Browsing by Author "Duffy, Carren"
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- ItemOpen AccessA theory evaluation and programme implementer decision analysis for two therapy-driven programmes operating in the disability and rehabilitation sector(2018) Minne, Lara; Duffy, CarrenThis dissertation focused on two therapy-driven programmes operating in the disability and rehabilitation sector in the Western Cape, South Africa. One programme is an inclusive education programme with a classroom component and parenting component to it and the other is a vocational rehabilitation programme. These two programmes, implemented by the Chaeli Campaign (CC), are aligned with the community-based rehabilitation model of service delivery. These programmes are implemented by personnel with a variety of qualifications, including community workers and occupational therapists. Key goals for programmes of this nature are to ensure that all persons with disabilities are active participants of socio-economic life, to ensure that the rights and dignity of all persons are respected and upheld and to reintegrate persons with disabilities into family and community life. Another goal of these programmes is to transfer skills from highly-skilled professionals to workers with less training and lay persons. With respect to the last mentioned goal, the skills required to services persons with disabilities are redistributed, so that professionals such as occupational therapists are no longer solely responsible for serving these persons. Both programmes under evaluation in this document are implemented either exclusively or with help from occupational therapists. Problem Statement: The problem statement is made up of two components. First, the underlying programme theories of the two therapy-driven programmes were not well articulated. According to CC’s director, this poor articulation made it difficult for programme staff to describe their programmes to potential programme donors. Second, the organisation struggles to obtain funding from potential programme donors to finance the use of occupational therapists in their programmes. The difficulty in obtaining funding is assumed to be due to potential donors’ belief that these programmes could be implemented at a reduced cost by community workers. Method: The evaluator decided to conduct two programme evaluations to address the two aspects mentioned in the problem statement. First, programme theory evaluations were done to address the poor articulation of the programmes’ theories. The programme theory evaluation aimed to elicit and articulate the underlying logic of each of the programmes, thus enabling the evaluator to assess their plausibility. Following this, three multi-criteria decision analyses (MCDAs) using the Analytical Hierarchy Process (AHP) were conducted. The MCDAs were intended to establish which implementer (an occupational therapist or a community worker) is most preferred by CC’s current programme stakeholders. The participants of the MCDA included programme beneficiaries, current programme donors, field experts, programme facilitators and programme staff. Results: Programme theories were made explicit and articulated. These were then depicted as logic models. Results indicate that when assessed against social science and evaluation literature, the programme theories elicited in this dissertation are plausible. The MCDA results indicate that programme stakeholders prefer occupational therapists for technical aspects of programme delivery and prefer community workers for psychosocial aspects of rehabilitation, such as relationship-building and providing emotional support. Of note is that stakeholders weighted the perceived benefits of occupational therapists and community workers as more important than the costs associated with each implementer. The results from the MCDA highlight that programme stakeholders perceive the benefits of implementers (occupational therapists and community workers) to be more important than their associated costs. The evaluator assessed these results against social science literature and found that in general, stakeholders value benefits more than costs of implementing personnel. Recommendations: Recommendations are made to the organisation to describe their programmes’ theories more coherently and more clearly express their need for both community workers and occupational therapists Conclusions: Rather than considering cost, potential donors should consider that occupational therapists and community workers serve specific purposes in programme implementation. Their purpose, rather than their cost, should be prioritised in order for programmes to be effective. The field should be made aware of this disjuncture, while costs are important considerations, stakeholders in the field of disability and rehabilitation should not compromise on the quality of services in order to reduce programme costs.
- ItemOpen AccessAn evaluation for the Therapeutic Learning Centre: A child inpatient and day-patient psychiatric unit in Cape Town, South Africa(2019) Nicholson, Lee; Duffy, CarrenThere are value and importance for inpatient and day-patient psychiatric units, particularly for children and adolescents. These facilities, which are scarcely established in South Africa, offer multidisciplinary and multifaceted treatment to persons experiencing varying symptoms and conditions of mental illness. This dissertation presents the findings of an implementation evaluation conducted for the Therapeutic Learning Centre (TLC), a child inpatient psychiatric unit in Rondebosch, Cape Town. The evaluation aimed to compare the TLC’s service and programme implementation with international standards. The Quality Network for Inpatient Child and Adolescent Mental Health Service (QNIC) checklist was used to assess the TLC on seven focused categories of service and implementation quality. Data were provided from selected TLC team members, which included mental health practitioners from various fields (e.g., psychology, psychiatry and social work to name a few). Overall, the programme established within the TLC was found to be implemented with fair fidelity when compared to the international unit standards. Most unit standards required and expected to be carried out by an inpatient unit were found to be satisfied by the TLC. There are, however, key aspects of the unit’s environment and facilities, staffing and training, care and treatment, and clinical governance that were highlighted as needing improvement. While the research yielded mostly positive results, the evaluator was able to make several recommendations to the TLC stakeholders. This evaluation contributes to limited research and implementation evaluations within the context of child inpatient psychiatric units. Furthermore, the findings are intended to support the promotion of quality psychiatric and behavioural treatment and mental health service policy in these units within South Africa.
- ItemOpen AccessAn outcomes evaluation of the Zim-TTECH cervical cancer intervention in Harare Metropolitan Province, Zimbabwe(2023) Tapera, Oscar; Duffy, CarrenThis report presents the findings of an outcomes evaluation of the Zimbabwe Technical Assistance, Training and Education for Health's (Zim-TTECH) cervical cancer intervention in Harare and Epworth districts (Harare Metropolitan province). This programme seeks to improve access and uptake of cervical cancer screening and treatment among women living with HIV through recruitment, training and mentorship of nurses, procurement of equipment and commodities, providing support for diagnosis and referral for treatment services, and quality assessment of cervical cancer services. The evaluation interrogated the plausibility of the programme theory of the Zim-TTECH intervention and assessed its short- and medium outcomes. Methods The evaluation used a mixed-methods approach with both qualitative and quantitative data collection methods. This comprised a desk review of programme documents and relevant literature, secondary analysis of programme routine data and collection of primary data. Quantative descriptive analysis was conducted to determine coverage (in percentage) of Zim-TTECH cervical cancer services between 2019- 2021. Qualitative analysis was used to complement quantitative data and aid in the interpretation of programme results. Key Results This assessment showed that the Zim-TTECH cervical cancer intervention contributed to the increase in awareness among women living with HIV and health workers. The programme capacitated health workers to conduct effective health education and awareness-raising campaigns for cervical cancer. The evaluation revealed that the Zim-TTECH cervical cancer intervention improved access to cervical cancer services among women living with HIV. Additionally, the intervention did not deny women who were HIV-negative services though the reach for this group is not routinely documented and reported. Results from the evaluation showed that LEEP was the main treatment type used in Harare and Epworth followed by cryotherapy and thermablation techniques. This assessment also showed that the Zim-TTECH cervical cancer intervention contributed positively to the following areas: increasing access to cervical cancer services, early detection of pre-cancers and invasive disease and increased health education and awareness of cervical cancer among women and health workers. The evaluation also revealed some negative implications of the Zim-TTECH intervention on the health system which include the following: the programme‘s screening resulted in the detection of invasive cervical cancer cases which were referred to weak and ill-capacitated public health facilities, and most screening services are offered in HIV clinics which results in some women who are not HIV positive not wanting to screen for fear of stigma and the programme also contributed to staff attrition in public health facilities as they search for better opportunities in the NGO sector and outside the country. The Zim-TTECH cervical cancer programme rapidly adjusted to the new COVID-19 protocols in 2020 to ensure continuity of services though the demand side was affected by protracted lockdowns. The programme has also been keeping in tandem with technological evolutions including the adoption of thermoablative techniques and planning for the rolling out of highly sensitive human papilloma virus (HPV) DNA testing in line with Ministry of Health strategies and WHO guidelines. However, discussions are still ongoing on the adoption of HPV screening as the primary method as it will negate the ‘see and treat' approach. This evaluation showed that cervical cancer services were likely to continue in Harare and Epworth after the cessation of Zim-TTECH support albeit at a lower scale. The Zim-TTECH intervention is based in public health facilities that have been offering cervical cancer services even before partner support came through and these are likely to continue in their absence. Conclusions Findings from this evaluation showed that Zim-TTECH cervical cancer intervention was relatively effective with regards to short-medium term outcomes, although the COVID-19 pandemic saw disruptions of cervical cancer services which affected service delivery/uptake in 2020-2021. However, the key shortfalls of the intervention revealed in this evaluation showed systemic/structural gaps with the design of health interventions in the country as well as the vertical approaches which are also being perpetuated by donors. Additionally, given the huge resource shortfalls in the MoHCC due to protracted underfunding, there is evidence of limited coordination/leadership capacities to guide partners who come up with piecemeal interventions. Despite the revealed shortcomings of the intervention there are opportunities to improve services including treatment of invasive cervical cancer. Overall, better partnerships and coordination among government, NGOs and donors will be a game changer in ensuring continuity of services for cervical cancer in low-resource settings.
- ItemOpen AccessEvaluating Mending Mamre: An Animal Welfare Intervention(2019) Rabier, Camille; Duffy, CarrenThe need to improve animal welfare and control companion animal populations is necessary for South Africa, especially in impoverished communities lacking resources and education to care for their pets responsibly. These programmes are often multi-dimensional in nature and aim to improve animal welfare in different ways. Sterilisation is often the first step but is not enough. Consequently, education is often used in combination, to teach responsible pet care and ownership to pet owners. By increasing their understanding and knowledge of animals it is hoped that the pets’ overall quality of life and welfare improve. The following dissertation presents the findings of an evaluation conducted for the Mending Mamre Mass Education and Sterilisation Programme. This programme had four components: surgical sterilisation of pets and feral cats, basic veterinary care, education sessions and the rehoming of stray dogs. Three evaluations were performed (as requested by the clients): a programme theory evaluation of the education sessions, a process evaluation to understand why some residents refused sterilisation and an outcome evaluation to measure if the pets’ living conditions and body scores had changed 16 months after the programme. Overall, the results of the programme theory evaluation demonstrated that: the activities and outcomes of the education sessions were consistent with similar programmes but the two causal pathways underlying the programme are not plausible. The results of the process evaluation highlighted that the most common reason why pet owners refused sterilisation was due to fear. Finally, the results of the outcome evaluation indicated mixed results; with an increase observed in the pets’ physical wellbeing but an overall decrease observed in their quality of living conditions. With the results, the evaluator was able to make recommendations to the client and highlight considerations for programme improvement. Overall this study contributes to the paucity of research on evaluations of animal welfare interventions at the community level.
- ItemOpen AccessAn implementation evaluation of a peer education programme(2010) Njovana, Rumbidzai; Duffy, CarrenProgramme evaluation is a process whereby the effectiveness of a programme is investigated, in order to "inform social action to improve social conditions" (Rossi, Lipsey & Freeman, 2004,p.16). Hence the aim of this evaluation was to assess the implementation of peer education programme, in order to recommend areas of improvement for future implementation. As a response to problems associated with high-risk behaviours and HIV prevalence amongst young people in Sub Saharan Africa, the Generation of Leaders Discovered (GOLD) Peer Education Development Agency developed a model that aims to address these issues. The model consists of a number of services that GOLD offers to implementing organisations (IOs) and enables them to roll out the GOLD Peer Education Programme. The programme is currently implemented by IOs in the Western Cape, Mpumalanga and Kwa-Zulu Natal provinces of South Africa, as well as Botswana and Zambia. The programme aims to equip young leaders with the necessary knowledge,skills and attitudes to be role models of health-enhancing behaviours that will ultimately contribute to HIV prevention and develop young leaders. As there has been an evaluation conducted on the level of the services offered by GOLD to IOs (Gelderblom, 2009), the focus of this evaluation was on the implementation of the programme from the IOs to the peer educators. Focus was on service utilisation, service delivery and organisational support.
- ItemOpen AccessInvestigating succession planning practices in South African construction companies(2022) Mfeka, Susan; Duffy, CarrenGlobally, the implementation of succession planning in the construction industry is not developing. Literature indicates that, while construction companies understand succession planning, their lack of implementation directly affects employee retention. This research employed a qualitative research design to investigate the extent to which certain South African construction companies implement succession planning. Data were collected from six human resource executives serving across six South African construction companies. Overall, the results confirmed a lack of succession planning implementation at the respective companies. This study found that the HR executives understand the concept of succession planning even though it is not formalised. Furthermore, leadership buy-in was found to be lacking, which was negatively impacting the succession planning implementation. Certain specific factors were also discovered to be contributing to the hindering of the succession planning implementation. These factors include lack of retention strategy, lack of career discussion, lack of skills development, and lack of available positions. Suggestions and recommendations in light of these findings are provided.
- ItemOpen AccessA theory-driven evaluation of a wellness initiative(2009) Duffy, Carren; Louw, JohannIncludes bibliographical references (leaves 41-43).