Evaluation use within a humanitarian non-governmental organization’s health care user-fee exemption program in West Africa

L’évaluation de l’action humanitaire (ÉAH) est un outil valorisé pour soutenir l’imputabilité, la transparence et l’efficience de programmes humanitaires contribuant à diminuer les inéquités et à promouvoir la santé mondiale. L’EAH est incontournable pour les parties prenantes de programme, les bailleurs de fonds, décideurs et intervenants souhaitant intégrer les données probantes aux pratiques et à la prise de décisions. Cependant, l’utilisation de l’évaluation (UÉ) reste incertaine, l’ÉAH étant fréquemment menée, mais inutilisé. Aussi, les conditions influençant l’UÉ varient selon les contextes et leur présence et applicabilité au sein d’organisations non-gouvernementales (ONG) humanitaires restent peu documentées. Les évaluateurs, parties prenantes et décideurs en contexte humanitaire souhaitant assurer l’UÉ pérenne détiennent peu de repères puisque rares sont les études examinant l’UÉ et ses conditions à long terme. La présente thèse tend à clarifier ces enjeux en documentant sur une période de deux ans l’UÉ et les conditions qui la détermine, au sein d’une stratégie d’évaluation intégrée au programme d’exemption de paiement des soins de santé d’une ONG humanitaire. L’objectif de ce programme est de faciliter l’accès à la santé aux mères, aux enfants de moins de cinq ans et aux indigents de districts sanitaires au Niger et au Burkina Faso, régions du Sahel où des crises alimentaires et économiques ont engendré des taux élevés de malnutrition, de morbidité et de mortalité. Une première évaluation du programme d’exemption au Niger a mené au développement de la stratégie d’évaluation intégrée à ce même programme au Burkina Faso. La thèse se compose de trois articles. Le premier présente une étude d’évaluabilité, étape préliminaire à la thèse et permettant de juger de sa faisabilité. Les résultats démontrent une logique cohérente et plausible de la stratégie d’évaluation, l’accessibilité de données et l’utilité d’étudier l’UÉ par l’ONG. Le second article documente l’UÉ des parties prenantes de la stratégie et comment celle-ci servit le programme d’exemption. L’utilisation des résultats fut instrumentale, conceptuelle et persuasive, alors que l’utilisation des processus ne fut qu’instrumentale et conceptuelle. Le troisième article documente les conditions qui, selon les parties prenantes, ont progressivement influencé l’UÉ. L’attitude des utilisateurs, les relations et communications interpersonnelles et l’habileté des évaluateurs à mener et à partager les connaissances adaptées aux besoins des utilisateurs furent les conditions clés liées à l’UÉ. La thèse contribue à l’avancement des connaissances sur l’UÉ en milieu humanitaire et apporte des recommandations aux parties prenantes de l’ONG.

Coordination in humanitarian logistics through clusters

Purpose – In the field of humanitarianism, cluster thinking has been suggested as a solution to the lack of coordinated disaster response. Clusters for diverse functions, including sheltering, logistics and water and sanitation, can be viewed as an effort to achieve functional coordination. The purpose of this paper is to contribute to a greater understanding of the potential of cluster concepts using supply chain coordination and inter‐cluster coordination. The focus is on the conceptual level rather than on specific means of coordination. Design/methodology/approach – The cluster concept in humanitarian relief, along with some key empirical issues, is based on a case study. The concept is then compared to the literature on clusters and coordination in order to develop a theoretical framework with propositions on the tradeoffs between different types of coordination. Findings – The results provide important reflections on one of the major trends in contemporary development of humanitarian logistics. This paper shows that there is a tradeoff between different types of coordination, with horizontal coordination inside cluster drawing attention away from important issues of the supply chain as well as the need to coordinate among the clusters. Research limitations/implications – There is a need for more in‐depth case studies of experiences with clusters in various operations. Various perspectives should be taken into account, including the field, responding agencies, beneficiaries, donors, military and commercial service providers, both during and between disasters. Practical implications – The paper presents the tradeoffs between different types of coordination, in which basic aims such as standardisation through functional coordination, must be balanced with cross‐functional and vertical coordination in order to more successfully serve the users' composite needs. Originality/value – The focus on possible trade‐offs between different types of coordination is an important complement to the literature, which often assumes simultaneous high degrees of horizontal and vertical coordination.

Theory development in humanitarian logistics : A framework and three cases

Purpose: There is a need for theory development within the field of humanitarian logistics to understand logistics needs in different stages of a crisis and how to meet these. This paper aims to discuss three dimensions identified in logistics and organization theories and how they relate to three different cases of humanitarian logistics operations - the regional concept of the International Federation of Red Cross Red Crescent Societies, the development and working of the United Nations Joint Logistics Centre and coordination challenges of military logistics in UN mandated peacekeeping operations. The purpose is to build a framework to be used in further studies. Design/methodology/approach: A framework for the study of humanitarian logistics along three dimensions is developed, followed by a discussion of the chosen cases in relation to these dimensions. The framework will be used as basis for the case studies to be undertaken for the purpose of understanding and identification of new questions and needs for other or revised concepts from theory. Findings: The paper shows the relevance of a wide literature to the issues pertinent to humanitarian logistics. There is considerable promise in extant literature on logistics, SCM and coordination, but this needs to be confronted with the particular issues seen in the humanitarian logistics setting to achieve further theory development. Originality/value: The major contribution of the paper lies in its breadth of theoretical perspectives presented and combined in a preliminary theoretical framework. This is applied more specifically in the three case studies described in the paper.

REFUGEES AND RESETTLEMENT: A QUALITATIVE ANALYSIS OF REFUGEE INTEGRATION THROUGH SOCIAL & SUPPORT SERVICES

This dissertation studies refugee resettlement in the United States utilizing the Integration Indicator’s framework developed by Ager and Strang for the U.S. context. The study highlights the U.S. refugee admissions program and the policies in the states of Maryland and Massachusetts while analyzing the service delivery models and its effects on refugee integration in these locations. Though immigration policy and funding for refugee services are primarily the domain of the federal government, funds are allocated through and services are delivered at the state level. The Office of Refugee Resettlement (ORR), which operates under the Department of Health and Human Services, was established after the Refugee Act of 1980 to deliver assistance to displaced persons. The ORR provides funds to individual states primarily through The Refugee Social Service and Targeted Assistance Formula Grant programs. Since the inauguration of the ORR three primary models of refugee integration through service delivery have emerged. Two of the models include the publicly/privately administered programs, where resources are allocated to the state in conjunction with private voluntary agencies; and the Wilson/Fish Alternative programs, where states sub-contract all elements of the resettlement program to voluntary agencies and private organizations —in which they can cease all state level participation and voluntary agencies or private organizations contract directly from the ORR in order for all states to deliver refugee services where the live. The specific goals of this program are early employment and economic self-sufficiency. This project utilizes US Census, state, and ORR data in conjunction with interviews of refugee resettlement practitioners involved in the service delivery and refugees. The findings show that delivery models emphasizing job training, English instruction courses, institutional collaboration, and monetary assistance, increases refugee acclimation and adaptation, providing insight into their potential for integration into the United States.

Evaluation use within a humanitarian non-governmental organization’s health care user-fee exemption program in West Africa

L’évaluation de l’action humanitaire (ÉAH) est un outil valorisé pour soutenir l’imputabilité, la transparence et l’efficience de programmes humanitaires contribuant à diminuer les inéquités et à promouvoir la santé mondiale. L’EAH est incontournable pour les parties prenantes de programme, les bailleurs de fonds, décideurs et intervenants souhaitant intégrer les données probantes aux pratiques et à la prise de décisions. Cependant, l’utilisation de l’évaluation (UÉ) reste incertaine, l’ÉAH étant fréquemment menée, mais inutilisé. Aussi, les conditions influençant l’UÉ varient selon les contextes et leur présence et applicabilité au sein d’organisations non-gouvernementales (ONG) humanitaires restent peu documentées. Les évaluateurs, parties prenantes et décideurs en contexte humanitaire souhaitant assurer l’UÉ pérenne détiennent peu de repères puisque rares sont les études examinant l’UÉ et ses conditions à long terme. La présente thèse tend à clarifier ces enjeux en documentant sur une période de deux ans l’UÉ et les conditions qui la détermine, au sein d’une stratégie d’évaluation intégrée au programme d’exemption de paiement des soins de santé d’une ONG humanitaire. L’objectif de ce programme est de faciliter l’accès à la santé aux mères, aux enfants de moins de cinq ans et aux indigents de districts sanitaires au Niger et au Burkina Faso, régions du Sahel où des crises alimentaires et économiques ont engendré des taux élevés de malnutrition, de morbidité et de mortalité. Une première évaluation du programme d’exemption au Niger a mené au développement de la stratégie d’évaluation intégrée à ce même programme au Burkina Faso. La thèse se compose de trois articles. Le premier présente une étude d’évaluabilité, étape préliminaire à la thèse et permettant de juger de sa faisabilité. Les résultats démontrent une logique cohérente et plausible de la stratégie d’évaluation, l’accessibilité de données et l’utilité d’étudier l’UÉ par l’ONG. Le second article documente l’UÉ des parties prenantes de la stratégie et comment celle-ci servit le programme d’exemption. L’utilisation des résultats fut instrumentale, conceptuelle et persuasive, alors que l’utilisation des processus ne fut qu’instrumentale et conceptuelle. Le troisième article documente les conditions qui, selon les parties prenantes, ont progressivement influencé l’UÉ. L’attitude des utilisateurs, les relations et communications interpersonnelles et l’habileté des évaluateurs à mener et à partager les connaissances adaptées aux besoins des utilisateurs furent les conditions clés liées à l’UÉ. La thèse contribue à l’avancement des connaissances sur l’UÉ en milieu humanitaire et apporte des recommandations aux parties prenantes de l’ONG.

The Influence of Place Attachment, Aspirations, and Rapidly Changing Environments on Resettlement Decisions

Resettlement associated with development projects results in a variety of negative impacts. This dissertation uses the resettlement context to frame the dynamic relationships formed between peoples and places experiencing development. Two case studies contribute: (a) the border zone of Mozambique’s Limpopo National Park where residents contend with changes to land access and use; and (b) Bairro Chipanga in Moatize, Mozambique where a resettled population struggles to form place attachment and transform the post-resettlement site into a “good” place. Through analysis of data collected at these sites between 2009 and 2015, this dissertation investigates how changing environments impact person-place relationships before and after resettlement occurs. Changing environments create conditions leading to disemplacement—feeling like one no longer belongs—that reduces the environment’s ability to foster place attachment. Research findings indicate that responses taken by individuals living in the changing environment depend heavily upon whether resettlement has already occurred. In a pre-resettlement context, residents adjust their daily lives to diminish the effects of a changing environment and re-create the conditions to which they initially formed an attachment. They accept impoverishing conditions, including a narrowing of the spaces in which they live their daily lives, because it is preferred to the anxiety that accompanies being forced to resettle. In a post-resettlement context, resettlement disrupts the formation of place attachment and resettled peoples become a placeless population. When the resettlement has not resulted in anticipated outcomes, the aspiration for social justice—seeking conditions residents had reason to expect—negatively influences residents’ perspectives about the place. The post-resettlement site becomes a bad place with a future unchanged from the present. At best, this results in a population in which more members are willing to move away from the post-resettlement site, and, at worse, complete disengagement of other members from trying to improve the community. Resettlement thus has the potential to launch a cycle of movement- displacement-movement that prevents an entire generation from establishing place attachment and realizing its benefits. At the very least, resettlement impedes the formation of place attachment to new places. Thus, this dissertation draws attention to the unseen and uncompensated losses of resettlement.

Avaliação da qualidade de vida de um grupo de tabagistas participantes de um programa interdisciplinar em Centro de Saude

Universidade Estadual de Campinas . Faculdade de Educação Física

Contemporary sexism - The relationships among hostility, benevolence, and neosexism

Previous research has examined the relationship between the Modern Sexism Scale (Swim, Aikin, Hall & Hunter, 1995) and the Ambivalent Sexism Inventory (ASI; Glick & Fiske, 1996) or the relationship between the Modern Sexism Scale and the Neosexism Scale (Campbell, Schellenberg, & Senn, 1997; Tougas, Brown, Beaten, & Joly, 1995). The present study examined the relationship between the ASI and the Neosexism Scale. Across three samples (N = 907), neosexism was found to be associated primarily with the hostile rather than the benevolent component of ambivalent sexism. Hostile sexism, benevolent sexism, and neosexism were all significantly associated with attitudes toward lesbians' and gay men's rights, and both hostile sexism and neosexism were significantly associated with attitudes toward women's rights. Neosexism and hostile sexism were negatively associated with a humanitarian-egalitarian orientation, whereas benevolent sexism was positively associated with a Protestant-ethic orientation. It is concluded that, although both the Neosexism Scale and ASI measure contemporary sexism, only the Benevolent Sexism subscale of the ASI taps the subjectively positive side of contemporary sexism.

THE POLICY AGENDA OF ISPRM

This paper suggests a comprehensive policy agenda and first steps to be undertaken by the International Society of Physical and Rehabilitation Medicine (ISPRM) in order to realize its humanitarian, professional and scientific mandates. The general aims of ISPRM, as formulated in its guiding documents, the relations with the World Health Organization (WHO) and the United Nations system, and demands of ISPRM`s constituency herein form the basis of this policy agenda Agenda items encompass contributions to the establishment of rehabilitation services worldwide and the development of PRM societies ISPRM`s possible input in general curricula in disability and rehabilitation, and in fighting discrimination against people experiencing disability are discuss. Moreover, the implementation of the International Classification of Functioning. Disability and Health (ICF) in medicine, contributions to WHO guidelines relevant to disability and rehabilitation the provision of a conceptual description of the rehabilitation strategy and the outline of a rehabilitation services matrix are seen as important agenda items of ISPRM`s external policy. With regard to its constituency and internal policy, a definition of the field of competence and a conceptual description of PRM, as well as the development of a consistent and comprehensive congress topic list and congress structure appear to be crucial items. The proposed agenda items serve as a basis for future discussions.

Image quality assessment and medical physics evaluation of different portable dental X-ray units

Introduction: Recently developed portable dental X-ray units increase the mobility of the forensic odontologists and allow more efficient X-ray work in a disaster field, especially when used in combination with digital sensors. This type of machines might also have potential for application in remote areas, military and humanitarian missions, dental care of patients with mobility limitation, as well as imaging in operating rooms. Objective: To evaluate radiographic image quality acquired by three portable X-ray devices in combination with four image receptors and to evaluate their medical physics parameters. Materials and methods: Images of five samples consisting of four teeth and one formalin-fixed mandible were acquired by one conventional wall-mounted X-ray unit, MinRay (R) 60/70 kVp, used as a clinical standard, and three portable dental X-ray devices: AnyRay (R) 60 kVp, Nomad (R) 60 kVp and Rextar (R) 70 kVp, in combination with a phosphor image plate (PSP), a CCD, or a CMOS sensor. Three observers evaluated images for standard image quality besides forensic diagnostic quality on a 4-point rating scale. Furthermore, all machines underwent tests for occupational as well as patient dosimetry. Results: Statistical analysis showed good quality imaging for all system, with the combination of Nomad (R) and PSP yielding the best score. A significant difference in image quality between the combination of the four X-ray devices and four sensors was established (p < 0.05). For patient safety, the exposure rate was determined and exit dose rates for MinRay (R) at 60 kVp, MinRay (R) at 70 kVp, AnyRay (R), Nomad (R) and Rextar (R) were 3.4 mGy/s, 4.5 mGy/s, 13.5 mGy/s, 3.8 mGy/s and 2.6 mGy/s respectively. The kVp of the AnyRay (R) system was the most stable, with a ripple of 3.7%. Short-term variations in the tube output of all the devices were less than 10%. AnyRay (R) presented higher estimated effective dose than other machines. Occupational dosimetry showed doses at the operator`s hand being lowest with protective shielding (Nomad (R): 0.1 mu Gy). It was also low while using remote control (distance > 1 m: Rextar (R) < 0.2 mu Gy, MinRay (R) < 0.1 mu Gy). Conclusions: The present study demonstrated the feasibility of three portable X-ray systems to be used for specific indications, based on acceptable image quality and sufficient accuracy of the machines and following the standard guidelines for radiation hygiene. (C) 2010 Elsevier Ireland Ltd. All rights reserved.

For Your Freedom and Ours: The Polish Question in Wilson's Peace Initiatives, 1916 - 1917

The first eighteen months of the Great War witnessed an unprecedented awakening of interest in the Polish Question, when worldwide attention was drawn to the prolonged devastation of the Polish territories. Thereafter, a steady increase in media comment and criticism, highlighting Poland's plight, fostered public indignation at the continual stalling of humanitarian relief efforts for Polish refugees. Such burgeoning popular sentiment focused wider political attention upon a growing movement for recognition of Polish claims to independence. This particularly proved to be the case for Woodrow Wilson and his administration's budding interest in Poland. Subsequently, nowhere did the Polish Question assume a greater role in diplomatic efforts to mediate for peace than in America, and at no time more than during the year preceding the President's hesitant decision to intervene in hostilities.

The Utility of the Human Security Agenda for Policy-makers

The idea of “human security” is gaining attention among policy-makers and security analysts. Little scholarly attention has been given to the questions of why states accept (or reject) a human security agenda or how such an agenda is incorporated into policy practices. The article suggests that a human security approach is most likely to be applied when both humanitarian and national interests combine. Yet when states or organisations adopt a human security approach, they often misjudge the complex and long-term commitment required of such an approach. There is also the potential for such an agenda to be manipulated to justify questionable courses of action. These issues frame an analysis of six recent case studies.

Moravia : das lógicas da informalidade às lógicas da formalidade

Dissertação (mestrado)—Universidade de Brasília, Faculdade de Arquitetura e Urbanismo, Programa de Pós-Graduação em Arquitetura e Urbanismo, 2016.