Sosiaalihistoria: johdatus tutkimukseen
In: Käsikirjoja. Suomen historiallinen seura 12
In: Käsikirjoja. Suomen historiallinen seura 12
In: Acta Universitatis Tamperensis. Ser. A 152
In: Suomalaisen Kirjallisuuden Seuran Toimituksia
The volume is a comprehensive handbook of oral history and memory studies in Finland. The Finnish research field has originally emerged at the collaborative intersection of history, folklore studies, and ethnology. Since then, this field has developed into vibrant multi- and cross-disciplinary arena characterized by a strong focus on methodological issues related to memory in culture and theoretical engagement with studies on narration and processes of remembering. The chapters of the book explore the perspectives on the production of memory-based knowledge in oral history interviews and collection campaigns of written reminiscences. Moreover, the book introduces versatile methodological approaches to the study of memory and memories, ranging from narrative to corpus analysis, and investigates the multiple media of remembrance from documentary film to museum exhibition. The chapters of the book also engage the field's disciplinary position and interrogate the potentials and challenges related to the application of the methods of oral history research and the use of memory-based knowledge beyond academia in political, societal, and community-based projects.
In: Suomalaisen Kirjallisuuden Seuran toimituksia 797
In: Kalevalaseuran vuosikirja
The theme and title of the 100th Yearbook of the Kalevala Society is "Paradigm". Paradigm is a framework of prevalent principles, beliefs, values, and norms, and incorporates ideas about what is correct in terms of theory and methodology. Accordingly, paradigm always leads to struggles of authority in relation to other trends and ways of thinking. This book grapples with the historical, contemporary, and ever-shifting paradigms and methods of cultural research. What was being researched in the early 20th century and how was the research conducted? What happened in the 1960s–1980s in this field of research? What methods do our peers use? What kinds of affiliations and antagonisms emerge with the changing paradigms? And how do the different 'turns' direct research?
Tutkimuksen kohteena on kokonaisturvallisuus julkisena toimintapolitiikkana, ja sitä tarkastellaan sekä monimutkaisena ja yhteenkietoutuneena ilmiönä että turvallisuuspoliittisena strategiana. Kokonaisturvallisuus on laajaan turvallisuuskäsitteeseen perustuva, aiemmasta kokonaismaanpuolustuksen käsitteistöstä ja strategiasta kehitetty toimintapolitiikka, jolla tavoitellaan kokonaisvaltaista yhteiskunnallisen turvallisuuden hallinnan mallia. Tutkimuksen päämääränä on analysoida kokonaisturvallisuutta systeeminä, arvioida sen kelpoisuutta, toteutettavuutta ja edellytyksiä vastata turvallisuusympäristön muutoksiin. Tutkimus on metodologisesti laadullinen. Aineistona ovat suomalaiset kokonaisturvallisuuden alaan liittyvät erilaiset ja eritasoiset strategiat, ohjelmat ja muut dokumentit, ja toimintaympäristöön ja sen muutokseen liittyvät Euroopan unionin strategiat ja ohjelmat. Teoriaviitekehys perustuu Niklas Luhmannin systeemiajatteluun, jossa systeemin perusrakenteita ovat kommunikaatio, tieto ja merkitykset, ja joka korostaa valintoja kompleksisuuden hallinnan välineinä. Ajattelussa korostuu myös huiputon ja keskukseton yhteiskunta. Prosessimaisen otteensa vuoksi tutkimus kiinnittää huomiota yksittäisten osatekijöiden tai toimijoiden sijaan prosessiin ja kokonaisuuden systeemisyyteen, mikä korreloi sekä kokonaisturvallisuuden tavoitteiden että kompleksisuuden vaatimusten suhteen. Kokonaisturvallisuuden analyysi sekä tunnistaa tutkimuksessa sen kehittämiseen liittyneen merkityskamppailun, että tuo esiin käsitteen epäselvyyden, epäanalyyttisyyden ja "jaetun merkityksen" puuttumisen, mikä heijastuu strategian ohjaavaan vaikutukseen sekä siihen, miten politiikkaideaa on kehitetty. Kokonaisturvallisuuden politiikkaidea on sinällään laajasti hyväksyttävä ja sillä on positiivista valenssia. Yhteistyön ja koordinoinnin korostamisella uskotaan olevan kokonaisuuden hallintaa kehittävä vaikutus. Turvallisuuden kokonaisuuden koordinointitarve onkin jo pelkästään uhkien keskinäisriippuvuuden vuoksi ilmeinen. Poliittista kelpoisuutta haittaavat kokonaisuuden strategisen ohjauksen ohuus ja hajanaisuus, mikä näkyy erityisesti yhteensovittavan tehtävän vaikeutena. Monet systeemin rakenteellisista peruselementeistä ovat jääneet kokonaisturvallisuuden kehittämisessä vähälle huomiolle. Tutkimuksen mukaan tämä vaikeuttaa sen toteutettavuutta. Kokonaisturvallisuuden hallinnassa olennaista on keskinäisriippuvuuksien ja systeemisyyden tunnistaminen ja hallinta. Tutkimuksen tulosten avulla kokonaisturvallisuutta systeemisenä turvallisuuden hallinnan mallina voidaan kehittää ja edistää. Tutkimus päätyy suositukseen kokonaisturvallisuuden kehittämisen ratkaisumallista (ns. älykkään adaptiivisen kompleksisen turvallisuussysteemin idean avulla). Tutkimus tarjoaa eväitä myös uusien kokonaisturvallisuutta koskevien poliittisten linjausten ja politiikkatoimien muotoilulle. ; The main objectives of this study are to clarify and deepen the understanding of the phenomena of comprehensive security and to analyze and evaluate the political viability and administrative operability. Furthermore, the study aims to analyze comprehensive security as a political process and a complex system. In addition, the research deals with changing security environment, emerging security threats. Originally, the concept of comprehensive security derived from the previous concept of comprehensive defense and preparedness in Finland, but it also has roots in the Nordic states' cooperation processes of civil security since 2009. At policy and doctrinal levels, the 2000s saw a converging trend in Nordic states to-wards the definition of societal or comprehensive security concepts that might co-exist with military-led planning for war-time, but within which the softer aspects of security were paramount. The "societal" approach defines the protection of society as a whole – with its own complex mechanisms, values and culture – as its goal, rather than physical boundaries or the isolated and abstract individual. It also rec-ognizes the capacity of non-state actors within society, from businesses to social organizations and individuals, to play a large role themselves in warding against, coping with, and recovering from disasters. The research questions are: 1. What is comprehensive security like as a policy or meta-strategy, political process and complex system? 2. Is the comprehensive security policy or meta-strategy politically viable and administratively feasible? What kind of conditions the strategies (policies) provide for the administrative operability and the development of capabilities? The theory framework is based on Niklas Luhmann's systems and complexity thinking. Luhmann perceives society as centerless and topless system in which communication, information and meanings are considered as the basic elements. The aim of communication is to cause action in systems and formulate new system levels by creating new chains of communication. The empirical part of the research is established on the methodology of concept analysis, content analysis and policy-analysis. The policy-analysis was conducted by the method of political reading. Political reading can be characterized as 'de-mapping', which refers to opening up new aspects of contingency and thus ex-panding of the presence of the political therein (Palonen 1993: 13-15). Through the analysis of the political process the struggle of meanings was iden-tified. As a concept, comprehensive security is ambiguous, unanalytical and unclear. There is a lack of shared meanings, which reflects on how difficult it is to steer the comprehensive security. By emphasizing its cooperative and coordinative nature, is believed to promote better governance of security. However, the lack of steering hampers the political viability which the difficulties of the coordination clearly indi-cate. Many of the basic elements of a system (information/knowledge, communica-tion and meanings) have been ignored in the development of comprehensive secu-rity. This hampers its administrative operability. The study emphasizes that systemic instruments, systems intelligence, identified interdependence and systemic nature of threats and security environment are essential components of comprehensive security governance. The research produced also 10 normative conclusions, by which the compre-hensive security can be developed further with. In addition, it gives the recommen-dation for the development of a model, according to the idea of intelligent adaptive complex system. It also offers information for new political aligning and policy formulations. Due to the process approach of the research, it pays attention to societal security system as a whole, not to single functions or actors. This fits to-gether with the goals set for comprehensive security and the requirements the se-curity environment and complexity imposes.
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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
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