Putting Adequate Financial and Human Resources in Healthcare for Effective Universal Health Coverage in Kenya: Lessons and Experiences from China

In recent years, most low and middle-income countries, have adopted different approaches to universal health coverage (UHC), to ensure equity and financial risk protection in accessing essential healthcare services. UHC-related policies and delivery strategies are largely based on existing healthcare systems, a result of gradual development (based on local factors and priorities). Most countries have emphasized on health financing, and human resources for health (HRH) reform policies, based on good practices of several healthcare plans to deliver UHC for their population.

Health financing and labor market frameworks were used, to understand health financing, HRH dynamics, and to analyze key health policies implemented over the past decade in Kenya’s effort to achieve UHC. Through the understanding, policy options are proposed to Kenya; analyzing, and generating lessons from health financing, and HRH reforms experiences in China. Data was collected using mixed methods approach, utilizing both quantitative (documents and literature review), and qualitative (in-depth interviews) data collection techniques.

The problems in Kenya are substantial: high levels of out-of-pocket health expenditure, slow progress in expanding health insurance among informal sector workers, inefficiencies in pulling of health are revenues, inadequate deployed HRH, maldistribution of HRH, and inadequate quality measures in training health worker. The government has identified the critical role of strengthening primary health care and the National Hospital Insurance Fund (NHIF) in Kenya’s move towards UHC. Strengthening primary health care requires; re-defining the role of hospitals, and health insurance schemes, and training, deploying and retaining primary care professionals according to the health needs of the population; concepts not emphasized in Kenya’s healthcare reforms or programs design. Kenya’s top leadership commitment is urgently needed for tougher reforms implementation, and important lessons from China’s extensive health reforms in the past decade are beneficial. Key lessons from China include health insurance expansion through rigorous research, monitoring, and evaluation, substantially increasing government health expenditure, innovative primary healthcare strengthening, designing, and implementing health policy reforms that are responsive to the population, and regional approaches to strengthening HRH.

Influence of Increased Human Presence in the Mills River Basin on Water Availability and Drought

Periods of drought and low streamflow can have profound impacts on both human and natural systems. People depend on a reliable source of water for numerous reasons including potable water supply and to produce economic value through agriculture or energy production. Aquatic ecosystems depend on water in addition to the economic benefits they provide to society through ecosystem services. Given that periods of low streamflow may become more extreme and frequent in the future, it is important to study the factors that control water availability during these times. In the absence of precipitation the slower hydrological response of groundwater systems will play an amplified role in water supply. Understanding the variability of the fraction of streamflow contribution from baseflow or groundwater during periods of drought provides insight into what future water availability may look like and how it can best be managed. The Mills River Basin in North Carolina is chosen as a case-study to test this understanding. First, obtaining a physically meaningful estimation of baseflow from USGS streamflow data via computerized hydrograph analysis techniques is carried out. Then applying a method of time series analysis including wavelet analysis can highlight signals of non-stationarity and evaluate the changes in variance required to better understand the natural variability of baseflow and low flows. In addition to natural variability, human influence must be taken into account in order to accurately assess how the combined system reacts to periods of low flow. Defining a combined demand that consists of both natural and human demand allows us to be more rigorous in assessing the level of sustainable use of a shared resource, in this case water. The analysis of baseflow variability can differ based on regional location and local hydrogeology, but it was found that baseflow varies from multiyear scales such as those associated with ENSO (3.5, 7 years) up to multi decadal time scales, but with most of the contributing variance coming from decadal or multiyear scales. It was also found that the behavior of baseflow and subsequently water availability depends a great deal on overall precipitation, the tracks of hurricanes or tropical storms and associated climate indices, as well as physiography and hydrogeology. Evaluating and utilizing the Duke Combined Hydrology Model (DCHM), reasonably accurate estimates of streamflow during periods of low flow were obtained in part due to the model’s ability to capture subsurface processes. Being able to accurately simulate streamflow levels and subsurface interactions during periods of drought can be very valuable to water suppliers, decision makers, and ultimately impact citizens. Knowledge of future droughts and periods of low flow in addition to tracking customer demand will allow for better management practices on the part of water suppliers such as knowing when they should withdraw more water during a surplus so that the level of stress on the system is minimized when there is not ample water supply.

Automata and men : the shift towards a human ideal in the fiction of Wyndham Lewis

Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.

Concept maps as a tool to analyze the ideas of teacher training students regarding what to teach on human nutrition in Primary Education

Concept maps are a technique used to obtain a visual representation of a person's ideas about a concept or a set of related concepts. Specifically, in this paper, through a qualitative methodology, we analyze the concept maps proposed by 52 groups of teacher training students in order to find out the characteristics of the maps and the degree of adequacy of the contents with regard to the teaching of human nutrition in the 3rd cycle of primary education. The participants were enrolled in the Teacher Training Degree majoring in Primary Education, and the data collection was carried out through a training activity under the theme of what to teach about Science in Primary School? The results show that the maps are a useful tool for working in teacher education as they allow organizing, synthesizing, and communicating what students know. Moreover, through this work, it has been possible to see that future teachers have acceptable skills for representing the concepts/ideas in a concept map, although the level of adequacy of concepts/ideas about human nutrition and its relations is usually medium or low. These results are a wake-up call for teacher training, both initial and ongoing, because they shows the inability to change priorities as far as the selection of content is concerned.

On gathering in Art therapy: a way to understand and build the discipline with the other

In the present article I try to share some reflections on a case study of an attachment disorder child I worked with for two years through art therapy in a day hospital. Those reflections let me go deeply in some specific elements concerning the discipline which let us delimit its theoretical and methodological possible scope. In this way, from the specific of the case study on propose to reflect on those elements that conform a methodology related to the art therapist way of doing, in order to concrete and evaluate other possible interventions to develop in similar cases and contexts.

The puppet as a tool for working in Art Therapy

This article aims to investigate the possibilities of building puppets in art therapy workshop, for this it realizes a tour of the primitive use of the puppet as a magical twin and potential towards the study of authors who have used the puppets as a therapeutic tool from the first half of the twentieth century. It’s raised an own theoretical organization, which includes the consideration of the significance of the body in the construction and management of the puppet and the puppet transitional perspective, halfway of external reality and psychic reality as an object that makes fantasy and reality arises built.

Sanctity of Human Life in the Context of Human Genetic Research

The study on the concept of sanctity of human life is a journey in finding out what is it said to be “human” in human life. It is an evaluation of the universal concept and the role it plays in controlling and moulding human conduct and relationships. This concept is a foundational principle of human rights law and the grundnorm of every legal system. However, of late, the challenges by way of certain advances in human genetic research had prompted the need to evaluate the significance and extent of the concept in human endeavours. Scientific advances by way of human genetic research promises significant diagnostic and therapeutic advances but at the same time pose threat to fundamental notions and assumptions on humanity, hence there is a global concern to derive common legal standards, Thus the major challenge is to analyse universal principles which can be a common criteria for evolving legal standards to control certain advances in human genetic research. Hence the relevance of the study. The study aims at analysing the content, scope, extent and limitation of the concept of sanctity of human life. In this attempt it evaluates the extent to which the concept had been accommodated by legal systems and international human rights regimes. The problem which had been undertaken in the study is the extent of intrusion made to the concept by virtue of certain advances in human genetic research.

Three essays on investment in human capital in Canada

Cette thèse examine l’investissement en capital humain au Canada en s’intéressant à la contribution de l’aide financière aux études, aux effets de la fiscalité, à la rentabilité de l’investissement en éducation postsécondaire et à la redistribution des revenus. Elle est subdivisée en cinq chapitres. Le premier chapitre présente une révue chronologique des études microéconomiques sur l’investissement en capital humain. Il présente également une synthèse des études canadiennes sur l’investissement en capital humain en insistant sur les limites portant essentiellement sur la non prise en compte de l’hétérogénéité des systèmes de prêts et bourses et des systèmes fiscaux à travers les provinces canadiennes et la faible analyse de la répartition des coûts et bénéfices de l’investissement en éducation au Canada. Le second chapitre présente la méthodologie de mesure des rendements de l’éducation et des gains issus des investissements en éducation. Il décrit les données utilisées et les résultats des régressions économetriques. Finalement, le chapitre présente SIMAID, un calculateur d’aide financière aux études élaboré pour les objectifs dans cette thèse et qui permet d’estimer le montant de l’aide financière devant être attribuée à chaque étudiant en fonction de ses caractéristiques personnelles et de celles de sa famille. Dans sa première section, le troisième chapitre présente les rendements sociaux, privés et publics de l’éducation et montre que les rendements de l’éducation varient selon les provinces, les filières de formation, le genre et les cohortes d’année de naissance et décroient avec le niveau d’éducation. Dans sa seconde section, le chapitre montre que l’aide financière aux études accroît le rendement des études du baccalauréat de 24.3% et 9.5% respectivement au Québec et en Ontario. Finalement, le chapitre indique qu’un changement du système d’aide financière aux études de Québec par celui de l’Ontario entraîne une baisse de 11.9% du rendement des études au baccalauréat alors qu’un changement du système fiscal québécois par celui ontarien entraine une hausse du rendement du baccalauréat de 4.5%. L’effet combiné du changement des systèmes d’aide financière et fiscal est une baisse du rendement du baccalauréat de 7.4%. Le quatrième chapitre fournit une décomposition comptable détaillée des gains sociaux, privés et publics des investissements en éducation. Le gain social de l’investissement au baccalauréat est de $738 384 au Québec et de $685 437 en Ontario. Ce gain varie selon les filières de formation avec un niveau minimal pour les études humanitaires et un niveau maximal pour les études en ingénierie. Le chapitre montre également que la répartition des bénéfices et des coûts de l’investissement en éducation entre les individus et le gouvernement est plus équitable en Ontario qu’à Québec. En effet, un individu qui investit à Québec supporte 51.6% du coût total et engrange 64.8% des gains alors que le même individu supporterait 62.9% des coûts sociaux et engrangerait 62.2% des gains en Ontario. Finalement, le cinquième chapitre présente et analyse les effets rédistributifs des transferts et des taxes suite à un investissement en éducation. Il examine aussi si l’aide financière aux études est effectivement allouée aux personnes les plus pauvres. L’argument selon lequel l’aide financière est destinée aux plus pauvres est rejeté en analysant la distribution du revenu permanent. En effet, il ressort que 79% des personnes bénéficiant de l’aide financière aux études se trouvent dans le cinquième quintile de la distribution des revenus permanents. Le chapitre montre également que l’investissement en éducation impacte positivement les effets rédistributifs en 2006, 2001 et 1996 et négativement en 1991 et 2011. L’impact est également perceptible sur les composantes de l’effet rédistributif. Toutefois, la sensibilité de l’impact au taux d’actualisation dépend de l’indice utilisé dans l’analyse.

Human traces in urban places.

Over the last two centuries many major cities have undergone large-scale modernisation that has led to the growing sense of homogenisation associated with such locales across the globe. The fractal logic that is at the heart of so many urban settings, where the whole system is made up of parts that are identical to the whole, seems to serve in making anonymous everyday experiences. Public transport and its corresponding street furniture, if thoughtfully designed and planned, has the potential to form an integral element in the promotion of a sense of identity, interconnectedness and flow within a city. Furthermore, bus stops, benches, litter bins, curb-sides, posts and pavements, to mention a few, offer interesting cases to consider how people truly engage with contemporary urban spaces. These objects—part of routine and made familiar—are elements of daily lives that are ingredients towards visual and multi-modal experiences. In addition, these are places where individuals encounter sociality and materiality in ordinary and sometimes extraordinary ways. This paper uses a visual ethnographic approach towards exploring the human traces of routine activities that have an impact on the cityscape. An Investigation of these details found within the urban landscape lead us towards understanding how we engage with and navigate cities. This is essentially an urban archaeological study that looks to reveal how non-designed phenomenon in urban places can contribute to our image of a city, providing a reflection on homogeneity within the built environment. Our visual ethnography focuses on six major cities: two each in Britain, Europe and North America. The findings of this work illustrate through visual analyses three key characteristics: first, how urban spaces are transformed intentionally and unintentionally; second, how transformations are practical, functional, beautiful and sometimes ridiculous; third, how transformations reveal values around visual and multi-modal experiences inherent to people.

The fisheries of the Kyoga lakes and the likely impact on them by human activities in the catchment

A review of the historical development of the fishery resources of the Kyoga basin shows that the fishery based on the alien fishes which surplanted the indigenous species in the 1960's and early 1970's has been evolving. The record catches of the 19705 and early 1980's were mainly influenced by increased nutrient supply and enlarged lake volume. The sudden collapse in the fishery particularly of the Nile perch in the mid 1980's was most probably imposed by bad fishing regimes. However, future trends in the fisheries of the Kyoga basin will most likely be controlled by nutrient availability and dynamics as well as by the impact of mans activities in the Kyoga catchment.

SFPE Engineering Guide to Human Behavior in Fire

Abstract not available

Detrimental human activities in critical fish habitats such as breeding and nursery zones

The poster explains human activties carried out in critical fish habitats such as breeding and nursery zones.

Organizational, systems and human issues in production planning, scheduling and control

With global markets and global competition, pressures are placed on manufacturing organizations to compress order fulfillment times, meet delivery commitments consistently and also maintain efficiency in operations to address cost issues. This chapter argues for a process perspective on planning, scheduling and control that integrates organizational planning structures, information systems as well as human decision makers. The chapter begins with a reconsideration of the gap between theory and practice, in particular for classical scheduling theory and hierarchical production planning and control. A number of the key studies of industrial practice are then described and their implications noted. A recent model of scheduling practice derived from a detailed study of real businesses is described. Socio-technical concepts are then introduced and their implications for the design and management of planning, scheduling and control systems are discussed. The implications of adopting a process perspective are noted along with insights from knowledge management. An overview is presented of a methodology for the (re-)design of planning, scheduling and control systems that integrates organizational, system and human perspectives. The most important messages from the chapter are then summarized.