Care seeking for under-five children and vaccine perceptions during the first two waves of the COVID-19 pandemic in Lagos State, Nigeria: a qualitative exploratory study

Objective: To explore healthcare seeking practices for children and the context-specific direct and indirect effects of public health interventions during the first two waves of COVID-19 in Lagos State, Nigeria. We also explored decision-making around vaccine acceptance at the start of COVID-19 vaccine roll-out in Nigeria. Design, setting and participants: A qualitative explorative study involving 19 semistructured interviews with healthcare providers from public and private primary health facilities and 32 interviews with caregivers of under-five children in Lagos from December 2020 to March 2021. Participants were purposively selected from healthcare facilities to include community health workers, nurses and doctors, and interviews were conducted in quiet locations at facilities. A data-driven reflexive thematic analysis according to Braun and Clark was conducted. Findings: Two themes were developed: appropriating COVID-19 in belief systems, and ambiguity about COVID-19 preventive measures. The interpretation of COVID-19 ranged from fearful to considering it as a ‘scam’ or ‘falsification from the government’. Underlying distrust in government fuelled COVID-19 misperceptions. Care seeking for children under five was affected, as facilities were seen as contagious places for COVID-19. Caregivers resorted to alternative care and self-management of childhood illnesses. COVID-19 vaccine hesitancy was a major concern among healthcare providers compared with community members at the time of vaccine roll-out in Lagos, Nigeria. Indirect impacts of COVID-19 lockdown included diminished household income, worsening food insecurity, mental health challenges for caregivers and reduced clinic visits for immunisation. Conclusion: The first wave of the COVID-19 pandemic in Lagos was associated with reductions in care seeking for children, clinic attendance for childhood immunisations and household income. Strengthening health and social support systems with context-specific interventions and correcting misinformation is crucial to building adaptive capacity for response to future pandemics

Visiting the iron cage: Bureaucracy and the contemporary workplace

Bureaucracy as an organizational form has always been a controversial issue and placed at the very heart of most discussions within organizational theory. One side of this prolonged discussion praises this administrative form as the ‘rational’ way to run an organization. It provides needed guidance and clarifies responsibilities, which enables employees to become more efficient. However, the opposition claims that in a non-linear world, where industrial organizations are forced to confront the challenging task of sensing and responding to unpredictable, novel situations of highly competitive markets, such an organizational form stifles creativity, fosters de-motivation and causes pressure on employees. Dealing with a bureaucratic form of organization and its consequences begs for a context. It would be appropriate to quit ‘taking sides’ and develop a sound analysis of this phenomenon under the conditions of today’s global workplace environment. This chapter intends to delineate the conditions under which bureaucracy has emerged and the way it has been interpreted since its inception and develop a sound and appropriate analytical approach to its functioning given the prevailing conditions of the contemporary workplace.Publisher's VersionAuthor Post Prin

Expatriation and Incapacity created by a Multitude of Hidden Inequalities

The ability of UK based Academics to function within collaborative partnerships is becoming an important part of the UK Universities internationalisation agenda. This chapter offers an auto-ethnographical academic expatriate experience detailing some of the challenges faced when moving to work in a ‘UK environment positioned abroad’, specifically in China. It will provide HR personnel with alternative understandings of possible support strategies that could assist individuals in dealing with a variety of hidden inequalities that surface. These hidden inequalities can contribute to a possible shortening of the assignment due to cultural contexts in which they are operating (Foster 1997; Wang and Varma 2017)

Organisationskultur. Eine Konkretisierung aus systemtheoretischer Perspektive

Kühl S. Organisationskultur. Eine Konkretisierung aus systemtheoretischer Perspektive. Managementforschung. 2018;28(1):7-35.Die Bestimmung des Verhältnisses von Informalität und Organisationskultur bereitet in der Organisationstheorie Schwierigkeiten. Das liegt daran, dass der Begriff Informalität häufig stillschweigend durch den Begriff der Organisationskultur ersetzt wurde, ohne dass dafür eine präzise, abgrenzungsscharfe Definition vorgenommen worden wäre. Unter Rückgriff auf Überlegungen von Dario Rodríguez argumentiert dieser Artikel, dass die beiden Begriffe Organisationskultur und Informalität das gleiche Phänomen bezeichnen: die nichtentschiedenen Entscheidungsprämissen einer Organisation. Dabei wird systematisch zwischen „unentscheidbaren Entscheidungsprämissen“ und „prinzipiell entscheidbaren, aber nicht entschiedenen Entscheidungsprämissen“ unterschieden. Es wird gezeigt, wie sich mit einer präzisen Bestimmung über das Konzept der Entscheidungsprämissen Ordnung in die „wilden Merkmallisten“ der Literatur sowohl über Informalität als auch Organisationskultur bringen lässt und empirische Phänomene genauer erfasst werden können

Community and stakeholders' engagement in the prevention and management of Type 2 diabetes : a qualitative study in socioeconomically disadvantaged suburbs in region Stockholm

Background: Community-based approaches have been identified as an effective strategy to address the growing burden of noncommunicable diseases (NCDs) worldwide. However, little is known about community as a concept among people living in socioeconomically disadvantaged settings and stakeholders’ interactions and engagement in NCDs prevention and management. Objective: The aim of this study was to understand; (1) the meaning of community among people living in socioeconomically disadvantaged suburbs in Region Stockholm and (2) how communities interact and engage with stakeholders at local and regional levels for the prevention and management of type 2 diabetes (T2D). Methods: This qualitative study was conducted in three municipalities in Region Stockholm with a high proportion of migrants. Multiple data collection methods were used, including observations of community activities; interviews with community members, representatives of public authorities and NGOs; and group interviews with healthcare providers. Data were analyzed using content analysis. Results: Community was perceived as living in close proximity with shared beliefs, values and resources. Although they recognized its social and cultural diversity, community members focused more on the commonalities of living in their neighborhood and less on their differences in country of birth and languages spoken. Several mismatches between awareness of community needs and the available skills and resources among stakeholders for T2D prevention were identified. Stakeholders expressed awareness of T2D risk and interest in addressing it in a culturally appropriate manner. Conclusion: Interaction between the communities and stakeholders was limited, as was engagement in T2D prevention and management. This highlights barriers in the collaboration between community, healthcare institutions and other stakeholders which consequently affect the implementation of preventive interventions. Innovative ways to link the community to the healthcare sector and other local government institutions are needed to build the capacity of health systems for T2D prevention in socioeconomically disadvantaged communities.De 2 sista författarna delar sistaförfattarskapet.</p