4,608 research outputs found
A Multi-level Analysis on Implementation of Low-Cost IVF in Sub-Saharan Africa: A Case Study of Uganda.
Introduction: Globally, infertility is a major reproductive disease that affects an estimated 186 million people worldwide. In Sub-Saharan Africa, the burden of infertility is considerably high, affecting one in every four couples of reproductive age. Furthermore, infertility in this context has severe psychosocial, emotional, economic and health consequences. Absence of affordable fertility services in Sub-Saharan Africa has been justified by overpopulation and limited resources, resulting in inequitable access to infertility treatment compared to developed countries. Therefore, low-cost IVF (LCIVF) initiatives have been developed to simplify IVF-related treatment, reduce costs, and improve access to treatment for individuals in low-resource contexts. However, there is a gap between the development of LCIVF initiatives and their implementation in Sub-Saharan Africa. Uganda is the first country in East and Central Africa to undergo implementation of LCIVF initiatives within its public health system at Mulago Women’s Hospital.
Methods: This was an exploratory, qualitative, single, case study conducted at Mulago Women’s Hospital in Kampala, Uganda. The objective of this study was to explore how LCIVF initiatives have been implemented within the public health system of Uganda at the macro-, meso- and micro-level. Primary qualitative data was collected using semi-structured interviews, hospital observations informal conversations, and document review. Using purposive and snowball sampling, a total of twenty-three key informants were interviewed including government officials, clinicians (doctors, nurses, technicians), hospital management, implementers, patient advocacy representatives, private sector practitioners, international organizational representatives, educational institution, and professional medical associations. Sources of secondary data included government and non-government reports, hospital records, organizational briefs, and press outputs. Using a multi-level data analysis approach, this study undertook a hybrid inductive/deductive thematic analysis, with the deductive analysis guided by the Consolidated Framework for Implementation Research (CFIR).
Findings: Factors facilitating implementation included international recognition of infertility as a reproductive disease, strong political advocacy and oversight, patient needs & advocacy, government funding, inter-organizational collaboration, tension to change, competition in the private sector, intervention adaptability & trialability, relative priority, motivation &advocacy of fertility providers and specialist training. While barriers included scarcity of embryologists, intervention complexity, insufficient knowledge, evidence strength & quality of intervention, inadequate leadership engagement & hospital autonomy, poor public knowledge, limited engagement with traditional, cultural, and religious leaders, lack of salary incentives and concerns of revenue loss associated with low-cost options.
Research contributions: This study contributes to knowledge of factors salient to implementation of LCIVF initiatives in a Sub-Saharan context. Effective implementation of these initiatives requires (1) sustained political support and favourable policy & legislation, (2) public sensitization and engagement of traditional, cultural, and religious leaders (3) strengthening local innovation and capacity building of fertility health workers, in particular embryologists (4) sustained implementor leadership engagement and inter-organizational collaboration and (5) proven clinical evidence and utilization of LCIVF initiatives in innovator countries. It also adds to the literature on the applicability of the CFIR framework in explaining factors that influence successful implementation in developing countries and offer opportunities for comparisons across studies
An empirical investigation of the relationship between integration, dynamic capabilities and performance in supply chains
This research aimed to develop an empirical understanding of the relationships between integration,
dynamic capabilities and performance in the supply chain domain, based on which, two conceptual
frameworks were constructed to advance the field. The core motivation for the research was that, at
the stage of writing the thesis, the combined relationship between the three concepts had not yet
been examined, although their interrelationships have been studied individually.
To achieve this aim, deductive and inductive reasoning logics were utilised to guide the qualitative
study, which was undertaken via multiple case studies to investigate lines of enquiry that would
address the research questions formulated. This is consistent with the author’s philosophical
adoption of the ontology of relativism and the epistemology of constructionism, which was considered
appropriate to address the research questions. Empirical data and evidence were collected, and
various triangulation techniques were employed to ensure their credibility. Some key features of
grounded theory coding techniques were drawn upon for data coding and analysis, generating two
levels of findings. These revealed that whilst integration and dynamic capabilities were crucial in
improving performance, the performance also informed the former. This reflects a cyclical and
iterative approach rather than one purely based on linearity. Adopting a holistic approach towards
the relationship was key in producing complementary strategies that can deliver sustainable supply
chain performance.
The research makes theoretical, methodological and practical contributions to the field of supply
chain management. The theoretical contribution includes the development of two emerging
conceptual frameworks at the micro and macro levels. The former provides greater specificity, as it
allows meta-analytic evaluation of the three concepts and their dimensions, providing a detailed
insight into their correlations. The latter gives a holistic view of their relationships and how they are
connected, reflecting a middle-range theory that bridges theory and practice. The methodological
contribution lies in presenting models that address gaps associated with the inconsistent use of
terminologies in philosophical assumptions, and lack of rigor in deploying case study research
methods. In terms of its practical contribution, this research offers insights that practitioners could
adopt to enhance their performance. They can do so without necessarily having to forgo certain
desired outcomes using targeted integrative strategies and drawing on their dynamic capabilities
Corporate Social Responsibility: the institutionalization of ESG
Understanding the impact of Corporate Social Responsibility (CSR) on firm performance as it relates to industries reliant on technological innovation is a complex and perpetually evolving challenge. To thoroughly investigate this topic, this dissertation will adopt an economics-based structure to address three primary hypotheses. This structure allows for each hypothesis to essentially be a standalone empirical paper, unified by an overall analysis of the nature of impact that ESG has on firm performance. The first hypothesis explores the evolution of CSR to the modern quantified iteration of ESG has led to the institutionalization and standardization of the CSR concept. The second hypothesis fills gaps in existing literature testing the relationship between firm performance and ESG by finding that the relationship is significantly positive in long-term, strategic metrics (ROA and ROIC) and that there is no correlation in short-term metrics (ROE and ROS). Finally, the third hypothesis states that if a firm has a long-term strategic ESG plan, as proxied by the publication of CSR reports, then it is more resilience to damage from controversies. This is supported by the finding that pro-ESG firms consistently fared better than their counterparts in both financial and ESG performance, even in the event of a controversy. However, firms with consistent reporting are also held to a higher standard than their nonreporting peers, suggesting a higher risk and higher reward dynamic. These findings support the theory of good management, in that long-term strategic planning is both immediately economically beneficial and serves as a means of risk management and social impact mitigation. Overall, this contributes to the literature by fillings gaps in the nature of impact that ESG has on firm performance, particularly from a management perspective
Towards Legislation Responsive to Integrated Watershed Management Approaches and Land Tenure
Land tenure affects integrated watershed management approaches in various ways, such as influencing land use and investment in sustainability practices and decisions. However, some land tenure and integrated watershed management relations need more examination, including how the prevailing relevant legislation responds and the needed course of action. In this paper, we provide relevant evidence to support a shift to responsive actions and legislation through (a) examining land tenure scenarios affecting integrated watershed management, including the public–private land tenure co-existence from a watershed perspective; (b) the responsiveness of the prevailing relevant legislation to integrated watershed management and the land tenure scenarios and (c) identifying legislative remedies recommendable for responsiveness. We use qualitative methods to review secondary data sources, including four legislations, and complement them with field survey data. Field experiences are from three sub-catchments in the Lake Victoria basin, each representing a different land tenure system, as case studies. Land tenure links with integrated watershed management in various ways, such as influencing land use decisions. However, underscoring the relationship from the private and public land tenure perspective also indicates a complex and tense spatial relationship. As such, it likely limits adopting sustainable land use and management practices in watersheds as a case. Regardless, the perceptions from the study area indicate the land tenure systems and forms enabling sustainable choices and decisions, despite limitations such as tenure insecurity. The disconnect between integrated watershed management aspirations of ensuring sustainability, the land tenure abilities and the subsequent human practices is mainly institutional, with the relevant legislation indicating a low to moderate level of responsiveness to integrated watershed management approaches and land tenure, thus, abating effectiveness. Therefore, we suggest a shift towards responsive programming and legislation and the adoption of model legislation to support responsiveness replication. We also recommend further studies to assess the legal gaps and feasibility thereof
COVID-19 Outbreak and Beyond
The COVID-19 pandemic drastically changed our lifestyle when, on 30 January 2020, the World Health Organization declared the coronavirus disease outbreak a public health emergency of international concern. Since then, many governments have introduced unprecedented containment measures, hoping to slow the spread of the virus. International research suggests that both the pandemic and the related protective measures, such as lockdown, curfews, and social distancing, are having a profound impact on the mental health of the population. Among the most commonly observed psychological effects, there are high levels of stress, anxiety, depression, and post-traumatic symptoms, along with boredom and frustration. At the same time, the behavioral response of the population is of paramount importance to successfully contain the outbreak, creating a vicious circle in which the psychological distress impacts the willingness to comply with the protective measures, which, in turn, if prolonged, could exacerbate the population’s distress. This book includes: i) original studies on the worldwide psychological and behavioral impact of COVID-19 on targeted individuals (e.g., parents, social workers, patients affected by physical and mental disorders); ii) studies exploring the effect of COVID-19 using advanced statistical and methodological techniques (e.g., machine learning technologies); iii) research on practical applications that could help identify persons at risk, mitigate the negative effects of this situation, and offer insights to policymakers to manage the pandemic are also highly welcomed
Perspectives on Public Policy in Societal-Environmental Crises
This is an open access book. Histories we tell never emerge in a vacuum, and history as an academic discipline that studies the past is highly sensitive to the concerns of the present and the heated debates that can divide entire societies. But does the study of the past also have something to teach us about the future? Can history help us in coping with the planetary crisis we are now facing? By analyzing historical societies as complex adaptive systems, we contribute to contemporary thinking about societal-environmental interactions in policy and planning and consider how environmental and climatic changes, whether sudden high impact events or more subtle gradual changes, impacted human responses in the past. We ask how societal perceptions of such changes affect behavioral patterns and explanatory rationalities in premodernity, and whether a better historical understanding of these relationships can inform our response to contemporary problems of similar nature and magnitude, such as adapting to climate change
Resource Recovery from Water
Throughout history, the first and foremost role of urban water management has been the protection of human health and the local aquatic environment. To this end, the practice of (waste-)water treatment has maintained a central focus on the removal of pollutants through dissipative pathways. Approaches like – in the case of wastewater treatment – the activated sludge process, which makes ‘hazardous things’ disappear, have benefitted our society tremendously by safeguarding human and environmental health. While conventional (waste-)water treatment is regarded as one of the greatest engineering achievements of the 20th century, these dissipative approaches will not suffice in the 21st century as we enter the era of the circular economy. A key challenge for the future of urban water management is the need to re-envision the role of water infrastructure, still holding paramount the safeguard of human and environmental health while also becoming a more proactive force for sustainable development through the recovery of resources embedded in urban water.
This book aims (i) to explain the basic principles governing resource recovery from water (how much is there, really); (ii) to provide a comprehensive overview and critical assessment of the established and emerging technologies for resource recovery from water; and (iii) to put resource recovery from water in a legal, economic (including the economy of scale of recovered products), social (consumer's point of view), and environmental sustainability framework.
This book serves as a powerful teaching tool at the graduate entry master level with an aim to help develop the next generation of engineers and experts and is also highly relevant for seasoned water professionals and practicing engineers
New Research and Trends in Higher Education
This book aims to discuss new research and trends on all dimensions of Higher Education, as there is a growing interest in the field of Higher Education, regarding new methodologies, contexts, and technologies. It includes investigations of diverse issues that affect the learning processes in Higher Education: innovations in learning, new pedagogical methods, and new learning contexts.In this sense, original research contributions of research papers, case studies and demonstrations that present original scientific results, methodological aspects, concepts and educational technologies, on the following topics:a) Technological Developments in Higher Education: mobile technology, virtual environments, augmented reality, automation and robotics, and other tools for universal learning, focusing on issues that are not addressed by existing research;b) Digital Higher Education: mobile learning, eLearning, Game-based Learning, social media in education, new learning models and technologies and wearable technologies for education;c) Case Studies in Higher Education: empirical studies in higher education regarding digital technologies, new methodologies, new evaluation techniques and tools, perceptions of learning processes efficiency and digital learning best practice
Convergence of Intelligent Data Acquisition and Advanced Computing Systems
This book is a collection of published articles from the Sensors Special Issue on "Convergence of Intelligent Data Acquisition and Advanced Computing Systems". It includes extended versions of the conference contributions from the 10th IEEE International Conference on Intelligent Data Acquisition and Advanced Computing Systems: Technology and Applications (IDAACS’2019), Metz, France, as well as external contributions
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