36 research outputs found
Factors affecting adoption, implementation fidelity, and sustainability of the Redesigned Community Health Fund in Tanzania: a mixed methods protocol for process evaluation in the Dodoma region
Get PDFBACKGROUND: Despite the implementation of various initiatives to address low enrollment in voluntary micro health insurance (MHI) schemes in sub-Saharan Africa, the problem of low enrollment remains unresolved. The lack of process evaluations of such interventions makes it difficult to ascertain whether their poor results are because of design failures or implementation weaknesses.
OBJECTIVE: In this paper, we describe a process evaluation protocol aimed at opening the 'black box' to evaluate the implementation processes of the Redesigned Community Health Fund (CHF) program in the Dodoma region of Tanzania.
DESIGN: The study employs a cross-sectional mixed methods design and is being carried out 3 years after the launch of the Redesigned CHF program. The study is grounded in a conceptual framework which rests on the Diffusion of Innovation Theory and the Implementation Fidelity Framework. The study utilizes a mixture of quantitative and qualitative data collection tools (questionnaires, focus group discussions, in-depth interviews, and document review), and aligns the evaluation to the Theory of Intervention developed by our team. Quantitative data will be used to measure program adoption, implementation fidelity, and their moderating factors. Qualitative data will be used to explore the responses of stakeholders to the intervention, contextual factors, and moderators of adoption, implementation fidelity, and sustainability.
DISCUSSION: This protocol describes a systematic process evaluation in relation to the implementation of a reformed MHI. We trust that the theoretical approaches and methodologies described in our protocol may be useful to inform the design of future process evaluations focused on the assessment of complex interventions, such as MHI schemes
URI Disambiguation in the Context of Linked Data
No full textThe Linked Data initiative has given rise to an increasing number of RDF datasets, many of which are freely accessible online. These resources often arise as a result of database exports; however sufficient consideration may not be given to the unseen implications caused when they are used in the wider context of the Semantic Web. This paper investigates two popular resources, DBLP and DBpedia, and discusses whether the issues regarding identity management and co-reference resolution have been suitably addressed. We find that a large percentage of authors in DBLP have been conflated, and that disambiguation pages have been incorrectly linked using owl:sameAs within DBpedia. Systems for dealing with these issues are presented, and directions are given for future research
Phylogenetic relationships of the diatom genus Gomphoneis, and the taxonomy, ultrastructure, and distribution of selected species.
No full textIn the diatom genus Gomphoneis gaps exist in knowledge in the taxonomy and morphology of the cluster of taxa described from Lake Baikal, the ultrastructure of G. elegans, and the taxonomy and ultrastructure of the widely distributed species G. herculeana and G. eriense. Skvortzow indicate species allied to Gomphoneis quadripunctata are present. G. hastata (Wisl.) comb. nov. and G. tumida (Skv. in Skv. and Meyer) comb. nov., possess longitudinal lines in girdle view, while two other species, G. quadripunctata (Ostr.) Dawson ex Ross and Sims and G. olivaceoides (Hust.) Carter and Bailey-Watts, lack longitudinal lines. All four species have stigmoids around the central area and undifferentiated apical pore fields. The Type species of the genus, G. elegans, differs from others first included in the genus, and is similar to the species from Lake Baikal. Gomphoneis elegans has porelli at the footpole undifferentiated from puncta and stigmoids positioned around the base of the central nodule. Longitudinal lines visible in valve view are formed by marginal laminae which extend beneath the valve face. Ultrastructural on G. herculeana and G. eriense indicate similarities with species from western North America and from France. Differentiated apical pore field porelli, longitudinal lines formed by an axial plate, and true stigmata are shared between these two species. Several new subspecific varieties and species closely allied to G. herculeana and G. eriense are proposed. Phylogenetic relationships of Gomphoneis species were evaluated using cladistics. The genus is defined by the features of doubly punctate striae and marginal laminae, and is separated into two subgroups. The two features which define Gomphoneis are sufficient for inclusion in the genus, when the context of the phylogenetic hypothesis is considered. Species previously considered enigmatic, such as G. cantalica, G. transsilvanica, and G. olivacea, are all referred to Gomphoneis. Stratigraphic data suggest Gomphoneis originated in the Mid-Late Miocene and speciated rapidly. Species which underwent an increase in size subsequently became extinct or limited in geographic distribution, while species which underwent a size reduction and lost or reduced their internal siliceous structure became widely distributed. Correlation between these results and changing paleoecologic conditions is discussed. (Abstract shortened with permission of author.)PhDBotanyUniversity of Michiganhttp://deepblue.lib.umich.edu/bitstream/2027.42/161822/1/8812928.pd
A Three-Stage Model for Innovation Adoption in Health Systems: Insights from the Health Promotion and System Strengthening Project in Tanzania
No full textWe explored the outcomes and challenges encountered during a 12-year collaborative development endeavor in Tanzania, focused on enhancing the healthcare system. The Health Promotion and System Strengthening (HPSS) project, supported by the Swiss Government and implemented by the Swiss Tropical and Public Health Institute (Swiss TPH) from 2011 to 2023, aimed to strengthen various aspects of Tanzania’s healthcare landscape. This included reforms in health insurance through the improved Community Health Fund (iCHF), the establishment of a public–private partnership to optimize the health commodity supply chain via a Prime Vendor System (Jazia PVS), the implementation of health technology management innovations, and the facilitation of participatory community and school health promotion initiatives. Operating in a multisectoral, interdisciplinary, and systemic manner, the HPSS project employed a variety of interconnected strategies, focusing on key entry points within the Tanzanian health system, starting from district level to national policies. These efforts followed a three-stages approach to reach a sustainable adoption of the innovations, going through the process of service and product innovation, integration into service delivery systems, and finally their adoption in the respective institutional policies. Each stage presented distinct frameworks and challenges, detailed in this article. The development of innovative concepts was complemented by capacity building through on-the-job training, establishment of new accredited training programs for pre-service trainings, and the development of new IT systems integrated into the governmental IT environment, as well as efforts to improve transparency, accountability, and governance. Activities in these fields were guided by operational research, following the translational approach of Swiss TPH to go from innovation and validation to application. The example of the HPSS project highlights the cycle of developing and testing innovations at the community and district level, followed by endeavoring national-level integration and policy adjustments, consequently resulting in improved service delivery at the district and community level
Observation of multiply charged cluster anions upon pulsed UV laser ablation of metal surfaces under high vacuum
No full textObservation of multiply charged cluster anions upon pulsed UV-laser ablation of metal surfaces under high vacuum
No full textCambio climático y ficción: Solar, A Novel de Ian McEwan
No full textAnglophone literary production of the last two decades shows a clear tendency to imagine and narrate the impact of anthropogenic climate change. These fictions ―recently called Cli-Fi― present humanity’s agency as a geological force in the current epoch of the Anthropocene (Crutzen-Stoermer 2000). From an ecocritical reading, the article explores how the Anthropocene paradigm is presented in Solar, A Novel by the British author Ian McEwan, particularly in the representation of three axes: time, space and risk (Trexler 2015; Mehnert 2016), parameters that need resignifying in the Anthropocene.La producción literatura anglófona de las últimas dos décadas ha mostrado una clara tendencia a imaginar y narrar el impacto del cambio climático antropogénico. Estas ficciones ―recientemente denominadas cli-fi― presentan la agencia de la humanidad como fuerza geológica en la actual época del Antropoceno (Crutzen-Stoermer 2000). Desde una lectura ecocrítica, el artículo busca explorar cómo se expone el paradigma Antropocénico en Solar,A Novel del escritor británico Ian McEwan, particularmente, en la representación de tres ejes: tiempo, espacio y riesgo (Trexler 2015; Mehnert 2016), parámetros que el Antropoceno exige resignificar
