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Tobacco has been projected for its economic prosperity in Pakistan and many other developing countries while the opportunity cost of domestic labor, health issues and associated health cost related with tobacco farming are often overlooked. Various health conditions associated with tobacco farming result in catastrophic health expenditures which not only increase the chances of poverty head counts but also deepens it further. Taking into account the opportunity cost of domestic labor and health cost associated with tobacco induced illnesses obscure the tobacco prosperity rhetoric. This study examined effect of incremental health cost associated with tobacco farming on poverty head counts and severity. Using survey data from the tobacco producing districts in Khyber Pakhtunkhwa, Pakistan, this study found that tobacco farmers experienced higher proportion of sever health hazards and illnesses like CVD and respiratory issues. The severe nature of ailments caused them higher share of out of pocket expenditures as compared to non-tobacco farmers and general population. Increase in health expenditures not only increased their poverty head counts by four and half percent but also severity of poverty worsened further by 8 percentage points using the Cost of Basic Needs (CBN) approach for measuring poverty. This study concludes that it is not only tobacco consumption associated with various health conditions but also tobacco farming. It is recommended that health cost associated with tobacco farming be considered both in setting up of minimum indicative prices for tobacco and consideration of health cost can be used as a tool against prosperity rhetoric which is used to block tobacco control policy.

Chronic thromboembolic pulmonary hypertension (CTEPH) is a serious complication of unresolved pulmonary embolism. CTEPH is a potentially curable disease and the treatment of choice is pulmonary endarterectomy (PEA) with complete clearance of pulmonary arteries being the principle of surgery. The surgery is performed under circulatory arrest during cardiopulmonary bypass circulation. We report 3 cases of CTEPH in 2018-2019 at department of cardiothoracic surgery, Rehman Medical Institute, Peshawar. They were detected by echocardiography (TTE) and confirmed by CTPA. Pulmonary endarterectomy was performed with good peri-operative outcome and significant improvement of hemodynamics.

Enacting Ordinance No LXXIV 2002, Pakistan has developed crucial anti-tobacco policies in the last two decades. We, therefore, examine in this paper effects of both price (cigarette taxation) and non-price (public regulations on cigarette smoking) anti-tobacco policies on cigarette demand. To accomplish this objective, we examine the short and long run dynamics of cigarette demand in Pakistan using auto-regressive distributed lag (ARDL) estimator covering the period 1981-2018 (annual observations). The study compares price elasticity estimated with and without regulations on cigarette smoking. The result obtained shows that when price increases by 10%, cigarette consumption decreases by 5% in the short run while it decreases by 6.9% in the long run. This finding confirms that cigarette demand model, in Pakistan, is in-elastic. More interestingly, the study finds that non-price regulations on smoking and cigarette demand have negative and statistically significant association. This finding confirms that non-price regulations influences the long-term dynamics of cigarette smoking in Pakistan. Furthermore, we obtain low price elasticity with non-price regulations and high price elasticity without non-price regulations while estimating cigarette demand equation. This empirical result is an evident of the fact that estimated cigarette price elasticity without incorporating non-price regulations into the demand model, are upward biased. The study therefore, concludes that smoking regulation policy based on overstated cigarette price elasticity would produce ambiguous outcomes. Hence, relying only on cigarette taxation (price policy) to regulate cigarette smoking would not produce desirable outcome. In addition, university education is positively and significantly associated with cigarette consumption. This finding show that our university education do not properly convey anti-smoking message to students. To reduce cigarette smoking, Pakistan will have to implement stronger, more comprehensive and better enforced non-price regulations along with taxes on cigarettes.

This study examines the difference between the total spending on the election campaign in 54 Union councils during local bodies’ election and the expected developmental fund for the same area. The study is based on primary data collected from 324 contesting candidates for the chairmanship/vice-chairmanship of 54 union councils (UCs) in district Pakpattan during the local bodies’ election of 2015 in Punjab, Pakistan. Per local bodies council rules, a winning chairman of UC has to allocate developmental funds in the area. So, the whole process of local bodies’ election is for the finalization of a person among the people, who could be given the mandate to use the developmental funds. In this regard, we assume that the prevailing process of election is rent-seeking for society, in the sense that the total cost of the election process for society is greater than the developmental funds for which the same process is conducted. Candidates consume more than the allowed limit set by the Election Commission of Pakistan (ECP). Hence, society bears the monetary cost of spending more than the set limit and non-monetary costs like rivalry, foes, conflicts, etc. The analysis of data shows that the total amount of campaign spending is 473.27 million rupees which are significantly more than the allowed limit, set by ECP as well as the total allocated developmental funds (128 million) of 54 union councils. The study shows that the whole process of local bodies’ election is putting rent of 345 million on society. Apart from monetary cost, this process brings those people to the power corridors who themselves break ECP rules. The study suggests comprehensive reforms in the process of the election campaign for saving society from its associated cost.

This paper examinespatternsof export creation and diversion by analyzing Pakistan’s trade agreements at the two-digit industry level for all 88 export-oriented industries. We compare the net change in exports with nine free trade agreement (FTA) partners and the top15 partners with most-favored nation (MFN)status. We find that 45 industries account for USD4.1 billion inexport creation across all Pakistan’s FTA partners.Here, net exports increase after FTAs with both FTA and MFN partners. Conversely, export diversion worth USD137million occurs in 10 industries with all FTA partners as net exports to FTA partners rise while net exports to MFN partners fall. In the same manner, we find that net exports in 33 industries declined by USD500 million with FTA and MFN partners. The totalnet exports addition after FTAs was USD3.5 billion or,on average,USD350 million annually,accounting for about 1.4 percent of Pakistan’s total annual goods exports. On average, Pakistan has successfullycreatedexports in half itsexport-oriented industries, althoughhighly subsidized industries exhibit either export diversion or a net decline with both MFN and FTA partners. A difference-in-differenceanalysis shows that exports to China and Mauritius rose significantly while the remainingseven FTA partners did not have a significant increase in exports after the FTAs were implemented. In view of these findings, wesuggest revisiting the policy of export subsidies.

Smoking has been the topic of research for long time. Scholars have written on this issue from different dimensions like revenue generation, employment creation, environmental and health hazards. However, it exposes a person to more than 400 carcinogenic chemicals, causing many detrimental diseases like lung cancer, coronary artery disease, heart attack, stroke which kill more than 7 million people annually. Due to high smoking attributable mortality and morbidity; the World Health Organization (hereafter WHO) passed Framework Convention on Tobacco Control (hereafter FCTC). WHO-FCTC stipulates certain obligatory rules for the control of smoking prevalence and tobacco hazards to its member states. This paper aimed to examine the compliance of tobacco control laws with the FCTC guidelines and their effects on smoking prevalence in South Asian countries. The work hypothesized that higher compliance of tobacco control laws with the WHO-FCTC rules reduces smoking prevalence. The study employed positivist approach using descriptive statistics to determine the role of compliance with tobacco control laws in controlling of smoking prevalence rates. The study used data from different sources like the official Gazette books, reports of the World Health Organization (WHO), website (tobacco control laws) of the campaign for Tobacco-free Kids, Our World in Data (OWID), population pyramid.net and The World Bank. We compared and contrasted the national laws governing tobacco control in South Asia with the WHO-FCTC guidelines to test our hypothesis. We constructed an overall compliance index for the countries. We found non-compliance with the FCTC proposed tax share and heterogeneities in tax rates among the countries to reduce the smoking prevalence rates. Bangladesh has attained the highest index score of 0.748 followed by Sri Lanka with 0.650 index score whereas, Nepal and India have the least scores on compliance. The least scores of India and Nepal go against our hypothesis because the countries have achieved maximum reduction in tobacco control despite their low scores on the index.

The extraction of molybdenum from the aqueous solution through poly inclusion membrane (PIM) containing tri-caprylylmethylammonium chloride (Aliquat-336) as a carrier has been investigated. A solution of molybdenum in phosphoric acid was used as a feed side while sodium hydroxide was used as stripping reagent. The results indicate that maximum flux value was obtained at 0.16 M Aliquat-336. Increase in H3PO4 concentration from 0.05 to 1.5 M results into an increase in molybdenum ions. The maximum flux of 3.00×10−6 mol/m2s through PIM was found at 1.5 M H3PO4. The optimized conditions were applied for removal of Mo(VI) from ore and more than 97 % Mo(VI) was extracted. Bull. Chem. Soc. Ethiop. 2020, 34(1), 93-104. DOI: https://dx.doi.org/10.4314/bcse.v34i1.9

Background: Coronary artery bypass graft (CABG) surgery can result in serious complications for the patients. It is being currently performed with cardiopulmonary bypass with cardiac arrest in 80% of the cases across the world. There have debate in the past regarding the cardiac revascularization via CABG approaches. Aim: The aim of this study is to study the difference in the patient’s ICU stay who have low ejection fraction and are undergoing cardiac revascularization between off pump and on pump coronary artery bypass grafting. Methodology: A sample size of 60 patients has been taken in the study with 30 patients' in the on-pump surgery group and 30 patients' in the off-pump surgery group. The data has been collected from department of Cardiac Srugery AFIC/NIHD, Rawalpindi. Results and Conclusion: The study concludes that the on-pump CABG patients tend to have shorter ICU stay than the off-pump CABG patients who have low ejection fraction and are undergoing cardiac revascularization. Therefore, on-pump treatment is recommended in the study. Keywords: Off pump, on pump, coronary artery bypass grafting, ICU stay, low ejection fraction, cardiac revascularization

The main purpose of the current article is to scrutinize the flow of hybrid nanoliquid (ferrous oxide water and carbon nanotubes) (CNTs + Fe3O4/H2O) in two parallel plates under variable magnetic fields with wall suction/injection. The flow is assumed to be laminar and steady. Under a changeable magnetic field, the flow of a hybrid nanofluid containing nanoparticles Fe3O4 and carbon nanotubes are investigated for mass and heat transmission enhancements. The governing equations of the proposed hybrid nanoliquid model are formulated through highly nonlinear partial differential equations (PDEs) including momentum equation, energy equation, and the magnetic field equation. The proposed model was further reduced to nonlinear ordinary differential equations (ODEs) through similarity transformation. A rigorous numerical scheme in MATLAB known as the parametric continuation method (PCM) has been used for the solution of the reduced form of the proposed method. The numerical outcomes obtained from the solution of the model such as velocity profile, temperature profile, and variable magnetic field are displayed quantitatively by various graphs and tables. In addition, the impact of various emerging parameters of the hybrid nanofluid flow is analyzed regarding flow properties such as variable magnetic field, velocity profile, temperature profile, and nanomaterials volume fraction. The influence of skin friction and Nusselt number are also observed for the flow properties. These types of hybrid nanofluids (CNTs + Fe3O4/H2O) are frequently used in various medical applications. For the validity of the numerical scheme, the proposed model has been solved by another numerical scheme (BVP4C) in MATLAB.

Introduction: Leiomyoma is one of the most common benign smooth muscle tumor of the uterus which on rare occasions may grow into the vessels and extend up till the Inferior Vena cava or the heart and hence be referred to as Intra-Venous Leiomyomatosis and Intra-Cardiac Leiomyomatosis respectively.Case Report: We herein report a rare presentation of leiomyoma in a 46 year old female who presented with complaints of shortness of breath on exertion associated with palpitations for the past 1 year with a history of irregular menstrual bleeding. Ultrasonography of the abdomen and pelvis revealed an enlarged, distorted uterus with multiple intramural fibroids. A trans-thoracic echocardiography was then performed which showed a large right atrial mass. To investigate further, a contrast enhanced computed tomography was performed covering entire chest and upper abdomen. It showed a large lesion in right atrium of heart measuring 6x5cm.

The introduction of hybrid nanofluids is an important concept in various engineering and industrial applications. It is used prominently in various engineering applications, such as wider absorption range, low-pressure drop, generator cooling, nuclear system cooling, good thermal conductivity, heat exchangers, etc. In this article, the impact of variable magnetic field on the flow field of hybrid nano-fluid for the improvement of heat and mass transmission is investigated. The main objective of this study is to see the impact of hybrid nano-fluid (ferrous oxide water and carbon nanotubes) CNTs-Fe3O4, H2O between two parallel plates with variable magnetic field. The governing momentum equation, energy equation, and the magnetic field equation have been reduced into a system of highly nonlinear ODEs by using similarity transformations. The parametric continuation method (PCM) has been utilized for the solution of the derived system of equations. For the validity of the model by PCM, the proposed model has also been solved via the shooting method. The numerical outcomes of the important flow properties such as velocity profile, temperature profile and variable magnetic field for the hybrid nanofluid are displayed quantitatively through various graphs and tables. It has been noticed that the increase in the volume friction of the nano-material significantly fluctuates the velocity profile near the channel wall due to an increase in the fluid density. In addition, single-wall nanotubes have a greater effect on temperature than multi-wall carbon nanotubes. Statistical analysis shows that the thermal flow rate of (Fe3O4-SWCNTs-water) and (Fe3O4-MWCNTs-water) rises from 1.6336 percent to 6.9519 percent, and 1.7614 percent to 7.4413 percent, respectively when the volume fraction of nanomaterial increases from 0.01 to 0.04. Furthermore, the body force accelerates near the wall of boundary layer because Lorentz force is small near the squeezing plate, as the current being almost parallel to the magnetic field.

The hybrid nanofluid is extensively used in manufacturing commercial applications due to its high exceptional capacity to increase the heat transfer rate. As a result, in the existence of nonlinear convection, the hybrid nanofluid is considered to flow on an inclined plane. The nonlinear convection has many applications in real life and is more relevant to the natural flow avoiding the flow restrictions. The focus has been executed on the thermal and mass Grashof numbers to analyse the fluid motion in the presence of these parameters for nonlinear nature. Moreover, the hybrid nanofluid flow analysis has been done to investigate the heat transfer analysis. The modelled equations are solved through an analytical approach. The heat and mass transfer rates and drag force are calculated under the influence of various physical parameters. The new parameter of the Grashof numbers improves the fluid motion for its larger values, and consequently, the fluid rapidly falls down from the inclined plane. The obtained outputs show that hybrid nanofluids are more effective in heat transfer analysis as compared to other conventional fluids.

The existing literature establishes that there exists inefficiency in energy consumption in Pakistan. In particular, with regard to electricity consumption, the problem of moral hazard is prevalent in the public sector. In this study, we observe this aspect by focusing on the behaviour of consumers once they are held liable to monitoring with the associated punishment mechanism. By providing evidence from a field experiment, we make three conclusions. First, individuals respond to both the monetary and non-monetary punishments. Alternatively, with the introduction of punishments, they reduce moral hazard with respect to electricity consumption. Second, the habitual violators of rules reform their behaviour after they are made accountable for their actions. Third, if appropriate monitoring systems along with the associated punishment mechanism are introduced, we can have beneficial effects in terms of resolving the energy crisis on the aggregate level. JEL Classification: H83, D12, D00, D03, D04 Keywords: Moral Hazard, Monitoring, Punishment, Electricity Consumption, Public Sector

Objective: To determine the frequency of stroke and common factors leading to it after coronary artery bypass grafting. Methods: This study was conducted at Cardiothoracic Surgery Department, Rehman Medical Institute, Peshawar. Study design was descriptive cross sectional study and the duration of the study was six months. The total sample size was 183 cases using 8.3% frequency of stroke after coronary artery bypass grafting, 95% confidence interval, 4% margin of error, using WHO sample size calculator. Results: In this study mean age was 45 years with SD ± 1.26. Seventy five percent patients were male while 46(25%) females. Six patients (3%) patients had stroke while 177(97%) patients did not have any stroke. Among the six patients who were analyzed, all of them had Diabetes Mellitus and 50% patients had recent AMI, while only one patient had prior history of Atrial Fibrillation. Conclusions: Diabetes Mellitus is an independent risk factor for stroke after CABG surgery. whereas, recent MI is also associated with increased incidence of stroke in post CABG patients. Abbreviations: OPCAB: off-pump coronary artery bypass, CABG: Coronary artery bypass grafting surgery, POAF: Postoperative atrial fibrillation, MI: myocardial infarction, LMS: Left main stem, CPB: cardiopulmonary bypass, AWMI: Anterior wall myocardial infarction, AMI: Acute myocardial Infarction. doi: https://doi.org/10.12669/pjms.37.1.3242 How to cite this:Shah SMA, Ur-Rehman M, Awan NI, Jan A. To determine the frequency of stroke and common factors leading to it after coronary artery bypass grafting. Pak J Med Sci. 2021;37(1):261-266. doi: https://doi.org/10.12669/pjms.37.1.3242 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Objective: To investigate the early outcomes of patients undergoing total-correction (TC) for Tetralogy of Fallot (TOF). Methodology: A retrospective study was carried out after acquiring Institutional ethical review committee approval. All patients diagnosed with TOF combined with pulmonary stenosis that had undergone primary repair between November 2016 and November 2018 at the Cardiothoracic Surgery Unit of Rehman Medical Institution, Peshawar were included while patients having anatomical defects alongside TOF were excluded from the study. Data was collected using a proforma. SPSS version 25 format was used for data entry and analysis. Comparisons between age related intraoperative parameters and age related early outcomes of the procedure was done by using the Student’s T-test and Chi-squared test keeping p ≤ 0.05 as significant. Results: A total of 186 patient’s data was retrieved from the hospital record. There were 109 (58.60%) males and 77 (41.40%) females. Mean cardiopulmonary bypass time (CBP) was 94.84±37.92 minutes and aortic cross clamp (ACC) time was 67.17±31.86 minutes. In the postoperative period, 11 (5.91%) patients developed Low cardiac output syndrome (LCOS). Prolonged ventilator support (>24 hrs.) was required in 21(11.29%) patients and prolonged ICU stay (>48 hrs.) was seen in 38(20.43%) patients. A total of 166 (89.25%) patients were discharged while 20 (10.75%) died post operatively due to complications. Conclusion: Total repair for TOF is a favorable option in most patients as early outcomes were satisfactory with acceptable mortality rate after surgery.

Objective: The aim of our study is to analyze the characteristics, morbidity and mortality of patients requiring an Intra-Aortic Balloon Pump (IABP) in Coronary Artery Bypass Grafting (CABG). Methods: An analysis was done on the prospectively collected data of 1216 patients who had CABG in our center between July, 2017 and May, 2019 at our hospital. We categorized patients in to an IABP and non-IABP group on the basis of IABP use. We then compared the pre-operative, per-operative and post-operative characteristics of the two groups. We further stratified the patients according to pre-op ejection fraction (EF). Results: Out of 1216 patients, 135(11.10%) patients required an IABP. 70(51.9%) patients of IABP group and 699(64.7%) patients of non-IABP group had hypertension (p-value 0.0036). 23.0% had previous myocardial infarction (MI) in the IABP group and 13.8% had prior myocardial infarction (MI) in non-IABP group (p-value 0.0463). Among the patients requiring an IABP, 21(15.5%) of patients had normal EF (>50%) (P-value

Nanofluids play a prominent role in the development of various electronic structures and technological devices. Herein, we devise new and efficient techniques for overcoming the problems faced by the base fluids. This article describes water-based carbon nanotubes, including two major types of single-wall carbon nanotubes (SWCNT) and multi-wall carbon nanotubes (MWCNT). A mathematical model is considered for unsteady three-dimensional CNTs nanofluids flow with a uniform magnetic field between two revolving disks. The basic equations of the modeled flow problem are solved by the BVPh 2.0 package which is implemented using the Optimal Homotopy Analysis Method (OHAM). It has been observed that by stretching the top disk while keeping the lower disk stationary, the rotation aspect is reduced, whilst radial velocity near the top disk significantly increases. Moreover, The higher the values of unsteadiness parameter, the more accurate the temperature profile.

This article, investigates the behaviour of an ionized nanoliquid motion regarding heat transmission between two parallel discs. In the proposed model, the squeezing flow of Cu-water nanofluid with electrical potential force is analysed for studying the flow properties and an uniform magnetic field is applied to that fluid, by taking the surface of the bottom disc porous. We have also studied the effects of different nanomaterials on the transmission of heat through nanofluids. Furthermore, the influence of various physical parameters in the proposed model of nanofluids flow like volume fraction of nanomaterials, squeezing number, Hartmann number, Eckert number, and Prandtl number are analysed and discussed quantitatively through various tables and graphs. The system of nonlinear partial differential equations (PDE’s) has been used to formulate the proposed flow model and later converted to a set of nonlinear ODE’s by mean similarity transformation. Further, the reduced form of ODEs has been solved by Parametric Continuation Method (PCM), which is a stable numerical scheme. The outcomes obtained from the proposed model could also be used to analyse nanofluid flow in several fields, such as polymer processing, power transfer and hydraulic lifts. We acknowledge the insightful comments of the editorial board to make this work more beautiful. We also acknowledge the financial support provided by the Postdoctoral research support fund of School of Mathematical Sciences, Jiangsu University, Zhenjiang, 212013, China. The work of U.F.-G. has been supported by the government of the Basque Country for the ELKARTEK21/10 KK–2021/00014 and ELKARTEK20/78 KK–2020/00114 research programs, respectively.

Information and communication technology (ICT) plays a key role in explaining the growth patterns of an economy. Many of Asian economies have exhibited high growth patterns in recent years. What explains economic performance of Asian economies? Does implementation of ICT in public sector matters for the growth of Asian economies? To answer this question, this study analytically explores and empirically tests the linkages of ICT in public sector with economic performance reusing the panel data of 34 Asian economies over the period 2003-2015. For empirical analysis, this study uses Fixed Effects, Random Effects, and System Generalized Method of Moments (SGMM) estimation techniques. The empirical results show that e-government plays a positive and significant role in economic performance of the Asian economies. This finding remains robust even after controlling the effects of trade, government consumption and inflation.

A vast literature has examined local public sector reform which offers insights into diagnosing problems, designing reform programs and implementing these programs. This chapter examines some of the more important strands in this voluminous body of work. It considers alternative ways of conceptualizing reform advanced by Peters, Hood and other scholars. It then summarizes the literature on local government failure, new institutional economics (NIE) with its emphasis on property rights, transaction costs and agency theory, as well as the role of leadership in implementing transformational reform in the local public sector. In terms of empirical evidence, two leading comparative studies are considered, one of which examines municipal reform in Anglosphere countries while the other study concentrates on comparative municipal reform across 28 European countries.

Tax administration ranges from complete centralization to complete autonomy with a mix of the two being the most common. In the past few decades, a number of advances have been made in strengthening the legal and regulatory framework; in broadening the tax base by identifying and registering taxpayers and potential taxpayers; in initiating programs/practices to improve taxpayer compliance; in improving the capacity to process information; in developing their risk-analysis capacity to focus on potential tax violators; in strengthening investigation, audit and enforcement capacity; in improving analytical capacity and ability for carrying out studies on tax burdens, collection trends, compliance gaps and impacts of policy changes; and in the implementation of procedures to reduce corruption.

Local property taxes are important sources of own revenues for local governments around the world. However, their potential as a source of own revenues are not fully exploited especially in the developing countries due to inefficiencies in tax administration. Even in industrial countries, use of this tax instrument in dealing with urban sprawl remains to be seen. This chapter presents a synthesis of global practices in real property tax to make this knowledge readily accessible to practitioners and students. It is intended to serve as a primer on worldwide practices on real property taxes to guide better design and administration of these taxes to fulfill fiscal and social policy and economic development objectives.

This chapter provides a brief survey of the program evaluation methods, their objectives, strengths, and weaknesses. The chapter first presents methods like cost-benefit analysis, cost-effectiveness analysis, the social marginal cost of funds analysis, and data envelopment analysis that are appropriate for guiding efficient allocation and utilization of resources. This is followed by a discussion on multiple-criteria evaluation (MCE), which is much more holistic. Apart from efficiency, it addresses issues like the relevance of a program, effectiveness of a program in achieving its objectives, and sustainability of the program benefits. Newer MCE approaches such as the Iron Triangle and the Results-Oriented Management Evaluation are briefly sketched. Finally, theory-based evaluation is outlined, where the focus is not just on whether a program succeeds or fails but also on how and why a program succeeds or fails.

Budgets are important as a means of controlling municipal expenditures and identifying revenues. Their structure, the information they provide, and their importance in decision-making has grown significantly. When properly designed, they contribute to the accountability and transparency of the overall municipal finance system and reduce the possibility of corruption and misappropriation of funds. Central to budget making is the role of municipal accounting. Three bases are used—cash accounting, accrual accounting and modified accrual accounting. Recently, most countries have moved to full accrual accounting or a version of it. This provides local decision-makers with the best information for making efficient and effective decisions in managing municipal budgets.

The impact of decentralization on corruption (defined as the abuse of public office for private gain or exercise of official powers against public interest) is an area of growing interest inviting much controversy and debate. While this debate has largely centered on the overall impact of decentralization, the focus of the current chapter is to examine various arguments in this debate in the specific case of decentralized provision of infrastructure—a yet largely unexplored area of research. This chapter takes an important first step in this direction by providing a synthesis of conceptual and empirical literature on this subject and highlighting the limits of our knowledge in this area especially the void in the area of empirical underpinnings of lessons in combating corruption.

This chapter evaluates the conditionality of development assistance in terms of its intended and unintended consequences. The chapter provides conceptual perspectives from the game theory, the public choice, the fiscal federalism, the political economy, the new institutional economics, and the new public management literature on the design of external assistance and its potential impacts. It shows how neglect of these conceptual considerations in the past resulted in the lack of effectiveness of aid conditionality and the waste of such assistance. It highlights the emerging consensus by the development assistance community on both the instruments of development finance and the associated conditions. It also briefly notes the progress, or lack thereof, for practice to conform to the emerging consensus. It cites examples where an inappropriate design of conditionality led to adverse consequences for project and program outcomes. Finally, the chapter provides lessons on major issues in the conditionality of development assistance.

This chapter argues that disappointing results in local government performance and accountability may be attributable to a lack of progress in citizen empowerment to hold governments accountable in between elections as a median voter lacks the information to evaluate government performance and hold it to account. This chapter highlights widely used mandatory and voluntary approaches to measure and monitor local government performance. It also develops a hybrid theory and practice approach on local government accountability and discusses implementation methods and processes of this approach. This is followed by highlighting real-world examples of better as well as not-so-good practices in local government performance accountability. A concluding section draws general lessons from these experiences.

This chapter presents a framework for evaluating the quality and timeliness of Public Expenditure Review (PER) as well as conducting a review of its impact. Public Expenditure Review (PER) is a widely used tool by the development assistance community to develop advice on budgetary institutions and allocations. This tool has also been used by both industrial and developing countries as an aid to public sector reforms. The chapter highlights specific elements to consider and to rate in such an analysis and how to develop final cost-efficiency and net benefit ratings.

This chapter provides a framework for the evaluation of anti-corruption programs. The impact of corruption on public service delivery performance and poverty alleviation is widely recognized. A wide consensus has also recently emerged that corruption is a symptom of failed governance and hence curtailing corruption requires addressing the causes of bad governance. Nevertheless, the menu of potential actions to curtail corruption is very large, so a framework is needed that guides ordering potential actions. Prioritization of various actions depends on both the conceptual and empirical views of what works and what does not work in the context of a specific situation. Such a framework is also needed for evaluating country anti-corruption programs and policies. The chapter concludes that path dependency is critical in determining the relative efficacy of various anti-corruption programs.

Since the recent emphasis on institutions for overall economic development of the countries, the research in this strand has expanded enormously. In this study, we want to see the impact of political institutions on economic development in pure cross-country setting. We take the Human Development Index (HDI) as a measure of economic development and use two alternative measures of dictatorship. We find that dictatorship is adversely affecting economic development in our sample of 92 countries. For instance, transition from extreme dictatorship to ideal democracy would increase HDI by 17 percent. Moreover, our results are robust to alternative specifications and the problems of endogeneity and reverse causation as is shown by the results of 2 Stages Least Squares (2SLS). JEL Classification: P16, H11, H41, H42 Keywords: Economic Development, Human Development Index, Dictatorship