This thesis aims to analyze the inner dynamics as well as the outcomes of the health sector restructuring process in Turkey, by focusing on Neo-Liberal transformation, New Public Management practices and European Integration process. The thesis argues that health reform process along with other public sector reforms have been initiated by Neo-Liberalism as the new face of institutional and structural arrangements during 1980s. Within that process, it is underlined that New Public Management approach with its commitment to private sector methodology and techniques reflected the underlying philosophy and basic premises of Neo-Liberalism which dominated the health sector restructuring process in Turkey, as well as in Eastern Europe since 1990s. Often characterized with the notion of &ldquo / efficiency&rdquo / , the New Public Management techniques and methodologies claimed to bring a more efficiently working health system. In order to refute this claim, the health sector reforms that have been exercised in the past two decades in Turkey as well as in Eastern Europe are analyzed within a historical context. It is also argued that while the Neo-Liberal policies and policy initiatives proposed by International Monetary Fund and World Bank had a direct effect on health sector restructuring process, the role of the European Union has been indirect with regard to organization and service provision. Therefore, the main objective of this thesis is to analyze the outcomes of the health reforms carried out in Turkey in a multidisciplinary manner in order to reveal its political, economic,social and administrative implications in terms of service providers and service takers.

The need for donor funding has increased significantly over the last decade. Without donor funding millions of people wouldn’t be alive today. Thanks either to research finding a cure, successful treatment, funds donated for food, aid toward building infrastructure, or giving people the opportunity to further their education. Donor funding thus facilitates a better future. A literature review was conducted to give background on the health sector and how these funds were distributed, ethical clearance, different types of reporting, the role project managers pays in a project and the sustainability of projects. Expenses in different countries were evaluated by gathering data from the internet, while two international funded projects are also used to state how funders divide their line items into different categories. The empirical study used a qualitative research approach by collecting and analysing data obtained from the MDG 2010 report and other freely available data on the web. The main findings from this thesis are: *The Millennium Development Goals (MDG’s) influence donor funding as it gives donors a guide towards funding needs. Donors are also influenced by their own preferences or what poses a burden to them individually. *The different types of reporting required for funding received, delay a project and the bureaucratic structures thereof are a hindrance. *Ethical clearance plays a fundamental role in the outcome of a project, as without ethical clearance a project cannot commence. *The objectives of a project play a critical role when applying for funding. This can change the focus of a project. *Expenses differ from country to country and funders need to take this into account when giving funding to recipient countries. *Project Managers and community involvement plays a critical role in ensuring sustainability of projects. THE SUSTAINABILITY OF DONOR FUNDED PROJECTS IN THE HEALTH SECTOR *The MDG’s are not on track and aid are focus on singular goals instead of multiple goals, to ensure an overall improved result. There is a major gap between needed funds and given funds. A single injection of funds will not be the solution to our health problem; different sectors need to collaborate together as we are facing a multi-dimensional problem. Trade and reform must also form part of this aid, ensuring a sustainable progression in the life’s of people. Donor funded projects may have a sustainable future, when taking in account the abovementioned findings. With the world trend in reporting changing rapidly, cost and management accountants as well as financial accountants and project managers have to equip them to adhere to the new way of reporting, namely integrated and sustainability reporting. South Africa is way behind and needs to catch up fast if they want to stay competitive in the “global donor funding market”. The limitations in this study were that not all expenses were evaluated and only 15 countries were looked at. An indebt look was taken into Africa with the empirical review, while Asia is also combating poor health issues. Some African countries like Sierra Leone and Zimbabwe did not have sufficient data to compare with other countries. From the research conducted, the following topics were identified that require further research: *Why are most projects in Third World countries not sustainable? *What plans are put into action to ensure that the MDG goals are reached? *Investigate what works for First World countries health systems and consider how that can be applied to Third World countries to ensure that they also get the best health care available. *Do donors take into account the different costs of countries when allocating funding to that specific country? *Establishing models to evaluate the sustainability of pilot projects and normal projects. *Establishing a model on how to distribute donor funds across different needs and not only one specific need. / MCom (Management Accountancy), North-West University, Vaal Triangle Campus, 2013

Rural and remote areas of Australia remain the last bastion of health disadvantage in a developed nation with an enviable health score-card. During the last ten years, rural and remote health has emerged as a significant issue in the media and the political arena. This thesis examines print media, policy documents and interviews from selected informants to ascertain how they represent medical practitioners and health services in rural and remote areas of Australia, why they do so, and the consequences of such positions. In many of these representations, rural and remote medical practitioners are aligned with national and cultural mythologies, while health services are characterised as dysfunctional and at crisis point. Ostensibly, the representations and identity formulations are aimed at redressing the health inequities in remote rural and Australia. They define and elaborate debates and contestations about needs and claims and how they should be addressed; a process that is crucial in the development of professional identity and power (Fraser; 1989). The research involves an analysis and critical reading of the entwined discourses of culture, power, and the politics of need. Following Wodak and others (1999), these dynamics are explored by examining documents that are part of the discursive constitution of the field. In particular, the research examines how prevailing cultural concepts are used to configure the Australian rural and remote medical practitioner in ways that reflect and advance socio-cultural hegemony. The conceptual tools used to explore these dynamics are drawn from critical and post-structural theory, and draw upon the work of Nancy Fraser (1989; 1997) and Ruth Wodak (1999). Both theorists developed approaches that enable investigation into the effects of language use in order to understand how the cultural framing of particular work can influence power relations in a professional field. The research follows a cultural studies approach, focussing on texts as objects of research and acknowledging the importance of discourse in the development of cultural meaning (Nightingale, 1993). The methodological approach employs Critical Discourse Analysis, specifically the Discourse Historical Method (Wodak, 1999). It is used to explore the linguistic hallmarks of social and cultural processes and structures, and to identify the ways in which political control and dominance are advanced through language-based strategies. An analytical tool developed by Ruth Wodak, Rudolf de Cillia, Martin Reisigl and Karin Leibhart (1999) was adapted and used to identify nationalistic identity formulations and related linguistic manoeuvres in the texts. The dissertation argues that the textual linguistic manoeuvres and identity formulations produce and privilege a particular identity for rural and remote medical practitioners, and that cultural myth is used to popularise, shore up and advance the goals of rural doctors during a period of crisis and change. Important in this process is the differentiation of rural and remote medicine from other disciplines in order to define and advance its political needs and claims (Fraser, 1989). This activity has unexpected legacies for the rural and remote health sector. In developing a strong identity for rural doctors, discursive rules have been established by the discipline regarding roles, personal and professional characteristics, and practice style; rules which hold confounding factors for the sustainability of remote and rural medical practice and health care generally. These factors include: the professional fragmentation of the discipline of primary medical care into general practice and rural medicine; and identity formulations that do not accommodate an ageing workforce characterised by cultural diversity, decreasing engagement in full time work, and a higher proportion of women participants. Both of these factors have repercussions for the recruitment and retention of rural and remote health professionals and the maintenance of a sustainable health workforce. The dissertation argues that the formulated identities of rural and remote medical practitioners in the texts maintain and reproduce relationships of cultural, political and social power. They have also influenced the ways in which rural and remote health services have been developed and funded. They selectively represent and value particular roles and approaches to health care. In doing so, they misrepresent the breadth and complexities of rural and remote health issues, and reinforce a reputational economy built on differential professional and cultural respect, and political and economic advantage. This disadvantages the community, professions and interest groups of lower value and esteem, and other groups whose voices are often not heard. Thus, regardless of their altruistic motivations, the politics of identity and differentiation employed in the formulated identities in the texts are based on an approach that undermines the redistributive goals of justice and equity (Fraser 1997), and works primarily to develop and advantage the discipline of rural medicine.

Submitted by Roberto Rivelino Martins Ribeiro (rivamga@hotmail.com) on 2017-07-04T14:47:20Z No. of bitstreams: 1 Tese - Roberto R M Ribeiro 2017.pdf: 2409539 bytes, checksum: ebee5deb818bd06bd771308b4fdaf29b (MD5) / Approved for entry into archive by Maria Tereza Fernandes Conselmo (maria.conselmo@fgv.br) on 2017-07-05T23:51:07Z (GMT) No. of bitstreams: 1 Tese - Roberto R M Ribeiro 2017.pdf: 2409539 bytes, checksum: ebee5deb818bd06bd771308b4fdaf29b (MD5) / Made available in DSpace on 2017-07-06T12:31:29Z (GMT). No. of bitstreams: 1 Tese - Roberto R M Ribeiro 2017.pdf: 2409539 bytes, checksum: ebee5deb818bd06bd771308b4fdaf29b (MD5) Previous issue date: 2017-06-01 / This thesis makes an empirical study about the budget cycle in a municipality, from the inquiry of those responsible for the process, with a view to know in detail how the same occurs throughout its cycle and, therefore, established as objective of the study investigate The Budgetary Cycle of the Health Sector in the Municipality of Maringá, in the period of 2013 and 2014. In order to conduct the research, in terms of an empirical object, the Budgetary Cycle was proposed before the Municipal Health Plan of the Municipality of Maringá, through The accomplishment of a research that, methodologically, fits as being of descriptive nature, of applied form, analyzed qualitatively, with the use of documentary techniques and survey. With regard to the collection of data, public health documents were used, which are composed of the Municipal Health Plan, the Pluriannual Plan, the Budgetary Guidelines Law, the Annual Budget Law and the Annual Management Report, as well as the Semi-structured interview with those responsible for the budget process, analyzed through the technique of content analysis. The findings of the research show that, in relation to the established variables, which, regarding the formation of the responsible, is adequate to the function; Already the elaboration of the budget in operational terms meets the criteria of public planning and it meets the established in the Municipal Plan of Health and Plurianual Plan. Therefore, there is synergy between the elements of planning. Regarding the role of the actors, the study shows that there is an effective participation in the elaboration phase of the budget proposal and that they are diminishing in the other phases of the cycle. Regarding the use of information technology for cycle management purposes, the research demonstrated that there is a satisfactory system. Regarding the review of expenses, the constant realization is close to what is verified in the literature, soon there is effective management of the financial aspects. Finally, in the verification of the autonomy, it was verified that the professional responsible for the budget process has a greater degree of autonomy in front of the other public agents involved. / Esta tese realiza um estudo empírico sobre o ciclo orçamentário em um município, a partir da inquirição dos responsáveis pelo processo, com vistas a conhecer em detalhes como o mesmo se dá ao longo de seu ciclo e, para tanto, estabeleceu como objetivo do estudo investigar o Ciclo Orçamentário do Setor da Saúde no Município de Maringá, no período de 2013 e 2014. Elegeu-se, para a realização da pesquisa, em termos de objeto empírico, o Ciclo Orçamentário ante o Plano Municipal de Saúde do Município de Maringá, mediante a realização de uma pesquisa que, metodologicamente, enquadra-se como sendo de natureza descritiva, de forma aplicada, analisada qualitativamente, com uso de técnicas documentais e levantamento. No que se refere à coleta dos dados, utilizou-se de documentos públicos da Saúde, que são compostos pelo Plano Municipal da Saúde, Plano Plurianual, Lei de Diretrizes Orçamentárias, Lei do Orçamento Anual e Relatório Anual de Gestão, bem como da realização de entrevista semiestruturada com os responsáveis pelo processo orçamentário, analisada mediante a técnica de análise de conteúdo. Os achados da pesquisa evidenciam, em verificação ante às variáveis estabelecidas que, no tocante à formação do responsável, é adequada à função; já a elaboração do orçamento em termos operacionais atende aos critérios de planejamento público e atende ao estabelecido no Plano Municipal de Saúde e Plano Plurianual. Portanto, há sinergia entre os elementos de planejamento. Sobre o papel dos atores, o estudo demonstra que há participação efetiva na fase de elaboração da proposta orçamentária e que vão diminuindo nas demais fases do ciclo. No que tange ao uso de tecnologia da informação para fins de gerenciamento do ciclo, a pesquisa demonstrou haver sistema satisfatório. Com relação à revisão de despesas, denota-se a realização constante próxima ao que se verifica na literatura, logo há gerenciamento efetivo dos aspectos financeiros. Por fim, na verificação da autonomia se averiguaram que o profissional responsável pelo processo orçamentário possui maior grau de autonomia ante os demais agente públicos envolvidos.

Esta tese argumenta que a Teoria dos Movimentos Sociais com o foco nos protestos como a forma de atuação dos movimentos e com a conceituação restrita da institucionalização mostra-se insuficiente para dar conta dos movimentos sociais que atuam nas instituições políticas. Esta constatação partiu da observação do Movimento Sanitário/pela Reforma Sanitária, que tem se mobilizado, desde os anos 1970, em prol da defesa do acesso universal à saúde no Brasil. A reconstituição da sua trajetória nacional e do seu repertório de ação abrangeu o período entre 1974 a 2006, conduzida por meio de um estudo de caso. Foram analisadas suas transformações e permanências em termos dos diagnósticos e prognósticos, dos atores e dos eventos, bem como das formas de ação. O caso do Movimento Sanitário pela Reforma Sanitária mostra que movimentos sociais podem atuar via instituições, sem deixar de sê-los, e que, nessa atuação, seus atores recorrem aos elementos inovadores que colocam as autoridades diante de situações novas e aumentam a capacidade de mobilização do movimento. / This thesis argues that the Theory of Social Movements which focuses on protests as the expression of movements actions proves to be insufficient to account for the social movements that operate in political institutions. This finding was based on the observation of the Sanitarista Movement, which has been engaged since the 1970s in defense of universal access to health care in Brazil. The case study covers the reconstitution of the movements national trajectory and repertoire of action from 1974 to 2006. We analyze its continuities and transformations in terms of diagnosis and prognosis, the actors and the events, and the forms of action. The case of the Sanitarista Movement shows that social movements do not cease to exist while acting in institutions and that in their institutional repertoire they are able to introduce innovative elements that put the authorities before new situations and increase the social movement capacity to mobilize.

Submitted by Caroline Falcao (caroline.rfalcao@ufpe.br) on 2017-06-05T16:18:45Z No. of bitstreams: 2 license_rdf: 811 bytes, checksum: e39d27027a6cc9cb039ad269a5db8e34 (MD5) Tamires Taís.pdf: 9141530 bytes, checksum: dab991dd87283a9e223705028b80d093 (MD5) / Made available in DSpace on 2017-06-05T16:18:45Z (GMT). No. of bitstreams: 2 license_rdf: 811 bytes, checksum: e39d27027a6cc9cb039ad269a5db8e34 (MD5) Tamires Taís.pdf: 9141530 bytes, checksum: dab991dd87283a9e223705028b80d093 (MD5) Previous issue date: 2013-04-04 / Esta dissertação apresenta um panorama do sistema de saúde brasileiro, com ênfase no caso do Estado de Pernambuco. A gestão de sistemas de saúde se manifesta sob a forma geral de longas filas de espera, que são analisados neste contexto, incluindo algumas abordagens que têm sido propostas e implementadas em Pernambuco, a fim de resolver o problema. Um modelo de crescimento econômico ótimo destacando o setor de saúde, e, em seguida, operando em conjunto, os setores de saúde e educação é proposto. Os resultados do princípio do máximo de Pontryagin aplicado a este modelo mostram os benefícios mútuos para ambos os setores e os seus efeitos no bem-estar da sociedade. Um estudo de caso de filas de espera no Hospital da Restauração, em Recife, Pernambuco, é apresentado. / An overview of the Brazilian health care system is presented, with an emphasis in the Pernambuco state case. One central issue concerning health systems management manifests itself under the general form of long waiting lines, which are then here analyzed in this context, including some approaches that have been proposed and implemented in Pernambuco in order to tackle the problem. An optimal economic growth model highlighting the health sector, and then, operating jointly, the health and education sectors, is proposed. The results of the Pontryagin Maximum Principle applied to this model show the mutual benefits for both sectors and their effects in the community welfare. A case study of queueing systems in Hospital da Restaura¸c˜ao (an emergency hospital) in Recife, Pernambuco, is presented.

Submitted by Jaqueline Silva (jtas29@gmail.com) on 2016-10-18T18:10:22Z No. of bitstreams: 2 Dissertação - Barbara Salatiel Borges - 2016.pdf: 2105651 bytes, checksum: c858adfeb6ff85a7a7392a349c63245d (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Approved for entry into archive by Jaqueline Silva (jtas29@gmail.com) on 2016-10-18T18:10:43Z (GMT) No. of bitstreams: 2 Dissertação - Barbara Salatiel Borges - 2016.pdf: 2105651 bytes, checksum: c858adfeb6ff85a7a7392a349c63245d (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Made available in DSpace on 2016-10-18T18:10:43Z (GMT). No. of bitstreams: 2 Dissertação - Barbara Salatiel Borges - 2016.pdf: 2105651 bytes, checksum: c858adfeb6ff85a7a7392a349c63245d (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2016-06-14 / Fundação de Amparo à Pesquisa do Estado de Goiás - FAPEG / The aim of this study is to investigate to what extent Brazilian federal deputies’ backgrounds influences their behavior in the legislative arena, more specifically, the variation in their conduct in the nominal voting in the Chamber of Deputies during the period that corresponds to the 54th legislature. Beyond this, owing to a methodological choice and given the limitation of this research, the social background that interests us is that which, and according to selected criteria, would be connected to the health sector. The result of the tabular analysis between the variables shows that the health background is not a predictor of behavior of political actors. / O objetivo deste trabalho é investigar em que medida o background do deputado federal brasileiro influencia o seu comportamento na arena legislativa, mais especificamente, a variação em sua atuação nas votações nominais na Câmara dos Deputados no período que corresponde a 54º Legislatura (2011-2015). Ademais, por uma escolha metodológica e dada a limitação deste trabalho, o background social que nos interessa é aquele que, de acordo com critérios selecionados, esteja vinculado ao setor da saúde. O resultado da análise tabular entre as variáveis demonstra que o background em saúde não é um preditor do comportamento parlamentar no Plenário.

El avance de la digitalización en distintas industrias trae consigo nuevos riesgos potenciales. Aquellas que pertenecen al sector salud se encuentran entre las que mayores riesgos deben enfrentar. La privacidad de los datos en el sector salud se encuentra regulada y las multas por el incumplimiento de normativas pueden afectar a las compañías, ya que esto indica que ponen en peligro los datos personales de sus clientes. Por ello, las industrias que pertenecen a este sector, necesitan una herramienta que facilite la identificación de capacidades en Ciberseguridad, Privacidad y gestión de datos de salud para cumplir con las normativas vigentes, y reducir los riesgos que comprometan la confidencialidad, integridad y accesibilidad de los datos. En este trabajo se propone un modelo de madurez de capacidades que identifica el grado de fiabilidad de los elementos de Ciberseguridad y Privacidad aplicados al Sector Salud. Esto se realizó mediante la selección de modelos, frameworks y normativas, aumentando su complejidad mediante la integración de capacidades de privacidad y gestión de datos de salud. El modelo se validó en una empresa del sector salud con una herramienta de diagnóstico y se observaron los resultados. Los resultados obtenidos se compararon con los componentes originales del modelo para verificar que los componentes se integraron holísticamente. Además, se entregó un formulario de evaluación del modelo a la empresa cliente para comprobar el nivel de satisfacción con respecto al uso del modelo y sus componentes. / The advancement of digitalization in different sectors brings along with it new potential risks. One of the sectors that have to confront said risks is the health sector. Data privacy in the health sector is heavily regulated and fines for non-compliance can affect the companies since it implies putting the client’s personal data at risk. Because of this, businesses belonging to the health sector need a tool to help with the identification of capabilities in Cybersecurity, Privacy and Health data management to achieve compliance with the current norms and reduce risks that might compromise the Confidentiality, Integrity and Availability of data This work proposes a capability maturity model that can identify the reliability of Cybersecurity and Privacy elements applied to the Health Sector. This was achieved through the use of models, frameworks and norms; allowing us to increase their complexity through the integration of privacy and health information management capacities. The model was validated by using a diagnosis tool in a health sector business and observing the results. The obtained results were compared with the original components of the model to verify the holistic integration of said components. We also used a model evaluation form to measure the satisfaction level of the business regarding the use of the model and its components. / Tesis

La presente tesis hace referencia a una propuesta de Arquitectura Empresarial para el macroproceso de Atención Hospitalaria de una Clínica privada, esta propuesta permitirá alinear los objetivos estratégicos del negocio con las Tecnologías de Información. En el primer capítulo, se abordan conceptos base para el desarrollo de la tesis como la descripción del sector salud en el Perú y los principales marcos de referencia de arquitectura empresarial. En el segundo capítulo, se conoce a la empresa y se detalla la misión, la visión, los valores y los principios de la organización, así como sus objetivos estratégicos, el mapa de procesos y su estructura organizativa. Además, se identifica los puntos de dolor clave del macroproceso de Atención Hospitalaria. En el tercer capítulo, se realiza el análisis y evaluación de la situación actual del macroproceso de Atención Hospitalaria con la finalidad de plantear mejoras a través de indicadores evaluados. Así mismo, en esta sección se define la propuesta de solución basada en el marco de referencia TOGAF empleando la metodología ADM hasta la quinta fase de su desarrollo. En el cuarto capítulo, se lleva a cabo la evaluación financiera del portafolio de proyectos producto del análisis de brechas realizadas en el capítulo anterior para determinar si el portafolio es viable financieramente. Finalmente, se exponen las conclusiones y recomendaciones producto del desarrollo del trabajo de investigación. / The current thesis details an Enterprise Architecture proposal for one of the main macro processes of the Healthcare Clinic, which is the Hospital Care, to allow the alignment of strategic objectives with information technologies. On the first chapter, concepts such as the healthcare industry in Peru and the main enterprise architecture frameworks are described as base for the thesis development. On the second chapter, current situation of the organization is detailed along with the mission, vision, values, principles, strategic objectives, macro processes and structure. Furthermore, key pain points are identified within Hospital Care macro process. On the third chapter, the analysis and evaluation of the selected macro process takes place, and a solution is proposed based on TOGAF as framework by applying the first five phases of ADM. This evaluation is done to improve the indicators and obtain better results. On the fourth chapter, the project portfolio financial evaluation is developed. This project portfolio is elaborated because of the gap analysis on the previous chapter to determine its financial viability. Finally, as consequence of the research, the current document provides conclusions and recommendations. / Trabajo de investigación

The thesis deals with the issue of cooperation between the health care and social care sectors in the framework of care for the elderly in the home environment. It focuses more closely on the case of the city of Prague. The aim of the thesis is to examine the current state of cooperation of the health care and social care sector in the city of Prague in the field of care for the elderly and to identify the impact of government decisions as well as decisions of individual city districts of Prague on the work of field workers. Attention is paid to the needs of field workers and to specific barriers that they have themselves identified and which, according to the workers, make it impossible to set up a functional cooperation system. On the basis of an analysis of national level documents, documents issued by the capital city of Prague or specific districts, good practice from European Union countries (namely Sweden, the Netherlands and Belgium) a set appropriate ways of dealing with the issue has been proposed.