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In terms of operations, the recommendations call for the implementation of concrete actions to reduce instances of abuse, including not paying advances or introducing reasonable flat-rate per diem. That said, the authors contacted stated that few per diem reforms had been implemented as a result of the issued recommendations. Conclusion The results of the study clearly identify possible levers of action. Such levers could make up the groundwork for further reflection on context and country-specific reforms that are carried out using a dy