This thesis investigates changes in knowledge required to complete tasks within business processes that have implemented planned/radical change. The research is based on the synthesis of three scholarly domains: change management, knowledge management, and business processes. Organisations implement planned/radical change for various reasons: due to perturbations in the external environment, to achieve strategic goals, or to improve profitability. Radical changes affect business processes and the people carrying out tasks within those processes. Yet, many radical process change initiatives founder. The conceptual argument underpinning this thesis is that planned/radical change initiatives are rarely fully implemented because knowledge does not fully evolve from pre-change to post-change knowledge. People can hold onto knowledge they have, or are unable to grasp new knowledge required, or attempt to apply knowledge that is redundant. This thesis posits that knowledge which does not evolve is a barrier to change. Consequently, this study contributes by providing a deeper understanding of knowledge evolution in the context of processes that have undergone planned/radical change, and specifically the evolution of declarative, procedural and heuristic knowledge necessary to complete new or redesigned tasks within business processes, which form the bedrock to enhancing the implementation of planned/radical change. Drawing on the literature related to change, knowledge, process and dynamic capabilities, a conceptual model is developed to explain evolutionary stages from pre-change to post-change declarative, procedural and heuristic knowledge within business processes. The model is based upon empirical data, collected qualitatively from two higher educational institutes based in Kuwait. This thesis also investigates redundant knowledge: knowledge that is no longer of use in post-change processes. In addition, the factors affecting knowledge evolution that exist during the period of implementing planned/radical change in a business process are identified and defined. Understanding these factors enhances the progression of staff members through the evolution stages. The model suggests that greater recognition of the pace at which knowledge evolves is important for implementing planned/radical change. The implications for practice are highlighted. This study has a number of limitations and suggestions for future research, which are set out in more detail in the concluding chapter.

Magister Public Health - MPH / This is a cross sectional survey study that explored determinant factors contributing to home child delivery and influence of traditional birth attendances on place of delivery in Rungwe District, Tanzania.The study focussed on three main aspects namely factors (socio-economic, cultural and knowledge) that influence women to deliver at health facilities and those who deliver ta home. Reasons/factors associated with the acceptability of health services and influence of traditional birth attendaces on place of delivery and whether accessibility to health services and traditional birth attendants influence women to decide the place of delivery. The study was descriptive cross-sectional in nature where a multistage random sampling procedure was used to select 8 wards and 16 villages. A systematic sampling was used to determine household interval in each village. Only one woman with at least one child was chosen in a household using a random sampling. In case of the absence of a woman with at least one child in a house falling in the interval, then the next house was considered. A total of 400 women with at least one child were selected at random from household cluster sample from all four divisions in Rungwe district. They were interviewed using semi-structured questionnaire. The participation rate was 100 % in both divisions. The age of the women ranged from 19-49 years with the mean age of 31 years (Std dev 7.5). Data entry and analysis were done using the quantitative statistics with Epi Info 2002 software. Results were presented using descriptive statistics, figures and tables, and analytical statistics, using Student’s t-test and chi-square. A total of 400 women were interviewed, among them, it showed that there were good attendance for antenatal care 395 (98.75%) and only 5 (1.25%) did not attend antenatal care. However, 243 (60.8%) of women interviewed had incidence of home delivery and 157 (39.3%) had incidence of health facility delivery. Home deliveries in a surveyed area are commonly assisted by unskilled persons, and consequently carry increased risks to the mother and to the new-born baby. Improvement of quality and accessibility of health care services by the health facility should involve harmonic balance between health service provider and beneficiaries in order to change the attitude towards minimizing the practice of home child delivery in Rungwe district, in Mbeya region, in Tanzania as awhole and elsewhere in the world.