Efeitos políticos na descontinuidade do orçamento participativo em municípios / Efectos políticos sobre la discontinuidad del presupuesto participativo en los municipios / Political effects on the discontinuation of participatory budgeting in municipalities

Resumo O artigo analisa fatores associados à descontinuidade do orçamento participativo (OP) em municípios brasileiros acima de 50 mil habitantes no período entre 2000 e 2016. A pesquisa foi analisada pela estimação de modelos econométricos com foco em variáveis explicativas políticas e pela propensão do ambiente local à participação. Os resultados indicam que a descontinuidade está associada positivamente com a troca do partido do prefeito municipal entre as eleições, a despeito da ideologia do partido; positivamente com a troca da ideologia do partido do prefeito, com a entrada de partidos de esquerda; negativamente com a entrada de partidos com outras ideologias; e positivamente com a troca entre partidos de esquerda. A descontinuidade não apresentou efeito com a troca entre partidos com outras ideologias. Os resultados indicam fatores locais e contextuais explicativos para a descontinuidade do OP, permitindo direcionar desenho de políticas públicas participativas e levantando reflexividade sobre mecanismos que devem ser adotados localmente para que não ocorra a descontinuidade, além de contribuir para a literatura ao demonstrar a associação entre a descontinuidade com a troca de partidos da esquerda, o que pode suscitar pesquisas futuras, dado que o resultado não era esperado.

Resumen El artículo analizó factores asociados a la discontinuidad del presupuesto participativo (PP) en municipios brasileños con más de 50.000 habitantes, en el período 2000-2016. La discontinuidad se analizó mediante la estimación de modelos econométricos con enfoque en variables políticas explicativas y la propensión del entorno local a participar. Los resultados indican que la discontinuidad se asocia: (i) positivamente con el cambio de partido del alcalde entre elecciones, independientemente de la ideología del partido; (ii) positivamente con el cambio de ideología del partido de la alcaldía, con la entrada de partidos de izquierda; (iii) negativamente con la entrada de partidos con otras ideologías; (iv) positivamente con el intercambio entre partidos de izquierda. La discontinuidad no tuvo efecto con el intercambio entre partidos con otras ideologías. Los resultados contribuyen al señalar factores locales y contextuales que explican la discontinuidad del PP, permitiendo orientar el diseño de políticas públicas participativas y planteando la reflexión sobre los mecanismos que deben ser adoptados localmente para que no ocurra la discontinuidad. También contribuye a la literatura al demostrar la asociación entre la discontinuidad y el intercambio de partidos de izquierda, lo que puede impulsar futuras investigaciones, dado que el resultado no era el esperado.

Abstract The article analyzes the factors associated with the discontinuation of participatory budgeting (PB) in Brazilian municipalities with more than 50,000 inhabitants between 2000 and 2016. We used econometric models to estimate PB's discontinuation based on political explanatory variables and people's local participation. The results indicate that discontinuation is associated: (i) positively with the election of a different local government, regardless of the winning party's ideology; (ii) positively with the election of a local government with a left-wing ideology'; (iii) negatively with the election of a non-left-wing local government; (iv) positively with the election of a left-wing local government replacing another left-wing government. Changes in local government where other non-left-wing parties replace non-left-wing parties had no significant effect on discontinuation. The results contribute to our knowledge by showing the local and contextual factors that explain the discontinuation of participatory budgeting; this should help guide the design of participatory public policies and allow practitioners to reflect on the mechanisms that could be adopted locally to avoid discontinuation. The article also contributes to the literature by demonstrating the association between discontinuation and changes in left-wing local governments, which may prompt future research, given the unexpected result.

Práticas de barganha política por meio da execução orçamentária federal / Prácticas de regateo político mediante la ejecución presupuestaria federal / Political bargaining practices through federal budget execution

Resumo O processo orçamentário brasileiro tem sido historicamente questionado pela suposta presença de barganha política na inclusão e na execução de emendas ao orçamento, fato que interfere nas premissas, nos critérios e nas práticas das escolhas alocativas. Este artigo, sustentado pela Teoria da Formação de Coalizões, investiga a existência de uma possível relação de barganha política entre os poderes Executivo e Legislativo no processo orçamentário na esfera federal. Tal pesquisa ocorre por meio da análise das execuções de emendas parlamentares singulares ao longo de cinco legislaturas (entre 2000 e 2017) e das decisões dos deputados na votação de projetos propostos pelo Executivo. Analisaram-se dados referentes à execução de emendas singulares, bem como aqueles concernentes à posição política do parlamentar com relação ao Executivo no instante da proposição das emendas. A metodologia envolveu técnicas econométricas que lidam com a correção do viés de seleção para avaliar a presença ou não da referida relação de barganha. Os resultados obtidos corroboram a hipótese de existência de barganha política entre os poderes Executivo e Legislativo, pois o parlamentar com maior aporte de execução de suas emendas singulares foi aquele que, além de ter exercido apoio ao Executivo através de votos favoráveis aos projetos enviados ao congresso nacional, era de fora da coligação de governo, alvo do Executivo na formação do quorum mínimo para a aprovação de seus projetos.

Resumen El proceso presupuestario brasileño ha sido históricamente cuestionado por la supuesta presencia de regateo político en la inclusión y ejecución de enmiendas al presupuesto, hecho que interfiere con las premisas, criterios y prácticas de las decisiones distributivas. Este artículo, apoyado en la Teoría de la Formación de Coaliciones, investiga la existencia de una posible relación de regateo político entre los poderes Ejecutivo y Legislativo en el proceso presupuestario a nivel federal. Dicha investigación se da a través del análisis de las ejecuciones de enmiendas parlamentarias singulares en cinco legislaturas (entre 2000 y 2017) y de las decisiones de los diputados en la votación de proyectos propuestos por el Ejecutivo. Se analizaron datos referentes a la ejecución de enmiendas singulares, así como los referentes a la posición política del parlamentario frente al Ejecutivo al momento de la proposición de las enmiendas. La metodología involucró técnicas econométricas que tratan la corrección del sesgo de selección para evaluar la presencia o ausencia de la referida relación de regateo. Los resultados obtenidos corroboran la hipótesis de existencia de regateo político entre los poderes Ejecutivo y Legislativo, ya que el parlamentario con mayor aporte de ejecución de sus enmiendas singulares fue quien, además de haber apoyado al Ejecutivo a través de votos a favor de los proyectos remitidos al Congreso Nacional, era ajeno a la coalición de gobierno, objetivo del Ejecutivo en la formación del quórum mínimo para la aprobación de sus proyectos.

Abstract The Brazilian budgetary process has historically been questioned based on the alleged use of political bargaining in the inclusion and implementation of amendments from deputies to the executive's budget, which affects the principles, criteria, and practices of allocative choices. Supported by the theory of coalition formation, this article examines a possible political bargaining relationship between the executive and legislative branches in the budgetary process at the federal level. The study analyzed the execution of amendments from deputies over five mandates (between 2000 and 2017) and the deputies' votes on projects proposed by the executive. Data regarding the execution of singular amendments were also analyzed, together with information concerning the deputies' political position toward the executive when proposing amendments. Econometric techniques were employed to correct selection bias, assessing the presence of political bargaining. The results corroborate the hypothesis that there is political bargaining in the relationship between the executive and legislative branches in Brazil. The deputy who had more of their amendments executed by the government was also the one that voted with the government in the bills sent from the executive to the legislative, even though they were not part of the governing coalition in the Congress. Therefore, the executive targeted deputies who were not part of the governing coalition to increase the number of votes in Congress.

Review of Gynaecological Diagnoses and Surgeries Performed at a Tertiary Health Facility in Niger-Delta of Nigeria from 2012-2017: Implications for Healthcare Planning and Budgeting

Background: Gynaecological disorders are a particularly common cause of morbidity and mortality among women of reproductive age and a common cause of hospital presentation/admission and surgery.Objective:This study sought to review gynaecological diagnoses and surgeries performed in a tertiary health facility from 2012 to 2017 and its implication for healthcare planning and budgeting.Methodology:This was a retrospective review of all gynaecological diagnoses and surgeries seen in the Rivers State University Teaching Hospital (RSUTH) from 2012 to 2017.Data were retrieved using a proforma comprising of year, gynaecological diagnosis and gynaecological surgeries. Data obtained was entered into Microsoft Excel for descriptive analysis.Results:The proportion of clinic attendees declined from an average of 23% in the first three years (2012-2014) to about 10% in the last three years (2015-2017). The most common gynaecological diagnosis were uterine fibroid (33.3%), infertility 28.1% (primary 5.7%, secondary 22.4%), PID (5.9%), ovarian tumour (4.2%), secondary amenorrhea (3.4%) and pelvic malignancies (3.4%). The commonest major surgeries were myomectomy 441(33.7%), salpingectomy 345(26.4%), hysterectomy 168(12.8%) and cervical cerclage 122(9.3%). The commonest minor surgeries were manual vacuum aspiration 314(41.0%), examination under anaesthesia and biopsy 110(14.3%) and adhesiolysis for synechiae 97(12.6%). The duo of uterine fibroid and infertility made up 50%-70% of all gynaecological diagnoses.Conclusion:This study showed that there has been a steady decline in gynaecological consultations over the years. However, the duo of uterine fibroid and infertility made up half to three-quarter of all gynaecological diagnoses over the 6 years. Infertility and uterine fibroids have a long cause and effect association. Healthcare policies and budgeting should be increased towards tackling these conditions, especially the setting up of a fertility center to provide assisted reproductive technologies and laparoscopy to improve practice and patient outcome

Interatividade e ciclo de políticas públicas no Orçamento Participativo Digital: uma análise internacional / Interactividad y ciclo de políticas públicas en el Presupuesto Participativo Digital: un análisis internacional / Interactivity and policy cycle within Electronic Participatory Budgeting: a comparative analysis

Resumo Contemporaneamente, verifica-se a apropriação de tecnologias de informação e comunicação (TIC) por iniciativas que têm como meta a participação cidadã, cujo exemplo emblemático é o orçamento participativo digital (OPD). O objetivo deste estudo foi analisar plataformas de OPD, buscando identificar seus modelos de interatividade e avaliar quão profícuas são as funcionalidades oferecidas em termos políticos no sentido de transmissão de informação política, formulação da agenda pública, emissão de opinião, negociação da diferença e tomada de decisão política. Essa análise possibilitou enquadrar as ferramentas disponibilizadas em seis níveis de interatividade, com base nas variáveis nível de controle do receptor e direção da comunicação, e identificar a quais modelos de OPD as diversas funcionalidades correspondem, bem como quais fases do processo decisório e do ciclo de políticas públicas são contempladas em cada experiência em foco. Foram desenvolvidos estudos de caso em perspectiva comparada, buscando contemplar a diversidade de formatos de OPD existentes.

Resumen Contemporáneamente, se constata la apropiación de las tecnologías de la información y la comunicación por parte de iniciativas que tienen como meta la participación ciudadana, cuyo ejemplo emblemático es el Presupuesto Participativo Digital (PPD). El objetivo de este estudio fue analizar plataformas de PPD, buscando identificar sus modelos de interactividad y evaluar en términos políticos cuán ventajosas son las funcionalidades ofrecidas en el sentido de transmisión de información política, formulación de la agenda pública, emisión de opinión, negociación de la diferencia y toma de decisión política. Este análisis permitió encuadrar las herramientas disponibles en seis niveles de interactividad basados en las variables nivel de control del receptor y dirección de la comunicación, e identificar a qué modelos de PPD corresponden las diversas funcionalidades, así como qué fases del proceso de decisión y del ciclo de políticas públicas están incluidas en cada experiencia analizada. Se desarrollaron estudios de caso en perspectiva comparada, tratando de considerar la diversidad de formatos de PPD existentes.

Abstract Participatory initiatives have increasingly used Information and Communication Technology, such as the Electronic Participatory Budgeting (ePB) to expand and improve participation. This research analyzes ePB platforms emphasizing interactivity aspects, as well as evaluating - in political terms - their functions regarding the dissemination of political information, sharing opinions, agenda-setting, and decision-making. This analysis examined the platforms' tools types of interactivity based on two variables: the level of the receiver's control and communication direction. The research identified ePB models and how the platforms' functions are connected to each of them. The study also recognized in which phases of the decision-making process and the policy cycle the electronic participation is more likely to occur. Case studies in a comparative perspective were used to understand the variety of experiences of ePB.

A study on the evaluation of medical equipment allocation depended on evidence-based and decision-making tree / 中国医学装备

Objective: To establish a scientific and efficient management mechanism depended on evidence-based and decision-making tree in order to improve the allocation of medical equipment asset that is a important work in modern governmental hospital. Methods: According to the current analysis for the decision-making process of asset allocation to propose the existed problem. And then these problems were analyzed by introduced management theory. At the same time, the efficient management tool was used as the decision-making method. Results: Through the combination of evidence-based and decision-making tree, a normalization, elaborate and operable decision-making method was formulated. And through analyzing concrete case to verify the decision-making process. These results indicated that this method has a certain feasibility. Conclusion: The method achieves elaboration, normalization and datamation for process and key point, and it weakens the subjective factors. Besides, it can obtain more accurate decision results through information collection and selection. Therefore, this method has a certain feasibility and generalization performance.

Los efectos de los programas sociales en la salud de la población en condición de pobreza: evidencias a partir de las evaluaciones de impacto del presupuesto por resultados a programas sociales en Perú / Effects of social programs on indigent population health: evidence from results-based budgeting’s impact evaluations to social programs in Peru

Este artículo describe la experiencia en la gestión de evaluaciones de impacto del Ministerio de Economía y Finanzas (MEF) como uno de los instrumentos del presupuesto por resultados, y documenta el diseño de las evaluaciones de impacto a tres programas sociales emblemáticos y los resultados obtenidos, haciendo énfasis en aquellos vinculados a la salud de su población objetivo. Estos son el Servicio de Acompañamiento a Familias (SAF) del Programa Nacional Cuna Más, el Programa Nacional de Apoyo Directo a los Más Pobres JUNTOS y el Programa Nacional de Asistencia Solidaria Pensión 65. Los resultados muestran que el SAF generó mejoras en el desarrollo cognitivo y de lenguaje en los niños mas no en las prácticas de cuidado infantil de las madres, ni en el estado nutricional de los niños. JUNTOS logró incrementos en el gasto per cápita, gasto en alimentos, disminución de la severidad de pobreza y mejoras en el logro educativo. Sin embargo, no se encontraron resultados significativos en la mayoría de indicadores de salud prenatal ni estado nutricional infantil. Pensión 65 mejoró la salud emocional del adulto mayor (depresión, autovaloración), pero no se evidenció aumentos en el uso de servicios de salud por parte de los adultos mayores ni mejoras en su salud física. Se recomienda que dichos programas fortalezcan sus diseños y acciones de articulación con el Ministerio de Salud y entre diferentes niveles de Gobierno, cuando corresponda, a fin de mejorar la oferta y contenidos de las prácticas saludables y optimizar la prestación de los servicios de salud.

This article describes the experience of the MEF’s impact evaluation management as one of the RBB instruments and documents the design and results obtained from three impact evaluations of the most emblematic government social programs. The Service of Visiting Families (SAF) of the National Program "Cuna Mas", conditional cash transfer Program "JUNTOS" and National Program "Pension 65" focusing on objective population’s health the outcomes. Among the main results, it was found the SAF generated improvements in cognitive and communication development in children, but had no impact on mothers’ child care practices or children’s nutritional status. In the case of JUNTOS, there were increases in per capita spending, food expenditure, decreases in severity and poverty gap, increases in school attendance and reductions of school dropout. However, no significant results were found in most indicators of prenatal health, child health, or chronic malnutrition. In the case of Pension 65, there were increases in household consumption and improvements in elderly’s emotional health (depression, self valoration); but there was no evidence of increases in the use of health services by the elderly or improvements in their physical health. Therefore, it is recommended that such programs boost their designs and inter-sectoral coordination with MINSA and subnational institutions, in order to improve contents of healthy practices and child care, and optimize the provision of health and education services, in order to meet the demands of their users.

Evaluaciones de diseño y ejecución presupuestal, un instrumento del presupuesto por resultados: algunas experiencias aplicadas en salud / Evaluation of budget design and execution, an instrument of performance-based budgeting: some experiences applied to health

RESUMEN Desde sus inicios en el año 2008, las evaluaciones de diseño y ejecución presupuestal (EDEP), uno de los instrumentos desarrollados por el Ministerio de Economía y Finanzas (MEF) en el marco de la implementación del presupuesto por resultados (PpR), buscan proporcionar información confiable acerca de la consistencia en el diseño y los avances en la implementación de las intervenciones públicas, con el fin de mejorar su gestión y tomar decisiones presupuestales informadas. Adicionalmente, las recomendaciones de las EDEP se traducen en una matriz de compromisos de mejora de desempeño, la cual constituye el medio a través del cual se materializan e incorporan las mejoras identificadas a la operación de las intervenciones evaluadas, con miras a optimizar sus resultados. El MEF realiza el seguimiento a la atención de estos compromisos y condiciona la revisión de solicitudes de recursos presupuestales de las entidades públicas al cumplimiento de estos compromisos. A casi 10 años de su implementación, se han realizado 57 EDEP de diferentes sectores, de las cuales siete están relacionadas a intervenciones en salud, entre las que se incluyen: el Sistema Integral de Salud, el servicio de vacunación, atención a partos normales, atención de infecciones respiratorias agudas y enfermedades diarreicas agudas. Más allá de las discrepancias en torno a la aplicación de este instrumento, las EDEP y sus matrices de compromisos han permitido la utilización de los resultados de las evaluaciones y se han convertido en un mecanismo para generar información válida que permita mejorar los servicios públicos en favor de la población.

ABSTRACT Since 2008, the evaluation of budget design and execution (EDEP for its acronym in Spanish) - one of the evaluations tools developed by the Peruvian Ministry of Economy and Finance (MEF) as part of the implementation of Performance Budgeting- seek to provide reliable information about design coherence and progress in the implementation of public interventions, in order to improve their management and make informed budget decisions. The EDEP methodology includes preparing an evaluation report and defining a matrix of commitments to improve performance. Commitments are defined based on the recommendation of the EDEP. The EDEP seeks to correct exiting problems in public programs and optimize their results. MEF tracks the fulfillment of these commitments and links together the analysis of public budget requests and the progress of these commitments. Now, almost 10 years after its implementation, 57 EDEP have been carried out in different sectors and 07 of them are related to health interventions such as: the comprehensive health system, vaccination service, normal births, acute respiratory infections and acute diarrheal diseases, among others. Beyond the discrepancies in the application of this tool, the EDEP and its matrix of commitments have allowed the use of the results of the evaluations and have become a mechanism to generate useful information to improve the public services.

O efeito da função orçamentária alocativa na redução da desigualdade de renda no Brasil: uma análise dos gastos em educação e saúde no período de 1995 a 2012 / El efecto de la función asignativa en la reducción de la desigualdad de ingresos en Brasil: un análisis del gasto en educación y salud 1995-2012 / The effect of allocation function in budgeting to reduce income inequality in Brazil: an analysis of spending on education and health from 1995 to 2012

Resumo A desigualdade de renda é apontada como um dos grandes problemas da sociedade atual. A fim de reverter o cenário desigual, o Estado pode atuar utilizando a função orçamentária alocativa. Este estudo buscou identificar os impactos da função alocativa do orçamento sobre a desigualdade de renda, para as unidades federativas brasileiras no período de 1995 a 2012. Foram considerados como proxy da função alocativa os gastos com educação e saúde, enquanto foram utilizados como proxy da desigualdade de renda o coeficiente de Gini, o coeficiente de Theil, a proporção entre os 10% mais ricos e os 40% mais pobres, e a proporção entre os 20% mais ricos e os 20% mais pobres. A relação funcional entre os dois conjuntos de variáveis foi explorada a partir da análise de dados em painel e da regressão tobit em painel. Considerando-se os gastos agregados em educação e saúde de estados e municípios no período, concluiu-se que as unidades da federação que investiram mais em saúde conseguiram reduzir as desigualdades de renda com maior intensidade, ocorrendo efeito oposto com as despesas com ensino. Quando os gastos em saúde e ensino foram desagregados em várias rubricas, concluiu-se que as unidades da federação com maior volume de gastos nas seguintes subfunções (2o nível da função): atenção básica, assistência hospitalar, suporte profilático e ambulatorial, e educação infantil conseguiram reduzir as desigualdades de renda com maior intensidade.

Resumen La desigualdad de ingresos se ve como un problema importante de la sociedad contemporánea. Con el fin de revertir la situación desigual, el Estado puede actuar mediante la función asignativa de presupuesto. Este estudio trata de identificar los impactos de la función de la asignación de recursos del presupuesto en la desigualdad de ingresos para los estados de Brasil 1995 a 2012. Fueron considerados como un indicador de la función asignativa el gasto en educación y salud, mientras que se utilizaron como apoderado la desigualdad de ingresos el coeficiente de Gini, el coeficiente de Theil, la relación entre el 10% más rico y el 40% más pobre, y la relación entre el 20% más rico y el 20% más pobre. La relación funcional entre los dos conjuntos de variables se exploró a partir del análisis de datos de panel y el panel de regresión Tobit. Teniendo en cuenta los gastos agregados sobre la educación y la salud de los estados y municipios en el período, se concluyó que las Unidades de la Federación que han invertido más en salud han logrado reducir la desigualdad de ingresos con mayor intensidad, que se producen efecto contrario con el costo de la educación. Cuando el gasto en salud y educación ha sido dividido en varias secciones, se concluyó que las unidades de la federación con mayor volumen de gasto en la siguientes subfunciones (segundo nivel de función): atención primaria, atención hospitalaria, asistencia preventiva y la atención ambulatoria, y educación de la primera infancia han logrado reducir la desigualdad de ingresos con mayor intensidad.

Abstract Income inequality is seen as a major problem of contemporary society. In order to reverse inequality the state can use allocation function in budgeting. This study sought to identify the impacts of allocation function in budgeting on income inequality for Brazilian states from 1995 to 2012. Spending on education and health was considered as an allocative function proxy, while the Gini coefficient, the Theil coefficient, was used as a proxy for income inequality. This found the ratio between the richest 10% and the poorest 40%, and the ratio between the richest 20% and poorest 20%. The functional relationship between the two sets of variables was explored in the analysis of panel data and tobit regression. Considering aggregate expenditure on education and health of states and municipalities in the period, it was concluded that federative units that invested more in health have been better at reducing income inequality, with the opposite effect occurring for the cost of education. When spending on health and education are broken down into several sections, it can be seen that the federation units with higher volume of spending in the following sub-functions (2nd level of function) — Primary health care, hospital and outpatient care, prophylactic and therapeutic support and early childhood education — have made greater gains in reducing income inequality.

Main Problems in Research Projects Budgeting Preparation and Countermeasures / 中国卫生经济

In the current research project budgeting preparovtion, there are many problems in the arrangement of construction, literal statement, and table settings; and the description of subject expenditure’s relevant to the objectives, consistent with policies and economic rationality. Based on the detailed presentation of problems and serious analysis, strategies and suggestions on budget improvement are proposed.

Key steps of application for 863 programs and corresponding suggestions by aiming at its new orientation in 11th five-year plan / 中华医学科研管理杂志

According to current situation of national Science & Technology development during the 11<'th> five-year plan period, the orientation and the management of the National High-tech Research & Develop Program (863 Program) were changed. Based on the 863 project application of Peking University, several key steps of the application process were discussed in this paper, including selecting subject, filling in appli-cation form, and budget-making etc. Meanwhile, corresponding suggestions were raised, which would be helpful to both scientific research personnel and administrators.