Alternative service delivery — responding to global pressures

The new South Africa came into being in 1994. The new government inherited the national public service and those of a variety of former provinces and homelands that had to be amalgamated to form a national unified public service. Although this task was accomplished rapidly, the resulting public service was very large, and exhibited many features of traditional bureaucracy, including hierarchical structures, limited automation and IT applications, low levels of training, a poor work culture, language and cultural barriers, and an overall orientation towards inputs and processes rather than service delivery and results. Within the first three years of the new order, substantial effort was devoted to reforming the bureaucracy. New public service legislation and regulations were introduced, new and powerful central personnel agencies were created, English became the language of administration, and substantial authority was devolved to departments and provinces. Despite these reforms, progress in improving results in terms of service delivery, especially to previously disadvantaged communities, was mixed. Towards the end of the 1990s increased attention was paid to means of improving service delivery. Three important initiatives in this regard were Batho Pele (1997), the adoption of eight nationwide principles for better service delivery; a public private partnerships initiative (2000) and the promotion of alternative service delivery. While alternative service delivery initiatives are largely at pilot stage, they offer a promising alternative both to traditional bureaucracy (with its cost and poor service delivery focus) and to a narrow version of privatisation (which could involve heavy social costs, job losses, and regressive redistribution of wealth). This paper reviews these developments and outlines some promising alternative service delivery pilot projects.

BackgroundIn response to the COVID-19 pandemic, sexual health services have started to implement alternative service delivery methods that reduce in-person contact (e.g., telemedicine, virtual health). We sought to understand acceptability...

Five - Alternative Service Delivery Options

Alternative service delivery (ASD) is a Canadian phenomenon that spread, surfaced important issues and made a wider impact. ASD refers to the many and varied organizational forms and delivery mechanisms governments use to achieve their objectives. It is anchored in a spectrum of options that mirrors the diversity of the nation, its governments and its public institutions. Innovations sustain the capacity to serve the public interest and to leverage efficiency, accountability and renewal. They embrace a strategy of collaboration across sectors and boundaries to overcome impediments to change and to transform service delivery. Countless spin-offs cascade throughout the Canadian public sector. Many governments benchmark the international scene and adapt innovations to their settings. Respect for situation and reciprocal learning facilitate the transfer of good practice. Lessons learned from ASD experiences across Canada and in countries like Tanzania, Latvia and New Zealand improve the prospects of `getting service delivery right'.

BackgroundAs a consequence of stay-at-home and other lockdown measures, such as social distancing, all health care service provisions during the COVID-19 pandemic have been affected, including the provision of speech therapy. Telehealth services can play a major role in maintaining access to health care, help speech and language pathologists (SLPs) overcome physical barriers by providing patients and caregivers with access to health care, and limit the discontinuity of patient care. To have a better understanding of the changes that have occurred in these services during COVID-19, this research was conducted to explore the nature and current situation of speech-language services in Saudi Arabia based on caregivers’ perspectives. It also investigated whether changes have occurred in these services during the COVID-19 lockdown. The study also determined the perception of caregivers in delivering SLS sessions remotely.MethodA cross-sectional study was conducted with 385 caregivers in Saudi Arabia. An online survey asked whether children were experiencing any SLS problems and if they had received any intervention. The survey also assessed the perception of changes in service during the COVID-19 lockdown and the perceptions, acceptance, and willingness of the caregivers to deliver telehealth speech services in Saudi Arabia.ResultsAbout 50% of the respondents had or were suspected to have a child with SLS problems, and just over half of them had accessed SLS services. Most of the respondents reported suspension of therapy sessions as a response to the COVID-19 pandemic. While the respondents had little experience using telehealth prior to the pandemic, they generally showed a willingness to use telehealth in therapy sessions, expressing a preference for video calls over other options.ConclusionThe study revealed that SLS services in Saudi Arabia are limited and that accessing these services is challenging. Alternative service delivery using remote services could help caregivers overcome such challenges. When telehealth was introduced as an option for service delivery, the caregivers showed welcoming responses, particularly with video calls.

This section focuses on the relationship between accountability and policy outcomes such as the quality of service delivery. This relationship, the main dimensions of accountability and several important contextual factors are analyzed in the context of decentralization. Then, this section focuses on the recent experience in alternative service delivery and financing models. The role of indicators/indices for policy, program, and project design and for monitoring results is also discussed. Finally, the last section deals with the lessons from the international experience and implications for the nexus approach to management of environmental resources.KeywordsAccountabilityGovernancePublic-private partnershipResults-based financing

Productivity Improvement and Alternative Service Delivery

Comparative Experiences with Functional Reviews and Alternative Service Delivery

Factors influencing the demand of the service of community based animal health care in Zimbabwe

BackgroundThe recent trend of increasing health care costs in the United States is likely not sustainable. To make health care more economically sustainable, attention must be directed toward improving the quality while simultaneously reducing the cost of health care. One of the recommended approaches to provide better care at a lower cost is to develop high-quality data collection and reporting systems, which support health care professionals in making optimal clinical decisions based on solid, extensive evidence.ObjectiveThe objective of this project was to develop an integrated mobile health Augmentative and Alternative Communication (AAC) platform consisting of an AAC mobile app and a Web-based clinician portal for supporting evidence-based clinical service delivery.MethodsA questionnaire and interviews were used to collect clinicians’ ideas regarding what constitutes their desired “clinically relevant” data. In response, a Web-based portal was designed by combining mobile and Web technologies with an AAC intervention to create an integrated platform for supporting data collection, integration, and reporting. Finally, a usability study was conducted with health care professionals.ResultsA Web-based portal was created and integrated with a tablet-based AAC mobile app and data analysis procedures. In the usability study, all participants agreed that the integrated platform provided the ability to collect comprehensive clinical evidence, automatically analyze collected data in real time, and generate clinically relevant performance measures through an easily accessible Web-based portal.ConclusionsThe integrated platform offers a better approach for clinical data reporting and analytics. Additionally, the platform streamlines the workflow of AAC clinical service delivery.

This book covers a comprehensive overview of organizational change, including theoretical frameworks, change agents and leadership, process-based change models, implementation strategies, and the relationship between organizational culture and change. Chapter-I provides an introduction to organizational change, while Chapter-II focuses on various theoretical frameworks of organizational change. In Chapter-III, the role of change agents and leadership in managing change is discussed. Chapter-IV examines process-based change models and their application in real-world situations. Chapter-V delves into the implementation of organizational change and the challenges associated with it. Chapter-VI explores the impact of organizational culture on change and the importance of managing cultural differences during the change process. Finally, Chapter-VII presents research on cultural differences in organizations. The book concludes with a bibliography that includes relevant literature on organizational change. Keywords: Organizational change, theoretical frameworks, change agents, leadership, process-based change models, implementation, organizational culture, cultural differences, research,

Contracting critics suggest that when governments outsource, they reduce their capacity to produce services and manage service delivery. In this paper, we decompose the service delivery decision into service production and service management components. When governments contract for service production, they may also choose to contract for a portion of service delivery management. Studies that only compare the management activities of contracting and direct service delivery governments, without examining the management activities contracted to vendors are likely to be incomplete and biased. Drawing on a unique survey of governmental refuse collection service directors, matched with a survey of refuse collection vendors operating under municipal contracts, we show that the vendors’ management activities offset the decline in management capacity that occurs when governments contract for service delivery for this particular service. Governments can «buy» management activities when contracting for service production.

Contracting critics suggest that when governments outsource, they reduce their capacity to produce services and manage service delivery. In this paper, we decompose the service delivery decision into service production and service management components. When governments contract for service production, they may also choose to contract for a portion of service delivery management. Studies that only compare the management activities of contracting and direct service delivery governments, without examining the management activities contracted to vendors, are likely to be incomplete and biased. Drawing on a unique survey of governmental refuse collection service directors, matched with a survey of refuse collection vendors operating under municipal contracts, we show that the vendors' management activities offset the decline in management capacity that occurs when governments contract for service delivery for this particular service. Governments can “buy” management activities when contracting for service production. © 2006 by the Association for Public Policy Analysis and Management

This paper discusses organization change in government and business in America. First the causes and dimensions of organization change are presented. The literature on organization change is review...

Researchers studying local governance, especially alternative service delivery arrangements, have long relied on the ICMA ASD survey to examine the scope and nature of service provision and production at the local level. Building upon Lamothe et al. (Public Administration Review, 2018, 78: 613) findings that raise questions concerning the accuracy of the ASD survey and resulting misconceptions about service provision, this paper refines how provision can be conceptualized and measured to promote a better understanding of local governance. Utilizing a unique survey design that incorporates, but also extends the ASD format, we demonstrate that service provision is multifaceted, and jurisdictions participate in varying degrees of provision activities based on the sector of the producing entity. Our findings highlight the importance of properly accounting for provision activities and call into question the efficacy of the conventional contracting framework as the primary theoretical underpinning of most studies of local service delivery arrangements.