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Contracting non-governmental organizations (NGOs) has been shown to increase health service delivery output considerably over relatively short time frames in low-income countries, especially when applying performance-related pay as a stimulus. A key concern is how to manage the transition back to government-operated systems while maintaining health service delivery output levels. In this paper we describe and analyse the transition from NGO-managed to government-managed health services over a 3-year period in a health district in Cambodia with a focus on the level of health service delivery. Data are derived from four sources, including cross-sectional surveys and health management and financial information systems. The transition was achieved by focusing on all the building blocks of the health care system and ensuring an acceptable financial remuneration for the staff members of contracted health facilities. The latter was attained through performance subsidies derived from financial commitment by the central government, and revenue from user fees. Performance management had a crucial role in the gradual handover of responsibilities. Not all responsibilities were handed back to government over the case study period—notably the development of performance indicators and targets and the performance monitoring.

The objective of the present work is to study the irradiation effects on third generation SiC fibers which fulfill the minimum requisites for nuclear applications, i.e. Hi-Nicalon type S, hereafter HNS, and Tyranno SA3, hereafter TSA3. With this purpose, these fibers have been ion-irradiated with 4 MeV Au ions at room temperature and increasing fluences. Irradiation effects have been characterized in terms of micro-Raman Spectroscopy and Transmission Electron Microscopy and compared to the response of the as-irradiated model material, i.e. 6H-SiC single crystals. It is reported that ion-irradiation induces amorphization in SiC fibers. Ion-amorphization kinetics between these fibers and 6H-SiC single crystals are similar despite their different microstructures and polytypes with a critical amorphization dose of ∼3 × 1014 cm−2 (∼0.6 dpa) at room temperature. Also, thermally annealing-induced cracking is studied via in situ Environmental Scanning Electron Microscopy. The temperatures at which the first cracks appear as well as the crack density growth rate increase with increasing heating rates. The activation energy of the cracking process yields 1.05 eV in agreement with recrystallization activation energies of ion-amorphized samples.