scholarly journals How do participatory methods shape policy? Applying a realist approach to the formulation of a new tuberculosis policy in Georgia

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e047948
Author(s):  
Bruno Marchal ◽  
Ibukun-Oluwa Omolade Abejirinde ◽  
Lela Sulaberidze ◽  
Ivdity Chikovani ◽  
Maia Uchaneishvili ◽  
...  
Keyword(s):  
Research Team ◽  
Service Providers ◽  
Realist Evaluation ◽  
Theory And Practice ◽  
Service Improvement ◽  
Causal Loop ◽  
Monitoring Tools ◽  
National Tuberculosis ◽  
Causal Loop Diagrams ◽  
Mapping Techniques

ObjectivesThis paper presents the iterative process of participatory multistakeholder engagement that informed the development of a new national tuberculosis (TB) policy in Georgia, and the lessons learnt.MethodsGuided by realist evaluation methods, a multistakeholder dialogue was organised to elicit stakeholders’ assumptions on challenges and possible solutions for better TB control. Two participatory workshops were conducted with key actors, interspersed by reflection meetings within the research team and discussions with policymakers. Using concept mapping and causal mapping techniques, and drawing causal loop diagrams, we visualised how actors understood TB service provision challenges and the potential means by which a results-based financing (RBF) policy could address these.SettingThe study was conducted in Tbilisi, Georgia.ParticipantsA total of 64 key actors from the Ministry of Labour, Health and Social Affairs, staff of the Global Fund to Fight AIDS, TB and Malaria Georgia Project, the National Centre for Disease Control and Public Health, the National TB programme, TB service providers and members of the research team were involved in the workshops.ResultsFindings showed that beyond provider incentives, additional policy components were necessary. These included broadening the incentive package to include institutional and organisational incentives, retraining service providers, clear redistribution of roles to support an integrated care model, and refinement of monitoring tools. Health system elements, such as effective referral systems and health information systems were highlighted as necessary for service improvement.ConclusionsDeveloping policies that address complex issues requires methods that facilitate linkages between multiple stakeholders and between theory and practice. Such participatory approaches can be informed by realist evaluation principles and visually facilitated by causal loop diagrams. This approach allowed us leverage stakeholders’ knowledge and expertise on TB service delivery and RBF to codesign a new policy.

scholarly journals All Is Good, but Not Really: Daily Reports of Satisfaction With Home- and Community-Based Services

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 639-640
Author(s):  
Jyoti Savla ◽  
Karen Roberto ◽  
Aubrey Knight ◽  
Rosemary Blieszner ◽  
Brandy Renee McCann ◽  
...  
Keyword(s):  
Service Use ◽  
Service Providers ◽  
Theory And Practice ◽  
Community Based ◽  
Daily Diaries ◽  
Rural Caregivers ◽  
Service Expectations ◽  
Extensive Body ◽  
Barriers To Health ◽  
Community Based Services

Abstract An extensive body of literature documents correlates of and barriers to health service use, yet much less is known about satisfaction with home- and community-based services for persons with dementia (PwD). Daily diary data from 122 rural caregivers (CG) of PwD (814 daily diaries) were used to assess everyday service use experiences. At the last diary interview, CG identified areas where service use expectations were and were not being met. CGs reported problems with services used on fewer than 5% of study days (e.g., service provider was delayed because of car trouble). In contrast, 82% of CG identified areas where service expectations were not being met. Their most common concerns were lack of control over service availability and lack of adequate training among service providers. Recommendations for alternative ways for capturing service use satisfaction will be offered, and implications for theory and practice will be discussed.

The most common issues in development of causal-loop diagrams and stock-and-flow diagrams

2020 ◽  
Vol 8 (5/6) ◽  
pp. 419
Author(s):  
Vladimír Bureš ◽  
Tereza Otčenášková ◽  
Marek Zanker ◽  
Martin Nehéz
Keyword(s):  
Causal Loop ◽  
Flow Diagrams ◽  
Causal Loop Diagrams

scholarly journals Designing a Knowledge Management System for Social Services Not-For-Profit Organisations

2018 ◽  
Vol 14 (3) ◽  
pp. 69-81 ◽  
Author(s):  
Peter Massingham ◽  
Rada Massingham ◽  
Alan Pomering
Keyword(s):  
Knowledge Management ◽  
Social Services ◽  
Management System ◽  
Best Practice ◽  
Research Team ◽  
Economic Value ◽  
Aged Care ◽  
Theory And Practice ◽  
Knowledge Management System ◽  
For Profit

This article discusses knowledge management system design for SSNFPOs. The transfer of best practice knowledge management to SSNFPOs is not easy. SSNFPOs have different strategies and ways of doing business compared to ‘for-profit' organisations. Sector reforms in disability services, aged care, and child services in Australia threaten to disrupt social value as new for-profit rivals enter and pursue economic value. In response, the case study organisation (CSO) has been working with the research team to consider how knowledge management might help it become a stronger organisation and ensure its survival and growth in the reformed sector. The research was informed by discussions involving the CSO's management and the research team over an 18 month period. A general framework for designing knowledge management for SSNFPOs was developed. It involves six theoretical platforms, along with problems associated with theory and practice, how knowledge management may address these problems, and measures of impact.

Employing proactive interaction for service failure prevention to improve customer service experiences

2017 ◽  
Vol 27 (1) ◽  
pp. 164-186 ◽  
Author(s):  
Hyunju Shin ◽  
Alexander E. Ellinger ◽  
David L. Mothersbaugh ◽  
Kristy E. Reynolds
Keyword(s):  
Customer Service ◽  
Service Provision ◽  
Service Providers ◽  
Service Failure ◽  
Marketing Research ◽  
Theory And Practice ◽  
Future Research ◽  
Content Type ◽  
Failure Prevention ◽  
Patronage Behavior

Purpose Services marketing research continues to be largely focused on firms’ reactive interactions for recovering from service failure rather than on proactive customer interactions that may prevent service failure from occurring in the first place. Building on previous studies that assess the efficacy of implementing proactive interaction in service provision contexts, the purpose of this paper is to compare the influences of proactive interaction to prevent service failure and reactive interaction to correct service failure on customer emotion and patronage behavior. Since proactive interaction for service failure prevention is a relatively underexplored and resource-intensive approach, the authors also assess the moderating influences of customer and firm-related characteristics. Design/methodology/approach The study hypotheses are tested with survey data from two scenario-based experiments conducted in a retail setting. Findings The findings reveal that customers prefer service providers that take the initiative to get to them before they have to initiate contact for themselves. The findings also identify the moderating influences of relationship quality, situational involvement, and contact person status and motive. Originality/value The research contributes to the development of service provision theory and practice by expanding on previous studies which report that proactive efforts to prepare customers for the adverse effects of service failure are favorably received. The results also shed light on moderating factors that may further inform the exploitation of resource-intensive proactive interaction for service failure prevention. An agenda is proposed to stimulate future research on proactive customer interaction to prevent service failure in service provision contexts.

Use of co-created causal loop diagrams and fuzzy-cognitive scenario analysis for water quality management

2021 ◽  
Author(s):  
Samaneh Seifollahi-Aghmiuni ◽  
Zahra Kalantari ◽  
Georgia Destouni
Keyword(s):  
Water Quality ◽  
Quality Management ◽  
Baltic Sea ◽  
Coastal Water ◽  
Scenario Analysis ◽  
Water Quality Management ◽  
Coastal Water Quality ◽  
Causal Loop ◽  
Causal Loop Diagrams ◽  
Quality Issues

<p>Current understanding is fragmented of the environmental, economic, and social processes involved in water quality issues. The fragmentation is particularly evident for coastal water quality, impacted both by local land catchment and larger-scale marine pressures and impacts. Research and policy so far has primarily addressed coastal water quality issues from either a land-based or a sea-based perspective, which does not support integrated management of the coupled land-coast-sea systems affecting coastal waters. For example, mitigation measures for improving the severe Baltic Sea eutrophication have mostly focused on land-based drivers, and not yet managed to sufficiently improve coastal or marine water quality. The strong human dimension involved in these water quality issues also highlights a need for participatory approaches to facilitate knowledge integration and drive synergistic strategic planning for sustainable management of coastal water quality. Considering the Swedish water management district of Northern Baltic Proper, including its main Norrström drainage basin and surrounding coastal catchment areas and waters, this study has used a participatory approach to evaluate various land-sea water quality interactions and associated management measures. A causal loop diagram has been co-created with different stakeholder groups, following a problem-oriented system thinking approach. This has been further used in fuzzy-cognitive scenario analysis to assess integrated land-coast-sea system behavior under changing human pressures and hydro-climatic conditions. Results show that synergy of several catchment measures is needed to improve coastal water quality locally, while cross-system/sector cooperation is also needed among all contributing national catchments to mitigate coastal eutrophication at the scale of the whole Baltic Sea. Furthermore, large-scale hydro-climatic changes and long-lived nutrient legacy sources also need to be accounted for in water quality management strategies and measures. System dynamics modelling, based on co-created causal loop diagrams and fuzzy-cognitive scenario analysis like those developed in this study, can support further quantification and analysis of the impacts of various mitigation strategies and measures on regional water quality problems and their possible sustainable solutions.</p>

Complexity Theory and System Dynamics for Project Risk Management

2017 ◽  
pp. 152-176 ◽  
Author(s):  
Robert J. Chapman
Keyword(s):  
System Dynamics ◽  
Systems Thinking ◽  
Complexity Theory ◽  
Systems Dynamics ◽  
Risk And Uncertainty ◽  
Causal Loop ◽  
General Systems ◽  
Big Picture ◽  
Causal Loop Diagrams ◽  
Managing Risk

As a consequence of the consensus that projects are growing in complexity from ever ambitious goals there is a perpetual search for methods aimed at pinpointing and describing the source of complexity with the objective of subsequently reducing uncertainty, managing risk and improving project performance. An area of study that has engaged enquiring minds for over fifty years but has not yet been accepted into mainstream project management is the study and application of systems thinking and system dynamics. The purpose of this chapter is to promulgate the view that the mapping of projects as systems should be re-examined as a means of articulating and responding to complexity. The chapter examines general systems theory, systems thinking and systems dynamics with examples of causal loop diagrams as an aid to describe and respond to risk exposure. It includes simple causal loop diagrams as a means of illustrating how risks may be identified and addressed. The emphasis is on seeing the ‘big picture' to avoid gaps and omissions in the management of risk and uncertainty.

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