District Teams Research Articles

Free bednets to pregnant women through antenatal clinics in Kenya: a cheap, simple and equitable approach to delivery

Kenya's National Malaria Strategy states that insecticide-treated nets (ITNs) would be considered as a free service to pregnant women assuming sufficient financial commitment from donors. In 2001, United Nation's Children's Fund (UNICEF) and the Government of Kenya brokered support to procure and distribute nets and K-O TABs (deltamethrin) to 70 000 pregnant women in 35 districts throughout Kenya around Africa Malaria Day. This intervention represented the single largest operational distribution of ITN services in Kenya to date, and this study evaluates its success, limitations and costs. The tracking process from the central level through to antenatal clinic (ANC) facilities suggests that of the 70 000 nets procured, 37 206 nets (53%) had been distributed to pregnant women throughout the country within 12 weeks. One-fifth of the nets procured (14 117) had gone out to individuals other than pregnant women, most of these at the request of the district teams, with only 2870 nets estimated to have gone astray at the ANC facilities. At 12 weeks, the remaining 18 677 nets were still in storage awaiting distribution, with more than two-thirds having reached the district, and nearly half already being held at ANC facilities. The cost of getting a net and K-O TAB to an ANC facility ready for distribution to a pregnant woman was US$ 3.81. Accounting for the 14 117 nets that had gone to other users, the cost for an ITN received by a pregnant woman was US$ 5.26. Delivering ITNs free to pregnant women through ANCs uses an existing system (with positive spin-offs of low delivery cost and simple logistics), is equitable (as it not only targets those who can afford it) and can have the added benefits of strengthening ANC service, delivery and use.

Crisis management preparedness of school districts in three southern states in the USA

The following paper describes the results of a baseline study to assess the status of crisis management preparedness in public school districts in three southern states in the United States. Self-reported responses were collected by distributing a 22 question self-reporting survey to all school districts and systems in the states of Tennessee, North Carolina and Georgia. Threats by students were indicated as requiring district team activation by 40% of responding districts. This baseline study indicated that 95% of responding districts have some type of district crisis management plan, 77% have a district crisis management team and 88% have a part- or full-time director designated for crisis situation. While these initial findings sound promising, the low number of districts (less than 50%) self-reporting at least one full day of training in the last year and no full-scale drill is indicative of a very low level of crisis preparedness. This lack of preparedness reported in combination with the relatively high level of crisis incidents, such as student deaths, violence (fights), weapons on campus, and student threats, gives rise for concern, and districts should pay special attention to increasing future training efforts and performing more full-scale drills. Overall, crisis plans should be improved in order to ensure adequate school district crisis preparedness.

Creating communities of reform: continuous improvement planning teams

Presents an analysis of the potential for continuous improvement planning teams to foster organizational learning and professional community in three school district teams. The findings of this three‐year study suggest that carefully orchestrated continuous improvement efforts can succeed in creating conditions responsive to the development of both learning and community. Organizational factors that influence development of both learning and community include: the development of leadership within and among faculty; ongoing focus on data‐driven decision making and the creation of venues for dense interpersonal dialogue related to issues of curriculum and instruction. The findings further suggest that the context of instruction and the work of instruction are important factors in sustaining learning and community.

School and literacy improvement

The article summarises the approach of Staffordshire LEA to supporting school improvement through district teams, the provision of useful data, the Staffordshire School Improvement Initiative and a developing approach to continuing professional development. It outlines the County's approach to the implementation of the National Literacy Strategy. The emphasis is on a pragmatic, problem-solving approach to meeting the needs of schools.

Coverage and cost of iodized oil capsule distribution in Tanzania.

Distribution of oral iodized oil capsules (IOC) is an important intervention in areas with iodine deficiency disorders (IDD) and low coverage of iodized salt. The mean reported coverage of 57 IOC distribution campaigns from 1986-1994 of people aged 1-45 years in 27 districts of Tanzania was 64% (range 20-96%). This declined over subsequent distribution rounds. However, due to delayed repeat distribution, only 43% of person-time was covered, based on the programme objective of giving two IOC (total 400 mg iodine) at 2-year intervals. Three different capsule distribution strategies used in 20 distribution rounds in 1992-1993 were analyzed in depth. Withdrawal of financial support for district distribution expenses under the 'district team' strategy, and the subsequent change to integrated 'primary health care' distribution, increased delays and capsule wastage. The third, more vertical strategy, 'national and district teams', accomplished rapid distribution of IOC about to expire and subsequently a return to the initial 'district team' allowance strategy was made. Annual cost of 'district team' distribution was 26 cents per person (400 mg iodine/2 years). Cost analysis revealed that the IOC itself accounts for more than 90% of total costs at the levels of coverage achieved. IOC will be important in the elimination of IDD in target areas of severe iodine deficiency and insufficient use of iodized salt, provided that high coverage can be achieved. Campaign distribution of medication with high item cost and long distribution intervals may be more cost-effectively performed if separated from regular PHC services at their present resource level. However, motivating health workers and community leaders to do adequate social mobilization remains crucial even if logistics are vertically organized. Insufficient support of distribution expenses and health education may lead to overall wastage of resources.

Thoughts from an old GP

In 1981 I retired early, mainly because of a reorganisation of the children’s beds which I had opposed, but in July of that year the offer of a locum post at a children’s hospital in east London gave me the opportunity to assess the effects of yet another reorganisation. This had abolished the area and district teams and substituted district health authorities and nine special health authorities (hospitals with one specialist function). Though the structure was simplified there was a further increase in administration at the district level. In September, 1982, I finally retired and became a spectator of the travails of the NHS and an intermittent consumer of its hospital service. What follows are my observations (and those of friends and colleagues) on inpatient care in the NHS in the 1990s. There has been a marked deterioration in the standard of care of patients in NHS hospitals. The traditional ward round, by doctors and nurses together, has disappeared, resulting in a fragmentation of care which is neither safe nor sensible. Consultants visit without nurses or junior staff. House-officers see patients at irregular times and not always every day; they take inadequate histories and make incomplete physical examinations. Nurses do not know how to give subcutaneous injections, measure blood pressure properly, or manage intravenous lines safely. The whole system of inpatient care requires a thorough reappraisal. Waiting lists have got longer, the public’s faith in the NHS is faltering, and the morale of doctors is low. The cost of hospital services continues to increase, and rationing is being seriously considered, though with no agreement on how this should be done or who would be the victims. The “internal market” reforms of 1990 have failed in many of their objectives but the 1997 white-paper, The New NHS: modern, dependable, offers constructive solutions to the distortions produced by the internal market; and this year’s green-paper, Our Healthier Nation, is the first government document since the Black report of 1980 to acknowledge the relation between poverty, poor housing, unemployment, and social exclusion and the social-class gradient in morbidity and mortality.

Labor-Management Cooperation—City of Portland, Maine

Portland, Maine had a traditional bargaining relationship. It now has one of the most complete programs of service-focused labor management cooperation of any place in the country. A broad range of city services, including an emerging effort in public safety are now run this way, with workers and their union leaders, managers and elected officials all benefitting from and praising the new relationship. Portland made this radical transformation without a crisis of fiscal pressure. New leadership in the city manager's office and responsive leadership in key bargaining units led to an experiment on the building of Hadlock Field. A partnership between the department head and the president of the AFSCME local led the project. Instead of contracting out to meet a short deadline and employ skills that didn't seem to exist, the parties worked out a special set of arrangements and via cross-training, teamwork and dedication completed the stadium in seven months, millions under the expected budget. From the pride and satisfaction of this joint effort, Portland, AFSCME and other key units worked to create a new participative relationship across the full range of city services. The effort has produced major cost savings and service improvements, has strengthened both the management and the union and has produced a far less adversarial bargaining relationship. In one innovation, separate services were split up and reorganized into district teams, providing customer-oriented public works services in areas that match city council districts. Cross training and new responsibilities have resulted in new opportunities and pay raises, yet have saved time and money. The piece, co-authored by union and management leaders from Portland, illustrates the breadth and depth of what they have achieved without a crisis as the initiating factor.

Mechanisms of and facility types involved in hazardous materials incidents.

The purpose of this study was to systematically investigate hazardous materials (hazmat) releases and determine the mechanisms of these accidents, and the industries/activities and chemicals involved. We analyzed responses by Massachusetts' six district hazmat teams from their inception through May 1996. Information from incident reports was extracted onto standard coding sheets. The majority of hazardous materials incidents were caused by spills, leaks, or escapes of hazardous materials (76%) and occurred at fixed facilities (80%). Transportation-related accidents accounted for 20% of incidents. Eleven percent of hazardous materials incidents were at schools or health care facilities. Petroleum-derived fuels were involved in over half of transportation-related accidents, and these accounted for the majority of petroleum fuel releases. Chlorine derivatives were involved in 18% of all accidents and were associated with a wide variety of facility types and activities. In conclusion, systematic study of hazardous materials incidents allows the identification of preventable causes of these incidents.

Mechanisms of and Facility Types Involved in Hazardous Materials Incidents

The purpose of this study was to systematically investigate hazardous materials (hazmat) releases and determine the mechanisms of these accidents, and the industries/activities and chemicals involved. We analyzed responses by Massachusetts' six district hazmat teams from their inception through May 1996. Information from incident reports was extracted onto standard coding sheets. The majority of hazardous materials incidents were caused by spills, leaks, or escapes of hazardous materials (76%) and occurred at fixed facilities (80%). Transportation-related accidents accounted for 20% of incidents. Eleven percent of hazardous materials incidents were at schools or health care facilities. Petroleum-derived fuels were involved in over half of transportation-related accidents, and these accounted for the majority of petroleum fuel releases. Chlorine derivatives were involved in 18% of all accidents and were associated with a wide variety of facility types and activities. In conclusion, systematic study of hazardous materials incidents allows the identification of preventable causes of these incidents.

Developmental aspects of visual disorders

The approach to care described above is time-consuming and requires specialist expertise and experience. The messages for the general paediatrician, paediatric ophthalmologist and general practitioner are: •To be born with severe visual impairment is a developmental emergency and requires prompt referral for developmental management •Tertiary level management will only be effective if liaison with district teams is of high quality •There is no room for complacency with babies in whom the visual impairment is very severe, even if development in the first year appears satisfactory. Regular developmental follow-up between the ages of 15 months and 2 1/2 years is essential •Functional assessment of vision is a priority for all babies during the first year and for all those with some form vision throughout the preschool era. •Linear acuity is the measure of choice. The approach to care described above is time-consuming and requires specialist expertise and experience. The messages for the general paediatrician, paediatric ophthalmologist and general practitioner are: •To be born with severe visual impairment is a developmental emergency and requires prompt referral for developmental management •Tertiary level management will only be effective if liaison with district teams is of high quality •There is no room for complacency with babies in whom the visual impairment is very severe, even if development in the first year appears satisfactory. Regular developmental follow-up between the ages of 15 months and 2 1/2 years is essential •Functional assessment of vision is a priority for all babies during the first year and for all those with some form vision throughout the preschool era. •Linear acuity is the measure of choice.

Coastal management in Tanga, Tanzania: a decentralized community-based approach

This paper describes a new initiative in coastal management in northeastern Tanzania. The region is within the equatorial part of the Western Indian Ocean. The priority environmental issues being faced include declining fish catches, use of destructive fishing techniques, mangrove cutting and coastal erosion. There is a widespread perception among the users of the coastal resources that management of these issues is inadequate. This programme initiative is developing flexible, community-based approaches to identifying the problems and to take achievable actions. The programme provides training in a wide range of skills and appropriate technical methods for government officials, extension workers and villagers. A collaborative process is evolving that includes participatory appraisals, village environmental committees, facilitation by government extension workers, technical advise and supervision by district technical teams, and regional-wide workshops with key players. Village initiatives taken so far include new by-laws, gear inspection, reef zoning and closures. A number of village mariculture projects are being piloted.

Strengthening health management: experience of district teams in The Gambia.

The lack of basic management skills of district-level health teams is often described as a major constraint to implementation of primary health care in developing countries. To improve district-level management in The Gambia, a 'management strengthening' project was implemented in two out of the three health regions. Against a background of health sector decentralization policy the project had two main objectives: to improve health team management skills and to improve resources management under specially-trained administrators. The project used a problem-solving and participatory strategy for planning and implementing activities. The project resulted in some improvements in the management of district-level health services, particularly in the quality of team planning and coordination, and the management of the limited available resources. However, the project demonstrated that though health teams had better management skills and systems, their effectiveness was often limited by the policy and practice of the national level government and donor agencies. In particular, they were limited by the degree to which decision making was centralized on issues of staffing, budgeting, and planning, and by the extent to which national level managers have lacked skills and motivation for management change. They were also limited by the extent to which donor-supported programmes were still based on standardized models which did not allow for varying and complex environments at district level. These are common problems despite growing advocacy for more devolution of decision making to the local level.

Reviewing Life Strategy in the Approach to Death

Reviewing Life Strategy in the Approach to Death Get access Hons Gavin Bissell Hons Gavin Bissell Hons Gavin Bissell, PhD, CQSW, is a social worker, Lancashire Social Services, Burnley District Team, Burnley, England. Search for other works by this author on: Oxford Academic PubMed Google Scholar Social Work, Volume 37, Issue 4, July 1992, Pages 374–375, https://doi.org/10.1093/sw/37.4.374 Published: 01 July 1992 Article history Accepted: 20 September 1991 Published: 01 July 1992

Promoting Comprehensive School Health Programs Through Summer Health Promotion Conferences

This study reports on the evaluation of the second North Carolina Healthful Living Institute (HLI), a statewide conference to promote comprehensive school health education. A comparison of year one and year two evaluation results is included. Based on a theoretical framework derived from the theory of diffusion of innovations within organizations, the impact of the HLI was assessed by studying characteristics of school districts sending representatives to the HLI and the composition of teams from each school district, and using pretest and posttest measures of participants' perceptions of the importance of health as a content area and participants' perceptions of the importance of the various components of comprehensive school health. Results indicate the effect of school health promotion conferences is linked to characteristics of school district teams, with the Institute needing to attract more varied teams, and teams from smaller, rural districts.

Measuring Symptoms in Terminal Cancer: Are Pain and Dyspnoea Controlled?

The symptoms of 86 patients referred to a district terminal care support team were rated throughout care using a standardized schedule. Pain was the most common main symptom at referral, occurring in 35 (41%) of the patients. The assessment scores for pain showed significant improvements after one week of care (P less than 0.01) and there was a further improvement into the week of death. However, towards death, 18 (21%) patients developed dyspnoea as their main symptom, and this became the most severe symptom at death. The symptom assessment scores for patients with dyspnoea showed no change over time, suggesting that existing methods to control dyspnoea are ineffective and that new interventions are needed.

The district team approach to malnutrition: Maposeni Nutrition Scheme.

THE DISTRICT TEAM APPROACH TO MALNUTRITION MAPOSENI NUTRITION SCHEME Get access J. R. K. ROBSON, M.B., B.S. (DUN-ELM), D.T.M. & H. (EDIN.), D.P.H. (LONDON), J. R. K. ROBSON, M.B., B.S. (DUN-ELM), D.T.M. & H. (EDIN.), D.P.H. (LONDON) Dar-es-SalaamTanganyika Search for other works by this author on: Oxford Academic PubMed Google Scholar G. A. CARPENTER, G. A. CARPENTER Dar-es-SalaamTanganyika Search for other works by this author on: Oxford Academic PubMed Google Scholar M. C. LATHAM, B.A., M.B., B.CH., B.A.O., (DUBLIN), D.T.M. & H. (LONDON), M. C. LATHAM, B.A., M.B., B.CH., B.A.O., (DUBLIN), D.T.M. & H. (LONDON) Dar-es-SalaamTanganyika Search for other works by this author on: Oxford Academic PubMed Google Scholar R. WISE, B.SC. (LONDON), R. WISE, B.SC. (LONDON) Dar-es-SalaamTanganyika Search for other works by this author on: Oxford Academic PubMed Google Scholar P. G. LEWIS P. G. LEWIS Dar-es-SalaamTanganyika Search for other works by this author on: Oxford Academic PubMed Google Scholar Journal of Tropical Pediatrics, Volume 8, Issue 3, December 1962, Pages 60–75, https://doi.org/10.1093/oxfordjournals.tropej.a057630 Published: 01 December 1962

Through Teamwork We Understand Children

AbstractThe “team process” was used to evolve this article. An appointed central committee was composed of a general subject matter supervisor, an art supervisor, a principal, two teachers, a psychologist, and a parent from Jordan School District in Utah. This Committee met many times and discussed the items under consideration. These same committee members acted as leaders for other groups of people who met to discuss the same topics. Parent and teacher personnel made up the other groups. Homeroom mothers, fathers and elementary faculty members were involved. Ideas in the article emerged from the combined thinking of everyone. There is probably nothing new in the ideas expressed; but to the group who met and shared, it was a rich and profitable experience. A greater faith in the teamwork process has been one result of the experience. The groups involved have a deep conviction that most problems can be better understood and solved if we will only get together, share together, plan together and act together.—The Team. Additional informationNotes on contributors The Jordan School District Team, Utah: Alta Miller, supervisor; Harold Ashman, principal; Roma Ganz, teacher; Evelyn O'Brien, teacher; H. W. Bartlett, art supervisor; Earl J. Thurman, psychologist; Nelda Donga, parent.

ADMINISTRATIVE AND DEPARTMENTAL STAFFS—CO‐ORDINATION OF WORK1

Public Administration and DevelopmentVolume 7, Issue 2 p. 75-76 Article ADMINISTRATIVE AND DEPARTMENTAL STAFFS—CO-ORDINATION OF WORK1 PROVINCIAL AND DISTRICT TEAMS First published: 01 April 1955 https://doi.org/10.1002/j.1099-162X.1955.tb00090.x 1Tanganyika Government Circular No. 7 of 1954 dated 22nd October, 1954. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume7, Issue2April 1955Pages 75-76 RelatedInformation