551,454 research outputs found

    Participatory approaches involving community and healthcare providers in family planning/contraceptive information and service provision: a scoping review.

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    As efforts to address unmet need for family planning and contraception (FP/C) accelerate, voluntary use, informed choice and quality must remain at the fore. Active involvement of affected populations has been recognized as one of the key principles in ensuring human rights in the provision of FP/C and in improving quality of care. However, community participation continues to be inadequately addressed in large-scale FP/C programmes. Community and healthcare providers’ unequal relationship can be a barrier to successful participation. This scoping review identifies participatory approaches involving both community and healthcare providers for FP/C services and analyzes relevant evidence. The detailed analysis of 25 articles provided information on 28 specific programmes and identified three types of approaches for community and healthcare provider participation in FP/C programmes. The three approaches were: (i) establishment of new groups either health committees to link the health service providers and users or implementation teams to conduct specific activities to improve or extend available health services, (ii) identification of and collaboration with existing community structures to optimise use of health services and (iii) operationalization of tools to facilitate community and healthcare provider collaboration for quality improvement. Integration of community and healthcare provider participation in FP/C provision were conducted through FP/C-only programmes, FP/C-focused programmes and/or as part of a health service package. The rationales behind the interventions varied and may be multiple. Examples include researcher-, NGO- or health service-initiated programmes with clear objectives of improving FP/C service provision or increasing demand for services; facilitating the involvement of community members or service users and, in some cases, may combine socio-economic development and increasing self-reliance or control over sexual and reproductive health. Although a number of studies reported increase in FP/C knowledge and uptake, the lack of robust monitoring and evaluation mechanisms and quantitative and comparable data resulted in difficulties in generating clear recommendations. It is imperative that programmes are systematically designed, evaluated and reported

    The provision of infrastructure services in Rohtak and Bhiwani districts, Haryana, India, 1981-98: a geographical analysis

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    Abstract: Provision of three basic infrastructure services (namely education, health and transport) in Rohtak and Bhiwani Districts (India) is examined using three types of data: 1. 507 households spreading in 8 villages, 2. Informal discussion with villagers and services providers in both districts, and 3. Secondary data for 921 villages and 14 towns and cities. These data were analysed using both statistical and GIS techniques. The analysis reveals that quantitatively there has been considerable expansion of education and health services over a period of fifteen years (1981 to 1996), and the average distance people have to travel to access these services has also declined significantly. But little evidence was found of any logical criterion being followed for the location of new services and the upgrading of existing services. Consequently, there was no improvement in the efficiency level (measured in terms of demand and geographical distance) of existing infrastructure services (both public and private); moreover, the efficiency level of private services was significantly lower than that of public services. It was further observed that the poor and women had relatively poor access to education, health and transport; and income, caste, gender, education level and village location had significant impact on access to and utilisation of basic services. In the study area, public services were functioning sub-optimally and service users were not satisfied with the quality of services; a significant proportion of clients had to rely on private services. Although public services may not be available in all the villages, the main focus should now be on improving the quality of existing services. Therefore, a solid transport network is needed in rural areas so that the availability of frequent and reliable transport services facilitate villagers' access to quality services even if located at distant places. Thus far, the role of the public in service provision has been minimal, which may be one of the reasons for poor quality of public services. Therefore, the active involvement of clients (service users) is essential in the operation, maintenance and monitoring of basic services in order to improve their quality and efficient functioning, and to effectively cater for people's needs in general and deprived sections of the society in particular

    Profession Driven Improvement of the Quality of Pharmacy Practice Implementation of Community Pharmacy Services Quality Guidelines in Estonia

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    Constant improvement of the quality of community pharmacy services is important in the development of contemporary patient care. A national and voluntary Community Pharmacy Services Quality Guidelines (CPSQG) was developed to formulate the principles of contemporary pharmacy services, including quality criteria for service provision. The purpose of this study was to identify the implementation of the CPSQG as a profession-driven initiative towards improving and harmonizing community pharmacy services in Estonia. Three cross-sectional electronic surveys were conducted among community pharmacies in Estonia in 2014 (N = 478 pharmacies), 2016 (N = 493), and 2019 (N = 494), and the CPSQG indicators were used for evaluation of the service quality. In this study, the aggregated data, collected in three study years were used to identify the implementation of guidelines into practice. For data analysis, the One-Way ANOVA test and Post-hoc multiple comparisons were used. The results demonstrated slow implementation of the CPSQG, but guidelines-based evaluation enabled a detailed overview of the community pharmacy activities and provided services. In order to develop community pharmacy services more efficiently, the use of implementation science principles, continuous introduction of the CPSQG to the pharmacists, and more active involvement of the state could be considered in the future.info:eu-repo/semantics/publishedVersio

    Under What Conditions Does Caseworker-Caregiver Racial/Ethnic Similarity Matter for Housing Service Provision? An Application of Representative Bureaucracy Theory

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    In this article, we examine child welfare caseworkers’ housing-related service strategies when they serve culturally similar versus culturally dissimilar clients. Testing hypotheses drawn from representative bureaucracy theory and using data from the second cohort of the National Survey of Child and AdolescentWell-Being, we find that when non-Caucasian caseworkers share the same racial/ethnic background as caregivers, caseworkers use more active strategies to connect caregivers to needed housing services. The relationship between racial/ethnic matching and frontline workers’ repertoire of service strategies is most pronounced when the need for housing has been registered formally via referrals and case plans and thus legitimated institutionally. These results reinforce basic tenets of representative bureaucracy theory and provide evidence of the benefits of racial and ethnic diversity in the human service workforce. Our findings also highlight the need for research identifying institutional and frontline organizational factors that enhance the quality of service provision

    Promoting and maintaining health of people with sight loss: A scoping study

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    This study was undertaken in response to a request by the Thomas Pocklington Trust to identify and explore the following issues: • The needs and concerns regarding immediate risks to health and safety related to sight loss; • Additional risks arising from sight loss for those who are also managing a long term disease; • The difficulties in maintaining and promoting health; • Whether or not health promotion activities and policies sufficiently address perceived needs. Findings pertaining to these objectives have been generated from data collected in Leeds, UK, a city where innovative programming for sight loss has either been planned or is being incorporated into health planning and a review of the literature. Findings related to the last two issues indicate that gaps exist in service provision for maintaining health and emphasise the need for more explicitly targeted health promotion initiatives that could address current weaknesses. - A review of the literature; - Focus group discussions with a range of people who had experienced sight loss; - Interviews with professional practitioners engaged in service provision to this population; - An expert hearing with four professional practitioners, one of whom had sight loss, and two service users with sight loss. Most participants were from the West Yorkshire region and the services described in the study are largely located in Leeds. Evidence from the literature review suggests that people with visual impairment have increased risk of accidents within the home and that ensuing consequences include injuries incurred and decreased confidence. Rates of depression among people who are blind or partially sighted are far higher than in the wider population and the likelihood of depression increases with age, although psycho-social interventions and technological assistance can be successfully implemented to improve quality of life. Sight loss together with other long term health conditions exacerbates the impact of other health conditions and has particularly severe impact on the wellbeing of older people insofar as it may affect their mobility, which in turn increases their risk of falls and depression. The nature and level of support available to people is variable but it is clear that access both to the right information at the right time and to appropriate services is a critical issue. Focus group discussions, interviews and the expert hearing corroborated and extended the themes noted in the literature and discuss the differential impact of different risks to health and the difficulties of coping with these at different times in a person’s life. A simple typology was defined using two dimensions of experience (‘stage of life’ and ‘early/late onset of sight loss’) as a means of organizing findings and providing a means of making further distinctions in interpreting the data. Potentially, this scheme can allow health promotion initiatives to be targeted more effectively to stages at which people with sight loss are more likely to encounter specific difficulties in managing and maintaining their health. There was a clear consensus throughout the study that interventions to meet the needs of people with sight loss must be tailored to meet the specific needs of individuals: people with sight loss are not a homogeneous group and the way in which each person experiences the challenges of sight loss and of managing their health will inevitably vary from person to person. Recommendations generated by this study include: • The scope for more pro-active services and need for closer collaboration between service providers; • The need for provision and promotion of targeted information; • The need for greater awareness of the needs of people with visual impairments among generic service providers; and • Further research that explores the usefulness of the typology with a larger sample more representative of population demographics such as BME communities that are more likely to slip through the cracks of service provision

    Holistic Resource Management for Sustainable and Reliable Cloud Computing:An Innovative Solution to Global Challenge

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    Minimizing the energy consumption of servers within cloud computing systems is of upmost importance to cloud providers towards reducing operational costs and enhancing service sustainability by consolidating services onto fewer active servers. Moreover, providers must also provision high levels of availability and reliability, hence cloud services are frequently replicated across servers that subsequently increases server energy consumption and resource overhead. These two objectives can present a potential conflict within cloud resource management decision making that must balance between service consolidation and replication to minimize energy consumption whilst maximizing server availability and reliability, respectively. In this paper, we propose a cuckoo optimization-based energy-reliability aware resource scheduling technique (CRUZE) for holistic management of cloud computing resources including servers, networks, storage, and cooling systems. CRUZE clusters and executes heterogeneous workloads on provisioned cloud resources and enhances the energy-efficiency and reduces the carbon footprint in datacenters without adversely affecting cloud service reliability. We evaluate the effectiveness of CRUZE against existing state-of-the-art solutions using the CloudSim toolkit. Results indicate that our proposed technique is capable of reducing energy consumption by 20.1% whilst improving reliability and CPU utilization by 17.1% and 15.7% respectively without affecting other Quality of Service parameters

    Logistic service quality as a mediator between logistics capabilities and customer satisfaction

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    Purpose – A way that companies have found to respond to the challenges of customer satisfaction (CS) is the development logistics services quality. In this sense, the purpose of this paper is to estimate the quality of logistical service as a mediator factor in the relationship between logistics capabilities (LC) and CS. For this, an exploratory survey of the descriptive type was carried out with 117 companies in the Brazilian market of lubricant oil. The collected data, modeled in structural equations, have shown evidence that the quality of logistics services totally mediates the relation between the LC and the satisfaction of clients. Design/methodology/approach – In order to respond to the research problem and to meet the stated objective, a study was carried out in two phases. The first used an exploratory qualitative design, and involved recorded in-depth interviews with five clients and five managers of a lubricant oil producer located in the municipality of Umuarama and nearby areas in Paraná state, Brazil. The second used an exploratory survey of the descriptive type was carried out with 117 companies in the Brazilian market of lubricant oil. Findings – The collected data, modeled in structural equations, have shown evidence that the quality of logistics services totally mediates the relation between the LC and the satisfaction of clients. Research limitations/implications – It is suggested that new studies be conducted in order to increase the size of the sample, since the number of responses obtained (117 respondents), for the number of initial variables (34 measures). Practical implications – In the pursuit of CS, the managers of lubricant oil producers should make major investments in LC, to enable the company to be active in the search for logistics solutions, integration and provision of reliable information to its customers. Social implications – The studies should also be carried out in other market segments, in order to compare the results obtained in the lubricating oil segment of Brazil and corroborate knowledge about the influence of logistical capabilities on the relation between logistics service quality and CS. Originality/value – The logistics services quality perceived by the customers is derived from the service capacity of the producer’s employees and the quality of information provided to the customers

    Urban environmental quality and wellbeing in the context of incomplete urbanization in Brazil: integrating directly experienced ecosystem services into planning

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    The benefits of urban greenspace to residents are increasingly recognized as important to planning for sustainable and healthy cities. However, the way that people interact with and benefit from urban greenspace is context dependent and conditioned by a range of social and material factors. This paper applies and expands the ecosystems services based approach to understanding urban environmental quality and the way in which greenspace is appropriated by residents in the context of incomplete urbanization in three peri-urban target areas in Brazil. We develop and employ the notion of indirect (scientifically detected) and directly experienced ecosystems services, and undertake a science based ecosystem services assessment and a qualitative analysis of interviews, walking narratives and images captured with a smartphone application to understand what functions urban greenspace serves in the daily life of the studied neighborhoods. Findings demonstrate how elements of urban greenspace and what can be termed ecosystem services serve both material and signifying functions and produce subjective and collective benefits and dis-benefits that hinge on aspects of livability such as quality of urban service delivery, housing status and perceptions of crime and neighborhood character. We identify factors that enable, hinder and motivate both active material and interpretative interactions with urban greenspace. The findings suggest that the relationship between ecosystem service provision and wellbeing is better understood as reciprocal rather than one way. Although at the neighborhood scale, fear of crime and poor access to urban services can hinder positive engagements with urban greenspace and experienced benefits form ES, urban squares and fringe vegetation is also being appropriated to address experienced disadvantages. Presently however these local interactions and ecosystem service benefits are overlooked in formal planning and conservation efforts and are increasingly compromised by growing population density and environmental degradation. We make recommendations for a nuanced assessment of the material and interpretative human-nature interactions and associated ecosystem services in an urban context, and discuss the potential for planning initiatives that could be employed to articulate and nurture these important interactions in our target areas
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