18 research outputs found

    Governance of basic services provision in sub-Saharan Africa and the need to shift gear

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    During 1970 to mid 1980s, governments’ policies on basic services in sub-Saharan Africa (SSA) had an almost exclusive focus on directly provided, publicly-funded. This approach coupled with disintegration of the economic structures resulted in steep decline in people’s access to basic services. Recent developments however show that policies and strategies have changed and so is people’s access to the services. Decentralisation within the state and from the state to market and to civil society has been implemented in an unprecedented fashion in a number of countries. In addition, the strategy of ‘unbundled’ chain of service production has resulted in increasingly complex institutional arrangements between governments and non-state actors. Using data on the provision of primary education, primary health care, sanitation and solid waste collection, and drinking water from a number of countries in SSA, this paper shows that the new approach has not only changed how basic services are provided and managed but has also influenced improvements in coverage and people’s access, though quality varies and inequalities between localities have not much declined

    A participatory action research approach to strengthening health managers’ capacity at district level in Eastern Uganda

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    BACKGROUND: Many approaches to improving health managers’ capacity in poor countries, particularly those pursued by external agencies, employ non-participatory approaches and often seek to circumvent (rather than strengthen) weak public management structures. This limits opportunities for strengthening local health managers’ capacity, improving resource utilisation and enhancing service delivery. This study explored the contribution of a participatory action research approach to strengthening health managers’ capacity in Eastern Uganda. METHODS: This was a qualitative study that used open-ended key informant interviews, combined with review of meeting minutes and observations to collect data. Both inductive and deductive thematic analysis was undertaken. The Competing Values Framework of organisational management functions guided the deductive process of analysis and the interpretation of the findings. The framework builds on four earlier models of management and regards them as complementary rather than conflicting, and identifies four managers’ capacities (collaborate, create, compete and control) by categorising them along two axes, one contrasting flexibility versus control and the other internal versus external organisational focus. RESULTS: The findings indicate that the participatory action research approach enhanced health managers’ capacity to collaborate with others, be creative, attain goals and review progress. The enablers included expanded interaction spaces, encouragement of flexibility, empowerment of local managers, and the promotion of reflection and accountability. Tension and conflict across different management functions was apparent; for example, while there was a need to collaborate, maintaining control over processes was also needed. These tensions meant that managers needed to learn to simultaneously draw upon and use different capacities as reflected by the Competing Values Framework in order to maximise their effectiveness. CONCLUSIONS: Improved health manager capacity is essential if sustained improvements in health outcomes in lowincome countries are to be attained. The expansion of interaction spaces, encouragement of flexibility, empowerment of local managers, and the promotion of reflection and accountability were the key means by which participatory action research strengthened health managers’ capacity. The participatory approach to implementation therefore created opportunities to strengthen health managers’ capacity

    Culture in sustainable infrastructure

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    The high failure rate of infrastructures around the world is alarming, most especially when such failures constrain economic growth and development. In most cases, existing institutions or strategies designed to maintain and reproduce effective infrastructures in areas that lack them have been mostly unsuccessful, particularly in sub-Saharan Africa. A carefully conducted survey covering the six geopolitical zones in Nigeria confirms the low-level stability, supply, quality and maintenance of infrastructure and its services. Using the severity index in matrix order model developed in this study, major factors responsible for unsustainable infrastructure delivery and failures are identified. The paper further argues that these major factors are interrelated rather than being peculiar to Nigeria or sub-Saharan Africa. Suffice it to say that the effects of these problems are widespread and of global impact. However, what cuts across all the major factors responsible for unsustainable infrastructure delivery and high failure rates are gross institutional lapses. In view of the fact that sustainable infrastructure is essential for sustainable development, this paper emphasises the uniqueness of the recipients' cultures and values alongside the integration of indigenous communities and infrastructure users: from conceptualisation to delivery within the framework for institutional building and sustainable infrastructure provision

    The riddle of community development

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    The effect of increased private sector involvement in solid waste collection in five cities in Ghana

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    Private sector involvement in solid waste management in developing countries has increased, but the effect is not always clear. This study assesses how it has been organized in five cities in Ghana, what has been its effect and what lessons for private sector development in developing countries can be drawn. Data were collected from 25 private companies and a sample of 1200 households. More than 60% of solid waste in Ghanaian cities is now collected by private enterprises. Sometimes, and increasingly, competitive bidding takes place, although sometimes no bidding is organized leading to rendering of this service and no contract being signed. Local governments and local solid waste companies have not changed to more customer-oriented delivery because of the slow pace of charging users and the resulting low rate of cost recovery. The participation of the population has been limited, which contributes to low cost recovery. However, a gradual better functioning of the system put in place is shown. We observed an increasing use of competitive bidding, signing of contracts and city-wide user charging. Keywords Solid waste, private sector involvement, urban management, cost recovery, pay-as-you-throw (PAYT
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