Search results for: reflective framework
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 5200

Search results for: reflective framework

3730 Evaluation of a Staffing to Workload Tool in a Multispecialty Clinic Setting

Authors: Kristin Thooft

Abstract:

— Increasing pressure to manage healthcare costs has resulted in shifting care towards ambulatory settings and is driving a focus on cost transparency. There are few nurse staffing to workload models developed for ambulatory settings, less for multi-specialty clinics. Of the existing models, few have been evaluated against outcomes to understand any impact. This evaluation took place after the AWARD model for nurse staffing to workload was implemented in a multi-specialty clinic at a regional healthcare system in the Midwest. The multi-specialty clinic houses 26 medical and surgical specialty practices. The AWARD model was implemented in two specialty practices in October 2020. Donabedian’s Structure-Process-Outcome (SPO) model was used to evaluate outcomes based on changes to the structure and processes of care provided. The AWARD model defined and quantified the processes, recommended changes in the structure of day-to-day nurse staffing. Cost of care per patient visit, total visits, a total nurse performed visits used as structural and process measures, influencing the outcomes of cost of care and access to care. Independent t-tests were used to compare the difference in variables pre-and post-implementation. The SPO model was useful as an evaluation tool, providing a simple framework that is understood by a diverse care team. No statistically significant changes in the cost of care, total visits, or nurse visits were observed, but there were differences. Cost of care increased and access to care decreased. Two weeks into the post-implementation period, the multi-specialty clinic paused all non-critical patient visits due to a second surge of the COVID-19 pandemic. Clinic nursing staff was re-allocated to support the inpatient areas. This negatively impacted the ability of the Nurse Manager to utilize the AWARD model to plan daily staffing fully. The SPO framework could be used for the ongoing assessment of nurse staffing performance. Additional variables could be measured, giving a complete picture of the impact of nurse staffing. Going forward, there must be a continued focus on the outcomes of care and the value of nursing

Keywords: ambulatory, clinic, evaluation, outcomes, staffing, staffing model, staffing to workload

Procedia PDF Downloads 163
3729 Young Adults’ Media Addiction Coping Strategies: A Longitudinal Study

Authors: Johanna Lindstrom, Jacob Mickelsson

Abstract:

Changes in the current media environment are transforming peoples’ everyday media consumption patterns all over the world. Digital media have become a natural, almost unavoidable, part of everyday lives of humans. While this has led to many positive consequences, there is also a growing concern for harmful effects. This paper contributes to knowledge about “the dark side” of media use by considering the topic of media addiction and subsequent coping strategies among young adults. The paper draws on a longitudinal media diary study conducted among young university students between the years 2013 and 2021. A total of 1029 diaries have been collected (approximately 100 each year), aiming at capturing the students’ everyday media behavior. In this paper, reflective narratives in the diaries have been analyzed, aiming at answering the following questions: Which of their own media behaviors do the students perceive as particularly destructive, addictive or problematic? How do they cope with such behaviors? Results from the study indicate a noticeable increase in reflections on addictive media behavior over the years. For example, compared to earlier years, the amount of such reflections significantly started to increase in the diaries in 2016 and 2017, and this trend has continued ever since. Furthermore, the nature of these reflections has changed, displaying a growing concern for one’s own excessive media use and general wellbeing. Media addiction seems particularly difficult to cope with as digital media is literally everywhere and media use in general is described as consistent and habitual, in terms of regularly repeated routines that are fragmented but performed continuously and often unintentionally throughout the day. Reflections on “the dark side” of everyday media consumption become particularly prominent in times of the Covid -19 pandemic. However, this trend was noticeable well before the pandemic started. The study also identifies a countertrend regarding reflections on how to deal and cope with problematic media behavioral patterns. This countertrend portrays a general development of increased awareness of factors that may trigger compulsive behavior and how to avoid or handle such trigger points. The countertrend is particularly evident in recent years, despite the ongoing pandemic and subsequent increases in time spent using media. Addictive media behavior may lead to severe consequences for students’ learning processes and general well-being. Increased awareness of this growing trend and coping strategies are needed on an individual as well as a broader educational level.

Keywords: coping strategies, media addiction, media behavior, well-being

Procedia PDF Downloads 186
3728 Self-Disclosure and Privacy Management Behavior in Social Media: Privacy Calculus Perspective

Authors: Chien-Wen Chen, Nguyen Duong Thuy Trang, Yu-Hsuan Chang

Abstract:

With the development of information technology, social networking sites are inseparable from life and have become an important way for people to communicate. Nonetheless, privacy issues are raised by the presence of personal information on social networking sites. However, users can benefit from using the functions of social networking sites, which also leads to users worrying about the leakage of personal information without corresponding privacy protection behaviors, which is called the privacy paradox. However, previous studies have questioned the viewpoint of the privacy paradox, believing that users are not so naive and that people with privacy concerns will conduct privacy management. Consequently, this study is based on the view of privacy calculation perspective to investigate the privacy behavior of users on social networking sites. Among them, social benefits and privacy concerns are taken as the expected benefits and costs in the viewpoint of privacy calculation. At the same time, this study also explores the antecedents, including positive feedback, self-presentation, privacy policy, and information sensitivity, and the consequence of privacy behavior of weighing benefits and costs, including self-disclosure and three privacy management strategies by interpersonal boundaries (Preventive, Censorship, and Corrective). The survey respondents' characteristics and prior use experience of social networking sites were analyzed. As a consequence, a survey of 596 social network users was conducted online to validate the research framework. The results show that social benefit has the greatest influence on privacy behavior. The most important external factors affecting privacy behavior are positive feedback, followed by the privacy policy and information sensitivity. In addition, the important findings of this study are that social benefits will positively affect privacy management. It shows that users can get satisfaction from interacting with others through social networking sites. They will not only disclose themselves but also manage their privacy on social networking sites after considering social benefits and privacy management on social networking sites, and it expands the adoption of the Privacy Calculus Perspective framework from prior research. Therefore, it is suggested that as the functions of social networking sites increase and the development of social networking sites, users' needs should be understood and updated in order to ensure the sustainable operation of social networking.

Keywords: privacy calculus perspective, self-disclosure, privacy management, social benefit, privacy concern

Procedia PDF Downloads 68
3727 Enhancing Police Accountability through the Malawi Independent Police Complaints Commission: Prospects and Challenges That Lie Ahead

Authors: Esther Gumboh

Abstract:

The police play a critical role in society and are an integral aspect of the rule of law. Equally, respect for human rights is an integral part of professional policing. In view of the vast powers that the police enjoy and the attendant risk of abuse and resulting human rights violations, the need for police accountability and civilian police oversight is internationally and regionally recognised. Policing oversight springs from the duty to investigate human rights violations. Those implicated in perpetrating or covering up violations must be disciplined or prosecuted to ensure effective accountability. Police accountability is particularly important in Malawi given the dark history of policing in the country during the 30-year dictatorial era under President Kamuzu Banda. Described as one of the most repressive regimes in Africa, the Banda administration was characterised by gross state-sponsored violence, repressive policing and human rights violations. Indeed, the police were involved in various forms of human rights abuse including arbitrary arrests and unlawful detentions, torture, and excessive use of force in conducting arrests and public order policing. This situation flourished within a culture of police impunity bolstered in part by the absence of clear oversight mechanisms for police accountability. In turn, there was immense public mistrust of the police. Unsurprisingly, the criminal justice system was one of the priority areas for reform when Malawi adopted its first democratic Constitution in 1994. Section 153 of the Constitution envisions a police service that is, for all intents and purposes, there to provide for the protection of public safety and the rights of persons in Malawi according to the prescriptions of the Constitution and any other law. This position reflects the view that the duty to protect and promote human rights is not incompatible with effective policing. Despite this, the police continue to engage in questionable behaviour in public order policing, excessive use of force, deaths in police custody, ill-treatment, torture and other forms of abuse including sexual abuse. Perpetrators of abuses are occasionally punished, but investigations are often delayed, abandoned, or remain inconclusive. Police accountability remains largely elusive. Commendably, the law does subject the police to significant oversight both internally and externally. However, until 2010, Malawi lacked a wholly independent civilian oversight mechanism specifically mandated to monitor the activities of the Malawi Police Service and held it accountable. This void has since been filled by the Independent Complaints Commission established under the Police Act. This is a positive development that reiterates Malawi’s commitment to the investigation of human rights violations by the police and to ending police impunity. This contribution examines the legal framework for this Commission to project the effectiveness of the Commission. While the framework looks promising on various fronts, there are potential challenges that lie ahead. Malawi must pre-emptively deal with these challenges carefully if the Commission is to have any practical significance in transforming police accountability in the country. Drawing on lessons from other jurisdictions like South Africa, the paper makes recommendations for legislative reform to strengthen the Commission’s framework.

Keywords: civilian policing oversight, Malawi, police, police accountability, policing, policing oversight

Procedia PDF Downloads 214
3726 A Framework Based Blockchain for the Development of a Social Economy Platform

Authors: Hasna Elalaoui Elabdallaoui, Abdelaziz Elfazziki, Mohamed Sadgal

Abstract:

Outlines: The social economy is a moral approach to solidarity applied to the projects’ development. To reconcile economic activity and social equity, crowdfunding is as an alternative means of financing social projects. Several collaborative blockchain platforms exist. It eliminates the need for a central authority or an inconsiderate middleman. Also, the costs for a successful crowdfunding campaign are reduced, since there is no commission to be paid to the intermediary. It improves the transparency of record keeping and delegates authority to authorities who may be prone to corruption. Objectives: The objectives are: to define a software infrastructure for projects’ participatory financing within a social and solidarity economy, allowing transparent, secure, and fair management and to have a financial mechanism that improves financial inclusion. Methodology: The proposed methodology is: crowdfunding platforms literature review, financing mechanisms literature review, requirements analysis and project definition, a business plan, Platform development process and implementation technology, and testing an MVP. Contributions: The solution consists of proposing a new approach to crowdfunding based on Islamic financing, which is the principle of Mousharaka inspired by Islamic financing, which presents a financial innovation that integrates ethics and the social dimension into contemporary banking practices. Conclusion: Crowdfunding platforms need to secure projects and allow only quality projects but also offer a wide range of options to funders. Thus, a framework based on blockchain technology and Islamic financing is proposed to manage this arbitration between quality and quantity of options. The proposed financing system, "Musharaka", is a mode of financing that prohibits interests and uncertainties. The implementation is offered on the secure Ethereum platform as investors sign and initiate transactions for contributions using their digital signature wallet managed by a cryptography algorithm and smart contracts. Our proposal is illustrated by a crop irrigation project in the Marrakech region.

Keywords: social economy, Musharaka, blockchain, smart contract, crowdfunding

Procedia PDF Downloads 62
3725 Third Places for Social Sustainability: A Planning Framework Based on Local and International Comparisons

Authors: Z. Goosen, E. J. Cilliers

Abstract:

Social sustainability, as an independent perspective of sustainable development, has gained some acknowledgement, becoming an important aspect in sustainable urban planning internationally. However, limited research aiming at promoting social sustainability within urban areas exists within the South African context. This is mainly due to the different perspectives of sustainable development (e.g., Environmental, Economic, and Social) not being equally prioritized by policy makers and supported by implementation strategies, guidelines, and planning frameworks. The enhancement of social sustainability within urban areas relies on urban dweller satisfaction and the quality of urban life. Inclusive cities with high-quality public spaces are proposed within this research through implementing the third place theory. Third places are introduced as any place other than our homes (first place) and work (second place) and have become an integrated part of sustainable urban planning. As Third Places consist of every place 'in between', the approach has taken on a large role of the everyday life of city residents, and the importance of planning for such places can only be measured through identifying and highlighting the social sustainability benefits thereof. The aim of this research paper is to introduce third place planning within the urban area to ultimately enhance social sustainability. Selected background planning approaches influencing the planning of third places will briefly be touched on, as the focus will be placed on the social sustainability benefits provided through third place planning within an urban setting. The study will commence by defining and introducing the concept of third places within urban areas as well as a discussion on social sustainability, acting as one of the three perspectives of sustainable development. This will gain the researcher an improved understanding on social sustainability in order for the study to flow into an integrated discussion of the benefits Third places provide in terms of social sustainability and the impact it has on improved quality of life within urban areas. Finally, a visual case study comparison of local and international examples of third places identified will be illustrated. These international case studies will contribute towards the conclusion of this study where a local gap analysis will be formulated, based on local third place evidence and international best practices in order to formulate a strategic planning framework on improving social sustainability through third place planning within the local South African context.

Keywords: planning benefits, social sustainability, third places, urban area

Procedia PDF Downloads 255
3724 Analytical Modeling of Globular Protein-Ferritin in α-Helical Conformation: A White Noise Functional Approach

Authors: Vernie C. Convicto, Henry P. Aringa, Wilson I. Barredo

Abstract:

This study presents a conformational model of the helical structures of globular protein particularly ferritin in the framework of white noise path integral formulation by using Associated Legendre functions, Bessel and convolution of Bessel and trigonometric functions as modulating functions. The model incorporates chirality features of proteins and their helix-turn-helix sequence structural motif.

Keywords: globular protein, modulating function, white noise, winding probability

Procedia PDF Downloads 457
3723 Evaluating the Evolution of Public Art across the World and Exploring Its Growth in Urban India

Authors: Mitali Kedia, Parul Kapoor

Abstract:

Public Art is a tool with the power to enrich and enlighten any place; it has been accepted and welcomed effortlessly by many cultures around the World. In this paper, we discuss the implications Public Art has had on the society and how it has evolved over the years, and how in India, art in this aspect is still overlooked and treated as an accessory. Urban aesthetics are still substantially limited to the installation of deities, political figures, and so on. The paper also discusses various possibilities and opportunities on how Public Art can boost a society; it also suggests a framework that can be incorporated in the legal system of the country to make it a part of the city development process.

Keywords: public art, urban fabric, placemaking, community welfare, public art program, imageability

Procedia PDF Downloads 173
3722 The Story of a Spoiled Identity: Blogging on Disability and Feminity

Authors: Anna Ślebioda

Abstract:

The paper discusses intersections between disability and femininity. Their imbrication may impede negotiation of identity. The analysis of a blog of a women with disability aims to prove this hypothesis. It involves 724 entries written in the span of six years. The conceptual framework for the considerations constitute the concepts of stigma and spoiled identity, and overlapping elements of femininity and disability. The empirical part comprises content analysis. It allows to locate the narrative on femininity and disability within the dimensions of imbricated categories described in the theoretical part. The results demonstrate aspects to consider in further research on identity in women with disabilities.

Keywords: disability, femininity, spoiled identity, stigma

Procedia PDF Downloads 650
3721 A Conceptual Framework for Knowledge Integration in Agricultural Knowledge Management System Development

Authors: Dejen Alemu, Murray E. Jennex, Temtim Assefa

Abstract:

Agriculture is the mainstay of the Ethiopian economy; however, the sector is dominated by smallholder farmers resulting in land fragmentation and suffering from low productivity. Due to these issues, much effort has been put into the transformation of the sector to bring about more sustainable rural economic development. Technological advancements have been applied for the betterment of farmers resulting in the design of tools that are potentially capable of supporting the agricultural sector; however, their use and relevance are still alien to the local rural communities. The notion of the creating, capturing and sharing of knowledge has also been repetitively raised by many international donor agencies to transform the sector, yet the most current approaches to knowledge dissemination focus on knowledge that originates from the western view of scientific rationality while overlooking the role of indigenous knowledge (IK). Therefore, in agricultural knowledge management system (KMS) development, the integration of IKS with scientific knowledge is a critical success factor. The present study aims to contribute in the discourse on how to best integrate scientific and IK in agricultural KMS development. The conceptual framework of the research is anchored in concepts drawn from the theory of situated learning in communities of practice (CoPs): knowledge brokering. Using the KMS development practices of Ethiopian agricultural transformation agency as a case area, this research employed an interpretive analysis using primary and secondary qualitative data acquired through in-depth semi-structured interviews and participatory observations. As a result, concepts are identified for understanding the integration of the two major knowledge systems (i.e., indigenous and scientific knowledge) and participation of relevant stakeholders in particular the local farmers in agricultural KMS development through the roles of extension agent as a knowledge broker including crossing boundaries, in-between position, translation and interpretation, negotiation, and networking. The research shall have a theoretical contribution in addressing the incorporation of a variety of knowledge systems in agriculture and practically to provide insight for policy makers in agriculture regarding the importance of IK integration in agricultural KMS development and support marginalized small-scale farmers.

Keywords: communities of practice, indigenous knowledge, knowledge management system development, knowledge brokering

Procedia PDF Downloads 319
3720 Human Development as an Integral Part of Human Security within the Responsibility to Rebuild

Authors: Themistoklis Tzimas

Abstract:

The proposed paper focuses on a triangular relationship, between human security, human development and responsibility to rebuild. This relationship constitutes the innovative contribution to the debate about human security. Human security constitutes a generic and legally binding notion, which orientates from an integrated approach the UN Charter principles and of the collective security system. Such an approach brings at the forefront of international law and of international relations not only states but non- state actors as well. Several doctrines attempt to implement the fore-mentioned approach among which the Responsibility to Protect- hereinafter R2P- doctrine and its aspect of Responsibility to Rebuild- hereinafter R2R. In this sense, R2P in general and R2R are supposed to be guided by human security imperatives. Human security because of its human- centered approach encompasses as an integral part of it, human development. Human development constitutes part of the backbone of human security, since it deals with the social and economic root- causes of the threats, which human security attempts to confront. In this sense, doctrines which orientate from human security, such as R2P and its R2R aspect should also take into account human development imperatives, in order to improve their efficiency. On the contrary though, R2R is more often linked with market- orientated policies, which are often imposed under transitional authorities, regardless of local needs. The implementation of such policies can be identified as a cause for striking failures in the framework of R2R. In addition it is a misinterpretation of the essence of human security and subsequently of R2P as well. The findings of the article, on the basis of the fore-mentioned argument is that a change must take place from a market- orientated misinterpretation of R2R to an approach attempting to implement human development doctrines, since the latter lie at the heart of human security and can be proven more effective in dealing with the root- causes of conflicts. Methodologically, the article begins with an examination of human security and of its binding nature on the basis of its orientation from the UN Charter. It also examines its significance in the framework of the collective security system. Then, follows the analysis of why and how human development constitutes an integral part of human security. At the next part it is proven that R2P in general and R2R more specifically constitute or should constitute an attempt to implement human security doctrines within the collective security system. Having built this triangular relationship it is argued that human development is proven to be the most suitable notion, so that the spirit of human security and the scopes of R2P are successfully implemented.

Keywords: human security, un charter, responsibility to protect, responsibility to rebuild, human development

Procedia PDF Downloads 268
3719 The Impact of Entrepreneurship Education on the Entrepreneurial Tendencies of Students: A Quasi-Experimental Design

Authors: Lamia Emam

Abstract:

The attractiveness of entrepreneurship education stems from its perceived value as a venue through which students can develop an entrepreneurial mindset, skill set, and practice, which may not necessarily lead to them starting a new business, but could, more importantly, be manifested as a life skill that could be applied to all types of organizations and career endeavors. This, in turn, raises important questions about what happens in our classrooms; our role as educators, the role of students, center of learning, and the instructional approach; all of which eventually contribute to achieving the desired EE outcomes. With application to an undergraduate entrepreneurship course -Entrepreneurship as Practice- the current paper aims to explore the effect of entrepreneurship education on the development of students’ general entrepreneurial tendencies. Towards that purpose, the researcher herein uses a pre-test and post-test quasi-experimental research design where the Durham University General Enterprising Tendency Test (GET2) is administered to the same group of students before and after course delivery. As designed and delivered, the Entrepreneurship as Practice module is a highly applied and experiential course where students are required to develop an idea for a start-up while practicing the entrepreneurship-related knowledge, mindset, and skills that are taught in class, both individually and in groups. The course is delivered using a combination of short lectures, readings, group discussions, case analysis, guest speakers, and, more importantly, actively engaging in a series of activities that are inspired by diverse methods for developing successful and innovative business ideas, including design thinking, lean-start up and business feasibility analysis. The instructional approach of the course particularly aims at developing the students' critical thinking, reflective, analytical, and creativity-based problem-solving skills that are needed to launch one’s own start-up. The analysis and interpretation of the experiment’s outcomes shall simultaneously incorporate the views of both the educator and students. As presented, the study responds to the rising call for the application of experimental designs in entrepreneurship in general and EE in particular. While doing so, the paper presents an educator’s perspective of EE to complement the dominant stream of research which is constrained to the students’ point of view. Finally, the study sheds light on EE in the MENA region, where the study is applied.

Keywords: entrepreneurship education, andragogy and heutagogy, scholarship of teaching and learning, experiment

Procedia PDF Downloads 106
3718 The Ethical Imperative of Corporate Social Responsibility Practice and Disclosure by Firms in Nigeria Delta Swamplands: A Qualitative Analysis

Authors: Augustar Omoze Ehighalua, Itotenaan Henry Ogiri

Abstract:

As a mono-product economy, Nigeria relies largely on oil revenues for its foreign exchange earnings and the exploration activities of firms operating in the Niger Delta region have left in its wake tales of environmental degradation, poverty and misery. This, no doubt, have created corporate social responsibility issues in the region. The focus of this research is the critical evaluation of the ethical response to Corporate Social Responsibility (CSR) practice by firms operating in Nigeria Delta Swamplands. While CSR is becoming more popular in developed society with effective practice guidelines and reporting benchmark, there is a relatively low level of awareness and selective applicability of existing international guidelines to effectively support CSR practice in Nigeria. This study, haven identified the lack of CSR institutional framework attempts to develop an ethically-driven CSR transparency benchmark laced within a regulatory framework based on international best practices. The research adopts a qualitative methodology and makes use of primary data collected through semi-structured interviews conducted across the six core states of the Niger Delta Region. More importantly, the study adopts an inductive, interpretivist philosophical paradigm that reveal deep phenomenological insights into what local communities, civil society and government officials consider as good ethical benchmark for responsible CSR practice by organizations. The institutional theory provides for the main theoretical foundation, complemented by the stakeholder and legitimacy theories. The Nvivo software was used to analyze the data collected. This study shows that ethical responsibility is lacking in CSR practice by firms in the Niger Delta Region of Nigeria. Furthermore, findings of the study indicate key issues of environmental, health and safety, human rights, and labour as fundamental in developing an effective CSR practice guideline for Nigeria. The study has implications for public policy formulation as well as managerial perspective.

Keywords: corporate social responsibility, CSR, ethics, firms, Niger-Delta Swampland, Nigeria

Procedia PDF Downloads 92
3717 Effect of Perceived Importance of a Task in the Prospective Memory Task

Authors: Kazushige Wada, Mayuko Ueda

Abstract:

In the present study, we reanalyzed lapse errors in the last phase of a job, by re-counting near lapse errors and increasing the number of participants. We also examined the results of this study from the perspective of prospective memory (PM), which concerns future actions. This study was designed to investigate whether perceiving the importance of PM tasks caused lapse errors in the last phase of a job and to determine if such errors could be explained from the perspective of PM processing. Participants (N = 34) conducted a computerized clicking task, in which they clicked on 10 figures that they had learned in advance in 8 blocks of 10 trials. Participants were requested to click the check box in the start display of a block and to click the checking off box in the finishing display. This task was a PM task. As a measure of PM performance, we counted the number of omission errors caused by forgetting to check off in the finishing display, which was defined as a lapse error. The perceived importance was manipulated by different instructions. Half the participants in the highly important task condition were instructed that checking off was very important, because equipment would be overloaded if it were not done. The other half in the not important task condition was instructed only about the location and procedure for checking off. Furthermore, we controlled workload and the emotion of surprise to confirm the effect of demand capacity and attention. To manipulate emotions during the clicking task, we suddenly presented a photo of a traffic accident and the sound of a skidding car followed by an explosion. Workload was manipulated by requesting participants to press the 0 key in response to a beep. Results indicated too few forgetting induced lapse errors to be analyzed. However, there was a weak main effect of the perceived importance of the check task, in which the mouse moved to the “END” button before moving to the check box in the finishing display. Especially, the highly important task group showed more such near lapse errors, than the not important task group. Neither surprise, nor workload affected the occurrence of near lapse errors. These results imply that high perceived importance of PM tasks impair task performance. On the basis of the multiprocess framework of PM theory, we have suggested that PM task performance in this experiment relied not on monitoring PM tasks, but on spontaneous retrieving.

Keywords: prospective memory, perceived importance, lapse errors, multi process framework of prospective memory.

Procedia PDF Downloads 431
3716 Machine Learning Framework: Competitive Intelligence and Key Drivers Identification of Market Share Trends among Healthcare Facilities

Authors: Anudeep Appe, Bhanu Poluparthi, Lakshmi Kasivajjula, Udai Mv, Sobha Bagadi, Punya Modi, Aditya Singh, Hemanth Gunupudi, Spenser Troiano, Jeff Paul, Justin Stovall, Justin Yamamoto

Abstract:

The necessity of data-driven decisions in healthcare strategy formulation is rapidly increasing. A reliable framework which helps identify factors impacting a healthcare provider facility or a hospital (from here on termed as facility) market share is of key importance. This pilot study aims at developing a data-driven machine learning-regression framework which aids strategists in formulating key decisions to improve the facility’s market share which in turn impacts in improving the quality of healthcare services. The US (United States) healthcare business is chosen for the study, and the data spanning 60 key facilities in Washington State and about 3 years of historical data is considered. In the current analysis, market share is termed as the ratio of the facility’s encounters to the total encounters among the group of potential competitor facilities. The current study proposes a two-pronged approach of competitor identification and regression approach to evaluate and predict market share, respectively. Leveraged model agnostic technique, SHAP, to quantify the relative importance of features impacting the market share. Typical techniques in literature to quantify the degree of competitiveness among facilities use an empirical method to calculate a competitive factor to interpret the severity of competition. The proposed method identifies a pool of competitors, develops Directed Acyclic Graphs (DAGs) and feature level word vectors, and evaluates the key connected components at the facility level. This technique is robust since its data-driven, which minimizes the bias from empirical techniques. The DAGs factor in partial correlations at various segregations and key demographics of facilities along with a placeholder to factor in various business rules (for ex. quantifying the patient exchanges, provider references, and sister facilities). Identified are the multiple groups of competitors among facilities. Leveraging the competitors' identified developed and fine-tuned Random Forest Regression model to predict the market share. To identify key drivers of market share at an overall level, permutation feature importance of the attributes was calculated. For relative quantification of features at a facility level, incorporated SHAP (SHapley Additive exPlanations), a model agnostic explainer. This helped to identify and rank the attributes at each facility which impacts the market share. This approach proposes an amalgamation of the two popular and efficient modeling practices, viz., machine learning with graphs and tree-based regression techniques to reduce the bias. With these, we helped to drive strategic business decisions.

Keywords: competition, DAGs, facility, healthcare, machine learning, market share, random forest, SHAP

Procedia PDF Downloads 77
3715 Small and Medium Sized Ports between Specialisation and Diversification: A Framework Tool for Sustainable Development

Authors: Christopher Meyer, Laima Gerlitz

Abstract:

European ports are facing high political pressure through the implementation of initiatives such as the European Green Deal or IMO's 2030 targets (Fit for 55). However, small and medium-sized ports face even higher challenges compared to bigger ones due to lower capacities in various fields such as investments, infra-structure, Human Resources, and funding opportunities. Small and Medium-Sized Ports (SMPs) roles in economic systems are various depending on their specific functionality in maritime ecosystems. Depending on their different situations, being an actor in multiport gateways, aligned to core ports, regional nodes in peripheries for the hinterland, specialized cluster members, or logistical nodes, different strategic business models may be applied to increase SMPs' competitiveness among other bigger ports. Additionally, SMPs are facing more challenges for future development in terms of digital and green transition of their operations. Thus, it is necessary to evaluate the own strategical position and apply management strategies alongside the regional growth and innovation strategies for diversification or specialisation of own port businesses. The research uses inductive perspectives to set up a transferable framework based on case studies to be analysed. In line with particular research and document analysis, qualitative approaches were considered. The research is based on a deep literature review on SMPs as well as theories on diversification and specialisation. Existing theories from different fields are evaluated on their application for the port sector and these specific maritime actors, paying respect to enabling innovation incorporation to enhance digital and environmental transition with fu-ture perspectives for SMPs. The paper aims to provide a decision-making matrix for the strategic positioning of SMPs in Europe, including opportunities to get access to particular EU funds for future development alongside the Regional In-novation Strategies on Smart Specialisation.

Keywords: strategic planning, sustainability transition, competitiveness portfolio, EU green deal

Procedia PDF Downloads 64
3714 Towards Natively Context-Aware Web Services

Authors: Hajer Taktak, Faouzi Moussa

Abstract:

With the ubiquitous computing’s emergence and the evolution of enterprises’ needs, one of the main challenges is to build context-aware applications based on Web services. These applications have become particularly relevant in the pervasive computing domain. In this paper, we introduce our approach that optimizes the use of Web services with context notions when dealing with contextual environments. We focus particularly on making Web services autonomous and natively context-aware. We implement and evaluate the proposed approach with a pedagogical example of a context-aware Web service treating temperature values. 

Keywords: context-aware, CXF framework, ubiquitous computing, web service

Procedia PDF Downloads 341
3713 The Role and Effects of Communication on Occupational Safety: A Review

Authors: Pieter A. Cornelissen, Joris J. Van Hoof

Abstract:

The interest in improving occupational safety started almost simultaneously with the beginning of the Industrial Revolution. Yet, it was not until the late 1970’s before the role of communication was considered in scientific research regarding occupational safety. In recent years the importance of communication as a means to improve occupational safety has increased. Not only as communication might have a direct effect on safety performance and safety outcomes, but also as it can be viewed as a major component of other important safety-related elements (e.g., training, safety meetings, leadership). And while safety communication is an increasingly important topic in research, its operationalization is often vague and differs among studies. This is not only problematic when comparing results, but also in applying these results to practice and the work floor. By means of an in-depth analysis—building on an existing dataset—this review aims to overcome these problems. The initial database search yielded 25.527 articles, which was reduced to a research corpus of 176 articles. Focusing on the 37 articles of this corpus that addressed communication (related to safety outcomes and safety performance), the current study will provide a comprehensive overview of the role and effects of safety communication and outlines the conditions under which communication contributes to a safer work environment. The study shows that in literature a distinction is commonly made between safety communication (i.e., the exchange or dissemination of safety-related information) and feedback (i.e. a reactive form of communication). And although there is a consensus among researchers that both communication and feedback positively affect safety performance, there is a debate about the directness of this relationship. Whereas some researchers assume a direct relationship between safety communication and safety performance, others state that this relationship is mediated by safety climate. One of the key findings is that despite the strongly present view that safety communication is a formal and top-down safety management tool, researchers stress the importance of open communication that encourages and allows employees to express their worries, experiences, views, and share information. This raises questions with regard to other directions (e.g., bottom-up, horizontal) and forms of communication (e.g., informal). The current review proposes a framework to overcome the often vague and different operationalizations of safety communication. The proposed framework can be used to characterize safety communication in terms of stakeholders, direction, and characteristics of communication (e.g., medium usage).

Keywords: communication, feedback, occupational safety, review

Procedia PDF Downloads 288
3712 An Approach towards Intelligent Urbanism in New Communities

Authors: Sherine Shafik Aly, Farida Ahmed El Mallah

Abstract:

Technology is a quoted keyword nowadays in all fields; it has been recently thought of and integrated into urban development. This research explains the role of technology in establishing intelligent urbanism to create a convivial and sustainable environment for people to live in. Cities are downgrading socially, economically and environmentally. A framework is to be developed where these three pillars are involved in the planning, design, and spreading of technology to create convivial environments. The aim of this research is achieved by highlighting the importance and approaches of intelligent urbanism, it’s characteristics and principles, then analyzing some relevant examples to achieve a set of guidelines.

Keywords: convivial, intelligent, technology, urban development

Procedia PDF Downloads 242
3711 Prioritizing Biodiversity Conservation Areas based on the Vulnerability and the Irreplaceability Framework in Mexico

Authors: Alma Mendoza-Ponce, Rogelio Corona-Núñez, Florian Kraxner

Abstract:

Mexico is a megadiverse country and it has nearly halved its natural vegetation in the last century due to agricultural and livestock expansion. Impacts of land use cover change and climate change are unevenly distributed and spatial prioritization to minimize the affectations on biodiversity is crucial. Global and national efforts for prioritizing biodiversity conservation show that ~33% to 45% of Mexico should be protected. The width of these targets makes difficult to lead resources. We use a framework based on vulnerability and irreplaceability to prioritize conservation efforts in Mexico. Vulnerability considered exposure, sensitivity and adaptive capacity under two scenarios (business as usual, BAU based, on the SSP2 and RCP 4.5 and a Green scenario, based on the SSP1 and the RCP 2.6). Exposure to land use is the magnitude of change from natural vegetation to anthropogenic covers while exposure to climate change is the difference between current and future values for both scenarios. Sensitivity was considered as the number of endemic species of terrestrial vertebrates which are critically endangered and endangered. Adaptive capacity is used as the ration between the percentage of converted area (natural to anthropogenic) and the percentage of protected area at municipality level. The results suggest that by 2050, between 11.6 and 13.9% of Mexico show vulnerability ≥ 50%, and by 2070, between 12.0 and 14.8%, in the Green and BAU scenario, respectively. From an ecosystem perspective cloud forests, followed by tropical dry forests, natural grasslands and temperate forests will be the most vulnerable (≥ 50%). Amphibians are the most threatened vertebrates; 62% of the endemic amphibians are critically endangered or endangered while 39%, 12% and 9% of the mammals, birds, and reptiles, respectively. However, the distribution of these amphibians counts for only 3.3% of the country, while mammals, birds, and reptiles in these categories represent 10%, 16% and 29% of Mexico. There are 5 municipalities out of the 2,457 that Mexico has that represent 31% of the most vulnerable areas (70%).These municipalities account for 0.05% of Mexico. This multiscale approach can be used to address resources to conservation targets as ecosystems, municipalities or species considering land use cover change, climate change and biodiversity uniqueness.

Keywords: biodiversity, climate change, land use change, Mexico, vulnerability

Procedia PDF Downloads 153
3710 Human Factors as the Main Reason of the Accident in Scaffold Use Assessment

Authors: Krzysztof J. Czarnocki, E. Czarnocka, K. Szaniawska

Abstract:

Main goal of the research project is Scaffold Use Risk Assessment Model (SURAM) formulation, developed for the assessment of risk levels as a various construction process stages with various work trades. Finally, in 2016, the project received financing by the National Center for Research and development according to PBS3/A2/19/2015–Research Grant. The presented data, calculations and analyzes discussed in this paper were created as a result of the completion on the first and second phase of the PBS3/A2/19/2015 project. Method: One of the arms of the research project is the assessment of worker visual concentration on the sight zones as well as risky visual point inadequate observation. In this part of research, the mobile eye-tracker was used to monitor the worker observation zones. SMI Eye Tracking Glasses is a tool, which allows us to analyze in real time and place where our eyesight is concentrated on and consequently build the map of worker's eyesight concentration during a shift. While the project is still running, currently 64 construction sites have been examined, and more than 600 workers took part in the experiment including monitoring of typical parameters of the work regimen, workload, microclimate, sound vibration, etc. Full equipment can also be useful in more advanced analyses. Because of that technology we have verified not only main focus of workers eyes during work on or next to scaffolding, but we have also examined which changes in the surrounding environment during their shift influenced their concentration. In the result of this study it has been proven that only up to 45.75% of the shift time, workers’ eye concentration was on one of three work-related areas. Workers seem to be distracted by noisy vehicles or people nearby. In opposite to our initial assumptions and other authors’ findings, we observed that the reflective parts of the scaffoldings were not more recognized by workers in their direct workplaces. We have noticed that the red curbs were the only well recognized part on a very few scaffoldings. Surprisingly on numbers of samples, we have not recognized any significant number of concentrations on those curbs. Conclusion: We have found the eye-tracking method useful for the construction of the SURAM model in the risk perception and worker’s behavior sub-modules. We also have found that the initial worker's stress and work visual conditions seem to be more predictive for assessment of the risky developing situation or an accident than other parameters relating to a work environment.

Keywords: accident assessment model, eye tracking, occupational safety, scaffolding

Procedia PDF Downloads 182
3709 Reculturing: The Key to Sustainability of Private Universities

Authors: Yu Sing Ong

Abstract:

This article explores the key issues and challenges facing private university leaders today. Universities are reculturing their operational processes, academic content and interactions with stakeholders. Many challenges centred around the need for university leaders to reculture the institutions and the redesigning of the teaching profession. It recommends a framework for university leaders to deal with the challenges they face. Only through reculturing, private universities can maintain the sustainability of its workforce and student population. The article has both theoretical and practical significance for private university leaders to follow.

Keywords: university leadership, reculturing, improvement, teacher education, motivation, private education

Procedia PDF Downloads 242
3708 A Proposal of a Strategic Framework for the Development of Smart Cities: The Argentinian Case

Authors: Luis Castiella, Mariano Rueda, Catalina Palacio

Abstract:

The world’s rapid urbanisation represents an excellent opportunity to implement initiatives that are oriented towards a country’s general development. However, this phenomenon has created considerable pressure on current urban models, pushing them nearer to a crisis. As a result, several factors usually associated with underdevelopment have been steadily rising. Moreover, actions taken by public authorities have not been able to keep up with the speed of urbanisation, which has impeded them from meeting the demands of society, responding with reactionary policies instead of with coordinated, organised efforts. In contrast, the concept of a Smart City which emerged around two decades ago, in principle, represents a city that utilises innovative technologies to remedy the everyday issues of the citizen, empowering them with the newest available technology and information. This concept has come to adopt a wider meaning, including human and social capital, as well as productivity, economic growth, quality of life, environment and participative governance. These developments have also disrupted the management of institutions such as academia, which have become key in generating scientific advancements that can solve pressing problems, and in forming a specialised class that is able to follow up on these breakthroughs. In this light, the Ministry of Modernisation of the Argentinian Nation has created a model that is rooted in the concept of a ‘Smart City’. This effort considered all the dimensions that are at play in an urban environment, with careful monitoring of each sub-dimensions in order to establish the government’s priorities and improving the effectiveness of its operations. In an attempt to ameliorate the overall efficiency of the country’s economic and social development, these focused initiatives have also encouraged citizen participation and the cooperation of the private sector: replacing short-sighted policies with some that are coherent and organised. This process was developed gradually. The first stage consisted in building the model’s structure; the second, at applying the method created on specific case studies and verifying that the mechanisms used respected the desired technical and social aspects. Finally, the third stage consists in the repetition and subsequent comparison of this experiment in order to measure the effects on the ‘treatment group’ over time. The first trial was conducted on 717 municipalities and evaluated the dimension of Governance. Results showed that levels of governmental maturity varied sharply with relation to size: cities with less than 150.000 people had a strikingly lower level of governmental maturity than cities with more than 150.000 people. With the help of this analysis, some important trends and target population were made apparent, which enabled the public administration to focus its efforts and increase its probability of being successful. It also permitted to cut costs, time, and create a dynamic framework in tune with the population’s demands, improving quality of life with sustained efforts to develop social and economic conditions within the territorial structure.

Keywords: composite index, comprehensive model, smart cities, strategic framework

Procedia PDF Downloads 162
3707 Measuring Green Growth Indicators: Implication for Policy

Authors: Hanee Ryu

Abstract:

The former president Lee Myung-bak's administration of Korea presented “green growth” as a catchphrase from 2008. He declared “low-carbon, green growth” the nation's vision for the next decade according to United Nation Framework on Climate Change. The government designed omnidirectional policy for low-carbon and green growth with concentrating all effort of departments. The structural change was expected because this slogan is the identity of the government, which is strongly driven with the whole department. After his administration ends, the purpose of this paper is to quantify the policy effect and to compare with the value of the other OECD countries. The major target values under direct policy objectives were suggested, but it could not capture the entire landscape on which the policy makes changes. This paper figures out the policy impacts through comparing the value of ex-ante between the one of ex-post. Furthermore, each index level of Korea’s low-carbon and green growth comparing with the value of the other OECD countries. To measure the policy effect, indicators international organizations have developed are considered. Environmental Sustainable Index (ESI) and Environmental Performance Index (EPI) have been developed by Yale University’s Center for Environmental Law and Policy and Columbia University’s Center for International Earth Science Information Network in collaboration with the World Economic Forum and Joint Research Center of European Commission. It has been widely used to assess the level of natural resource endowments, pollution level, environmental management efforts and society’s capacity to improve its environmental performance over time. Recently OCED publish the Green Growth Indicator for monitoring progress towards green growth based on internationally comparable data. They build up the conceptual framework and select indicators according to well specified criteria: economic activities, natural asset base, environmental dimension of quality of life and economic opportunities and policy response. It considers the socio-economic context and reflects the characteristic of growth. Some selected indicators are used for measuring the level of changes the green growth policies have induced in this paper. As results, the CO2 productivity and energy productivity show trends of declination. It means that policy intended industry structure shift for achieving carbon emission target affects weakly in the short-term. Increasing green technologies patents might result from the investment of previous period. The increasing of official development aids which can be immediately embarked by political decision with no time lag present only in 2008-2009. It means international collaboration and investment to developing countries via ODA has not succeeded since the initial stage of his administration. The green growth framework makes the public expect structural change, but it shows sporadic effect. It needs organization to manage it in terms of the long-range perspectives. Energy, climate change and green growth are not the issue to be handled in the one period of the administration. The policy mechanism to transfer cost problem to value creation should be developed consistently.

Keywords: comparing ex-ante between ex-post indicator, green growth indicator, implication for green growth policy, measuring policy effect

Procedia PDF Downloads 432
3706 Assessing Diagnostic and Evaluation Tools for Use in Urban Immunisation Programming: A Critical Narrative Review and Proposed Framework

Authors: Tim Crocker-Buque, Sandra Mounier-Jack, Natasha Howard

Abstract:

Background: Due to both the increasing scale and speed of urbanisation, urban areas in low and middle-income countries (LMICs) host increasingly large populations of under-immunized children, with the additional associated risks of rapid disease transmission in high-density living environments. Multiple interdependent factors are associated with these coverage disparities in urban areas and most evidence comes from relatively few countries, e.g., predominantly India, Kenya, Nigeria, and some from Pakistan, Iran, and Brazil. This study aimed to identify, describe, and assess the main tools used to measure or improve coverage of immunisation services in poor urban areas. Methods: Authors used a qualitative review design, including academic and non-academic literature, to identify tools used to improve coverage of public health interventions in urban areas. Authors selected and extracted sources that provided good examples of specific tools, or categories of tools, used in a context relevant to urban immunization. Diagnostic (e.g., for data collection, analysis, and insight generation) and programme tools (e.g., for investigating or improving ongoing programmes) and interventions (e.g., multi-component or stand-alone with evidence) were selected for inclusion to provide a range of type and availability of relevant tools. These were then prioritised using a decision-analysis framework and a tool selection guide for programme managers developed. Results: Authors reviewed tools used in urban immunisation contexts and tools designed for (i) non-immunization and/or non-health interventions in urban areas, and (ii) immunisation in rural contexts that had relevance for urban areas (e.g., Reaching every District/Child/ Zone). Many approaches combined several tools and methods, which authors categorised as diagnostic, programme, and intervention. The most common diagnostic tools were cross-sectional surveys, key informant interviews, focus group discussions, secondary analysis of routine data, and geographical mapping of outcomes, resources, and services. Programme tools involved multiple stages of data collection, analysis, insight generation, and intervention planning and included guidance documents from WHO (World Health Organisation), UNICEF (United Nations Children's Fund), USAID (United States Agency for International Development), and governments, and articles reporting on diagnostics, interventions, and/or evaluations to improve urban immunisation. Interventions involved service improvement, education, reminder/recall, incentives, outreach, mass-media, or were multi-component. The main gaps in existing tools were an assessment of macro/policy-level factors, exploration of effective immunization communication channels, and measuring in/out-migration. The proposed framework uses a problem tree approach to suggest tools to address five common challenges (i.e. identifying populations, understanding communities, issues with service access and use, improving services, improving coverage) based on context and available data. Conclusion: This study identified many tools relevant to evaluating urban LMIC immunisation programmes, including significant crossover between tools. This was encouraging in terms of supporting the identification of common areas, but problematic as data volumes, instructions, and activities could overwhelm managers and tools are not always suitably applied to suitable contexts. Further research is needed on how best to combine tools and methods to suit local contexts. Authors’ initial framework can be tested and developed further.

Keywords: health equity, immunisation, low and middle-income countries, poverty, urban health

Procedia PDF Downloads 130
3705 Preventing Corruption in Dubai: Governance, Contemporary Strategies and Systemic Flaws

Authors: Graham Brooks, Belaisha Bin Belaisha, Hakkyong Kim

Abstract:

The problem of preventing and/or reducing corruption is a major international problem. This paper, however, specifically focuses on how organisations in Dubai are tackling the problem of money laundering. This research establishes that Dubai has a clear international anti-money laundering framework but suffers from some national weaknesses such as diverse anti-money laundering working practice, lack of communication, sharing information and disparate organisational vested self-interest.

Keywords: corruption, governance, money laundering, prevention, strategies

Procedia PDF Downloads 262
3704 Relevance of Copyright and Trademark in the Gaming Industry

Authors: Deeksha Karunakar

Abstract:

The gaming industry is one of the biggest industries in the world. Video games are interactive works of authorship that require the execution of a computer programme on specialized hardware but which also incorporate a wide variety of other artistic mediums, such as music, scripts, stories, video, paintings, and characters, into which the player takes an active role. Therefore, video games are not made as singular, simple works but rather as a collection of elements that, if they reach a certain level of originality and creativity, can each be copyrighted on their own. A video game is made up of a wide variety of parts, all of which combine to form the overall sensation that we, the players, have while playing. The entirety of the components is implemented in the form of software code, which is then translated into the game's user interface. Even while copyright protection is already in place for the coding of software, the work that is produced because of that coding can also be protected by copyright. This includes the game's storyline or narrative, its characters, and even elements of the code on their own. In each sector, there is a potential legal framework required, and the gaming industry also requires legal frameworks. This represents the importance of intellectual property laws in each sector. This paper will explore the beginnings of video games, the various aspects of game copyrights, and the approach of the courts, including examples of a few different instances. Although the creative arts have always been known to draw inspiration from and build upon the works of others, it has not always been simple to evaluate whether a game has been cloned. The video game business is experiencing growth as it has never seen before today. The majority of today's video games are both pieces of software and works of audio-visual art. Even though the existing legal framework does not have a clause specifically addressing video games, it is clear that there is a great many alternative means by which this protection can be granted. This paper will represent the importance of copyright and trademark laws in the gaming industry and its regulations with the help of relevant case laws via utilizing doctrinal methodology to support its findings. The aim of the paper is to make aware of the applicability of intellectual property laws in the gaming industry and how the justice system is evolving to adapt to such new industries. Furthermore, it will provide in-depth knowledge of their relationship with each other.

Keywords: copyright, DMCA, gaming industry, trademark, WIPO

Procedia PDF Downloads 53
3703 Deploying a Transformative Learning Model in Technological University Dublin to Assess Transversal Skills

Authors: Sandra Thompson, Paul Dervan

Abstract:

Ireland’s first Technological University (TU Dublin) was established on 1st January 2019, and its creation is an exciting new milestone in Irish Higher Education. TU Dublin is now Ireland’s biggest University supporting 29,000 students across three campuses with 3,500 staff. The University aspires to create work-ready graduates who are socially responsible, open-minded global thinkers who are ambitious to change the world for the better. As graduates, they will be enterprising and daring in all their endeavors, ready to play their part in transforming the future. Feedback from Irish employers and students coupled with evidence from other authoritative sources such as the World Economic Forum points to a need for greater focus on the development of students’ employability skills as they prepare for today’s work environment. Moreover, with an increased focus on Universal Design for Learning (UDL) and inclusiveness, there is recognition that students are more than a numeric grade value. Robust grading systems have been developed to track a student’s performance around discipline knowledge but there is little or no global consensus on a definition of transversal skills nor on a unified framework to assess transversal skills. Education and industry sectors are often assessing one or two skills, and some are developing their own frameworks to capture the learner’s achievement in this area. Technological University Dublin (TU Dublin) have discovered and implemented a framework to allow students to develop, assess and record their transversal skills using transformative learning theory. The model implemented is an adaptation of Student Transformative Learning Record - STLR which originated in the University of Central Oklahoma (UCO). The purpose of this paper therefore, is to examine the views of students, staff and employers in the context of deploying a Transformative Learning model within the University to assess transversal skills. It will examine the initial impact the transformative learning model is having socially, personally and on the University as an organization. Crucially also, to identify lessons learned from the deployment in order to assist other Universities and Higher Education Institutes who may be considering a focused adoption of Transformative Learning to meet the challenge of preparing students for today’s work environment.

Keywords: assessing transversal skills, higher education, transformative learning, students

Procedia PDF Downloads 116
3702 Number of Parameters of Anantharam's Model with Single-Input Single-Output Case

Authors: Kazuyoshi Mori

Abstract:

In this paper, we consider the parametrization of Anantharam’s model within the framework of the factorization approach. In the parametrization, we investigate the number of required parameters of Anantharam’s model. We consider single-input single-output systems in this paper. By the investigation, we find three cases that are (1) there exist plants which require only one parameter and (2) two parameters, and (3) the number of parameters is at most three.

Keywords: linear systems, parametrization, coprime factorization, number of parameters

Procedia PDF Downloads 199
3701 Assessing the Quality of Maternity Care in Sub-Saharan Africa Using the Donabedian Quality of Care Framework: A Systematic Scoping Review

Authors: Bernice Boafoaa Gyapong, Anne Jones, Sam Bassett, Janet Anderson

Abstract:

Background: Maternal mortality and morbidity are global concerns, especially in sub-Saharan Africa (SSA). Most maternal mortalities occur at the time of birth. Quality intrapartum care is essential for improving maternal and newborn health outcomes. This scoping review aimed to assess and describe the quality of care during childbirth in SSA to provide an overview of the regional trend of the quality of intrapartum care, the challenges to quality care provision, and identify research gaps. Methods: A scoping review based on Arksey and O’Malley’s scoping review framework was conducted. Medline, CINAHL, PsycINFO, and maternal-infant databases were searched to identify the relevant studies for this review. A narrative summary was presented using themes based on the Donabedian structure, process, and outcome quality of care model. Results: A total of five hundred and forty-seven (547) publications were identified. Fifty-six (56) studies conducted in twenty (20) countries were included in the review. Thirty-four (34) were quantitative, sixteen (16) were qualitative, and six (6) were mixed methods. Most of the studies were related to the process component of quality of care. The provision of emergency obstetric care services, infrastructure, and availability of essential staff and equipment for perinatal care was inadequate in many facilities, particularly rural and peripheral health facilities. Many women experienced disrespectful care during childbirth. Routine care during labour and delivery was observed to be sub-optimal, yet some women reported high satisfaction with care. The use of health facilities for delivery was lower in health centres compared to hospitals. Conclusion: There are variations in the quality of maternity care provided in SSA. Intrapartum care quality is generally deficient in SSA, particularly in peripheral health facilities, health centres, and community clinics. Many of the quality-of-care issues identified are related to the structure component. Stakeholders must develop interventions that comprehensively address these interrelated issues to improve maternal healthcare quality, especially in primary healthcare facilities.

Keywords: quality of care, maternity health, Sub-Saharan Africa, intrapartum

Procedia PDF Downloads 53