5,989 research outputs found

    A Multi-level Analysis on Implementation of Low-Cost IVF in Sub-Saharan Africa: A Case Study of Uganda.

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    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

    The Future of Work and Digital Skills

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    The theme for the events was "The Future of Work and Digital Skills". The 4IR caused a hollowing out of middle-income jobs (Frey & Osborne, 2017) but COVID-19 exposed the digital gap as survival depended mainly on digital infrastructure and connectivity. Almost overnight, organizations that had not invested in a digital strategy suddenly realized the need for such a strategy and the associated digital skills. The effects have been profound for those who struggled to adapt, while those who stepped up have reaped quite the reward.Therefore, there are no longer certainties about what the world will look like in a few years from now. However, there are certain ways to anticipate the changes that are occurring and plan on how to continually adapt to an increasingly changing world. Certain jobs will soon be lost and will not come back; other new jobs will however be created. Using data science and other predictive sciences, it is possible to anticipate, to the extent possible, the rate at which certain jobs will be replaced and new jobs created in different industries. Accordingly, the collocated events sought to bring together government, international organizations, academia, industry, organized labour and civil society to deliberate on how these changes are occurring in South Africa, how fast they are occurring and what needs to change in order to prepare society for the changes.Deutsche Gesellschaft fĂŒr Internationale Zusammenarbeit (GIZ) British High Commission (BHC)School of Computin

    Management controls, government regulations, customer involvement: Evidence from a Chinese family-owned business

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    This research reports on a case study of a family-owned elevator manufacturing company in China, where management control was sandwiched between the state policies and global customer production requirements. By analysing the role of government and customer, this thesis aimed to illustrate how management control operated in a family-owned business and to see how and why they do management control differently. In particular, it focused on how international production standards and existing Chinese industry policies translated into a set of the management control practices through a local network within the family-owned business I studied. Based on an ethnographic approach to research, I spent six months in the field, conducted over 30 interviews, several conservations, and reviewed relevant internal documents to understand how management control (MC) techniques with humans cooperated in the company. I also understood how two layers of pressure have shaped company behaviour, and how a company located in a developing country is connecting with global network. I also found there is considerable tension among key actors and investigated how the company responded and managed it. Drawing on Actor Network Theory (ANT), I analysed the interviews from key actors, examined the role of government regulations and customer requirements to see how management control being managed under two layers of pressure, i.e., the government regulations (e.g., labour, tax, environment control) and customer requirement (e.g., quality and production control). Management controls were an obligatory passage point (OPP), and transformation of those elements of Western production requirements and government requirements arrived at the Chinese local factory and influenced management control and budgeting. The findings suggest that management control systems are not only a set of technical procedures, but it is also about managing tensions. This understanding shows a linear perspective on MC practices rather than a social perspective. However, when we use ANT as a theoretical perspective, we see those actors who, being obliged and sandwiched, and controlled by external forces for them to follow. Consequently, human actors must work in an unavoidable OPP. This is the tension they face which constructed mundane practices of MC. Hence, MCs are managing such tensions. This study contributes to management control research by analysing management controls in terms of OPP, extends our understanding by illustrating the role of the government and customers, and our understanding of family-owned business from a management controls perspective in a developing country

    Power struggles: An exploration of the contribution of renewable energy to sustainable development, decent work and the “just transition” through a case study of wind farm development outside Loeriesfontein, Northern Cape Province (2011-2020)

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    Thesis (PhD)--Stellenbosch University, 2022.ENGLISH ABSTRACT: Through a case study of the development of two linked wind farms outside Loeriesfontein, a small town in the Northern Cape Karoo, this dissertation explores the contribution of renewable energy to sustainable development, “decent work” and the “just transition” to a lowcarbon economy in South Africa. In considering how the just transition can be realised in Loeriesfontein and the wider Hantam Local Municipality, this dissertation draws on an understanding of sustainable development that rests on three non-negotiable moral imperatives: satisfying human needs, enhancing social equity and respecting environmental limits. It also locates the political struggles around the introduction of renewable energy into South Africa’s energy mix within an analysis of the Minerals-Energy-Complex (MEC) and the continued influence of this complex in South Africa’s political economy after the democratic transition of 1994. This dissertation thus broadens the focus on the plight of workers and their communities in the coal sector in current debates on the just transition, to include communities in the Northern Cape. This province is currently home to over half the projects in the Renewable Energy Independent Power Producer Procurement Programme (REIPPPP). Since the introduction of the REIPPPP in 2011, studies have highlighted the programme’s potential for community development and job creation in the “host” communities located within a 50km radius from where renewable energy projects are constructed. However, there has been little research on actual developments within these sites and, as a result, the voices of the marginalised people living in these communities have been missing in the debates. My study utilised a case-study research design involving semi-structured in-depth interviews with key informants and former workers employed during the construction of the two wind farms, along with policy and documentary analysis, observation and primary data from a household survey. Main findings were the following. Firstly, the jobs created during the construction of the wind farms satisfied some but not all of the criteria of “decent work”: while wages and work conditions were generally better than those offered by other local employers, training opportunities were neglected. Furthermore, very few local workers could be absorbed into the workforce once the wind farms began operating. Company claims around the number of (short-term) jobs created were also misleading. Secondly, the community development projects initiated in terms of the REIPPPP’s local economic development scorecard were introduced in a piecemeal, top-down fashion and mired in local patronage politics. While targeting certain community needs, they fell short of advancing holistic sustainable development. The Community Trust established as part of the ownership structure of the two wind farms may have potential in alleviating household poverty once it becomes operational, but that will require strong, democratic management and ensuring that impoverished households in the municipality are targeted as beneficiaries. This dissertation confirms the importance of harnessing the investment in renewable energy towards sustainable development in host communities and broadening the understanding of what the just transition to a low-carbon economy entails in South Africa. It concludes with certain policy and research recommendations in this regard.AFRIKAANSE OPSOMMING: Hierdie tesis verken die bydrae van hernubare energie tot volhoubare ontwikkeling, behoorlike werk en die ‘billike oorgang’ na Ɖ laekoolstof-ekonomie in Suid-Afrika deur middel van Ɖ gevallestudie van die ontwikkeling van twee gekoppelde windplase buite Loeriesfontein, Ɖ klein dorpie in die Noord-Kaapse Karoo. Die tesis neem in oenskou hoe die ‘billike oorgang’ in Loeriesfontein en die groter Hantam Plaaslike Munisipaliteit verwerklik kan word, en steun in hierdie oorweging op Ɖ begrip van volhoubare ontwikkeling wat op drie ononderhandelbare morele noodsaaklikhede berus: voldoen aan menslike behoeftes, versterk maatskaplike billikheid en respekteer omgewingsperke. Dit plaas ook die politieke stryd oor die toevoeging van hernubare energie tot Suid-Afrika se energiemengsel binne Ɖ ontleding van die mineraleenergie- kompleks (MEK) en die voortgesette invloed van hierdie kompleks op Suid-Afrika se politieke ekonomie na die demokratiese oorgang in 1994. Hierdie tesis verbreed dus die fokus op die posisie van werkers en hulle gemeenskappe in die steenkoolsektor, binne die huidige debat oor ‘billike oorgang’, om gemeenskappe in die Noord-Kaap in te sluit. Hierdie provinsie huisves tans meer as die helfte van die projekte in die program vir die verkryging van onafhanklike kragprodusente vir hernubare energie (Renewable Energy Independent Power Producer Procurement Programme, of REIPPPP). Sedert die bekendstelling van die REIPPPP in 2011, het studies die program se potensiaal vir gemeenskapsontwikkeling en werkskepping in die “gasheer”-gemeenskappe binne Ɖ omtrek van 50 km van waar hernubare-energieprojekte gebou word, uitgelig. Daar is egter nog min navorsing oor werklike ontwikkelings binne hierdie terreine gedoen en dus word die stemme van die gemarginaliseerde mense in hierdie gemeenskappe nie in die debat gehoor nie. My studie het ‘n gevallestudie- navorsingsontwerp gebruik, wat semigestruktureerde, diepgaande onderhoude met hoofinformante en voormalige werkers, wat tydens die konstruksie van die twee windplase in diens was, tesame met beleids- en dokumentere ontleding, waarneming en primere data uit Ɖ huishoudelike opname, behels. Die hoofbevindings was die volgende: Eerstens het die werk wat tydens die konstruksie van die windplase geskep is, aan sommige van die kriteria van ‘behoorlike werk’ voldoen, maar nie aan almal nie – hoewel lone en werkstoestande oor die algemeen beter was as enigiets wat deur ander plaaslike werkgewers aangebied is, het opleidingsgeleenthede agterwee gebly. Voorts kon baie min van die plaaslike werkers in die werksmag opgeneem word nadat die windplase in werking gestel is. Die maatskappy se bewerings oor die aantal (korttermyn-) werke wat geskep is, is ook misleidend. Tweedens is die gemeenskapsontwikkelingsprojekte wat ingevolge die REIPPPP se telkaart vir plaaslike ekonomiese ontwikkeling begin is, stuksgewys, hierargies ingestel en was dit vasgevang in plaaslike patronaatskapspolitiek. Hoewel sekere gemeenskapsbehoeftes geteiken is, het die projekte nie daarin geslaag om holistiese volhoubare ontwikkeling te bevorder nie. Die gemeenskapstrust, wat as deel van die eienaarstruktuur van die twee windplase gestig is, het dalk die potensiaal om huishoudelike armoede te verlig wanneer dit in werking tree, maar dit sal sterk demokratiese bestuur vereis en daar sal seker gemaak moet word dat verarmde huishoudings in die munisipaliteit as begunstigdes geteiken word. Hierdie tesis bevestig hoe belangrik dit is om die belegging in hernubare energie ten bate van volhoubare ontwikkeling in gasheer-gemeenskappe in te span en die begrip van wat die ‘billike oorgang’ na Ɖ laekoolstof-ekonomie in Suid-Afrika behels, te verbreed. Dit sluit af met sekere beleids- en navorsingsaanbevelings in hierdie verband.Doctora

    Studies of strategic performance management for classical organizations theory & practice

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    Nowadays, the activities of "Performance Management" have spread very broadly in actually every part of business and management. There are numerous practitioners and researchers from very different disciplines, who are involved in exploring the different contents of performance management. In this thesis, some relevant historic developments in performance management are first reviewed. This includes various theories and frameworks of performance management. Then several management science techniques are developed for assessing performance management, including new methods in Data Envelopment Analysis (DEA) and Soft System Methodology (SSM). A theoretical framework for performance management and its practical procedures (five phases) are developed for "classic" organizations using soft system thinking, and the relationship with the existing theories are explored. Eventually these results are applied in three case studies to verify our theoretical development. One of the main contributions of this work is to point out, and to systematically explore the basic idea that the effective forms and structures of performance management for an organization are likely to depend greatly on the organizational configuration, in order to coordinate well with other management activities in the organization, which has seemingly been neglected in the existing literature of performance management research in the sense that there exists little known research that associated particular forms of performance management with the explicit assumptions of organizational configuration. By applying SSM, this thesis logically derives some main functional blocks of performance management in 'classic' organizations and clarifies the relationships between performance management and other management activities. Furthermore, it develops some new tools and procedures, which can hierarchically decompose organizational strategies and produce a practical model of specific implementation steps for "classic" organizations. Our approach integrates popular types of performance management models. Last but not least, this thesis presents findings from three major cases, which are quite different organizations in terms of management styles, ownership, and operating environment, to illustrate the fliexbility of the developed theoretical framework

    Towards the development of care management in community care for elderly people in Korea

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    This study is concerned with the feasibility of several forms of care management in the development of community care for elderly people in Korea. Chapter one introduces the background of community care in Korea in the light of demographic, socio-economic, and political realities. This chapter reviews the changing Korean society as a barometer to understand the scope, size, and speed of social needs, especially community care for elderly people, over the last few decades. Chapter two explores various definitions, concepts, and theories of community, community care, and care management by building upon trends previously established in the research. This helps to identify the different models of care management and the pre-conditions necessary for the application of different models in Korea. Chapter three explores what factors have affected the development of community care, and what community dare has achieved for elderly people in the UK. Especially, care management in community care for elderly people in the UK is examined in detail. Chapter four details the findings of field research on community care for elderly people in Korea. This covers the needs of elderly people and their carers, and the social worker's tasks and available resources. The potential for the use of care management based on the findings of field research is assessed. Chapter five investigates whether the UK models of care management are suitable for Korean society, which interventions are useful for developing care management, and the strategies, and principles involved
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