When Public Services Contracts are Poorly Managed: An Analysis of Malawi’s Service Level Agreements

This paper contributes to the debate about the understanding of contextual factors in contracting out public services in developing countries. It argues that contractual rela-tionships that the Ministry of Health enters with faith-based health service providers in Malawi are not effective due to poor design, implementation and management ar-rangements. As a result the contracts have become more mechanisms for quantitative increase and access to services rather than tools for ensuring quality and accountability in service delivery. Although the arrangement contributes to the increased access to health services, it is not cost-effective and the quality of services in church health facili-ties remains low, because the process is filled with management and governance chal-lenges. Meanwhile, the Ministry of Health is often accused of delaying payments to the church health service providers thereby sustaining the efficiency and accountability malaise

Health system strengthening—Reflections on its meaning, assessment, and our state of knowledge

Sophie Witter - ORCID 0000-0002-7656-6188 https://orcid.org/0000-0002-7656-6188Comprehensive reviews of health system strengthening (HSS) interventions are rare, partly because of lack of clarity on definitions of the term but also the potentially huge scale of the evidence. We reflect on the process of undertaking such an evidence review recently, drawing out suggestions on definitions of HSS and approaches to assessment, as well as summarising some key conclusions from the current evidence base. The key elements of a clear definition include, in our view, consideration of scope (with effects cutting across building blocks in practice, even if not in intervention design, and also tackling more than one disease), scale (having national reach and cutting across levels of the system), sustainability (effects being sustained over time and addressing systemic blockages), and effects (impacting on health outcomes, equity, financial risk protection, and responsiveness). We also argue that agreeing a framework for design and evaluation of HSS is urgent. Most HSS interventions have theories of change relating to specific system blocks, but more work is needed on capturing their spillover effects and their contribution to meeting overarching health system process goals. We make some initial suggestions about such goals, to reflect the features that characterise a “strong health system.” We highlight that current findings on “what works” are just indicative, given the limitations and biases in what has been studied and how, and argue that there is need to rethink evaluation methods for HSS beyond finite interventions and narrow outcomes. Clearer concepts, frameworks, and methods can support more coherent HSS investment.Department for International Development, Grant/Award Number: Supported by the ReBUILD and ReSYST RPCshttps://doi.org/10.1002/hpm.288234pubpub

Public sector management accounting in emerging economies: A literature review

This paper reviews public sector management accounting (PSMA) research in emerging economies (EEs) and suggests ways forward. A political economy approach to management accounting and development is adopted to analyze the findings of the papers reviewed. Our review covers the past two decades and is based on 69 papers published in international accounting and public administration journals. We find that different development phases give rise to distinctive types of management accounting practice, which often do not live up to expectations owing to local politics and other socio-economic factors. Although the quantity of PSMA research on EEs is growing, there is a need for future research that addresses how management accounting practices in the public sector in EEs are impacted by the interplay between the public management programmes of international donor agencies and the political, economic and cultural contexts of EEs. In order to capture these complex socio-political and socio-cultural contexts, solid theoretical foundations are recommended, relying especially on critical and social theories, as well as on qualitative research such as case studies

New Public Management between reality and illusion: Analysing the validity of performance-based budgeting

Drawing from the theoretical insights of pragmatic constructivism, this paper aims to explain the difficulties faced by organizational actors in the translation of performance-based budgeting (PBB) into practice. The dichotomy of reality and illusion at the centre of pragmatic constructivism sheds light on the limitations and shortcomings that characterize the implementation of a business-like practice introduced as a component of the reform movement known as New Public Management (NPM). The paper investigates the case of an Italian Ministry through the analysis of interviews, policy documents, and governmental reports. The analysis shows that a failed integration of communication, values and aims between actors and an illusionary analysis of factual possibilities constrain the construction of causalities, hence jeopardizing the successful implementation of the performance-based budgeting reform. Rather than engaging in a co-authoring process, the actors are left with illusionary constructs that, while providing the appearance of a compliant organization, fail to produce the desired changes

Determinants of Nigerian managers’ environmental attitude: Africa's Ubuntu ethics versus global capitalism

We investigate the impact of economic, institutional, and ethical pressures on African managers' corporate social and environmental attitude based on a survey involving 377 Nigerian executives in the extractive industry. We find that environmental orientation and behavior are mostly induced by instrumental economic motives, while ethical considerations exert a weak impact. This finding is significant because it contradicts mainstream corporate social responsibility (CSR) literature in Africa, which suggests the dominance of the culturally based, altruistic African Ubuntu philosophy. Based on this research finding, we suggest that economic globalization has spurned a transnational capitalist cadre of managers whose values are shaped far more by global capitalist instincts than any putative cultural philosophy. The findings also undercut the fundamental logic underpinning the numerous global initiatives to promote environmental responsibility by multinational corporations in developing countries, which assumes that managers will pursue environmental sustainability voluntarily in the absence of robust regulations and strict enforcement

Reforming the Malawian Public Sector : Retrospectives and Prospectives

Reforming the Malawian Public Sector argues that the new public management model that Malawi, like most African countries, adopted under the influence of donor organisations has not led to the intended development. The book examines decentralisation, performance contracting, and public-private partnerships as key aspects of the reforms and comes to the conclusion that at best, it can be argued that the failures have been due to poor implementation and this could be attributed to the fact that the process was led by donors who lacked the necessary institutional infrastructure. The book uses the 2005/6 fertiliser subsidy programme, which the government embarked on despite donor resistance that it went against market models, but which turned out to be overwhelmingly successful to demonstrate the state's developmental ability and potential. This volume is essential reading for academics, students, and practitioners seeking a deeper understanding of public administration, management, policy, development and governance in Africa and the rest of the developing world. The book is dedicated to the memory Guy Mhone, a Malawian, who was among Africa's leading scholars in public administration and governance. His works focused mainly on public sector reforms and development

Tiptoeing towards a representative bureaucracy : engendering gender equality in Malawi Public Service

The article uses representative bureaucracy theory to analyze the prospects of engendering gender equality in the Malawi Public Service. It holds that where women are integrated into Public Service on an equal footing, there is anecdotal evidence of effectiveness, efficiency, and responsiveness. This article finds that despite policy, legal, and institutional interventions by the Malawi Government, there are critical structural, systemic, cultural, institutional, and implementation challenges that militate against the realization of a representative bureaucracy in terms of gender in the Public Service. A distinction between descriptive and substantive representation suggests that gender equality in Public Service should not necessarily be a matter of sheer numbers. The article finds that women are fewer in the Public Service employ in terms of proportions with males; and, that they are also disadvantaged in regard to leadership positions. From both perspectives, the article notes that women’s voice is not accorded the necessary status it deserves in Public Service decision-making processes. Also, the article concludes that the few women in leadership positions within the Public Service have not vigorously championed the cause for effective implementation of gender-based policies. As a result, the article recommends that the process of engendering gender equality in Public Service should involve collaborative effort

Can the state perpetuate the marginalisation of the poor? The socio-economic effects of the state's ban on minibus 'callboys' in Malawi

Malawi is a southern African country that has a huge informal sector due to high levels of unemployment. One of the ways people earned income in this sector was minibus-calling. This considerably reduced the vulnerability of many who would otherwise have been excluded economically. However, the state has recently declared such acts illegal and anyone found minibus-calling is now arrested. This paper critically investigates the socio-economic impacts of this ban on the former beneficiaries' livelihoods. A survey and interviews conducted in Zomba Municipality and Blantyre City (supplemented by various newspaper articles) show that the ban has adversely affected the socio-economic status of these marginalised Malawians.