Understanding the introduction and use of a mobile device-supported health information system in Nigeria

Copyright @ 2014 The Authors.This paper presents an in-depth analysis of efforts to introduce a mobile health information system in Nigeria as part of a development initiative aimed at improving maternal and child health. Specifically, it examines the use of mobile devices to facilitate maternal health information accessibility and exchange among health practitioners in order to reducing maternal, newborn and child mortality. Further, it also looks at the challenges raised while introducing mobile devices into work practices in the healthcare sector. The study adopts a case study approach, relying on semi-structured interviews and document analysis as its main methods for collecting data. The specific case examined is a mobile phone-based information system introduced to support a national government effort in Nigeria, known as the midwives service scheme. The findings of this study show that this integrated approach of using mobile phones to support (health) information systems has vast potential; for instance increasing the timeliness of (health) data available to stakeholders for monitoring and planning purposes. However, we also find that over time, attaining the potential of development efforts such as this remains difficult as initiatives involving the use of mobile devices is not just about getting the technical aspect right. It is equally dependent on deep seated social-cultural influences such as poor political and financial commitment. These two mutually reinforcing influences have been identified in this study as significant impediments to efforts of this kind. Therefore, this paper argues for, first a strong political commitment across all levels of government whereby their words are backed with action. Second it is important that the government maintains financial integrity by releasing the funds budgeted to support the smooth running of these efforts, for such initiatives to thrive and ultimately contribute to development

Scraping the Social? Issues in live social research

What makes scraping methodologically interesting for social and cultural research? This paper seeks to contribute to debates about digital social research by exploring how a ‘medium-specific’ technique for online data capture may be rendered analytically productive for social research. As a device that is currently being imported into social research, scraping has the capacity to re-structure social research, and this in at least two ways. Firstly, as a technique that is not native to social research, scraping risks to introduce ‘alien’ methodological assumptions into social research (such as an pre-occupation with freshness). Secondly, to scrape is to risk importing into our inquiry categories that are prevalent in the social practices enabled by the media: scraping makes available already formatted data for social research. Scraped data, and online social data more generally, tend to come with ‘external’ analytics already built-in. This circumstance is often approached as a ‘problem’ with online data capture, but we propose it may be turned into virtue, insofar as data formats that have currency in the areas under scrutiny may serve as a source of social data themselves. Scraping, we propose, makes it possible to render traffic between the object and process of social research analytically productive. It enables a form of ‘real-time’ social research, in which the formats and life cycles of online data may lend structure to the analytic objects and findings of social research. By way of a conclusion, we demonstrate this point in an exercise of online issue profiling, and more particularly, by relying on Twitter to profile the issue of ‘austerity’. Here we distinguish between two forms of real-time research, those dedicated to monitoring live content (which terms are current?) and those concerned with analysing the liveliness of issues (which topics are happening?)

Doctors are inconsistent in estimating survival after CPR and are not using such predictions consistently in determining DNACPR decisions

Background: It is unclear whether doctors base their resuscitation decisions solely on their perceived outcome. Through the use of theoretical scenarios, we aimed to examine the ‘do not attempt cardiopulmonary resuscitation’ (DNACPR) decision-making. Methods: A questionnaire survey was sent to consultants and specialty trainees across two Norfolk (UK) hospitals during December 2013. The survey included demographic questions and six clinical scenarios with varying prognosis. Participants were asked if they would resuscitate the patient or not. Identical scenarios were then shown in a different order and doctors were asked to quantify patients’ estimated chance of survival. Results: A total of 137 individuals (mean age 41 years (SD 7.9%)) responded. The response rate was 69%. Approximately 60% were consultants. We found considerable variation in clinician estimates of median chance of survival. In three out of six of our scenarios, the survival estimated varied from <1% to 95%. There was a statistically significant difference identified in the estimated median survival between those clinicians who would or would not resuscitate in four of the six scenarios presented. Conclusion: This study has highlighted the wide variation between clinicians in their estimates of likely survival and little concordance between clinicians over their resuscitation decisions. The diversity in clinician decision-making should be explored further

Using MCDA to generate and interpret evidence to inform local government investment in public health

Smoking is the single biggest cause of preventable death in the Uited Kingdom (UK) and is a major cause of coronary heart disease, some cancers, and respiratory disease, including chronic obstructive pulmonary disease. At the time of initiating the project, smoking prevalence had not changed across four local government areas in South Yorkshire for some years. Most spending had been focussed on helping people quit, an intervention where there was clear evidence of effectiveness. A number of changes occurred in public health structures and targets, requiring a reappraisal of the range of interventions offered. This was challenging due to a lack of clear evidence for some of the areas’ alternative interventions. The aim of this paper is to describe the use of a multi-criteria decision analysis (MCDA) approach to support the health priority setting in local authorities to reduce smoking prevalence. There were three phases to this process: (1) problem structuring; (2) the multiple criteria decision analysis; (3) and using the MCDA results to influence decision making at the local government level. The MCDA approach was used to collate information in a consistent and transparent manner, using expert, stakeholder and public opinion to fill known gaps in evidence. Fifteen interventions (such as stop smoking support services, smoke-free spaces, communication and marketing exercises, and increased investment in enforcement) were ranked across eight criteria (relating to reductions in prevalence across relevant groups, as well as aspects relating to equity and feasibility), allowing a range of relevant concerns to be incorporated. Subsequent steps were taken to translate the results of this stage into workable policy options. The results differed significantly from current practice. Sensitivity analysis showed that the findings were robust to changes in preference weights. These results informed subsequent changes to the interventions offered across the four boroughs. The ability of MCDA techniques to incorporate data and both qualitative and quantitative judgements in a formal manner mean that they are well suited to support public health decision making, where evidence is often only partially available and many policies are value driven. MCDA methods, if used, should be chosen carefully based on their resource/time constraints, scientific validity, and the significance and broader context of the decision problem.This is the final version of the article. It first appeared from Springer via http://dx.doi.org/10.1007/s40070-016-0059-

Just how difficult can it be counting up R&D funding for emerging technologies (and is tech mining with proxy measures going to be any better?)

Decision makers considering policy or strategy related to the development of emerging technologies expect high quality data on the support for different technological options. A natural starting point would be R&D funding statistics. This paper explores the limitations of such aggregated data in relation to the substance and quantification of funding for emerging technologies. Using biotechnology as an illustrative case, we test the utility of a novel taxonomy to demonstrate the endemic weaknesses in the availability and quality of data from public and private sources. Using the same taxonomy, we consider the extent to which tech-mining presents an alternative, or potentially complementary, way to determine support for emerging technologies using proxy measures such as patents and scientific publications

Untangling the Biological Contributions to Soil Stability in Semiarid Shrublands

Communities of plants, biological soil crusts (BSCs), and arbuscular mycorrhizal (AM) fungi are known to influence soil stability individually, but their relative contributions, interactions, and combined effects are not well understood, particularly in arid and semiarid ecosystems. In a landscape-scale field study we quantified plant, BSC, and AM fungal communities at 216 locations along a gradient of soil stability levels in southern Utah, USA. We used multivariate modeling to examine the relative influences of plants, BSCs, and AM fungi on surface and subsurface stability in a semiarid shrubland landscape. Models were found to be congruent with the data and explained 35% of the variation in surface stability and 54% of the variation in subsurface stability. The results support several tentative conclusions. While BSCs, plants, and AM fungi all contribute to surface stability, only plants and AM fungi contribute to subsurface stability. In both surface and subsurface models, the strongest contributions to soil stability are made by biological components of the system. Biological soil crust cover was found to have the strongest direct effect on surface soil stability (0.60; controlling for other factors). Surprisingly, AM fungi appeared to influence surface soil stability (0.37), even though they are not generally considered to exist in the top few millimeters of the soil. In the subsurface model, plant cover appeared to have the strongest direct influence on soil stability (0.42); in both models, results indicate that plant cover influences soil stability both directly (controlling for other factors) and indirectly through influences on other organisms. Soil organic matter was not found to have a direct contribution to surface or subsurface stability in this system. The relative influence of AM fungi on soil stability in these semiarid shrublands was similar to that reported for a mesic tallgrass prairie. Estimates of effects that BSCs, plants, and AM fungi have on soil stability in these models are used to suggest the relative amounts of resources that erosion control practitioners should devote to promoting these communities. This study highlights the need for system approaches in combating erosion, soil degradation, and arid-land desertification

Public Benefits of Undeveloped Lands on Urban Outskirts: Non-Market Valuation Studies and their Role in Land Use Plans

Over the past three decades, the economics profession has developed methods for estimating the public benefits of green spaces, providing an opportunity to incorporate such information into land-use planning. While federal regulations routinely require such estimates for major regulations, the extent to which they are used in local land use plans is not clear. This paper reviews the literature on public values for lands on urban outskirts, not just to survey their methods or empirical findings, but to evaluate the role they have played--or have the potential to play-- in actual land use plans. Based on interviews with authors and representatives of funding agencies and local land trusts, it appears that academic work has had a mixed reception in the policy world. Reasons for this include a lack of interest in making academic work accessible to policy makers, emphasizing revealed preference methods which are inconsistent with policy priorities related to nonuse values, and emphasis on benefit-cost analyses. Nevertheless, there are examples of success stories that illustrate how such information can play a vital role in the design of conservation policies. Working Paper 07-2

Research Project as Boundary Object: negotiating the conceptual design of a tool for International Development

This paper reflects on the relationship between who one designs for and what one designs in the unstructured space of designing for political change; in particular, for supporting “International Development” with ICT. We look at an interdisciplinary research project with goals and funding, but no clearly defined beneficiary group at start, and how amorphousness contributed to impact. The reported project researched a bridging tool to connect producers with consumers across global contexts and show players in the supply chain and their circumstances. We explore how both the nature of the research and the tool’s function became contested as work progressed. To tell this tale, we invoke the idea of boundary objects and the value of tacking back and forth between elastic meanings of the project’s artefacts and processes. We examine the project’s role in India, Chile and other arenas to draw out ways that it functioned as a catalyst and how absence of committed design choices acted as an unexpected strength in reaching its goals