100 research outputs found

    ICTs and the Challenge of Health System Transition in Low and Middle-Income Countries

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    The aim of this paper is to contribute to debates about how governments and other stakeholders can influence the application of ICTs to increase access to safe, effective and affordable treatment of common illnesses, especially by the poor. First, it argues that the health sector is best conceptualized as a ‘knowledge economy’. This supports a broadened view of health service provision that includes formal and informal arrangements for the provision of medical advice and drugs. This is particularly important in countries with a pluralistic health system, with relatively underdeveloped institutional arrangements. It then argues that reframing the health sector as a knowledge economy allows us to circumvent the blind spots associated with donor-driven ICT-interventions and consider more broadly the forces that are driving e-health innovations. It draws on small case studies in Bangladesh and China to illustrate new types of organization and new kinds of relationship between organizations that are emerging. It argues that several factors have impeded the rapid diffusion of ICT innovations at scale including: the limited capacity of innovations to meet health service needs, the time it takes to build new kinds of partnership between public and private actors and participants in the health and communications sectors and the lack of a supportive regulatory environment. It emphasises the need to understand the political economy of the digital health knowledge economy and the new regulatory challenges likely to emerge. It concludes that governments will need to play a more active role to facilitate the diffusion of beneficial ICT innovations at scale and ensure that the overall pattern of health system development meets the needs of the population, including the poor

    Using qualitative and quantitative methods to choose a habitat quality metric for air pollution policy evaluation

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    Atmospheric nitrogen (N) deposition has had detrimental effects on species composition in a range of sensitive habitats, although N deposition can also increase agricultural productivity and carbon storage, and favours a few species considered of importance for conservation. Conservation targets are multiple, and increasingly incorporate services derived from nature as well as concepts of intrinsic value. Priorities vary. How then should changes in a set of species caused by drivers such as N deposition be assessed? We used a novel combination of qualitative semi-structured interviews and quantitative ranking to elucidate the views of conservation professionals specialising in grasslands, heathlands and mires. Although conservation management goals are varied, terrestrial habitat quality is mainly assessed by these specialists on the basis of plant species, since these are readily observed. The presence and abundance of plant species that are scarce, or have important functional roles, emerged as important criteria for judging overall habitat quality. However, species defined as ‘positive indicator-species’ (not particularly scarce, but distinctive for the habitat) were considered particularly important. Scarce species are by definition not always found, and the presence of functionally important species is not a sufficient indicator of site quality. Habitat quality as assessed by the key informants was rank-correlated with the number of positive indicator-species present at a site for seven of the nine habitat classes assessed. Other metrics such as species-richness or a metric of scarcity were inconsistently or not correlated with the specialists’ assessments. We recommend that metrics of habitat quality used to assess N pollution impacts are based on the occurrence of, or habitat-suitability for, distinctive species. Metrics of this type are likely to be widely applicable for assessing habitat change in response to different drivers. The novel combined qualitative and quantitative approach taken to elucidate the priorities of conservation professionals could be usefully applied in other contexts

    Lange-termijnveranderingen van chemie en biologie van vennen in relatie tot veranderingen van atmosferische depositie

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    verkrijgbaar bij AquaSense TEC, Martine van Nugteren Postbus 95125, 1090 HC Amsterdam fax 020 - 592 2249De voornaamste veranderingen in de chemie en biologie van drie vennen in de loop van 16 jaar zijn gemeten. Deze gegevens werden vergeleken met oudere waarnemingen (1912-1970) om verbanden te leggen tussen deze veranderingen en de veranderingen van de atmosferische depositie, in het bijzonder van zwavel- en stikstofverbindingen. Modelberekeningen werden toegepast. Tussen 1979 en 1994 is in twee van de drie onderzochte vennen het sulfaatgehalte sterk gedaald. Uit modelberekingen bleek dat dit veroorzaakt werd door de sterke afname van depositie van zwavelverbindingen in die periode. Dit had zeer positieve gevolgen voor de soortensamenstelling van de kiezelwieren, die sterk indicatief zijn voor de verzuringstoestand. Uit de modelberekingen blijkt dat er geen goede meetresultaten zijn van de depositie van stikstofverbindingen op oppervlaktewateren. Het is zeer noodzakelijk dat hiervoor metingen worden uitgevoerd.Major changes in chemistry and biota of three moorland pools have been registered in the period 1979 - 1994 in view of the acidification and eutrophication by atmospheric deposition. The data have been compared with data from the period 1912-1970. By model calculations the changes in these periods were studied with regard to particularly sulphur and nitrogen compounds. Recommendations for future monitoring are made, tailored to the needs of environmental policy.DGM/L
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