Depois de se proceder a levantaciento epidemiológico de cárie dental, na população escolar de São Luis, matriculada na rede oficial do Estado efetuou-se a análise do sistema público de prestação de serviços odontológicos, no que se refere às Instituições participantes, serviços produzidos, custos e recursos humanos envolvidos. Constatou-se uma escassa repercussão sobre os níveis de saúde bucal, da população e do trabalho desenvolvido pelos Orgãos PÚblicos, o que sugere a necessidade de implementar um programa de Assistência Odontológica, a partir da articulação inter-setorial, das Instituições Públicas dirigido a escolares de 1º Grau, matriculados em estabelecimentos da rede oficial de ensino. É feita uma proposta de Assistência Odontológica a escolares envolvendo todas as Instituições do Setor Público. / After carrying out an epidemiological survey on dental caries among the school population, registered with the state school system, of São Luís, an analysis of the public organization of the offer of dental services, with regard to the institutions involved, the services effectively rendered, the costs and the human resources involved, was made. Little effect on the levels of the mouth health of the population was verified, nor of the work carried out by the public organs concerned, which suggests the need for the implementation of a program of odontological assistance, starting with the intersectorial coordination of those public institutions which are directed to the care of lower-grade school children (i.e. those of 7-14 years of age); registered with the state school system. A proposal for odontological assistance to school children, involving all the Public Health organizations, is made.

The current socio-economic and political challenges, globalisation, introduction of information technology and competition with private firms are challenging the way governments operate. In recent years, the UAE Government have thus invested heavily in the innovative projects to achieve the UAE vison 2021, which is to become one of the most innovative governments globally. Developing a better understanding of how innovation happens in governments appears to be gaining increased traction among policy makers and researchers alike. This study examined the relationship between Transformational leadership (TL), Innovation process (INN) and Knowledge sharing (KS) within public sector organisation the case of the UAE Ministry of Interior (MoI). There are several models of innovation available, however, most of them are based on product innovation and derived from private sector experiences. Moreover, there is a lack of models linking transformational leadership, knowledge sharing, and innovation within public organisation of developing countries in general and the UAE in particular The main research objective is to investigate the impact of the four main components of transformational leadership on knowledge sharing and innovation process within the public sector organisation, and the impact of knowledge sharing on the innovation process. To achieve the research objectives, a positivist paradigm is used throughout the research process. Using deductive approach, ten hypotheses were tested in the MoI context. Respondents no. The survey was administered to employees of the ministry of Interior as a method of data collection. Applying SPSS 23 and AMOS 23, the data was analysed and a structural model was developed, which can be serve as a predictive model for workplace innovation. Paragraph3 The findings of this research reveal that inspirational motivation (IM) has non-significant influence on the innovation process within the MoI, while the other three components of transformational leadership were found to have a significant influence on innovation process. Similarly, inspirational motivation (IM), and idealised influence (IF) were found to have non-significant influence on knowledge sharing. In addition, knowledge sharing (KS) was significantly associated with the innovation process. Finally, demographic variables specifically position and level of education were found to have a significant difference in terms of the respondents' views towards the innovation process within the MoI. This study contributes to the field of organizational innovation in public sector as the outcome of the research provides a specific framework for the conditions and needs of the public sector organisation. The study contributes to the theory by providing new insights into the factors that influence innovation process in the MoI. The study identifies four factors that directly and indirectly affect innovation process; these factors based on the degree of their importance are IC, IS, KS and IF. Moreover, the study contributes to the knowledge by investigating the mediating role of knowledge sharing in supporting the relationship between transformational leadership and innovation process. Finally, one major contribution of this study is the development of a 33-item instrument which measures factors affecting innovation process, particularly in the context of public sector of the UAE. From a practical perspective, MoI leaders trying to implement innovation can use the final model and set of recommendations provided to implement innovation effectively.

Magister Commercii (Information Management) - MCom(IM) / Long waiting times before receiving a health service, give rise to long queues and congested health facilities, both of which are unnecessary and avoidable. Since patients in part judge the quality of the service by the length of time they spent waiting for it, it is imperative to measure waiting times, and determine and mitigate the immediate and underlying causes of lengthy waits. The facility under investigation was known to have excessively long waiting times. Since the immediate causes of long waiting times were known, it was thus required to research and understand the underlying causes of long waiting times and consequently whether there were any barriers to implementing recommendations to reduce waiting times at this primary health care facility. AIM: The aim of the study was to determine the underlying causes of long waiting times and the barriers to implementing recommendations to reduce waiting times. METHODS: A quantitative cross-sectional analytical study with a small qualitative component was undertaken. The qualitative study took a workshop format by piggy-backing onto feedback sessions held to present the results of the previously conducted waiting time survey to staff. Staff commentary at the workshops on possible underlying causes and barriers to recommendations to reduce them, were then used to develop a questionnaire for the quantitative portion of the study. The population and sample for the qualitative part of the study were all staff working at the facility who attended the feedback sessions. The cross-sectional descriptive quantitative study intended to uncover what underlying causes affected long waiting times, what recommendations could be explored to mitigate long waiting times and improve the patient experience, and if there were any barriers to these recommendations. The quantitative study population and sample were all staff who worked at the facility for more than six months and all patients who had utilised the services at the facility for three or more times. Data was collected using structured questionnaires, which were different for staff and patients. A detailed descriptive analysis was conducted.

Depois de se proceder a levantaciento epidemiológico de cárie dental, na população escolar de São Luis, matriculada na rede oficial do Estado efetuou-se a análise do sistema público de prestação de serviços odontológicos, no que se refere às Instituições participantes, serviços produzidos, custos e recursos humanos envolvidos. Constatou-se uma escassa repercussão sobre os níveis de saúde bucal, da população e do trabalho desenvolvido pelos Orgãos PÚblicos, o que sugere a necessidade de implementar um programa de Assistência Odontológica, a partir da articulação inter-setorial, das Instituições Públicas dirigido a escolares de 1º Grau, matriculados em estabelecimentos da rede oficial de ensino. É feita uma proposta de Assistência Odontológica a escolares envolvendo todas as Instituições do Setor Público. / After carrying out an epidemiological survey on dental caries among the school population, registered with the state school system, of São Luís, an analysis of the public organization of the offer of dental services, with regard to the institutions involved, the services effectively rendered, the costs and the human resources involved, was made. Little effect on the levels of the mouth health of the population was verified, nor of the work carried out by the public organs concerned, which suggests the need for the implementation of a program of odontological assistance, starting with the intersectorial coordination of those public institutions which are directed to the care of lower-grade school children (i.e. those of 7-14 years of age); registered with the state school system. A proposal for odontological assistance to school children, involving all the Public Health organizations, is made.

No presente trabalho desenvolvemos um estudo histórico identificando os principais traços definidores da sociedade brasileira, com destaque para a paulista, à época da fundação do Instituto Butantan. Descrevemos os principais eventos ocorridos na evolução e desenvolvimento do Instituto. Utilizamos a \"Técnica de Programação do Setor Público Aplicada à Saúde\" para analisar as variáveis: Recursos, Financiamento, Gasto e Produção do Instituto Butantan no período de 1970 a 1982, comparando-a, quando possível com as de outras instituições. Identificanos e analisamos o mercado de imunobiológicos para menores de um ano, segundo o Programa Nacional de Imunizações de 1982, no Brasil e em São Paulo, destacando a participação do Instituto Butantan nesse mercado. Assim, observamos que o Instituto Butantan surgiu como resposta às necessidades específicas definidas, pela conjuntura econômica, social, política, sanitária e científica do início da República. De um lado veio ao encontro das necessidades de expansão do café, principal produto exportado, e a continuação da política de atração de imigrantes europeus como mão-de-obra. De outro, enquadrava-se no projeto modernizador que marca a consolidação do regime republicano. A vitalidade do Instituto Butantan, desde a sua fundação até hoje tem sido garantida pelo permanente relacionamento com os principais problemas de saúde pública do País, ocorrendo de forma constante um sinergismo entre a produção e a pesquisa. Assim, felizmente, todas as tentativas de transformar o Instituto em apenas uma \"fábrica\" de medicamentos não obtiveram sucesso. O aspecto comercial do Instituto Butantan tem sido uma questão problemática, pois, desde a sua fundação, realizou três contratos com empresas para a distribuição de seus produtos e nos três nomentos esses contratos mostraram-se prejudiciais à Instituição; atualmente mantém um convênio com a CEME que já se mostra um risco de descapitalização. No período de 1968 a 1982 houve uma ampliação do número de servidores de 424 para 963 e no período de 1970 a 1982 foram construídos 5.708,00 m2, que somados à área construída anteriormente, totalizam 42.778,00 m2 de edificações adequadas para desenvolver suas atividades especializadas, neste período ocorreu também a ampliação da produção de soros e vacinas. Durante o período de 1970 a 1982 o Instituto Butantan mostrou a falta de uma política financeira definida sofrendo variações bruscas em seu financiamento, porém, mesmo assim, mostrou-se em melhor situação quanto ao Financiamento e Gasto quando comparado com o Instituto Biológico e com o Instituto Agronômico. Em relação ao mercado de imunobiológicos verificamos que a CEME, a partir de 1973, tem ampliado a distribuição das vacinas a ponto de em 1982 superar em muito as necessidades definidas pelo PNI para menores de 1 ano. Durante o período estudado as vacinas antipoliomielite e anti-sarampo foram importadas, enquanto que o BCG-Id foi produzido pela Fundação ATHAULFO DE PAIVA e a vacina tríplice foi produzida principalmente pelo Instituto Butantan. Porém, a partir de 1980, a CEME ampliou a aquisição da tríplice de um laboratório privado e a partir de 1981 iniciou a sua importação em grande quantidade, sugerindo inclusive que o Instituto Butantan interrompesse sua produção. / We will identify the main defining pillars o f Brazilian society, especially the \"paulista\" society at the time of the foundation of Instituto Butantan by means of a historical study. We will describe the main events in the development of the Institute. We will analyse variables such as Resources, Financing and Production o f the Institute, from 1970 to 1982 and compare them with those of other institutions using the \"Técnica de Programação do Setor PÚblico Aplicada à Saúde\". We will identify the market for vaccine drugs for children with less than one year old according to the National Immunization Program (1982) for Brazil and São Paulo, pointing to the share of the Institute in this market. Thus we observed that Instituto Butantan was created to respond to specific needs set by economic, social, political, sanitation and scientic conjuncture of the begining of the Republic. It came as a consequence to the need of expansion of coffee plantations worked by european immigrants and it conformed to the modernization projeet set by the Republic. The vitality of the Institute, from its beginning till the present days is related to its permanent taking into account of the main public health problems in the country and working in both production and research. Fortunately all the attemps to convert the Institute into a drug production plant only, failed. The comercial abitity of the Institu te has always been a problem because, since its early days the distribution contructs established with there firms proved to be infavorable to its interests. Its present contract with CEME is already pointing to a descapitalization tendency. From 1968 to 1982 the manpower of the Institute increased from 424 to 963. From 1970 to 1982, 5.708 m2 were built, which summed up 42.778 m2 buildings adequate to develop its specialised activities. The production of serum and vaccines increased also. From 1970 to 1982 the Institute showed a lack of finantial policy with abrupt changes in its financing yet, it has fared better than Instituto Biologico and Instituto Agronomico on this aspect. From 1973 onwards CEME has been expanding the distribution of vaccines in such a degree that in 1982 it was well above the needs, as establishede by PNI for chi1dren with less than one year old. During the period studied antipolio and antimeasles vaccines have been imported, whereas intradermic BCG has been produced by Fundação Athaulfo de Paiva. Triple vaccine was produced mainly by the Butantan. Nevertheless, from 1980 onwards, CEME expanded its byings of the latter vaccine from a private firm and from 1981 started a massive importation, sugesting to the Instituto Butantan to stop its production.

Magister Commercii (Information Management) - MCom(IM) / Long waiting times before receiving a health service, give rise to long queues and congested health facilities, both of which are unnecessary and avoidable. Since patients in part judge the quality of the service by the length of time they spent waiting for it, it is imperative to measure waiting times, and determine and mitigate the immediate and underlying causes of lengthy waits. The facility under investigation was known to have excessively long waiting times. Since the immediate causes of long waiting times were known, it was thus required to research and understand the underlying causes of long waiting times and consequently whether there were any barriers to implementing recommendations to reduce waiting times at this primary health care facility. Aim: The aim of the study was to determine the underlying causes of long waiting times and the barriers to implementing recommendations to reduce waiting times. Methods: A quantitative cross-sectional analytical study with a small qualitative component was undertaken. The qualitative study took a workshop format by piggy-backing onto feedback sessions held to present the results of the previously conducted waiting time survey to staff. Staff commentary at the workshops on possible underlying causes and barriers to recommendations to reduce them, were then used to develop a questionnaire for the quantitative portion of the study. The population and sample for the qualitative part of the study were all staff working at the facility who attended the feedback sessions. The cross-sectional descriptive quantitative study intended to uncover what underlying causes affected long waiting times, what recommendations could be explored to mitigate long waiting times and improve the patient experience, and if there were any barriers to these recommendations. The quantitative study population and sample were all staff who worked at the facility for more than six months and all patients who had utilised the services at the facility for three or more times. Data was collected using structured questionnaires, which were different for staff and patients. A detailed descriptive analysis was conducted. Results: The study found a number of potential underlying causes for each immediate cause of long waiting times at the facility. For early morning batching the underlying causes found were: 45% of patients were given early appointments which caused clients to arrive early; 100% of patients with appointments after 10H00 arrived before 10H00; and 43% of the patients stated that they arrived early because they feared being turned away.

Em um ambiente de competição globalizada a disputa pelo cliente está mais acirrada. Neste cenário, o sucesso e progresso das organizações privadas, cada vez mais, estão relacionados com a capacidade das mesmas de agir frente às oportunidades e ameaças apresentadas. Ao longo das últimas décadas, o setor público, de um modo geral, também se viu sob maior pressão para melhorar seu desempenho. Tais pressões do ambiente têm levado as instituições a vivenciarem constantes mudanças, cuja implementação deve ser realizada por meio de projetos. Com intuito de aprimorar o gerenciamento e o desempenho de seus projetos várias organizações têm adotado as práticas recomendadas pelos modelos de maturidade em gerenciamento de projetos. Apesar disso, poucos estudos têm apresentado, particularmente para o setor público e para projetos de engenharia e construção, qual a efetividade das ferramentas e técnicas propostas por tais modelos. O presente trabalho tem como principal objetivo avaliar a relação entre a evolução na maturidade em gerenciamento de projetos e a melhoria no gerenciamento e no nível de desempenho dos projetos em relação a prazo e a custo. As principais dificuldades enfrentadas no processo de evolução também são discutidas. Com este propósito foi realizado um estudo de caso no Governo do Estado do Rio de Janeiro. Com base na análise do caso citado, percebeu-se que, com a evolução na maturidade, os projetos da organização pesquisada apresentaram indícios de melhoria no desempenho do gerenciamento em relação a prazo e a custo. As melhorias no gerenciamento dos projetos também são relevantes, merecendo destaque: estabelecimento de um ambiente de maior seriedade em relação ao cumprimento das metas e maior controle e transparência dos projetos. As principais dificuldades encontradas no processo de evolução na maturidade foram: gerente de projeto conseguir superar a forte centralização oriunda da migração de uma estrutura funcional para a matricial e a incorporação da metodologia de gerenciamento de projetos como algo natural. / In an environment of global competition the battle to secure clients has become even tougher and unyielding. In this scenario the success and progress of private organisations is increasingly related to their capacity to act in advance of the opportunities and threats presented. Throughout the last decades the public sector has also seen itself come under greater pressure to improve its performance. Such pressure has meant that institutions have to live with constant change which the implementation should be accomplished through projects. With the task of enhancing the management and performance of their projects, various organisations have adopted the practices recommended by project management maturity models. However, in spite of this, few studies have presented evidence as to the effectiveness of the tools and technical proposals utilised in such approaches particularly for the public sector and in relation to engineering and construction projects. This work has as its main objective an evaluation of the relationship between maturity evolution in project management and the improvement in the project management and project management performance in relation to schedule and cost. The principal difficulties confronted in the process of evolution are also discussed. As such a case study in the Government of Rio de Janeiro was carried out. From the analysis of the case cited it is shown that with maturity evolution in project management, the projects of the organisations researched manifested signs of improvement in project management performance for schedule and cost. The project management improvements are also noteworthy for establishing an environment of greater seriousness in relation to meeting targets and better project control and transparency. The principal difficulties confronted in the process of maturity evolution in project management were: project management able to overcome the strong centralisation originating from the migration from a functional to a matricial structure and the incorporation of project management methodology as something natural.

The last two decades of the twentieth century saw unprecedented change in the Western Australian public sector. Legislative reform, royal commissions and new policies aimed at enhancing public sector accountability, transparency and efficiency have served to highlight the critical role of CEOs in delivering change. Underpinning sustainable organisational change is cultural change, which in-turn is most effectively driven by a transformational leadership style. There has been little research into CEOs' perceptions of their role in leading cultural change in their organisations. This thesis details an exploratory study of WA public sector CEOs. It discovered that CEOs identified with elements characterising the theoretical construct of a transformational leader. They perceived cultural change as the realignment of organisational values and behaviour with mission, government and community expectations, efficiency and effectiveness. CEOs actively deployed a number of strategies to bring about cultural change but were uncertain about the extent which substantive cultural change was taking place within the public sector. Factors they saw as impacting on their capacity to lead such change included the Government's policy agenda, management theory and potentially, peer support. CEOs who participated in the study were predominantly career public servants, male, over the age of fifty, had worked exclusively in the public sector and only led a small number of organisations. They had mixed views about the impact of such demographics on a CEO's capacity to effectively lead cultural change citing situational factors and personal attributes as being significant variables. There were a number of clear findings from the study that have significant, practical implications for the public sector. CEOs would benefit from a government that communicated a stronger sense of vision about the ++ / future directions of the sector. CEOs require structured opportunities to enhance their competencies in the leadership of change and incentives to commit to change agendas that may extend well beyond the tenure of their employment contacts. Finally, CEOs cannot effectively transform organisational culture without support from other leaders and strategic plans that take account of emerging demographic shifts in the workforce that will inevitably impact on staff values, behaviours and expectations.

This thesis is an applied study of the response of a selected group of large construction companies in the Sydney Basin to the National Training Reform Agenda (NTRA). The thesis emanates from an interest in the modern view of public policy that suggests public sector intervention should 'augment rather than impede market forces' (Dollery, 1994:225). This view argues that too much public intervention has the potential to culminate in government failure because governments can be self-interested bureaucracies that are divorced from the interests and constraints of the market. To avoid such an outcome, this policy position advocates that governments should develop and implement public policy that encourages community, industry and individual participation in the policy agenda. This minimalist approach to public sector intervention, and the values it espouses, was investigated through research into the NTRA and the construction industry. / Doctor of Philosophy (PhD)

In recent years public sector organisations in New South Wales have been subjected to changes in their operating environments. Changes have included micro-economic reforms by Government and changes in stakeholders' expectations of how public sector organisations manage their affairs. The need to deal with the increasing number and diversity of issues arising, has motivated public sector managers to become increasingly involved in strategic management. The focus of this research was to study how strategic issues were processed within the context of their approach to strategic management. Strategic issue management has been proposed as an appropriate management system for use in conditions of moderate to high levels of environmental turbulence as a means to providing a mechanism for real time response to emerging issues. Three of the four organisations in the study indicated a progressive increase in perceptions of environmental turbulence over a six year period to points mid way between the 'Changing' and 'Discontinuous' levels on the Ansoff and McDonnell (1990) environmental turbulence scale. Research findings indicted that all four public sector organisations undertake a form of strategic issue management which is separate to the periodic strategic planning cycle. In answer to the criticism of the theoretical void which is seen to exist in linking organisational response to changes in the environment, theoretical models were developed for the Sensing, Deciding and Executing functions of the processing dimension of Ansoff's (1987) proposed paradigm of emerging strategic behaviour. The models provide the framework for tracking how eight strategic issues were processed in four public sector organisations. Field research-was conducted over a fifteen month period collecting both secondary and primary data. A case study research methodology was developed for the project following a review of the relevant literature. There were clear indications that the Sensing, Deciding and Executing functions were performed and that the issues under study passed through numerous phases during their processing cycles. The interconnected and iterative nature of issue processing across the Sensing, Deciding and Executing phases were demonstrated in the research findings.