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This thesis aims to contribute to the body of work that seeks to unpack development by asking: how does development work? Using a purposive case study of Uganda and taking a mixed methods approach, the thesis explores the reality behind the rhetoric of aid coordination in a developing health sector, questioning the premise that coordination is pursued exclusively to improve the efficacy of official development assistance (as inferred by partners‟ vocal commitments to the tenets of the Paris Declaration on Aid Effectiveness). The study focuses on the member groups currently empowered to join Uganda‟s most important multi-stakeholder forum for health - the Health Policy Advisory Committee - finding that all members are guilty of picking and choosing from a checklist of voluntary coordination commitments. This is found to be at once logical - for facilitating the semblance of partnership between a disparate grouping of stakeholders with differing modi operandi, agency objectives and tolerance for risk – and advantageous - for masking difference and allowing outwardly homogenous groupings like the Health Development Partners to speak with “one voice” when addressing the Ugandan government. Most importantly of all however, partial adherence to the aid coordination ethos is found to permit the framing that aid to Uganda is at once necessary and well targeted, as the Government of Uganda actively invites its partners to participate in the processes of government at the central level. Such tangible commitments to the tenets of partnership and transparency are integral to maintaining donor confidence in the aftermath of two financial scandals involving the Global Fund for AIDS, Tuberculosis and Malaria and the Global Alliance for Vaccines and Immunisation in 2005. In sum, the thesis argues that while on the surface coordination appears important for its internal significance - as an organising principle to improve the effectiveness of aid - in fact, the value of coordination stems from its external significance. Coordination creates a façade of unity which permits the continuance of aid flows to Uganda, with coordination activities now playing a pivotal role in determining who gives and receives aid, and how it should be spent.

The study examined organizational climate and turnover in the health sector of Ghana with particular reference to a case study on the country’s premier teaching hospital formally called Korle-Bu Teaching Hospital. In the light of high uncertainty in retention of healthcare workers in Ghana, despite the several interventions of government in providing incentives and infrastructure, the issue of employee turnover has attracted academic interest among several researchers globally and locally. Most researches on turnover related issues in the healthcare sector of Ghana have focused on the influence of employees’ overall job satisfaction. However, none has been able to neither explain nor investigate the influence of potent psychological features of the workplace on turnover. This study undertook a comprehensive review of the current state of employees’ turnover intentions in relation to the organizational climate and other working conditions prevalent at the Korle-Bu Teaching Hospital. The study was guided by the hypothesis that climate factors will emerge as a significant predictor of employees’ turnover intentions. A sample size of 80 employees was used for the study. Correlation and multiple regression analysis were used to analyze data obtained with a Likert scale designed questionnaire. The results of the study indicate that stress and organizational pride are the most proximal factors to employees’ intentions to quit. Further analysis identified influences on stress and organizational pride and pointed to management priorities for reducing employee turnover.

The study examined organizational climate and turnover in the health sector of Ghana with particular reference to a case study on the country’s premier teaching hospital formally called Korle-Bu Teaching Hospital. In the light of high uncertainty in retention of healthcare workers in Ghana, despite the several interventions of government in providing incentives and infrastructure, the issue of employee turnover has attracted academic interest among several researchers globally and locally. Most researches on turnover related issues in the healthcare sector of Ghana have focused on the influence of employees’ overall job satisfaction. However, none has been able to neither explain nor investigate the influence of potent psychological features of the workplace on turnover. This study undertook a comprehensive review of the current state of employees’ turnover intentions in relation to the organizational climate and other working conditions prevalent at the Korle-Bu Teaching Hospital. The study was guided by the hypothesis that climate factors will emerge as a significant predictor of employees’ turnover intentions. A sample size of 80 employees was used for the study. Correlation and multiple regression analysis were used to analyze data obtained with a Likert scale designed questionnaire. The results of the study indicate that stress and organizational pride are the most proximal factors to employees’ intentions to quit. Further analysis identified influences on stress and organizational pride and pointed to management priorities for reducing employee turnover.

In their seminal work on policy implementation, Pressman and Wildavsky (1973:143) have argued that 'there is no point in having good ideas if they cannot be carried out.' The use of a New Public Management (NPM) service delivery approach in the Australian Capital Territory (ACT) health area, referred to as the Purchaser Provider Model (PPM), was seen as one of those good ideas. The then-ACT Government hoped that the use of this model as part of its public policy reform agenda would assist it in successfully achieving its goal of restraining the growth of ACT public health care costs. The PPM was in operation between 1996 and 2002, when it was discontinued, suggesting a policy implementation failure. In this thesis, the PPM is used as a case study as a basis for supporting the argument that the administrative architecture through which public policy is implemented plays a crucial part in the success or otherwise of the implementation of that policy, especially in the area of public service delivery. The administrative architecture is defined as, the administrative components that have been designed to assist the implementation of public policy. To undertake the analysis the PPM is expressed in terms of the following three extremely important components of the administrative architecture: - the configuration of role and role relationships; - resource allocation arrangements; and - the performance management framework. Pattern matching logic in conjunction with the literature is used to show how crucial was the part played by the above components and hence the administrative architecture in the implementation of public policy. While the thesis provides compelling evidence (based on the case study and the academic literature) to support its claim, the crucial part played by the administrative architecture in the implementation of public policy, especially in the area of service delivery, has hitherto received little attention in the implementation literature.

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No / As several studies indicate, the National Health Service (NHS) in the United Kingdom is one of the largest employers for Black and minority ethnic (BME) people. Despite many positive action (PA) initiatives to support disadvantaged groups, only a handful of people have managed to progress to senior management. This article considers published literature in relation to BME leadership in NHS and the specific types of PA activities that have been set up to address some issues around inequality. In addition to PA activities, the article also considers the U.K. equality framework. Positive action is allowed under the U.K. legislation for organizations to recruit people from underrepresented communities on merit. It allows organizations to create different initiatives for people to gain appropriate qualifications, skills, and experience to compete for promotions or for better job opportunities.

Philosophiae Doctor - PhD

O estudo acompanha o desenvolvimento da reforma admnistrativa da Secretaria de Estado da Saúde, definida em 1967, face aos condicionantes existentes no Plano de Reforma Administrativa do Serviço Público Estadual. Esses condicionantes situavam-se na configuração institucional, principalmente legislativa do Estado, na forma de divisão, duplicidade e vazios de competência dos órgãos centrais da administração, na crescente tendência do Governo para adoção de figuras jurídicas de Direito Privado na organização de serviços públicos e no reforço do consenso divulgado de uma administração centralizada ingovernável e ineficiente. Pretende, também, demonstrar como a definição clara e precisa de princípios e diretrizes de saúde pública, como base de reforma da Secretaria, demandou tanto esforço e tempo que se descuidou da adoção de mecanismo de proteção frente aos condicionantes citados. São examinados três conjuntos de medidas propostas, mais recentemente, para a organização de Saúde, quanto às soluções que demandariam, evidenciando que aqueles condicionantes, mais do que a disponibilidade de tecnologia adequada para organização, continuam a restringir a operacionalização de qualquer plano. / The administrative reform of the State Secretariate of Health, carried out in 1967, is analysed considering the conditionning factors and limitations of the Reform Plan of the State Civil Service. Among the conditionning factors we may state: institutional configuration, especially the legislative one; division of attributions and lack of competence of State Administrative Central Organs; the increasing tendency to adopt juridical figures of Private Law in the organization of public services. The formulation of Public Health principais and guide-lines as a basis for the reform took such an effort and consumed so much time that mechanisms of self-protection agains the conditionning factors were not instituted. Three sets of measures proposed \"a posteriori\" for the organization of health services in the State are analysed. Operational difficulties observed are due the conditionning factors rather than dificiency or lack of administrative technology adequate to the reform.

O estudo acompanha o desenvolvimento da reforma admnistrativa da Secretaria de Estado da Saúde, definida em 1967, face aos condicionantes existentes no Plano de Reforma Administrativa do Serviço Público Estadual. Esses condicionantes situavam-se na configuração institucional, principalmente legislativa do Estado, na forma de divisão, duplicidade e vazios de competência dos órgãos centrais da administração, na crescente tendência do Governo para adoção de figuras jurídicas de Direito Privado na organização de serviços públicos e no reforço do consenso divulgado de uma administração centralizada ingovernável e ineficiente. Pretende, também, demonstrar como a definição clara e precisa de princípios e diretrizes de saúde pública, como base de reforma da Secretaria, demandou tanto esforço e tempo que se descuidou da adoção de mecanismo de proteção frente aos condicionantes citados. São examinados três conjuntos de medidas propostas, mais recentemente, para a organização de Saúde, quanto às soluções que demandariam, evidenciando que aqueles condicionantes, mais do que a disponibilidade de tecnologia adequada para organização, continuam a restringir a operacionalização de qualquer plano. / The administrative reform of the State Secretariate of Health, carried out in 1967, is analysed considering the conditionning factors and limitations of the Reform Plan of the State Civil Service. Among the conditionning factors we may state: institutional configuration, especially the legislative one; division of attributions and lack of competence of State Administrative Central Organs; the increasing tendency to adopt juridical figures of Private Law in the organization of public services. The formulation of Public Health principais and guide-lines as a basis for the reform took such an effort and consumed so much time that mechanisms of self-protection agains the conditionning factors were not instituted. Three sets of measures proposed \"a posteriori\" for the organization of health services in the State are analysed. Operational difficulties observed are due the conditionning factors rather than dificiency or lack of administrative technology adequate to the reform.