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Publications

Publications by Miguel Alves Pereira

2021

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

Authors
Pereira, MA; Marques, RC;

Publication
WATER RESEARCH

Abstract
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. For this reason, understanding whether low-and middle-income countries have been approximating towards or deviating from the SDG 6 is crucial to derive and communicate key information for the sake of improved public governance and political decision-making. In this paper, we extend a state-of-the-art methodology based on data envelopment analysis for assessing the convergence of the low-and middle-income UN Member States regarding the SDG 6 between 2016 and 2017. We find that, on average, not only did the Member States converge by decreasing the performance spread and the gap between the best and worst practice frontiers, but also the Level of water stress: freshwater withdrawal as a proportion of available freshwater resources was the indicator in which the majority exhibited the worst performances. In the end, we derive possible policy implications, which, as our results show, are aligned with the recent UN reports on the subject.

2021

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

Authors
Pereira, MA; Marques, RC; Ferreira, DC;

Publication
HEALTHCARE

Abstract
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. In the end, we derive possible policy implications and strategies. This holistic approach highlighted the positive impact of the primary healthcare reform in the upgrade of physical resources and human capital but stressed the geosocial asymmetries and the lack of intra- and inter-sectorial coordination. The proposed framework serves also as a guideline for future primary healthcare reforms, both national- and internationally.

2021

Measuring the efficiency of the Portuguese public hospitals: A value modelled network data envelopment analysis with simulation

Authors
Pereira, MA; Ferreira, DC; Figueira, JR; Marques, RC;

Publication
EXPERT SYSTEMS WITH APPLICATIONS

Abstract
In contrast to conventional data envelopment analysis (DEA), where a system is considered as a "black-box", network DEA acknowledges its internal structure to generate more enlightening results. It goes without saying that putting network DEA in practice is natural-and progressively rarer as the complexity of a system's structure increases. In particular, its employment in healthcare is no exception. Thus, we designed a slacks based model to measure the efficiency of the Portuguese secondary healthcare providers bearing in mind their internal services. However, the absence of data regarding the connections between those services called for the additional use of a simulation method - the well-known Monte Carlo method -, modelled with the judgements of a decision-maker. This unprecedented application of static systems with a matrix-type structure found that two-thirds of those providers were inefficient and allowed the identification of target areas for future policy reforms in the Portuguese National Health Service.

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