Variations in the design of CHW interventions have a significant and direct influence on CHW performance. Our systematic review of the literature, which included 140 studies on CHW programmes, found that multiple intervention design factors, such as different types of supervision, incentives, training, accountability and communication structures, logistics and supplies, influence CHW performance [9]. This and other reviews stress the importance of building elements into the intervention design that facilitate performance from both the health sector and community side [1, 8, 9, 14,15,16]. We furthermore identified contextual factors that influence CHW performance. These include community context, such as cultural and gender norms, the economy including market forces, the environment, and health system policy and practice (e.g. availability of a CHW and human resources policy and human resources provisions and governance structure) [17]. Both intervention design and contextual factors form an interactive web, influencing performance of CHW programmes through the experiences, mindsets and values that shape the behaviour of actors and their relationships. To further explore the pathways leading to CHW performance, we undertook a qualitative comparative study of the CHW programmes in Ethiopia, Kenya, Malawi and Mozambique. The study included a total of 15 focus group discussions (FGDs) and 38 interviews with CHWs, 70 interviews with CHW supervisors and managers and 33 FGDs and 46 interviews with various types of community members. The intermediary position of CHWs and the concept of performance as a transactional social process led us to focus on how relationships between different actors influenced CHW performance. The study demonstrated a complex interplay of factors influencing trust, and thereby the strength of relationships, between CHWs, their communities and actors in the health sector, such as supervisors and managers. In different contexts, these relationships were shaped through various mechanisms, such as feelings of (dis)connectedness, (un)familiarity, self-fulfilment and serving the same goals and perceptions of support received, respect, competence, honesty, fairness and recognition. CHW performance was clearly related to trusting relationships among different actors, which are often related to experiences regarding power and hierarchy. The socio-economic situation, the history and value of community participation and volunteerism and the role of traditional leaders were found to influence relationships. The programme context, e.g. selection and recruitment systems, extent of task-shifting, volunteering and mode of supervision, was also of influence [18].
situating the self pdf download
It should to be noted that the systematic review [9, 17] and empirical research [18] conducted by REACHOUT did not focus on all hard- and software elements that could influence CHW performance, but many of these elements emerged during the qualitative studies in the six countries. In addition, the attributes of CHW performance were taken from the literature and not individually analysed nor assessed; rather, they were taken as (sometimes self-reported) outcome measures in the respective studies. The conceptual framework does not visualize the effects of CHW performance at the end user and impact level; however, we assume that improved CHW performance leads to improved service delivery, positive changes in health-seeking behaviour and utilization of services by communities and ultimately impacts on the health of the population [9, 10].
Listed on this webpage are a number of papers that Professor Benhabib has written on various topics and for various events. These are all in PDF format. If you do not have a PDF reader, you can download the free Adobe Reader at
In essence, traditional epidemiology focusses on risk factors and outcomes, with the link between them being an opaque black box [29]. However, in order to develop interventions to change the relationship between risks and outcomes, what is within that black box itself needs to be changed. This requires understanding mechanisms and having a theory of change in order to modify them. Statistical methodology does not provide the tools to model mechanisms, so researchers tend to focus on tasks that statistical methods can solve, which is the description of inequalities identified by the data without necessarily providing solutions. ABMs, in contrast, require people to model mechanisms explicitly, at least in the abstract, and provide a set of tools that encourages people to focus on the parts of the system where change might occur and could have the greatest impact. This leads us more toward solutions-focused research.
We refer to computer programming in the sense of using general-purpose programming languages, like C/C++, Python or Java, to construct self-contained computer programs. This is a distinct skill set from using domain-specific scripting languages, like R or Stata, to construct statistical models.
In this article, I'll go through why self-publishing an ebook is a good idea, how to format an ebook for publication, exclusivity vs going wide on multiple platforms, the specific sites available for self-publishing ebooks and what information you need, thoughts on pricing, and piracy.
It is free to self-publish on the most popular ebook platforms. Obviously, you have to pay upfront for editing and cover design but the actual publishing is free and the stores take a small percentage of sales. Compared to most other business models, publishing in this digital age has low overheads, low entry costs and potentially a high margin of return.
If you're going to self-publish ebooks or you are already selling them, then I do recommend that you buy an ebook reader or at least try reading an ebook on one of the many free apps. You need to understand the mindset of an ebook reader as well as their online experience. I read 99% ebooks these days, mostly on the Kindle Paperwhite and my iPhone Kindle app. I mostly download samples before buying, unless I know and trust the author. I also have preferences around pricing, and you will pick these things up if you try reading digitally.
In Dec 2014, a law was brought in across the EU that meant sales of digital products, including ebooks, would now be subject to Value Added Tax based on the country of the customer, not the supplier. The law was aimed at stopping companies like Amazon, Google and Apple from situating their companies in countries with specific tax breaks to lower their tax in other countries. But of course, it hit every author and small business selling digitally. This tax is now spreading to other countries, so we can assume it will be part of the global digital marketplace going forward. 2ff7e9595c
Comments