This thesis is concerned with the role of new information and communication technologies (lCTs) in community development. Bhalla and James (1988) have stated, 'The rapidly advancing scientific and technological frontier will inevitably have monumental consequences for the Third World ... Equally predictable, however, is that modem technologies will be deployed in developing countries ... ' With this in mind, questions central to the current research are asked: Is Africa being left behind in the new information revolution? Will the new ICTs aid deVelopment in African countries, and in particular, are local communities going to be empowered or marginalized? Is there room for optimism? To address these questions and investigate the potential of ICTs to aid community development, the author outlines the importance of community development, particularly the role played by small enterprises and women in development (Chapter Two). Further, the chapter looks at the information needs of these economic sectors and the intermediary bodies that have been formed to assist them. Chapter Three seeks to show the importance of technology within the development process, and in particular, the importance of local capacities and local technologies. These are deemed necessary for technology blending which adapts new technologies to local circumstances. In Chapter Four, the author reviews the growth ofICTs and related institutions identifying constraints that have been encountered and how they are being addressed. Significant is the discovery that African telecommunications generate higher profits than those in other parts of the world; this should allow efficiency gains which should permit major expansion in ICTs within current investment levels. Reports on field research carried out in Kenya and South Africa are given in Chapter Five. In both countries, small enterprises and women's development were identified as key players in community development. To this end, intermediary organizations involved in these two areas were identified for study: the Women's Bureau and the Kenya Industrial Estates in Kenya; and the Women's National Coalition, the Small Businesses Advisory Bureau, BRIDGES and Mamelodi in South Africa. Whilst all the organizations were providing benefits to target communities, the South African organizations showed greater capacity for delivering assistance. All demonstrated high management skills and exploited the new opportunities provided through a sound infrastructure and a political will, to extend assistance to local communities in various ways. The final Chapter draws reasoned conclusions pointing out three necessary success factors: infrastructure, management skills and political will. With these three critical factors in mind, the author makes recommendations to government, commerce and industry, agencies serving local communities, international agencies and to researchers. To this end, the thesis makes a contribution of value to all potential stakeholders. It also provides guidance to future researchers into African development.

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No description available.

Equity of access to healthcare services is a concept which underpins current UK health policy. However evidence suggests that this is not achieved within community palliative care. Referrals can be tardy or not made at all. Most literature describes inequality in service utilisation, but does not aid understanding of why such inequalities exist. There is little research exploring the processes underpinning referral making rather than the outcomes of referrals such as service utilisation. The aim of this research was to investigate the influences on referral decisions made within community palliative care services. A qualitative case study strategy was chosen as the research approach as it provided a framework for facilitating the incorporation of multiple perspectives in a complex context, in a field where there has been little previous research, and where there is little theory to guide the investigation. Three cases (Primary Care Trusts) were studied. Data collection used multiple methods (interviews, observation and documentary analysis, as well as mapping and profiling the palliative care services provided within the cases) from multiple perspectives (general and specialist palliative care professionals, managers, commissioners and patients). Detailed data analysis followed a framework approach, comparing and contrasting patterns within and across cases with existing and developing theoretical propositions. Two core influences on the way health care professionals made referral decisions were found. First, their perception of their own role in providing palliative care. Autonomous professionals made independent judgements about referrals, influenced by their expertise, workload, the special nature of palliative care and the relationship they developed with patients. Second, their perception about those to whom they may refer. Professionals needed to know about services to refer, and then made a complex judgement about the professionals involved and what they could offer the referrer as well as the patient. These findings indicate that many more factors than an assessment of patients' clinical need affect referrals within community palliative care services. It appears that personal, inter-personal and inter-professional factors have the potential to shape referral practices. It may be that the combination of these factors has an influence on equitable access to community palliative care services. Practitioners could be more explicit about referral or non-referral rationales, and policy makers take account of these complex influences on referrals rather than just mandating change.

published_or_final_version / Electrical and Electronic Engineering / Doctoral / Doctor of Philosophy

published_or_final_version / Electrical and Electronic Engineering / Doctoral / Doctor of Philosophy

published_or_final_version / Urban Planning / Master / Master of Science in Urban Planning

published_or_final_version / abstract / Computer Science and Information Systems / Master / Master of Philosophy

published_or_final_version / Computer Science / Master / Master of Philosophy

published_or_final_version / Electrical and Electronic Engineering / Master / Master of Philosophy