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For over a decade, the early grade reading assessment (EGRA) has been used to measure and report on students’ acquisition of five reading skills. Education development initiatives funded by the US Agency for International Development, the World Bank, Department for International Development (DFID), and other agencies have facilitated the use and adaptation of the EGRA into over 100 languages in more than 65 countries (Dubeck & Gove, 2015, p. 315). Guidelines for the proper use and the limitations of the EGRA have been circulated widely. An international evidence base that challenges the theoretical underpinnings and the expanded use of the EGRA is also growing (Bartlett, Dowd, & Jonason, 2015). Not yet explored to date, however, is the use of the EGRA as a measure to determine Payment by Results (PbR) in a donor agency initiative. This chapter examines the use of the EGRA oral reading fluency (ORF) subtest as a PbR learning outcomes measure in DFID’s Girls’ Education Challenge (GEC) projects, and it concludes that the way in which the EGRA ORF was used for PbR was a misuse of the EGRA, and ultimately it did not serve well the PbR project beneficiaries, the marginalized girls.

Purpose – The aim of this paper is to examine the diffusion of a new surgical procedure with lower per-case cost and how its diffusion path is affected by the simultaneous introduction of a new drug class that may be an effective treatment to prevent surgery. In particular, we examine whether a process of technology substitution exists that influences the diffusion process of the surgical technology. Given their different cost implications, the interaction of these two different technologies, surgery and drug intervention, is relevant from the perspective of health expenditure. This is of particular interest in health care as technology adoption and diffusion has been cited as a major driver of expenditure growth. Such expenditure growth has been increasingly targeted through the use of market-orientated policy tools aimed at increasing efficiency. Our research is thus addressing the question of how economic incentives influence the diffusion process and we discuss the impact of a set of incentives on hospital behavior.

Design/methodology – Hospital admission data for the financial years 1998/1999 to 2007/2008 in England are used to empirically test the contribution of prescription uptake and market-oriented reforms. Dynamic panel data models are used to capture any changes in technology preference during the period of study.

Findings – Our results suggest that the hospital sector exhibits a strong new technology preference, tempered by the interaction of competition for patients and the ability of the primary care sector to substitute treatments.

Value/originality – Given the current fast technological change, we examine the technological race occurring in the health care sector. We account simultaneously for the diffusion of different technologies not only within the same typology but also with technologies of a different class.

Purpose: In this chapter, we examine the National Health Service (NHS) and Adult Social Care (ASC) in England, focussing on policies that have been introduced since 2000 and considering the challenges that providers face in their quest to provide a high standard and affordable health service in the near future.

Methodology/Approach: We discuss recent policy developments and published analysis covering innovations within major aspects of health care (primary, secondary and tertiary) and ASC, before considering future challenges faced by providers in England, highlighted by a 2017 UK Parliament Select Committee.

Findings: The NHS and ASC system have experienced tightening budgets and serious financial pressure, with historically low real-terms growth in health funding from central government and local authorities. Policymakers have tried to overcome these challenges with several policy innovations, but many still remain. With large-scale investment and reform, there is potential for the health and social care system to evolve into a modern service capable of dealing with the needs of an ageing population. However, if these challenges are not met, then it is set to continue struggling with a lack of appropriate facilities, an overstretched staff and a system not entirely appropriate for its patients.

As entrepreneurship and market mechanisms are increasingly seen as a central part of public sector reforms to health and education, this chapter examines the entrepreneurial behaviour of public service providers in rural areas of the United Kingdom. Specific questions to be addressed include: How do rural providers (GPs, hospitals, schools) respond to the ‘market’ for provision of public services in rural areas? What are the constraints in acting entrepreneurially in these rural ‘markets’?

This chapter draws on a review of the literature and an empirical study of health care providers and schools with an emphasis on provision in rural areas and non-metropolitan urban areas. The results are based on 130 interviews with public, private and not-for-profit sector providers, and commissioners in health and education. Providers interviewed include schools, primary health care providers (General practitioners) and hospitals.

The challenges facing rural provision are examined. In terms of income generation providers reported the difficulties in having the critical mass required to keep services viable. There was particular attention to finding ways of diversifying income sources to increase turnover. Providers for rural areas are also having to find ways of coping with increased costs compared to urban providers, with limited account taken by the commissioners/buyers of services. The constraints related to introducing entrepreneurial behaviour to individuals who are resistant to risk taking and innovation based on market forces are also examined.

The work is based on a qualitative survey of a number of sectors. Further larger sample work is required to explore the propositions identified in more detail. The policy context has also been changing, with a need to identify how changes in government have affected the nature of entrepreneurship in public services.

The chapter provides policy implications and insights for providers of rural public services. There is a need to encourage diversity of income sources and to encourage collaboration between providers. There is also a need to identify where entrepreneurs in the public, private and social enterprise sectors are unwilling to deliver.

The chapter identifies key theoretical issues related to the role of enterprise in delivering public services. Further insights are provided regarding the role of rurality on both enterprise behaviour and public service delivery.

This chapter problematizes the body politics of American liberalism, as viewed through the lens of health policy. The author suggests that American efforts to pursue basic health goals are undercut by the particular way in which American liberals – and their state – conceptualize bodies. To understand the theoretical basis of this body politics, the chapter examines policy preoccupations such as the institution of informed consent, malpractice reform, and efforts to establish a Patients’ Bill of Rights. Finally, considering the ideological contexts that have given rise to the Patient Protection and Affordable Care Act, the author gestures toward the establishment of a stronger liberal – and possibly post-liberal – health care system that takes the embodiment of its subjects seriously.

This chapter reviews the ongoing processes of marketisation in secondary school teaching and its further embedment through commodification of teachers’ performance. We track developments through documentary evidence from Government statements and other agency reports and unstructured interviews with teachers’ union representatives in the South West of England. Following Carter and Stevenson (2012) we begin by introducing the labour process debate concerning teachers’ productive labour to provide the backdrop for the argument that teachers’ work is increasingly commodified and judged along neoliberalised requirements. Commodification has taken place through measurement of abstract standards constructed by associating individual teachers with their pupils’ achievements, as well as subjective assessment of teacher behaviour judged against newly introduced ‘Teacher Standards’. We argue that this attempted quantification of teacher output is constructed, in Marxist terms, to accommodate to the ‘socially necessary labour time’ and to indirectly maximise work ‘output’ for individual teachers through a process of standardisation of processes involved in task completion. We attempt to define new ways of measuring teachers’ work through the lens of abstract labour and link such processes to workplace alienation. In such fashion, teachers are subject to work intensification, increased monitoring and surveillance, further standardisation of work and weakening of creative autonomy leading to intensified alienation from the professional nature of the job.

African Economies are a mix of emerging and developing economies, characterised by regional imbalances and socio-economic differences. Foreign Direct Investment and Trade has been important for the growth prospects of African Economies. In this paper, we attempt to study the impact of FDI and Trade in a COVID-19 scenario on the African Economies. We also study the lockdown restrictions in different regions of Africa. Applying Neural Network Analysis for the sample of 36 African Economies we identify the significant economic variables for GDP. The analysis based on a feedforward structure suggests that Merchandize Exports (MEXP) and Foreign Direct Investment Stock (FDIS) have very strong causal linkages with the GDP for African Economies sample. On the other hand, Merchandise Imports (MIMP), Services Exports (SEMP), Services Imports (SIMP), and Foreign Direct Investment Inflows (FDII) have a strong and significant relationship with GDP for the African Economies. Tariff Measures (TRFF), Anti-Dumping measures (ADP) and Foreign Direct Investment Outflows (FDIO) have no significant relationship.