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Success factors in Turkey’s Elaziğ healthcare PPP

Matthew Jordan-Tank's picture

Editor's Note: Join us April 22nd at 10AM ET for the 2017 Global Infrastructure Forum when the Multilateral Development Banks (MDBs), the United Nations, the G-20, and development partners from around the world meet to discuss opportunities to harness public and private resources to improve infrastructure worldwide, and to ensure that investments are environmentally, social and economically sustainable. Check out the event site to view the livestream on April 22.



Imagine the difficulty of designing, financing, building and operating a €360 million, 1,000-bed hospital campus that serves a region of 1.6 million people? This is exactly what the government of Turkey is doing in Elaziğ, a city of 350,000 in eastern Anatolia. The facility will serve and accommodate about 20,000 patients and their relatives per day with a broad range of services including women and children’s health, psychiatric services, and a dental clinic.
 
A project of this size is bound to be challenging and complex. But the approach taken by the Turkish Government has been a success—to involve a private-sector partner through a public-private partnership (PPP) with support from multilateral development banks. How did they do it?

Partnering to measure impacts of private sector projects on job creation

Alvaro Gonzalez's picture
Worker in Ghana
For the poor and vulnerable of the world, jobs are key to ending poverty and driving development. But not all jobs are equally transformational.  
Photo: Jonathan Ernst / World Bank

Jobs are what we earn, what we do, and sometimes even who we are. For the poor and vulnerable of the world, jobs are key to ending poverty and driving development. But not all jobs are equally transformational. Good jobs add value to society, taking into account the benefits they have on the people who hold them, and the potential spillover effects on others. For example, inclusive jobs, such as those that employ women, can change the way families spend money and invest in the education and health of children.  

Assessing disaster risk in Europe and Central Asia – what did we learn?

Alanna Simpson's picture
Heavy rains on June 13-14, 2015 caused a 1 million cubic-meter landslide to flow down the Vere River valley and damage the capital city of Tbilisi, Georgia. (Photo via Wikimedia Commons)
Across the Europe and Central Asia region today, policymakers are confronted daily with a wide range of development challenges and decisions, but the potential impacts of adverse natural events and climate change – such as earthquakes or flooding – may not always be first and foremost in their thoughts.

Admittedly, the region does not face the same daunting disaster risks as some other parts of the world – especially in South Asia, East Asia and Latin America – but nevertheless, it is far from immune to the effects of natural hazards – as the past clearly reminds us.

Research rigor and risks: Investigating gender-based violence in the European refugee crisis

Throughout the 16 Days of Activism Against Gender-Based Violence campaign, we celebrate the strides made since the first Women’s Global Leadership Institute in 1991. Despite significant advances in programming and policy, gender-based violence remains pervasive, especially in crisis-affected populations. The ongoing conflict in Syria and the risks of gender-based violence for Syrian refugees challenge us as a global community to focus our attention and intensify our efforts and activism against gender-based violence.
 
Photo: Women and Health Alliance (WAHA) International

The 16 Days of Activism campaign also allows us to reflect on the important role of research in activism. Without rigorous research, activism against gender-based violence may be misguided or misaligned with individual or community perceptions and needs.
 
What is meant by rigorous research?

Rigorous research has been defined as research that applies the appropriate research tools to investigate a set of stated objectives. While some researchers may argue that quantitative research methodologies generate more rigorous data, using this definition we can see that qualitative research methodologies can also generate rigorous data to inform programming, policy and activism.

Our project, funded by the World Bank Group and Sexual Violence Research Initiative Development Marketplace for Innovations to Prevent Gender-Based Violence, aims to do just that—generate rigorous data using qualitative research methodologies to better understand the gender, social, and cultural norms that contribute to intimate partner violence among Syrian refugees. Women and Health Alliance (WAHA) International in collaboration with academic and organizational partners in Turkey and Greece will collect data using focus group discussions and participatory action learning activities in order to inform future interventions targeting intimate partner violence among displaced populations.

Management Quality Matters: Measuring and Benchmarking the Quality of Firms' Management in Turkey

Ximena Del Carpio's picture


This is an edited excerpt from a chapter, “Quality of Firm Management in Turkey,” from the upcoming report, “Creating Good Jobs in Turkey.”

 
How well firms are managed, and whether their management quality (or lack thereof) affects firm performance, are questions that policymakers and researchers everywhere – especially in emerging economies – are very interested in answering.
 
This area of inquiry is important because much of the evidence shows that the quality of management techniques that are used to run a firm – how it manages its capital and human resources, and how it monitors inventory, among other important areas in the production process – affect firm productivity, adaptability to change, and potential for growth. These factors are especially important in competitive and challenging environments. 
 
Despite the potential effect of management practices on firm performance, it is a relatively understudied area in the economics literature. Survey-data limitations have made it difficult for economists to analyze the relationship between firm management practices and firm performance.
 
But that pattern is changing: The World Management Survey (WMS) team designed a new interview-based evaluation tool to quantify the quality of management practices in firms across countries and sectors, and across 18 basic practices in four categories: operations, target-setting, performance monitoring, and talent or human-resource management. (The WMS was started by researchers at the London School of Economics and Stanford University, and it has been conducting management surveys worldwide for more than 10 years.)
 
In the last decade, many countries interested in benchmarking their firms’ performance have participated in the surveys. Turkey joined this effort in 2014. The new data allows us to measure how Turkish firms perform across the four benchmark dimensions of management. and it allows us to measure how they compare with competing firms across the globe. The results help the private sector and the public sector offer suitable support to improve firm performance and productivity as a whole.
 
In this analysis, we’ll share some of the early results from Tukey’s first quality-of-management survey, including how Turkey compares to other countries; we'll highlight the importance of measurement; and we'll try to motivate Turkish researchers and policymakers to use the results to help firms in Turkey.  
 
Average scores for firms in Turkey are low relative to the country’s development level (Figure 1). Firms in comparator countries like Mexico and Poland have higher absolute scores, and relatively higher scores for their development level. (The average scores combine sub-scores for each of the four categories: operations, targeting, monitoring and human resources.)

Figure 1: Per Capita Income and Average Management Score



Note: On this chart, Turkey's position is just above the position of Malaysia.
Source: World Management Survey and authors’ calculations.


Relatively poor performance in Turkey, and key comparator countries, is mostly driven by a large “left tail” of poorly managed firms – a factor that is not uncommon across developing countries (Figure 2). In particular, the fraction of firms performing below the lowest quartile of U.S. firms ranges between 55 percent and 70 percent in such countries as Turkey, Brazil, Poland, Chile, but also China and India. Although there is a large variation in management scores across firms, the distribution of scores in these countries, compared to the distribution in the United States, is either narrow or flat, bimodal and/or nonsymmetrical.

Figure 2: Smooth distribution of total management scores


Note: The vertical red dashed line represents the lowest quartile of the US distribution.
Source: World Management Survey and authors’ calculations.

People’s living standards – do numbers tell the whole story?

Giorgia DeMarchi's picture
Numbers don’t lie. That’s why, in our day-to-day lives, we rely heavily on numbers from household surveys, from national accounts, and from other traditional sources to describe the world around us: to calculate, to compare, to measure, to understand economic and social trends in the countries where we work.

But do we perhaps rely too much on numbers to gain an understanding of people’s lives and the societies in which they live? Do numbers really tell us the whole story, or give us the full picture?


 

From a rubber boat in the sea to swimming in Rio: A story of resilience

Bassam Sebti's picture


On a chilly October day in 2015, 24-year-old Rami Anis boarded a rubber boat in the Aegean Sea in Turkey. His destination was Europe and his goal was a better life away from war and hardship.

Looking at the people around him on the boat, he was horrified. They were children, men, and women. The fact that they might not make it never escaped his mind, even though he is a professional swimmer.

“Because with the sea, you can’t joke,” said the Syrian refugee.

But on Aug. 11, Rami will not be worried about swimming in the sea. He, instead, will be swimming at the Olympics. He made it safely to Belgium after days of heart-wrenching journey, from Istanbul to Izmir to Greece before setting off a trek through Macedonia, Serbia, Croatia, Hungary, Austria, Germany and eventually Belgium.

Rami will be competing at the 2016 Olympic Games in Rio de Janeiro as a member of the Refugee Olympic Team — the first of its kind — and march with the Olympic flag immediately before host nation Brazil at the opening ceremony. 

Renewables, solar, and large size projects trending in new data on private participation in infrastructure

Clive Harris's picture



Translations available in Chinese and Spanish.

Many of you are already familiar with the PPP (Public-Private Partnerships) Group’s Private Participation in Infrastructure (PPI) Database. As a reminder for those who aren’t, the PPI Database is a comprehensive resource of over 8,000 projects with private participation across 139 low- and middle-income economies from the period of 1990-2015, in the water, energy, transport and telecoms sectors.

We recently released the 2015 full year data showing that global private infrastructure investment remains steady when compared to the previous year (US$111.6 billion compared with US$111.7 the previous year), largely due to a couple of mega-deals in Turkey (including Istanbul’s $35.6 billion IGA Airport (which includes a $29.1 billion concession fee to the government). When compared to the previous five-year average, however, global private infrastructure investment in 2015 was 10 percent lower, mainly due to dwindling commitments in China, Brazil, and India. Brazil in particular saw only $4.5 billion in investments, sharply declining from $47.2 billion in 2014 and reversing a trend of growing investments over the last five years.

Pathways to Prosperity: An e-Symposium

Onno Ruhl's picture

 

Blog #1: Five key drivers of reducing poverty in India

India is uniquely placed to drive global poverty reduction. The country is home to the largest number of poor people in the world, as well as the largest number of people who have recently escaped poverty. Despite an emerging middle class, many of India’s people are still vulnerable to falling back into poverty.

Over the next few weeks, this series will look back and analyze publicly available data to better understand what has driven poverty reduction from the mid-1990s until 2012, and the potential pathways that can lead to a more prosperous India. Since it is clearly not feasible to elaborate on all the myriad pathways out of poverty available to India, we focus on a few key themes that the diagnostics show to be of particular relevance to the country. We hope this series will contribute to the ongoing discussions on how poverty can be eliminated from India.

We are thankful to the Indian Express for partnering with us in disseminating this series to its readers.

Predicting success for infrastructure in emerging markets: Moving from art to science

Jyoti Bisbey's picture

with research contributions from Zichao Wei

At conferences, in meetings, and even during casual work conversations, I am asked the same two questions:  “Which countries are ideal for investments in infrastructure?  Where should the investors invest and what new opportunities should they look toward?” 

While sitting in the World Bank gives us a bird’s-eye view of emerging markets and developing economies (EMDEs), it doesn’t offer the up-close-and-personal perspective that investors demand in order to answer these questions in a succinct way.  Not that there’s any shortage of synoptic responses. Any number of “market gurus” can assess projects in a second, gathering all the low hanging fruits which are out there in EMDEs.  If there is a private deal to be made, then the deal is already done.


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