Porters Diamond Model

Competitive advantage of nation’s theory Michael Porter introduced the Diamond model for competitive advantage of nations that analyses the competitiveness of a nation or even a major geographic region in the global competition. This moves away from the traditional economic factor of comparative advantage of countries such as land, resources, labor, population and location (Porter, 2009).Advertising We will write a custom essay sample on Porter’s Diamond Model specifically for you for only $16.05 $11/page Learn More He said that these are passive factors since they can actually undermine the competitive advantage of a nation and cannot guarantee a sustained industrial growth. The competitive advantage of nations arises from four interlinked factors and activities by companies within or between clusters. Proactive governments influence on these factors complete the picture (Hanson et al, 2011). The factors of competitive advantage of nations include; factor conditions which are defined as the necessary inputs into an industry to allow competition. These include human, physical, knowledge, capital and infrastructure resources. For a competitive nation in these factors mere availability is not enough. Their richness in categorization, deployment and creation and factor disadvantages play a major role (Porter, 1990). Demand factors in the competitive model move beyond market size to encompass the nature of the market, level of sophistication and demand of local buyers and how these local buyers relate to the global trends and markets (Ankli, 1992). Related and supporting industries in the Diamond model mean the presence of such industries locally and who are also competitive internationally. These are important since they provide the vital industries with low-cost, high quality and early access to inputs. They also provide new ideas which fuel innovation (Kogut, 2001). Lastly, firm strategy, structure and rivalry factor w hich encompasses domestic firm strategy and structure that utilizes the competitive advantage of the national environment, goals that are oriented to the sources of competitive advantage of a nation and domestic rivalry among strong domestic rivals who will be forced to look for new markets elsewhere (Grant, 2001). Outside these factors of competitive advantage of a nation are two important elements. These include; chance which comprise elements outside the firms or sectors control such as wars, demand surges and major technological advancements (Serin Civan, 2008).Advertising Looking for essay on business economics? Let's see if we can help you! Get your first paper with 15% OFF Learn More Government policy influence the competitive advantage of nations by negatively or positively impacting the four factors of competitive advantage but on itself it cannot construct competitive advantage (Hanson, Hitt, Hoskisson, 2011). Competitive advantage of Greece The geographic al location of Greece at the crossroads of North and South, East and West provide the country with an advantage of accessing emerging markets in all locations be it in Europe, Asia and Middle East (Sultana, 2011). These emerging markets have a combined GDP of about 1 trillion Euro as Porter, (2010) says and a population of about 350 million people who are composed of consumers that portray a demand for new products every year for a long time to come. The Greece population enjoys a high income and high standards of living where the country was ranked 22nd by the Human development Index in 2010 (Hanson, Hitt, Hoskisson, 2011). Greece has a population of 10,787,690 according to the preliminary results for the 2011 Census, which provides an advantage in human capital. The labor force consists of 4.9 million people. The country is positioned in the third place in â€Å"working hour per year ranking’ among the European countries with an average of 1,811 working hour per year. Bef ore the recession in 2007, the country average worker produced 20 dollars per hour. In South East Europe, Greece boasts of the most well educated and trained workforces. This workforce is well versed with foreign languages (Hanson, Hitt, Hoskisson, 2011). Greece has a natural resources base that is the most attractive in Southeast Europe. These have resulted into a vibrant tourism industry cluster, food and beverages sector and renewable energy development sector according to Porter, (2010). The geography of the country with its many islands and sandy beaches coupled with a favorable climate has provided the country with a flourishing tourism industry. It contributes to 20% of the GDP and has shown strong signs of growth since the country records a higher number of tourists each year than the local population (Dimireva, 2009). The climate and technological advancement in the agricultural sector has also ensured a healthy, year round agricultural output which has supported the food and beverage cluster (Vaknin, 2008).Advertising We will write a custom essay sample on Porter’s Diamond Model specifically for you for only $16.05 $11/page Learn More In terms of the renewable energy sources, Greece boasts one of the best aeolic profiles in Europe and also in solar density. The country is also investing heavily in the biomass and biofuel production (Kakissis, 2010). Other competitive factors include increased collaboration between businesses and universities/ research institutes, easy access to loans from the European Monitory Union (EMU) which have resulted to low interest rates, financial market sophistication and advancement in communication and transport infrastructure among others as New York Times Dealbook, (2010) notes. However, there are still factors that hinder the competitiveness of Greece as a country which include; an aging population that saw a drop in population by 1.6% in 2011 from the 2001 census (Ministry of For eign Affairs, 2011). The debt crisis in relation to GDP is one of the highest in the European Union which has been concealed by successive governments but has now come to haunt the country. In relation to this, the country was given a bailout by the EU on condition that it adopts austerity measures on spending which in turn have triggered strikes by trade Unions, riots and demonstrations (Ewing, 2010). This coupled with rising levels of unemployment may lower the competitiveness of the country (Porter, 2010). Reference List Ankli, R. (1992). Michael Porrter’s Competitive Advantage and Business History.  Business and Economic History Conference (pp. 288-314). New York: University of Guelph. Dimireva, I. (2009, October 29). Greece Investment Climate 2009. EU Business. Ewing, J. (2010, April 29). Already Holding Junk, Germany Hesitates. New York Times, p. B1.Advertising Looking for essay on business economics? Let's see if we can help you! Get your first paper with 15% OFF Learn More Grant, R. (2001). Porter’s ‘Compeetitive Advantage of nations’: An Assessment.  Strategic Management Journal , 535-548. Hanson, D., Hitt, M., Hoskisson, R. (2011). Strategic management: Competitiveness  and Globalisation. Melbourne: Cengage. Kakissis, J. (2010, October 17). Behind Greece’s Courting of Foreign Investment. Time  Business. Kogut, B. (2001). The Competitive Advantage of Nations: Some Differences that  Countries Make. United States of America: Global Strategy IOB. Ministry of Foreign Affairs. (2011, June 19). Investments in Greece. Retrieved from Ministry of Foreign Affairs Greece in the World: http://www2.mfa.gr/en/ New York Times Dealbook. (2010, April 28). German Banks Have Big Investment in Greece. New York Times. Porter, M. (2010). The Competitive Advantage of Greece: Moving to the Next Level.  Athens: Havard Business School. Porter, M. (2009). The Competitive Advantage of Nations, States and Regions. Unted States of America: H avard Business School. Porter, M. (1990). The Competitive Advatage of Nations. United States of America: Free Press. Serin, V., Civan, A. (2008). Revealed Comparative Advantage and Competitiveness: A Case Study for Turkey Towards the EU. Journal of Economics and Social Research , 25-41. Sultana, C. (2011, September 28). GO’s Greece Investment Devalues by â‚ ¬25.3m. The  Malta Business Weekly , p. B3. Vaknin, S. (2008, March 12). Greece and its Investments in the Balkans: Trojan Horse  or Reliable Partner? Web. This essay on Porter’s Diamond Model was written and submitted by user Emelia H. to help you with your own studies. You are free to use it for research and reference purposes in order to write your own paper; however, you must cite it accordingly. You can donate your paper here.

3 pasos para renovar sin entrevista la visa de turista

3 pasos para renovar sin entrevista la visa de turista La renovacià ³n de la visa de turista para Estados Unidos puede hacerse siguiendo un trmite rpido y sencillo siempre que se realice dentro de plazo. En este artà ­culo se informa sobre quià ©nes no necesitan la visa de turista y por lo tanto no precisan renovarla. Tambià ©n cundo se tiene que renovar, si se tiene una, cà ³mo es el proceso, quà © 3 decisiones puede tomar el oficial consular y quà © no se debe hacer porque pone en peligro la visa y/o su renovacià ³n. Con esta informacià ³n ser fcil obtener la renovacià ³n del visado. Quià ©nes no necesitan una visa de turista para ingresar a Estados Unidos Es importante saber que las personas extranjeras que desean viajara a Estados Unidos como turistas o para recibir tratamiento mà ©dico necesitan de una visa B2 o la combinacià ³n de una B1/B2 de turista/negocios, si bien existen importantes excepciones: Mexicanos y extranjeros residentes en Mà ©xico que viven junto a la frontera pueden solicitar una tarjeta de cruce, tambià ©n conocida como visa lser. Pero sà ³lo sirve para un tiempo ms limitado que la visa de turista y tambià ©n est restringida a ingresos terrestres y no permite adentrarse ilimitadamente en territorio de los Estados Unidos.CanadiensesCiudadanos de 38 paà ­ses parte del Programa de Exencià ³n de Visas.   Entre esos 38 paà ­ses se encuentran, entre otros, Espaà ±a, Chile, Italia y Portugal, lo cual puede ser de interà ©s para muchos latinoamericanos que cuentan con doble nacionalidad, siendo una de ellas la de un paà ­s incluido ese ese Programa de Exencià ³n de Visas. Cundo es necesario renovar la visa de turista Si ya se tiene una visa de turista, conocida en algunos paà ­ses como de paseo o de placer, à ©sta tiene una vigencia limitada. Puede dejar de ser vlida porque se aprueba por un nà ºmero limitado de ingresos y estos ya se han agotado o porque ya ha llegado su fecha de expiracià ³n (tambià ©n conocida como de vencimiento). En cualquiera de estos casos es necesario renovar la visa si se quiere viajar de nuevo a los Estados Unidos. El proceso es muy similar a los de peticià ³n por primera vez, pero con dos importantes novedades: el porcentaje de aprobacià ³n es mucho ms alto en las renovacionesen  algunos  casos no es necesaria la entrevista en el consulado. Estas circunstancias se han endurecido desde que el presidente Donald Trump entrà ³ en la Casa Blanca. 3 trmites para la renovacià ³n de la visa de turista americana Deben seguirse los siguientes pasos: En primer lugar, completar en là ­nea el documento DS-160.  La opcià ³n que aplica es la de visa renewal. Aunque el formulario est en inglà ©s, es posible ver una traduccià ³n al espaà ±ol colocando el cursor encima del texto que se quiere traducir. En segundo lugar, pagar la cuota correspondiente. El procedimiento de pago tiene variaciones de paà ­s a paà ­s por lo que se debe seguir las instrucciones del DS-160. Esta tarifa nunca se regresa, aunque la visa no sea aprobada. En tercer lugar, si es necesario cerrar una cita para la entrevista en la oficina consular, seguir el procedimiento. Si no es obligatorio, proceder a entregar la documentacià ³n como se seà ±ala en el formulario de internet.   Casos de exencià ³n de la entrevista para renovar la visa de turista americana La entrevista en el consulado o embajada es uno de los trmites que ms disgusta a los solicitantes de las visas de turista. Una de las razones es porque la necesidad de presentarse en el edificio consular obliga a dedicar buena parte de una maà ±ana a ese trmite o incluso ms, si hay que desplazarse a otra ciudad. Pero adems, hay el factor subjetivo de los nervios. No todas las persona se ponen nerviosas, pero muchas sà ­, por no saber quà © le van a preguntar, por temor a dar una respuesta equivocada, etc. Por todo ello, la posibilidad de no tener que acudir a la entrevista es festejado por muchos solicitantes de la renovacià ³n de la visa. El  Programa de Exencià ³n de la Entrevista, conocido por sus siglas en inglà ©s de  IWP, que establecià ³ paulatinamente el gobierno del presidente Barack Obama permità ­a muchos casos de renovacià ³n sin necesidad de entrevista. Sin embargo, el  Ã‚  Donald Trump ha anulado esa waiver en muchos casos. Actualmente, estos son los lineamientos para no tener que presentarse a la entrevista durante la tramitacià ³n de la visa de turista americana: Nià ±os de 6 aà ±os o menoresPersonas mayores de 80 aà ±osPersonas cuya visa de turista haya expirado hace menos de 12 meses y que nunca hayan tenido problemas en las aduanas de EE.UU., nunca hayan sido detenidas y a las que nunca se les haya negado o anulado una visa americana. En todos los casos, las embajadas y consulados de Estados Unidos pueden decidir unilateralmente que un solicitante debe presentarse a la entrevista aà ºn cuando entre dentro de las excepciones que en teorà ­a permitirà ­an no tener que cumplir con ese propà ³sito. Quà © puede suceder durante el proceso de  renovacià ³n de la visa El oficial consular puede decidir: aprobar la visadeclarar un procedimiento administrativo, es decir, ni aprobacià ³n ni negacià ³nNegar la visa. ​ Las posibilidades de que esto suceda son pequeà ±as, ya que en los casos de renovacià ³n se produce menos de un dos por ciento de rechazo de entre todas las solicitudes. Pero sà ­ que es una posibilidad real. No obstante, es mucho menor a lo que sucede cuando se solicita por primera vez, donde el rechazo en general supera el 20 por ciento de las peticiones, si bien hay grandes diferencias segà ºn el consulado. Las causas por las que se produce un rechazo caen bsicamente dentro de dos grandes categorà ­as, causas que convierten a una persona en inelegible para la visa de turista y las que la convierten en inadmisible para ingresar a los Estados Unidos.   Si el problema se origina por una de estas à ºltimas causas, es aconsejable asesorarse con un abogado de inmigracià ³n especialista en waivers para analizar si es conveniente solicitar uno. A esto tambià ©n se le conoce como perdones o permisos. Quà © puede poner en peligro conservar la visa de turista Para evitar problemas muy desagradables e incluso sufrir la cancelacià ³n de la visa es conveniente saber la respuesta correcta a estas dos preguntas:  ¿es conveniente quedarse en EEUU el mximo tiempo permitido? En este punto es de extrema importancia conocer las consecuencias, ya que desde el punto de vista migratorio son graves. Adems, es importante saber  con quà © frecuencia se puede regresar  a Estados Unidos como turista ya que la mayorà ­a de los viajeros no son conscientes de que el ingreso a EE.UU. les puede ser negado por un oficial migratorio aunque, en teorà ­a, estn movià ©ndose dentro de los parmetros que marca la ley. Para mayor informacià ³n sobre cà ³mo obtener y conservar la visa, se recomienda tomar este  este quiz, trivial o test sobre visas. Este artà ­culo tiene una finalidad informativa. No es asesorà ­a legal para ningà ºn caso en particular.

How to Make APA In-Text Citations and Examples

How to Make APA Ins APA style is the format that is typically required of students who are  writing essays and reports  for courses in psychology and the social sciences. This style  is similar to MLA, but there are small but important differences. For example,  the APA format calls for fewer abbreviations in the citations, but  it places more emphasis on publication  dates in the notations.   The author and date are stated any time you use information from an outside source. You place these in parentheses  immediately after the cited material, unless you have mentioned the authors name in your text. If the author is stated in the flow of your essay text,  the date is parenthetically stated immediately after the cited material. For example: During the outbreak, the doctors thought the psychological symptoms were unrelated (Juarez, 1993). If the author is named in the text, only put the date in parenthesis. For example: Juarez (1993) has analyzed many reports written by psychologists directly involved in the studies. When citing a work with two authors, you should cite the last names of both authors. Use an ampersand () to separate the names in the citation, but use the word and in the text. For example: The small tribes along the Amazon that have survived over the centuries have evolved in parallel ways (Hanes Roberts, 1978). or Hanes and Roberts (1978) claim that the ways in which the small Amazonian tribes have evolved over the centuries are similar to each other. Sometimes you will have to cite a work with three to five authors, if so, cite them all in the first reference. Then, in following citations, state only the first authors name followed by et al. For example: Living on the road for weeks at a time has been linked to many negative emotional, psychological, and physical health issues (Hans, Ludwig, Martin, Varner, 1999). and then: According to Hans et al. (1999), lack of stability is a major factor. If you use a text that has six or more authors, cite the last name of the first author followed by et al. and the year of publication. The complete list of authors should be included in the works cited list at the end of the paper. For example: As Carnes et al. (2002) have noted, the immediate bond between a newborn baby and its mother has been extensively studied by many disciplines. If you are citing a corporate author, you should state the full name in each in-text reference followed by the publication date. If the name is long and the abbreviated version is recognizable, it may be abbreviated in subsequent references. For example: New statistics show that owning pets improves emotional health (United Pet Lovers Association [UPLA], 2007). The type of pet seems to make little difference (UPLA, 2007). If you need to cite more than one work by the same author published in the same year, differentiate between them in the parenthetical citations by putting them in alphabetical order in the reference list and assigning each work with a lower case letter. For example: Kevin Walkers Ants and the Plants They Love would be Walker, 1978a, while his Beetle Bonanza would be Walker, 1978b. If you have material written by authors with the same last name, use the first initial of each author in every citation to distinguish them. For example: K. Smith (1932) wrote the first study done in his state. Material obtained from sources such as letters, personal interviews, phone calls, etc. should be stated in the text using the persons name, the identification personal communication and the date said communication was obtained or took place. For example: Criag Jackson, Director of Passion Fashion, stated that the color changing dresses are the wave of the future (personal communication, April 17, 2009). Keep in mind a few punctuation rules as well: Always put the citation at the end of the material used.If you are using a direct quote, put the citation on the outside of the closing quotation mark.End punctuation (period, exclamation point) for the text follows the parenthetical citation.If you are using a block quotation, place the citation after the final punctuation mark of the paragraph.Always include a page reference for the material being cited.

Solar Thermal Energy for Domestic Use in New Zealand Essay

Solar Thermal Energy for Domestic Use in New Zealand - Essay Example Meanwhile literature shows that the use of solar water technology in the country is still at its minimum. Solar hot water installations were at an average of 1,200 units per year and was expected to contribute as must as 15% of hot water requirements in New Zealand households. Yet, what few people realize is that solar thermal power can be utilized to generate electricity and totally eradicate the use of coal in electricity generation. The use of solar energy for electricity generation could reduce carbon emissions by atleast 270,000 tCO2 and generate employment to as many as 400 people (Energy Efficiency and Conservation Authority 2001). Installation of solar hot water energy systems costed about NZ$4,000 for a full installation, which generated about 2,400 kWh to 3,100 kWh of electricity annually. To see how much economic benefit this SHW installations offered, one can use the â€Å"payback period† or the â€Å"lifecycle cost† as indicators. The Energy Efficiency and Conservation Authority (EECA) calculated that over the 20-year lifetime of the system, energy production cost was only at 12 cents per kWh. Yet, it was important to note that this calculation was based on retrofits to existing homes, which typically costed more since the structure of the home had to customized to ensure that its energy demand was low. Meanwhile, installation of solar hot water systems on new homes were much cheaper because these systems were now built into the roof structure instead of around it.... This report has four sections: a) the research plan, b) results of the research, c) discussion of these results and d) conclusion and recommendation. Methodology or Research Plan To determine the advantages of solar energy and why it should be adopted in New Zealand, the researcher utilized the following research plan: Phase 1: Discover the potential of using solar thermal energy. This is done through an interview with an expert professional and through online search. The respondent for the interview received through email so as not to impede his work schedule. Meanwhile, the online search was done through search engines. It utilizes search terms like â€Å"solar power in New Zealand† and â€Å"solar thermal energy for domestic use. Phase 2: Determine the barriers to uptake of solar technology and create recommendation Results The Use of Solar Energy in New Zealand. To determine the potential of solar power in New Zealand, Brian Fawdray, an electrical engineer was interviewed . According to him, solar power was rarely utilized in electricity generation. Unlike other countries which started utilizing solar thermal energy, in New Zealand, electricity using solar power was done mainly through PV cells, which in itself had a limited market reach. When asked what he thought of using PV technology in the household, Fawdray said that he could not readily promote it because the technology is not yet cost effective for all households. In his words, â€Å"Cost efficiency depends on many factors. He believes, however that the backup system provided by PV batteries were important since most grid connected systems do not have it, and perhaps this is something PV

To what extent has the UKs Vocational Education and Training (VET) Essay

To what extent has the UKs Vocational Education and Training (VET) system contributed to a skills gap Discuss with reference to the UKs potential to learn from other countries VET systems - Essay Example 5). Despite that, UK still continues to suffer from a skills gap that has affected its high economy. 3 This paper provides arguments that establish the participation degree played by the UK national VET system in bridging the skills gap. The aim is not to provide a theoretical analysis of UK’s performance, but rather to reference performance frameworks to Australian and Germany VET systems by establishing what can be learnt. 3 The term Vocational education and training (VET) originates from the content and purpose of the training. International bodies define VET as the means of preparing occupation professional fields for effective participation in the labour market (Bosch and Charest 2010, p. 1). However, this definition may not fit the current educational dimension that is characterised by university education that also prepares individuals for the workforce under specific professions. Thus, while higher education is concerned with the preparation to the labour market, vocational training is more concerned with earlier specialization for an occupational field. For this paper, we shall adopt Brockmann’s (2008 p, 2). Definition of VET an integrated and comprehensive system aimed to offer learners the ability to act competently within an occupation. 6 VET helps to match individual skills with labour force and existing market needs, equips individuals with lower levels of education with developed skills that can enable them fit into the expanding global economy that has introduced competition among countries. Vocational training also empowers young and inexperienced employees with ‘job ready’ skills, and develops a high skilled labour force that encourages and country investments by increasing economic growth (OECD 2011, p.7). 6 The universal decisive shift from holistic to vocational training in recent years has induced the UK to seek initiatives that aim at addressing her

The Convention on the Rights of Children Essay -- Essays Papers

The Convention on the Rights of Children Growing up, I could not possibly count the number of times my parents told me how hard it was to raise a child in this world. I can, however, remember how hard it was being one. Luckily, I was blessed with two loving parents who always had my best interests in mind and eventually as I passed through the innocence of my youth and the awkwardness of adolescence to where I am today, I got to fully understand the sacrifices that they made on my behalf. I also realize that not everyone has guardians who are able or willing to make such sacrifices, and as a result children can often suffer. As a society, we must investigate potential dangers to children that could hurt their upbringing both physically and mentally, and come to terms with certain solutions that would help underprivileged children. According to UNICEF, an estimated 12 million children under the age of five die every year of easily preventable causes, and about 160 million children are severely or moderately malnourished. Th ese figures only describe the tip of the iceberg in terms of physical barriers that children around the world face, and we cannot ever truly know the amount of emotional abuses that coincides with this figure. Clearly, something is not right and needs to be addressed in order to protect children on a global level. In order to determine the manner in which to protect children, we have to examine the nature of their rights. Do children have the need for special rights aside from established adult human rights? I would think so, and many would agree with that conclusion. Issues such as infant mortality, child labor, and child abuse extend beyond the scope of adult human rights. For instance, whereas an adu... ... to be addressed in addition to the human rights afforded to adults. Children are more vulnerable than adults and face several different issues that currently are not addressed in world affairs. The Convention on the Rights of the Child attempts to address these matters, but the lack of support from the United States gives the document a lack of esteem in terms of world respect. Obviously, there is something wrong with the picture that the U.S. and Somalia (which only does not sign because it does not have an official government) are the only countries to hold out from the process. The United States has the obligation as a world leader to not only participate in human rights issues, but to be an active leader in such matters. The U.S. has failed in both respects, and owes it to the children of the world to be a signatory on the Convention on the Rights of the Child.

Classical Approach Essay

These clinics provide a range of primary health care services with eye care often being a neglected component. The personnel at this level of the health care system are expected to be multi-skilled with eye care skills being one of their range of skills. The eye care personnel are usually primary health care nurses who have completed a course in eye care. Vision screening and treatment of basic acute eye conditions such as  conjunctivitis, is the main role of eye care personnel at this level. In addition they should be able to engage in health promotion activities by developing eye health education tools and communicating these messages to the community the clinic serves. District health clinic Primarily responsible for primary health care services and serves or receives referral from a number of primary health care clinics. These clinics are generally staffed by primary health care nurses with medical doctors on a permanent or part time basis depending on the number of people in the catchment area or remoteness of the clinics. Furthermore ophthalmic nurses (ON), ophthalmic clinical officers (OCO) and/or ophthalmic medical assistants (OMA) are deployed in some countries to these clinics. THE DISTRICT HEALTH SYSTEM (CONT.) District Hospital Secondary level of care is provided in these hospitals. These hospitals serve a number of health districts, which refer patients to them. Ocular disease diagnosis and management, refraction and low vision are usually provided at this level. The district hospitals can be staffed by ophthalmologists, optometrists, ON, OCO, OMA. REGIONAL HOSPITAL Secondary and tertiary level of eye care is provided at these hospitals, which are often the referral site for a group of district hospitals Eyecare staff may include ON, OCO, OMA, optometrists and ophthalmologists PROVINCIAL HOSPITAL Tertiary and quaternary care is provided at this level. Serves a few regional hospitals which refer cases that cannot be managed at a regional level Eyecare staff may include ophthalmologists, optometrists and ON DEFINING THE ROLE OF DIFFERENT CADRES It is critical that there be a clear definition of roles within the health district. Duplication should be avoided and a clearly defined referral system should be developed as in a climate of limited resources and overworked staff, duplication is illogical and wasteful. There are various participants of the eye care teams. The following are the possible roles that the different personnel play within health districts. These roles can vary across districts and are often not consistent, in the sense that their job descriptions could change periodically depending on resources and challenges at the district level: COMMUNITY HEALTH WORKERS The key roles for community health workers are usually screening, case finding, health promotion and health education. Key tasks for eye care include case finding and/or screening for ocular disease and refractive errors. While the primary health care nurse is well trained and ideal for ocular health and vision, case finding and/or screening, outreach from clinics is usually very difficult due to the plethora of tasks and patient numbers at this level. The community health workers therefore constitute an ideal cadre for community based eye care activity. They can be particularly useful in health promotion activity. This is necessary in rural areas in particular due to the high usage of alternative approaches to managing eye diseases e.g. urine being used as a treatment for conjunctivitis resulting in patients presenting at clinics with gonococcal conjunctivitis (Naidoo K  2006, pers. comm). PRIMARY HEALTH CARE NURSE (PHCN) The Primary Health Care Nurse is based at the primary health care clinic. The primary health care nurse is primarily responsible for case finding and for the basic therapeutic management of a broad range of diseases. Eye care is but one of the many tasks that they engage in. In terms of eye care they usually screen for eye diseases and visual loss and refer to the nearest clinic. However, they could also be responsible for the prescribing of presbyopic glasses after having ruled out the presence of any potentially blinding disease.Given the lack of knowledge about eye care their tasks can also include liaising with local community structures to promote eye care activities and uptake of the clinical services. The PHCN should address community groups and schools regarding the promotive and preventive approaches to eye care. An example is the alarming number of diabetic and hypertensive patients who are never informed about the impact of these systemic diseases on their eyes, usually du e to the hectic schedule of clinicians who diagnose these patients. This leads to diabetic and hypertensive patients only seeking eye care services when visual loss has occurred. Such patients can benefit tremendously from preventive and promotive efforts. DEFINING THE ROLE OF DIFFERENT CADRES(CONT.) OPHTHALMIC NURSE (ON) / OPHTHALMIC MEDICAL ASSISTANT (OMA) / OPHTHALMIC CLINICAL OFFICER (OCO) ONs / OMAs / OCOs are mainly allocated to the district hospital but can also be deployed at the district clinic. In many health districts the ophthalmic nurses are the foundation of the eye care system as optometrists and ophthalmologists are unavailable. The ophthalmic nurses manage all ocular disease as well as conduct refractions in instances where they have been  provided with the additional training. OPTOMETRISTS Optometrists at the district hospital level are a very valuable resource in providing ocular disease management and refractive services. However the current limited number of posts as well as the unavailability of optometrists for the public sector often prevents these appointments from occurring. Given the current remuneration scales for optometry and the lack of posts in many countries insufficient number of optometrists are mobilised to take on positions at district hospitals. The role of the optometrist at a district hospital level in such circumstances should therefore be one of a visiting clinician to provide support for the ophthalmic nurse in the form of training and mentoring and managing complex cases. The optometrist’s primary location in such circumstances will be at the regional hospital level handling referrals from different district hospitals. At this level the optometrist should provide refraction services, low vision services and ocular disease diagnosis and co-management/management. OPHTHALMOLOGIST Ophthalmologists provide treatment and management of ocular disease, and surgical care. The lack of ophthalmologists as well as the attractiveness of the private sector makes it difficult to deploy ophthalmologists to district hospitals. They are therefore usually located at regional hospitals or large district hospitals. In order to significantly impact on the cataract surgical rates in the developing world it is necessary to increase the role of the ophthalmic nurses and optometrists in disease management and co-management of post surgical patients. DISTRICT HEALTH MANAGER The district manager is an integral component of the human resource team of the district. A supportive manager can enable enormous developments in terms of eye care, as the allocation of resources in the public sector is usually centrally controlled. The decentralisation of tasks to the district managers from the provincial government level creates an opportunity for greater  success with district level planning. THE TEAM APPROACH The public health system is often under-utilized due to the lack of a team effort in the delivery of health care services. The different personnel work independently and are often engaging in a duplication of tasks. Territorial approaches by professionals are quite common with a â€Å"my role† mentality predominating rather than an â€Å"us† mentality (Croasdale A 2006, pers. comm).In order to effectively generate cooperation team training in the form of clinical and planning workshops are important. Further there is also a lack of integration between the eye care personnel and other departments. This hinders the effective management of patients e.g. diabetic patients should be co-managed between the physician and the eye care personnel. DEFINING THE ROLE OF DIFFERENT CADRES (CONT.) CIVIL SOCIETY INTERVENTIONS The LV Prasad Eye Institute (LVPEI) in India has developed an innovative model for the delivery of eye care in the developing world (Fig. 2-1), which has been implemented very successfully (Rao, 2005). In this pyramid model, basic eye care screening is done by â€Å"Vision Guardians† at the village level, at a ratio of 1:5,000.â€Å"Vision Technicians† in Vision Centres at the community level provide primary eye care (1:50,000), while advanced tertiary care takes place at the Centre of Excellence level (1:50 million).Tasks are thus divided amongst the available workforce, so that the relatively few individuals capable of high-end tasks are freed to deliver those. Local communities should always be involved in the establishment of eye care services, and educated about eye care – since available facilities are not always accessed spontaneously.The WHO recommends that the minimum target for mid-level eye care personnel be 1:50,000 populations.