Developing Outcomes Based Policy for Education

Developing Outcomes Based Policy for Education Since 1994, South Africa has experienced the policy cycle in a fast-forward mode due to the transition phase from the apartheid era. As a result, policy design, legislation and policy implementation have proceeded rapidly in all sectors. This transition meant that many of the policies that were inherited from the apartheid era were inappropriate for the democratic dispensation. To this effect Roux (2002:420) notes that constitutional reform has led to change and transformation in almost all spheres of government and administration. Such changes affected virtually all the functional fields of government, and consequently redefined the role of policy- and decision-makers. Echoing this sentiment Brynard (2005:3) states that an extraordinary degree of intellectual and political energy was harnessed to generate public policies that would suit the current needs of the State. South Africa, in a policy context, went through a major review of policies especially between 1995 and 1996; Brynard (2005:3) terms this period the White Paper Era. Brynard (2000:164-165) further states that after 1994, the democratic government embarked on an aggressive process of policy formulation with a view to remove discrimination in the governments public policy and statute. This continued until the end of 1990s. The second democratic government (1999 to 2004) shifted focus more towards implementation of policies of a democratically elected government, which still continues. The focus of this paper is on the performance of such policies. Goldfrank (1998:1) highlights the importance of looking beyond the euphoria that comes with the installation of new governments when assessing such governments performance. He contends that, in studying the relatively recently democratised countries, scholars have largely moved beyond the theme of transitions to democratically-elected governments and have begun to ask questions regarding the kind of democracies that have arisen and how to sustain democratic practices. Almost uniformly, political analysts and actors deplore the quality of the new democracies, pointing to one or another deficiency, including ineffective legislatures, inefficient public bureaucracies, corrupt judiciaries, and, perhaps most strikingly governments inability to deliver their mandates. Sanderson (2002:2) support this view when he points out that with increasing questioning and scrutiny of public intervention in economic and social spheres, governments are turning to evidence of performance for legitimacy since it is no longer guaranteed solely by democratic political processes. This paper argues that for the government to be able to provide evidence of performance of its policies, it must institutionalise an outcomes-based evaluation system. An Outcomes-based Policy Evaluation system is presented in this paper as a tool through which the government can objectively demonstrate achievements of its policies while at the same time accounting about the performance of its policies. However, for such a framework to be successful it must be embedded on a well crafted evidence based system. Thus, the researcher will argue that Evidence-based practice is a cornerstone for an outcomes-based policy performance system. Hence a saying that the system will only be as good as the data that it is based on holds true for this paper. In support of this exposition, Rosanbalm, Owen, Rosch and Harrison (2009:6) contend that evidence-based policy provides an effective mechanism to establish, in a scientifically valid way, what works or does not work, and for whom it works or does not work. With this structured approach to evaluation, knowledge can be used to improve practice, allowing successful programs to develop iteratively over time. Without this approach, interventions go in and out of practice, little is learned about what works, and the effectiveness of social programs does not advance significantly over time. Rigorous evaluation can end the spinning of wheels and bring rapid progress to social policy as it has to the field of medicine. This paper, though critical of the emerging policy evaluation framework in SA, it acknowledges the efforts made in the policy arena since 1994. Further, in identifying challenges, this paper seeks to take a forward-looking approach that would outline the issues which government must grapple with in order to develop an outcomes based policy evaluation framework. Research Problem After fifteen years of policy implementation, questions on whether or not such policies are delivering the intended outcomes are continuously being raised by different stakeholders including the government and the ruling party, African National Congress (ANC). For instance, since its landmark victory in 1994, the ANC government has introduced several policies with the aim of improving the living conditions of the South Africans. Now the dilemma that is facing the ruling party is its inability to objectively determine the extent to which the implemented policies are adding value to the lives of the previously disadvantaged communities. The ANC has reiterated this concern in its Strategy and Tactics document of 2002 where it argues that, à ¢Ã¢â€š ¬Ã‚ ¦policy leadership responsibility is compromised by the general absence of reliable and appropriate information that will evaluate policy performance and the impact of government policy decisions. Where there is information available it i s compiled and communicated by those responsible for implementation, which raises the question as to the reliability and validity of the evidence that is being presented to the Executive, Parliament and the ruling party. This suggests that performance measurement systems in government require serious rethinking. The biggest challenge is that most performance measurement systems in government are still input-based and, at the most, report on outputs without justifying input-output ratio (Sangweni 2006:6). Schacter (1993:1) is very accurate in his diagnosis of the problem when he contends that public sector performance has often been measured in terms of what the government has done, meaning an amount of funding provided, number of kilometers of road tarred, number of new hospital beds and so forth. Such measures focus on how busy the government has been rather than on what it has achieved. They highlight means rather than ends. Schacter (1993:2) further argues that this is not to say that keeping track of means, as opposed to ends isnt important. Governments need to measure how much they spend and do. But when performance measurement focuses too heavily or exclusively on how much is spent -inputs or done outputs as opposed to impact on society outcomes the result is often that public sector organisations lose sight of why they were created in the first place. Public organisations may be very busy but be accomplishing little from societys perspective. For example, it would be futile for the Department of Transport to build thousands of kilometers of roads to places where no one travels. The danger of this approach, as noted by Radebe and Pierre (2007:110) is that organisations take their own implementation decisions which may not be in line with national priorities. One of the consequences of the apparent absence of strategic leadership was pointed out as inappropriate infrastructure developments such a s building new parking facilities at Durban International Airport while the airport would be decommissioned in 2009. The purpose of the Study and Research Questions The purpose of this study is to explore the extent to which Evidence based and Results based management approaches are being applied in SA in the area of public policy with an aim of improving policy performance feedback (performance information or evidence of whether policies are successful or not). In order to achieve this purpose the researcher will be guided by two main research questions. The first question to be addressed is: Why does the increased attention to outcomes and accountability intersect with the growing demand for evidence-based policies and programs? In other words, how does the advancement of connections between science (evidence-based policy making approach) and policy making improve policy evaluation? The researcher will contend that a government that basis its policy decisions on scientific evidence enhances its chances not only of implementing sound policies but also of executing effective performance evaluation of its policies. According to Lasswell (quoted b y Hoppe 1999:1), policy science is about the production and application of knowledge of and in policy. Policymakers, who desire to successfully tackle problems on the political agenda, should be able to mobilise the best available knowledge. This requires high quality knowledge in policy. Policymakers and, in a democracy, citizens, also need to know how policy processes really evolve. This demands precise knowledge of policy. There is an obvious link between the two: the more and better knowledge of policy, the easier it is to mobilise knowledge in policy. Hartig, DePinto, Stone and McIntyre (2003:1) observed that informing public policy with sound science has long been recognized as a vital need for effective policy management However, delivering scientific findings to policy-makers in a useful manner has been problematic. Policy-makers have often lacked timely access to scientific information. And when they do have access, this information is often too technical and needs interpretation to be truly useful for decision-making. Clearly, there is a need to strengthen science-policy linkages in order to improve policy performance. The second question to be addressed is: what strides have been made by SA towards an outcomes-based policy performance evaluation framework Where are we and what are the gaps? To this end, Scott (2006:87) argues that South African government need to be able to determine whether government policies, interpreted into government programmes and projects, are causally linked to policy outcomes. We need to be able to determine whether progress, or lack of it, is due to (or happening despite) government policies and activities. Thus this paper will carefully examine the extent to which the South African government is able to objectively report on the performance of its policy interventions and also whether policy evaluation data is utilised to improve future policy interventions. Objectives of the Study This paper has three main objectives: Firstly, the study aims to examine the extent to which departments apply the Government-wide Policy Framework on Monitoring and Evaluation which was published by government in 2007; this is an overarching policy framework that ushers a new culture on monitoring and evaluation and is predicated on a RBM approach (The Presidency 2007:1). Secondly, the study aims to assess the manner in which government departments generate and use evidence throughout the policy lifecycle (policy formulation, policy implementation and policy closure or redesign). Thirdly, the study aims to assess the impact of the existing accountability mechanisms on the utilisation of scientifically generated evidence in government. Theoretical Framework This paper employs a dynamic analysis approach of the systems theory as a basis for understanding the interrelationship between policy making and policy evaluation. Dynamic analysis examines interdependent effects among variables over time, with time lags on effects and feedback loops as part of the analysis. Dynamic analysis differs significantly from static analysis which assumes unidirectional relationships between the independent and dependent variables in the analysis. While static analysis assumes that a change in some independent variables will result in change in one or more dependent variables, dynamic analysis introduces two-way relationship or feedback loops into the system of relationships being investigated (that is, in the two-way relationship, a change in one variable affects the second, which in turn affects the first changes in both variables continue until equilibrium or system collapse occurs (Melcher A and Melcher B, 1980:235-239). Thus this paper moves from the premise that if policies are based on tested theories (theories that have been subjected to vigorous scientific procedures); examination of their performance during and after implementation is made easy. Subsequently, evidence of whether policies work or not will be feedback to the initial phase of policy formulation for policy redesign where necessary. This is premised on the fact that public policies are not eternal truths but rather hypotheses subject to alteration and to devising of new and better ones until these in turn are proved unsatisfactory (Wildavsky 1979:16). To this end, this paper ventures into assessing which procedures are in place in SA and which processes, according to literature, ought to be in place in order for government to be able to account to its citizens on the implementation of public policies. Literature is very rich on how governments ability to account on the implementation of public policies can be improved. The focus of study is limited to two interventions. They are Evidence-Based Policy Making and Results-Based Management approaches. Evidence-Based Policy Making approach finds its expression through policy science which can be summarised as the intersection between scientific research and public policy. Davies as cited by Segone (2004:27) defines evidence-based policy as an approach which helps people make well informed decisions about policies, programmes and projects by putting the best available evidence at the heart of policy development and implementation. Segone (2004:27) points out that this definition matches that of the UN in the MDG guide where it is stated that Evidence-based policy making refers to a policy process that helps planners make better-informed decisions by putting the best available evidence at the centre of the policy process. Evidence may include information produced by integrated monitoring and evaluation systems, academic research, historical experience and good practice information. This approach stands in contrast to opinion-based policy, which relies heavily on either the selective use of evidence (e.g. on single studies irrespective of quality) or on the untested views of individuals or groups, often inspired by ideological standpoints, prejudices, or speculative conjecture. Proponents of evidence-based policy and practice acknowledge that not all sources of evidence are sufficiently sound to form the basis of policy making. Much research and evaluation is flawed by unclear objectives; poor design; methodological weaknesses; inadequate statistical reporting and analysis; selective use of data; and, conclusions which are not supported by the data provided (Davies 2003:54). On the other hand, Results-Based Management (RBM) is defined as a management strategy aimed at achieving important changes in the way organisations operate, with improving performance in terms of results as the central orientation. RBM provides the management framework and tools for strategic planning, risk management, performance monitoring and evaluation. Its primary purpose is to improve efficiency and effectiveness through organisational learning, and secondly to fulfill accountability obligations through performance reporting. Key to its success is the involvement of stakeholders throughout the management lifecycle in defining realistic expected results, assessing risk, monitoring progress, reporting on performance and integrating lessons learned into management decisions (Meier 2003:6) Scott, Joubert and Anyogu (2006:11) concur with Meier when they contend that RBM is a management strategy or approach by which an organization ensures that its processes, products and services contribute to the achievement of clearly stated results. RBM provides a coherent framework for strategic planning and management by improving learning and accountability. It is also a broad management strategy aimed at achieving important changes in the way agencies operate, with improving performance and achieving results as the central orientation, by defining realistic expected results, monitoring progress towards the achievement of expected results, integrating lessons learned into management decisions and reporting on performance. Key RBM concepts central to this paper include; theory of change, causal chain, programme theory and logic model. According to Bickman (1987:2) program theory can be defined as a plausible and sensible model of how a program [policy] is supposed to work. A good program theory logically and reasonably links program activities to one or more outcomes for participants. Program theories can often be captured in a series of if-then statements IF something is done to, with, or for program participants, THEN theoretically something will change. Figure 1 below illustrates how a program theory can be captured in a logframe. On the other hand logic model is a tool for illustrating an underlying program theory. A logic model illustrates the linkages between program components and outcomes (Wilder Research Center1987:2-4). It is this theory that must be backed-up by sound evidence as discussed in chapter 2. Figure 2 below illustrates how a logic model can be captured. ACTIVITIES OUTPUTS RESULTS IMPACT Research, monitoring, analysis of information Dissemination of information to health workers and population Informed Stakeholders Population assumes responsibility to protect, maintain, improve its health Improved general health. Reduced variances between segments of the population. Research Design This is a qualitative research which is located within the evaluation field of study. A qualitative research methodology has been chosen because of its approach towards finding the truth which bodes very well with the requirements of this study. Qualitative methods draw up an interpretive paradigm where there are multiple truths regarding the social world. In qualitative methods knowledge gathering is always partial, and the researcher is encouraged to be on the same plane as the researched in an effort to promote a co-construction of meaning Try to link this statement to your study to make what you are saying clearer to the reader. (Hesse-Biber and Leavey 2006:320). The researcher will use literature review to achieve three objectives. Firstly, this paper will examine literature on the application of evidence-based and RBM approaches throughout the policy lifecycle in order to construct a framework of analysis for the study. Secondly, the paper will identify critical variables that may help government to institutionalise an outcomes-based policy evaluation framework. Thirdly, the paper will examine strides that have been made by the SA government towards an outcomes based policy evaluation framework. Comparative views on the achievement of other developing and developed countries will be included in this study in order to augment theoretical exposition of this study with empirical evidence. The literature review will further be augmented with empirical findings arising from the semi-structured interviews. The interviews will be carried out with a sample of respondents from government whose jobs functions entail research, policy analysis and evaluation. The nature of the study requires (experts focused input) that the sample be stratified; as a result the paper will use a non-probability sampling technique (judgmental sample). With regard to data analysis, the researcher will use content analysis method which has been credited for its versatility to both quantitative and qualitative research enquiries. For instance, Creswell (2003:289) contends that content analysis has historically been conducted quantitatively; however, now there is a rich tradition of qualitative content analysis. The primary difference in these two broad applications is in research design. Quantitative approaches to content analysis are largely deductive and follow a linear model of research design. Qualitative approaches are mainly inductive and follow what is termed a spiral model of research design. When using a linear design the researcher has a preconceived set of steps to follow in a linear (vertical) path through each phase of the research process. A spiral design, employed by qualitative researchers, allows the investigator to, metaphorically, drive in and out of the data. In this model a researcher generates new understandings , with varied levels of specificity (Hesse, et al 2003:289). This paper will employ the spiral model together with the memo writing approach in analysing the findings. By writing memos one can raise a code to the level of a category. The idea of a grounded theory approach is to read carefully through the data and to uncover the major categories and concepts and ultimately the properties of these categories and their interrelationships. Memo writing is an integral part of the grounded theory process and assists the researcher in elaborating on their ideas regarding their data and code categories. Reading through and sorting memos can also aid the researcher in integrating his or her ideas and may even serve to bring up new ideas and relationships within the data. (Hess, et al 2003:349) As the process of analysis continues the researcher may begin to see more developed codes focused codes especially through the process of writing memos. Coding is a central part of a grounded theory approach and involves extracting meaning from non-numerical data such as text and multimedia such as audio and video. Coding is the analysis strategy many qualitative researchers employ in order to help them locate key themes, patterns, ideas, and concepts that may exist within their data (Hesse, et al: 2003, 349). To conclude, Karp (2003:356) notes that after pondering the ideas in the memos and coding interviews when you think you have been able to grab onto a theme it is time to begin what he term data memo. By this he means a memo that integrates the theme with data and any available literature that fits; something that begins to look like a paper. Importance of the Study Even though the focus of this paper is on performance evaluation, it ultimately addresses a very critical issue of an accountable government. Thus the researcher will also argue that a performance evaluation system should enable the government to account to its citizens about the effective and efficient use of their resources. This paper will thus contribute to the growing body of knowledge of policy making and performance evaluation in the South African literature, which aims at strengthening the accountability mechanisms of government. Summary of Literature Review The second chapter of this study focuses on the evolution of the policy analysis with specific focus on policy making and evaluation as well as on the progress made by SA towards an outcomes-based policy evaluation framework. A brief outline of some of the sections covered in the literature is provided below: Role of theories in policy making While policy could be defined in several ways, the point of departure for this paper is that policy is viewed as a theory. The proposition of this paper is that theories that underlie policies must be backed up by scientific evidence so that measures of success for policy performance will be effective. This proposition is backed up by scholars such as Pressman and Wildavsky (1973, 1979), Bardach (1977) and more recently by Pawson (2002). For instance, Pressman and Wildavsky (1973) described any policy as a hypothesis containing initial conditions and predicted consequences. That is, the typical reasoning of the policy-maker is along the lines of if x is done at time t(1) then y will result at time t(2). Hill (1998) concludes that thus every policy incorporates a theory of cause and effect (normally unstated in practice) and, if the policy fails, it may be the underlying theory that is at fault rather than the execution of the policy. Role of Evidence in Policy Making Evidence Based Policy Making (EBPM) Approach As stated above, the proposition of this paper is that theories that underlie policies must be backed up by scientific evidence so that measures of success for policy performance will be effective. This view is supported by scholars such as Gray (1997), Davies (1999, 2003), Nutley (2003) and Segone (2004). Arguments presented by these scholars are discussed in detail in chapter two, which is the literature review chapter. These scholars concur that evidence-based decision making draws heavily upon the findings of scientific research, including social scientific research that has been gathered and critically appraised according to explicit and sound principles of scientific inquiry. Framework for an accountable and learning Government Recently, we have observed a growing interest in performance measurement or evaluation in the public sector. The question is, what drives this interest in performance measurement and evaluation, in the public sector? In answering this question Schacter (2002:5) argues that the fundamental reason why performance measurement matters to us is that it makes accountability possible, and accountability goes to the heart of our system of political governance. Schacter further contends that citizens grant their governments a high degree of control over their lives. Citizens allow governments to take part of their income through taxes for instance, and to limit their freedom through enforcement of laws and regulations. In return citizens expect their governments to be accountable to them for the ways in which they exercise power. Performance evaluation is not only beneficial to citizens but to government as well. A government that utilises findings on the performance of its policies is able to improve on new policies as well as on the implementation of such policies. Wildavsky (1984:255) echoes this point when he contends that learning evaluation strives to unearth faulty assumptions, reshape misshapen policy designs, and continuously refine goals in light of new information derived during implementation. Previous research on Policy Making and Evaluation in South Africa Literature reviewed indicates that a significant amount of work has been done on policy making and evaluation in SA. Key topics covered in the reviewed literature include transition from apartheid to democratic era, Public policy making in a post-apartheid South Africa, policy evaluation, Electoral system and political accountability. These topics are addressed in chapter 2 where I discuss the work of scholars like Van Niekerk, Van Der Waldt and Jonker (2001) Roux (2002), Cloete and Wissink (2004), Scott (2006 and 2007), Radebe and Pierre (2007), Christo de Coning (2008), Gumede (2008), Carter (2008). Government reports, covering framework and performance documents, are also used in this study to present the side of government. Notwithstanding the existence of literature on policy making and evaluation, more work is still needed on how evidence-based approach improves policy performance as well as quality of performance data; this is the area this study seeks to address. Limitations of the Study This paper will not venture to quantifiably assess the extent to which the introduction of Evidence-Based Policy Making and Results-Based Management approaches have improved policy performance feedback in SA. Such an enquiry will require more time and a different strategy; this will be a subject for further research. Nevertheless, this paper will explore scholarly literature so as to identify main arguments on how policy evaluation could be improved. Themes emanating from the literature will then be tested through an interview with a sample of policy and evaluation practitioners. The other limitation of this paper is that, no matter how relevant it may be, it does not represent the official position of government. Hence there is no guarantee for the implementation of the recommendations of this paper. Finally, the timeframe as well as the financial resources will limit the researcher from doing an in-depth analysis of key variable of the study, i.e. the relationship between policy making and policy performance measurement approaches. Chapter Outline Abstract: presents an overview of the paper and introduces contents of each chapter. Introduction: presents a background to the study, the motivations for embarking on the proposed study as well as the purpose of the study are also presented. Chapter one: This chapter provides a reader with a methodology to be employed in search for the answers to the research questions. It also presents a brief summary of the theoretical framework which includes concepts and theories. Chapter two: looks into the literature that is already available on the evolution of the policy analysis with specific focus on policy making and evaluation. Key variables for an effective policy performance assessment framework will also be identified in this chapter Chapter three: examines strides that have been made by the government towards an ideal (evidence-outcomes based framework as espoused in chapter two) policy performance evaluation framework Chapter four: provides analysis and interpretation of the research findings based on the reviewed literature and interview outcomes. The purpose of this chapter is to present solid descriptive data and to lead the reader to understand the meaning of the phenomenon that is being studied. Content analysis approach and memo writing approach are utilised to analyse and interpret the findings of the study. Chapter five: presents conclusions and recommendations that have been drawn from the reviewed literature, constructed theoretical framework, as well as the interview results. The chapter also proposes research areas requiring further research in the field of policy assessment. Conclusion In this paper the researcher intends to assess critical strides made by SA towards an outcome-based policy evaluation framework. The researcher will use evidence emanating from literature and interviews to highlight weaknesses in the SA public sector performance evaluation system.

Emergency Response in Franklin County Essay

The role of major health personnel in an emergency is to manage the safety and well being of the people in their community during and after a natural or man-made disaster. This is done by assessing the details of what occurred, what needs must be met and facilitating a team to organize information about the event and provide logistics as quickly as possible. This is seen in the simulation exercise for the â€Å"Disaster in Franklin County†. (Olson, Larsen, Scheller, & Johnson, 2006) Roles are appointed in a chain of command format. It is ideal that all personnel have received some type of emergency management training, but even if not, skill sets must be assessed and duties assigned accordingly. An Incident Commander will be appointed and the Public Health Director assigns rolls that include finances, planning, logistics, public information liaison and operators. The Public Health Team will work closely and concurrently with other entities, such as the Fire Chief, Police Chief, Hazardous Materials Team, Public Works and EMS teams. The public health department is mostly concerned with the safety and logistics of sheltering victims and being sure that food and water provided is safe for consumption. The community health nurse is primarily concerned about the immediate welfare and safety of the public, including issues of safety in homes, sanitary food options and safe water availability. It is important to have press releases ready to go that are clear and informative, yet simple. Any public statement made by the nurse should be thoughtful and considerate, assuring the community that they are in good hands and that things are being taken care of by appropriate people and in a timely manner. Public Service Announcements (PSAs) are an opportunity to gain trust and respect and show competence and compassion. In the Franklin County scenario, the public health nurse is assigned to do door-to-door interviews in an area of town hit the hardest by flood damage. The nurse is assessing for personal safety, being certain that there are no medically fragile patients, home bound persons or persons with special needs. Without electricity, a patient that requires at home oxygen, nebulizers, chemo or dialysis will need to be assisted to a shelter. Families with infants must be comfortable with an abundance of supplies. Contamination risks from food spoilage must be made aware, and the nurse must assess if he or she believes that the family has the means to safely prepare meals and have access to clean water. Finally, the nurse assesses for structural safety and advises community members on whether or not they should consider relocating to a shelter. With the uncertainty of going door-to-door, a nurse must be prepared to assess needs that are out of their scope of practice. They must be prepared to offer resources that may be out of their area of expertise. Situations that occur may range greatly, such as difficulty with foreign language communication, to chemical spills in yards or improper use of a generator. In cases such as this, the actions of the community health nurse must be resourceful and know that he or she can call on other professionals to reach out where they needed. A family with chemical leakage from flooding may be guided to a shelter for their immediate safety and the community health nurse may follow up by asking an Environmental Director to assess the property, instead of offering wrong or false advice to the homeowner. Natural and man-made disasters not only put community members at a physical risk, but also at emotional risk, as situation arise as homes are destroyed, insurance issues arise, or being separated from loved ones. The public health nurse also needs to take action and be resourceful in providing appropriate referrals for mental health, including providing phone numbers, access to call or reach out, and to follow up and be sure that there is enough man-power to assist with answering phones or counseling people. Techniques that were used were active listening and repeating statements back, validating that their thoughts and fears are heard. Assurance was given that the situation was grave, but not hopeless. Encouragement was provided to make appropriate, yet difficult, decisions such as leaving one’s house and personal belongings in a time of crisis. In widespread disaster scenarios, that affect greater areas, such as Hurricane Katrina, not only are public nurses needed, but it is important that nursing personnel from hospitals and state health departments are involved. In times of crisis, all professionals need to be on the same page to avoid offering mixed messages or advise to the public. Basic training in emergency management should be provided for all health care professionals. Emergency communication must also be set in place, as with no electricity or land lines, there must be agreed upon and practiced means of communication between all emergency responders. In area with high incidences of particular storms, flooding or power outages, PSA’s can be prepared ahead of time and are ready to go during times of crisis with minor modifications. The community health nurse is an import piece of the emergency management team, and is a direct liaison between the public and the resources.

Discussing Improving Umbilical Cord Health Health And Social Care Essay

This chapter deals with the treatment of the consequence of the informations analysis to measure the effectivity of topical application of chest milk versus dry cord attention for bettering umbilical cord wellness position of neonates. The treatment is based on the aims of the survey and the hypothesis specified in the survey. With several demographic features of the sample in the experimental group, bulk of neonates 16 ( 58.3 % ) were males and staying 14 ( 46.7 % ) neonates were females. Majority of female parents 17 ( 56.7 % ) were primiparas and staying 13 ( 43.3 % ) female parents were multiparas. Majority of neonates 18 ( 60 % ) were born between 37-38 hebdomads, 10 ( 33.3 % ) neonates were born between 39-40 hebdomads and staying 2 ( 6.7 % ) neonates were born between 41-42weeks. Majority of neonates 19 ( 63.3 % ) had normal birth weight and staying 11 ( 36.7 % ) neonates had low birth weight. Majority of female parents 24 ( 80 % ) did non had any complications and staying 6 ( 20 % ) female parents had maternal complications like gestation induced high blood pressure and gestational diabetes. Majority of female parents 15 ( 50 % ) had lower segmental cesarean subdivision, 12 ( 40 % ) had normal vaginal bringing and staying 3 ( 10 % ) had forceps bringing. Majority of neonates 19 ( 63.3 % ) had tonss of eight and above and staying 11 ( 36.7 % ) neonates had less than eight mark. In the control group, bulk of neonates 18 ( 60 % ) were females and staying 12 ( 40 % ) neonates were males. 15 ( 50 % ) female parents were para Is and 15 ( 50 % ) female parents were multiparas. Majority of neonates 21 ( 70 % ) were born between 37-38 hebdomads, 6 ( 20 % ) neonates were born between 39-40 hebdomads and staying 3 ( 10 % ) neonates were born between 41-42weeks. Majority of neonates 19 ( 63.3 % ) had normal birth weight and staying 11 ( 36.7 % ) neonates had low birth weight. Majority of female parents 22 ( 73.3 % ) did non had any complications and staying 8 ( 26.7 % ) female parents had maternal complications like gestation induced high blood pressure and gestational diabetes. Majority of female parents 15 ( 50 % ) had lower segmental cesarean subdivision, 12 ( 40 % ) had normal vaginal bringing and staying 3 ( 10 % ) had forceps bringing. Majority of neonates 18 ( 60 % ) had tonss of eight and above and staying 12 ( 40 % ) neonates had less than eight mark.The firs t aim was to measure the effectivity of dry cord attention on umbilical cord wellness position among neonates of control group.Data findings in the tabular array 3 showed the appraisal of umbilical cord wellness position of neonates in dry cord attention group by Modified REEDA graduated table. Regard to umbilical cord wellness position by Modified REEDA Scale, On first twenty-four hours of intercession 90 % neonates had no infection, 10 % of neonates had mild infection and none of them had moderate and terrible infection and on the 7th twenty-four hours of intercession 30 % of neonates had no infection, 33.3 % of neonates had mild infection, 26.7 % of neonates had moderate infection and 10 % of neonates had terrible infection on umbilical cord. Data findings in the tabular array no 4 showed the bacterial colonisation of umbilical cord on 3rd twenty-four hours of intercession. With respect to bacterial colonisation, 10 ( 33.3 % ) neonates had no bacterial growing, 8 ( 26.7 % ) neonates had staphylococcus aureus infection, 7 ( 23.3 % ) neonates had proteus infection and 5 ( 16.7 % ) neonates had klebsiella infection in dry cord attention group neonates. Data findings in the tabular array 5 showed the appraisal of umbilical cord wellness position based on umbilical cord falls off on. Regard to umbilical cord falls off yearss, the average figure of cord falls off yearss in dry cord attention group was 7.7 A ± 1.7 yearss. The above consequence was supported by Shoaeib & A ; Barrawy ( 1990 ) conducted a quasi experimental survey on intoxicant or traditional methods versus natural drying for neonate ‘s cord attention in university infirmaries at Alexendria and Minia. In this survey 70 neonates were selected, which was divided into two groups. Group I newborns standard traditional methods or intoxicant cord attention and Group II received natural drying of the umbilical cord. Culture specimens were obtained from umbilical cord on first and 3rd twenty-four hours of birth to observe bacterial colonisation. Rate of bacterial colonisation was significantly lower in the natural drying cord attention group than intoxicant or traditional methods groups. Average clip of cord separation was shorter in natural drying cord attention group as compared with the intoxicant or traditional methods group.The 2nd aim was to measure the effectivity of topical application of chest milk on umbilical cord wellness posit ion among neonates of experimental group.Data findings in the tabular array 3 showed the appraisal of umbilical cord wellness position of neonates in topical application of chest milk cord attention group by modified REEDA graduated table. Regard to umbilical cord wellness position by modified REEDA Scale, On first twenty-four hours of intercession none of the neonates had infection, likewise on the 7th twenty-four hours of intercession 63.4 neonates did non had infection, 33.3 % of neonates had mild infection, 3.3 % of neonates had moderate infection and no 1 had terrible infection. Data findings in the tabular array 4 showed the bacterial colonisation of umbilical cord on 3rd twenty-four hours of intercession. With respect to bacterial colonisation, 18 ( 60 % ) neonates had no bacterial growing, 5 ( 16.7 % ) neonates had staphylococcus aureus infection, 4 ( 13.3 % ) neonates had proteus infection and 3 ( 10 % ) neonates had klebsiella infection in topical application chest milk cord attention group neonates. Data findings in the tabular array 5 showed the appraisal of umbilical cord wellness position based on umbilical cord falls off on. Regard to umbilical cord falls off yearss, the average figure of cord falls off yearss in breast milk group was 6.3A ± 1.3days. The above consequence was supported by Ezmaeili & A ; Ghazvini ( 2006 ) conducted a randomised clinical test survey on effectivity of topical application of chest milk on bacterial colonisation in umbilical cord in Omolbanin infirmary in Mashhad. In this survey 118 samples were selected which was divided into two groups. Each group 59 neonates were assigned. Group I newborns received dry cord attention. All female parents in both groups were instructed about attention of umbilical cord within three hours of birth. Group II neonates were applied breast milk to the umbilical stump three hours after birth and continued every 12 hourly until two yearss after cord separation. Nothing was applied to the umbilical stump of the dry cord attention group. The research worker were obtained an umbilical swab three hours after birth and the 3rd twenty-four hours of life from the base of the cord. Rate of bacterial colonisation were recorded in both groups. They found out that most common civilize d beings were S.Epidermidis, S.Aureus, E.Coli and Klebsiella Pneumoniae in the umbilical stump and there were important differences between dry cord card and human chest milk groups in colonisation rate. Topical application of breastmilk on umbilical cord leads to cut down bacterial colonisation and cord separation clip and it can be used as easy, inexpensive, non hurt methods for umbilical cord attention.The 3rd aim was to compare the umbilical cord wellness position between the experimental and control group among neonates.Data findings in the tabular array 6 shows the comparing of mean and standard divergence value of topical application of chest milk versus dry cord attention group by modified REEDA graduated table. The above tabular array 6 shows that comparing of mean and standard divergence value of topical application of chest milk versus dry cord attention among experimental and control group. On first twenty-four hours intercession the average value was 0.0 and the standard divergence was 0.0 in the experimental group and the average value was 0.1 and the standard divergence was 0.3 in the control group. On 7th twenty-four hours of intercession the average value was 0.533 and Standard divergence 0.899 in experimental group. In control group mean value was 2.93 and standard divergence was 2.63. The deliberate ‘t ‘ value was 3.247 in the experimental group and 6.011 in the control group, which shows that there was significance difference among the topical application of chest milk and dry cord attention group at P & lt ; 0.001 degree. Table – 7 shows that comparing of bacterial colonisation among experimental and control group on 3rd twenty-four hours of intercession. With respect to bacterial colonisation, per centum difference of no bacterial growing was ( 26.7 % ) , staphylococcus aureus ( 10 % ) , Proteus ( 10 % ) , Klebsiella it was ( 6.7 % ) . The deliberate ‘t ‘ value of no growing of bacterial colonisation was 2.151, staphylococci aureus colonisation was 0.946, proteus colonisation was 1.010 and klebsiella colonisation was 0.767, which shows that there was important difference among the experimental and control group newborns in bacterial colonisation at P & lt ; 0.05 degree. The above tabular array -8 shows that appraisal of cord falls off among experimental and control group. Regard to umbilical cord falls off yearss, the average value of experimental group was 6.3 and 7.7 in control group. The standard divergence of experimental group was 1.3 and in control group was 1.7. The difference of agencies among experimental and control group was 1.4. The deliberate ‘t ‘ value was 3.522, which shows that extremely important difference among the experimental and control groups in cord falls off on yearss at P & lt ; 0.001 degree. Hence, the hypothesis ( RH1 ) stated that there is a important difference in umbilical cord wellness position among the experimental and control group neonates. Thus the hypothesis was accepted. The average figure of cord falls off yearss in experimental group was 6.3 A ± 1.3 yearss and control group was 7.7 A ± 1.7 yearss. The average difference was 1.4 yearss. It was statistically important, so hypothesis ( RH1 ) was accepted. The above consequence was supported by Sezer kiza ( 2006 ) conducted a instance control design on umbilical cord attention: comparing topical human milk, providone I and dry cord attention, in urban university infirmary at Turkey. In this survey 150 samples were selected and it was divided into three groups. Each group had 50 neonates. Group I received breast milk on their umbilical cord, group II received providone I and group III received dry cord attention. This survey shows that the mean cord separation clip of chest milk group was significantly shorter than dry cord attention and providone I group at P & lt ; 0.001 degree. Hence, the research hypothesis ( RH1 ) stated that there is a important difference on umbilical cord wellness position between the experimental and control group. This shows that topical aplication of chest milk on umbilical cord has an effectual than dry cord attention. Thus the hypothesis is acceptedThe 4th aim was to tie in the umbilical cord wellness position of neonates between experimental and control group with their demographic variables.Table 9a shows the chi-square value for the association between the cord wellness position with their sex was ( 0.325 ) , para ( 0.597 ) , gestational age ( 1.239 ) , birth weight ( 0.627 ) , maternal complications during gestation ( 4.342 ) , type of bringing ( 3.095 ) and Apgar mark ( 1.556 ) . So these survey findings shows that there was no association between experimental group with their demographic variables include sex, para gestational age, birth weight, maternal complications during gestation, type of bringing, apgar mark at P & lt ; 0.05 degree. Table 9b shows the chi-square value for the association between the cord wellness position with their sex was ( 6.400 ) , para ( 0.844 ) , gestational age ( 12.738 ) , birth weight ( 3.026 ) , maternal complications during gestation ( 2.784 ) , type of bringing ( 3.701 ) and Apgar mark ( 2.928 ) . So these survey findings shows that there was no association between experimental group with their demographic variables include sex, para gestational age, birth weight, maternal complications during gestation, type of bringing, apgar mark at P & lt ; 0.05 degree. Table 10 ( a ) shows the Chi-square value for the association between bacterial colonisation among experimental group with their sex was ( 2.299 ) , para ( 6.606 ) , gestational age ( 4.456 ) , birth weight ( 1.507 ) , maternal complications during gestation ( 2.708 ) , type of bringing ( 9.361 ) and Apgar mark ( 0.311 ) . So these survey findings shows that there was no association between experimental group with their demographic variables include sex, para gestational age, birth weight, maternal complications during gestation, type of bringing, apgar mark at P & lt ; 0.05 degree. Table 10 ( B ) shows the Chi-square value for the association between bacterial colonisation among control group with their sex was ( 3.274 ) , para ( 7.586 ) , gestational age ( 3.480 ) , birth weight ( 1.948 ) , maternal complications during gestation ( 2.752 ) , type of bringing ( 4.341 ) and Apgar mark ( 5.714 ) . So these survey findings shows that there was no association between experimental group with their demographic variables include sex, para gestational age, birth weight, maternal complications during gestation, type of bringing, apgar mark at P & lt ; 0.05 degree. Table 11 ( a ) shows the Chi-square value for the association between umbilical cord falls off among experimental group with their sex was ( 3.519 ) , para ( 4.455 ) , gestational age ( 0.795 ) , birth weight ( 0.895 ) , maternal complications during gestation ( 0.170 ) , type of bringing ( 2.813 ) and Apgar mark ( 0.003 ) . So these survey findings shows that there was association among para and umbilical cord falls off. No association between experimental group with other demographic variables include sex, gestational age, birth weight, maternal complications during gestation, type of bringing, apgar mark at P & lt ; 0.05 degree Table 11 ( B ) shows the Chi-square value for the association between umbilical cord falls off among control group with their sex was ( 0.089 ) , para ( 0.4641 ) , gestational age ( 3.597 ) , birth weight ( 0.741 ) , maternal complications during gestation ( 1.099 ) , type of bringing ( 3.817 ) and Apgar mark ( 1.094 ) . So these survey findings shows that there was no association between experimental group with their demographic variables include sex, para, gestational age, birth weight, maternal complications during gestation, type of bringing, apgar mark at P & lt ; 0.05 degree The demographic variables ( Sex, Parity, gestational age, birth weight, maternal complications during gestation, type of bringing, apgar mark ) of both groups were non holding any association and therefore they were non confounded with the umbilical cord attention. Hence, the research hypothesis ( RH2 ) stated that there is a important association between umbilical cord wellness position between the experimental and control group with their demographic variables ( Sex, Parity, gestational age, birth weight, maternal complications during gestation, type of bringing, apgar mark ) . Tables 9 ( a, B ) , 9 ( B ) , 10 ( a, B ) , 11 ( a, B ) , shows that there was no important association between that umbilical cord wellness position between experimental and control group with the selected demographic variables. Table 9a, showed that there was important association between para and umbilical cord falls off yearss in experimental group. Newborns of para I female parents had lengthier yearss of cord falls off than the neonates of multipara female parents. But, in regard to dry cord attention group there was no association between the cord falls off twenty-four hours with para. From the above analysis and readings, the hypothesis ( H1 ) â€Å" There is a important difference in cord wellness position between the experimental and control group neonates † was accepted. The above credence of ( H1 ) were attributed to the effectivity of topical application chest milk for bettering umbilical cord wellness position of neonates. The hypothesis ( H2 ) â€Å" There is a important association in cord wellness position between the experimental and control group with the demographic variables † . In this survey there will be no important association between experimental and control group except para.

12 Steps for writing effective paper

During our education, work, or sometimes leisure we are confronted with the assignment of writing a paper. And like every person we want the paper to be good and effective and get praised for it. Here are some tips, which may help to create an effective paper. Getting ready: Step 1 First thing you ought to do is to make sure that you completely understand the topic you are supposed to write. Without understanding the topic you will be lacking a part of confidence in the paper you are writing and confidence of what you are writing about, which is one of the major steps to an effective paper. You should know as much as you can about your topic, to be able to write it briefly and cover all the main aspects of it. Step 2 The next thing you should do is to define the purpose of your paper. A clear purpose is always the best foundation for effective writing. To write a clear purpose place an emphasis on the problem you are facing and then highlight the goal of the paper. Always keep the main purpose in mind in order to decide whether you have to include or exclude anything from your paper when having difficulties. Step 3 You should be clearly focused on the topic. For these aims divide your topic into main and supportive points. This is done in order to not to get lost in your paper and to carry the main idea through the paper with the help of supportive points. Step 4 It is really necessary for you to make a list of all paper requirements. This is done not to forget to mention anything in your paper that is required. Step 5 You should always keep in mind the audience you are referring to. Your success greatly depends on the views and attitudes of your audience. Being aware of these you will have more chances to effectively adjust and present your writing. Step 6 Poor organization of a paper is one of the most common things we confront with. So one of the most important steps in your paper is outline. The outline basically is not just a simple plan of your thoughts and ideas. It is the main structure or the plot of your paper. The structure of the paper is supposed to be straight and understandable; and you can only achieve this by writing down the complete outline, making it well balanced and as detailed as possible. The most typical outline is supposed to have at least a beginning, the main part and a conclusion. Step 7 The best way to mention everything needed in your paper is to take a minute or two before writing the paper and to put down some basic ideas you would like to mention in future. This is for being sure you wont forget anything and will mention what you consider reasonable and important. Writing the paper: Step 1 Any paper you are writing is a formal statement of your thoughts. This is how it differs from any conversation on the same topic so try to use more sophisticated words and sentences. But dont get carried away. Step 2 Your logical relationships should be obvious to everyone. Otherwise the reader of your paper will not follow your lead. Step 3 In order for the reader of your paper to get acquainted with the problem you are writing about, you are allowed to use some quotations and citing. Whenever you quote an idea, you ought to provide a bibliography (in an endnote or footnote) to the source of quotation. Step 4 Use normal expressions in your paper in order for it to be understandable for everyone. The best example is foreigners that are not familiar with dialectical expressions and colloquialisms. Step 5 When a reader analyzes a paper he also pays a lot of attention to grammar mistakes. So before you turn the paper in make sure that all grammar mistakes are detected and removed. These are the basic principles for writing effective paper. By following these steps you are on halfway to success.