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Given the complexity of health system reforms, there is a need for a more coherent approach to change that includes a deeper understanding of the contexts of reforms; understanding how the health system operates; the need for information for decision making; and institutions issues (1, 4, 7).
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I suggest that we see periurbanization not merely as land development, but as a place-making and institution-building process, during which dense matrices of new institutions are established, often with enduring impacts.
"The effectiveness, stability, and predictability of American policy making and political institutions have weakened at a time of ongoing fiscal and economic challenges," it said.
Excerpts from Standard & Poor's report, "United States of America Long-Term Rating Lowered To 'AA+' On Political Risks And Rising Debt Burden; Outlook Negative," Aug. 5, 2011: The downgrade reflects our view that the effectiveness, stability, and predictability of American policy making and political institutions have weakened at a time of ongoing fiscal and economic challenges.
Standard & Poor's, a larger credit rating agency, downgraded United States debt a notch in August 2011 after the last standoff over the federal debt limit, reflecting "our view that the effectiveness, stability, and predictability of American policy making and political institutions have weakened at a time of ongoing fiscal and economic challenges to a degree more than we envisioned".
Standard & Poor's, one of the three major rating agencies that evaluates debt, said in a statement that "the downgrade reflects our view that the effectiveness, stability, and predictability of American policy making and political institutions have weakened at a time of ongoing fiscal and economic challenges".
"The effectiveness, stability, and predictability of American policy-making and political institutions have weakened at a time of ongoing fiscal and economic challenges," wrote S.& P. in its downgrade report.
From embezzlement in Ashgabat to bribery in Bogotá, virtually all forms of corruption can ultimately be traced back to the hijacking of urban public policy-making and civic institutions by vested interests, and the financial bounty reaped by elites has to end up somewhere.
The document pledged to "streamline" decision making and to strengthen institutions for enforcing the economic liberalization.
The SAPCR operates as a decision making and policy making institution, organized in 2 sections: 1) the statistics and information section and 2) the programs section.
Inadequate inefficient programme implementation, unprofessional and ad-hoc target-making and inadequate institution building are also some of the reasons contributing to unchanging traditional behaviour [ 4].
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com