Philosophiae Doctor - PhD / The prime aim of this thesis is to examine the link between fiscal decentralization and local financial governance in fiscally empowered woreda administrations (districts) of the Amhara region in Ethiopia. Local financial governance has been one of the reasons and arguably the crucial one that drives many countries to subscribe to fiscal decentralization. The presumption is that public finance mobilization and spending can be implemented in a more efficient, responsive, transparent and accountable manner at the local government level than at the centre. Nonetheless, empirical studies show that the linkage between fiscal decentralization and these local financial governance benefits is not automatic. Several developing countries that have tried to implement fiscal decentralization have failed to realise the promised financial governance gains largely due to design and implementation flaws. A review of the various theoretical perspectives suggest that local financial governance is not a factor of just devolution of fiscal power but also other intervening forces such as financial management system, citizen voicing mechanisms and the social and political context. It is within the framework of this theoretical argument that this study sought to investigate how the mixed and incomplete efforts of the district level fiscal decentralization program in the Amhara region has impacted on financial governance of woreda administrations. The study assesses the efficacy and role of various initiatives of the district level decentralization program of the Amhara region, such as the fiscal empowerment of woredas; financial management system reforms; citizen voicing mechanisms and political party structures and system in influencing woreda financial governance. To this end, the investigation process largely took the form of an interpretative approach employing a combination of various methods of gathering the required qualitative and quantitative data from respondents and documents in the selected four case woredas or districts. Findings on the assessment of the intergovernmental relations to measure the adequacy of devolution of fiscal power indicate that, despite the constitutional provision that affords the woredas the power to mobilize and spend public finance for the provision of various local public services, several design and implementation shortcomings have constrained woreda administrations from exercising such power effectively. As a result, the district level fiscal decentralization framework of the Amhara region appears to have features of decentralization by de-concentration rather than by devolution. Despite the extensive financial management reforms that have been undertaken, the research findings indicate that the financial management system in woreda administrations faces a range of challenges triggered largely by important design and implementation shortcomings. It is observed that the ‘getting the basics right first’ reforms in various financial management processes of woreda administrations are not only incomplete but also found to be inconsistent with each other and therefore could not serve their purpose. Furthermore, there has not been any other change in the last two decades since the initial implementation of these reforms despite such serious shortcomings. Most importantly, woreda administrations could not properly implement the techniques, methods, procedures and rules that constituted the reform process due to serious implementation problems such as the lack of manpower competency and problems associated with the lack of administrative accountability. The results of the study’s assessment regarding the practice of social accountability show that currently there is no arrangement for citizens to participate in public financial decisions and controls. In general, people have little interest in participating in the meetings organised by woreda government. Formal and informal community based organizations suffer from important capcity constraints, and the lack of strong civil society organizations to support these community based organizations makes such problems more difficult to resolve. However, local communities did indicate that they would be interested in participating in financial and budgeting processes if a number of conditions were satisfied. These included the availability of adequate and relevant information; the introduction of genuine forms of participation in which citizens were empowered; and evidence that popular participation was making a visible impact on financial decisions related to service delivery in their surroundings. The assessment of the ruling party structure and system suggests that the centralized system of the regional ruling party has created a dominant relationship between party organs at various levels so much sothat it has undermined the fiscal discretionary power of woreda administrations; blurred relationship between party and woreda financial management systems; and undermined direct voicing. Consequently, the genuine devolution of fiscal power, the effective implementation of the decentralised financial management systems, and direct participation of citizens are unlikely to be realised within the current ruling party system and structure. Moreover, the study shows that the intergovernmental relations, the implementation of financial management reforms and direct involvement of people influence each other. The evidence suggests that the effective implementation of the financial management reforms is not possible without genuine devolution of fiscal power and arrangements for the activeinvolvement of citizens. Despite these limitations and shortcomings, the research nevertheless reveals that the decentralization process has achieved some positive results, such as the expansion of access to basic services; the economic use of resources for such expansion; the mobilization of resources from local communities; and the streamlining of a number of bureaucratic processes. However, the prevalence of various financial governance challenges such as excessive budget transfers; low budget execution; uneconomical procurement; illicit spending; budget pressure; inadequate revenue collection; poor financial transparency; and compromised accountability in fiscally decentralized woreda administrations means the promised local financial governance benefits of fiscal decentralization are remain largely unrealized. The evidences in the study strongly suggest that the shortcomings in the design and implementation of intergovernmental relations, financial management system reforms, and direct voicing mechanisms areresponsible in combination with each other for these local financial governance challenges. Thus, the study concludes that local financial governance is a result of a complex network of interactions of intergovernmental relations, public financial management arrangements and social accountability mechanisms. The success of initiatives to improve local financial governance is dependent on contextual factors such as the capacity of civil society organizations and the ruling party system and structure. Therefore, while recommending further efforts of genuine devolution of power, in particular through the continuation of the financial management reform processes towards full-fledged reforms, the study contends that opening enough space for the proliferation of civil society organizations and alternative political parties will be the main priority.

AbstractAnalysing the Impact of Stigma and Discrimination on the Linkages Across the Continuum of HIV Services for Men who have Sex with Men: A Realist ApproachBackground and Aim The world has now entered the third decade of the AIDS epidemic. Men who have sex with men (MSM) continue to be disproportionately affected by HIV/AIDS. Haiti still struggles in its response to this ongoing crisis throughout the continuum of services: disease prevention, treatment, and HIV related stigma, prejudice, and discrimination. Much of the information reported on people living with HIV has come from the general population, but only a few parts of some of those studies have focused on MSM. Therefore, the overall aim of this dissertation was to analyse the impact of stigma and discrimination on the continuum of HIV services for MSM in order to ascertain why, how and under which circumstances MSM are engaged, linked and retained along the care continuum.Methods For this dissertation, data were collected via literature review, electronic medical records, participant observations, focus groups and semi structured interviews with medical students, health care workers and MSM. Using a realist approach based on mixed methods design we sought to address the influence of HIV and sexual stigma on the continuum of HIV services and to identify key mechanisms emerging from the context and leading to the outcomes. Quantitative social and medical data were gathered and analysed to produce descriptive and analytic statistics and qualitative data were analysed thematically regarding the objectives.FindingsResults indicated that MSM experienced stigma in multiple and overlapping layers. MSM described stigmatizing experiences stemming from religious sources, communities, family and friends, and from the medical establishment. From the social construction of heteronormativity in the society, several social and cultural factors, gender norms lie behind the stigma associated with sexual orientation and HIV. Moreover, medical students and healthcare givers still carry discriminatory attitudes towards them despite tailored interventions. Our analysis showed that current service delivery models are less than optimal in linking and retaining MSM, resulting in loss to follow-up in the continuum of care and failure to fully realize the health and prevention benefits. However, multi-level, contextual-based and socially accountable interventions can produce stigma mitigation through personal, health systems’ and contextual mechanisms for better engagement, adherence and retention throughout the continuum.ConclusionsThe results within this dissertation are intended to inform health professionals in the planning and implementation of interventions for better continuum outcomes in Haiti and similar contexts. This thesis provides insight and contextual information for a socially accountable framework of adapted interventions. To end the AIDS epidemic by 2030, Haiti, the Caribbean region and the entire world urgently need to defy expectations to reach the left behind.KeywordsHIV; Continuum of HIV Services; Stigma; Discrimination; Realist Evaluation; Context-Mechanism-Outcome; Social Accountability / Doctorat en Sciences de la santé Publique / info:eu-repo/semantics/nonPublished

Submitted by Diones Gomes da Rocha (dionesgr222@hotmail.com) on 2017-09-05T16:58:49Z No. of bitstreams: 1 Tese_Diones_2017_depositada.pdf: 1462916 bytes, checksum: 685176a8e555b895c246b885b1572e4d (MD5) / Approved for entry into archive by Pamela Beltran Tonsa (pamela.tonsa@fgv.br) on 2017-09-05T18:17:44Z (GMT) No. of bitstreams: 1 Tese_Diones_2017_depositada.pdf: 1462916 bytes, checksum: 685176a8e555b895c246b885b1572e4d (MD5) / Made available in DSpace on 2017-09-06T13:36:25Z (GMT). No. of bitstreams: 1 Tese_Diones_2017_depositada.pdf: 1462916 bytes, checksum: 685176a8e555b895c246b885b1572e4d (MD5) Previous issue date: 2017-08-25 / For many critics, democracy is a utopian enterprise. More moderate observers, on their turn, propose enhancements for the democratic models of contemporary societies. One of these proposals is to increase citizen insertion in the public sphere, so citizens may participate in State decisions and control the actions of public representatives. The literature has also shown that the process of elections is not enough to guarantee that political representatives will act in the best interest of their constituencies. To attain this aim, it would be necessary to reduce both the information asymmetries between State and society, and the distance between representatives and constituencies. Bearing this context in mind, the relevance of the Courts of Accounts must be highlighted, since they are autonomous and independent institutions that can become important instruments for enhancing the control that society must or should exert over its political representatives. But are these Courts prepared to play this leadership role, considering that they would need to be permeable to society while providing mechanisms to help and facilitate the exercise of social accountability over the public administration? Based on this premise, the aim of this work is to assess the permeability of Brazilian Courts of Accounts to the society, and whether these courts are working to facilitate the exercise of social accountability over the public administration. This descriptive research was developed in two stages. The first stage was a review of the theoretical literature on the theme, to build a framework for assessing the permeability of the Courts of Accounts to the society and their potential for enabling social control. This stage was followed by exercises of Multidimensional Scaling (MDS) that produced perceptual maps of similarities and dissimilarities among the Courts of Account based on the explored factors and indicators. Finally, a round of interviews was carried out with Councilors from the three Courts of Accounts found to be the most similar, and also from the three most dissimilar ones. The results generally show that Brazilian Courts of Accounts are still poorly permeable to society and count on few mechanisms to help and facilitate citizen control. They also show that the means of social participation are still limited, and are basically represented by the Office of the Ombudsman, the Transparency Web Portal and the Citizen Assistance Service. Yet, this study has identified a strong influence of the Fiscal Responsibility Law (LRF) and the Access to Information Law (LAI) at the Courts of Accounts. Although gradually, these elements can lead to future changes in terms of an increasingly prominent role of the Courts of Accounts as strong allies in the process of enhancing vertical accountability. / Para muchos críticos la democracia es sólo una utopía. Otros, no tan duros en su crítica, proponen mejoras en el modelo democrático actual de las sociedades contemporáneas. Entre ellas, una mayor participación del ciudadano en la esfera pública con el fin de tomar parte en las decisiones del estado, así como controlar las acciones de sus representantes. La teoría también ha demostrado que el proceso electoral no es suficiente para asegurar que el representante actúe en el mejor interés de los representados. Por ello, se necesitan de otros instrumentos que puedan contribuir a la reducción de la asimetría informativa entre el Estado y la sociedad, o de la distancia representante-representado. En este contexto, los Tribunales de Cuentas ganan relieve, pues tienen autonomía e independencia y se pueden convertir en instrumentos importantes para la mejora del control que la sociedad debe o debería ejercer sobre sus representantes. Sin embargo, estos Tribunales estarán preparados para tal protagonismo ya que deben ser permeables a la sociedad y, al mismo tiempo, deben proporcionar mecanismos para auxiliar o facilitar el ejercicio del control social sobre la administración pública. Partiendo de esta premisa, este trabajo tiene por objetivo analizar la permeabilidad de los Tribunales de Cuentas brasileños a la sociedad, así como si estos Tribunales actúan para facilitar el ejercicio del control social sobre la administración pública. Se trata, por lo tanto, de una investigación descriptiva que se desarrolló en dos fases. La primera, eminentemente teórica, se recurrió a la teoría para la construcción de referencial que permitiese evaluar la permeabilidad de los TC a la sociedad y su potencial posibilidad de auxiliar el control social. A continuación, se utilizó la técnica estadística de Multidimensional Scaling (MDS) para crear mapas perceptuales de similitudes/disimilitudes de los TCs a partir de los factores e indicadores planteados. Finalmente, se realizó encuestas con los Consejeros de los tres TCs considerados más similares y de los tres más disimilares. Los resultados revelaron que, en general, los TCs son todavía poco permeables a la sociedad y poseen pocos mecanismos para auxiliar o facilitar el control ciudadano. Se observó, aún, la limitación de medios para la participación social, reducidos, fundamentalmente, a la Oidoría, al Portal de la Transparencia y al Servicio de Atendimiento al Ciudadano. Se identificó, sin embargo, la fuerte influencia de la LRF y la LAI en los TCs. Esto puede significar cambios futuros, aunque incrementales, en la dirección de la actuación de los TCs como fuertes aliados al perfeccionamiento de la accountability vertical. / Para muitos críticos a democracia é apenas uma utopia. Outros, mais amenos em suas críticas, propõem aperfeiçoamentos no modelo democrático vigente nas sociedades contemporâneas. Dentre esses, maior inserção do cidadão na esfera pública a fim de que possa tomar parte nas decisões estatais, bem como controlar as ações de seus representantes. A literatura também tem demonstrado que o processo eleitoral não é suficiente para garantir que o representante atue no melhor interesse do representado. Para tanto, seriam necessários outros instrumentos que pudessem contribuir para a redução da assimetria informacional entre Estado-Sociedade, ou da distância representante-representado. Nesse contexto, os Tribunais de Contas ganham relevo, pois gozam de autonomia e independência e podem se converter em instrumentos importantes para o aperfeiçoamento do controle que a sociedade deve ou deveria exercer sobre os seus representantes. Entretanto, estariam esses Tribunais preparados para tal protagonismos, vez que precisariam ser permeáveis à sociedade e, ao mesmo, tempo proporcionar mecanismos para auxiliar ou facilitar o exercício do controle social sobre a administração pública. Com base nessa premissa, este trabalho tem por objetivo analisar a permeabilidade dos Tribunais de Contas brasileiros à sociedade, bem como se esses tribunais atuam de forma a facilitar o exercício do controle social sobre a administração pública. Trata-se de uma pesquisa descritiva que foi desenvolvida em duas fases. A primeira, eminentemente teórica, se recorreu à literatura para a construção de referencial que permitisse avaliar a permeabilidade dos TCs à sociedade e a sua potencial possibilidade de auxiliar o controle social. Em seguida, foi utilizada a técnica estatística Multidimentional Scaling (MDS) para criar mapas perceptuais de similaridade/dissimilaridades dos TCs a partir dos fatores/indicadores levantados. Por fim, realizou-se entrevistas com Conselheiros dos três TCs considerados mais similares e três considerados mais dissimilares. Os resultados, de maneira geral, evidenciaram que os TCs ainda são pouco permeáveis à sociedade e possuem poucos mecanismos para auxiliar ou facilitar o controle cidadão. Constatou-se, ainda, limitação de meios para participação social, reduzindo-se, basicamente, à Ouvidoria, ao Portal da Transparência e ao Serviço de Atendimento ao Cidadão. Identificou-se, porém, a forte influência da LRF e da LAI nos TCs. Isso pode significar mudanças futuras, mesmo incrementais, na direção da atuação dos TCs como fortes aliados ao aprimoramento da accountability vertical.

Made available in DSpace on 2016-12-01T19:11:34Z (GMT). No. of bitstreams: 1 121350.pdf: 11953559 bytes, checksum: 4a9a6c9211752ce668a53a7acadc51bf (MD5) Previous issue date: 2014-10-31 / Conselho Nacional de Desenvolvimento Científico e Tecnológico / In the last two decades, Latin America witnessed the emergence of civil society initiatives aimed at qualifying citizen participation, the production and systematization of information, the development of citizen perception surveys and in monitoring public administration. Leading this phenomenon are networks Red de Ciudades Cómo Vamos, Red Latinoamericana por Ciudades y Territorios Justos, Democráticos y Sustentables and its related Brazilian network. A common feature of these networks is their political goal of building fairer, democratic and sustainable cities. This work aimed to understand the extent of the experiences of three Brazilian cities - Florianópolis, Ilhabela and Ilheus, comprising the Brazilian and Latin American network, understood as collective action and expressing and influencing democratic governance and social accountability, generating incidence in political institutions and in other areas. The research is a qualitative and interpretive study. Data was collected in loco, in the participation of meetings and workshops that occurred through experiences, as well as conducting 25 interviews with leaders and participating groups, including local government. The analysis model was constructed from the analytical category of contencious politics, of Tarrow (2009), and the theory of collective action of political mobilization, linking them to references about democratic governance and prospects for associated accountability such as social, hybrid, diagonal and relational accountability. The results show the mutual influence between democratic governance and accountability, generated by these initiatives. While they represent new actors in governance, they show strategies for strengthening existing governance channels, demonstrating new possibilities and forms of accountability, such as social, in the construction of what they perceive as sustainable cities. Incidence is observed in areas such as: local agenda, city governance, political institutions, political and electoral debate, public policy, partner organizations and people. / A América Latina presenciou, nas duas últimas décadas, o surgimento de iniciativas da sociedade civil voltadas à qualificação da participação cidadã, à produção e à sistematização de informações, ao desenvolvimento de pesquisas de percepção cidadã e ao monitoramento do poder público. Expressões desse fenômeno são a Red de Ciudades Cómo Vamos, a Red Latino-americana por Ciudades y Territorios Justos, Democráticos y Sustentables e a sua correlata brasileira. Característica comum a estas redes é o seu objetivo político de construir cidades mais justas, democráticas e sustentáveis. Este trabalho buscou compreender em que medida as experiências de três cidades brasileiras - Florianópolis, Ilhabela e Ilhéus, que integram a rede brasileira e latino-americana, entendidas enquanto ação coletiva, expressam e influenciam a governança democrática e a accountability social, gerando incidência nas instituições políticas e em outros âmbitos. A pesquisa de cunho qualitativo e interpretativo, coletou dados in loco, na participação em reuniões e encontros promovidos pelas experiências, além da realização de 25 entrevistas com lideranças e grupos participantes, incluindo o poder público local. O modelo de análise foi construído a partir da categoria analítica do confronto político, de Tarrow (2009), e da teoria da ação coletiva da mobilização política, articulando-as a referenciais sobre governança democrática e perspectivas de accountability associadas, como a social, a híbrida, a diagonal e a relacional. Os resultados apontam a mútua influência entre governança democrática e accountability, geradas por estas iniciativas. Ao mesmo tempo em que elas representam novos atores na governança, evidenciam estratégias de fortalecimento dos canais da governança existente, demonstrando novas possibilidades e modalidades de accountability, como a social, na construção daquilo que entendem como cidades sustentáveis. A incidência é observada em âmbitos como: agenda local, governança da cidade, instituições políticas, debate político e eleitoral, políticas públicas, organizações parceiras e pessoas.

Submitted by Kerla Mattiello (m_kerla@yahoo.com.br) on 2018-10-23T18:20:38Z No. of bitstreams: 1 Tese - Kerla Mattiello.pdf: 741937 bytes, checksum: a03388efe4978011c16279b498b30f90 (MD5) / Approved for entry into archive by Maria Tereza Fernandes Conselmo (maria.conselmo@fgv.br) on 2018-10-23T20:41:32Z (GMT) No. of bitstreams: 1 Tese - Kerla Mattiello.pdf: 741937 bytes, checksum: a03388efe4978011c16279b498b30f90 (MD5) / Approved for entry into archive by Suzane Guimarães (suzane.guimaraes@fgv.br) on 2018-10-24T14:27:11Z (GMT) No. of bitstreams: 1 Tese - Kerla Mattiello.pdf: 741937 bytes, checksum: a03388efe4978011c16279b498b30f90 (MD5) / Made available in DSpace on 2018-10-24T14:27:11Z (GMT). No. of bitstreams: 1 Tese - Kerla Mattiello.pdf: 741937 bytes, checksum: a03388efe4978011c16279b498b30f90 (MD5) Previous issue date: 2018-05-04 / O Observatório Social de Maringá (OSM) foi criado por um grupo de instituições em um contexto pós-escândalo de corrupção na cidade de Maringá, com o objetivo de efetivar a participação da sociedade na gestão pública por meio da análise de processos licitatórios e controle na aplicação dos recursos públicos. O presente estudo teve como objetivo entender quais são os efeitos, sobre a gestão pública, das ações adotadas pelo Observatório Social de Maringá sob a perspectiva da accountability social. Para o alcance de tal objetivo foi utilizada a abordagem qualitativa, por meio de estudo de caso. Os dados foram coletados por meio dos relatórios apresentados pelo OSM, notícias, resultados de estudos já realizados sobre o OSM e entrevistas. Os dados foram organizados em períodos sucessivos e identificados os pontos de destaque, estes foram analisados. Para análise das ações do OSM e seus efeitos foram utilizadas teorias de Aprendizagem Organizacional para buscar identificar o alcance dos efeitos na prefeitura municipal, a New Public Management como uma teoria que explica as reformas do Estado e o desenho da Administração Pública no Brasil e a Accountability, em especial a Accountability Social ou Societal que é voltada para o controle social, iniciada por cidadãos, atores locais, organizações da sociedade civil, movimentos sociais e até mesmo por meio de comunicação dispostos a participar e influenciar nas questões públicas locais. Como resultados, foi possível identificar a estratégia de ação do OSM como participação por meio do diálogo e do estabelecimento de uma relação de confiança com os gestores públicos que permitiu a criação de um espaço de participação institucionalizado, com a cooperação de órgãos de accountability horizontal e da imprensa. A forma de atuação preventiva do OSM permite evitar a necessidade da utilização frequente de mecanismos de responsabilização, ainda que eles sejam ativados quando necessário. Tais fatores permitiram estimular a capacidade de resposta da gestão municipal e desencadearam uma mudança cultural entre os servidores, produziram melhorias no processo de compras e geraram aprendizagem organizacional, porém não de maneira generalizada. A atuação em procedimentos administrativos cotidianos e com necessidade de conhecimento técnico e a necessidade de controle das ações desenvolvidas pelo OSM dificultam a ampliação da participação, ainda que as ações tenham apoio popular. Desta forma, há dificuldade em também ampliar a capacidade de resposta da gestão pública. / The Social Observatory of Maringá (OSM) was created by a group of institutions in a postcorruption context in the city of Maringá, with the objective of effecting the participation of society in public management through the analysis of bidding processes and control in application of public resources. The purpose of this study was to understand the effects on public management of the actions taken by the Social Observatory of Maringá under the perspective of social accountability. To reach this objective, a qualitative approach was used, through a case study. The data were collected through the reports presented by the OSM, news, results of studies already done on the OSM and interviews. For the analysis, the data were organized in successive periods and the highlighted points were identified, these were analyzed. In order to analyze the actions of the OSM and its effects, theories of Organizational Learning were used to seek to measure the effects of the municipal government, New Public Management as a theory that explain the reforms of the State and influenced the design of Public Administration in Brazil and the Accountability, especially Social or Societal Accountability that is geared towards social control, initiated by citizens, local actors, civil society organizations, social movements and even through communication willing to participate and influence local public issues. As a result it was possible to identify the strategy of action of the OSM as participation through dialogue and the establishment of a relationship of trust with the public managers that allowed the creation of an institutionalized space of participation, with the cooperation of horizontal and of the press. The OSM's preventive approach can avoid the need for frequent use of accountability mechanisms, even if they are activated when necessary. These factors allowed to stimulate the responsiveness of municipal management and triggered a cultural change among the servers, produced improvements in the purchasing process and generated organizational learning, but not in a generalized way. The performance in daily administrative procedures and the need for technical knowledge and the need to control the actions developed by the OSM make it difficult to increase participation, even though the actions have popular support. In this way, it is also difficult to increase the responsiveness of public management.