5,137 research outputs found

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

    Get PDF
    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

    Tourism and heritage in the Chornobyl Exclusion Zone

    Get PDF
    Tourism and Heritage in the Chornobyl Exclusion Zone (CEZ) uses an ethnographic lens to explore the dissonances associated with the commodification of Chornobyl's heritage. The book considers the role of the guides as experience brokers, focusing on the synergy between tourists and guides in the performance of heritage interpretation. Banaszkiewicz proposes to perceive tour guides as important actors in the bottom-up construction of heritage discourse contributing to more inclusive and participatory approach to heritage management. Demonstrating that the CEZ has been going through a dynamic transformation into a mass tourism attraction, the book offers a critical reflection on heritagisation as a meaning-making process in which the resources of the past are interpreted, negotiated, and recognised as a valuable legacy. Applying the concepts of dissonant heritage to describe the heterogeneous character of the CEZ, the book broadens the interpretative scope of dark tourism which takes on a new dimension in the context of the war in Ukraine. Tourism and Heritage in the Chornobyl Exclusion Zone argues that post-disaster sites such as Chornobyl can teach us a great deal about the importance of preserving cultural and natural heritage for future generations. The book will be of interest to academics and students who are engaged in the study of heritage, tourism, memory, disasters and Eastern Europe

    Wildlife trade in Latin America: people, economy and conservation

    Get PDF
    Wildlife trade is among the main threats to biodiversity conservation and may pose a risk to human health because of the spread of zoonotic diseases. To avoid social, economic and environmental consequences of illegal trade, it is crucial to understand the factors influencing the wildlife market and the effectiveness of policies already in place. I aim to unveil the biological and socioeconomic factors driving wildlife trade, the health risks imposed by the activity, and the effectiveness of certified captive-breeding as a strategy to curb the illegal market in Latin America through a multidisciplinary approach. I assess socioeconomic correlates of the emerging international trade in wild cat species from Latin America using a dataset of >1,000 seized cats, showing that high levels of corruption and Chinese private investment and low income per capita were related to higher numbers of jaguar seizures. I assess the effectiveness of primate captive-breeding programmes as an intervention to curb wildlife trafficking. Illegal sources held >70% of the primate market share. Legal primates are more expensive, and the production is not sufficiently high to fulfil the demand. I assess the scale of the illegal trade and ownership of venomous snakes in Brazil. Venomous snake taxa responsible for higher numbers of snakebites were those most often kept as pets. I uncover how online wildlife pet traders and consumers responded to campaigns associating the origin of the COVID-19 pandemic. Of 20,000 posts on Facebook groups, only 0.44% mentioned COVID-19 and several stimulated the trade in wild species during lockdown. Despite the existence of international and national wildlife trade regulations, I conclude that illegal wildlife trade is still an issue that needs further addressing in Latin America. I identify knowledge gaps and candidate interventions to amend the current loopholes to reduce wildlife trafficking. My aspiration with this thesis is to provide useful information that can inform better strategies to tackle illegal wildlife trade in Latin America

    TOWARDS AN UNDERSTANDING OF EFFORTFUL FUNDRAISING EXPERIENCES: USING INTERPRETATIVE PHENOMENOLOGICAL ANALYSIS IN FUNDRAISING RESEARCH

    Get PDF
    Physical-activity oriented community fundraising has experienced an exponential growth in popularity over the past 15 years. The aim of this study was to explore the value of effortful fundraising experiences, from the point of view of participants, and explore the impact that these experiences have on people’s lives. This study used an IPA approach to interview 23 individuals, recognising the role of participants as proxy (nonprofessional) fundraisers for charitable organisations, and the unique organisation donor dynamic that this creates. It also bought together relevant psychological theory related to physical activity fundraising experiences (through a narrative literature review) and used primary interview data to substantiate these. Effortful fundraising experiences are examined in detail to understand their significance to participants, and how such experiences influence their connection with a charity or cause. This was done with an idiographic focus at first, before examining convergences and divergences across the sample. This study found that effortful fundraising experiences can have a profound positive impact upon community fundraisers in both the short and the long term. Additionally, it found that these experiences can be opportunities for charitable organisations to create lasting meaningful relationships with participants, and foster mutually beneficial lifetime relationships with them. Further research is needed to test specific psychological theory in this context, including self-esteem theory, self determination theory, and the martyrdom effect (among others)

    Examining the Impact of Personal Social Media Use at Work on Workplace Outcomes

    Get PDF
    A noticable shift is underway in today’s multi-generational workforce. As younger employees propel digital workforce transformation and embrace technology adoption in the workplace, organisations need to show they are forward-thinking in their digital transformation strategies, and the emergent integration of social media in organisations is reshaping internal communication strategies, in a bid to improve corporate reputations and foster employee engagement. However, the impact of personal social media use on psychological and behavioural workplace outcomes is still debatebale with contrasting results in the literature identifying both positive and negative effects on workplace outcomes among organisational employees. This study seeks to examine this debate through the lens of social capital theory and study personal social media use at work using distinct variables of social use, cognitive use, and hedonic use. A quantitative analysis of data from 419 organisational employees in Jordan using SEM-PLS reveals that personal social media use at work is a double-edged sword as its impact differs by usage types. First, the social use of personal social media at work reduces job burnout, turnover intention, presenteeism, and absenteeism; it also increases job involvement and organisational citizen behaviour. Second, the cognitive use of personal social media at work increases job involvement, organisational citizen behaviour, employee adaptability, and decreases presenteeism and absenteeism; it also increases job burnout and turnover intention. Finally, the hedonic use of personal social media at work carries only negative effects by increasing job burnout and turnover intention. This study contributes to managerial understanding by showing the impact of different types of personal social media usage and recommends that organisations not limit employee access to personal social media within work time, but rather focus on raising awareness of the negative effects of excessive usage on employee well-being and encourage low to moderate use of personal social media at work and other personal and work-related online interaction associated with positive workplace outcomes. It also clarifies the need for further research in regions such as the Middle East with distinct cultural and socio-economic contexts

    The Role of English and Welsh INGOs: A Field Theory-Based Exploration of the Sector

    Get PDF
    This thesis takes a field theory-based approach to exploring the role of English and Welsh international non-governmental organisations (INGOs), using the lens of income source form. First, the thesis presents new income source data drawn from 933 Annual Accounts published by 316 INGOs over three years (2015-2018). The research then draws on qualitative data from 90 Leaders' letters include within the Annual Reports published by 39 INGOS, as well as supplementary quantitative and qualitative data, to explore the ways in which INGOs represent their role. Analysis of this income source data demonstrates that government funding is less important to most INGOs than has previously been assumed, while income from individuals is more important than has been recognised in the extant development studies literature. Funding from other organisations within the voluntary sector is the third most important source of income for these INGOs, while income from fees and trading is substantially less important than the other income source forms. Using this income source data in concert with other quantitative data on INGO characteristics as well as qualitative data drawn from the Leaders' letters, I then show that the English and Welsh INGO sector is a heterogenous space, divided into multiple fields. The set of fields identified by this thesis is arranged primarily around income source form, which is also associated with size, religious affiliation, and activities of focus and ways of working. As Bourdieusian field theory suggests, within these fields individual INGOs are engaged in an ongoing struggle for position: competing to demonstrate their maximal possession of the symbolic capitals they perceive to be valued by (potential) donors to that field. Further analysis of these Leaders' letters, alongside additional Annual Reports and Accounts data, also reveals a dissonance in the way in which INGOs describe their relationship with local partners in these different communication types. While these Leaders' letters and narrative reports tell stories of collaborative associations with locally-based partners, this obscures the nature of these relationships as competitive and hierarchical. The thesis draws on the above findings to reflect on the role of INGOs as suggested in the extant literature. This discussion highlights how the various potential INGO fields identified are associated with differing theoretical roles for INGOs. Finally, the thesis considers how INGO role representations continue to contribute to unequal power relations between INGOs and their partners

    Developing end-of-life care at a Portuguese nursing home through participatory action research

    Get PDF
    Background: Nursing homes are places where older people live and often die but little is known about the needs of those who care for them, in Portugal. Aim: to identify the needs of nursing home staff when caring for older people at the end of life; to understand the cultural nuances of providing care at the end-of-life in nursing homes; to develop, with nursing home staff, a culturally appropriate programme that meets their needs; and to plan for future development. Methods: Participatory Action Research was used to identify needs and to develop interventions, designed by the staff themselves, aimed at improving care. Up to ten nursing home staff participated in a six-cycle research process, with data collected, analysed, and used in sequential plan-act-reflect steps. Findings: The silence that surrounds a resident’s death has a severe impact on the lives of those who survive him/her. Lacking competencies in grief management, and with no emotional and relational space to express grief emotions, staff strive to manage their loss, while trying to support other residents. Acknowledging the existence of death and its impact on nursing home life made the invisibility of death and mourning visible, and interventions possible, providing closure to all. Conclusion: The impact of death and dying on nursing home life needs to be recognised. If adequately supported, nursing home staff can develop strategies to manage grief and mourning, to improve their knowledge of the residents’ needs and wishes, improve communication among staff, and ultimately improve care
    • …
    corecore