Suchergebnisse

This study examined the role of an international Agency (USAID) and Democratic Election; A Prognosis to the role of Security Personnel in Nigerian 2015 Elections. USAID and other international Agencies have relentlessly assisted both the emerging and consolidating democracies such as Nigeria, in conducting free and fair elections via provision of some forms of technical assistance so as to achieve credible elections and ensure improved governance but in spite of all these, events and happenings from developed democracies and across the globe have shown that the vitality of election security to the credibility of elections cannot be ignored because the conduct of free and fair elections to a large extent depend on the security system available in the country. This study anchored on Elite theory propounded by Paredo and Gaetano with descriptive qualitative method of data collection and Content analysis. It discovered that the fact that consistently undermined democratic consolidation in Nigeria is the varying degrees and measures of electoral violence so it therefore recommends that impartial and unbiased security agencies should be recruited for each election in order to prevent the reoccurrence of electoral violence during each election.

Myanmar is currently faced with conflicts mainly considered as crimes against humanity that require resolution sooner or later. The conflict in Myanmar is closely linked to ethnicity, creating a cycle of violence that continues to escalate without any possibility of diminishing. The inability of the state to address ethnic minority grievances or provide adequate security to communities has created a literal arms race among minority groups. More action needs to be taken to finally resolve the situation and crisis unfolding in Myanmar, and that is where countries in Southeast Asia play a very important role for conflict resolution. This research was carried out using qualitative method with descriptive analysis regarding to the situation that occurred in Myanmar, especially regarding the Rohingya crisis and the Myanmar Military Coup which was the focus of the research. The escalation of the humanitarian conflict and the deprivation of democracy by the Myanmar people, requires joint handling in order to avoid further expansion of the conflict. In this case, neighboring countries such as Indonesia have an important role as a driver of mediation in regional forums to resolve conflicts in Myanmar. ASEAN, as a diplomatic platform in the Southeast Asian region, must be put forward and reach a consensus for finally intervening in the Myanmar conflict, which is taking more and more lives. The United Nations with the principle of responsibility to protect can also play a role in overcoming the conflict, considering that the conflict has resulted in crimes against humanity that cannot be tolerated.

Global developments that are full of dynamics are marked by the emergence of interdependence between countries. Global developments are in line with the development of science and technology which causes countries to seem borderless. The blurring of boundaries between countries and the development of an increasingly dynamic environment are also accompanied by the development of increasingly broad and multidimensional threats. This global development is also marked by the emergence of new actors in international relations. The development of threats and increasing global issues that cannot be handled by the state alone have created a new phenomenon in the international relations order, namely global governance. Previously, the state was the sole actor in the order of international relations. However, with global governance, there is a new arrangement in the international relations system that accommodates all actors who play a role. This research will use a qualitative phenomenological method. The theory used in this research are global governance, defense diplomacy and international organization as a basis theory and concept, and also a security theory as supporting theory. In the end, we can see that the change of international order can bring the positive effect for countries in achieving their national goals and accomplish their national interests.

Raportissa tarkastellaan sotilaallisen t&k-panostuksen ja kilpailukyvyn välisiä yhteyksiä. Aineistona käytetään brittiläisen International Institute for Strategic Studies -laitoksen (IISS) "The Military Balance" -raportin tietoja länsimaiden sotilaallisen t&kpanostuksen kehityksestä. Julkisen vallan sotilaallisia t&k-panostuksia verrataan maiden julkisiin siviilipuolen t&k-menoihin, sotilaallisiin hankintamenoihin, sekä suhteessa maiden BKT:hen ja puolustusbudjetteihin. Raportissa on mukana myös tiivis katsaus sotilaallisen t&k-panostuksen ja tuottavuuden välistä yhteyttä kuvaavista kansainvälisistä tutkimuksista. Raportin tulosten mukaan sotilaallisella t&k-panostuksella ja kilpailukyvyllä ei ole suoraa yhteyttä. ; This study discusses the relationship between military R&D and competitiveness. The study is based mainly on a British International Institute for Strategic Studies -institutes publication "The Military Balance", and furthermore its information about the development of Western countrye´s military R&D-stakes for the years 1994 -2001. Government military R&D is compared for government R&D, defence expenditure and also to the countries gross domestic product and defence budgets. The study also includes tight review about the previous international studies, which are focused to study the relationship between military R&D and productiveness. The study concludes, that there are no direct connection between military R&D and competitiveness.

The Industrial Revolution 4.0 (IR4.0) is taking shape and has a strong impact on all areas of social life. For the state administration, the IR4.0 creates many opportunities as well as challenges that require managers to promptly grasp to have appropriate orientations and solutions, to perfect the state administration, to meet the requirements of national development. On the basis of analyzing the positive effects and challenges of IR4.0 on the reform of the state administration, the article proposes a number of recommendations: actively improve the institutional system of the administration, create a legal corridor for the development of industries and fields; promote the application of modern technological achievements to the management activities of administrative agencies; actively, proactively build and improve the qualifications and capacity of civil servants. Thereby, it will continue to perfect the state administration, and meet the requirements of IR4.0.

Critical discourse analysis (CDA) is previously not a homogenous model, nor a school or a paradigm, but at most a shared respective in doing linguistics, semantics, or discourse analysis. The objective of CDA is to perceive language use as social practice. The researchers in this paper have done this at the 58th session of the UN General assembly, New York. The theoretical framework used for the analysis is Fairclough's model, 1992. This research paper has analysed the data qualitatively. This research work has explained and clarified the intellectual and invulnerable strategies, ideologies of President Musharraf, Pakistani president for global, political, economic, social and cultural development not only for his own country but for the entire world, especially developing countries. CDA of G-P-M speech shows that his motto is peace, security and development of human rights, implementation of international law, social justice for everyone and multilateral diplomacy by the support of the war on terror and cooperation with the international community. Pervaiz Musharaf has presented a positive and soft image of Pakistan.

This paper is an analysis of the foreign Aid Policies of two OECD Development Assistance Committee member countries – Finland and Ireland. The analysis reveals that both Finland and Ireland share high principles on their relations with the developing world, although their current policy outlooks appear to differ significantly. Despite Finland's good economic performance and prosperity largely generated by the global demand and market access, the government has so far failed to include the increasing of ODA on its priority agenda. In addition to the declining commitment, the selection criteria for Finnish aid recipients appears to be partially commercially motivated. Ireland on the other hand has a solid record of targeting the poorest of the poor with its development assistance and has recently increased development country focus in national policies. The challenge for Ireland is the effective utilisation of these funds and even more importantly keeping the government's public, international commitment to the 0,7 percent recommendation level despite the possible future slowdown of the economy.

India and Pakistan both are South Asian nuclear states, having a historical animosity that mainly stems from unresolved Kashmir issue. Both states realized the importance of peace therefore went for the negotiations after every battle. However, neither war nor negotiation could lead to the permanent solution. This article presents a critical analysis of the talks and negotiations held from 1998 to 2004 in order to restore peace and to resolve conflicts between both neighbors. The official documents i.e. declarations, agreements and recommendations of the CBMs have provided quite solid material for analytical discussion. Though a great desire of resolving all issues peacefully, including the issue of water and Kashmir through dialogue on both sides have been explored from this analysis, however the resilient elements prevail and deteriorate the peace process on both sides. The role of media has also been found negative in making public opinion. If the international law is implemented and the people of Kashmir are given their right of self-determination under the UNO resolutions both countries can live in peace and address their other issues

Ex ante assessment of regulatory impact upon businesses: A neo-institutional study on the context, international influences, and Finnish experiences Regulatory impact assessment (RIA) has an established place in the European Union and its member states. This article considers evolving Finnish ex ante RIA concerning certain regulatory costs to firms. Drawing upon a neo-institutional theoretical framework and proposing three generally oriented hypotheses we received the following results. (1) The rationality of theevolving Finnish ex ante RIA of selected administrativeregulatory costs to firms gives rise issuesgiven the low implementation rate of thegeneral natonal RIA guidelines. (2) Reference to the ex ante RIA of regulatory costs to firmsin other countries has served the legitimation of preferred procedures in Finland rather than offerssolid evidence on the rationality of the foreign procedures. (3) Without a stronger contextualization of the evolving Finnish ex ante RIAmof regulatory costs to firms its procedures risk adverse effects because of their confined scope, the uneven quality of their input data, and their weak connections to the general national ex ante RIA. These results suggest the redesign of the Finnish RIA to take better into account the institutional, political, historical and cultural characteristicsof governance in this country. Keywords: regulatory impact assessment, public policy evaluation, public policymaking, lawmaking, legal policy, deregulation ; Peer reviewed

: Energy diplomacy as a country's foreign policy agenda in securing access to international energy sources. The significance of energy for a country can always be a cause or proxy for its foreign policy or even its military actions. The plan for the development of nuclear power plants in Indonesia in support of the climate change program is based on global agreements and is able to provide a deterrent effect on national defense. However, until now the role of defense diplomacy in achieving national interests has not been optimal and its achievements are still limited to defense issues only (Sudarsono et al., 2018). This study aims to analyze the role of diplomacy on energy and defense, where diplomacy provides a first treat on energy, thereby realizing national energy security supported by defense diplomacy. This study uses a literature study to collect relevant data related to energy diplomacy, nuclear power plant development plans to support the NDC program, and defense diplomacy. The results of the study indicate that a diplomacy synergy is needed in achieving the national interest. Defense diplomacy can be synergized with energy diplomacy, which in this case is able to accelerate the development of nuclear power plants in Indonesia which provides a multiplier effect both in terms of energy security in the issue of climate change, even to the deterrent effect of Indonesian defense. The effect of diplomacy on energy indicates that diplomacy has a significant role in politics and the economy that a country's energy can create.

This article explores the significant role that the state is still expected to play in initiating and implementing the energy transition. In this regard, it is laid out in three parts. Part I focuses on the premise of the role that derives from constitutional law. This role is considered classic, because it is based on different functions of the state, and the legitimate constrain that distinguishes it from other social actors, including non-state actors. Tremendous materials are offered by the analysis either from the perspective of sociology or law studies when it comes to the specific situation of French-speaking African states. The scope of analysis is broadened with the energy law approach. With a focus on African English-speaking countries, the article examines both the way the state is enforcing statutes aiming to design its own transition scheme and exercising its discretionary power through its energy policy. Beyond the functions of the state—deriving from its sovereign power—these elements set out the direction in quest of a specific role the state can play in the energy transition as a process in Part II. As such, the energy transition, if it is to lead to coherent social change, requires strong and dynamic leadership, including clear, nuanced, and forward-looking direction on the broad sections of the overall process, and the environmental justice issues that necessarily cluster around them. For this reason, the role of the state is construed as both a steering role, and an integrative role for environmental, economic and social issues. Part III provides a rationale for the necessary and strong support of international cooperation—to the state—in order to achieve the paradigm shift smoothly. In Part IV, I emphasize the African Union's transition initiatives in the run-up to COP 25, which I hold out as an inducement for states' efforts. In fact, this article seeks to address these issues. Taken together, they could help build a coherent pattern of the role that African states play in the energy ...

Abstract The present study concerns the recruitment of foreign workforce in municipalities and private enterprises which provide local services. We scrutinize in which professions the workforce is required in the future. This research also focuses on ways how the employer can hire the best suitable foreign employees in the organization. As the final step the aim is to develop a model for recruitment of foreign workforce. This topic is currently interesting because of the increase of the share of older population and the decrease of available workforce in Finland in the near future. It is estimated that for example there will be 185 000-210 000 new jobs available in social and health care sectors during 2005-2020. The purpose of this dissertation is to increase the knowledge regarding the recruitment of foreign workforce in the municipality sector. The research was carried out using questionnaires for ten different organizations in Northern Ostrobothnia. These are Pudasjärvi, Kempele, Liminka, Muhos, Hailuoto, Sievi, Lumijoki and Tyrnävä municipalities, Mäntykoti ry in Oulu and the Family home Ojantakanen in Pulkkila. The main research question of this dissertation is: How the recruitment of foreign workforce can be carried out in the municipality sector? The theoretical background of the analysis is based on international human resource management and multicultural literature, knowledge about the quantities of foreigners, and demographic prognosis of population statistics. Methodologically the study is a qualitative study. The research method is content analysis based on research data. The data were collected during 2011-2013 using three questionnaires to municipality and business managers. According to the results of this research the organizations need further information on how to organize the recruitment of foreign workforce the best way. There is need for the recruitment of foreign workforce in the Northern Ostrobotnia, but there are no strategies of how to carry out work-based immigration, or the strategies are inadequate. The personnel and the managers need further education to learn how to meet and orientate foreign employees. ; Tiivistelmä Tutkimus käsittelee ulkomaisen työvoiman rekrytointia kuntiin ja kunnallisia palveluja tuottaviin yksityisiin yrityksiin. Työssä selvitetään, mille aloille työvoimaa tulevaisuudessa tarvitaan ja millä keinoilla työnantaja voi palkata sopivimmat ulkomaiset työntekijät organisaatioonsa. Lisäksi tutkimuksessa on tavoitteena kehittää ulkomaisen työvoiman rekrytointimalli. Aihe on ajankohtainen, sillä väestön ikääntyminen ja työvoiman tarjonnan väheneminen vaikuttavat lähivuosina Suomen työvoiman määrään. On arvioitu, että muun muassa sosiaali- ja terveyssektorilla avautuu 185 000–210 000 työpaikkaa vuosina 2005–2020. Väitöskirjatyön tarkoituksena on lisätä tietoa ulkomaisen työvoiman rekrytoinnista kuntasektorilla. Tutkimusaineisto kerättiin Pohjois-Pohjanmaalta kymmenestä eri organisaatiosta. Nämä ovat Pudasjärven, Kempeleen, Lumijoen, Limingan, Muhoksen, Hailuodon, Tyrnävän ja Sievin kunnat, Oulun Seudun Mäntykoti ry ja Ojantakasen perhekoti Pulkkilassa. Väitöskirjan keskeinen tutkimuskysymys on: Miten ulkomaisen työvoiman rekrytointi voidaan toteuttaa kuntasektorilla? Tutkimuksen teoreettinen tausta perustuu kansainvälisen henkilöstöjohtamisen sekä monikulttuurisuuden kirjallisuuteen ja väestötilastoihin liittyviin demografisiin ennusteisiin. Tutkimusote on laadullinen. Tutkimusmenetelmänä käytettiin aineistolähtöistä sisällönanalyysiä. Tutkimusaineisto kerättiin vuosina 2011–2013 kolmella kunta- ja yritysjohtajille suunnatulla kyselyllä. Tutkimustulosten mukaan organisaatiot tarvitsevat lisätietoa siitä, mikä on paras tapa toteuttaa ulkomaisen työvoiman rekrytointi. Pohjois-Pohjanmaalla on tarvetta ulkomaisen työvoiman rekrytoinnille, mutta suunnitelmia työperäisen maahanmuuton toteuttamiseksi ei ole tai ne ovat puutteellisia. Henkilöstö ja esimiehet tarvitsevat koulutusta ulkomaalaisten työntekijöiden kohtaamiseen ja perehdyttämiseen.

Tutkimuksessa selvitetään, missä määrin työpaikkojen työsuojeluvalvontaa toteutetaan alueellisesti eri tavalla eli toteutuuko valvonta työpaikoilla yhtenäisesti eri puolilla Suomea. Tutkimuksen ennakko-oletuksena on, että merkittävä syy työsuojeluvalvonnan alueelliseen erilaisuuteen on valvonnan organisointi viiden itsenäisen aluehallintoviraston työsuojelun vastuualueen tehtäväksi. Työsuojeluhallintoa ja työsuojeluvalvonnan toteutumisen yhtenäisyyttä työpaikoilla ei ole tutkittu tieteellisesti 2000-luvulla. Tämä tutkimus arvioi työsuojeluhallinnon rakennetta ja valvonnan toteutumista sekä hallinnon että työpaikkojen näkökulmasta. Tutkimus antaa sekä tieteellisesti perusteltuja teoreettisia että hallinnon asiakkaiden näkökulmia työsuojeluhallinnossa käynnissä olevaan valvonnan yhtenäistämiskehitykseen. Tutkimuksen teoreettisena viitekehyksenä on hallinnon evaluaatiotutkimus, joka tarkoittaa hallinnon toimivuuden arviointia käyttäjä- ja asiakasnäkökulmasta. Työsuojeluhallinto toteuttaa työpaikoille kohdistuvaa työsuojeluvalvontaa työsuojelutarkastuksina, jolloin hallinnon asiakkaita ovat työpaikat ja niiden työnantajat ja työntekijät. Pääasiallisena tutkimusaineistona ovat valvontatietojärjestelmä Veran raportit ja niistä tehdyt 27 valvonnan alueellista vertailua sekä henkilöhaastattelut, jotka kohdistuvat 52:een työsuojeluhallinnon, työmarkkinajärjestöjen ja työpaikkojen työsuojeluhenkilöön. Tutkimuksessa on kolme päälukua: työsuojeluhallituksen aika 1973-1993, itsenäisten alueellisten työsuojeluviranomaisten aika vuodesta 1993 lähtien sisältäen työmarkkinajärjestöjen roolin työsuojeluvalvonnassa ja valvonnan alueellinen vertailu. Tutkimusmatkani kohti yhtenäistä työpaikkojen työsuojeluvalvontaa alkoi työsuojeluhallituksesta, joka perustettiin vuonna 1973 osana hyvinvointivaltion rakentamista ja valtiojohtoista suunnitteluoptimismia. Valtiollinen työsuojelu koottiin yhden ministeriön alaisuuteen. Työsuojeluhallituksen aikana oli keskusjohtoinen, ainakin osittain yhtenäinen työsuojeluvalvonta, mutta keskusviraston toiminta ei onnistunut, koska työnantajat vastustivat sitä koko ajan pitäen sen toimintaa konspiratiivisena, vehkeilevänä. Työsuojeluhallitus lakkautettiin vuonna 1993 osana keskusvirastojärjestelmän purkamista 1990-luvun alun taloudellisen laman seurauksena. Valtion harjoittamaa sääntelyä purettiin hallinnon kaikilla sektoreilla, ja hallintoa madallettiin lähemmäksi asiakasta. Valtion merkitystä vähennettiin koko yhteiskunnassa ja hyvinvointivaltiosta tehtiin kilpailuvaltio, jolloin markkinaliberalismi ja New Public Management voimistuivat. Työsuojeluhallituksen lakkautuksessa tehtiin ehkä muutakin politiikkaa; pirstaloimalla valvovaa hallintoa heikennettiin samalla työpaikoille kohdistuvaa keskitettyä valvonnan voimaa. Itsenäisten alueellisten työsuojeluviranomaisten aikana vuodesta 1993 lähtien entisten työsuojelupiirien ja nykyisten aluehallintoviraston työsuojelun vastuualueiden toiminnallinen itsenäisyys korostui. Hallinnon toiminnassa näkyy, ettei työsuojeluvalvonnalla ole yhteistä keskusjohtoa. Sosiaali- ja terveysministeriön työ- ja tasa-arvo-osasto, jonka alaisuuteen työsuojelu keskushallinnossa kuuluu, toteuttaa Kansainvälisen työjärjestön ILO:n (International Labour Organization) sopimusten tulkintaa, että työsuojeluhallinto on riippumaton valvontatehtävää suorittaessaan eikä ministeriö siten puutu valvonnan alueellisiin menettelytapoihin. Tutkimus käsittelee myös työsuojeluhallinnon laajaa yhteistyötä työmarkkinajärjestöjen kanssa. Järjestöt osallistuvat kaikkeen päätöksentekoon, jossa käsitellään hallinnon tavoitteita, painopisteitä, valvontaohjeita ja resursseja. Tutkimuksessa arvioidaan edustuksellisen demokratian näkökulmasta korporatiivisen etujärjestövaikutuksen ja hallinnon suhdetta riippumattoman työsuojeluvalvonnan päätöksenteossa ja toimeenpanossa. Tarkastuskertomuksiin perustuva alueellisen valvonnan vertailu osoittaa, että työsuojeluvalvonta on eriytynyt vastuualueittain. Työpaikkojen kunnossaolo määritellään usein eri tavalla, joten tarkastajien valvoma työturvallisuuden minimitaso ei toteudu yhdenmukaisesti koko maassa. Siten velvoitteita korjata tai poistaa työturvallisuusepäkohtia annetaan eri tavalla ja lopputuloksena on se, ettei työnantajia kohdella tasapuolisesti. Tutkimuksen johtopäätöksenä on, että työsuojeluvalvonta on osa kansallista hallintotoimintaa ja laillisuusvalvontaa, ei alueellista tai paikallista hallintoa. Työsuojelu ei eroa toimialoittain maantieteellisesti, koska eri ammattialojen työ on pääpiirteissään samanlaista koko maassa ja niiden työturvallisuus ei juurikaan eroa maantieteellisesti. Tämän vuoksi myös työsuojeluvalvonnan pitäisi olla yhdenmukaista koko maassa. Suomeen pitäisi perustaa Pohjoismaiden mallin mukainen työsuojelun keskusorganisaatio, joka koordinoisi yhtenäistä laillisuusvalvontaa samalla tavalla kuin Poliisihallitus, Syyttäjälaitos ja uusi Tuomioistuinvirasto koordinoivat toimialojensa laillisuusvalvontaa ja toiminnan menettelytapoja. ; This study examines the extent to which workplace occupational safety and health (OSH) enforcing is carried out differently across the Finnish regions, in other words whether workplace enforcing is uniform across Finland. The presupposition of the study is that an important reason for the regional disparity in labour inspection is the decentralized organization of the inspection to by the five independent divisions of occupational health and safety of the regional state administrative agency. The OSH administration and the uniformity of the implementation of OSH in the workplace have not been scientifically studied in the 21st century. This study assesses the structure and implementation of the OSH administration from the perspective of both the administration and the workplace. The study provides a scientifically justified analysis covering both theoretical and customers' perspectives on OSH management and the ongoing integration of health and safety enforcement. The chosen theoretical approach of the study is the administrative evaluation framework, which means assessing the functionality of administration from the user and customer perspective. The Labour Inspectorate carries out workplace safety inspections in the form of occupational safety inspections, whereby the customers of the administration are the workplaces and their employers and employees. The main research material are OSH inspection database Vera reports and personal interviews carried out with 52 persons in the job protection administration, labour organizations and employment OSH personnel. The study consists of three main empirical chapters: the Labour Protection Board, the Central Office 1973-1993, the independent Regional Labour Inspectorate since 1993, including the role of labour organizations in labour inspection and the regional comparison of labour inspection. Shift towards an integrated job labour inspection started with the Labour Protection Board which was established in 1973 as part of the construction of the welfare state during the era of optimism in state-directed planning State labour protection was brought together under one ministry. The Labour Protection Board the system was center-led, at least regarding uniform occupational health and safety enforcing, but the Board's operations were not successful, mainly because the employers were opposed to it throughout its existence. The Labour Protection Board was abolished in 1993 as part of the dismantling of the central office system that followed the economic recession in the early 1990s. State regulation in all sectors of government was decentralized and administration was brought closer to the customers. The role of the state was diminished in society as a whole and the welfare state became a competitive state, with neoliberalism and New Public Management becoming stronger. Other objectives were also part of the decision to abolish the Labour Protection Board; at the same time, the fragmentation of supervisory authorities weakened the efficiency of workplace control. The era of the independent regional labour inspectorates since 1993 underlines the functional independence of the former OSH Inspectorate and the current division of occupational health and safety of the regional state administrative agency. The operation shows that there is no common central management for labour enforcement. The Department for Work and Gender Equality of the Social and Health Ministry, which is responsible for occupational safety in central administration, interprets International Labour Organization (ILO) conventions as meaning that the labour administration is independent in carrying out its supervisory function. Thus, the Ministry does not interfere with regional control procedures. The study also deals with the extensive co-operation between the labour protection administration and the labour market organizations. Trade unions are involved in all decision-making concerning management objectives, priorities, control guidelines and resources. The study examines the influence of corporatist interest groups and the governance of occupational health and safety enforcing decision-making and implementation from the perspective of representative democracy. A comparison of regional control based on inspection reports shows that OSH control of occupational health and safety has varied between the regional divisions. The condition of workplaces is often defined differently, so the minimum level of occupational safety supervised by inspectors is not uniformly applied throughout the country. Thus, obligations to remedy or eliminate occupational safety deficiencies in workplaces are given different treatment and the result is that employees are not treated equally. The conclusion of the study is that health and safety control should be in the competence of national administration and judicial review, not regional or local administration. Occupational safety and health does not differ geographically by industry, as the work of the various occupations is broadly similar throughout the country and there is little geographical variation in occupational safety. For this reason, labour inspection should also be uniform throughout the country. Finland should set up the Nordic model of a more centralized OSH system, which would coordinate an integrated review of legality in the same way as the National Police Board, the Prosecutor's Office and the Court of Justice co- ordinate the law enforcement and operational procedures of their respective sectors.

VTT Symposium 191 ; Energian ja ympäristön leikkauskohdassa on viime vuosina tapahtunut suuria mullistuksia. Energiamarkkinat ovat vapautuneet ja osana kestävään kehitykseen pyrkimystä ekologinen ajattelu on saanut jalansijaa myös perinteisessä markkinataloudessa, tyyppiesimerkkinä vihreän sähkön käsite ja kierrätys. Ympäristöproblematiikassa on siirrytty megasarjaan, esimerkiksi ilmastokysymyksessä eletään suurten päätösten aikaa. Energia- ja ympäristöteknologian myynnissä myyjältä vaaditaan yhä enemmän osaamista. Tuotteiden käytön pitkäaikaiset ympäristöominaisuudet vaikuttavat ratkaisevasti kaupan syntyyn. Perinteisen kovan teknologian rinnalle tarvitaan uutta innovatiivista pehmoteknologiaa. SIHTI-ohjelma on paneutunut näihin kysymyksiin niin sanotuilla strategisilla selvityksillään. Ympäristönsuojelun ohjaukseen tarvittavaa tietoutta on luotu lukuisissa ympäristövaikutusten arvottamiseen liittyvissä hankkeissa sekä talouden ja ympäristönsuojelun optimia hakevissa selvityksissä. Yritystasolla tehtävää ympäristölaskentaa varten on luotu uusia työkaluja ja menetelmiä ja päästöpörssien monulotteisia vaiktuksia on analysoitu. Poliittisen päätöksenteon tueksi on kehitetty kasvihuonekaasujen kehitystä kuvaavia indikaattoreita ja analysoitu vaihtoehtoisten päästörajoitustekniikoiden kustannuksia ja tehokkuutta. SIHTI-ohjelmassa savukaasujen puhdistustekniikka-alueelle on syntynyt oma vahva tutkimuskokonaisuutensa, jonka ympärille on kehittynyt kansainvälisestikin arvostettuja tutkimusryhmiä. Pienhiukkasten tärkeimpiä päästölähteitä on kartoitettu, koostumuksia ja kokojakaumia mitattu ja erilaisia keinoja vaikuttaa pesureitten ja sähkösuodattimien erotustehokkuuteen tutkittu. Tutkimusryppääseen on kuulunut sekä teoreettisia mallinnuslaskelmia, laboratoriomitan laiteteknistä kehitystyötä että täyden mitan koetoimintaa. Osoituksena onnistuneesta panostuksesta on, että tutkimustuloksia on jo voitu hyödyntää kaupallisesti ja täyden mittakaavan laitetoimituksia ulkomaille on jo toteutettu. Uusia innovatiivisia teknisiä ratkaisuja ympäristöpäästöjen mittaamisella on myös kehitetty. Metsäteollisuuden ympäristövaikutusten hallinnan parantamiseksi on ohjelman puitteissa perusteellisesti mitattu ja mallinnettu haitallisten aineiden kulkeutumista eri virroissa ja prosessiyksiköissä sekä tutkittu ja kehitetty uusia säästävän teknologian ratkaisuja mm. sellutehtaan vesikiertojen sulkemiselle, viherlipeäsakan ja tuhkan hyödyntämiselle sekä siistauslietteen ja jätepaperin poltosta syntyvän tuhkan kierrättämiselle. Turvetuotannon valumavesien sekä pöly- ja melupäästöjen paremmalle hallinnalle on kehitetty uusia menetelmiä ja ohjeita, joita on jo otettu käyttöön. Vaihtoehtoisia ratkaisuja käytettyjen turvetuotantoalueiden jälkikäytölle on niin ikään tutkittu. Poikkitieteellisen lähestymistavan takia SIHTI-ohjelma on pyrkinyt tiedottamaan tutkimustuloksistaan mahdollisimman laajasti. Ohjelman vuosiseminaari ja sen yhteydessä pidettävät istunnot energiantuotannon päästöjen ympäristövaikutuksista, pienhiukkasten erottamisesta ja kiinteiden jätteiden hyötykäytöstä suovat oivallisen tilaisuuden niin esitelmänpitäjille kuin kuulijoillekin antaa oman panoksensa meitä kaikkia hyvin läheisesti askarruttavaan kysymykseen, mikä on oikea tie ja etenemistapa kestävään energiantuotantoon. ; Great revolutions have taken place in the intersection of energy and environment in recent years. The energy market has been liberated, and in part of sustainable development, an ecological pattern of thought has gained a footing in traditional market economy, typical examples being green electricity and recycling. As regards environmental problems, we have moved towards a mega-league; for example, we are living an era of great resolutions on environmental issues. More diversified knowhow is required from the sellers of energy and environmental technology. Long-term environmental impacts of the use of products are of decisive significance in business transactions. New innovative soft-line technology is required in addition to conventional hard technology. The Finnish National SIHTI Programme has attended to these issues via so-called strategic surveys. Knowledge required for the control of environmental protection was created in a number of projects on evaluation of environmental impacts and in assessments searching an optimum for economy and environmental protection. New tools and methods were developed for environmental accounting in enterprises, and diversified impacts of emission exchange were analysed. Indicators describing the development of greenhouse gases were developed and costs and efficiency of alternative technologies for limiting emissions were analysed to support political decision-making. In the SIHTI Programme, a strong research integrity was formed in the field of flue gas cleaning technology, and research groups with a high international esteem were also formed. Most significant emission sources of particulates were surveyed, their composition and particle size distributions were measured, and different tools of improving the separation capacity of scrubbers and electrical precipitators were studied. This research integrity included both theoretical modelling calculations, laboratory-scale equipment-technical development and full-scale testing. An indicator of successful focusing is that research results have already been utilised commercially, and industrial-scale equipment commissions have been executed. New innovative technical solutions for measuring emissions to the environment have also been developed. To improve the control of environmental impacts of the pulp and paper industry, the transportation of detrimental substances in different flows and process units were measured and modelled, and new solutions of non-waste technology were developed for closed water cycles in pulp mills, for the use of green liquor sludge and ash and for the recovery of ash from the combustion of deinking sludge and waste paper. In peat production, new methods and instructions were developed and introduced for the control of drainage waters and for dust emissions and noise problems. After-use alternatives for exhausted peat production fields were also studied. Due to the interdisciplinary approach, the SIHTI Programme has disseminated information about research results as widely as possible. The Annual Seminars of the Programme, and sessions on environmental impacts of emissions from energy production, separation of particulates, and utilisation of solid wastes have offered excellent opportunities to the lecturers and to the audience to bring their own contribution to the issue occupying our mind: what would be the right way of approaching sustainable energy production.

Pro gradu ­tutkielma koostuu seuraavista osista: Rouvinen, Kaisa. Lisääntymisterveydenhuollon haasteet ja naisten hyvinvointi vähiten kehittyneissä maissa. Tampereen yliopisto. Terveystieteen laitos. Kirjallisuuskatsaus. Osasuoritus Pro gradu ­tutkielmaan. 26 s. 2003 Rouvinen, Kaisa. Quality of care in reproductive health services at health posts in Nepal. International EuroQuan Conference on Quality and Nursing Practice. Proceedings. Norsk sykepleieforbund. 1997; 224-231. Rouvinen, Kaisa. Quality of care in reproductive health services at five government health posts in Siraha District, Eastern Nepal. A dissertation submitted to the University of Liverpool (School of Tropical Medicine) in partial fulfilment of the degree of Master in Community Health. 95 pages. 1996 ; 1. JOHDANTO 6 2. LISÄÄNTYMISTERVEYS KEHITYKSEN INDIKAATTORINA 7 3. NAISEN ELÄMÄN TÄRKEÄT JA KRIITTISET VAIHEET 10 3.1. RASKAUS JA SYNNYTYS - TURVALLISEN ÄITIYDEN TAVOITE 10 3.2. PERHESUUNNITTELU JA ABORTTI 15 3.3. HIV JA MUUT SUKUPUOLITAUDIT 17 3.4. LAPSETTOMUUS JA LAPSEN SUKUPUOLI 19 3.5. SUKUPUOLIELINTEN TRADITIONAALINEN SILPOMINEN 20 3.6. KÖYHYYDEN, TRADITIOIDEN JA OLOSUHTEIDEN MERKITYS 22 4. HAASTEET JA MAHDOLLISUUDET 23 LÄHTEET 26 QUALITY OF CARE IN REPRODUCTIVE HEALTH SERVICES AT FIVE GOVERNMENT HEALTH POSTS IN SIRAHA DISTRICT, EASTERN NEPAL ACKNOWLEDGEMENTS 1 TABLE OF CONTENTS III LIST OF TABLES VI LIST OF FIGURES VII LIST OF ABBREVATIONS AND ACRONYMS VIII GLOSSARY IX EXECUTIVE SUMMARY X CHAPTER 1. INTRODUCTION 1 1.1. THE CLIENT AND THE CONCERN 1 1.1.1. Save the Children US in Nepal 1 1.1.2. Save the Children Siraha project 1 1.1.3. Problem statement 2 1.2. THE STUDY 2 1.2.1. Study question 2 1.2.2. Aim and objectives of the study 2 1.2.1. Action plan and accomplishment of the study 3 1.3. STUDY LOCATION 4 1.3.1. Nepal 4 1.3.2. Siraha District 4 CHAPTER 2. LITERATURE REVIEW 6 2.1. GLOBAL VIEWS OF WOMEN'S HEALTH 6 2.2. PRIMARY HEALTH CARE IN NEPAL 8 2.2.1. Safe Motherhood and Family Planning 8 2.3. QUALITY IN HEALTH CARE 10 2.3.1. What is quality? 10 2.3.2. Approaches to assessment of quality in health care 10 2.4. SELECTED ISSUES IN QUALITY OF HEALTH CARE 14 2.4.1. The structure of the health care and its relevance in quality assessment 14 2.4.2. Health care providers' job motivation and its impact on quality of health care 15 2.4.3. User satisfaction 16 2.5. CONCLUSION 17 CHAPTER 3. METHODOLOGY 19 3.1. EVALUATION OF HEALTH POST FACILITIES AND SERVICE ARRANGEMENTS 20 3.1.1. Study location 20 3.1.2. Selection of health posts 20 3.1.3. Issues and variables used to explore the objective 20 3.1.4. Tools and strategies of data collection 20 3.2. EXPLORING HEALTH CARE PROVIDERS' PERCEPTIONS ABOUT THE QUALITY OF CARE 21 3.2.1. Study population 21 3.2.2. Selection of informants 21 3.2.3. Issues and variables used to explore the objective 21 3.2.4. Tools and strategies of data collection 21 3.3. DESCRIBING THE LEVEL OF USERS' SATISFACTION 22 3.3.1. Study population 22 3.3.2. Selection of informants 22 3.3.3. Issues and variables used to explore the objective 22 3.3.4. Tools and strategies of data collection 23 3.4 ADDITIONAL DATA COLLECTION METHODS 24 3.5. PRE-TESTING AND TRANSLATION 24 3.6. DATA HANDLING AND STORAGE 25 3.7. DATA ANALYSIS 25 3.8. QUALITY ASSURANCE AND ENCOUNTERED CONSTRAINTS IN DATA COLLECTION 25 CHAPTER 4. RESULTS 27 4.1. EVALUATION OF HEALTH POST FACILITIES AND SERVICE ARRANGEMENTS 27 4.1.1. Location and accessibility 27 4.1.2. Target population and service statistics 27 4.1.3. Sub-health posts, outreach clinics and staffing 28 4.2.4. Waiting facilities at health posts 28 4.1.5. Rooms for counselling and MCH and FP services 28 4.1.6. Infection prevention 29 4.1.7. Equipment and instruments for use in MCH and FP 29 4.1.8. Availability of contraceptives and essential medicines 29 4.1.9. IEC material and activities 29 4.1.10. Record keeping and reporting 30 4.1.11. Health post management and supervision 30 4.1.12. Conclusion 30 4.2. HEALTH CARE PROVIDERS' PERCEPTION ABOUT THE QUALITY OF CARE 31 4.2.1. Job satisfaction and experience as a health care provider 31 4.2.2. Health workers' perception of what is good quality in health care 32 4.2.3. Health workers' perception about users' expectations 33 4.2.4. Health workers' suggestions for improvement of health care 33 4.2.5. What are the specific reasons for low utilisation of FP and AN services 34 4.2.6. Conclusion 35 4.3. QUALITY OF CARE FROM THE USERS' POINT OF VIEW 35 4.3.1. The sample 35 4.3.2. Perceptions of the quality of care 37 4.3.3. Suggestions for improvement for the quality of care at a health post 40 4.3.4. Conclusion 40 4.4. SUMMARY OF RESULTS 41 CHAPTER 5. DISCUSSION 43 5.1. IMPACTS OF STRUCTURE OF HEALTH CARE ON QUALITY OF THE SERVICE 43 5.1.1. Accessibility 43 5.1.2. Clinical settings and procedures 44 5.1.3. Service arrangements 44 5.2. HEALTH WORKERS' ROLE 47 5.2.1. Users' expectations contradicting providers' perceptions 47 5.2.2. Implications of health workers' perceptions for improvement of quality 48 5.2.3. Job motivation 48 5.2.4. Quality assurance cycle 50 5.3. CONCLUSIONS 50 5.4. COMMENTS ON METHODS USED IN THE STUDY 51 CHAPTER 6. RECOMMENDATIONS 53 REFERENCES 54 APPENDICES APPENDIX 1 PHOTPGRAPHS: WALL PAINTINGS AND TBA TRAINING 58 APPENDIX 2 MAPS OF NEPAL AND SIRAHA DISTRICT 59 APPENDIX 3 INVENTORY FORM FOR HEALTH POST FACILITIES 60 APPENDIX 4. BACKGROUND VARIABLES 70 APPENDIX 5.A STRUCTURED QUESTIONNAIRE FOR USER EXIT INTERVIEW 71 APPENDIX 5.B MAITHALI TRANSLATION OF THE QUESTIONNAIRE 75 APPENDIX 6 EVALUATION OF HEALTH POST FACILITIES AND SERVICE ARRANGEMENTS 79 APPENDIX 7. FINDINGS FROM HEALTH PERSONNEL IN-DEPTH INTERVIEWS 84 APPENDIX 8. USERS' EXPRESSIONS OF THE QUALITY OF CARE. QUOTATIONS. 85