262,217 research outputs found
Understanding Stakeholders’ Roles in Health Sector Reform Process in Tanzania: The Case of Decentralizing the Immunization Program.
No full textThe current need and enthusiasm for health reforms open an important arena for deeper analysis of the policy process with a view to understanding the political determinants of reforms and strengthening implementation. The studies described in this thesis analyse positions of different actors in the reform process, their actions in support or opposition of the process, and their impact on the health sector reform process. Globally and especially in developing countries health sector reforms have been implemented over long periods. Although there have been improvements in health, the remaining burden of disease in many countries is still very high. Reasons for the high burden of disease have been classified into lack of resources and poor organizational and managerial capacity. Good stewardship was needed to facilitate improvement in the performance of health systems. Stakeholders’ alignment and support was one of the most important components of good stewardship. However, stakeholder analysis had not been a common undertaking in developing countries despite the reforms that were being implemented in most of them. It was the aim of this study to answer the question: What has been the role and importance of stakeholders in supporting or opposing the health sector reform process? The study was conducted in Tanzania as one of the poorest countries in Africa, using the decentralization of the Expanded Programme on Immunization (EPI) as a case reference. The study units were the Ministry of Health Headquarters, Medical Stores Department, Expanded Programme on Immunization, national archives, regions and districts. At district level the study units were District Council, Council Health Management Team, EPI managers at regional and district levels, ward and village authorities, health facility, facility providers and households. Qualitative and quantitative methods were used to collect data from January 2000 to June 2002. Relevant data collection instruments were prepared and pre-tested. The qualitative data collection methods included document review, in-depth interviews, key informants interviews and observations. Quantitative methods involved retrieval of secondary data, health facility survey and household surveys. Regular discussions with key informants and data collectors were held to verify the findings. Qualitative data was analysed manually. Quantitative data was captured and analysed using Epi Info version 6.1 and STATA version 6.0. The study involved answering five main questions. The first question was: Do reforms learn from history? Analysis of the waves of health reforms prior to the current reforms from 1926 was done to answer the question. The main stakeholders in the reforms were the political party in power, the government and donors who supported the reforms each time. Each wave of health sector reforms provided information on health provision, financing and resource generation. Due to the political contexts, information on failures of health financing did not provide lessons for succeeding reforms of the health sector. Stakeholders’ political interests opposed lessons that did not match the political ideology at the time i.e. free public services versus privatization and paying for social services. Lessons from previous health reforms were selective, and did not consider health-financing needs among others. The ongoing health reforms needed to use information from all functional aspects of the health system to provide lessons for improving the health system. The second question was: Who were the stakeholders in the current health reforms and what were their interests and reactions? The main stakeholders were donors, and the government. The two had a very high support for the reforms evidenced by their participation in problem identification, justification, reform design, planning and implementation. The health sector reforms thus had high political support at central level. In the implementation process, issues that triggered stakeholders’ reaction included sectoral versus local government decentralization. Another issue was the donor modality in financing the health sector and need for adopting new financial management systems. Among the donors there was hesitancy to join the common financing modalities that included a Sector Wide Approach (SWAp) and Basket Funding. As a result, there was delay in the process in order to reach better consensus. The third question was: What was the impact of stakeholders in the process of reforming a vertical programme like EPI? Health Sector Reforms in EPI included integration of generic functions, for example, vaccine procurement to medical stores department. Qualitative and quantitative data was collected and analysed from the Ministry of Health, EPI management unit. This again revealed that EPI reforms were well supported by the government and donors centrally. EPI managers at both district and regional levels opposed some of the EPI reforms. They argued that coverage was falling due to the reforms. However, there was no concrete evidence relating reforms in the EPI programme and falling coverage. The primary aim of certain actors was to make sure that they continued receiving extra income from EPI functions. One of the effects of stakeholders’ reaction was reversal of reforms (recentralization) and return to the status quo. The fourth question was: What was the immediate reaction of stakeholders to decentralization at district level and how might it have affected performance of EPI functions and the challenges? The immediate reaction of stakeholders was reduced cooperation between the Council Health Management Team (CHMT) and the District Council who were politically supreme in the district. Within the Council Health Management Team there was inadequate communication, which led to poor teamwork. The result of this was reduced supervisory visits to peripheral health facilities. The EPI coverage in the study district was 52.8 per cent, which was well below the previous national average (80 per cent). A logistic regression model for EPI service quality variables on children between 12 months and 23 months who had completed vaccination was applied. Certain EPI quality of service variables predicted significant changes in the odds ratio for completing vaccination. It was then suggested that strategies were needed to improve management skills among the CHMT and District Council members. Also there was a need of hastening the process of increasing remuneration and motivation of peripheral health workers. The fifth and final question was: What was the interest of the stakeholders and prospects of increasing EPI coverage at district level? Decentralization and integration of EPI functions were among the reforms at district level. The analysis revealed that active stakeholders at district level were the Ministry of Health, CHMT, EPI managers at district and regional levels and facility providers. The Ministry of Health opposed integration of EPI at district level by issuing the directive that DCCOs and MCHCOs (EPI manager at district level) should resume their tasks. However, the CHMT had no option but to comply. This action reversed some of the health reforms at district level. Analysis of the importance the community attached to EPI, using willingness to pay for EPI cold chain kerosene, was done. The support was low (48.7 per cent). EPI service quality variables were significantly negatively associated with odds ratio for willingness to pay for EPI input. Simulation with Policy Maker computer software predicted that an increased number of stakeholders through community participation would significantly improve the current low level of EPI coverage. It was then proposed to do a similar analysis in other vertical programmes and implement on a trial basis the results of the simulation. In conclusion, stakeholders were found to be active and influential in the health sectors of developing countries like Tanzania but poorly considered in implementation of reforms. Stakeholders are important since some strongly support while others oppose the reforms. The reaction of stakeholders is evident through deployment or non-deployment of information depending on interest and context. This would result in poor management leading to inefficiency in resource use, which would then be followed by poor quality of services, poor support by communities and consequently poor utilization of health services. It is suggested that stakeholder analysis be conducted in other vertical programmes in the process of integration. Promotion of stakeholder analysis and also Policy Maker as a tool to manage stakeholders will facilitate the management of reforms in the health sector
Trends in immunization completion and disparities in the context of health reforms: the case study of Tanzania.
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Of global concern is the decline in under five children mortality which has reversed in some countries in sub Saharan Africa (SSA) since the early 1990 s which could be due to disparities in access to preventive services including immunization. This paper is aimed at determining the trend in disparities in completion of immunization using Tanzania Demographic and Health Surveys (DHS). DHS studies randomly selected representative households from all regions in Tanzania since 1980 s, is repeated every five years in the same enumeration areas. The last three data sets (1990, 1996 and 2004) were downloaded and analyzed using STATA 9.0. The analysis included all children of between 12-23 months who would have completed all vaccinations required at 12 months. Across the time periods 1990, 1996 to 2004/05 the percentage of children completing vaccination was similar (71.0% in 1990, 72.7% in 1996 and 72.3% in 2005). There was no disparity in completion of immunization with wealth strata in 1990 and 1996 (p > 0.05) but not 2004. In 2004/05 there was marked disparity as most poor experienced significant decline in immunization completion while the least poor had significant increase (p < 0.001). All three periods children from households whose head had low education were less likely to complete immunization (p < 0.01). Equity that existed in 1990 and more pronounced in 1996 regressed to inequity in 2005, thus though at national level immunization coverage did not change, but at sub-group there was significant disparity associated with the changing contexts and reforms. To address sub-group disparities in immunization it is recommended to adopt strategies focused at governance and health system to reach all population groups and most poor.\u
Going Beyond Counting First Authors in Author Co-citation Analysis
No full textThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Protecting Animals 36: Author Witi Ihimaera
No full textIn this very special episode of Knowing Animals I am joined by beloved New Zealand author Witi Ihimaera. Witi has written many books featuring nonhuman animals. He offers us a non-colonial lens through which to think about the human/nonhuman relationship
Author Under Sail The Imagination of Jack London, 1893-1902
No full textIn Author Under Sail, Jay Williams offers the first complete literary biography of Jack London as a professional writer engaged in the labor of writing. It examines the authorial imagination in London's work, the use of imagination in both his fiction and nonfiction, and the ways he defined imagination in the creative process in his business dealings with his publishers, editors, and agents. In this first volume of a two-volume biography, Williams traverses the years 1893 to 1902, from London's "Story of a Typhoon" to The People of the Abyss. The Jack London who emerges in the pages of Author Under Sail is a writer whose partnership with publishers, most notably his productive alliance with George Brett of Macmillan, was one of the most formative in American literary history. London pioneered many author models during the heyday of realism and naturalism, blurring the boundaries of these popular genres by focusing on absorption and theatricality and the representation of the seen and unseen. London created an impassioned, sincere, and extremely personal realism unlike that of other American writers of the time. Author Under Sail is a literary tour de force that reveals the full range of London as writer, creative citizen, and entrepreneur at the same time it sheds light on the maverick side of machine-age literature.Intro -- Title Page -- Copyright Page -- Dedication -- Contents -- Acknowledgments -- Introduction -- 1. Spirit Truth -- 2. From Absorption to Theatricality and Back Again -- 3. "I Will Build a New Present" -- 4. Sons as Authors -- 5. Fathers as Publishers -- 6. The Daughter as Author -- 7. Lovers as Authors -- 8. At Sea with the Family -- 9. Yellow News, Yellow Stories -- 10. The Return Home -- Notes -- Bibliography -- Index -- About Jay WilliamsIn Author Under Sail, Jay Williams offers the first complete literary biography of Jack London as a professional writer engaged in the labor of writing. It examines the authorial imagination in London's work, the use of imagination in both his fiction and nonfiction, and the ways he defined imagination in the creative process in his business dealings with his publishers, editors, and agents. In this first volume of a two-volume biography, Williams traverses the years 1893 to 1902, from London's "Story of a Typhoon" to The People of the Abyss. The Jack London who emerges in the pages of Author Under Sail is a writer whose partnership with publishers, most notably his productive alliance with George Brett of Macmillan, was one of the most formative in American literary history. London pioneered many author models during the heyday of realism and naturalism, blurring the boundaries of these popular genres by focusing on absorption and theatricality and the representation of the seen and unseen. London created an impassioned, sincere, and extremely personal realism unlike that of other American writers of the time. Author Under Sail is a literary tour de force that reveals the full range of London as writer, creative citizen, and entrepreneur at the same time it sheds light on the maverick side of machine-age literature.Description based on publisher supplied metadata and other sources.Electronic reproduction. Ann Arbor, Michigan : ProQuest Ebook Central, YYYY. Available via World Wide Web. Access may be limited to ProQuest Ebook Central affiliated libraries
Author in Essay by I. A. Goncharov “Pepiniere”
No full textFeatures of the embodiment of the author’s position in the essay by I. A. Goncharov “Pepiniere” are considered. The relevance of the study is due to the poorly studied poetics of this work. A review of the scientific literature on relevant topics is performed. Methodological and theoretical definitions are given. The scientific novelty of the article is in the fact that for the first time attention is paid to artistic techniques that allow to identify the author's position in the specified literary text. The author of the article grounds her opinion from the fact that, despite the dominance of the subjective point of view, other characters’ views stand out in the work. It is concluded in the study that the text of the work represents a biographical author and author-creator. It was established that the position of the author-creator is expressed through the title, epigraphs, which are quotes, as well as through different points of view, including the author-character, the author-narrator, the characters of the work. The author of the article dwells in detail on different ways of expressing the points of view of the author-character and the author-narrator. It is proved that the point of view of the author-character and the author-narrator can intersect, they are interchanged. The author's development of the term comic “point of view” is presented in the article
Espai i identitat en l'obra de Jordi Pere Cerdà. Una geografia literària cerdaniana
No full textL'obra de l'autor nord-català Jordi Pere Cerdà (1920-2011) teixeix una cartografia literària que abasta tota dimensió espacial -real, imaginada i ficcional. Les prospeccions que assagen els seus texts es fonen en el medi natural i rural, canten a l'amor, als veïns i als éssers fantàstics del folklore català, es comprometen amb els refugiats encarant-se a tota frontera i, també, a tot abisme interior i exterior que oprimesca l'ésser. El mapatge cognitiu i literari que crea Cerdà sobrepassa qualsevol obstacle per construir espais oberts i possibles, en comunió amb l'altre. Partint d'una aproximació teòrica geocrítica, aquest treball d'investigació aprofundeix en diverses nocions sobre l'espacialitat lligades a un context convuls, ple de transformacions a nivell socioeconòmic, polític, cultural i lingüístic, el qual determinarà la vida d'un autor i d'un territori transfronterer com el de la Cerdanya i la Catalunya del Nord. En definitiva, la rica experiència vital de Jordi Pere Cerdà ens permet reflexionar sobre les relacions que vulguem establir entre els individus i amb el nostre hàbitat natural i cultural, a fi d'esdevenir membres actius que participen de la transformació dels espais que configuren les nostres identitats.The work of the North Catalan author Jordi Pere Cerdà (1920-2011) weaves a literary cartography which reaches all spatial dimensions -real, imagined and fictional. The prospections proved by their texts merge with the natural and rural environment, sing to love, neighbours and the fantastic beings of the Catalan folklore. Such prospections also commit themselves with the refugees facing every frontier and, also, facing all interior and exterior abyss that oppresses the being. The cognitive and literary mapping created by Cerdà overcomes any obstacle to construct opened and possible spaces, in communion with the other. Based on the theoretical approach called geocriticism, this research study delves into various notions about spatiality linked to a convulsive context, full of transformations at a socioeconomic, political, cultural and linguistic level; these transformations will determine the life of an author and a cross-border territory such as Cerdagne and Northern Catalonia. In short, the rich experience of Jordi Pere Cerdà allows us to reflect on the relationships we want to establish between individuals, as well as between human groups and our natural and cultural habitat, in order to become active members that participate in the transformation of the spaces that make up our identities.Programa de Doctorat en Llengües Aplicades, Literatura i Traducci
Els llibres d'il·lustració infantil i juvenil en l'Educació Artística. Un cas concret a partir de l’autora Olga de Dios
No full textTreball Final de Grau en Mestre o Mestra d'Educació Primària (Pla de 2018). Codi: MP1840. Curs acadèmic: 2021/2022El treball de fi de grau que aneu a veure a continuació, és un projecte que consisteix en com es poden
treballar a les aules de primària els llibres de l’autora i il·lustradora Olga de Dios. Tractant de treballar
el llibre com a objecte artístic a nivell elemental. A més, de presentar a l’autora i il·lustradora, donarla a conèixer i veure els valors que transmet, també llegiríem quatre de les seues obres a l’aula com
són: “Leotolda”, “En familia”, “Rana de Tres Ojos”, i “Pájaro Amarillo”. Tot açò sumat a la
realització d’un quadern de classe on es colorejaria alguns dels seus personatges de les obres seguint
pautes a nivell curricular. Realitzaríem també una eixida a la biblioteca municipal, on a banda de
rebre una educació no formal, ens facilitaria una mica el fet d’endinsar-nos al món de la il·lustració
infantil, on allí dins, el professional encarregat ens guiarà pels llibres que hi haurà a la biblioteca. I,
per a concloure, elaboraríem un llibre creat per l’alumnat on seguint unes pautes establertes per Olga
de Dios al seu llibre “Leotolda” buscaríem fer una retroalimentació intentant contactar amb ella.
D’aquesta manera tancaríem el cicle que vam començar donant-la a conèixer com a escriptora i
il·lustradora, i exploraríem on està el límit de la creativitat del propi alumnat.The final degree project you are going to see below is a project that looks at how books by author and
illustrator Olga de Dios can be worked on in primary school classrooms. Considering the book as an
artistic object at an elementary level. Besides presenting the author and illustrator, introducing her,
and seeing the values she transmits, we would also read four of her works in the classroom, such as:
"Leotolda”, "In the family", "Three-Eyed Frog", and "Yellow Bird.". All this, in addition to the
creation of a class notebook in which some of his characters from her work would be colored
following guidelines at the curricular level. We would also go out to the local library, where in
addition to receiving a non-formal education, it would make it a little easier for us to enter the world
of children's illustration, where inside, the professional in charge will guide us through the books
which will be in the library. And, to conclude, we would make a book created by the students, where
following some guidelines established by Olga de Dios in her book "Leotolda" we would look for
feedback by trying to contact her. In this way, we would close the cycle that we started by presenting
her as an author and illustrator, and we would explore where the limit of creativity of the students
themselves is
The construction of Karen Karnak: The multi-author-function
No full textThis thesis is situated within the comparatively recent developments of Web 2.0 and the emergence of interactive WikiMedia, and explores the mode of authorship within a Read/Write culture compared to that of a Read/Only tradition. The hypothesis of this study is that the role of the audience has become merged with the author, and as such, represents new functions and attributes, distinct from a more conventional concept of authorship, in which the roles of audience and author are more separate. Read/Write and participatory culture, as defined by this study, is focused on collaboration, and includes the influences of D.I.Y. culture, Open-Source practices and the production of text by multiple authors. Multi-authorship presents a re-thinking of several concepts which support the notion of the individual author, since the focus of multi-authorship is not on attribution and ownership of a finished text, but on the continued malleability of a text. Modes of multi-authorship, demonstrated in the use of the pseudonyms Alan Smithee and Karen Eliot, represent declarative authors whose names signify multiple origins, whilst concurrently indicating a distinct body of work. The function of these names form an important context to this study, since primary research involves the construction of an experimental mode of multi-authorship utilising WikiMedia technology and the interaction of thirty nine participants, who are invited to create a body of work under the collective pseudonym Karen Karnak. The data generated by this experiment is analysed using aspects of Michel Foucault's author-function to identify and determine power structures inherent in the WikiMedia context. The interplay of power structures, including concepts such as identity, ownership and the body of work, affect the resulting mode of authorship and contribute to the construction of Karen Karnak, suggesting further areas of research into the emerging multi-author
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