Lessons learned from stakeholders in a facilitation intervention targeting neonatal health in Quang Ninh province, Vietnam

BACKGROUND: In northern Vietnam the Neonatal health - Knowledge Into Practice (NeoKIP, Current Controlled Trials ISRCTN44599712) trial has evaluated facilitation as a knowledge translation intervention to improve neonatal survival. The results demonstrated that intervention sites, each having an assigned group including local stakeholders supported by a facilitator, lowered the neonatal mortality rate by 50% during the last intervention year compared with control sites. This process evaluation was conducted to identify and describe mechanisms of the NeoKIP intervention based on experiences of facilitators and intervention group members. METHODS: Four focus group discussions (FGDs) were conducted with all facilitators at different occasions and 12 FGDs with 6 intervention groups at 2 occasions. Fifteen FGDs were audio recorded, transcribed verbatim, translated into English, and analysed using thematic analysis. RESULTS: Four themes and 17 sub-themes emerged from the 3 FGDs with facilitators, and 5 themes and 18 sub-themes were identified from the 12 FGDs with the intervention groups mirroring the process of, and the barriers to, the intervention. Facilitators and intervention group members concurred that having groups representing various organisations was beneficial. Facilitators were considered important in assembling the groups. The facilitators functioned best if coming from the same geographical area as the groups and if they were able to come to terms with the chair of the groups. However, the facilitators' lack of health knowledge was regarded as a deficit for assisting the groups' assignments. FGD participants experienced the NeoKIP intervention to have impact on the knowledge and behaviour of both intervention group members and the general public, however, they found that the intervention was a slow and time-consuming process. Perceived facilitation barriers were lack of money, inadequate support, and the function of the intervention groups. CONCLUSIONS: This qualitative process evaluation contributes to explain the improved neonatal survival and why this occurred after a latent period in the NeoKIP project. The used knowledge translation intervention, where facilitators supported multi-stakeholder coalitions with the mandate to impact upon attitudes and behaviour in the communes, has low costs and potential for being scaled-up within existing healthcare systems.

Gas-filled, flat plate solar collectors

This work treats the thermal and mechanical performances of gas-filled, flat plate solar collectors in order to achieve a better performance than that of air filled collectors. The gases examined are argon, krypton and xenon which all have lower thermal conductivity than air. The absorber is formed as a tray connected to the glass. The pressure of the gas inside is near to the ambient and since the gas volume will vary as the temperature changes, there are potential risks for fatigue in the material. One heat transfer model and one mechanical model were built. The mechanical model gave stresses and information on the movements. The factors of safety were calculated from the stresses, and the movements were used as input for the heat transfer model where the thermal performance was calculated. It is shown that gas-filled, flat plate solar collectors can be designed to achieve good thermal performance at a competitive cost. The best yield is achieved with a xenon gas filling together with a normal thick absorber, where normal thick means a 0.25 mm copper absorber. However, a great deal of energy is needed to produce the xenon gas, and if this aspect is taken into account, the krypton filling is better. Good thermal performance can also be achieved using less material; a collector with a 0.1 mm thick copper absorber and the third best gas, which is argon, still gives a better operating performance than a common, commercially produced, air filled collector with a 0.25 mm absorber. When manufacturing gas-filled flat plate solar collectors, one way of decreasing the total material costs significantly, is by changing absorber material from copper to aluminium. Best yield per monetary outlay is given by a thin (0.3 mm) alu-minium absorber with an argon filling. A high factor of safety is achieved with thin absorbers, large absorber areas, rectangular constructions with long tubes and short distances between glass and absorber. The latter will also give a thin layer of gas which gives good thermal performance. The only doubtii ful construction is an argon filled collector with a normal thick (> 0.50 mm) aluminium absorber. In general, an assessment of the stresses for the proposed construction together with appropriate tests are recommended before manufacturing, since it is hard to predict the factor of safety; if one part is reinforced, some other parts can experience more stress and the factor of safety actually drops.

Evaluation of a thermally driven heat pump for solar heating and cooling applications

Exploiting solar energy technology for both heating and cooling purposes has the potential of meeting an appreciable portion of the energy demand in buildings throughout the year. By developing an integrated, multi-purpose solar energy system, that can operate all twelve months of the year, a high utilisation factor can be achieved which translates to more economical systems. However, there are still some techno-economic barriers to the general commercialisation and market penetration of such technologies. These are associated with high system and installation costs, significant system complexity, and lack of knowledge of system implementation and expected performance. A sorption heat pump module that can be integrated directly into a solar thermal collector has thus been developed in order to tackle the aforementioned market barriers. This has been designed for the development of cost-effective pre-engineered solar energy system kits that can provide both heating and cooling. This thesis summarises the characterisation studies of the operation of individual sorption modules, sorption module integrated solar collectors and a full solar heating and cooling system employing sorption module integrated collectors. Key performance indicators for the individual sorption modules showed cooling delivery for 6 hours at an average power of 40 W and a temperature lift of 21°C. Upon integration of the sorption modules into a solar collector, measured solar radiation energy to cooling energy conversion efficiencies (solar cooling COP) were between 0.10 and 0.25 with average cooling powers between 90 and 200 W/m2 collector aperture area. Further investigations of the sorption module integrated collectors implementation in a full solar heating and cooling system yielded electrical cooling COP ranging from 1.7 to 12.6 with an average of 10.6 for the test period. Additionally, simulations were performed to determine system energy and cost saving potential for various system sizes over a full year of operation for a 140 m2 single-family dwelling located in Madrid, Spain. Simulations yielded an annual solar fraction of 42% and potential cost savings of €386 per annum for a solar heating and cooling installation employing 20m2 of sorption integrated collectors.