Decentralizing supervision to attain higher productivity: the case of the ecuadorian health system

There is growing interest in developed and developing countries about how to best administer public programs in order to maximize the return on invested resources. This paper examines the extent to which decentralized supervision can help improve health worker productivity. Data on health workers in Ecuador are analyzed. The results suggest that local (or decentralized) supervision is conducive to higher productivity and more hours worked per day by Ecuador's health promoters. The implications for higher health status, and for improving health care in other developing countries are discussed.     

Associations between national gambling policies and disordered gambling prevalence rates within Europe

Policymakers and other interested stakeholders currently are seeking information about the comparative effectiveness of different regulatory approaches to minimising gambling-related harm. This study responds to this research gap by exploring associations between gambling policies and disordered gambling prevalence rates. We gathered information about gambling policies for thirty European jurisdictions and past-year prevalence rates for disordered gambling for twelve of these jurisdictions. We present policy trends and prevalence rates and then describe the level of association between policy and prevalence. We observe one statistically significant association between policy and prevalence: rates of sub-clinical (i.e., Level 2) disordered gambling were higher within environments that mandated less strict regulation of advertising for online gambling. Finally, we discuss the implications of our research in the context of the current process regarding the pan-European regulation of gambling. Our findings do not offer evidence for certain assumptions made in the past by the European judiciary.