Policies, institutions, and regulations: PIRs of a stormwater management system.

Urban services, like stormwater management, are complex tasks that depend on many actors and involve activities that fall within several fields of knowledge, but infrastructure solutions have been known for a long time. Recently, the view that urban water should be treated in an integrated way has become more pronounced, breaking the pathway dependency that treated it in isolation. Since the last decade, the perception that policies, institutions, and regulations (PIRs) condition good results has become more pronounced.

-Insights on the Impact of Water Services.

Epidemics in general and dengue in particular surcharge the health services and the economy. However, the fighting actions are circumscribed to the health sector despite the known positive economic impacts that the investments in water supply and sanitation services (WSS) may cause on society and public health. Besides the fact that urban WSS infrastructure is closely linked to disease prevention, in Brazil, the user's perception and demand are very few and many institutional aspects, like the integration between local WSS, health, environment, and development of city councils, need to be improved and better aligned.

Institutional paradigm shift: transitions in stormwater management principles.

In most cities, stormwater systems are part of the invisible and expensive urban infrastructure that plays a vital role in the urban environment but depends on weak institutional and organizational structures. Based on the evidence that solving the issues only from a technological point of view is not sufficient for the provision of stormwater services, in several countries, sustainable drainage systems (SuDS) structures are being implemented, but a new paradigm shift involving a new socio-institutional mentality that meets not only the old but also the new demands of climate and territorial changes, migratory issues, and participatory management is required.

A network Data Envelopment Analysis to estimate nations' efficiency in the fight against SARS-CoV-2.

The ongoing outbreak of SARS-CoV-2 has been deeply impacting health systems worldwide. In this context, it is pivotal to measure the efficiency of different nations' response to the pandemic, whose insights can be used by governments and health authorities worldwide to improve their national COVID-19 strategies. Hence, we propose a network Data Envelopment Analysis (DEA) to estimate the efficiencies of fifty-five countries in the current crisis, including the thirty-seven Organisation for Economic Co-operation and Development (OECD) member countries, six OECD prospective members, four OECD key partners, and eight other countries.

Sustainable water and sanitation for all: Are we there yet?

The lack of access to water and sanitation services (WSS) of a considerable share of the world population has been challenging the international community for decades. The proposal of the Millennium Development Goals and, later on, the Sustainable Development Goals (SDGs) by the United Nations (UN) intended to act as a blueprint to achieve a more equitable future for all and, in the case of WSS, "Ensure the availability and sustainable management of water and sanitation for all" (SDG 6). However, the current global pandemic further emphasised the importance of WSS, given the increasing asymmetries faced by billions worldwide, and the gaps between high-income and low- and middle-income nations.

An Incentive-Based Framework for Analyzing the Alignment of Institutional Interventions in the Public Primary Healthcare Sector: The Portuguese Case.

Over the years, the Portuguese National Health Service has undergone several reforms to face the challenges posed by internal and external factors on the access to and quality of its health services. One of its most recent reforms addressed the primary healthcare sector, where understanding the incentives behind the actors of the inherent institutional interventions and how they are aligned with the governing health policies is paramount for reformative success. With the purpose of acknowledging the alignment of the primary healthcare sector's institutional interventions from an incentive-based perspective, we propose a framework resting on a SWOT (Strengths, Weaknesses, Opportunities, and Threats) analysis, which was built in cooperation with a panel of decision-making actors from the Portuguese Ministry of Health.

Investment in drinking water and sanitation infrastructure and its impact on waterborne diseases dissemination: The Brazilian case.

Investment in sanitation and drinking water infrastructure is essential for universal access to these services in developing countries. Universal coverage of water and sanitation services (WSS) can prevent the dissemination of waterborne diseases and mitigate their adverse effects. These diseases are responsible for many deaths worldwide, especially among the disadvantaged population and children.

A critical look at the Portuguese public-private partnerships in healthcare.

The pre-conceived idea that contracts in a public-private partnership (PPP) regime, in healthcare or in any other economic sector, are, as a rule, ruinous and appealing for only a share of the stakeholders, lacks a solid basis that confirms it. This idea, outset and nurtured by the media, has been instigating the distrust of the users who, in turn, demand a more rigorous and efficient utilisation of public resources. Being Portugal in the top of countries that resort to PPPs, it is urgent to inquire if its respective contracts originated an inefficient and ineffective management of resources.

Waste services' performance assessment: The case of Tuscany, Italy.

This paper assesses the performance of waste services in the region of Tuscany in Italy. It adopts non-parametric techniques for this purpose. Furthermore, it investigates the influence of the operational environment on the estimated performance by using the robust order-m technique.

Monitoring inequality in water access: Challenges for the 2030 Agenda for Sustainable Development.

The diffusion of the indicators for monitoring sustainable development goals (SDG) has conceptual and symbolic uses far beyond their instrumental uses. Despite its value in dismantling social and economic inequalities, the goal regarding guaranteed of water and sanitation for all did not specify any indicators for this purpose. This research contributes to the discussions on the best way to monitor inequality in access to water by the SDG.

Water utilities performance analysis in developing countries: On an adequate model for universal access.

The results of the analysis of water utility performance studies based on data envelopment analysis (DEA) can be very sensitive to the methodological approach and the variables employed. This study investigates approaches and variables for developing countries in order to identify an adequate model for universal access. Three models were developed and compared.

Transnational resource generativity: Efficiency analysis and target setting of water, energy, land, and food nexus for OECD countries.

Depletion of natural resources needs quantification and efficiency analysis of the use of resources to improve sustainability. This paper evaluates the efficiency of Organization for Economic Co-Operation and Development (OECD) countries in terms of Water-Energy-Land-Food (WELF-Nexus) to ensure sustainability and environmental viability for both present and future generations. An input-output index system is built at a transnational level.

An analytical review of the efficiency of water and sanitation utilities in developing countries.

Due to the importance of analyzing the efficiency of water utilities and the large number of publications in this area, at least five reviews have already been carried out to identify patterns and trends. These reviews aimed to cover worldwide studies, and the results may not correspond to the reality in developing countries. Therefore, this review provides a literature update on the quantitative studies of water and sanitation services, focusing on studies carried out in developing countries.

The impact of household connection to public network wastewater systems: regulatory impact assessment.

Brazil faces a severe lack of wastewater coverage. Even in urban areas, wastewater is directly disposed of in watercourses without any treatment for a large part of the population. Although the federal, state, and local governments have invested in water and wastewater services (WWS), the expected results have not been achieved.

Tariff regulation in the waste sector: An unavoidable future.

Waste management and other services of general economic interest are normally out of market. Therefore, regulation may be required to provide sustainable services with the desired quality of service at affordable and fair prices. Some countries have created regulatory authorities to supervise service levels and tariffs.

Doctors, nurses, and the optimal scale size in the Portuguese public hospitals.

This study analyses the scale efficiency, optimal scale for hospital clinical staff, and the exogenous dimensions that can be associated with them. They offer useful insights for health policy design, particularly when human resources need to be reallocated across the country due to uneven distributions. Initial data considered a sample of 27 Portuguese general/acute-care public hospitals belonging to the National Health Service, observed between 2013 and 2016.

Identifying congestion levels, sources and determinants on intensive care units: the Portuguese case.

Healthcare systems are facing a resources scarcity so they must be efficiently managed. On the other hand, it is commonly accepted that the higher the consumed resources, the higher the hospital production, although this is not true in practice. Congestion on inputs is an economic concept dealing with such situation and it is defined as the decreasing of outputs due to some resources overuse.

The involvement of community leaders in healthcare, the environment and sanitation in áreas of social vulnerability.

The main purpose of this article is to identify access to: social assistance inclusion programs; assistance from health agents; public water supply services; and water saving practices, in areas of irregular occupation in Brazil. A stratified random sampling technique by clusters was adopted with a simple sampling strategy. In the universe of 14,079 households, 68 community leaders were identified, representing 6,800 households on average, in a normalized distribution (mean zero, standard deviation 1), deemed to include situations covering 96% of the cases with a margin of error of + or - 1% of the average.

Estimating size and scope economies in the Portuguese water sector using the Bayesian stochastic frontier analysis.

This study aims to search for economies of size and scope in the Portuguese water sector applying Bayesian and classical statistics to make inference in stochastic frontier analysis (SFA). This study proves the usefulness and advantages of the application of Bayesian statistics for making inference in SFA over traditional SFA which just uses classical statistics. The resulting Bayesian methods allow overcoming some problems that arise in the application of the traditional SFA, such as the bias in small samples and skewness of residuals.

Is bigger better? An empirical analysis of waste management in New South Wales.

Across the world, rising demand for municipal solid waste services has seen an ongoing increase in the costs of providing these services. Moreover, municipal waste services have typically been provided through natural or legal monopolies, where few incentives exist to reduce costs. It is thus vital to examine empirically the cost structure of these services in order to develop effective public policies which can make these services more cost efficient.

Should inpatients be adjusted by their complexity and severity for efficiency assessment? Evidence from Portugal.

Hospital efficiency analysis depends largely on the model specifications. This study discusses the importance of the case-mix index (CMI) to homogenize the sample of inpatient discharges. It proposes a new index where they are classified by service, since it is usual to have lack of data to compute the CMI and this can influence the credibility of results.

Did the corporatization of Portuguese hospitals significantly change their productivity?

This paper aims to investigate if the market structure reforms in the Portuguese health system have improved hospital performance and productivity. A robust non-parametric Malmquist index is applied to measure group performance. The significance of the results achieved is examined using a conditional and non-conditional subsampling bootstrapped-based methodology, enhanced by the likelihood cross validation criterion based on the k-nearest neighbors method.

On evaluating health centers groups in Lisbon and Tagus Valley: efficiency, equity and quality.

Background: Bearing in mind the increasing health expenses and their weight in the Portuguese gross domestic product, it is of the utmost importance to evaluate the performance of Primary Health Care providers taking into account both efficiency, quality and equity. This paper aims to contribute to a better understanding of the performance of Primary Health Care by measuring it in a Portuguese region (Lisbon and Tagus Valley) and identifying best practices. It also intends to evaluate the quality and equity provided.

Packaging waste recycling in Europe: is the industry paying for it?

This paper describes and examines the schemes established in five EU countries for the recycling of packaging waste. The changes in packaging waste management were mainly implemented since the Directive 94/62/EC on packaging and packaging waste entered into force. The analysis of the five systems allowed the authors to identify very different approaches to cope with the same problem: meet the recovery and recycling targets imposed by EU law.

On the economic performance of the waste sector. A literature review.

In a context of increasing international concern about public cost savings, research interest in the waste sector has gradually emerged. The literature on waste cost and inefficiency, particularly the use of parametric and non-parametric methods has increased exponentially in the last years. This paper reviews the developments, themes, objectives, concerns and characteristics of this kind of research, by reviewing a comprehensive database consisting of more than 100 relevant papers on economic performance of the waste services were published since 1965.