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An action plan to integrate abortion care with HIV and family planning services in Ethiopia
No full textIntegrated health services improve health system efficiency, horizontalization of
vertical programmes, and appropriate use of human, financial and medical resources.
The integration of maternal health services reduces the risk of unintended pregnancy
and the transmission of HIV, especially in a country like Ethiopia, where the prevalence
of HIV is high. Thus, delivering integrated abortion care and HIV-family planning (FP)
services to clients in a one-stop service can improve maternal health.
The study aimed to develop an action plan to facilitate the integration of abortion care
with HIV-FP services in public health facilities of the South Nation Nationality and
People Region (SNNPR), Ethiopia. An explanatory sequential mixed-method
approach was used to undertake the study over three phases. In the first phase,
quantitative data were gathered from childbearing-aged women who received abortion
care in public healthcare facilities and healthcare providers using face-to-face and selfadministered
questionnaires, respectively. The analysed data from phase one and a
literature review were used to develop the draft action plan, while programme officers
participated in the e-Delphi technique in phase three to validate the draft action plan
for the integration of abortion care with FP-HIV services in the public health facilities
of Ethiopia.
The change logic model was the theoretical framework applied to conduct the study.
The inputs of the change logic model in this study included geographic accessibility,
human resources, medical resources, infrastructure, fiscal resources, policies, strategies, and guidelines, and behavioural change and communication. Facilities
nearer to the community are preferable for maternal health services. In-service training
and offering healthcare providers incentives improve integrated maternal health
services. Ensuring a consistent supply of medical resources in public healthcare
facilities also enhances the integration of abortion care with HIV-FP services. The
availability of adequate service-providing areas, water supply, sanitary systems,
electricity, and computer connectivity improves the integration of maternal health
services. Allocating a budget and providing the service free of charge can enhance
the integration of abortion with HIV-FP services. Availing and utilising regulatory
documents and improving the community’s awareness on integrated health services
can enhance the integration of abortion care with HIV-FP services. The developed action plan will be shared with stakeholders to implement integrated
abortion care-HIV-FP services in public health facilities of Ethiopia.Ph. D. (Public Health)Health Studie
Measurement of exclusive pion pair production in proton–proton collisions at s = 7 TeV with the ATLAS detector
No full textAbstract
The exclusive production of pion pairs in the process
p
p
→
p
p
π
+
π
-
has been measured at
s
=
7
TeV
with the ATLAS detector at the LHC, using
{80}\,{\upmu \textrm{b}}^{-1}
80
μ
b
-
1
of low-luminosity data. The pion pairs were detected in the ATLAS central detector while outgoing protons were measured in the forward ATLAS ALFA detector system. This represents the first use of proton tagging to measure an exclusive hadronic final state at the LHC. A cross-section measurement is performed in two kinematic regions defined by the proton momenta, the pion rapidities and transverse momenta, and the pion–pion invariant mass. Cross-section values of
4.8 \pm 1.0 \mathrm {\ (stat)} {~}^{+0.3}_{-0.2} \mathrm {\ (syst)}\ {\upmu \textrm{b}}
4.8
±
1.0
(
stat
)
-
0.2
+
0.3
(
syst
)
μ
b
and
9 \pm 6 \mathrm {\ (stat)} {~}^{+2}_{-2} \mathrm {\ (syst)}\ {\upmu \textrm{b}}
9
±
6
(
stat
)
-
2
+
2
(
syst
)
μ
b
are obtained in the two regions; they are compared with theoretical models and provide a demonstration of the feasibility of measurements of this type
The role of digital technologies in increasing operational efficiency in South Africa's systems integrator information technology industries
Get PDFThis research study analyses the intricate landscape of South Africa's Systems Integrator Information Technology industries, centering its focus on Dimension Data. Through a meticulous exploration, the study addresses critical aspects of digital transformation, uncovering specific digital technologies, industry challenges, and essential strategies for successful adoption and implementation. The identification of specific digital technologies employed within the Systems Integrator IT Industry, elucidated through interviews with Dimension Data's Senior Managers and Team Leads (five participants from a population sample of 25), establishes a foundational understanding of the industry's technological landscape. The challenges uncovered, encompassing resistance to change, cybersecurity concerns, and regulatory requirements, highlight the complex obstacles organizations face in their digital journey. These challenges underscore the need for strategic interventions and proactive measures to ensure seamless technology integration and operational efficiency. Furthermore, the study outlines key strategies for effective digital technology adoption and implementation. A comprehensive digital strategy, a culture of innovation, and collaborative partnerships emerge as indispensable elements for success. Organizations, particularly within the Systems Integrator IT Industry, are encouraged to craft robust digital strategies aligned with organizational goals, foster an innovative culture that embraces experimentation and cultivate collaborative partnerships to navigate challenges and propel technological advancement. In the ever-evolving digital landscape, the findings of this study provide a valuable compass for organizations, policymakers, and industry stakeholders seeking to augment operational efficiency through the adept integration of digital technologies. The insights gained contribute significantly to the broader discourse on digital transformation, offering pragmatic recommendations for organizations aspiring to thrive in the competitive Systems Integrator IT Industry. In conclusion, the study, provided valuable insights into specific technologies, challenges, and strategies. The findings underscore the importance of comprehensive digital strategies, a culture of innovation, and collaborative partnerships as the major recommendation for successful technology adoption and implementation in the dynamic landscape of digital transformation.M.B.L.Graduate School of Business Leadershi
Bank accounts, bank concentration and mobile money innovations
No full textThe present study investigates how increasing bank accounts and bank concentration affect mobile money innovations in 148 countries. It builds on scholarly and policy concerns in the literature that increasing bank accounts may not be having the desired effects on financial inclusion on the one hand and on the other, that bank concentration which is a proxy for market power is a relevant mobile money innovation demand factor. The empirical evidence is based on Tobit regressions. From the findings, it is apparent that boosting bank accounts is positively related to the three mobile money innovations (i.e. mobile bank accounts and the mobile phone used to send money). Moreover, some critical levels of bank account penetration require complementary policies in order to maintain the positive relationship between boosting bank accounts and positive outcomes in terms of money mobile innovations. Conversely, financial inclusion in terms of the three mobile money innovations is not significantly apparent upon enhancing bank concentration. Policy implications are discussed in the light of the provided thresholds for complementary policies.Economic
The efficacy of government incentives in creating sustainable entrepreneurial growth in the agribusiness SMMEs entrepreneurial ecosystem in Botswana
Get PDFThis study investigates the efficacy of government incentives in creating sustainable entrepreneurial growth in the agribusiness SMMEs entrepreneurial ecosystem in Botswana. The study uses a conceptual framework to organize divergent variables that influence growth into numerous coherent themes linked to SMMEs. As a cross- sectional and primarily empirical study, it draws data from a nationally representative sample of 600 owner/managers of agribusiness SMMEs who benefited from government incentives. Multivariate analysis techniques, namely SEM using SPSS and AMOS, analysed the relationships of variables relating to the statistical significance, causal and direct effects of various factors on sustainable entrepreneurial growth of agribusiness SMMEs.
Empirical evidence of this research, among many others, revealed that the majority of owner/managers (219) belonged to micro-companies, 129 belonged to small companies, 135 were from medium companies and lastly, 48 owner/managers were from large companies. Most of the agribusiness SMMEs surveyed had moved past that stage of start-up formalisation and had been operating for more than 2 years with a median firm age of 5 years. Despite a high youth unemployment rate in Botswana, in this empirical study the age category of 18 to 24 years was the smallest group of represented owner/managers of SMMEs in agribusiness value chains. The majority owner/managers of SMMEs were involved in rain-fed agriculture; and followed by owner/managers of SMMEs in cattle breeding. In addition, they were followed by those involved in agribusiness inputs, agribusiness services and others. Results from the inferential analysis suggest that SMME owner/managers of larger agribusinesses had a statistically significant, causal and direct effect on higher opinion on policy environment capital and infrastructural capital. The effect was more on the owner/manager’s counterparts who owned and managed smaller SMMEs.
Size of company and type of business activity in the agribusiness value chain were dependent, such that certain types of agribusiness attracted more entrepreneurs due to their higher growth prospects. Agribusiness SMMEs that sought to exploit existing opportunities based on existing market knowledge showed more chances of attaining growth than those which sought to exploit opportunities based on new market knowledge. Regarding entrepreneurial orientation, owner/managers from larger agribusiness SMMEs were at variance with other agribusiness SMME owners over the statement that past entrepreneurial orientation helped to overcome barriers (roadblocks) in establishing their agribusiness SMMEs. Conversely, respondents from smaller agribusiness SMMEs were more likely to agree, as shown by the negative correlations. These empirical results confirm that increasing the degree of interdependency, interaction and interrelations among four key principal components of the entrepreneurial ecosystem and government incentives facilitates organisational birth and death cycles. Considering these results, certain policy implications are deduced. On this basis, the study recommends that academics, practitioners and policymakers converge their focus on four principal components, namely financial capital, social capital, policy environment and historical capital. These components would serve as indicators of government support for sustainable entrepreneurial growth of agribusiness SMMEs in a healthy ecosystem. An integrative entrepreneurial ecosystem model framework was developed to strengthen the contribution of new knowledge. The framework also proposed what needs to be done in order to create a healthy ecosystem. It thus increases the success rate of entrepreneurial ventures in an emerging market and enhancing implementation of long-term outcomes in sequence.Ph. D. (Entrepreneurial ecosystem and Small, Medium and Micro Enterprises)Colleges of Economic and Management Science
Inclusive and differential cross-sections for dilepton t t ¯ production measured in s = 13 TeV pp collisions with the ATLAS detector
No full textAbstract
Differential and double-differential distributions of kinematic variables of leptons from decays of top-quark pairs (
t
t
¯
) are measured using the full LHC Run 2 data sample collected with the ATLAS detector. The data were collected at a pp collision energy of
s
= 13 TeV and correspond to an integrated luminosity of 140 fb−1. The measurements use events containing an oppositely charged eμ pair and b-tagged jets. The results are compared with predictions from several Monte Carlo generators. While no prediction is found to be consistent with all distributions, a better agreement with measurements of the lepton pT distributions is obtained by reweighting the
t
t
¯
sample so as to reproduce the top-quark pT distribution from an NNLO calculation. The inclusive top-quark pair production cross-section is measured as well, both in a fiducial region and in the full phase-space. The total inclusive cross-section is found to be
σ
t
t
¯
=
829
±
1
stat
±
13
syst
±
8
lumi
±
2
beam
pb
,
where the uncertainties are due to statistics, systematic effects, the integrated luminosity and the beam energy. This is in excellent agreement with the theoretical expectation
A quantitative assessment of the consistency of projections from five mathematical models of the HIV epidemic in South Africa: a model comparison study
No full textAbstract
Background
Mathematical models are increasingly used to inform HIV policy and planning. Comparing estimates obtained using different mathematical models can test the robustness of estimates and highlight research gaps. As part of a larger project aiming to determine the optimal allocation of funding for HIV services, in this study we compare projections from five mathematical models of the HIV epidemic in South Africa: EMOD-HIV, Goals, HIV-Synthesis, Optima, and Thembisa.
Methods
The five modelling groups produced estimates of the total population, HIV incidence, HIV prevalence, proportion of people living with HIV who are diagnosed, ART coverage, proportion of those on ART who are virally suppressed, AIDS-related deaths, total deaths, and the proportion of adult males who are circumcised. Estimates were made under a “status quo” scenario for the period 1990 to 2040. For each output variable we assessed the consistency of model estimates by calculating the coefficient of variation and examining the trend over time.
Results
For most outputs there was significant inter-model variability between 1990 and 2005, when limited data was available for calibration, good consistency from 2005 to 2025, and increasing variability towards the end of the projection period. Estimates of HIV incidence, deaths in people living with HIV, and total deaths displayed the largest long-term variability, with standard deviations between 35 and 65% of the cross-model means. Despite this variability, all models predicted a gradual decline in HIV incidence in the long-term. Projections related to the UNAIDS 95–95-95 targets were more consistent, with the coefficients of variation below 0.1 for all groups except children.
Conclusions
While models produced consistent estimates for several outputs, there are areas of variability that should be investigated. This is important if projections are to be used in subsequent cost-effectiveness studies
Patients’ preferences for delivering bad news in palliative care in Ethiopia: a qualitative study
No full textAbstract
Background
One of the major challenges for healthcare professionals relates to awareness of patients’ preferences relative to how and when to break bad news and how much information should be disclosed in the eventuality of a serious medical diagnosis or prognosis. On occasions, a serious medical diagnosis or prognosis is withheld from the patient. There is a scarcity of evidence about cultural preferences regarding breaking bad news in the palliative care setting in Ethiopia. Therefore, it is necessary to understand the surrounding cultural issues to properly convey bad news. The purpose of the study was to explore Ethiopian patients’ cultural preferences for receiving bad news in a palliative care setting.
Methods
A qualitative research approach and nonprobability, purposive sampling method were applied. In-depth interviews were employed to collect data from eight patients who were diagnosed with cancer and cancer with HIV/AIDS during the time of data collection. Thematic analysis was applied to identify themes and subthemes. The data were transcribed verbatim and analysed using ATLAS.ti 22 computer software.
Results
The following three themes emerged and are reported in this study: (1) Perceptions about life-threatening illness: religious values and rituals are essential for establishing perspectives on life-threatening illnesses and preferences in receiving bad news. (2) Experiences with life-threatening illness: study participants’ experience with the method of breaking bad news was sad, and they were not provided with sufficient details about their medical condition. Making appropriate decisions, fulfilling the ordinance of religious faith, and avoiding unnecessary costs were outlined as benefits of receiving bad news. (3) Preferred ways of breaking bad news; the findings revealed that incremental, amiable and empathic methods for delivering bad news were preferred. It was suggested that the presence of family members is crucial when receiving bad news.
Conclusion
Patients choose to be told about their medical conditions in the presence of their family. However, the patient’s needs for receiving bad news were unmet. Patients should be involved in the treatment decision process. Delivery of bad news needs to tailor the preferred methods, cultural values, and religious beliefs. Delivering bad news according to the patients’ preferences helps to fulfil their wishes in palliative care
Development of practice guidelines for solid health care waste management in Ethiopia
No full textThe purpose of this study was to investigate solid health care waste management
practices in the health sector in order to develop guidelines for improving solid health
care waste management practice. The setting is all health facilities found in
Hossaena town. A convergent mixed-methods study design was used. For the
quantitative part of this study a census method of study, which is all health care
facilities found in the town was studied. All health facilities and health facility workers
(540 in number) who are available in the study health facilities and having a role in
HCW management practice were included in the quantitative phase of this study.
Qualitative research sampling is purposive and relies on different methods. For the
purpose of this study, small purposeful samples were used. The researcher of this
study purposefully selected the research participants who have experienced the solid
health care waste practice or key concept being explored in this study. One hospital,
three government health centres, 17 medium clinics, 19 small clinics, and one
surgical centre participated in this study. Both samples were drawn from the same
population. The quantitative part of the study included all health facility staff who play
a role in the practise of health care waste management
In the qualitative phase of the data collection open-ended interviews, focus group
discussions, and analysis of visual materials were used. Questionnaires were used
for the quantitative phase.
The data were analysed quantitatively by using relevant statistical tools. Descriptive
statistics and Pearson correlation tests were used for the bivariate associations to
assess the relationships between independent and dependent variables and analysis of variance to compare health care waste generation rates by the type of health
facilities. In most of the variables, percentages and means were used to report the
findings with a 95% confidence interval. Open-ended responses and focused group
findings were undertaken by quantifying and coding the data to provide a thematic
narrative explanation.
These guidelines were designed and developed based on the study findings and the
current knowledge available and reviewed in the literature. The purpose of these
guidelines is to show the gap on SHCWMP and to provide the scientific
recommendation to health facility workers, health facility managers, and regulatory
bodies. The objectives of these guidelines are to improve and maintain public health
safety by: Minimising solid HCW generation rate and impacts on the surrounding
environment. These guidelines were developed based on the world health
organization recommendation of the guide line development process and findings of
this study and the extensive literature review. The final guidelines were tested and
the comments from practical users were evaluated and incorporated into the
guideline. In the light of the finding of this research, there are several gaps regarding
proper SHCWM practice. Colour coded waste bins should be available, adequate
awareness and training programmes for health facility workers, patients and visitors
should be provided.
Result: Health care waste segregation practice was not implemented in 78% of the
health facilities. The qualitative observation asserted that inappropriate segregation
practice was observed in 98.3% of the solid health care waste containers. The main
problem that was encountered in the effective management of solid health care
waste management practice was a lack of awareness and commitment.
Observational findings revealed that in 97.6% of the health facilities, infectious
wastes are collected daily. Pre-treatment before disposal was not practised. All
health facilities used incineration by using brick or barrel incinerators, and all are not
meet the minimum standards solid health care waste management. The qualitative
observation shows that 97.6% of the health facilities were not using the colour-coded
waste bin, which leads to the mixing of infectious and non-infectious waste.
Focus group participant recommend that ‘’providing waste management training and
creating awareness are the two aspects to improve SHCW segregation practice.
health facility must avail all the necessary supplies that used for SHCWMP, punishment for those violating the rule of SHCWMP, Mask, disposable gloves and
changing gowns are a critical shortage at all health facilities’’
Conclusions: Lack of knowledge, absence of training and orientation, lack of
protective vaccinations, and inappropriately constructed incinerators are the leading
causes of inappropriate solid health care waste management practice.Ph. D. (Public Health)Health Studie
Plausible subjective experience versus fallible corroborative evidence: The formulation of insanity in Nigerian criminal courts
No full textInsanity as a defence against criminal conduct has been known since antiquity. Going through significant reformulations across centuries, different jurisdictions across the globe, including Nigeria, have come to adopt various strains of the insanity defence, with the presence of mental disorder being the causative mechanism of the crime as their central theme. A critical ingredient in the Nigerian insanity plea is the presence of ‘mental disease’ or ‘natural mental infirmity’ as the basis for the lack of capacity in certain cognitive and behavioural domains resulting in the offence. Mental disorders, which are the biomedical formulations of this critical legal constituent are primarily subjective experiences with variable objective features. Using illustrative cases based on psycho-legal formulation as well as reform-oriented and fundamental legal research, it is shown that Nigerian courts have held that claims of insanity based on the accused person’s evidence alone should be regarded as “suspect” and not to be “taken seriously.” Thus, Nigerian judicial opinions rely on non-expert accounts of defendants’ apparent behavioural abnormalities and reported familial vulnerability to mental illness, amongst other facts while conventionally discountenancing the defendants’ plausible phenomenological experiences validated by expert psychiatric opinion in reaching a conclusion of legal insanity. While legal positivism would be supportive of the prevailing judicial attitude in entrenching the validity of the disposition in its tenuous precedential utility, legal realism invites the proponents of justice and fairness to interrogate the merit of such preferential views which are not supported by scientific evidence or philosophical reasoning. This paper argues that disregarding the subjective experience of the defendant, particularly in the presence of sustainable expert opinion when it stands unrebutted is not in the interest of justice. This judicial posturing towards mentally abnormal offenders should be reformed on the basis of current multidisciplinary knowledge. Learning from the South African legislation, formalising the involvement of mental health professionals in insanity plea cases, ensures that courts are guided by professional opinion and offers a model for reform