Bulgaria is one of the first countries from the former socialist block, which adopted a new democratic Constitution as early as 1991. The Constitution affirms the model of modern democratic state and outlines the principle of decentralization, admitting the right of self-government to the municipalities. Development of the legal frame of the local self-government and the enlargement of its functions, including the regulation of the financial independence of the municipalities, was accepted as a good perspective for further development of the local self-government. \n \nBased on the above the paper analyses: \n⢠Political, administrative and financial decentralization in Bulgaria as an integral part of the process of making public institutions more efficient, responsive and accountable to citizens; \n⢠Historical background of the decentralization process - undertaken reforms; adoption of legal texts; Constitutional amendment for providing local authorities with taxation powers; establishment of a joint Working Group on Financial Decentralization; adoption of a Concept and a Program for Financial Decentralization; creation of a system of incentives which target higher local revenues, consolidated financial management potential, and maximum level of local autonomy to determine the type, scope and provision of municipal services; division of municipal budget financed public services into two groups (state delegated and local); development of Strategy for decentralization and a Program for its implementation; \n⢠The impact of national and international (Council of Europe, European Commission) institutions and NGOâs on the decentralization process. \n \nThe purpose of the paper is not only to reveal the past reforms, but to stress on the present results and to examine the intergovernmental fiscal relations and local financial management. Unfortunately despite the positive changes, made in the first years after the period of centralized economy and governance, nowadays the local finance system is almost unchanged. Some of the ascertained problems might be summarized in the following: \n \n- Presence of permanent structural deficit in the municipal budgets, caused by the discrepancy between expenditure responsibilities and the income base; \n- Complicated, non-transparent and frequently changing transfer system; \n- Insufficient financing of delegated responsibilities; \n- Reduction of the recourses for municipal investments. \n \nThe experience in our country shows that a number of former decisions and initial intentions in the sphere of decentralization end with stabilization of the centralization. In this respect the paper searches arguments, connected with the reasons for the above described situation â is it a result from: \n⢠the unpreparedness of local government institutions and local stakeholders to operate in a reformed environment and the limited capacity to design, implement and monitor decentralization policies; \n⢠or from the wish for realizing a lot of changes for very short period of time; \n⢠or the reason is in the lack of political will.
Numerous studies have been made of regional differences in income and level of development in Italy, and these studies basically differ in the responses they give to the question of whether the said differences were already of a substantial nature prior to Unification, or whether in fact they have widened since then. The present essay is going to examine this problem by focusing on the local administrative system adopted after Italian Unification, in order to ascertain the existence of a different approach to public intervention at the local level, and thus to the existence of disparities in local public spending. The paper offers an analysis of the actual working of the post-Unification administrative system in Italy, in terms both of the powers attributed to Italyâs municipalities and provinces, and of the degree of autonomy they had in deciding on funding methods. This analysis aims to ascertain whether the chosen strategy could have been maintained in a state characterized by strong regional differences, and to establish the kind of impact such a strategy had on the regional differences themselves. The main conclusion is that in absence of any sort of automatic transfer from the more industrialized regions to the poor ones, the adoption of a decentralized tax system for the financing of local public expenditure contributed to the deepening of regional divide. As a consequence at the beginning of the 19th century the central government started to subsidize the poorest regions and little by little move towards a more centralized fiscal system.
Development of public services is the effect of applying administrative reforms involving the banks and financial contribution. Decentralization strengthening and modernization of administrative structures and public services is supported by the World Bank, International Monetary Fund and the European Union, supplement the financial resources to facilitate development. To attract financing funds, local governments often resort to loans from the banks that manage the funds targeted. Money is used to supplement the income of local governments who needs loans for financing European projects. Empirical research on this way will make disclosures regarding the various types of banks involved in this process.
This paper describes the Brazilian health system, which includes a public sector covering almost 75% of the population and an expanding private sector offering health services to the rest of the population. The public sector is organized around the Sistema Unico de Saude (SUS) and it is financed with general taxes and social contributions collected by the three levels of government (federal, state and municipal). SUS provides health care through a decentralized network of clinics, hospitals and other establishments, as well as through contracts with private providers. SUS is also responsible for the coordination of the public sector. The private sector includes a system of insurance schemes known as Supplementary Health which is financed by employers and/or households: group medicine (companies and households), medical cooperatives, the so called Self-Administered Plans (companies) and individual insurance plans. The private sector also includes clinics, hospitals and laboratories offering services on out-of-pocket basis mostly used by the high-income population. This paper also describes the resources of the system, the stewardship activities developed by the Ministry of Health and other actors, and the most recent policy innovations implemented in Brazil, including the programs saude da Familia and Mais Saude.
<p>Successful cultural politics in Russia may be carried out on the basis of its management decentralization principle. Regional and municipal culture development is not possible without common national cultural aims and priorities. The state should play an essential role, however<br />regional cultures should be given self-development possibilities. Culture management decentralization should not get reduced to the financing issues. Decentralization priority aim should be improvement in efficiency of both cultural organizations and governmental authorities of the<br />federal and local levels.</p>
The collection of household waste is the only sector that is the full responsibility of municipalities in Jordan. Lise Debout gives a highly original analysis, dealing with the emergence of public-private partnerships and the role of NGOs and private contractors. The author explains that the public service of collecting household waste is an element of the relationship between citizens and government, then she describes the scope of the Jordanian government in the process of privatization and decentralization of this little-studied sector, which leads her to address the issue of state sovereignty. With 255kg to 310kg per capita per year, or about 1.46 million tons per year, the amount of waste produced in Jordan is higher than the average in low-income countries, by virtue of its high rate of urbanization, but 56% of this waste is organic. Under the 1955 Municipalities Act, the collection of household waste is the responsibility of municipalities, along with the financing thereof. It is the only public utility that is their full responsibility. The service is managed by the Department of the Environment and Public Health within municipalities. However, there is a conflict with the new Ministry of the Environment.Institutional reforms have been limited lest they undermine national stability. Thus the autonomy of municipalities is a risk factor for the Jordanian government, as shown by the amalgamation reforms which provided for the autonomy of senior municipalities, but which has not been implemented in Irbid or Zarqa. This is also why programs of municipal development and decentralization are doomed to failure. The Jordanian State wishes to maintain its sovereignty while its people are reluctant to accept privatization measures which are seen as interference by foreign powers.
The availability of abundant renewable resources, lack of fossil fuels and difficult geographical terrain for grid line extensions contribute to the advantages of renewable based decentralized rural electrification in Ne-pal. Solar home system (SHS) and micro-hydro are the most commonly adopted off-grid renewable energy technologies in the country. This dis-sertation examines the market of renewable energy based rural electrifi-cation within prevailing policy and programmes framework. The study verifies whether the market has been able to serve the poor in Nepal. It also captures the perception of various stakeholders (e.g. private sup-ply/installation companies, NGOs, financial institutions and the donorâs programme) regarding the business, financing issues and the role of gov-ernment policy on the market development. In addition, the study dis-cusses and analyses renewable based rural electrification supply models, the economics behind rural electrification, market drivers and market distribution in the rural areas of Nepal. The financial mix in the off-grid rural electrification is generally charac-terized by subsidy, equity and credit. The study shows that awareness about renewable energy technologies and willingness to pay for electricity access has increased considerably. However, there is a huge financial gap between the cost of electrification and affordability among the poor. The distribution analysis shows there is significant increment in the extensive growth but decrease in the intensive growth rate of rural electrification thus indicating market expansion with uneven penetration among the ru-ral people. Solar PV technology is still not in the reach of the economic poor. Access to credit and cumbersome subsidy delivery mechanisms have been perceived as the major factors affecting the expansion of rural electrification by the stakeholders, requiring innovation in the credit and subsidy delivery system so that a larger rural population can be given ac-cess to electrification.
In the last three decades, the supply of housing in Argentina has not kept pace with demand. This study analyzes the main drivers of Argentina's housing market and relates them to the macroeconomic environment in order to advance a policy agenda for housing policy reform. The demand for housing was calculated and tenure choice was analyzed. Structural characteristics affecting Argentina's housing market include the high concentration of the urban population in a few large metropolitan areas, te association of urban poverty with the housing deficit, and overcrowding. The mortgage market lost its appeal following the 2001-02 crisis due to widespread breaches of contract legitimized through protective legislation (still in place), insufficient long-term financing, and high inflation. The housing deficit could be eliminated in five to eight years if well-coordinated policy initiatives to develop the mortgage market and provide low-income housing were adopted under a decentralized, demand-driven, subsidized program.
We construct a model of endogenous investment specific techological change in which the stock of public capital influences the real price of capital goods. We show that the growth and welfare maximizing tax rates coincide in the planned economy. When factor income taxes finance public investment infintely many tax-subsidy combinations can decentralize the planner's allocations. The optimal capital income tax can be positive in this environment. We then augment the model to incorporate administrative costs. A unique combination of factor income taxes now decentralizes the planner's allocations. A simple calibration exercise suggests that changes in factor income taxes does not cause a significant change in the optimal growth rate or welfare. Our framework broadens the environment in which investment specific technological change occurs, and characterizes the role of optimal factor income taxation in raising long run growth and welfare.
Over the past twenty years, important changes in the Italian health system have led to different approaches in organizing, delivering and financing health services throughout the regions of the country. This study aims to examine the impact these factors have had on efficiency. The methodology adopted is based on the developments in bootstrapping Data Envelopment Analysis (DEA). In particular, employing a two-stage procedure, we analyzed the impact that political interventions have produced on healthcare efficiency. The data, which were at the local health unit level for the period 2004-2005, were aggregated to the provincial level in order to take into account patient mobility. The study reveals that the organizational model adopted by the Lombardia region allows for the best results in healthcare efficiency. Second, administrative decentralization from the regional governments to local health units is a source of inefficiency. Third, adjusting the cost of delivering care, by taking into consideration regional health characteristics, improves efficiency. Finally, future policy interventions should make careful valuations of the impacts of patient mobility on healthcare efficiency.
Open access
Efficiency Analysis Using DEA
Health Systems, Economic Evaluations, Quality of Life
The present study describes and explains the changing role of the state in the Italian healthcare system since the beginning of the 1970s, with a particular focus on developments following 1978 when the healthcare system was transformed from a social insurance system into a national health service. In order to address these changes in a systematic way, we track healthcare system development along three dimensions: regulation, financing, and service provision. With regard to regulation, we observe a relative retreat of the state due to decentralization processes and internal market mechanisms. Quantitative measures for the financing and service provision dimension also indicate a modest relative retreat of the state. Taking regional data into account, we identify a clear North-South-divide in the public/private mix of financing and service provision. Although the focus of the paper is to describe the changing role of the state in the Italian healthcare system, we also offer preliminary explanations. We seek to identify the role of exogenous shocks such as economic crises versus endogenous stressors specific to the healthcare system itself (i.e. inherent inefficiencies) on healthcare system change. Therefore, the paper aims to provide a tentative, yet dynamic account of healthcare system change that is both descriptive and explanatory.
The new era of forest governance in Indonesia was marked by publication of the Act 22, 1999 about District Autonomy, which led to shift from the old centralized forest management to decentralized one. The decentralized forest governance is expected to improve the overall of forest governance. It is evident, however, that the degradation of forest has actually increased under the decentralized governance. Why does this uncontrolled destruction of forest occur? The aims of the study are to research and understand dynamics and complexity of the monitoring administration for forest gavernance in local autonomous era in Indonesia, taking on case of West Java Province. The study also to detect variables having effects on the success of forest governance monitoring administration. The study was conducted using qualitative research method, employing in-depth interview techniques, combined with aspect of legislation and library study. The key informans was interviewed such as the stakeholders of senior foresters of Forestry Services of the Regency, Province, Forestry Department, Forestry Researcher Team, Non Government Organization, Government Forestry Bussiness, Forestry Lecturer, and the Local Community. The number of key informan of 23 persons, and have expertise more than 15 years at Bandung City, Bandung Regency, West Bandung Regency , Bogor Regency, Purwakarta Regency and Jakarta. This study found that the decentralized model only adds more destruction and complexity to the forest governance. The complexity of the problem is deteriorated by reformation euphoria and autonomous sentiments. The success of forest governance monitoring is determined by several major variables are: (i) Regulation, comprising of law and supporting rules,policy, and institution; (ii)Infrastructure comprising of financing, technology, information system, communication, coordination, and societal Involvement, and (iii) Human Resources, comprising of feasibility, perception, and integrity. The success of the forest governance monitoring is affected by secondary variables: The Quality of Forest Governance Planning and the prevailing Political Situation. For conclusion, the results of the study were contributing to theory, practice, and politics for improving the understanding and knowledge of the decentralization of forest governance.
Providing financial resources for public funds is difficult to effectuate and the central government and local government level. Since local budgets do not own income sufficient to ensure the financing of all expenditures on behalf of local collectivities, then the state budget provides funding for social, economic local destinations. Decentralization of public services is accompanied by financial descentralization. In this paper we present some aspects of VAT revenue from the state budget used to support certain activities at the local level, the evolution of these allocations in the context of current budgetary constraints due to financial crisis.
Developing countries are facing a great challenge to collect, treat and dispose their waste in a more sustainable way. Today, most of the produced waste ends up on landfills, where they pose a great threat to the environment and human health. Kumasi, the second largest city in Ghana, faces the same issues as other cities in developing countries; waste management is run poorly and most waste ends up on the cities largest landfill, Dompoase, which will be full in a few years time. Issues such as low financial resources, bad urban planning and a growing population aggravate the implementation of a more sustainable development. Since most solid waste in developing countries is organic, composting is a good option towards a more sustainable waste management. There are numerous amounts of articles stating that decentralized composting is the best option for developed countries. Decentralized compost facilities are less costly to install and maintain, they require less technology and decrease the cost of waste transportation. Transportation poses a large expense when it comes to waste management in developing countries. There is an advantage in integrating a more sustainable waste management in to the existing waste infrastructure since cities often are densely built up and there is a shortage of land. Therefore this thesis has investigated the possibilities of having waste sorting stations and decentralized compost facilities at public dumping sites in the Bantama area, one of ten sub--âmetros in Kumasi. Based on literature and observations during field visits in the Bantama area, a classification scheme was developed. The classification scheme was designed to simplify identification and differentiation of the sites. It contains thirteen criteria to consider when planning for organic waste sorting stations and decentralized compost facilities. Suitable sites for sorting stations and decentralized compost facilities were selected by a SQL analyzes in a Geographic Information System (GIS). The analyzes was based on the classification scheme. The result shows that of twenty--âone public dumpingsites, seven were suitable as sorting stations and two sites were suitable for a decentralized compost facility. The expectation is that in due time and with infrastructure improvements, more than only seven communal sites can become sorting stations. When it comes to sites for composting the result reveals an issue in many cities there is just not enough land to build as many decentralized facilities as would be necessary to recycle all organic waste. However, due to the advantages of having decentralized facilities, the recommendation is that Kumasi should start with a decentralized approach and as finance and technological skills exists the organic waste management can extend to also include larger facilities. Further this thesis shows the advantage of having decentralized composting when it comes totransportation costs. A transport analyzes was done in a GIS, which showed the difference intransportation distances between having decentralized and centralized composting. The result showed that waste recycled close to its source, i.e. having decentralized waste management, is transported shorter distance compared to having centralized composting and thus saving on cost for transportation.
Published as: Jorge Martinez and Paul Smoke. Introduction in <em>Local Government Finance: The Challenges of the 21st Century. </em>United Cities and Local Governments' Second Global Report on Decentralization and Local Democracy, Barcelona 2010.Edward Elgar, 2011. (c) United Cities and Local Governments. Published by <a href="http://www.e-elgar.co.uk/">Edward Elgar</a>. Posted with the permission of the publisher for personal use only.
Claudia Dziobek, Miguel Alves, Majdeline El Rayess, Carlos Alberto Gutierrez Mangas ¡ 5 authors
A useful but little known feature of the IMFâs Government Finance Statistics Yearbook (GFSY) is the information on the structure of governments. Institutional tables, included in the GFSY, provide detail on the central, state, and local levels of governments, social security, and extrabudgetary units. We refer to the main levels of government as GL1, GL2, and GL3 in ascending order of institutional coverage. We present maps of the various levels of government for 74 countries to illustrate the usefulness of this database and make it more accessible to users. The maps provide information about how centralized or decentralized government finances and employment are and their size relative to the overall economy. Government map data facilitate the monitoring of fiscal policy and fiscal rules.
Anna Sagan, Dimitra Panteli, W Borkowski, M Dmowski ¡ 31 authors
Since the successful transition to a freely elected parliament and a market economy after 1989, Poland is now a stable democracy and is well represented within political and economic organizations in Europe and worldwide. The strongly centralized health system based on the Semashko model was replaced with a decentralized system of mandatory health insurance, complemented with financing from state and territorial self-government budgets. There is a clear separation of health care financing and provision: the National Health Fund (NFZ) the sole payer in the system is in charge of health care financing and contracts with public and non-public health care providers. The Ministry of Health is the key policy-maker and regulator in the system and is supported by a number of advisory bodies, some of them recently established. Health insurance contributions, borne entirely by employees, are collected by intermediary institutions and are pooled by the NFZ and distributed between the 16 regional NFZ branches. In 2009, Poland spent 7.4% of its gross domestic product (GDP) on health. Around 70% of health expenditure came from public sources and over 83.5% of this expenditure can be attributed to the (near) universal health insurance. The relatively high share of private expenditure is mostly represented by out-of-pocket (OOP) payments, mainly in the form of co-payments and informal payments. Voluntary health insurance (VHI) does not play an important role and is largely limited to medical subscription packages offered by employers. Compulsory health insurance covers 98% of the population and guarantees access to a broad range of health services. However, the limited financial resources of the NFZ mean that broad entitlements guaranteed on paper are not always available. Health care financing is overall at most proportional: while financing from health care contributions is proportional and budgetary subsidies to system funding are progressive, high OOP expenditures, particularly in areas such as pharmaceuticals, are highly regressive. The health status of the Polish population has improved substantially, with average life expectancy at birth reaching 80.2 years for women and 71.6 years for men in 2009. However, there is still a vast gap in life expectancy between Poland and the western European Union (EU) countries and between life expectancy overall and the expected number of years without illness or disability. Given its modest financial, human and material health care resources and the corresponding outcomes, the overall financial efficiency of the Polish system is satisfactory. Both allocative and technical efficiency leave room for improvement. Several measures, such as prioritizing primary care and adopting new payment mechanisms such as diagnosis-related groups (DRGs), have been introduced in recent years but need to be expanded to other areas and intensified. Additionally, numerous initiatives to enhance quality control and build the required expertise and evidence base for the system are also in place. These could improve general satisfaction with the system, which is not particularly high. Limited resources, a general aversion to cost-sharing stemming from a long experience with broad public coverage and shortages in health workforce need to be addressed before better outcomes can be achieved by the system. Increased cooperation between various bodies within the health and social care sectors would also contribute in this direction. The HiT profiles are country-based reports that provide a detailed description of a health system and of policy initiatives in progress or under development. HiTs examine different approaches to the organization, financing and delivery of health services, and the role of the main actors in health systems; they describe the institutional framework, process, content and implementation of health and health care policies; and highlight challenges and areas that require more in-depth analysis.
Open access
Global Health Care Issues
Healthcare Policy and Management
Health Systems, Economic Evaluations, Quality of Life
The Croatian âdecentralization packageâ from mid-2001 has shown how multiple pressures for shifting power to the local level may actually result in relative failure. The central government has ceded the control in particular policy sectors by shifting responsibilities for certain educational, welfare and health services to the counties and municipalities. However, the decentralization initiative was excessively marked as very limited and strongly labeled by the vertical policy dimension, expressing the dominance of top-down incentives of the central government in comparison to bottom-up initiatives stemming from the local government units. The 2001 decentralized package did not substantially increase the portion of local governments finance in total public finance, showing a failure to provide local government units with stronger fiscal capacity. The central government bodies also did not take into account the alternative proposals made by various policy actors ranging from academic institutions, researchers in NGOs, and associations of local government organizations. All these things have contributed to a relatively negligible influence of the horizontal policy dimension on the decentralization outcome. The whole process can therefore be described as centrally controlled decentralization, or decentralization from above.
One of the fundamental tenets of fiscal federalism is that, absent various sorts of externalities, decentralized governments that rely on own-source revenues should be more fiscally efficient than decentralized governments that rely on grant financing. The argument relies in part on the idea that sub-national governments, being closer to the people, are more accountable to its citizens. Accountability to citizens is also important in understanding the presence of corruption in government. This suggests that the financial structure and institutions of decentralized governments can potentially influence the degree and extent of corrupt activity. Financial structures that make governments more accountable should be associated with less corruption (other things equal), while financial structures with less accountability should be associated with more corrupt activities. We develop a simple model in which the use of grants rather than locally raised taxes increases corruption. We then use a panel data set of Mexican states to study the relationship between funding sources for Mexican states and the level of corruption in those states. We find that greater use of own tax revenues lowers corruption while greater use of grants increases corruption. This suggests that expenditure decentralization that is accompanied by revenue decentralization is likely to discourage corruption while expenditure decentralization that is funded by grants tends to encourage corruption. We also find that poverty, a measure of uninformed citizens, leads to greater corruption.
In climate change, as in other areas, recent years have produced a âCambrian explosionâ of transnational institutions, standards, financing arrangements, and programs. As a result, climate governance has become complex, fragmented, and decentralized, operating without central coordination. Most studies of climate governance focus on inter state institutions. In contrast, I map a different realm of climate change governance: the diverse array of transnational schemes. I analyze this emerging system in terms of two theoretical frameworks developed to describe, explain, and evaluate complex governance arrangementsâregime complex theory and polycentric governance theoryârevealing fruitful avenues for positive and normative research. I conclude by arguing that the benefits of institutional complexity could be increased, and the costs reduced, through nonhierarchical âorchestrationâ of climate change governance, in which international organizations or other appropriate authorities support and steer transnational schemes that further global public interests.