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Purpose – The paper explains how internal reporting systems, as embedded practices informing organizational actions and “know-how”, contributed to the inertia in implementing a corporate form of governance in a transitional public organization in a developing country – Egypt.

Design/methodology/approach – The paper synthesizes an institutional theory framework in order to capture the case study mixed results. Drawing on DiMaggio and Powell's (1983) notions of isomorphic mechanisms, Ocasio (1999) and Burns and Scapens’ (2000) notions of organizations’ memory, history, cumulative actions and routines, Brunsson's (1994) notion of organizational institutional confusion as well as Carruthers's (1995) notion of “symbolic window-dressing” adoption of new practices, the paper explores the dynamic of a public hospital corporatization processes. Data collection methods include semi-structured interviews, documentary evidence and direct observation.

Findings – The case study evidence shows that the interplay between the new form of “corporate” governance and the intra-organizational power, routines and “know-how” created internal organizational confusion and changed organizational members’ narrative of risk and uncertainties.

Research limitations/implications – The paper does not reveal the role of reformers involved in the public sector “governance” reform in developing countries. Exploring such a role goes beyond the scope of this paper and represents an area of future research.

Originality/value – The paper provides a comprehensive account of public sector “governance” reform in a developing nation, while exploring the role of management accounting and costing systems in facilitating or otherwise that reform processes.

Based on the Current Population Survey, 46.6 million Americans did not have health insurance in 2005 (Center on Budget and Policy Priorities, 2006). Lack of insurance is often associated with lower utilization rates, which may in turn adversely affect health status (Ayanian, Weissman, Schneider, Ginsburg, & Zaslavsky, 2000). Since universal health insurance is not provided for in the US, uninsured individuals must either self-pay or rely on charity care provided by hospitals and health clinics. The majority of charity care is produced in the public sector, either at the state, county, or local level (federal hospitals primarily serve a particular segment of the population – e.g., veterans in the case of Veterans Administration hospitals). Public hospital provision of “safety net” hospital services is particularly prevalent in large urban areas (Lipson & Naierman, 1996). These safety net hospitals are defined by the Institute of Medicine as having an “open door policy to serve all patients regardless of their ability to pay and provide substantial levels of care to Medicaid, the uninsured, and other vulnerable patients” (IOM, 2000). Private not-for-profit (NFP) hospitals also provide charity care but to a lesser extent than public providers, especially since the imposition of cost cutting measures both by Medicare and Medicaid (federal programs that fund health care for the elderly and indigent, respectively) and by managed care. Given that approximately 15% of US GDP is allocated to health care, cost cutting measures are laudable; however, care still needs to be provided for individuals who cannot afford it, and the burden of providing this care has to be borne somewhere in the health care system.

Hospitals are complex organisations accounting for most of total health expenditure. They play a critical role in providing care to patients with high levels of need. A key policy concern is that patients receive high quality care. Policymakers have attempted to influence hospital quality in different ways. This chapter focuses on three key policy levers: the extent to which hospital competition and higher hospital tariffs (of the DRG type) can stimulate quality, and whether non-profit hospitals provide higher or lower quality than for-profit ones. The chapter outlines key methodological challenges and selectively reviews the main findings from the literature. While several studies suggest that hospital competition reduces mortality rates for heart attack cases when hospital tariffs are fixed (under a DRG system), at this stage is unclear whether the effect holds across a range of quality indicators. Moreover, the limited literature on hospital mergers tends to suggest that hospital quality does not change following a merger. Finally, whether non-profit hospitals provide higher or lower quality varies across regions and institutional arrangements. The economic theory suggests several mechanisms with opposite effects on quality. To guide policy, future work needs to further unpack the various mechanisms through which these three key policy issues affect hospitals incentives.

Healthcare for the poor in India has traditionally been a domain of public services. New business models based on cross-boundary cooperation between stakeholders are unique in their attempts to be inclusive, affordable, and viable. This chapter studies the process of cross-boundary cooperation by analyzing partnerships in Aravind Eye Care System (Aravind), a renowned eye care service delivery in southern India, known for its low cost, high quality, and high volume. Through the use of ethnographic narratives, one sees the process of partner selection, achievement of network goals, and cooperative learning—as well as the way these factors influence inclusivity and affordability in eye care. The chapter attempts to understand how values like empathy and compassion, integral to healthcare services, get transmitted outside the boundaries of the participating organizations and become embedded in the extended network. The chapter is divided into two sections. The first shows how Aravind has attempted to scale up compassion by partnering with local organizations in Tamil Nadu, the state where it primarily operates. The second part examines the process of blurring organizational boundaries where Aravind extends its services to other hospitals in India and elsewhere. Atypically, Aravind gives away its knowledge to these hospitals.

Transnational migrant entrepreneurship is an increasingly important and multi-faceted process. Because of the ‘double transition’ of Albanian migrants, in terms of migration (spatial transition) and in terms of transition from socialism to capitalism and more specifically the absence of entrepreneurship experience in their homeland during the communist regime, we might think of Albanians as being in a weak position for mastering entrepreneurship. But, paradoxically, the evidence tends to prove the opposite. Albanians have succeeded in identifying various entrepreneurial opportunities, and are nowadays increasingly engaging in a wider range of entrepreneurial activities. The overall aim of this chapter thus is to analyse the causes and consequences of transnational entrepreneurship among Albanian migrants doing business with Albania and Albanian returnees pursuing business activities with their former destination countries. For this purpose, the author draws on face-to-face interviews with 50 Albanian migrant entrepreneurs engaged in cross-border economic activities in Albania, Italy and Greece, supplemented by further interviews with key informants, as well as government policy documents. The analysis in this chapter offers important insights into the two main types of entrepreneur, which are ‘necessity’ and ‘opportunity’ entrepreneurs; the emergence of academic entrepreneurship among Albanian transnational entrepreneurs; and the contribution of transnational migrant entrepreneurs in terms of added value at the individual and community levels, as well as potentially impacting on the country’s economic and social development.

Having a baby is a sensitive matter and the child's body occupies a relevant space within the imaginary and the concerns of the intentional, biomedicalized contemporary reproducers. Besides, the myth of ‘the perfect child’ claims specific moral injunctions about making bodies since the body conveys social recognition codes both through flesh or genetic matrix and embodied practices. So, having a child with an unexpected ‘defective’ body becomes a stressful challenge for the reproductive experience of the intentional parent(s). In any case, both parent(s) and biomedical professionals enact a hierarchization among the ‘damaged’ materials of the child's body based on the perceived and/or the classified degree of physical or mental abnormality, on its behavioural embodiments and on the possibility to re-order, fix and control the (biosocial) disorder of an abnormal unable and/or undisciplined body.

Based on recent investigations on reproduction and disability in two regions of Italy, this essay comparatively investigates the experiences of two associations of parents with asthmatic and ADHD children.

Specifically, I tried to explore how parents of children with misleading bodies emotionally, practically and morally face their unexpected reproduction, and if and how they are being entrapped in or resist the pressure of neuro-biomedical governance, schooling disciplining techniques and social blame. I tried to articulate some suggesting concepts, such as ‘delegate biopolitics’ and ‘discursive surveillance’ (Memmi, 2008), and ‘self-constraint behaviours’ (Elias, 1998), in order to analyze ethnographic material.

This research explores the subjective health experiences of women incarcerated in a provincial detention center in Ottawa, Canada.

Narrative interviews conducted with 16 previously incarcerated women were analyzed to explore how health issues shaped their experiences in detention.

Women identified a set of practices and conditions that negatively impacted health, including the denial of medication, medical treatment, and healthcare, limited prenatal healthcare, and damaged health caused by poor living conditions.

Findings suggest that structural health problems emerge in penal environments where healthcare is provided by the same agency responsible for incarceration. The incompatibility between the mandates of incarceration and healthcare suggests that responsibility for institutional healthcare should be transferred to provincial healthcare bodies.

This research responds to the lack of research on carceral health experiences within both penal scholarship and medical sociology, particularly in relation to women and those confined in jails.