Health system context and implementation of evidence-based practices-development and validation of the Context Assessment for Community Health (COACH) tool for low- and middle-income settings

Background: The gap between what is known and what is practiced results in health service users not benefitting from advances in healthcare, and in unnecessary costs. A supportive context is considered a key element for successful implementation of evidence-based practices (EBP). There were no tools available for the systematic mapping of aspects of organizational context influencing the implementation of EBPs in low- and middle-income countries (LMICs). Thus, this project aimed to develop and psychometrically validate a tool for this purpose. Methods: The development of the Context Assessment for Community Health (COACH) tool was premised on the context dimension in the Promoting Action on Research Implementation in Health Services framework, and is a derivative product of the Alberta Context Tool. Its development was undertaken in Bangladesh, Vietnam, Uganda, South Africa and Nicaragua in six phases: (1) defining dimensions and draft tool development, (2) content validity amongst in-country expert panels, (3) content validity amongst international experts, (4) response process validity, (5) translation and (6) evaluation of psychometric properties amongst 690 health workers in the five countries. Results: The tool was validated for use amongst physicians, nurse/midwives and community health workers. The six phases of development resulted in a good fit between the theoretical dimensions of the COACH tool and its psychometric properties. The tool has 49 items measuring eight aspects of context: Resources, Community engagement, Commitment to work, Informal payment, Leadership, Work culture, Monitoring services for action and Sources of knowledge. Conclusions: Aspects of organizational context that were identified as influencing the implementation of EBPs in high-income settings were also found to be relevant in LMICs. However, there were additional aspects of context of relevance in LMICs specifically Resources, Community engagement, Commitment to work and Informal payment. Use of the COACH tool will allow for systematic description of the local healthcare context prior implementing healthcare interventions to allow for tailoring implementation strategies or as part of the evaluation of implementing healthcare interventions and thus allow for deeper insights into the process of implementing EBPs in LMICs.

Gender in international economic development projects: how is gender being institutionalized in the Inter-American Development Bank?

O Banco Interamericano de Desenvolvimento, o Banco Mundial, e outras organizações financiam iniciativas para acelerar o desenvolvimento da região da América Latina e Caribe. Antes do final da década de 80, vários projetos e políticas dessas instituições careciam de considerações ligadas à gênero e foram criticadas por essa falta (Flora, 1998). Em 1987, o BID publicou um documento sobre uma nova política operacional sobre mulheres e desenvolvimento e vem desde então buscando institucionalizar gênero e criar indicadores para medir os impactos relacionados à gênero em seus projetos. O objetivo dessa dissertação é explorar o tema de gênero no contexto do desenvolvimento internacional através de uma análise de como o Banco Interamericano de Desenvolvimento inclui gênero em suas operações. Após uma revisão literária sobre a importância de gênero e de bancos de desenvolvimento, essa dissertação irá analisar de que maneira gênero é incluído nas discussões dos projetos do Banco à nível institucional. A pesquisa será feita através de documentação disponível para o público geral, documentos internos e entrevistas em vídeo com pessoal do BID. Após uma análise dos dados coletados, recomendações para ações futuras serão dadas.

Decision-Making Tool for Knowledge-Based Projects in Offshore Production Systems

The development of an offshore field demands knowledge of many experts to choose the different components of an offshore production system. All the specialized parts of this knowledge are intrinsically related. The aim of this paper is to use Fuzzy Sets and knowledge-based systems to describe and formalize the phases of development of an offshore production system project, in order to share and to manage the required knowledge for carrying out a project, while at the same time proposing alternatives for the oil field configuration.

Structural reforms, technological gaps and economic development: a Latin American perspective

Includes bibliography

Social dimensions of economic development and productivity: inequality and social performance

Includes bibliography

The importance of the manufacturing sector for Brazilian economic development

Includes bibliography

Changing population age structures and their implications on socio-economic development in the Caribbean

Includes bibliography

Applications and Potentials for Biogenic Methane Recovery Operations in Nebraska Agriculture, Industry, and Economic Development

ABSTRACT: This thesis report illustrates the applications and potentials of biogenic methane recovery in Nebraska’s agricultural and industrial sectors and as a means for increasing sustainable economic development in the state’s rural communities. As the nation moves toward a new green economy, biogenic methane recovery as a waste management strategy and renewable energy resource presents significant opportunities for Nebraska to be a national and world leader in agricultural and industrial innovation, advanced research and development of renewable energy technology, and generation of new product markets. Nebraska’s agricultural economy provides a distinct advantage to the state for supporting methane recovery operations that provide long-term economic and environmental partnerships among producers, industry, and communities. These opportunities will serve to protect Nebraska’s agricultural producers from volatile energy input markets and as well as creating new markets for Nebraska agricultural products. They will also serve to provide quality education and employment opportunities for Nebraska students and businesses. There are challenges and issues that remain for the state in order to take advantage of its resource potential. There is a need to produce a comprehensive Nebraska biogenic methane potential study and digital mapping system to identify high-potential producers, co-products, and markets. There is also a need to develop a web-based format of consolidated information specific to Nebraska to aid in connecting producers, service providers, educators, and policy-makers.

Self-Organizing Mechanisms for Task Allocation in a Knowledge-Based Economy

A prevalent claim is that we are in knowledge economy. When we talk about knowledge economy, we generally mean the concept of “Knowledge-based economy” indicating the use of knowledge and technologies to produce economic benefits. Hence knowledge is both tool and raw material (people’s skill) for producing some kind of product or service. In this kind of environment economic organization is undergoing several changes. For example authority relations are less important, legal and ownership-based definitions of the boundaries of the firm are becoming irrelevant and there are only few constraints on the set of coordination mechanisms. Hence what characterises a knowledge economy is the growing importance of human capital in productive processes (Foss, 2005) and the increasing knowledge intensity of jobs (Hodgson, 1999). Economic processes are also highly intertwined with social processes: they are likely to be informal and reciprocal rather than formal and negotiated. Another important point is also the problem of the division of labor: as economic activity becomes mainly intellectual and requires the integration of specific and idiosyncratic skills, the task of dividing the job and assigning it to the most appropriate individuals becomes arduous, a “supervisory problem” (Hogdson, 1999) emerges and traditional hierarchical control may result increasingly ineffective. Not only specificity of know how makes it awkward to monitor the execution of tasks, more importantly, top-down integration of skills may be difficult because ‘the nominal supervisors will not know the best way of doing the job – or even the precise purpose of the specialist job itself – and the worker will know better’ (Hogdson,1999). We, therefore, expect that the organization of the economic activity of specialists should be, at least partially, self-organized. The aim of this thesis is to bridge studies from computer science and in particular from Peer-to-Peer Networks (P2P) to organization theories. We think that the P2P paradigm well fits with organization problems related to all those situation in which a central authority is not possible. We believe that P2P Networks show a number of characteristics similar to firms working in a knowledge-based economy and hence that the methodology used for studying P2P Networks can be applied to organization studies. Three are the main characteristics we think P2P have in common with firms involved in knowledge economy: - Decentralization: in a pure P2P system every peer is an equal participant, there is no central authority governing the actions of the single peers; - Cost of ownership: P2P computing implies shared ownership reducing the cost of owing the systems and the content, and the cost of maintaining them; - Self-Organization: it refers to the process in a system leading to the emergence of global order within the system without the presence of another system dictating this order. These characteristics are present also in the kind of firm that we try to address and that’ why we have shifted the techniques we adopted for studies in computer science (Marcozzi et al., 2005; Hales et al., 2007 [39]) to management science.

Topics in Local Economic Development

This thesis contributes to the current debate in literature about local economic development by considering two different topics: quality of institutions, and the role of clusters in innovation and productivity growth. The research is built upon three papers. The first paper deals with the analysis of the effect of administrative continuity on administrative efficiency. The analysis underlines the importance of different typologies of social capital. Findings reveal a positive impact on administrative efficiency (AE) by administrative continuity (AC) when it is coupled by bridging and linking social capital. On the contrary, bonding social capital influences negatively the effect by AC on AE. The second paper investigates the spatial interaction in levels of quality of government (QoG) among European regions. Notwithstanding the largely recognised role by institutions in the design of regional policies, no study has been conducted about the mechanisms of interaction and diffusion of QoG at regional level. This research wants to overcome this knowledge gap in literature. Findings reveal a heterogeneity in spatial interaction among groups of regions, i.e. ‘leader regions’ (Northern regions) and ‘lagging regions’ (Southern regions), when considering different mechanisms of interaction (learning / imitating competition and pure competition). Moreover, the effect of wealth on the levels of QoG is nonlinear. Finally, the third paper analyses the relation among specialization and productivity within the agricultural sector. In literature, the study of clusters dynamics has long neglected agriculture. The analysis describes the changes in sectorial specialization for eight main crop groups in Italian regions (NUTS 3), assessing the existence of spatial autocorrelations by using an exploratory data analysis. Furthermore, the effect of specialization on productivity is analysed within the main crop groups using a spatial panel data model. Findings reveal a marked tendency to specialization in the Italian agriculture, and a heterogeneous effect by specialization on productivity.

Increasingly Rank: The Use and Misuse of Rankings in Economic Development

Debates over the merits of competing schemes for ranking metropolitan areas as hightech centers shed little light on the important policy questions that should be the core of economic development policy. There are no strong theoretical reasons for preferring one ranking system to others. Rankings often conflate different industries and ignore history, obscuring the varied and often idiosyncratic processes that drive growth in different regions. Although an occupational perspective is a useful one for examining economic activity, it is a supplement to, not a replacement for, a careful understanding of metropolitan industrial specialization. Practitioners should not put too much weight on any ranking system but instead should work to develop detailed knowledge of their region’s special economic niche and to develop relationships and strategies that build on established strengths.

Economic development capitalizing on brand agriculture : turning development strategy on its head

This paper explores the possibilities of two unique Japanese concepts - the One Village One Product Movement (OVOP) and Michino Eki (or Roadside Stations) - as potential tools for bridging the gap between cities and rural areas through community-driven development. From the viewpoint of spatial economics and endogenous growth theory, this paper considers both OVOP and Michino Eki as rural development strategies of a broader nature based on "brand agriculture." Here, brand agriculture represents a general strategy for community-based rural development that identifies, cultivates and fully utilizes local resources for the development of products or services unique to a certain "village." Selected examples of OVOP and Michino Eki from Japan and developing countries are introduced.