5,989 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 Womenâs Hospital.
Methods: This was an exploratory, qualitative, single, case study conducted at Mulago Womenâs 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
Recommended from our members
Ensuring Access to Safe and Nutritious Food for All Through the Transformation of Food Systems
Recommended from our members
Home and School Literacy Practices of Children in a Rural Village in India: An Ethnography
The Indian state is responsible for providing free and compulsory education to all its 6-14-year-old children. A significant majority of these children attend state schools and belong to some of the most socio-economically disadvantaged sections of the country. Researchers who document teaching in these schools continue to provide accounts of teacher-led instruction. Both international and Indian assessments of literacy also evidence dismal levels of learning among children.
Unlike previous studies from India which have focused on teachers and teaching, this study broadens its focus to include children and learning. It does this by exploring the range of literacy practices that children engage with at home and school, and by taking into consideration the beliefs of caregivers and teachers shaping these practices. Theoretically rooted in a sociocultural theory, it shines a light on how childrenâs literacy practices are cultural and personal and, consequently, uncovers the relationship between home and school practices.
Ethnography provides the methodological framework for the study. The five participant children live in a resource-poor, agrarian village and attend the state school within the village. The literacy practices of two are discussed in detail in this current study. Participant observation of childrenâs practices in naturalistic settings, that is, their homes and school, and conversations with them lie at the heart of the fieldwork. Interviews with caregivers and teachers were also undertaken. Data were recorded with audio and video devices, in the form of fieldnotes, and childrenâs texts were captured through photographs. Consequently, it is the first known research to endeavour a qualitative exploration of childrenâs home literacy practices in India and to do so within a rural community.
This study makes significant contributions to theory. This has been possible because of the depth of its fieldwork and the theories it has chosen to draw on for analysis. The cultural nature of childrenâs practices has been highlighted using Geeâs (2002, 2012, 2014) conceptualisation of Discourse and identity and their personal nature has been examined using Hedges and her colleagues (Hedges et al., 2011; Hedges & Cooper, 2016) theorisation of interests. As a result, this study has been successful in highlighting the personal nature of childrenâs literacy practices. It also provides evidence of the potential of both theories to illuminate the nature of childrenâs literacy practices
The Future of Work and Digital Skills
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
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
Recommended from our members
After Creation: Intergovernmental Organizations and Member State Governments as Co-Participants in an Authority Relationship
This is a re-amalgamation of what started as one manuscript and became two when the length proved to be more than any publisher wanted to consider. The splitting consisted of removing what are now Parts 3, 4, and 5 so that the manuscript focused on the outcome-related shared beliefs holding an authority relationship together. Those parts were last worked on in 2018. The rest were last worked on in late 2021 but also remain incomplete.
The relational approach adopted in this study treats intergovernmental organizations and the governments of member states as co-participants in an authority relationship with the governments of their member states. Authority relationships link two types of actor, defined by their authority-holder or addressee role in the relationship, through a set of shared beliefs about why the relationship exists and how the participants should fulfill their respective roles. The IGO as authority holder has a role that includes a right to instruct other actors about what they should or should not do; the governments of member states as addressees are expected to comply with the instructions. Three sets of shared beliefs provide the conceptual âglueâ holding the relationship together. The first defines the goal of the collective effort, providing both the rationale for having the authority relationship and providing a lode star for assessments of the collective effortâs success or lack of success. The second set defines the shared understanding about allocation of roles and the process of interaction by establishing shared expectations about a) the selection process by which particular actors acquire authority holder roles, b) the definitions identifying one or more categories of addressees expected to follow instructions, and c) the procedures through which the authority holder issues instructions. The third set focus on the outcomes of cooperation through the relationship by defining a) the substantive areas in which the authority holder may issue instructions, b) the bases for assessing the relevance actions mandated in instructions for reaching the goal, and c) the relative efficacy of action paths chosen for reaching the goal as compared to other possible action paths.
Using an authority relationship framework for analyzing cooperation through IGOs highlights the inherently bi-directional nature of IGO-member government activity by viewing their interaction as involving a three-step process in which the IGO as authority holder decides when to issue what instruction, the member state governments as followers react to the instruction with anything from prompt and full compliance through various forms of pushback to outright rejection, and the IGO as authority holder responds to how the followers react with efforts to increase individual compliance with instructions and reinforce continuing acceptance of the authority relationship. Foregrounding the dynamics produced by the interaction of these two streams of perception and action reveals more clearly how far intergovernmental organizations acquire capacity to operate as independent actors, the dynamic ways they maintain that capacity, and how much they influence member governmentsâ beliefs and actions at different times. The approach fosters better understanding of why, when, and for how long governments choose cooperation through an IGO even in periods of rising unilateralism
Power struggles: An exploration of the contribution of renewable energy to sustainable development, decent work and the âjust transitionâ through a case study of wind farm development outside Loeriesfontein, Northern Cape Province (2011-2020)
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, âdecent workâ and the âjust transitionâ 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 Africaâs energy mix within an analysis of the Minerals-Energy-Complex (MEC) and the
continued influence of this complex in South Africaâs 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 programmeâs potential for community
development and job creation in the âhostâ 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 âdecent workâ: 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 REIPPPPâs 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 âbillike oorgangâ na Ć laekoolstof-ekonomie in Suid-Afrika deur middel van Ć
gevallestudie van die ontwikkeling van twee gekoppelde windplase buite Loeriesfontein, Ć
klein dorpie in die Noord-Kaapse Karoo. Die tesis neem in oenskou hoe die âbillike oorgangâ
in Loeriesfontein en die groter Hantam Plaaslike Munisipaliteit verwerklik kan word, en steun
in hierdie oorweging op Ć 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 Ć 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 âbillike oorgangâ, 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 âgasheerâ-gemeenskappe binne Ć 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 ân 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 Ć 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 âbehoorlike werkâ voldoen, maar nie
aan almal nie â 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 âbillike
oorgangâ na Ć 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
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
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
- âŠ