Using primary health care (PHC) workers and key informants for community based detection of blindness in children in Southern Malawi.

BACKGROUND: There is great interest in providing primary eye care (PEC) through integration into primary health care (PHC). However, there is little evidence of the productivity of PHC workers in offering primary eye care after training and integration, and there is need to compare their effectiveness to alternative methods. The current study compared the effectiveness of trained Health Surveillance Assistants (HSAs) versus trained volunteer Key Informants (KIs) in identifying blind children in southern Malawi. METHODS: A cluster community based study was conducted in Mulanje district, population 435 753. Six clusters each with a population of approximately 70 000 to 80 000, 42% of whom were children were identified and randomly allocated to either HSA or KI training. From each cluster 20 HSAs or 20 KIs were selected for training. Training emphasized the causes of blindness in children and their management, and how to identify and list children suspected of being blind. HSAs and KIs used multiple methods (door to door, school screening, health education talks, village announcements, etc.) to identify children. Using the World Health Organization (WHO) estimates (eight blind children per 10 000 children); approximately 144 to 162 blind children were expected in the chosen clusters. Listed children were brought to a centre within the community where they were examined by an ophthalmologist and findings recorded using the WHO form for examining blindness in children. RESULTS: A total of 59 HSAs and 64 KIs were trained. HSAs identified five children of whom two were confirmed as blind (one blind child per 29.5 HSAs trained). On the other hand, the KIs identified a total of 158 children of whom 20 were confirmed blind (one blind child per 3.2 KIs trained). More blind boys than girls were identified (77.3% versus 22.7%) respectively. CONCLUSION: Key Informants were much better at identifying blind children than HSAs, even though both groups identified far fewer blind children compared with WHO estimates. HSAs reported lack of time as a major constraint in identifying blind children. Based on these findings using HSAs for identifying blind children would not be successful in Malawi. Gender differences need to be addressed in all childhood blindness programs to counteract the imbalance

Possible ways for improving the competitiveness of SMEs. A Central-European approach.

An SME is able to cope with the global challenge if it runs reliable, balanced and high-standard operation in its business. There are different possible management methods for increasing the competitiveness of SMEs. In the last few years competitiveness of SMEs isalso analyzed on state level. It is very important to create a good business environment for this group of firms. In the time of crisis the outstanding role of SMEs in GDP creation is emphasized all over Europe and overseas.A network of researchers was found five years ago for the better understanding of SMEs problems and for carrying out research in this field.This network .evaluated the current situation and made a declaration recently for the future Hungarian government.globalisation, competitiveness factors, family business speciality.SMEs, Small Business Act, networking, research, SME policy

Developments in Hungary in Staffing Practices - Results of Two Consecutive Cranet Surveys

Management of human resources, the same as other fields of management, has altered significantly in Hungary since the democratic transformation and in many respects it is still changing. This paper – while describing the specific Hungarian staffing practice and its alterations – makes a comparison of the characteristics of the Hungarian samples of two Cranet surveys. Based on these, we outline the ratio of similarity between the Hungarian and the global (or that of the 32 countries participating in the network) HR practice and the features of HR practices of (6 network member) countries from the Central and Eastern European (CEE) region.Human Resource Management, staffing, Hungary, Cranet

Assessing the governance of the health policy-making process using a new governance tool: The case of Lebanon

Background: In the international agenda, it has become common to assert that the assessment of health system governance using a practical tool is crucial. This approach can help us better understand how health systems are being steered as well as to identify gaps in the decision-making process and their causes. The authors developed a new assessment tool, the Health Policymaking Governance Guidance Tool (HP-GGT), that was designed to be conceptually sound and practical. This tool enables policy-makers and stakeholders to systematically review and assess health system governance at policy-making level. This article presents first use of the HP-GGT in Lebanon, together with generated results, recommendations, and discusses how these results improve governance practices when initiating new health policy formulation processes.Methods: The HP-GGT, which is a multidimensional structured tool, was used retrospectively to assess and review the process used to develop a new mental health strategy; this process was compared against consensus-based good governance principles, focusing on participation, transparency, accountability, information and responsiveness. The assessment was conducted through face-to-face interviews with 11 key informants who were involved in the development of the strategy.Results: The HP-GGT enabled policy-makers to reflect on their governance practices when developing a mental health strategy and was able to identify key areas of strengths and weaknesses using good governance practice checklists given by the questions. The insights generated from the assessment equipped the national policy-makers with a better understanding of the practice and meaning of policy-making governance. Identifying weaknesses to be addressed in future attempts to develop other national health policies helped in this regard. Using the tool also increased awareness of alternative good practices among policy-makers and stakeholders.Conclusions: Assessing a health policy formulation process from a governance perspective is essential for improved policy-making. The HP-GGT was able to provide a general overview and an in-depth assessment of a policy formulation process related to governance issues according to international good practices that should be applied while formulating health policies in any field. The HP-GGT was found to be a practical tool that was useful for policy-makers when used in Lebanon and awaits applications in other low- and middle-income countries to further show its validity and utility

Institutional Reactions to the Impact of Global Crisis at Source and Destination Cities of Migration in China

This paper relates on the impact of global crisis on China from a systemic point of view. In what ways external and internal adaptation pressures influenced the transformation of the party-state system in China? Did reactions have an impact on the transformation of political or economic system? The purpose of our small field research was to respond to this question by examining institutional reactions to crisis from late 2008 to late 2009. We have examined the common and disparate characteristics of institutional adaptation at prefecture level at sources and destination cities of migration. We have also tried to detect their common or different sensitivity to crisis analyzing the periods before, during and after the crisis. We shall reflect on the reasons of prevailing political stability despite sudden large unemployment, and substantial economic, social and political impact on the party-state system. The paper uses interviews in 13 prefectures and newspaper analysis of 16 prefectures from mid 2008 to the end of 2009 complemented by available relevant statistical data.system transformation, global crisis, migration, economic policy reactions,prefectures

Spartan Daily, October 12, 1988

Volume 91, Issue 31https://scholarworks.sjsu.edu/spartandaily/7757/thumbnail.jp

The regulators and the regulated: fisheries management, options and dynamics in Kenya's Lake Victoria fishery

The study divides the history of the fishery into five 'regulatory periods': the pre-colonial fishery (pre-1901), the colonial fishery (1901-1963), the post indipendence fishery (1963-1980), the Nile perch 'boom' years (1980-1989), and finally the fishery in the 1990's. Within each of these periods, the nature of and the relationship between, formal and informal regulations differs and changes with time. In the pre-colonial period, the outcome of formal and informal regulations largely sustained the fishery in a productive and species diverse state. However, at no time since then have formal regulations worked, with the result that the nature of production from the fishery changes over time and is dependent on a number of factors, amongst which the most important are effort level increases, technological introductions, species introductions, changes in regional and national job markets, the change from community-based controls to state-based controls within the fishery, and finally, considerable changes to the fish markets