Staff Publications

Staff Publications

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    'Staff publications' is the digital repository of Wageningen University & Research

    'Staff publications' contains references to publications authored by Wageningen University staff from 1976 onward.

    Publications authored by the staff of the Research Institutes are available from 1995 onwards.

    Full text documents are added when available. The database is updated daily and currently holds about 240,000 items, of which 72,000 in open access.

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    The tree under which you sit : district-level management and leadership in maternal and newborn health policy implementation in the Greater Accra Region, Ghana
    Kwamie, A. - \ 2016
    Wageningen University. Promotor(en): Han van Dijk; I.A. Agyepong. - Wageningen : Wageningen University - ISBN 9789462576742 - 158
    health policy - birth - pregnancy - policy - management - administration - ghana - west africa - gezondheidsbeleid - geboorte - zwangerschap - beleid - bedrijfsvoering - bestuur - ghana - west-afrika

    Health system governance has to do with decision-making – who makes decisions, when, where, how and why. At the district level – the level of care which operationalises health policies – governance is critical, yet remains little understood. Governance has the ability to influence health system performance, and this is essential in maternal and newborn health, where timely decisions are required to support policy implementation. In this regard, district managers are particularly important. They are the link in the middle of the health system, connecting top-end policy formulation to bottom-end implementation. Their abilities to interpret, translate, support and challenge policy will have an effect on what gets operationalised. However, capacity weaknesses in district management and leadership are often cited as a factor in poor health system performance.

    This thesis seeks to deepen understandings of district-level management, leadership and decision-making for policy and programme management and implementation for maternal and newborn health. Within this, the thesis also seeks to understand the scope for change that an intervention to strengthen management and leadership capacities can bring.

    This thesis contributes to the applied field of health policy and systems research by drawing on policy implementation theory, organisational management theory and complexity theory as its theoretical basis. A realist approach methodology was undertaken to understand the contexts in which district managers are embedded, how this influences their decision-making, and what the effects of a managerial intervention are, given these contexts. The thesis followed an embedded case study flexible design. The first case study was an exploratory qualitative case study to understand how and why district managers make decisions in maternal and newborn health policy implementation. The second case study was an historical case study of district manager decision-space over time. The third case study was an explanatory qualitative case study of the management and leadership intervention. The final validation of our theorising throughout the cases was achieved through the administration of a questionnaire across all district health management teams of the Great Accra Region.

    This thesis demonstrates that district managers find themselves in contexts of strong hierarchical authority and resource uncertainty – in particular, lacking financial transparency. This promotes a management and leadership typology which attunes managers towards serving the health system bureaucracy, resulting in reduced district-level responsiveness to maternal and newborn health challenges. The outcome is that district manager decision-space is narrow surrounding resource allocation decisions, and this in turn affects local planning programming and management.

    The thesis further demonstrates that broader patterns of centralised governmental decision-making have affected the development of the district health system over time. Particularly, the sequencing of decentralisation processes has ensured that national-level decision-making has remained empowered in contrast to district-level decision-making. System fragmentation – through reduced Government of Ghana funds and increasingly verticalised donor funds – has also been a contributor. This accounts for the observed hierarchical authority and resource uncertainty which affects district managers. As a result of these contexts, this thesis also showed that an intervention to strengthen management and leadership capacities was limited in its sustainability.

    This thesis raises the issues of health system organisation as critical to the potential of district management and leadership effectiveness. It provides evidence that weaknesses in district management and leadership arise out of the organisational governance mismatches in autonomy and responsibility. It suggests that in strengthening management and leadership, approaches which seek to address organisational capacities, not only individual capacities, are needed to convey sustainable change. Advancements in this regard have the scope to improve district manager decision-making for maternal and newborn health policy and programme implementation in the future.

    Pupping habitat ofd grey seals in the Dutch Wadden Sea
    Brasseur, S.M.J.M. ; Groot, A.V. de; Aarts, G.M. ; Dijkman, E.M. ; Kirkwood, R.J. - \ 2015
    Den Burg : IMARES (Report / IMARES C009/15) - 104
    halichoerus grypus - habitats - whelping - birth - vegetation - geomorphology - wadden sea - halichoerus grypus - habitats - jongen werpen - geboorte - vegetatie - geomorfologie - waddenzee
    Atlantic grey seals (Halichoerus grypus grypus) started recolonising Dutch coastal haul-outs in the 1950s, after practically 500 years of rarity in the Dutch coastal zone which was caused mainly by human hunting. The first pup-birth was recorded in 1985 at the Wadden Sea sandbank of Engelschhoek. Sandbanks in the Wadden Sea may form and recede in periods of decades, but may change abruptly as a result of a single storm. These rapidly evolving places are not the perfect breeding habitat for grey seals, which exhibit long-term fidelity to breeding sites and only reluctantly shift. Little is known of the geomorphology of the currently utilised pupping sites, nor the implications of change in structure on future occupation and selection of new sites.
    Maternal and paternal infant representations: A comparison between parents of term and preterm infants
    Tooten, A. ; Hall, R.A.S. ; Hoffenkamp, H.N. ; Braeken, J. ; Vingerhoets, A.J.J.M. ; Bakel, H.J.A. van - \ 2014
    Infant Behavior and Development 37 (2014)3. - ISSN 0163-6383 - p. 366 - 379.
    disorganized attachment - early-childhood - insightfulness - birth - preschoolers - metaanalysis - narratives - resolution - behavior - emotion
    Objective: Research on parental attachment representations after preterm birth is limited and inconclusive. The present study is the first in which maternal and paternal attachment representations after term, moderately and very preterm birth are compared. In addition, special attention was directed toward disrupted attachment representations. Method: Mothers and fathers of term infants (>= 37 weeks of gestational age, n=71), moderately preterm infants (>= 32-37 weeks of gestational age, n = 62) and very preterm infants (
    Regio heeft grote invloed op levensvatbaarheid
    Pellikaan, F. ; Ouweltjes, W. ; Windig, J.J. ; Muskens, J. ; Linden, R. van der; Pelt, M.L. van; Calus, M.P.L. - \ 2014
    Veeteelt 31 (2014)14. - ISSN 0168-7565 - p. 10 - 13.
    melkveehouderij - kalveren - levensvatbaarheid - geboorte - vaarzen - grote landbouwbedrijven - bedrijfsgrootte in de landbouw - landbouwstatistieken - bedrijfsvergelijking in de landbouw - invloeden - dairy farming - calves - viability - birth - heifers - large farms - farm size - agricultural statistics - farm comparisons - influences
    Een afname van zes procent levend geboren kalveren van vaarzen tussen 1995 en 2010 was aanleiding voor nieuw sectoronderzoek. Uit de inventarisatie blijkt dat naast bekende factoren als draagtijd en geboorteverloop de regio waar het bedrijf is gehuisvest en het seizoen van afkalven zorgen voor opmerkelijke verschillen in levensvatbaarheid van kalveren.
    Random regression models in the evaluation of the growth curve of Simbrasil beef cattle
    Mota, M. ; Marques, F.A. ; Lopes, P.S. ; Hidalgo, A.M. - \ 2013
    Genetics and Molecular Research 12 (2013)1. - ISSN 1676-5680 - p. 528 - 536.
    covariance functions - variance-components - genetic-parameters - nellore cattle - birth - cows - traits - weight - age
    Random regression models were used to estimate the types and orders of random effects of (co)variance functions in the description of the growth trajectory of the Simbrasil cattle breed. Records for 7049 animals totaling 18,677 individual weighings were submitted to 15 models from the third to the fifth order including as fixed effects sex, contemporary group, feeding regimen, and type of reproduction and as random effects additive direct genetic effect, animal permanent environment, maternal additive genetic effect, and maternal permanent environment. The best-fit model presented order five to additive direct genetic effect, animal permanent environment, and maternal additive effect, with 6 classes of residual variances, and the maternal permanent environment effect was not significant, likely owing to the low average number of calves per cow. However, the model chosen for the growth curve presents three classes of residual variances, because even not showing the best fit
    Parental perceptions and experiences after childbirth: a Comparison between mothers and fathers of term and preterm infants
    Tooten, A. ; Hoffenkamp, H.R. ; Hall, R. ; Braeken, J. ; Vingerhoets, A. ; Bakel, H. van - \ 2013
    Birth 40 (2013)3. - ISSN 0730-7659 - p. 164 - 171.
    intensive-care-unit - clinical interview - premature-infants - transition - birth - risk - multicenter - children - home
    Background Parents experience a lot of positive and negative feelings and emotions after birth. The main purpose of this study was to compare perceptions and experiences of mothers and fathers with term, moderately and very preterm infants. Methods We included 202 infants with both parents, divided into three groups: 1) term infants (= 37 weeks’ gestation), 2) moderately preterm infants (=32–
    Ruimte voor natuurlijke geboorte
    Napel, Jan ten - \ 2012
    cattle husbandry - cattle - animal production - caesarean section - birth - pelvis - animal welfare - animal health - beef cattle
    Naar een probleemloos afkalvende dikbilkoe = Towards an easy-calving double-muscled cow
    Napel, J. ten; Hoving, A.H. ; Bohte-Wilhelmus, D.I. ; Hannewijk, P. - \ 2012
    Lelystad : Wageningen UR Livestock Research (Rapport / Wageningen UR Livestock Research 648) - 40
    rundveehouderij - vleesvee - dierenwelzijn - keizersnede - dierveredeling - selectief fokken - geboorte - dierlijke productie - diergezondheid - vleesveerassen - cattle husbandry - beef cattle - animal welfare - caesarean section - animal breeding - selective breeding - birth - animal production - animal health - beef breeds
    A measuring and breeding programme has been developed for easy calving doublemuscled beef cattle.
    Vijftig procent natuurlijk kalven is economisch te verantwoorden. Een kwestie van durf?
    Eilers, C.H.A.M. - \ 2012
    Veeteeltvlees (2012). - ISSN 1570-3312 - p. 10 - 13.
    rundveehouderij - vleesproductie - geboorte - dierenwelzijn - kosten-batenanalyse - agrarische bedrijfsvoering - cattle husbandry - meat production - birth - animal welfare - cost benefit analysis - farm management
    Meer natuurlijk afkalven vergt een gericht fokkerijbeleid en een andere houding van vleesveehouders ten opzichte van natuurlijk afkalven. In onderzoek is nagegaan of een gedeeltelijke omschakeling de economische resultaten in de praktijk onder druk zet.
    Natuurlijke geboorte extreme vleesrassen
    Napel, J. ten - \ 2012
    V-focus 9 (2012)5a. - ISSN 1574-1575 - p. 15 - 17.
    rundveehouderij - vleesvee - verbeterd roodbont - belgisch witblauw - dierveredeling - fokwaarde - geboorte - dierenwelzijn - dierlijke productie - cattle husbandry - beef cattle - improved red pied - belgian blue - animal breeding - breeding value - birth - animal welfare - animal production
    Dikbilkoeien die probleemloos natuurlijk afkalven is geen utopie. Na drie jaar voorbereidend onderzoek en vier jaar onderzoek in de praktijk binnen het project Natuurlijke Luxe is duidelijk hoe dat moet. Het belangrijkste is om met fokkerij de ruimte in het geboortekanaal te vergroten. Of dat ook gebeurt, is nu een kwestie van willen en doen.
    Natuurlijke geboorte bij dikbilrassen
    Napel, Jan ten - \ 2011
    cattle husbandry - beef breeds - birth - caesarean section - animal welfare
    China's one-child policy and "the mystery of missing women": Ethnic minorities and male-biased sex ratios
    Bulte, E.H. ; Zhang, X. ; Heerink, N. - \ 2011
    Oxford Bulletin of Economics and Statistics 73 (2011)1. - ISSN 0305-9049 - p. 21 - 39.
    rural china - gender bias - health-care - hepatitis-b - mortality - number - birth - fertility - account - poverty
    Recent estimates suggest that as many as 40 million women are ‘missing’ in China. We exploit a special provision in the Chinese one-child policy (OCP; allowing for preferential treatment of ethnic minority groups) to revisit the mystery of these missing women, and in particular to explore the contribution of China's OCP in distorting sex ratios. Our results imply that preference for boys is the main driver of the gender gap, and that the OCP is responsible for about half of it. This is true even before ultrasound technologies for prenatal gender determination were available. Not surprisingly, interaction between the OCP and ultrasound technologies has contributed to the gender gap
    Lammerensterfte, leverbot en ureum bij melkschapen
    Verkaik, J.C. ; Smolders, G. - \ 2010
    Lelystad : Wageningen UR Livestock Research (Rapport / Wageningen UR Livestock Research 417) - 27
    biologische landbouw - schapenhouderij - mortaliteit - lammeren - schapen - leverbot - ureum - geboorte - agrarische bedrijfsvoering - quarantaine - eiwitopname - zware metalen - organic farming - sheep farming - mortality - lambs - sheep - liver flukes - urea - birth - farm management - quarantine - protein uptake - heavy metals
    The monitored lamb mortality at organic dairy sheep farms is relativly high with big differences. Mortality over 10% is caused by poor management and infectious abortions. Short term improvements needs a structured approach. Treatment of the dairy sheep is limited to the dry period. Avoiding infection by housing ewes in early lactation appears effective. Liver fluke is well predictable on the prognosis and the fluke and grazing history. The time between infection intake and appearance in blood or dung makes these researches risky. Urea appears dependable upon the amount of protein fed. Protein wastage reduces when more energy is fed.
    Minder keizersneden bij dikbillen
    Napel, J. ten - \ 2010
    Kennis Online 7 (2010)nov. - p. 8 - 8.
    rundveehouderij - vleesvee - keizersnede - geboorte - dierveredeling - cattle husbandry - beef cattle - caesarean section - birth - animal breeding
    Vrijwel alle dikbilkoeien komen met een keizersnee ter wereld. Wageningen UR Livestock Research werkt in het project ‘Natuurlijke luxe’ met de Federatie van Vleesveestamboeken Nederland aan meer natuurlijke geboorten.
    Cultuuromslag nodig : natuurlijke Luxe bij Verbeterd Roodbont : dier & welzijn
    Napel, J. ten - \ 2010
    V-focus 7 (2010)5A. - ISSN 1574-1575 - p. 24 - 25.
    dierenwelzijn - geboorte - rundveerassen - rundveehouderij - rassen (dieren) - verbeterd roodbont - animal welfare - birth - cattle breeds - cattle husbandry - breeds - improved red pied
    Het streven naar meer natuurlijke geboorten bij Verbeterd Roodbont is in een nieuwe fase gekomen. Het stamboek heeft de trekkende rol overgenomen van Wageningen UR Livestock Research en stimuleert en ondersteunt zijn leden met concreet advies. Het doel wat het stamboek voor ogen heeft is 50 procent natuurlijke geboorten in 2020. Een portret van een cultuuromslag.
    Meetprogramma dikbilrassen biedt veel perspectief
    Napel, J. ten - \ 2010
    V-focus 7 (2010)5. - ISSN 1574-1575 - p. 42 - 43.
    rundveehouderij - vleesvee - vleesveerassen - belgisch witblauw - geboorte - dierveredeling - selectief fokken - bekken - verbeterd roodbont - cattle husbandry - beef cattle - beef breeds - belgian blue - birth - animal breeding - selective breeding - pelvis - improved red pied
    De inwendige bekkenhoogte van een koe vertoont veel variatie, is sterk erfelijk en hangt nauw samen met de kans op een natuurlijke geboorte van het kalf. Dit maakt selectie voor een grotere inwendige bekkenhoogte een geschikt instrument om bij Verbeterd Roodbont en Belgisch Witblauw vleesvee te selecteren voor natuurlijke geboorten.
    Intermittent suckling affects feeder visiting behaviour in litters with low feed intake
    Kuller, W.I. ; Soede, N.M. ; Bolhuis, J.E. ; Beers-Schreurs, H.M.G. van; Kemp, B. ; Verheijden, J.H.M. ; Taverne, M.A.M. - \ 2010
    Livestock Science 127 (2010)2-3. - ISSN 1871-1413 - p. 137 - 143.
    social facilitation - weight-gain - solid food - pigs - piglets - performance - consumption - growth - birth
    Intermittent suckling (IS) has proven to stimulate creep feed intake in suckling piglets. This paper describes the development of feeding behaviour in three litters with high (H) and three litters with low (L) feed intake during lactation in both control (C) and IS treatment. In order to synchronize the start of intermittent suckling within a farrowing room, treatment day 0 (T0) was designated as the start of data collection. IS litters were separated from the sow for a period of 12 h/day (0930 to 2130) from T14 to weaning (T25). Feeder visits of individual piglets and nursing behaviour were analysed from continuous video recordings at 5 treatment days: T13, T16, T24, T25 and T26. A high number of CL piglets never visited the feeder during lactation; at T24, 56% of the CL piglets did not visit the feeder. On the other hand, 91% of the ISL and CH piglets and all ISH piglets visited the feeder at least once at T24. In contrast to the other groups, no increase was seen in visiting frequency during lactation in CL piglets. At T24, visiting frequency was higher in ISL than in CL piglets. So, IS stimulated piglets from low feed intake litters to visit the feeder. Between T16 and T24, total feeder time increased in piglets from all groups (P <0.05), except in CL piglets in which no change was found (P > 0.10). Latency to first visit to the feeder after weaning did not differ between groups. It is concluded that IS stimulates piglets from litters with a low level of creep feed intake to visit the feeder during lactation, which familiarizes them with the feeder and the feed during lactation. The IS treatment does not affect feeder visiting behaviour of piglets with an anyhow high level of feed intake during lactation
    Sensor signaleert naderende geboorte
    Ipema, A.H. ; Hogewerf, P.H. ; Bleumer, E.J.B. - \ 2009
    V-focus 2009 (2009)12. - ISSN 1574-1575 - p. 24 - 25.
    melkveehouderij - melkkoeien - sensors - geboorte - kalven - dairy farming - dairy cows - sensors - birth - calving
    Met de nieuwe generatie draadloze sensoren, die momenteel in ontwikkeling is en langzaam voor de praktijk beschikbaar komt, kunnen steeds meer signalen van het individuele dier automatisch worden vastgelegd, zoals een naderende geboorte
    Reference values for spot urinary iodine concentrations in iodine-sufficient newborns using a new pad collection method
    Dorey, C.M. ; Zimmermann, M.B. - \ 2008
    Thyroid 18 (2008)3. - ISSN 1050-7256 - p. 347 - 352.
    breast-fed infants - nutrition - pregnancy - children - birth - women - life - salt
    Background: Iodine deficiency in infancy can impair neurocognitive development, but there are few available indicators of iodine intake during this critical period. In many countries, access to newborns in maternity clinics in the first few days after birth is high. If spot urine samples could be collected, reference data for urinary iodine concentration (UIC) would be useful to evaluate their iodine status. The study objectives were 1) to develop and validate a simple pad system for collection of spot urine samples for iodine; 2) to establish a reference range for UIC in newborns in the first week after birth for use in monitoring iodine nutrition. Methods: A two-stage cluster sampling was used to obtain a representative national sample of healthy, term Swiss infants, 0 to 5 days old (n = 634). Gestational information, whole blood for thyrotropin, and spot urine samples on two consecutive days were collected. Results: The pad collection system was well-accepted and performed well during recovery and contamination testing. Median UIC in the total sample (n = 1224) was 77 (95% confidence interval; 76, 81) ¿g/L; there was a gradual increase in median UIC within the range of 70¿100 ¿g/L from days 1 through 4. Because urinary creatinine concentrations were high and variable, the UI:creatinine ratio was not useful for standardization. Conclusions: The current WHO median UIC cut-off (> 100 ¿g/L) for iodine sufficiency in infancy may be too high for the first week after birth. Reference data from iodine-sufficient newborns and a simple collection system may facilitate use of UIC as an indicator of iodine status in this age group.
    Ruimere koe... lichter kalf
    Napel, J. ten - \ 2008
    V-focus 5 (2008)2. - ISSN 1574-1575 - p. 36 - 37.
    rundveehouderij - vleesvee - geboorte - keizersnede - bevallingscomplicaties - dierenwelzijn - probleemoplossing - werkgroepen - cattle husbandry - beef cattle - birth - caesarean section - parturition complications - animal welfare - problem solving - working groups
    Hoe buig je de cultuur van systematisch toepassen van een keizersnede om naar meer natuurlijke geboorten? Wageningen UR begeleidt dit proces door vleesveehouders in werkgroepen zelf te laten zoeken naar oplossingen
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