Multi-objective optimisation focuses on optimising multiple objectives simultanuously. Evolutionary and immune-based algorithms have been developed in order to solve multi-objective optimisation problems. These algorithms often include a property called elitism, a method of preserving good solutions. This study has focused on how different approaches of elitism affect an algorithm's ability to find optimal solutions in a multi-objective optimisation problem with a discrete and highly discontinuous decision space. Three state-of-the-art algorithms, NSGA-II, SPEA2+ and NNIA2, were implemented, validated and tested against a multi-objective optimisation problem of a miniature plant. Final populations yielded from all the algorithms were included in an analysis. The results of this study indicate that external populations are important in order for algorithms to find optimal solutions in multi-objective optimisation problems with a discrete and highly discontinuous decision spaces.

In low-income countries where maternal and child mortality remains high, there is limited use of context-specific evidence for decision making and prioritization of interventions in the planning process at the sub-national level, such as the district level. Knowledge on the utility of tools and interventions to promote use of district-specific evidence in the planning process is limited, yet it could contribute to the prioritization of high-impact interventions for women and children. This thesis aims to investigate, in the planning process, the use of district-specific evidence to identify gaps in service delivery in the district health system in Uganda in order to contribute to improving health services for women and children. Study I evaluated the use of the modified Tanahashi model to identify bottlenecks for service delivery of maternal and newborn interventions. Study II and III used qualitative methods to document the experiences of district managers in adopting tools to facilitate the utilization of district-specific evidence, and the barriers and enablers to the use of these tools in the planning process. Study IV used qualitative methods, and analysis of district annual health work plans and reports. District managers were able to adopt tools for the utilization of district-specific evidence in the planning process. Governance and leadership were a major influence on the use of district-specific evidence. Limited decision space and fiscal space, and limited financial resources, and inadequate routine health information systems were also barriers to the utilization of district-specific evidence. Use of district-specific evidence in the planning process is not an end in itself but part of a process to improve the prioritization of interventions for women and children. In order to prioritize high impact interventions at the district level, a multifaceted approach needs to be taken that not only focuses on use of evidence, but also focuses on broader health system aspects like governance and leadership, the decision and fiscal space available to the district managers, limited resources, and inadequate routine health information systems.