Browsing by Subject "Decision-making"

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    Open Access
    Learning sites for health system governance in Kenya and South Africa: reflecting on our experience
    (2020-05-11)
    Background Health system governance is widely recognised as critical to well-performing health systems in low- and middle-income countries. However, in 2008, the Alliance for Health Policy and Systems Research identified governance as a neglected health systems research issue. Given the demands of such research, the Alliance recommended applying qualitative approaches and institutional analysis as well as implementing cross-country research programmes in engagement with policy-makers and managers. This Commentary reports on a 7-year programme of work that addressed these recommendations by establishing, in partnership with health managers, three district-level learning sites that supported real-time learning about the micro-practices of governance – that is, managers’ and health workers’ everyday practices of decision-making. Paper focus The paper’s specific focus is methodological and it seeks to prompt wider discussion about the long-term and engaged nature of learning-site work for governance research. It was developed through processes of systematic reflection within and across the learning sites. In the paper, we describe the learning sites and our research approach, and highlight the set of wider activities that spun out of the research partnership, which both supported the research and enabled it to reach wider audiences. We also separately present the views of managers and researchers about the value of this work and reflect carefully on four critiques of the overall approach, drawing on wider co-production literature. Conclusions Ultimately, the key lessons we draw from these experiences are that learning sites offer particular opportunities not only to understand the everyday realities of health system governance but also to support emergent system change led by health managers; the wider impacts of this type of research are enabled by working up the system as well as by infusing research findings into teaching and other activities, and this requires supportive organisational environments, some long-term research funding, recognising the professional and personal risks involved, and sustaining activities over time by paying attention to relationships; and working in multiple settings deepens learning for both researchers and managers. We hope the paper stimulates further reflection about research on health system governance and about co-production as a research approach.
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    Open Access
    Leveraging business Intelligence and analytics to improve decision-making and organisational success
    (2017) Mushore, Rutendo; Kyobe, Michael
    In a complex and dynamic organisational environment, challenges and dilemmas exist on how to maximise the value of Business Intelligence and Analytics (BI&A). The expectation of BI&A is to improve decision-making for core business processes that drive business performance. A multi-disciplinary review of theories from the domains of strategic management, technology adoption and economics claims that tasks, technology, people and structures (TTPS) need to be aligned for BI&A to add value to decision-making. However, these imperatives interplay, making it difficult to determine how they are configured. Whilst the links between TTPS have been previously recognised in the Socio-Technical Systems theory, no studies have delved into the issue of their configuration. This configuration is addressed in this study by adopting the fit as Gestalts approach, which examines the relationships among these elements and also determines how best to align them. A Gestalt looks at configurations that arise based on the level of coherence and helps determine the level of alignment amongst complex relationships. This study builds on an online quantitative survey tool based on a conceptual model for aligning TTPS. The alignment model contributes to the conceptual development of alignment of TTPS. Data was collected from organisations in a South African context. Individuals who participated in the survey came from the retail, insurance, banking, telecommunications and manufacturing industry sectors. This study's results show that there is close alignment that emerges between TTPS in Cluster 6 which comprises of IT experts and financial planners. Adequate training, coupled with structures encouraging usage of Business Intelligence and Analytics (BI&A), result in higher organisational success. This is because BI&A technology is in sync with the tasks it is being used for and users have high self-efficacy. Further analysis shows that poor organisational performance can be linked to gaps in alignment and the lack of an organisational culture that motivates usage of BI&A tools. This is because there is misalignment; therefore respondents do not find any value in using BI&A, thus impacting organisational performance. Applying a configurational approach helps researchers and practitioners identify coherent patterns that work well cohesively and comprehensively. The tangible contribution of this study is the conceptual model presented to achieve alignment. In essence, organisations can use the model for aligning tasks, technology, people and structures to better identify ideal configurations of the factors which are working cohesively and consequently find ways of leveraging Business intelligence and Analytics.
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    Open Access
    Modelling perception-action coupling in the phenomenological experience of “hitting the wall” during long-distance running with exercise induced muscle damage in highly trained runners
    (Springer International Publishing, 2018-07-10) Venhorst, Andreas; Micklewright, Dominic P; Noakes, Timothy D
    Background “Hitting the wall” (HTW) can be understood as a psychophysiological stress process characterised by (A) discrete and poignant onset, (B) dynamic interplay between physiological, affective, motivational, cognitive, and behavioural systems, and (C) unintended alteration of pace and performance. A preceding companion article investigated the psychophysiological responses to 20-km self-paced treadmill time trials after producing exercise-induced muscle damage (EIMD) via a standardised muscle-lengthening contraction protocol. Methods A 5-step procedure was applied determining the extent to which the observed data fit the hypothesised cause-effect relationships. Running with EIMD negatively impacts performance fatigability via (A) amplified physiological responses and a non-adaptive distress response and (B) deterioration in perceived fatigability: increase in perceived physical strain precedes decrease in valence, which in turn precedes increase in action crisis, eventually dissolving the initially aspired performance goal. Results First, haematological indicators of EIMD predicted increased blood cortisol concentration, which in turn predicted increased performance fatigability. Second, perceived physical strain explained 44% of the relationship between haematological indicators of EIMD and valence, which in turn predicted increased action crisis, which in turn predicted increased performance fatigability. The observed data fitted the hypothesised dual-pathway model well with good model-fit indices throughout. Conclusions The hypothesised interrelationships between physiological strain, perception, and heuristic and deliberative decision-making processes in self-regulated and goal-directed exercise behaviour were applied, tested, and confirmed: amplified physiological strain and non-adaptive distress response as well as strain-perception-thinking-action coupling impact performance fatigability. The findings provide novel insights into the psychophysiological processes that underpin the phenomenological experience of HTW and alteration in pacing behaviour and performance.