Browsing by Author "Herbst, Christi Johannes Christoffel"

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    Developing a management tool for scaling- up health service innovations in marginalized communities: a systems perspective
    (Stellenbosch : Stellenbosch University, 2023-02) Herbst, Christi Johannes Christoffel; Grobbelaar, Sara Saartjie; Grobler, Jacomine; Stellenbosch University. Faculty of Engineering. Dept. of Industrial Engineering.
    ENGLISH ABSTRACT: Systems transformation depends on the impact scale delivered through Innovations for Inclusive Development (I4ID). Simmons et al. [1] stated that “scaling up is primarily a managerial, political, and organizational development issue rather than tied to a particular set of technical interventions.” The relationship between implementation procedures and the large-scale institutionalization of health service innovations is significantly influenced by systems dynamics. Scaling up consists of two paradigms. Firstly, scaling up comprises a linear, intervention-oriented expansive strategy that prioritizes the introduction of evidence-based interventions into current systems to promote the spread of their use. Secondly, scale-up can be perceived from a complex systems paradigm where interventions are conceptualized as events in systems. Implementation and scale-up operations should concentrate on creating changes within the system to achieve the desired result. This study investigates scaling up from a systems-orientated perspective to develop a practical management tool for guiding implementers and practitioners of health service innovations during scaling up. To achieve this goal, the researcher developed ten research objectives, which were then converted into a research design based on the six Design Science Research Methodology (DSRM) activities developed by Peffers et al. [2]. The first activity, namely problem identification and motivation, discussed the background and research approach. The second activity, defining solution objectives, included the research objectives for developing a qualified knowledge base that would allow the researcher to define the solution objectives for the management tool accurately. To develop the knowledge base, the researcher conducted a conceptual literature review to gain in-depth knowledge about the research problem and the main elements of scaling up health service innovations. The conceptual literature review’s conclusions served as the foundation for additional research undertaken as part of a systematic literature review to identify the prevalent frameworks and models for scaling up health service innovations. The knowledge acquired during the two reviews was used to determine the design requirements needed to develop the preliminary management tool based on the iceberg model [3] to incorporate a systems perspective of scaling up during the third DSRM activity, namely design and development. During activities four and five, namely demonstration and evaluation, semi-structured interviews were conducted to validate the concepts used in the management tool and gain insight from various subject matter experts in the healthcare implementation and practice field. An impact-effort study of the suggested management routines yielded more qualitative data on the preliminary tool’s efficacy. Following the analysis of the evaluation data, structural and conceptual improvements to the preliminary management tool were suggested. Improvements included adding additional routines, renaming routines, and restructuring and reorganizing the management tool. The preliminary management tool was updated to form the final management tool, which was presented and discussed during the final DSRM activity, namely communication.