Barriers and facilitators in the provision of post-abortion care at district level in central Uganda : a qualitative study focusing on task sharing between physicians and midwives

Background: Abortion is restricted in Uganda, and poor access to contraceptive methods result in unwanted pregnancies. This leaves women no other choice than unsafe abortion, thus placing a great burden on the Ugandan health system and making unsafe abortion one of the major contributors to maternal mortality and morbidity in Uganda. The existing sexual and reproductive health policy in Uganda supports the sharing of tasks in post-abortion care. This task sharing is taking place as a pragmatic response to the increased workload. This study aims to explore physicians' and midwives' perception of post-abortion care with regard to professional competences, methods, contraceptive counselling and task shifting/sharing in post-abortion care. Methods: In-depth interviews (n = 27) with health care providers of post-abortion care were conducted in seven health facilities in the Central Region of Uganda. The data were organized using thematic analysis with an inductive approach. Results: Post-abortion care was perceived as necessary, albeit controversial and sometimes difficult to provide. Together with poor conditions post-abortion care provoked frustration especially among midwives. Task sharing was generally taking place and midwives were identified as the main providers, although they would rarely have the proper training in post-abortion care. Additionally, midwives were sometimes forced to provide services outside their defined task area, due to the absence of doctors. Different uterine evacuation skills were recognized although few providers knew of misoprostol as a method for post-abortion care. An overall need for further training in post-abortion care was identified. Conclusions: Task sharing is taking place, but providers lack the relevant skills for the provision of quality care. For post-abortion care to improve, task sharing needs to be scaled up and in-service training for both doctors and midwives needs to be provided. Post-abortion care should further be included in the educational curricula of nurses and midwives. Scaled-up task sharing in post-abortion care, along with misoprostol use for uterine evacuation would provide a systematic approach to improving the quality of care and accessibility of services, with the aim of reducing abortion-related mortality and morbidity in Uganda.

Feature nodes : an interaction construct for sharing initiative in design exploration

Exploration with formal design systems comprises an iterative process of specifying problems, finding plausible and alternative solutions, judging the validity of solutions relative to problems and reformulating problems and solutions. Recent advances in formal generative design have developed the mathematics and algorithms to describe and perform conceptual design tasks. However, design remains a human enterprise: formalisms are part of a larger equation comprising human computer interaction. To support the user in designing with formal systems, shared representations that interleave initiative of the designer and the design formalism are necessary. The problem of devising representational structures in which initiative is sometimes taken by the designer and sometimes by a computer in working on a shared design task is reported in this paper. To address this problem, the requirements, representation and
implementation of a shared interaction construct, the feature node, is
described. The feature node facilitates the sharing of initiative in formulating and reformulating problems, generating solutions, making
choices and navigating the history of exploration.

Information sharing in supply chain systems

This chapter considers the importance of information-sharing techniques and strategies employed by industry sectors. Well-developed supply chain management often brings with it improved buyer-supplier communication processes, and we consider the impact of these not only from an intersector point of view, but also from a cross-sector viewpoint. The particular perspectives of the small business within a supply chain structure and of the supply chain customer are examined in detail. We conclude that information sharing is a critical component of business success both inside and outside the supply chain structure. However, while globally and at the large business level, both development and implementation of such technologies have mushroomed, smaller enterprises have tended to be left behind to cope as best they can with multiple pressures to conform.

On Arbitrary Selection Strategies for Basic Superposition

For first-order Horn clauses without equality, resolution is complete with an arbitrary selection of a single literal in each clause [dN 96]. Here we extend this result to the case of clauses with equality for superposition-based inference systems. Our result is a generalization of the result given in [BG 01]. We answer their question about the completeness of a superposition-based system for general clauses with an arbitrary selection strategy, provided there exists a refutation without applications of the factoring inference rule.

Toward a receiver-based theory of knowledge sharing

Managers and researchers alike have sought new ways to address the challenges of sharing dispersed knowledge in modern business environments. Careful consideration by sharers of receivers' knowledge needs and behaviours may improve the effectiveness of knowledge sharing. This research examines how sharers react to their perceptions of receivers' knowledge needs and behaviours when making choices relating to sharing knowledge. The focus of this article is to propose and empirically explore a theoretical framework for a study of the role of the receiver in knowledge sharing--receiver-based theory. Data collected from two case studies highlight a key role played by perceived receiver knowledge needs and behaviours in shaping sharer choices when explicit knowledge is shared. A set of receiver influences on knowledge sharing is provided that highlights key receiver and sharer issues. The paper concludes that companies should develop better ways to connect potential sharers with receivers' real knowledge needs. Further, the findings suggest that sharing on a need-to-know basis hinders change in organisational power structures, and prevents the integration of isolated pockets of knowledge that may yield new value.

Sharing and reuse of web developers experience

Development of commercial web systems is laborious, lengthy and costly. This is partly due to the fact that the methods of their development can hardly cope with the complexity of provided services. Such services may need to be distributed and collaborative, require sophisticated software architecture, be rich in form, content and interactivity, and have a wide range of potentially casual users. While web development methodologies are slowly emerging from research methodologies, their adoption is far from wide-spread. To improve this situation, the authors propose an approach based on the observed practices of professional web developers, who openly share and reuse their web development experience, while guarding their development workproducts. To this end, we suggest to enhance web development methods, by collecting problem-solving experience of web developers, packaging it into a reusable form, and providing a navigable decision structure assisting developers in identifying proven expert solutions suitable for a given problem context.

Utilisation of intranets for knowledge sharing : a socio-technical study

Although intranets appear to be ideal environments for employees to share knowledge quickly and efficiently, usage in practice appears limited. We report findings from two case studies that highlight three key issues limiting intranet utilisation for knowledge sharing: organisational structures and strategies, the impact of the receiver on sharer choices, and the availability of alternative channels for knowledge sharing. This study suggests that for companies to obtain more effective intranets, they need to better align organisational structures and strategies with intranet objectives, develop a comprehensive corporate communication plan, and find new ways to better link sharers with receivers’ knowledge needs.

Considering the receiver in knowledge sharing: when the receiver seems ready the sharer appears

The knowledge needs and knowledge-related behaviours of receivers are among the most crucial, yet of ten overlooked, aspects of successful knowledge-sharing. This research examines how sharers consider receivers' knowledge needs and knowledge-related behaviours when choosing whether to share their knowledge and which channels to use for the transmission of that knowledge. A new theory of knowledge sharing - Receiver Theory - is introduced, and a receiver-based model of knowledge sharing is developed from existing literature. Two exploratory case studies are conducted using the model as a guiding framework. A key finding shows that perceived receiver knowledge needs and behaviours are Important motivators and inhibitors in sharer choices in intra-organisational knowledge sharing. This finding was suggested for both personalised and codified knowledge sharing strategies. The study suggests that for companies to realise more effective knowledge sharing, they should develop better ways to connect potential sharers with receivers' real knowledge needs. The study also suggests that sharing on a need-to know basis impedes change In organisational power structures and prevents the integration of isolated pockets of knowledge that may yield new value.

Receiver influences on knowledge sharing

Sharer consideration of receiver knowledge needs and behaviours may improve the quality and results of knowledge sharing. This paper examines how sharers may be influenced by perceived receiver knowledge needs and behaviours when making knowledge sharing choices. Such a consideration adopts an emancipatory approach aimed at acknowledging the rights of those employees who need knowledge to receive it, despite the conflicting goals, agendas or efficiency pressures of sharers. Based on a literature review, a receiver-based theory of knowledge sharing is proposed. Empirical data from two case studies highlight the key role played by perceived receiver knowledge needs and behaviours as motivators and inhibitors in sharer choices. A set of key receiver influences on knowledge sharing is provided. This study concludes that companies should develop better ways to connect potential sharers with the real knowledge needs of receivers, particularly when knowledge technologies mediate sharing. Further, the findings suggest that sharing on a need-to-know basis impedes change in organisational power structures and prevents the integration of isolated pockets of knowledge that may yield new value.

Understanding the impact of organisational downsizing on knowledge sharing

Careful consideration by managers of the potential impact of the popular strategy of economic restructuring (downsizing) on organisational structure and culture could improve the quality of organisational knowledge sharing, however this influence has not yet been addressed in the knowledge management literature. This paper explores how a strategy of downsizing may reshape organisational structure and culture and inhibit organisational knowledge sharing, drawing on an interpretive case study of knowledge sharing in an information technology services function at a large Australian education service provider. Key findings indicate that when specialised teams are downsized, subcultures may develop where teams become mistrustful and insular, and knowledge sharing is constrained across teams. Further, when a hierarchical structure is present and downsizing occurs, managers may become more cautious about sharing knowledge with subordinates. The study also suggests that Internet technologies may play a key role in helping to compensate for the shortfall in knowledge stock resulting from downsizing. In conclusion, this paper highlights an important need for companies to consider the potential negative influences of downsizing on organisationalknowledge sharing.