Understanding pathways leading to stillbirth: The role of care-seeking and care received during pregnancy and childbirth in Kabul province,Afghanistan

BackgroundThe underlying pathways leading to stillbirth in low- and middle-income countries are not well understood. Context-specific understanding of how and why stillbirths occur is needed to prioritise interventions and identify barriers to their effective implementation and uptake.AimTo explore the contribution of contextual, individual, household-level and health system factors to stillbirth in Afghanistan.MethodsUsing a qualitative approach, we conducted semi-structured in-depth interviews with women and men that experienced stillbirth, female elders, community health workers, healthcare providers, and government officials in Kabul province, Afghanistan between October-November 2017. We used thematic analysis to identify contributing factors and developed a conceptual map describing possible pathways to stillbirth.FindingsWe found that low utilisation and access to healthcare was a key contributing factor, as were unmanaged conditions in pregnancy that increased women’s risk of complications and stillbirth. Sociocultural factors related to the treatment of women and perceptions about medical interventions deprived women of interventions that could potentially prevent stillbirth. The quality of care from public and private providers during pregnancy and childbirth was a recurring concern exacerbated by health system constraints that led to unnecessary delays; while environmental factors linked to the ongoing conflict were also perceived to contribute to stillbirth. These pathways were underscored by social, cultural, economic factors and individual perceptions that contributed to the three-delays.DiscussionEfforts are needed at the community-level to facilitate care-seeking and raise awareness of stillbirth risk factors and the facility-level to strengthen antenatal and childbirth care quality, ensure culturally appropriate and respectful care, and reduce treatment delays.     

Research approaches to networked employment services: A systematic review

Research on networked services aimed at the (re)employment of groups marginalised from the labour market has gained momentum in different scholarly traditions (e.g., public administration, healthcare and social policy), but the topic remains somewhat fragmented. In this paper, we systematise and synthesise this research with the aim of outlining distinct research approaches, facilitating increased cross-disciplinary understandings and promoting interdisciplinary research. Based on a systematic review of the literature (1990–2018, n = 273), we highlight four dominant research approaches: rehabilitation, disability, welfare and governance. We show that these research approaches involve distinct conceptualisations of labour market inclusion, networked services and the target groups. Nevertheless, the research approaches also apply similar terms and concepts (e.g., partnership, collaboration) but with different (more or less implicit) connotations, which lead to fragmentation. We do not suggest that there be a unified use of concepts across traditions; however, we argue for the necessity of increased awareness of the similarities and differences between these research traditions in order to increase understanding of the networked employment services available to marginalised groups.     

A New Direction for Library Technical Services: Using Metadata Skills to Improve User Accessibility

Abstract

An increased awareness about the importance of resource accessibility for all library users has set the stage for transforming traditional cataloger roles into a new realm of possibility. The Acquisitions & Discovery (A&D) and the User Experience (UX) departments of North Carolina State University Libraries have formed a partnership to explore the benefits of working together amidst this climate of innovation and change. A pilot project was created to develop a workflow through which technical services staff can use their metadata skills to help resolve accessibility issues found on the Libraries’ main website. By performing this work, staff can grow in technical expertise, enhance the quality of metadata in web content, and build mutually beneficial partnerships within the library community.     

Commerce et emploi en Europe: le rôle des exportations de services «mode 5»

Dans l'UE, l'emploi lié aux exportations extracommunautaires de biens et de services a augmenté sensiblement ces dernières décennies, et la contribution à cet emploi des services incorporés dans des articles manufacturés s'est élevée. Pour mieux comprendre le phénomène, les auteurs procèdent à une décomposition systématique des flux commerciaux, en utilisant un modèle entrées‐sorties multirégional et des données de la base WIOD. L'analyse porte sur 40 pays et 35 branches d'activité, suivis de 1995 à 2011. Elle tend à remettre en question la classification en quatre modes de fourniture de services de l'Accord général sur le commerce des services, qui ne reflète plus la réalité actuelle.     

The quasi-market of employment services in Italy

This paper aims to study pros and cons of the first experiment of quasi-market in the provision of employment services in Italy: the Lombardy DUL (Dote Unica Lavoro). The program, which has inspired the 2015 national reform within the Jobs Act and lines towards the recent experience of several Anglo-Saxon countries, has revitalized the sector by providing important job opportunities to jobless workers. We find the typical problems of quasi-markets (lion’s share of private organizations; cherry picking; gaming and asymmetric information). However, different expedients were devised in the program to minimize these shortcomings. The empirical analysis suggest that such phenomena are at a physiological level. Analysis of the determinants of completing successfully the program provides non-trivial results as to, among others, the role of organizations of different ownership type and of the type of services provided. On these we base our policy advice.     

Networks,case managers,and the job-search experiences of unemployed people

Employment services are commonly provided in network settings, but it is rare to find social policy analyses of how unemployed people search for jobs through networks. In a germinal analysis of social networks and employment, Mark Granovetter argued that “weak ties” (less familiar contacts) are more important to finding employment than are “strong ties” (family and friends). This is because weak ties provide more novel job-relevant information. Scholarship since Granovetter has predominantly supported the opposite argument, namely, that strong ties are more important for the unemployed, because they are more plentiful and thus provide more information in aggregate. Findings are also generally coloured by the focus being on “informal” networks or personal contacts. “Formal” networks, as represented most cogently by employment service providers, are absent or underestimated in most social network studies. On the basis of a qualitative study of 80 long-term unemployed people in Australia, incorporating analysis of both informal and formal networks, we argue that although “strong informal” ties are vital to job search, it is also important to consider “weak formal” ties, which can be complementary if and where service organizations are able to supply positive case management experiences.     

Digitally connected services: Improvements through customer-initiated feedback

A growing number of manufacturers advances their offerings by providing digitally connected services (DCS) that require companies to revisit quality improvements based on customer feedback. This paper explores how firms use customer-initiated feedback for quality improvement of DCS. DCS entail a human-to-digital interface that enables ongoing provider-customer interaction. Based on a case study of a manufacturer that offers DCS, we conclude that the scope of improvements extends into the use phase of services, and customer-initiated feedback is both codified and personalized. In particular, systematic use of customer-initiated feedback for improving DCS requires three distinct efforts. First, channeling aims to capture feedback provided by a large number of customers through various entries into the organization. Second, processing refers to utilizing this feedback within the organization for service improvements. Third, knowledge conversion seeks to turn learning from feedback into knowledge that is dealt effectively across various functions such as quality management and customer services. In addition, research should investigate further quality improvement and customer feedback of services that are digitally configured by customers themselves.     

网格服务在我国的普及之路

网格服务目前正以爆炸式增长势头向前发展。世界各国政府及跨国IT公司也都纷纷推出计算机网格发展计划及方案,我国目前也有相应的计划,但缺乏商用市场解决方案,很难在市场上得到普及,所以,大力开发实用解决方案是网格普及的必由之路。     

Participation in stakeholder-based evaluation: A case study

This paper reports on the evaluation of some of the elements of a multi-component program aimed at improving the accessibility of health and social services for the homeless. The program involved provincial, regional and municipal authorities and more than 20 non-profit and public agencies. In accordance with the overall approach of the program, the principle of stakeholder participation in the evaluation was emphasized by the funding agencies. However, even if the evaluation started under promising conditions, including administrative support, a strong commitment from the involved agencies and experience in formative evaluation within the research team, participation of stakeholders from charitable non-profit agencies met with many difficulties. Using a case study approach, this paper attempts to analyze and discuss how the organizational context of the evaluation, certain stakeholder characteristics and methodological features may have impacted on the evaluation process.     

农村资金短缺、资金非农化与信贷支农

改善支农服务 ,解决农民贷款难问题是农村信用社改革的出发点和落脚点。从现阶段农村经济发展中资金短缺与农村资金非农化并存的现状出发 ,并结合目前信贷支农服务中出现的资金需求问题提出合理化建议 ,以推动农村信用社的改革工作