Strengthening good governance and preventing corruption in health care are universal challenges. The Karnataka Lokayukta (KLA), a public complaints agency in Karnataka state (India), was created in 1986 but played a prominent role controlling systemic corruption only after a change of leadership in 2001 with a new Lokayukta (ombudsman) and Vigilance Director for Health (VDH). This case study of the KLA (2001-06) analysed the:Scope and level of poor governance in the health sector; KLA objectives and its strategy; Factors which affected public health sector governance and the operation of the KLA. We used a participatory and opportunistic evaluation design, examined documents about KLA activities, conducted three site visits, two key informant and 44 semi-structured interviews and used a force field model to analyse the governance findings. The Lokayukta and his VDH were both proactive and economically independent with an extended social network, technical expertise in both jurisdiction and health care, and were widely perceived to be acting for the common good. They mobilized media and the public about governance issues which were affected by factors at the individual, organizational and societal levels. Their investigations revealed systemic corruption within the public health sector at all levels as well as in public/private collaborations and the political and justice systems. However, wider contextual issues limited their effectiveness in intervening. The departure of the Lokayukta, upon completing his term, was due to a lack of continued political support for controlling corruption. Governance in the health sector is affected by positive and negative forces. A key positive factor was the combined social, cultural and symbolic capital of the two leaders which empowered them to challenge corrupt behaviour and promote good governance. Although change was possible, it was precarious and requires continuous political support to be sustained.
Abstract:In this paper, we discuss a non-Markovian batch arrival general bulk service single-server queueing system with server breakdown and repair, a stand-by server, multiple vacation and re-service. The main server's regular service time, re-service time, vacation time and stand-by server's service time are followed by general distributions and breakdown and repair times of the main server with exponential distributions. There is a stand-by server which is employed during the period in which the regular server remains under repair. The probability generating function of the queue size at an arbitrary time and some performance measures of the system are derived. Extensive numerical results are also illustrated.
In this paper, we discuss a batch arrival bulk service queue with rework for
the faculty item, possibility of breakdown, repair, and two kinds of
multiple vacation with different threshold policy. The server serves the
remaining service after repair completion. This type of queueing model has a
lot of applications in the manufacturing/production industries. Performance
measures and stability conditions are obtained. Numerical illustrations are
made to examine the validity of analytical results.
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