Sustainability of family planning and health projects

USAID has assisted the Ghanian Ministry of Health since 1991 to boost family planning services under the Ghana Family Planning and Health Project by providing supplies and information and increasing the effectiveness of HIV/AIDS prevention and control. The sustainability of the health system is endangered by favoring capital expenditures in lieu of continuous expenditures; the lack of linkage between project activities and regular activities; the centralization of resource flow; and too ambitious targeting. Capital outlays provided by USAID featured in the construction of four public health laboratories, but their operation also requires continuous financing amounting to about 10% of the whole investment. The latter is the responsibility of the government, although the details of these recurrent costs were not detailed at the outset and providing these funds for continuous operation may impair the operation of other systems. The resource constraints could be alleviated by an effective cost-recovery system or by the general improvement of the economy. The lack of linkage between project and regular activities is serious at regional and district levels. The centralization of resource flow means that most resources are kept for headquarter level activities, thus other activities suffer and the health sector becomes excessively reliant on donor support. Too ambitious planning stems from pressure on donors and hastily implemented projects result in duplication and waste. Closer consultation with the parties involved would improve the situation. The rivalry of technical and policy groups has contributed to past deficiencies. Double funding for the same activity has also occurred further increasing the dependence on donor funding. By concentration on people and systems sustainability would be enhanced, while cost recovery would help the operation of the laboratories. The Health Education Unit (HEU) recognized the importance of IEC and obtained financing for such activities.     

Characterizations,length-biasing,and infinite divisibility

SupposeL(X) is the law of a positive random variableX, andZ is positive and independent ofX. Admissible solution pairs (L(X),L(Z)) are sought for the in-law equation $\hat X \cong X o Z$ °Z, where $L\left( {\hat X} \right)$ is a weighted law constructed fromL(X), and ° is a binary operation which in some sense is increasing. The class of weights includes length biasing of arbitrary order. When ° is addition and the weighting is ordinary length biasing, the class of admissibleL(X) comprises the positive infinitely divisible laws. Examples are given subsuming all known specific cases. Some extensions for general order of length-biasing are discussed.     

Socially Diverse Polis: Social and School Exclusion

This paper addresses the questions of citizenship in socially diverse polities. Such issues are presently not dealt with adequately because social scientists, parliamentarians and policy makers do not have an informed view which is relevant for the governance of stable democratic systems which embody cultural diversities. The role of social policy systems in ensuring equity in the delivery of services is important in ensuring the citizenship rights of all groups in society.

At the present time economic policies have created a culture of winners and losers which makes the efforts of schools more difficult.

The schools and the educational systems face the challenge of creating a common and shared values orientation on the diversities in the polity. Such communities also present the schools with immense possibilities, if teacher education, school policies and practice, curriculum and classroom organisation can be optimised. Such measures may help obviate the school exclusion of specific groups.     

The context of correctness: A comment on rushton

According to Philippe Rushton, the equalitarian fiction, a scientific hoax that races are genetically equal in cognitive ability, underlies the politically correct objections to his research on racial differences. He maintains that there is a taboo against race unequaled by the Inquisition. I show that while Rushton has been publicly harassed, he has had continuous opportunities to present his findings in diverse, widely available, respectable journals, and no general suppression within academic psychology is evident. Similarly, Henry Garrett and his associates in the LAAEE, dedicated to preserving segregation and preventing race suicide, disseminated their ideas widely, although Garrett complained of the equalitarian fiction in 1961. Examination of the intertwined history ofMankind Quarterly, German Rassenhygiene, far right politics, and the work of Roger Pearson suggests that some cries of political correctness must be viewed with great caution.Preparation of this paper was not supported by any grant, foundation, political, or religious organization.specializing in the history of psychology and psychological aesthetics.     

Health care futures. Part 2: The future of physician executives? Panel discussion

What is the future of health care in America? This is Part 2 of The Physician Executive panel discussion that explores the future of health care in America. To narrow this ambitious focus somewhat, the future is defined as five to 10 years hence. In Part 1, which was published in the May/June issue, Russell C. Coile, Jr., Barbara LeTourneau, MD, MBA, FACPE, James Reinertsen, MD, Uwe Reinhardt, PhD, Marshall Ruffin, MD, MPH, MBA, FACPE, and David Vogel, MS, shared their opinions about what the future holds in managed care, information technology, and biotechnology. In Part 2, Susan Cejka, Barbara LeTourneau, MD, MBA, FACPE, John Henry Pfifferling, PhD, Uwe Reinhardt, PhD, and James Todd, MD, share their views on the future of medical education and physician executives.     

Mortality Risk Perceptions: A Bayesian Reassessment

"This study uses data on perceived and actual mortality risks to test several alternative Bayesian models of the factors influencing risk beliefs. The analysis...indicates that while the hazard rate for the individual age group is an influential factor, the overall population death rate and the discounted expected number of life years lost due to the cause of death are also influential in affecting risk perceptions.... The predictive power of a linear perception model increases with the level of the risk and is least accurate for very small risks."     

An Exploration of the Meaning and Consequences of Workaholism

Although much has been written aboutworkaholism, rigorous research andtheoretical development on the topic is in its infancy.We integrate literature from multiple disciplines andoffer a definition of workaholic behavior. We identify three types ofworkaholic behavior patterns: compulsive-dependent,perfectionist, and achievement-oriented workaholism. Apreliminary model is proposed; it identifies potential linkages between each type of workaholismpattern and important outcomes such as performance, joband life satisfaction, and turnover. Specificpropositions for future research are articulated. Weconclude that, depending on the type of workaholicbehavior pattern, workaholism can be good or bad, andits consequences may be experienced or evaluateddifferently by individuals, organizations, and societyat large. Researchers and managers should avoidmaking judgments about the positive or negative effectsof workaholism until more carefully controlled researchhas been published.     

Introduction to the Special Issue

Organizational innovation is now widely seen tobe a major source of competitive advantage for firms,along with product and process innovation. One of themajor intellectual sources for the upheavals, in which firms strive for some formof international best practice, is thesociotechnical systems tradition, which traces its rootsback to innovations such as semi-autonomous work teamsin manufacturing in the 1960s, associated with the work of theTavistock Institute. An international Colloquium wasstaged in Melbourne, Australia, in May 1995, to explorethe current relevance and contributs to organizational innovation.     

The Limitations and Opportunities of Business Process Re-engineering in a Politicized Organizational Climate

This paper is concerned with the organizationalchange and project management issues raised by theimplementation of a business process re-engineering(BPR) approach in the politicized hospital context. This is a report of research in progress,focusing on the issues arising at the problem definitionand project planning stages of a BPR application in anoperating theaters department experiencing problems with scheduling and delays. The research designrelies on a case study approach, with the researcher asparticipant observer, as both an adviser to the projectteam and as field interviewer. The paper argues that an ambitious BPR agenda is compromised inat least two regards. First, the lack of precisionsurrounding the focus and methodology of BPR givespolitically motivated actors considerable influence with respect to defining terms of reference in wayswhich will shape potential outcomes in their favor.Second, the complexity and indeterminacy of the businessprocess or patient trail can also diluteredesign attempts. The principal limitations of theapproach thus concern the impracticality of embarking onrapid and radical change working from a blanksheet of paper with respect to organizational and job design. BPR, unlike other organizationdevelopment interventions, is not a contextsensitive approach. The role of project manageris critical in establishing a working balance betweenindividual, occupational, and organizational goals in a manner perceivedto be legitimate in the context. Effective BPR projectmanagement thus requires a combination of political andprocess analysis skills. The principal opportunities of BPR derive from its process orientation,which brings a fresh perspective to a traditionally andfunctionally fragmented organizational setting, andwhich presents a potentially valuable platform for anevolutionary approach to process improvement.