Non-use of Formal Health Services in Malawi: Perceptions from Non-users

Background The study upon which this paper is based was undertaken to understand users’ and non-users’ perceptions concerning facilitators and barriers to equitable and universal access to health care in resource-poor countries such as Malawi. In this study, non-users of health services were defined as people who were not in need of health services or those who had stopped using them due to significant barriers. Methods A total of 80 interviews with non-users of health services were conducted in Rumphi, Ntchisi, Phalombe and Blantyre Districts of Malawi. Interviews focused on why informants were not using formal health services at the time of data collection. In order to identify non-users, snowballing was used health surveillance assistants, village headmen and community members also helped. One focus group discussion was also conducted with non-users of health services who were members of the Zion Church. Results Informants described themselves as non-users of health services due to several reasons: cost of health services; long distances to health facilities; poor attitude of health workers; belief in the effectiveness of traditional medicines; old age and their failure to walk. Others were non-users due to their disability; hence they could not walk over long distances or could not communicate effectively with health providers. Some of these non-users were complete non-users, namely members of the Zion Church and those who believed in traditional medicine, and they stated that nothing could be done to transform them into users of health services. Other non-users stated that they could become users if their challenges were addressed e.g. for those who were non-users of health services due to poor attitudes of health workers, they stated that if these health workers were transferred they would be able to access health services. Conclusions Public health education targeting both health workers and non-users, ensuring a functional outreach program and addressing other health system challenges such as shortage of drugs and human resources would assist in transforming non-users into users of health services.

VOX POPULI: THREE ESSAYS ON THE USE OF SOCIAL MEDIA FOR VALUE CREATION IN SERVICES

Prior research shows that electronic word of mouth (eWOM) wields considerable influence over consumer behavior. However, as the volume and variety of eWOM grows, firms are faced with challenges in analyzing and responding to this information. In this dissertation, I argue that to meet the new challenges and opportunities posed by the expansion of eWOM and to more accurately measure its impacts on firms and consumers, we need to revisit our methodologies for extracting insights from eWOM. This dissertation consists of three essays that further our understanding of the value of social media analytics, especially with respect to eWOM. In the first essay, I use machine learning techniques to extract semantic structure from online reviews. These semantic dimensions describe the experiences of consumers in the service industry more accurately than traditional numerical variables. To demonstrate the value of these dimensions, I show that they can be used to substantially improve the accuracy of econometric models of firm survival. In the second essay, I explore the effects on eWOM of online deals, such as those offered by Groupon, the value of which to both consumers and merchants is controversial. Through a combination of Bayesian econometric models and controlled lab experiments, I examine the conditions under which online deals affect online reviews and provide strategies to mitigate the potential negative eWOM effects resulting from online deals. In the third essay, I focus on how eWOM can be incorporated into efforts to reduce foodborne illness, a major public health concern. I demonstrate how machine learning techniques can be used to monitor hygiene in restaurants through crowd-sourced online reviews. I am able to identify instances of moral hazard within the hygiene inspection scheme used in New York City by leveraging a dictionary specifically crafted for this purpose. To the extent that online reviews provide some visibility into the hygiene practices of restaurants, I show how losses from information asymmetry may be partially mitigated in this context. Taken together, this dissertation contributes by revisiting and refining the use of eWOM in the service sector through a combination of machine learning and econometric methodologies.

Using SeaDataNet Management System to preserve the XBT Data-Set of the Mediterranean Sea

significant amount of Expendable Bathythermograph (XBT) data has been collected in the Mediterranean Sea since 1999 in the framework of operational oceanography activities. The management and storage of such a volume of data poses significant challenges and opportunities. The SeaDataNet project, a pan-European infrastructure for marine data diffusion, provides a convenient way to avoid dispersion of these temperature vertical profiles and to facilitate access to a wider public. The XBT data flow, along with the recent improvements in the quality check procedures and the consistence of the available historical data set are described. The main features of SeaDataNet services and the advantage of using this system for long-term data archiving are presented. Finally, focus on the Ligurian Sea is included in order to provide an example of the kind of information and final products devoted to different users can be easily derived from the SeaDataNet web portal.