Innovative partnerships for Safe Motherhood::participation and transdisciplinary collaboration as tools towards increasing skilled birth attendance

Motherhood is far from safe in various contexts and settings. Maternal mortality is still unacceptably high, as World Health Organization (WHO) reports indicate. In 2017, around 295 000 women died during pregnancy, childbirth and puerperium. Many initiatives contribute to decreasing the number of maternal deaths, among which those stemming from the Millennium Development Goals and more recently, the Sustainable Development Goals. The new goal is that in 2030, less than 70 women die per 100.000 live births. However, especially in vulnerable populations, the decrease in maternal mortality is too slow to reach this target. Although clear international strategies exist, these are not effective in some contexts. One of the strategies to decrease maternal mortality, is giving birth in the presence of a skilled birth attendant (SBA). Unfortunately, diverse barriers to SBA utilization exist. The underlying causes are often complex and insufficiently researched. In this thesis, underutilization of SBAs is analyzed in two ways. In the first part, is described if interventions can increase skilled birth attendance through using the Birth Preparedness and Complication Readiness model (BPCR). In part two a local context in northern Tanzania is studied, where most women of the mainly Maasai population, give birth in the presence of a traditional birth attendant (TBA) instead of a SBA. This thesis endorses, through analysis of the BPCR model and a local context in northern Tanzania, the importance of: participatory evaluation of contexts in which skilled birth attendance is low, collaboration between all parties involved through co-creating context specific solutions and maternity care. Possibly this facilitates skilled birth attendance, but more certain this increases experiences quality of care and collaboration between maternity care providers, like TBAs and SBAs. The adaptive research approach made the research directly locally relevant. In the discussion I describe that context specific care is often a social innovation and inherently a challenging process. Challenges include: making context specific care measurable, sustainable within health systems, taking power dynamics within communities and health systems into account. It is essential, that those who hold power in (the organization of) maternity care, give way to wishes and needs of women, their families and of those who care for them, both TBAs and SBAs. The research in this thesis fits new definitions of implementation research, in which knowledge is represented in a trans disciplinary way. Insights from this thesis add, modestly, to how we can bridge the “know-do” gap between knowledge and practice. More specifically: how we can understand and counter underutilization of SBA: through participation and collaboration while respecting local expertise. I recommend continuing the co-creation in maternity care and as such contribute to maternity health, wellbeing and the decrease of maternal mortality globally

Cora Sears Roggeveen Papers

Scrapbook of Cora Sears Roggeveen who homesteaded two miles west of Abercrombie, North Dakota

Assessing Attitudes Toward Technology Among Older Adults and Usability of Software for Elders - Report Series # 20

Computer software is frequently not created with the common limitations of the older user in mind. Poor design and usability of computers is a significant barrier for many older adults who wish to use computers. PointerWare Innovations’ software breaks down barriers that Windows software frequently presents to older users. This research study explores issues relevant to PointerWare Innovations, as well as any software developer seeking to accommodate the needs older adults

Beyond community: an analysis of social capital and the social networks of Brazilian immigrants in Amsterdam

In this paper we scrutinize the social networks and the social capital invested within these, of a relatively new and understudied immigrant group in the North-European context. We show how the social networks of Brazilian immigrants in Amsterdam are segmented along strong dividing lines, especially surrounding legal status. We show that this segmentation has different outcomes for migrants belonging to the different segments of the community, and that within these segments, variation also exists. By analyzing in-depth interviews with 30 Brazilian immigrants in Amsterdam, we find that a Brazilian community does not exist, and that assistance, non-assistance, and a commercialization of social relations all take place at the same time among the social networks of Brazilians in Amsterdam. In doing so, we also uncover some of the mechanisms related to these processes and hence provide relevant insights for literature that studies the contexts in which immigrant social networks provide for social mobility and the contexts in which such networks do not

China's New Navy: A short guide for Australian policy-makers

In this Centre of Gravity paper, Sam Roggeveen, Senior Fellow at the Lowy Institute and Visiting Fellow at the SDSC, argues that China’s focus on developing a large ocean-going surface fleet indicates its growing ambitions. China already has the second most powerful navy in the Pacific and is developing the capability to match America’s maritime strength in the Pacific. China may already be building a ‘post-American navy’, one designed not to confront US naval predominance in the Pacific, but to inherit it as the US baulks at the increasing cost of continued regional leadership. Thanks to China’s rise and America’s relative decline, Australia faces its most challenging maritime security environment since World War II. To meet the challenge, the ADF needs a force structure that is itself inspired by lessons from China

The influence of leadership on the prevention of safety incidents: on risk reduction, leadership, safety principles and practices

This research revealed the role of leaders in relation to incident prevention in organisations. The acquired data showed that Dominance-oriented leaders have a negative influence on safety. Relation-oriented leaders appeared to be friendly people with no real influence on safety. Production-oriented leaders are real achievers, committed to meeting production targets. A new character emerged during our research: the Process-oriented leader. This leader proved a dedicated safety minded leader, who fulfils his production duties in a responsible way, taking care of the reliability of production without compromising the safety of his team members. Also, we developed a Risk Reduction Cycle, showing the risk reduction process. This model revealed that the recognition of risks and implementation of remedial actions are the weakest links. In conclusion, we argue that this research revealed that the effectiveness of incident prevention depends predominantly on the individual behaviour of their leaders. Consequently, in order to foster Process-oriented Safety Leadership, we recommend not to focus on operational safety practices to be carried out by the workforce. Instead, we deliberately emphasise the influential power of their leaders, and propose a set of Process-oriented Safety Leadership Principles, directed at the board room level of organisations and three external parties. Security and Global Affair

Transport of a passive scalar in wide channels with surface topography

We generalize classical dispersion theory for a passive scalar to derive an asymptotic long-time convection-diffusion equation for a solute suspended in a wide, structured channel and subject to a steady low-Reynolds-number shear flow. Our theory, valid for small roughness amplitudes of the channel, holds for general surface shapes expandable as a Fourier series. We determine an anisotropic dispersion tensor, which depends on the characteristic wavelengths and amplitude of the surface structure. For surfaces whose corrugations are tilted with respect to the applied flow direction, we find that dispersion along the principal direction (i.e., the principal eigenvector of the dispersion tensor) is at an angle to the main flow direction and becomes enhanced relative to classical Taylor dispersion. In contrast, dispersion perpendicular to it can decrease compared to the short-time diffusivity of the particles. Furthermore, for an arbitrary surface shape represented in terms of a Fourier decomposition, we find that each Fourier mode contributes at leading order a linearly-independent correction to the classical Taylor dispersion tensor.Comment: under consideration for publication in the Journal of Physics: Condensed Matter (JPCM