Reproductive Health Coordination Gap, Services Ad hoc: Minimum Initial Service Package (MISP) Assessment in Kenya

The post-election violence in Kenya in the early months of 2008 displaced more than 500,000 people. In any humanitarian crisis, certain priority reproductive health (RH) services must be put in place from the earliest stages of an emergency. These essential activities are defined in the Minimum Initial Services Package (MISP) -- the established international standard for providing RH care in emergencies. They include activities to prevent sexual violence and treat survivors; protect against the transmission of HIV; ensure delivery supplies and emergency care for pregnant women and newborns; and lay the groundwork for comprehensive RH services once conditions allow. The Women's Commission for Refugee Women and Children (Women's Commission) undertook a mission to Kenya in April 2008 to assess the progress the humanitarian community has made in the institutionalization of the MISP in emergency response operations. The assessment took place four months after the crisis erupted and included visits to camp settings in the Nairobi, Kisumu, Kitale, Eldoret and Nakuru regions.Key Findings1) Despite the ongoing and urgent needs of large numbers of displaced persons, the Women's Commission found that funding was clearly inadequate to meet the unaddressed health needs of the displaced. UN emergency appeals to address humanitarian needs related to the post-election violence remained significantly underfunded at the time of the assessment, and organizations that could have continued to respond were bringing their emergency response operations to a close.2) The most significant and overarching gap in the implementation of the MISP was the absence of RH coordination at all levels.3) Awareness of the MISP among humanitarian workers in Kenya was higher than awareness levels registered in two earlier MISP assessments conducted by the Women's Commission. However, the MISP was not guiding action in Kenya which meant there were still unacceptable gaps in protection and key RH services.4) Planning to prevent high levels of sexual violence, inlcuding sexual exploitation and abuse, were strong at the national level but still inadequate at the field level. Poor security measures were noted at all but one camp and the assessment team received numerous disturbing reports of sexual exploitation and abuse by humanitarian workers, police and others.5) Mechanisms to respond to sexual violence, inlcuding sexual exploitation and abuse, were also weak at the field level. Displaced persons and representatives of humanitarian organizations reported a general atmosphere of impunity toward perpetrators of sexual violence. Health workers also suggested that many of the displaced did not know the importance of seeking treatment for sexual assault or where it was offered. Many displaced women were only slowly seeking care months after the height of the violence.6) In terms of priority activities taken to protect against HIV transmission, the findings were mostly positive. It was encouraging that health care providers were concerned from the start of the crisis about the need to prevent the transmission of HIV and to ensure people living with AIDS had continuing access to antiretroviral medicines. By all accounts, there were sufficient supplies of male condoms; however, some displaced persons reported that they were still not freely available or easy to obtain.7) The Women's Commission found that referral systems to care for pregnancy-related emergencies were not uniformly in place, and transportation for women and girls suffering from complications of their pregnancy or delivery was highly problematic in some places. While clean delivery kits were available in some settings, they were not consistently distributed to visibly pregnant women and there were shortages in some settings. In addition, no displaced women we spoke with were aware of or had heard of clean delivery kits.8) Young people appeared to be the most severely affected, with many reporting idleness due to a lack of jobs and opportunities to attend secondary school and university. In addition, young people noted that the sudden movement from their busy lives in rural areas to overcrowded urban camps where they were now idle created more exposure to the opposite sex. A sudden increase in sexual activity enhanced their vulnerability to sexually transmitted infections, including HIV, and unwanted pregnancies.Although the Kenya crisis has disappeared from the headlines, daily life remains a crisis for people who are still displaced from their homes and communities. The Kenyan government and international aid agencies must take immediate and coordinated action to address the priority RH needs of the displaced populations. In particular, the needs of young people should be prioritized considering their vulnerability to sexual exploitation and abuse and heightened risk of unsafe sex as they remain displaced or return to their homes.More broadly, this assessment highlights the need for a deeper commitment on the part of donors and the humanitarian community to the institutionalization of the MISP in humanitarian crises, particularly to ensure RH coordination from the beginning of an emergency. Adequate funding for MISP activities must be provided at the onset of an emergency, and more humanitarian workers must be trained and skilled in MISP implementation.Key RecommendationsThe United Nations Population Fund (UNFPA) and the Ministry of Health's Division of Reproductive Health should initiate reproductive health coordination, as people continue to be displaced in camps, transit camps and communities, and those returning can also benefit from such services.All agencies working to prevent sexual violence and provide care to survivors should enforce rules and procedures to prevent and manage sexual violence, address the issue of impunity, and inform communities of where and how to report incidents and the importance of seeking medical care.All agencies working in or funding the health sector should strengthen the health care system to provide care for pregnancy-related problems, especially as international agencies hand over their projects to the government and local organizations.All organizations should better engage young people in the recovery process, enhance their educational and job opportunities, and address their specific reproductive health needs

Outsourcing information systems: Drawing lessons from a banking case study

Financial and costs benefits are often put forward as the reasons why organisations decide to outsource. Emerging patterns and trends indicate that today’s outsourcing decisions are often motivated by factors other than cost. Thus, the decision-making process is more complex than it may at first appear. This paper presents findings from a case study from an organisation in the UK banking sector that was motivated to outsource aspects of its information technology/information system (IT/IS). The underlying motives and decision-making process that influenced the bank outsource its IT/IS are presented and discussed. Findings from the case study suggest political perspectives, as well as human and organisational issues influenced the bank’s strategic decision-making to outsource certain aspects of its business. An examination of the case study findings suggests that cost alone is not always responsible for decisions to outsource, as it was found the bank’s outsourcing decision was driven by a series of complex, interrelated motives in a bid to reduce the risks and uncertainties of managing its own technology. Considering the complex nature of the outsourcing process a frame of reference that can be used to assist managers with their decision to outsource IT/IS is propagated. The case study is used to present an organisation’s experiences as to how and why it decided to outsource its IS and thus offers a learning opportunity for other organisations facing similar difficulties. In addition, the case study findings highlight the need to focus greater attention on discriminating between the short and long-term consequences of IT/IS decision-makin

E-logistics of agribusiness organisations

Logistics is one of the most important agribusiness functions due to the idiosyncrasy of food products and the structure of food supply chain. Companies in the food sector typically operate with poor production forecasting, inefficient inventory management, lack of coordination with supply partners. Further, markets are characterised by stern competition, increasing consumer demands and stringent regulation for food quality and safety. Large agribusiness corporations have already turned to e-logistics solutions as a means to sustain competitive advantage and meet consumer demands. There are four types of e-logistics applications: (a) Vertical alliances where supply partners forge long-term strategic alliances based on electronic sharing of critical logistics information such as sales forecasts and inventory volume. Vertical alliances often apply supply chain management (SCM) which is concerned with the relationship between a company and its suppliers and customers. The prime characteristic of SCM is interorganizational coordination: agribusiness companies working jointly with their customers and suppliers to integrate activities along the supply chain to effectively supply food products to customers. E-logistics solutions engender the systematic integration among supply partners by allowing more efficient and automatic information flow. (b) e-tailing, in which retailers give consumers the ability to order food such as groceries from home electronically i.e. using the Internet and the subsequent delivery of those ordered goods at home. (c) Efficient Foodservice Response (EFR), which is a strategy designed to enable foodservice industry to achieve profitable growth by looking at ways to save money for each level of the supply chain by eliminating inefficient practices. EFR provides solutions to common logistics problems, such as transactional inefficiency, inefficient plant scheduling, out-of-stocks, and expedited transportation. (d) Contracting, a means of coordinating procurement of food, beverages and their associated supplies. Many markets and supply chains in agriculture are buyer-driven where the buyers in the market tend to set prices and terms of trade. Those terms can include the use of electronic means of communication to support automatic replenishment of goods, management of supply and inventory. The results of the current applications of e-logistics in food sector are encouraging for Greek agribusiness. Companies need to become aware of and evaluate the value-added by those applications which are a sustainable competitive advantage, optimisation of supply chain flows, and meeting consumer demands and food safety regulations. E-business diffusion has shown that typically first-movers gain a significant competitive advantage and the rest companies either eventually adopt the new systems or see a significant decline in their trading partners and perish. E-logistics solutions typically require huge investments in hardware and software and skilled personnel, which is an overt barrier for most Greek companies. Large companies typically are first-movers but small and medium enterprises (SMEs) need institutional support in order to become aware that e-logistics systems can be fruitful for them as well

Cultural audit - managing marketing performance

A report looking at a cultural audit of a well known international project management compan

Strategic application of events

This paper explores the area of strategy and events through a qualitative study. Organisations are increasingly seeking to achieve strategic objectives though the delivery of events. Particularly, as regards the role of events in the communication of brand strategy. This paper seeks to illuminate the underpinning reasoning for this trend, and examine prevalent issues relating to event management and event experience. There is a critical evaluation of the factors that facilitate and constrain events in supporting organisational strategy, with a number of themes identified that impede events from realising their strategic potential