Tunisia's Fragile Democracy: Decentralization, Institution-Building and the Development of Marginalized Regions - Policy Briefs from the Region and Europe

Although Tunisia has made great strides over the past seven years, its democratization process remains fragile. Disillusionment with and distrust in the government, particularly high among the young, also manifest themselves in low voter turnout. Young voters were strikingly absent in the 2014 parliamentary elections, and in the first municipal elections in May 2018, only 33.7 percent of Tunisians cast their votes. To a great extent, this disillusionment stems from the various, persistent socio-economic problems which had led to the uprisings and the ouster of the former autocratic regime in 2011. Especially in Tunisia’s historically marginalized regions, these issues remain a key challenge

Waste Management Minimization Strategies in Hospitals

During the delivery of healthcare services, hospital employees use enormous amounts of water, energy, and nonbiodegradable carcinogenic plastics. In the U.S., hospital staff generate an average of over 7,000 tons of waste per day at an average cost of $0.28 per pound for the disposal of regulated medical trash, which if efficiently managed or reduced, could result in substantial cost savings. Using the organizational learning and the transaction cost economics theories as the conceptual frameworks, the purpose of this qualitative case study was to explore strategies healthcare leaders used to minimize their waste management operational costs. Data were collected using semistructured interviews with 4 managers at a healthcare system in the Midwestern United States and reviewing financial documents as well as the participants\u27 hospital website. Based on the thematic analysis, 4 primary themes emerged: (a) engaged leadership, (b) incorporate sustainability into the mission, vision, and values of the organization, (c) create an organizational culture of sustainability, and (d) innovation. Because society\u27s health is largely dependent on the environment around them, these findings could assist hospital leaders in the implementation of cost-effective waste management strategies and contribute to positive social change

Cancer in the Arab World

This is an Open Access book. This book is a must-have for healthcare providers and researchers, public health specialists and policy makers who are interested and involved in cancer care in the Arab world. The Arab world consists of 22 countries, which are members of the Arab League and spanning over 13,132,327 km2 with over 423,000,000 population. Over the past few decades, the Arab world has witnessed a swift evolution in healthcare provision. Nonetheless, Arab countries have considerable variability in economic capabilities, resource allocation, and intellectual talent that inevitably reflect on access to modern cancer care and prevention. This book is authored by experts from the Arab world who provide vital information on cancer statistics and risk factors, available clinical care pathways and infrastructure, and prevention programs in their individual countries. The chapters also address specific challenges in each country and insights into future directions to achieve optimal care with conventional and novel diagnostics and therapies to keep up with the era of precision medicine. Special topics of interest and unique to the Arab world are also discussed, such as out of the country’s medical tourism for cancer care and cancer care during war and conflict. Other special chapters include: Cancer research in the Arab world, Radiation therapy in Arab World and Pediatric Oncology in the Arab World Cancer in the Arab World is the first comprehensive book that addresses cancer care in depth in all Arab countries and it is endorsed by the prestigious Emirates Oncology Society

Cancer in the Arab World

This is an Open Access book. This book is a must-have for healthcare providers and researchers, public health specialists and policy makers who are interested and involved in cancer care in the Arab world. The Arab world consists of 22 countries, which are members of the Arab League and spanning over 13,132,327 km2 with over 423,000,000 population. Over the past few decades, the Arab world has witnessed a swift evolution in healthcare provision. Nonetheless, Arab countries have considerable variability in economic capabilities, resource allocation, and intellectual talent that inevitably reflect on access to modern cancer care and prevention. This book is authored by experts from the Arab world who provide vital information on cancer statistics and risk factors, available clinical care pathways and infrastructure, and prevention programs in their individual countries. The chapters also address specific challenges in each country and insights into future directions to achieve optimal care with conventional and novel diagnostics and therapies to keep up with the era of precision medicine. Special topics of interest and unique to the Arab world are also discussed, such as out of the country’s medical tourism for cancer care and cancer care during war and conflict. Other special chapters include: Cancer research in the Arab world, Radiation therapy in Arab World and Pediatric Oncology in the Arab World Cancer in the Arab World is the first comprehensive book that addresses cancer care in depth in all Arab countries and it is endorsed by the prestigious Emirates Oncology Society

Exploring waste tyre problems and sustainable waste management in the Tunisian context

Waste tyres represent one of the environmentally damaging fractions of the solid waste stream in Tunisia, where the problem of inefficient waste tyre management is endemic. This is easily identified by the piles of accumulating tyre waste located on both sides of many streets and in illegal places; therefore the efficient management of this category of solid waste is important given the large quantities being generated annually. The difficulties represented by waste tyres in waste management stem from the physical and chemical characteristics of the tyres. Significant environmental problems can also arise due to improper management and disposal of waste tyres. Few studies in the Global South and even Global North countries have been carried out to assess the challenges regarding waste tyre management and suggestions for the best alternative solutions for managing this waste stream. Nevertheless, Global North countries have made progress in waste tyres management needs by implementing more efficient innovative recovery and recycling methods, and restrictive regulations regarding the management of waste tyres. However, in many Global South countries, including Tunisia, the management of waste tyres has not received adequate interest, and the processing, treatment and disposal of the waste tyres are still nascent. In recent years, worldwide but especially in some EU countries, several measures and methods for managing waste tyres, including other principal alternatives for managing end-of-life tyres defined in the waste hierarchy, prevention, re-use, recovery and recycling, have been adopted and applied. These measures and methods are designed to minimize serious threats to both human life and the natural environment. This study attempts to establish the actions of stakeholders who have the responsibility for waste tyre management as an aspect of solid waste in Tunisia. This study also assesses and analyses important aspects of waste tyres management in Tunisia. A combination of two methods is employed in the present investigation: qualitative and quantitative, to determine the factors influencing the effective performance of tyre waste management practice in Tunisia. Data for the present research study was gained using relevant published literature, scientific journals, academic sources, other third sector sources such as government statistical data, and research derived from governments and other agencies and field observations. In addition to the semi-structured interviews with stakeholders involved in waste management, other interviews with actors including governmental, private, academic institutions and NGOs were carried out.The outcomes of this investigation and assessment are a wide-range outline concerning the participants that are important in tyre waste management, and a set of aspects affecting the management of waste tyres. The information provided by this study is very critical for reviewing and updating the methods and tools to update waste tyres data and trends to improve tyre waste management system efficiency and suggesting management options of recovering and recycling this waste stream that are most sustainable and beneficial to the environment from a life cycle assessment (LCA) perspective, for the Tunisian context. With relation to current Tunisia waste tyre management systems, they have to be improved by introducing specific legislation, with sustainable finance, on the disposal of waste tyres and forming schemes to oversee and manage the country's waste tyre activities. The research has enabled the researcher to produce a set of recommendations to improve the management of waste tyres in a sustainable manner in Tunisia

Modelo de apoio à decisão, para avaliação da logística reversa e gestão de resíduos do serviço de saúde em hospitais

Os hospitais estão entre os principais geradores de resíduos infecciosos e não infecciosos, isto é, os Resíduos do Serviço de Saúde (RSS). A gestão dos RSS é um desafio para a administração hospitalar, visto que são resíduos de grande risco à saúde humana e ao meio ambiente. Neste contexto, surge a necessidade da criação de ferramentas que auxiliem os estabelecimentos a avaliarem a Gestão dos Resíduos do Serviço de Saúde (GRSS). De fato, algumas propostas de avaliação já foram realizadas no meio acadêmico, no entanto, nenhuma abrangeu as áreas operacional, humana, econômica e ambiental em uma única investigação. Sendo assim, este trabalho tem como objetivo, elaborar uma ferramenta de apoio que auxilie na identificação de melhorias a serem realizadas na GRSS dos hospitais. Para isto, foi elaborado o Índice de Gestão Hospitalar de Resíduos do Serviço de Saúde (IGeReS), que foi desenvolvido a partir da elaboração de indicadores desta área. Estes indicadores foram organizados em três dimensões: Operacional, Recursos Humanos e Gestão Ambiental / Econômica. Para a atribuição do grau de importância aos indicadores foi utilizado um método de análise multicritério. O índice foi aplicado em hospitais de três regiões de Minas Gerais: Sul de Minas, Região Metropolitana de Belo Horizonte e Vale do Jequitinhonha. Sua aplicação mostrou ser muito satisfatória, pois foi possível quantificar a realidade de cada hospital investigado, facilitando o entendimento do quão eficiente pode ser a GRSS dos estabelecimentos. De maneira geral, observou-se que mesmo que grande parte das avaliações tenham sido consideradas satisfatórias, os resultados apontam que os hospitais sentem maiores dificuldades em capacitar corretamente os seus funcionários, no sentido de conscientiza-los da importância da GRSS, e também em incentivar práticas mais sustentáveis, principalmente com relação a não geração de RSS. Isso posto, visto que a ferramenta de avaliação da GRSS elaborada neste trabalho foi efetiva em apontar a situação dos hospitais, verifica-se que a aplicação do IGeReS pode ser estendida a qualquer hospital brasileiro. Com isso, seria possível analisar se as dificuldades encontradas pelos hospitais investigados são as mesmas de outros estabelecimentos de saúde do Brasil

Wastewater use in irrigated agriculture : confronting the livelihood and environmental realities

Co-published with CAB International and the International Water Management Institut

The policies for poverty reduction strategies in Iraq (2005-2014): factors and challenges

This study examines factors and challenges behind the failure of Iraqi government’s poverty reduction strategies in the aftermath of US military occupation from 2005 to 2014. Therefore, the purpose of this study is to explain why, how and to what extent political, economic and security challenges affected the achievement of the goals of those strategies. To fullfil the objectives of this study, the qualitative approach was adopted. The Integrative theory was the main reference of analysis framework for this study. The study also employed elite interviews as one of the primary data sources. The interviewees were divided into three main groups. The first group of interviewees included members of parliamentary committees for economy, integrity, security and defence. Meanwhile, the second group consisted of the former Minister of Planning and three general managers in the same Ministry; whereas the third group comprised of professors from the Faculty of Political Science of University of Baghdad and University of Mustansiriya. Primary data were also obtained from various government and parliamentary reports, as well as legislative and policy instruments. Meanwhile, secondary data were mostly sourced from academic writings, such as books, and journal articles. The findings of the study show that rampant corruption in public administration and state financial management, as well as security threat and instability, have severely affected the effectiveness of poverty reduction strategies in Iraq. The country has been haunted by political corruption and security collapse that accompanied the country’s political process after the US invasion (2005-2014). There has also been a weakening of Iraqi judiciary body in terms of law enforcement against corrupters and criminals. In addition, the political and economic challenges that are currently confronted by the Iraqi governments have been arguably attributed by the wrong decisions taken by the US government. The study recommends that there is an urgent need to address the problem of corruption that is presently grasping Iraqi economy, along with the adoption of appropriate security strategies for ensuring not only the country’s stability and prosperity, but also attaining national reconciliation