Exploring the role of traditional authorities in managing the public as stakeholders on PPP projects: a case study

Previous research indicates that involving representatives of the public in stakeholder management increases the likelihood of obtaining successful outcomes when managing the public as stakeholders on PPP projects. Relatively little is however known about the exact roles played by traditional authorities, who are powerful public representatives and significantly influence the public and the stakeholder management process on PPP projects worldwide. A case study of a PPP was conducted to explore this question. Through a thematic analysis of data collected from multiple sources, four main roles of traditional authorities were identified: mediation; project monitoring; community representation; and custody management of community culture and physical resources. These roles and their associated outcomes make traditional authorities a crucial link between project executors and the public during stakeholder management. This study provides a step towards developing strategies for collaborating with traditional authorities for better stakeholder management of the public on PPP projects

Global injury morbidity and mortality from 1990 to 2017 : results from the Global Burden of Disease Study 2017

Correction:Background Past research in population health trends has shown that injuries form a substantial burden of population health loss. Regular updates to injury burden assessments are critical. We report Global Burden of Disease (GBD) 2017 Study estimates on morbidity and mortality for all injuries. Methods We reviewed results for injuries from the GBD 2017 study. GBD 2017 measured injury-specific mortality and years of life lost (YLLs) using the Cause of Death Ensemble model. To measure non-fatal injuries, GBD 2017 modelled injury-specific incidence and converted this to prevalence and years lived with disability (YLDs). YLLs and YLDs were summed to calculate disability-adjusted life years (DALYs). Findings In 1990, there were 4 260 493 (4 085 700 to 4 396 138) injury deaths, which increased to 4 484 722 (4 332 010 to 4 585 554) deaths in 2017, while age-standardised mortality decreased from 1079 (1073 to 1086) to 738 (730 to 745) per 100 000. In 1990, there were 354 064 302 (95% uncertainty interval: 338 174 876 to 371 610 802) new cases of injury globally, which increased to 520 710 288 (493 430 247 to 547 988 635) new cases in 2017. During this time, age-standardised incidence decreased non-significantly from 6824 (6534 to 7147) to 6763 (6412 to 7118) per 100 000. Between 1990 and 2017, age-standardised DALYs decreased from 4947 (4655 to 5233) per 100 000 to 3267 (3058 to 3505). Interpretation Injuries are an important cause of health loss globally, though mortality has declined between 1990 and 2017. Future research in injury burden should focus on prevention in high-burden populations, improving data collection and ensuring access to medical care.Peer reviewe

Critical activities for the successful management of external stakeholders in construction projects

The increasing number of external stakeholders and multiplicity of their needs and expectations require careful consideration and management in projects. However, external stakeholders have received relatively little attention in research and practice when compared to internal stakeholders. Therefore, this study focuses on evaluating the critical activities contributing to external stakeholder management success at the project planning stage from the perspective of developing countries. Questionnaire survey data was collected from project management practitioners in Ghana and analysed using mean scoring, factor analysis, and fuzzy synthetic evaluation. Seven groups of contributing activities were established, namely; involving external stakeholders and ensuring mutual trust (weighting = 0.163), effective communication with external stakeholders (weighting = 0.162), sustaining relationships with external stakeholders (weighting = 0.152), preliminary planning (weighting = 0.140), analysing project and external stakeholder information (weighting = 0.130), assessing external stakeholder attributes and needs (weighting = 0.128), and developing and applying effective strategies (weighting = 0.126). Following, a practice framework was developed, exemplified, and validated with experts in Ghana. The findings contribute to advancing stakeholder theory in construction research in the context of developing countries. Practitioners can effectively implement, evaluate, compare and improve the contributing activities in external stakeholder management process to inform about needed managerial decisions in projects. The findings will guide practitioners to be more externally oriented and accommodating toward external stakeholders; distribute managerial attention properly in undertaking activities; proactively mitigate external stakeholder issues; manage project more ethically and sustainably; and develop managerial competency requirements

Exploring the cost-effectiveness of high versus low perioperative fraction of inspired oxygen in the prevention of surgical site infections among abdominal surgery patients in three low- and middle-income countries

Background: This study assessed the potential cost-effectiveness of high (80–100%) vs low (21–35%) fraction of inspired oxygen (FiO2) at preventing surgical site infections (SSIs) after abdominal surgery in Nigeria, India, and South Africa. Methods: Decision-analytic models were constructed using best available evidence sourced from unbundled data of an ongoing pilot trial assessing the effectiveness of high FiO2, published literature, and a cost survey in Nigeria, India, and South Africa. Effectiveness was measured as percentage of SSIs at 30 days after surgery, a healthcare perspective was adopted, and costs were reported in US dollars ($). Results: High FiO2 may be cost-effective (cheaper and effective). In Nigeria, the average cost for high FiO2 was$216 compared with $222 for low FiO2 leading to a −$6 (95% confidence interval [CI]: −$13 to −$1) difference in costs. In India, the average cost for high FiO2 was $184 compared with$195 for low FiO2 leading to a −$11 (95$15 to −$6) difference in costs. In South Africa, the average cost for high FiO2 was$1164 compared with $1257 for low FiO2 leading to a −$93 (95% CI: −$132 to −$65) difference in costs. The high FiO2 arm had few SSIs, 7.33% compared with 8.38% for low FiO2, leading to a −1.05 (95% CI: −1.14 to −0.90) percentage point reduction in SSIs. Conclusion: High FiO2 could be cost-effective at preventing SSIs in the three countries but further data from large clinical trials are required to confirm this