Organisational Legitimacy, Capacity and Capacity Development

The European Centre for Development Policy Management (ECDPM) has undertaken a study of capacity development, with a focus on organisational change and performance enhancement. Both individual organisations and networks of organisations have been studied with the aim of identifying important relationships among endogenous change factors (e.g. ownership, commitment and managerial style), key internal organisation variables (e.g. structures, procedures, staffing and management systems), performance and sustainability outcomes, and external environmental factors (e.g. policy frameworks, resource availability, politics, stakeholders, governance regimes, etc.).To date, the ECDPM study team has conducted 16 case studies (see Appendix). Among the findings that have emerged from several of the cases is the presence of an organisation's legitimacy as a factor contributing to successful capacity and performance. To delve in more detail into the concept of legitimacy, and to identify the implications for capacity building, ECDPM commissioned a working paper on the topic. This exploratory paper reviews the relevant literature and examines: differing definitions, types and sources of legitimacy; the links between legitimacy and organisational capacity, performance and sustainability; and management strategies for building and maintaining legitimacy. It discusses a selected set of the ECDPM cases in terms of the legitimacy concept

Confronting corruption in the health sector in Vietnam: patterns and prospects

This repository item contains a single issue of the Health and Development Discussion Papers, an informal working paper series that began publishing in 2002 by the Boston University Center for Global Health and Development. It is intended to help the Center and individual authors to disseminate work that is being prepared for journal publication or that is not appropriate for journal publication but might still have value to readers.Corruption in Vietnam is a national concern which could derail health sector goals for equity, access, and quality. Yet, there is little research on vulnerabilities to corruption or associated factors at the sectoral level. This article examines current patterns of corruption in Vietnam’s health sector, identifies key corruption vulnerabilities, and reviews strategies for addressing corruption in the future. The article builds on the findings and discussion at the sixth Anti-Corruption Dialogue between the Vietnamese Government and the international donor community. Development partners, government agencies, Vietnamese and international non-governmental organizations, media representatives and other stakeholders explored what is known about important problems such as informal payments, procurement corruption, and health insurance fraud. The participants proposed corruption-reduction interventions in the areas of administrative oversight, transparency initiatives and civil society participation, and health reforms to change incentives. The analysis assesses the prospects for success of these interventions given the Vietnamese institutional context, and draws conclusions relevant to addressing health sector corruption in other countries

Measuring governance at health facility level: developing and validation of simple governance tool in Zambia.

BACKGROUND: Governance has been cited as a key determinant of economic growth, social advancement and overall development. Achievement of millennium development goals is partly dependant on governance practices. In 2007, Health Systems 20/20 conducted an Internet-based survey on the practice of good governance. The survey posed a set of good practices related to health governance and asked respondents to indicate whether their experience confirmed or disconfirmed those practices. We applied the 17 governance statements in rural health facilities of Zambia. The aim was to establish whether the statements were reliable and valid for assessing governance practices at primary care level. METHODS: Both quantitative and qualitative methods were used. We first applied the governance statements developed by the health system 20/20 and then conducted focus group discussion and In-depth interviews to explore some elements of governance including accountability and community participation. The target respondents were the health facility management team and community members. The sample size include 42 health facilities. Data was analyzed using SPSS version 17 and Nvivo version 9. RESULTS: The 95% one-sided confidence interval for Cronbach's alpha was between 0.69 and 0.74 for the 16 items.The mean score for most of the items was above 3. Factor analysis yielded five principle components: Transparency, community participation, Intelligence & vision, Accountability and Regulation & oversight. Most of the items (6) clustered around the transparency latent factor. Chongwe district performed poorly in overall mean governance score and across the five domains of governance. The overall scores in Chongwe ranged between 51 and 94% with the mean of 80%. Kafue and Luangwa districts had similar overall mean governance scores (88%). Community participation was generally low. Generally, it was noted that community members lacked capacity to hold health workers accountable for drugs and medical supplies. CONCLUSIONS: The study successfully validated and applied the new tool for evaluating health system governance at health facility level. The results have shown that it is feasible to measure governance practices at health facility level and that the adapted tool is fairly reliable with the 95% one-sided confidence interval for Cronbach's alpha laying between 0.69 and 0.74 for the 16 items. Caution should be taken when interpreting overall scores as they tended to mask domain specific variations

Identification of capacity development indicators for faculty development programs: A nominal group technique study.

BackgroundAlthough there have been many research studies of the effectiveness of faculty development in health profession education, the contribution of these programs to organizational development through capacity development has not been studied. Further understanding of capacity development requires appropriate indicators and no previous indicators for faculty development of health profession educators were identified. The aim of the study was to identify indicators of capacity development in the context of faculty development programs at Tehran University of medical sciences (TUMS).MethodsA nominal group technique session was conducted with key informants from faculty development program providers to generate and prioritize a list of capacity development indicators.ResultsA list of 26 indicators was generated and five categories were identified: Development and innovation in teaching and learning process, Development and innovation in communication and collaboration at different levels, Development and sustaining faculty development programs, Development of educational leadership and management, Development in scholarship.ConclusionsCapacity development for faculty development interventions of health profession educators is a process of engagement within a wider system, including individual and collective action, and involves the socialization of the teachers into suitable roles through professional identity development and participation within the wider system

What is health systems responsiveness? Review of existing knowledge and proposed conceptual framework

Responsiveness is a key objective of national health systems. Responsive health systems anticipate and adapt to existing and future health needs, thus contributing to better health outcomes. Of all the health systems objectives, responsiveness is the least studied, which perhaps reflects lack of comprehensive frameworks that go beyond the normative characteristics of responsive services. This paper contributes to a growing, yet limited, knowledge on this topic. Herewith, we review the current frameworks for understanding health systems responsiveness and drawing on these, as well as key frameworks from the wider public services literature, propose a comprehensive conceptual framework for health systems responsiveness. This paper should be of interest to different stakeholders who are engaged in analysing and improving health systems responsiveness. Our review shows that existing knowledge on health systems responsiveness can be extended along the three areas. First, responsiveness entails an actual experience of people’s interaction with their health system, which confirms or disconfirms their initial expectations of the system. Second, the experience of interaction is shaped by both the people and the health systems sides of this interaction. Third, different influences shape people’s interaction with their health system, ultimately affecting their resultant experiences. Therefore, recognition of both people and health systems sides of interaction and their key determinants would enhance the conceptualisations of responsiveness. Our proposed framework builds on, and advances, the core frameworks in the health systems literature. It positions the experience of interaction between people and health system as the centrepiece and recognises the determinants of responsiveness experience both from the health systems (eg, actors, processes) and the people (eg, initial expectations) sides. While we hope to trigger further thinking on the conceptualisation of health system responsiveness, the proposed framework can guide assessments of, and interventions to strengthen, health systems responsiveness

Micro-ion Traps for Detection of (Pre)-Biotic Organic Compounds on Comets

Comets are currently believed to be a mixture of interstellar and nebular material. Many of the volatiles in comets are attributed to interstellar chemistry, because the same species of carbonaceous compounds are also observed in ices in interstellar molecular (ISM) clouds. Comets are thus likely to be a relatively pristine reservoir of primitive material and carbonaceous compounds in our solar system. They could be a major contributor to the delivery of prebiotic organic compounds, from which life emerged through impacts on early Earth. Mass spectrometers are very powerful tools to identify unknown chemicals, and much progress bas been made in miniaturizing mas spectrometers for space applications. Most miniatu rized mass spectrometers developed to date, however, are still relatively large, power hungry, complicated to assemble, and would have significant impact on space flight vehicle total payload and resource allocations

Bacteriophages: Paving the Road for the Future of Medicine

Antibiotics will not be used forever by society due to antibiotic resistance. By the year 2050, it is predicted to have caused millions of casualties throughout the world. Thankfully, bacteriophages and phage therapy could be a potential solution to this problem