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Martijn Buijvoets will defend his master thesis “Yes We Care! How health workers in low resource settings get stuck and can escape capability traps” at the Eindhoven University of Technology. This work was supervised by Bob Walrave.
“It’s not enough. It is really not enough,” said a Tanzanian neonatal intensive care nurse when explaining her work situation. Unfortunately, this is the reality of many health workers that serve patient populations in low resource settings. They have to make the most out of the available resources while dealing with intensifying demand for a higher quality of care (Kruk et al., 2018). While wishing to offer a solution to this problem as a whole, this study limits its scope to the role of an individual health worker. Specifically, how they can get the most out of the limited human and knowledge resources they possess. The study is based on an in-depth case study of hospital wards in Eastern Africa, focusing on quality improvements in neonatal care. Data were gathered during the last half-year of 2021, and an inductive case study exposes underlying mechanisms (Gioia et al., 2013). The dynamic nature of these mechanisms is modeled as a causal loop diagram which represents a capability trap (Repenning and Sterman, 2001; Landry and Sterman, 2017). Health workers can get the most out of their human and knowledge resources by finetuning their effort allocation to operational work (More Care loop) and investing in improving the quality of care (Better Caring loop). An optimal allocation can launch the ward into a virtuous cycle of continual development and escape the capability trap. Or, if the allocation is not optimal, the ward risks going into a vicious cycle where it struggles to deliver a reduced quality of care. The findings of this study offer important implications for capacity-building and healthcare services inspired by the capability trap model in human systems.