Enhancing organizational effectiveness in developing countries: The training and visit system revisited

Improving the effectiveness of public sector organizations in developing countries has become a major focus for national governments and foreign aid agencies. This study reviews the experience of a major organizational reform strategy, the training and visit system of extension, that has operated for more than 20 years. Several lessons drawn from this experience are that aid donors must: (i) eschew their preference for organizational blueprints and recognize the contingent nature of reforms; (ii) recognize that many public sector organizations have only a small ‘controlled’ decision-making space and thus pay more attention to ‘influenceable’ decision-making opportunities; (iii) acknowledge that machine model approaches are likely to reinforce the negative aspects of hierarchical control in bureaucracies, and; (iv) pay much more attention to organizational sustainability in terms of finance and strategic management capacity.     

Complex Congenital Heart Malformation Including Transposition of the Great Vessels,Presenting as Sudden Unexplained Infant Death

Transposition of the great vessels (TGV) is a common congenital heart defect that is difficult to diagnose before birth. Antenatal diagnosis is associated with increased survival. Unusual features such as anomalous pulmonary artery origin may delay cyanosis, decreasing clinical suspicion. A three‐week old female infant who had never been cyanotic presented for forensic autopsy due to onset of unresponsiveness at home. History included risk factors for TGV and signs of heart enlargement that were not recognized during life. Cardiac pathology consultation identified D‐type TGV with additional rare anomalies. TGV may present as sudden unexplained infant death (SUID) for forensic autopsy if variant features prevent development of cyanosis. Cardiac pathology consultation is helpful in clarifying these features.     

Sperm elution: An improved two phase recovery method for sexual assault samples

This report describes the validation of a two phase cell recovery technique for the elution of two common cell types, epithelia and spermatozoa, from frequently examined items submitted as part of sexual assault casework. Furthermore, separation of cell types prior to microscopic examination of cell pellets improves the scientist's confidence in observing and scoring spermatozoa that may be present. During the validation, Orchid Cellmark's Sperm Elution© method consistently recovered a greater number of spermatozoa from simulated sexual assault items and swabs taken following consensual sexual intercourse compared to a water extraction technique. On average the Sperm Elution method recovered over twice the number of spermatozoa compared to the water method. The ability to separate the cell types present allows a rapid microscope slide search for spermatozoa and faster DNA extraction protocol in comparison to Cellmark's previous preferential method.     

Decentralization by default: Local governance and the view from the village in The Gambia

Policies to decentralize government activities in The Gambia have been on the agenda for more than a decade but no decisions have been taken. During this period the quality of government services to rural areas has declined dramatically. The linchpin of provincial administration, the divisional commissioner, has become redundant as far as development is concerned. The activities of line ministries have deteriorated as their expenditures have been reduced and they lack the funds to permit staff to operate at village level. Area councils that were previously regarded as wasteful are now totally discredited. Village development committees (VDCs) have been formed, but the results are mixed and often they are ineffective. By default, decentralization in the 1980s and early 1990s in The Gambia has been achieved by non-governmental organizations (NGOs), which have rapidly grown in number and significance. This article explores the perceptions of villagers in The Gambia about the various organizations that are meant to serve their needs. Its conclusion speculates on proposals to implement a new decentralization policy in the country and points to the need for aid agencies to adopt a less simplistic approach to the issue of local governance.