Developing Country Perspectives on Public Service Delivery
The last decade has witnessed significant government focus on service delivery in developing nations like South Africa, Philippines, India and Malaysia. At the forefront of this movement has been the public sector reforms significantly driven by two broad factors: public sector inefficiencies, and liberal economic ideology. This move towards efficient public service delivery in developing nations (versus developed nations) has required a significant shift in institutional thinking and institutional capacity for the governments. It is therefore no surprise that while economic liberalization has been relatively easy to implement, governance reforms towards public service delivery has been significantly more challenging. In this background, this book examines the status of the public service in developing countries, in the sectors of health, infrastructure, labour and marginalized populations, rural economy, and public administration. The chapters, with sector themes, examine the three basic foundations of public policy, namely, courses of action; regulatory measures and issues; and funding structures and priorities, in public service delivery. The book is a multi country, multi sector, perspective. It includes studies from Russian Federation, India, Ethiopia, Pakistan, Fiji, South Africa, Columbia, Philippines, Macedonia, and India. The multi country and multi sector perspective lends itself to the investigation for a comprehensive overall development model. The book will take the lessons from the chapters and use theory to develop and suggest model(s) of development on delivering effective and efficient public service, applicable across countries.
The problem of medical doctors (MDs) as a professional group has become acute since the mid-2000s when Russia began to implement “The Health” (2006–2011), a national priority project which aimed to improve the quality and accessibility of primary health care for its population. Official governmental reports regarding the implementation of the national project “Health” focus only on the material component of the reform process, namely the quantity of purchased equipment and the amount of funding spent. Until now, there has been little assessment of the sociopolitical processes involved in reforming the health care system and little understanding of whether the socioeconomic status and prestige of the medical profession have improved. This chapter seeks to fill that gap. The empirical data reported in this chapter is based on national statistics on health care reform (1995–2011) and several mass surveys of Russian physicians and the population, namely the Russian longitude monitoring survey (RLMS-HSE, HSE, 2005–2011, N = 12641), and “The prestige of the medical profession in Russian society” (Moscow, St. Petersburg, Novosibirsk, HSE, 2011, N = 120). The results show that the rhetoric of neoliberal reforms in the Russian system of public health care includes the professional group of doctors as a social institute in the regulation processes. In practice we observe the rather weak tendencies of medical professionalization.