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In the past two decades, much of the literature in the area of government financial management has been devoted to studying the causes of fiscal stress. Most studies emphasized the role of such factors as economic cycles, business relocation and factors beyond the control of policy makers as major causes of fiscal stress. This study extends the scope of the research in this area to investigate whether state and local fiscal structures contribute to fiscal stress. Using a pooled cross-sectional time-series approach with the state-local data ranging from 1982 to 1997, the result shows that: there is more significant difference in the composition of tax structures than that of total revenue; high aggregate spending is associated with high fiscal stress; state and local governments over-commit on the social welfare category; local revenue diversification is associated with low fiscal stress; and fiscal decentralization or high spending responsibility assumed by local governments is associated with low fiscal stress. The findings suggest that local revenue diversification and fiscal decentralization can be used as measures to reduce fiscal stress.

This study seeks to identify locational and gendered determinants of inclusion of households in Livelihood Empowerment Against Poverty (LEAP) and estimate the respective impacts of LEAP on children education enrolment of beneficiary households in Ghana.

The study used secondary data of the Ghana Living Standard Survey Round 7 and employed the propensity score matching (PSM) model for the analysis of the objectives.

The PSM results established that different factors determine the inclusion of households in LEAP in rural and urban areas. Similarly, different factors determine the inclusion of male-headed and female-headed households in the programme. The impact of LEAP on children education is higher in urban areas compared to rural areas. The impact of LEAP on children's education is 10.4% higher in urban areas than in rural areas. Lastly, female-headed households are better at using the cash received from LEAP to take care of their wards' education relative to male-headed households.

The study recommends that different selection criteria should be used in selecting male-headed and female-headed as well as urban and rural poor households for inclusion in the LEAP programme. Female-headed households should be prioritised for benefiting from LEAP. The social welfare department disbursing the LEAP funds in rural areas should intensify education on the need for LEAP beneficiary households to enrol their wards in schools.

In this paper, the authors demonstrate that household inclusiveness of LEAP is influenced by locational and gendered factors. Also, the impact of LEAP on children education enrolment is relatively higher in urban areas than rural areas. Lastly, female-headed households relatively educate their wards with LEAP benefits than male-headed households.

The purpose of this paper is to assess farmers’ willingness to participate and pay for weather-based index insurance in the Upper East Region of Ghana, and what factors influence the participation and purchase of crop insurance schemes.

A survey of 200 farmers in the region was carried out in 2018 to measure demographic information, farm characteristics, risks and risk-management practices and attitudes to crop insurance programs. The survey also captured maximum willingness to pay (WTP) for crop insurance. The double-bounded contingent valuation technique was used to estimate the WTP for crop insurance and the variables that affected WTP.

Farmers, in general, had an indifferent attitude to crop insurance in the region, but were willing to participate in the crop insurance programme, and were willing to pay between 7.5 and 12.5 per cent of the cost of growing maize as a premium for crop insurance. Demographic and economic variables did not impact WTP, but attitude towards crop insurance, farm diversification and frequency of drought negatively impacted on the WTP for crop insurance.

Education programs could be undertaken to improve the attitude and understanding towards crop insurance, as some farmers perceived the programme as not trustworthy, and others did not truly understand the operation of the programme.

Drought can have a significant impact on household welfare, particularly in food insecure countries or regions. Crop insurance can provide a method of securing income for farmers allowing them to purchase food rather than other choices, such as removing children from education to reduce household expenses, improving the long-term welfare of the farm household.

This paper considers willingness to participate and WTP for a crop insurance programme in Ghana, it is one of a small number of papers that consider attitude to, and willingness to participate and WTP for crop insurance in developing countries. The value of the research is the expanded understanding of farmer attitude to crop insurance and their lack of knowledge of crop insurance operations.

This study examines how resource dependency affects municipal budgetary process; specifically, it investigates how politically aligned resource sharing between different levels of government along with clientelism interferes with the budgetary process of municipal organizations in developing countries.

The paper adopts a qualitative approach to study two municipal organizations in Bangladesh. The qualitative data are collected from semi-structured interviews with key organizational members. Besides, the study also relies on various publicly available documents and the Local Government Acts to complement the interview data.

The findings of the study divulge dependence on partisan aligned nonprogrammable government funds poses significant problems for municipal organizations in carrying out their budgetary process. Clientelism and informal negotiations of incumbent political leaders are found to play a vital role in such resource sharing decisions. The consequent uncertainties in getting funds have the potentials of interrupting the budgetary process at the organizational level. In some cases, budgets do not appear to be useful as a management tool for guiding organizational activities.

Like other qualitative studies, the results of these case studies are not generalizable because their interpretations are highly dependent on the context of the research sites.

Despite the limitation of a case study research, the results of this study are useful to deepen our understanding of how uncertainty in resource sharing creates clientele behavior and interferes with the organizational budget. Such an understanding helps practitioners and policymakers devise a sound resource sharing mechanism for effective delivery of municipal services on a sustainable basis.

This study provides insight into how precarious central government transfers and clientelism interfere with local governments' budgetary process.

Heavy metals constitute one of the most hazardous substances that could be accumulated in biota coming from human activities such as agricultural and industrial wastes. This paper aims to study the levels of some of the most common heavy metals in muscles of the fish caught in the Karun River (Ahvaz, Iran) and to assess the health risks associated with their consumption.

In present study, the concentrations of three heavy metals (Pb, Cd and Cu) in the muscle of highly consumed fish species Ctenopharyngodon Idella (Cyprinidae) collected from three selected markets (Khoram Kooshk, Ahvaz-e Qadim and Padad Shahr; total number of samples was 45) in Ahvaz city and human health risk associated with their consumption were detected by Inductively Coupled Plasma Mass Spectrometry (ICP-MS).

The results indicated that the highest and lowest accumulated metal concentrations were related to Cu (20.36 ± 0.84) and Cd (0.53 ± 0.02), respectively. In addition, the mean difference for Pb and Cu across two pairwise of sampling sites were significant (Ahvaz-e Qadim and Khoram Kooshk, P for Pb = 0.025, P for Cu = 0.033; Ahvaz-e Qadim and Padad Shahr, p for Pb = 0.018, p for Cu = 0.039). The estimated daily intake of all metals in muscles of fish in this study were below the legal limit, and mean differences were not statistically significant among the sampling sites, except for Cu (Ahvaz-e Qadim and Khoram Kooshk, p =0.048; Ahvaz-e Qadim and Padad Shahr, p =0.041). Target hazard quotient values were also all below 1.

It can be concluded that the fishes from Ahvaz city markets are comparatively clean and do not constitute a risk for human health.

This study develops an integrated approach combining data envelopment analysis (DEA) and structural equation modeling (SEM) for estimating the working capital management (WCM) efficiency and evaluating the effects of diverse exogenous variables on the WCM efficiency and firms' performance.

DEA is applied for deriving WCM efficiency for 212 Indian manufacturing firms over a period from 2008 to 2019. Also, the effect of human capital (HC), structural capital (SC), cost of external financing (CEF), interest coverage (IC), leverage (LEV), net fixed asset ratio (NFA), asset turnover ratio (ATR) and productivity (PRD) on the WCM efficiency and firms' performance is examined using SEM.

The average mean efficiency scores ranging from 0.623 to 0.654 highlight the firms operating at around 60% of WCM efficiency only, which is a major concern for Indian manufacturing firms. Further, IC, LEV, NFA, ATR revealed direct effect on the WCM efficiency as well as indirect effect on firms' performance, whereas CEF had only a direct effect on WCM efficiency. HC, SC and PRD had no effects on WCM efficiency and firms' performance.

The findings offer vital insights in guiding policy decisions for Indian manufacturing firms.

This study is the first to identify the endogenous nature of the relationship of HC, SC, CEF, IC altogether with firms' performance, compounded by the WCM efficiency, by applying a comprehensive methodology of DEA and SEM and provides an efficiency performance model for better decision-making.

The purpose of this paper is to establish the main factors influencing willingness to pay for health insurance and pension schemes among informal workers in low- and middle-income countries (LMICs). Historically, informal economy workers have been excluded from social protection coverage. There is a growing need, interest and policy discourse in LMICs to extend social security to informal economy workers. However, little is known about informal workers' willingness to pay (WTP) for social security services in different LMIC settings.

The authors conducted a systematic review and searched five databases from 1987 to 2017. Included papers focused on “social security”, “social insurance”, “pension”, “informal economy”, “informal sector” and “informal workers” in LMICs. Authors conducted independent data appraisal and data extraction. A total of 1790 papers were identified. After exclusion, 34 papers were included in the analysis. Given the heterogeneous results, the authors performed a narrative synthesis to consolidate the findings of the different studies.

In total, 34 studies from 17 countries were included in the review, out of which 23 studies focused on health insurance, 7 studies on pension schemes and 4 studies on social security in general. The study showed that income and trust were associated with WTP for both health insurance and pension schemes. In addition, family size, age, education and residential area were common factors for both forms of social security. For health insurance, experience of sickness, attitude and presence of medical doctors as well as distance from the healthcare facility all played a role in determining WTP. For pension schemes, low and flexible contribution rates, benefit package, government subsidies and quality of administration of the schemes influenced enrolment and contributions.

More evidence is needed for WTP for pensions among informal workers.

The findings show that socio-economic differences, scheme-type (health or pension) and level of trust influence WTP for health insurance or pension among informal sector workers. The review results suggest that the factors influencing WTP for health insurance and pensions interplay in a complex web of relations. More evidence is needed on WTP for pensions among informal workers.

Further studies are particularly needed on the interrelationship of the influences to WTP, including gender issues, access barriers and socioeconomic factors, among program design issues for social security.

This paper is based on a systematic review methodology and contributes to the discourse on extending social security to informal economy workers based on evidence from various countries.

The purpose of this study is to determine the extent to which total quality management (TQM) initiatives can improve the quality of services delivery at the medical records unit of the Korle-Bu Teaching Hospital (KBTH) to help meet the expectations and aspirations of patients and customers of the hospital.

This research adopted the survey strategy as its research design. The total study population consisted of 114 medical records staff of the KBTH. Questionnaires and personal observations were employed as the data collection instruments. The study recorded a response rate of 98 per cent. Data gathered from respondents were analysed in qualitative terms.

The overall finding of this study was that, although the medical records department of the KBTH had a fair degree of understanding on the benefits of TQM to records management service delivery, the exiting values for TQM did not meet the framework of good TQM practice, principles and standards.

Even though the subjects for the study were from the biggest hospital in Ghana, the findings of this study may not be generalised to the whole country.

The study has demonstrated the need for the medical records department of the KBTH to have and develop good TQM standards to improve the quality of services to patients and varied customers of the hospital.

The literature reviewed indicated that this study is a maiden attempt to examine how TQM initiatives including sensitivity, customer satisfaction, commitment of top management, team work, effective leadership and participatory management, people development and effective and open communication can improve the quality of medical records service delivery at the KBTH in Ghana.