دانلود کتاب DELIVERING QUALITY EDUCATION AND HEALTH CARE TO ALL : preparing regions for democratic change.

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Preface
Foreword
Acknowledgements
Abbreviations and acronyms
Executive summary
Rethink the future of rural schools with networks and digital solutions
Address territorial health care gaps by reinforcing primary and integrated care
Tackle skill and Internet access gaps to harness digital provision
Increase the scale and quality of services with decentralisation
1 Assessment and recommendations
Introduction
Assessment
Education
Health care
Digital connectivity
Governance
Recommendations
Education
Health care
Digital connectivity
Governance
2 Setting the scene
Introduction
Megatrends that shape the future of service provision
Depopulation is at the doorstep of many rural communities
Healthier and longer lives mean more ageing in rural areas
The COVID-19 pandemic has revolutionised service provision
Rural regions face teacher and care worker shortages even if specialised in services
Digital skills and connectivity gaps limit switch to digital provision
What are public services and who pays for them?
Defining public services
How states provide public services and to whom
How are rights to public services defined within legal frameworks across the OECD?
Who pays for public services?
The governance of public service delivery
The spatial implications of public spending and public management reforms
Fiscal equalisation mechanisms
Roles and responsibilities across levels of government
New and emerging service provision models
Colocation, collaboration and co-production
Flexible approaches – Mobile, on-demand and e-services
Integrated spatial planning
Conclusions
References
Notes
3 Delivering quality education in rural communities
Introduction
How is education provided?
How is education provided?
Education system organisation and governance
Education resources and quality
Inputs to providing education
Education outputs and outcomes
What can policymakers do to ensure access to quality education services in rural areas while pursuing cost efficiency?
Restructuring rural schools
Creating school clusters and establishing co-operations
Adapting the definition and distribution of education levels across schools
Consolidating schools
Comprehensive and digital approaches
Information and communication technology (ICT)-based support to education delivery
Involve stakeholders and draw on local community support
Improve transport provision for students and teachers
Extending and combining services provided in a single location
Consider rural education provision as part of regional economic development efforts
Conclusions
References
Notes
4 Delivering quality health services in rural communities
Introduction
Structural trends affecting health systems and their effect in rural areas
Structural trends in affecting health systems
Lower income and education levels are linked to poorer health outcomes
Longer lives can raise health costs
Exposure to risk factors increases the risk of chronic conditions
Evidence of the effect of broad health system trends in rural areas
Geographical dimensions of health systems
Objectives and organisation of health systems
System organisation and spatial distribution of healthcare within countries
Balancing quality, access and cost of health care in rural areas
Quality health care in rural areas
Life expectancy is lower and mortality is higher in rural areas
Survival rates to major causes of death are lower in rural areas
Avoidable admissions are higher and disease prevention is lower in rural areas
Equitable access to health care in rural areas
Higher unmet medical needs in rural areas
Lower access to facilities and medical professionals
Sustainable health costs in rural areas
Health expenditures and the impact of austerity measures on rural health
Financial sustainability of rural hospitals
Comprehensive measures to save costs and improve performance in rural areas
Reinforcing primary care
Reducing financial barriers and increasing financial incentives for primary care professionals
Patient involvement
Shifting responsibilities across health care professionals
Increase care co-ordination through integrated care
Innovative approaches for sustainable rural health care provision
Exploiting the power of networks to expand and co-ordinate rural care
Clinical networks
Hub-and-spoke model
Reorganisation into multi-disciplinary teams
Increasing access in rural areas with telemedicine and mobile clinics
Overcoming workforce shortages
Foreign recruitment
Educational reforms
Financial incentives
Shifting responsibilities
Combining strategies
Conclusion
References
Notes
5 Unleashing the potential of digital services in rural communities
Introduction
Digital provision of education and healthcare
Unlocking funding, skills and connectivity barriers to distance learning in rural schools
Resources, skills and connectivity gaps limit the potential of distance learning
The COVID-19 pandemic stressed the need to overcome barriers to distance learning in rural areas
Unleashing the potential of telemedicine to increase access to quality health care in rural areas
Evidence of effectiveness of telemedicine
More telemedicine uptake in rural areas requires a change in culture, more funding and sounder legislation
COVID-19 has uncovered the potential and limitations of telemedicine for rural areas
Service provision in low-density rural areas and the digital gap
Barriers to higher broadband connectivity in rural areas
Technology options to boost provision in low-density rural and remote areas
Current approaches to closing connectivity gaps
Supporting the business case through demand aggregation models
Putting the community in control through locally owned co-operatives
Dakota Carrier Network
B4RN
Simplifying subsidies using vouchers for consumers and businesses
Project and auction-based subsidy programmes to drive change at scale
Spain
United States
Canada
Driving competition through the creation of publicly owned market entrants
SaskTel
Reykjavik Fibre Network
Sunet and municipal fibre in Finland and Sweden
Gaining expertise and sharing risk through public-private partnerships
Community Fibre Partnership
Westminster, Maryland
National Broadband Ireland (NBI)
The complex public wholesale monopoly
COVID 19 responses
Conclusions
References
Notes
6 The governance of public service delivery across territories
Introduction
Decentralisation, multi-level governance and service provision
Spending and revenue assignments to subnational government
Spending assignments: Theory and practice
Assigning subnational government revenues: The “finance should follow function” principle
Transfer systems to reduce fiscal disparities
Addressing the challenges of decentralisation to improve service provision
Benefit spill-overs and externalities
Lack of scale economies
Unbalance between spending and revenue assignments
Unfunded or underfunded mandates
Insufficient capacity of subnational governments
Overlapping responsibilities
Intermediary institutions and cross-border services
Decentralisation and education services
Education is the main spending item of subnational governments
In many countries, transfers form a major source of education funding for subnational governments
About half of the education decision-making is done at school or subnational government level
Effects of decentralisation on student achievement
Decentralisation of the health systems
Financing of health systems across OECD countries
Why do countries decentralise their health care?
Healthcare decentralisation in OECD countries
The effects of decentralisation on health outcomes
Conclusion
References
Notes