification, identify providers who prescribe private anti-TB drugs and sensitize them to the Standards of TB Care in India, and sensitize providers on prescribing practices for TB. Key Implications Program managers may use pharmacy-based surveillance data judiciously to identify the missing TB cases, engage health care providers in prescribing practices, and improve the quality of TB diagnosis and care.Policy makers may realize the potential of pharmacy-based surveillance to improve TB patient notification, build public-private partnerships, and enhance standards for TB care., Introduction: Eleven anti-TB drugs were included in the Government of India's Schedule H1 drug regulations in 2014. The National Strategic Plan for TB Elimination in India 2017–2025 recognized the opportunity to strengthen the TB surveillance system and improve the quality of TB care by implementing the Schedule H1 regulation. However, there were no documented systematic large-scale efforts to use Schedule H1 regulation to support TB surveillance or improve the quality of care. We aimed to document the process of implementation of the Schedule H1 regulation to enhance the quality of TB care and strengthen the TB surveillance system in Kerala, India. Methods: We conducted 33 in-depth interviews of the drugs control department enforcement officers, chemist shop owners, private-sector doctors, leaders of professional medical associations, and program managers and key staff of the TB Elimination Program in Kerala. Major themes identified were the process of implementation of Schedule H1 and how the National TB Elimination Program used the information. Findings from the qualitative interviews were corroborated with the quantitative information from the annual program performance reports and anti-TB drug sales data. Results: The TB Elimination Program of Kerala used the information from the Schedule H1 drug register to identify the missing TB cases and strengthen TB notification, identify providers for engagement and extend support to them for ensuring standards of TB care, and provide feedback to providers regarding prescription practices. Stakeholders felt that implementation of Schedule H1 surveillance has helped to improve TB patient notifications from the private sector, build better public-private partnerships, and improve the quality of TB diagnosis and treatment in Kerala. Conclusion: Pharmacy-based drug sales data collected either through regulatory or non-regulatory methods have immense potential to support TB elimination programs.

To compare short- and long-term outcomes after transcatheter aortic valve implantation (TAVI) in the public and private hospital setting.Propensity-matched, retrospective analysis of a prospective registry.Patients with severe aortic stenosis who underwent TAVI at a tertiary public hospital (n=507) and an experienced private hospital (n=436).The primary endpoint was all-cause mortality.Patients that underwent TAVI in the public hospital were younger than patients in the private hospital (82±8 years vs 84±6 years, p0.001), with lower estimated short-term mortality risk (Society of Thoracic Surgeons Predicted Risk of Mortality [STS-PROM] score4.0%: 43% vs 56%, p0.001). There was no difference between public and private hospitals in 30-day mortality (1.5% vs 1.2%, p=1.0), and the rate of complications was similar. Long-term survival was similar in propensity-matched public (n=344) and private (n=344) patient cohorts. The 1-year, 2-year, 5-year and 7-year survival rates were 95%, 90%, 67% and 47% in public patients, and 92%, 86%, 67% and 51% in private patients (p=0.94). In multivariable analysis, the hospital setting was not a predictor of mortality.Despite increased age and predicted mortality in private hospital patients, short- and long-term outcomes after TAVI were comparable between public and private hospital settings. This study demonstrates the feasibility of performing TAVI in a private hospital with a dedicated and experienced team and questions the current restricted access to TAVI in the private sector.

The 21st century brings countless social, economic, environmental, and technological challenges to humanity and, to face them, the United Nations (UN) created the Sustainable Development Goals (SDGs). The auto industry, which is part of the private sector, aims to reach them. In this context, this study aims to evaluate the consumption and emissions of pollutants by using an automatic transmission of the CVT (Continuously Variable Transmission) type concerning the automatic transmission of the "Planetary" type. This study will be based on the Consumption/Energy Efficiency tables, published annually by INMETRO (National Institute of Metrology, Quality, and Technology) and whose data will be processed and evaluated using the Quik Sense Software. Thus, the work aims to appraise the advantages of vehicles with automatic transmission of the CVT type about fuel consumption, energy efficiency and emissions, in markets such as Brazil, where these vehicles use ethanol or a mixture of gasoline with up to 27 as fuel % Ethanol. This research can contribute to studies of emission control and approval, benefiting the automotive industry in general, government agencies, the environment, the economy, and society, contributing to the UN's SDGs achievement.

Background and PurposeAccreditation is viewed to enhance the total quality of healthcare. The present study aims at assessing patients’ perspectives toward the quality of emergency healthcare services at different hospitals with different characteristics in Jordan. The elements of patients’ perception were aligned with the conceptual framework of Patient Centeredness Model.MethodsThis descriptive cross-sectional study was carried out in four emergency departments from different healthcare sectors and accreditation statuses in Jordan. Less urgent/nonurgent, alert, and cooperative patients were identified directly after the completion of emergency treatment. The perspectives of patients about the quality of emergency services were evaluated by 10 domains articulated in a validated accident and emergency questionnaire.ResultsA total of 276 patients were enrolled in the study. Private sector scored higher in all assessment domains in both accredited and nonaccredited hospitals in comparison with the government sector. Accredited government hospitals scored higher in patients’ evaluation for “doctor and nurse,” “investigations,” “pain,” and “overall respect of medical staff” domains than nonaccredited government hospitals. The overall experience was significantly different between accredited and nonaccredited government hospitals.Implications for PracticeQuality of emergency care services should be assessed through various dimensions related to patients’ perspectives. Patients’ perception toward the quality of emergency health services is evidently enhanced by accreditation especially in the government sector.

BACKGROUND: The study is of practical importance for policy makers and family planning (FP) program managers as the profile of FP method-mix with a shift from a mechanical method as intrauterine devices (IUD) to hormonal methods such as oral contraceptives (OCs) and injectables predicts a critical situation for maternal and child health and reflects shortcomings in FP service delivery program. AIM: The purpose of the current study was to identify reasons for the progressive shift from IUD to OCs in Egypt. METHODS: The study is an-operations research conducted at four levels of the Ministry of Health and Population/FP (MOHP/FP) service delivery: Central (headquarter, HQ), governorate, district, and service delivery points. It included five of MOHP/United Nations Fund for Population Activities-Contraceptive Security Project governorates that represent, urban governorates, Lower Egypt, and Upper Egypt. Both qualitative data in-depth interviews with MOHP/HQ staff, Two Focus Group Discussions with FP Health Directorates staff and nurses in the five governorates, and quantitative data through a self-administered questionnaire for 607 service providers (SP). RESULTS: There was a consensus on the actual shift from IUD to OCs use. Reasons were the absence of incentives for healthcare providers for IUD insertion services (64%) and improper training of physicians (45%), and the availability of OCs all time. CONCLUSION: The three articulating issues that lead to shifting from IUD to OCs are: Unsatisfactory training and incentive systems for SPs and the clients’ choice of OCs for independent use/autonomy, and availability of OCs all the times at a reasonable cost in both the public and private sectors.

Purpose The most recent advent of the unsolicited proposal in the public private partnership mode of infrastructure procurement has changed the duties and roles of private and public sector agencies. Also, they have increased the practitioners' difficulties to work out strategic mechanisms and methods to manage these unsolicited proposals (USP) effectively. So, this study aims to understand how well equipped are the Indian USP guidelines for managing procurement. Design/methodology/approach Content analysis with coding procedures was carried to understand the regulations of USP frameworks of India over the four stages of USP procurement. Findings The findings show that there are severe flaws in various states' frameworks. The states have flaws in their policies in implementation features across the stages of USP such as defined objectives, the absence of fees and review timeframes in the submission, time frame and guidance on benchmarking and market testing in evaluation and development, time frame for bidding and access to information in procurement stages. Originality/value The USP implementation framework developed as part of this study can direct the policymakers and practitioners to improve public procurement regulations and the necessary changes for the successful implementation of USPs. In doing this, the private sector is enabled to develop more competitive and innovative proposals.

Background Prior studies have reported for several cancer types that treatment in the private sector is associated with improved survival outcomes. Data for patients with locally advanced unresectable and metastatic pancreatic ductal adenocarcinoma (PDAC) have not previously been reported. Methods Analysis of patients from January 2016 to June 2020 registered to a multicentre prospective cancer database. Baseline demographic and clinicopathologic characteristics were compared. The Kaplan-Meier method was used to compare overall survival (OS). Multivariate Cox and logistic regression analyses were used to determine predictors of mortality and first-line chemotherapy treatment, respectively. Results Of 822 patients, 22.5% received private care. Private patients were older (median 71.5 vs. 68.9 years, p ≤ .05), had better performance status (ECOG 0 to 1: 82.2 vs. 73.5%, p = .05) and more likely to reside in an area with high socioeconomic advantage (67.0 vs. 19.6%, p ≤ .01). Private patients were more likely to receive first-line chemotherapy (69.7 vs. 54.2%, p ≤ .01) with logistic regression demonstrating private care (OR: 1.87, 95% CI: 1.20 to 2.97) as an independent predictor of receiving chemotherapy. Private patients had prolonged survival (median OS: 9.2 vs. 6.9 months, HR 1.2, p = .05). Receiving first-line chemotherapy was an independent predictor of mortality, but private care was not. Conclusions Care in the private system is associated with improved OS, with higher uptake of first-line chemotherapy appearing to be the main contributor. Given the discrepancy, further studies are needed to determine what factors are driving this difference.

Threats such as liquidation, competition, and profitability may be of urgent concern to private sector organizations, but are significantly less relevant in a government context. Factors that are more important for the government include long-term stability, the ability to consistently cover annual expenditures and debts, and the management of public funds, the development of accounting in the field of government has become an important role in the administration and governance of government finances so that research in the field of government accounting in recent years is indispensable. This study aims to find out how to study the development of research in the field of government accounting by conductinganalysis bibliometric to investigate references to scientific articles in the field of government accounting. The research method used is a quantitative method to analyze a literature review that summarizes and evaluates a collection of writings on a topic. Research in the field of government accounting occurred at most in 2017. Based on theanalysis bibliometric that has been carried out, research on government accounting is very necessary to meet the needs of stakeholders to assess government accountability and to make political, social, and economic decisions.

This study aims to examine adaptive governance aspects of the issues from each stakeholder related to the management of Limboto Lake. The implementation of this research uses a qualitative deductive approach. The types of research that will be used are descriptive and explanative types. Sources of data from this research, namely documents and archival records grouped into documentation sources, interviews sourced from people/informants, and direct observation, observation of the role of physical devices grouped in observation sources, and Focus Group Discussions (FGD). The results of this study indicate that efforts to revitalize, rehabilitate and conserve are, of course, not the task of the Government alone but require the participation of the community in them. Conditions of good synergy between the Government, the community and the private sector in efforts to save and manage Lake Limboto are desirable, this is also in line with the achievement of the objectives of adaptive governance in terms of resilience to rapid and unpredictable environmental changes.

Accreditation in higher education has become omnipresent and, on many occasions, has been used as a synonym for quality assurance. The establishment of accreditation agencies as a worldwide phenomenon, however, is relatively recent in the history of higher education. Through a predominantly qualitative approach, this paper aims to analyze how programs from different academic disciplines perform in terms of the accreditation of graduate programs in Argentina and how different programs respond to the same accreditation process. Additionally, it analyzes the performance of private sector programs. As expected, academic disciplines play a vital role in the accreditation process, programmatic performance, and responses to this quality assurance mechanism while sector may not play a vital role. Surprisingly, soft pure programs perform better than both hard and soft applied programs. The results highlight the importance of considering both the paradigm (hard or soft) and level application (pure or applied) when analyzing the role of academic disciplines in higher education studies.

The main purpose of our research is to seek insight into the antecedents of employee empowerment at both organizational and individual levels. We also address the outcomes of empowerment at the individual level. Subsequently, the research discusses the mediation effect of psychological empowerment on structural empowerment and its outcome as job satisfaction. A total of 400 samples were collected from the employees of public and private sector banks in India using an online questionnaire, during the Covid-19 pandemic period. To test the hypotheses, Confirmatory factor analysis (CFA) and path analysis were used. The study proved that the antecedents such as psychological and structural empowerment have a positive and significant effect on job satisfaction, while psychological empowerment partially mediates between structural empowerment and job satisfaction. This research attempts an integrative approach as suggested by the Social Cognitive Theory for predicting empowerment. We have used unidimensional constructs of psychological empowerment, structural empowerment, and job satisfaction in the Indian banking sector. This study contributes to both theory and practice by providing insights into the benefits of public and private sector bank employees which is gained through the implementation of empowerment policies during the Covid-19 period. Supplementary Information The online version contains supplementary material available at 10.1007/s10672-021-09393-z.

In recent years women have been making great strides in the legal profession with female law students outnumbering male students in law faculties in Universities as well as the Law College in Sri Lanka. However, despite the high numbers of women entering the legal profession in Sri Lanka, this is not reflected in the number of leadership positions and high-profile roles taken on by women Attorneys-at-Law. The legal practice is largely dominated by male attorneys in Sri Lanka. In addition, women comprise almost one-third of the total number of judges and have served as Chief Justice. This under-representation of women in the legal profession can negatively affect women’s rights and access to justice as well as detract from the justice system’s overall effectiveness. It is apparent that the majority of women law graduates do not pursue careers as practicing lawyers, prosecutors or judges but tend to seek employment in the private sector companies and other financial institutions and organizations. The aim of this article is to discuss the challenges and women’s experience in entry and retention in the legal practice. The paper is focused on two-panel discussions conducted in two districts in Sri Lanka, during my tenure as a gender specialist in a justice project. The discussion is based on the experiences shared by the Panellists and the feedback collected from the women attorneys and the female law students who attended the panel discussions held in the two districts. This paper explores the experiences shared by the women attorneys and suggests new approaches in overcoming the barriers.

This article examines the resource sharing functionality of the decryption platform of Europol. The platform supports European law enforcement agencies (LEAs) that are having difficulties accessing legally obtained encrypted evidence due to the lack of human and technical resources. The article investigates Europol’s resource transmission role with sharing economy variables such as transaction cost and trust-building. The core argument of the article is that Europol’s sharing platform has a strong potential to reduce the transaction cost of outsourcing the decryption services and diminish trust-related problems for national policing agencies by replacing private sector actors. However, for a more sustainable cybercrime investigation strategy, the decryption platform needs a new market-oriented model supported with robust vetting and evidence security mechanisms to encourage more private company participation.

This study aimed at identifying talent retention strategies for female academics in the higher education sector, paying particular attention to the Sub-Saharan context. Higher education institutions rely on the knowledge, abilities, and skills of their academics in order to keep abreast of the changing nature of higher education globally. These institutions of higher learning are required to be competitive and achieve their strategic goals in order to remain relevant in the sector. Studies have shown that female academics are leaving the higher education sector for the private sector for numerous reasons, including better salaries and further development. Additionally, some female academics are emigrating to European countries in search of greener pastures. Therefore, higher education institutions have to ensure that talent retention strategies are implemented to retain female academics, as well as to facilitate their progress to top leadership positions. The study utilized four crucial retention strategies identified in Kenya by Mutiria, Rukangu and Kubaison in 2015. These retention strategies include compensation and benefits, formal succession planning, training and development and career development opportunities. A quantitative research design was adopted for this study, whereby online questionnaires were completed by 112 female academics at a Sub-Saharan university. The data were analyzed using the Statistical Package for the Social Sciences (SPSS) version 27 for Windows. The results revealed a significant relationship between the four identified strategies and retention. Thus, institutions of higher learning should effectively implement these strategies in order to retain talented female academics, considering the dynamics in the sector.

Brand choice has historically played an important role in a wide range of industries, particularly in the private sector, where billions of Rands are invested to entice potential customers. Taking this into consideration, the purpose of this study is to investigate the effect of brand awareness and brand image on first-year student selection of a University of Technology in KwaZulu-Natal. The objectives of the study were to establish and identify the brand preference and image attributes that entice first-year students’ selection of a University of Technology (UoT). The study also examined the biographic variables of those students. To accomplish these objectives, an exploratory study using a quantitative research approach was conducted, in which questionnaires were administered to 500 first-year students at the selected Universities of Technology in KwaZulu-Natal. The study revealed that topics such as investments in brand awareness and brand image, safety and security, the caliber of staff, delays in academic programmes, student-lecturer relationships, and service delivery were identified as factors that influenced the participants' selection and willingness to recommend their institutions to potential students. Thus, the study recommends that UoTs should pay more attention to branding strategies as an agendum to ensuring institutional profitability and viability, relationship management, and human resource. Finally, the findings of this study are limited to KwaZulu-Natal and should not be extrapolated outside this region.