Browsing by Subject "Developing Country"
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Item Designing Public Health Supply Chains: Towards Improving Health Commodity Availability in Developing Countries(2020-07) Karimi, AmirIn developing countries, significant resource constraints (e.g., funding and human resource limitations) hamper the effective delivery of health commodities from upstream suppliers to the last-mile, leading to supply chain failures such as “stock-outs.” For individuals who are deprived access to basic health commodities due to stock-outs, the consequences can be dire. For example, without reliable access to contraceptives, women may suffer unintended pregnancies, imposing economic and psychological burden, and unsafe abortions that often cause death. While the prevalence of health commodity stock-outs and the consequent repercussions for clients in developing countries are well-documented, there is a paucity of rigorous empirical research into the factors that drive such stock-outs. Focusing on this context, this dissertation aims to (i) empirically evaluate and uncover the factors that contribute to health commodity stock-outs in developing countries by leveraging field data collected from health facilities and using a combination of rigorous econometric and predictive modeling techniques; (ii) generate actionable insights that public health organizations, governments, and donors can use to mitigate the risk of stock-outs in developing countries. Toward addressing these objectives, the first dissertation study focuses on the effect of factors at the upstream level of the public health supply chain and explores the impact of the distribution model (i.e., pull vs. push) on the likelihood of stock-outs. At the downstream level, the second study investigates the role of practices that health facilities can use to mitigate the likelihood of stock-outs. The third dissertation study also focuses on the downstream level of the public health supply chain by examining how the provision of training to frontline healthcare providers can help reduce the likelihood of stock-outs. Taken together, the three dissertation studies serve as the first systematic attempt in the literature to conduct a rigorous empirical evaluation of the factors driving the stock-outs of health commodities in developing countriesItem School principals as instructional leaders: an investigation of school leadership capacity in the Philippines.(2009-09) Sindhvad, Swetal P.Decentralization and school-based management are shaping the role of the school principal as instructional leader. However, in Asia many principals are not prepared for this new role. This study identified factors related to the extent Filipino school principals thought they were capable of supporting teachers' classroom instruction through instructional supervision, professional development, and classroom resources; and the extent they thought these instructional supports were effective. It also measured principals' confidence in supporting teachers' classroom instruction after participation in an instructional leadership training program offered by the Southeast Asian Ministers of Education Organization Regional Center for Educational Innovation and Technology (SEAMEO INNOTECH). This study was conceptually grounded in the principal-agent relationship as described by Galal (2002) and Chapman (2008), and Kemmerer's (1990) model for teacher incentives. Bandura's (1977) concept of self-efficacy served as a framework for investigating school principalship. Analyses were conducted on data from 364 principals. Linear regression analysis showed that Filipino principals thought their capacity to support teachers through instructional supervision and professional development was dependent on their beliefs as to whether these instructional supports could make a difference in classroom instruction, their level of control, time they spent on instructional leadership and their degree of job satisfaction. Principals thought their capacity to support teachers through classroom resources was only dependent on their level of control over them and their beliefs as to whether they could make a difference in classroom instruction. Results also showed that principals' beliefs as to whether instructional supports were effective in supporting teachers' classroom instruction were dependent upon how effective they think they are as school principals and how capable they think their teachers are in guiding student achievement. MANOVA results indicated no differences related to demographic and contextual factors among principals' beliefs about their capacity to support teachers and their beliefs about the effectiveness of the instructional supports. Seventy-five percent of principals attributed their capacity to the hands-on training they received. The findings are important for formulation and implementation of school-based management policies, and for the design of education reform initiatives and training programs supporting school principals to be instructional leaders.