Saudi Cultural Missions Theses & Dissertations
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Item Restricted Developing and Assessing the Effectiveness of a Web-based Breastfeeding Educational Resource on Exclusive Breastfeeding Rate among Saudi Women(University of Wollongong, 2024-09) Alahmed, Salma; Frost, Steve; Meedya, Shahla; Fernanadez, Ritin; Win, Khin; Almutair, AbbasBackground Breastfeeding is not only a very cost-effective way of feeding a baby, but it is also associated with multiple health benefits for both mothers and infants. Henceforth, the World Health Organization highly recommends early initiation of breastfeeding within an hour after birth, followed by exclusive breastfeeding for up to six months. However, the rates of early initiation of breastfeeding and exclusive breastfeeding vary around the world, and in some countries, they are well below the WHO targets. Similarly, in Saudi Arabia, the rate of early initiation of breastfeeding ranges from 26.3% in the Northern region to 62.7% in the Southern region. Furthermore, the rate of exclusive breastfeeding at six months after birth varies from 19.2% to 28%. Despite national efforts to promote breastfeeding, a decline in breastfeeding practices has been recorded, coinciding with increased use of infant formula. Introducing formula milk during hospital stays in Saudi Arabia is common practice. Several misconceptions about body shape, the safety of colostrum, and breastmilk insufficiency, coupled with rapid economic growth, have contributed to this decline and early breastfeeding cessation, even though Saudi women are offered breastfeeding education during pregnancy. Therefore, there was a need to develop an online educational intervention to motivate Saudi women to breastfeed for a longer duration. Saudi Arabia has a deep-rooted cultural heritage based on the Islamic religion, and its main language is Arabic. Hence, the cultural and linguistic aspects of the educational intervention were considered important determinants of its successful implementation. Aim The aim of this program of Higher Degree Research (HDR) was to develop and assess the effectiveness of a Web-based Breastfeeding Educational Resource (WEBBER) on exclusive breastfeeding rate during the hospital stay until one month after birth. Method The multi-method study was carried out in three phases to address the research aim. In the first phase, a systematic review was conducted to collect evidence-based information. The content of the website was based on the knowledge gaps identified in the systematic review, the WHO recommendation and the Milky Way app. In the second phase, the content of the website was finalised through a consensus development conference involving local stakeholders from the participating hospital in Saudi Arabia and university researchers. Participants of the Consensus Development Conference were asked to give feedback before the meeting, and changes were made to the content accordingly. The meeting was conducted on Zoom, and polling was used to indicate whether consensus was reached about the content, images and layout. The Persuasive System Design model informed the framework of the website development phase. The third phase was divided into two stages. In the first stage, a quasi-experimental study with a before and after intervention design was used to assess the effectiveness of the Web-based breastfeeding educational resource in promoting breastfeeding practices. An online survey was conducted to collect information about the breastfeeding practices during a hospital stay and at one month after birth before (Standard Care group) and after (Intervention group) giving access to the website. In the second stage, a semi-structured interview was undertaken to explore women’s experiences using the website. The interview was digitally recorded and transcribed verbatim using the Otter application before translating into English. The quantitative data was analysed using R language for statistical computing. A log-binomial regression model was used to adjust for any confounding factors that were identified. The qualitative data was analysed using content and thematic analysis. Results A total of sixteen studies were included in the systematic review. Data from ten studies that reported on breastfeeding knowledge demonstrated that 42.3% to 82.3% of Saudi women had good knowledge. However, several gaps in knowledge were identified including managing breastfeeding challenges. A meta-analysis of seven studies that reported on attitudes showed that most Saudi women hold positive attitudes towards breastfeeding. However, around 40% of women believed that formula milk was as healthy as breastmilk, and 59.4% believed that formula feeding was more convenient. The literature review was crucial in developing the content of the website. After making changes to the content based on feedback received from the members of the Consensus Development Conference, 100% agreement about the content, layout and images was achieved during the meeting. This confirmed the cultural and linguistic appropriateness of the content of the website, which was successfully developed using the Persuasive Systems Design model. Findings from the quasi-experimental experimental demonstrated an almost three times increase in the rate of exclusive breastfeeding at one month after birth in the intervention group that was given access to the website. Several predictors of exclusive breastfeeding were identified, including intention to breastfeed for six months or more, baby not receiving pre-made infant formula, and unemployment status of the women. Thematic analysis of the data from the semi-structured interview revealed three themes, including “Satisfying,” “Helpful,” and “Motivational.” Participants found the website “satisfying” due to its “Accessibility,” “Visual attraction,” “User-friendliness,” “Informative content,” “Trustworthiness,” and “Uniqueness.” They qualified the website as being helpful because it was perceived as a “Problem solver,” “Supportive,” and “Confidence booster.” The four sub-themes associated with “Motivational” were “Motivation to continue breastfeeding,” “Preparedness for managing breastfeeding challenges,” “Facilitating the continuation of breastfeeding,” and “Enhancement of intention to Breastfeed for a longer period.” Overall, the women’s experience of using the website was very positive. Conclusion This program of Higher Degree Research (HDR) has demonstrated the effectiveness of the Web-based Breastfeeding Education Resource in improving the exclusive breastfeeding rate during the hospital stay until one month after birth in Saudi Arabia. The Consensus Development Conference facilitated the engagement with local stakeholders, who ensured the cultural and linguistic appropriateness of the evidence-based content derived from the systematic review, WHO and Milky Way App. The Persuasive Systems Design model was successfully employed in developing the website, which was confirmed by the positive feedback from breastfeeding women who felt more motivated to breastfeed. This study has demonstrated that a women-centred online breastfeeding educational intervention can improve breastfeeding practices in Saudi Arabia.6 0Item Restricted Balancing Innovation and Protection: Is AI Regulation the Future of Saudi FinTech?(King's College London, 2024-09) Alkhathlan, Alaa Saad; Keller, AnatThis study investigates the implications of artificial intelligence in the Saudi FinTech sector, focusing on the evolving regulatory landscape. While AI holds substantial promise for driving innovation, it also poses ethical and practical challenges such as data privacy, algorithmic transparency, and fairness. This study examines the current regulatory framework in Saudi Arabia, highlighting efforts like the AI Ethics Principles and the Personal Data Protection Law. Despite these measures, significant gaps remain due to the voluntary nature of the AI Ethics Principles and Generative AI Guidelines, resulting in inconsistent implementation. The primary aim of this study is to guide policymakers on regulating AI in the Saudi FinTech sector while preserving innovation. Key recommendations urge policymakers to develop regulations based on international best practices, addressing issues such as data privacy, algorithmic biases, and systemic risks. Emphasising the need for continuous dialogue among regulators, FinTech companies, and international partners, the study also calls for enhancing human-machine collaboration, establishing regulatory sandboxes, creating an AI Oversight Committee, and supporting research to better understand AI's implications. By aligning with Saudi Vision 2030 goals, these recommendations aim to strengthen Saudi Arabia's AI regulatory framework, support sustainable growth in the FinTech sector, and build public trust in AI-driven financial services.5 0Item Restricted Photovoltaic System Applications in Saudi Arabia: A Systematic Review to identify a road map for future opportunities(Cardiff University, 2024) Alzahrani, Jamaan Ramadan; Brousseau, EmmanuelThis study presents a systematic review of photovoltaic (PV) system applications in Saudi Arabia, exploring the potential, challenges, and opportunities for solar energy adoption within the framework of Vision 2030. The research examines how PV technology could help diversify the Kingdom’s energy portfolio, reduce carbon emissions, and promote sustainability. Using a systematic review methodology aligned with PRISMA guidelines, 148 studies were analyzed to evaluate current trends, sectoral applications, and barriers to PV integration. The findings highlight that PV adoption in Saudi Arabia is driven by abundant solar resources, decreasing installation costs, and supportive government policies. Applications extend across residential, commercial, industrial, and utility-scale sectors, with emerging interest in off-grid solutions and transportation projects. However, challenges such as economic barriers, regulatory constraints, and cultural resistance persist, hindering widespread implementation. The study identifies key themes, including the need for public-private partnerships, enhanced policy frameworks, and innovative financing models. Recommendations emphasize accelerating PV deployment through infrastructure development, regulatory reforms, and educational initiatives aimed at promoting public acceptance. This research contributes to Saudi Arabia’s energy transition by offering insights that could guide policymakers, investors, and stakeholders in expanding PV adoption. The integration of solar energy with complementary technologies such as wind and geothermal power is also proposed to ensure a sustainable, diversified energy future for the Kingdom.9 0Item Restricted STRATEGIC NAVIGATION IN SAUDI ARABIA’S EVOLVING DENTAL MARKET: BALANCING GROWTH, COMPETITION, AND REGULATION UNDER VISION 2030(University College London, 2024-08-28) Alrushaid, Abdullah; Catena, RodolfoThe dental service industry in Saudi Arabia is experiencing rapid growth, driven by demographic expansion, increased public awareness of oral health, and substantial government reforms under Vision 2030. This study examines the challenges faced by dental service providers in this evolving market, focusing on the competitive landscape and the complex regulatory environment. Using Porter’s Five Forces framework and a systematic literature review, the research identifies key factors influencing the operational and growth strategies of dental providers. The findings highlight the need for continuous innovation, strategic differentiation, and robust compliance with regulatory standards. The study also emphasizes the importance of workforce development, particularly in addressing the challenges posed by reliance on expatriate labour. Additionally, the research suggests that strategic geographic expansion into underserved regions and service diversification are crucial for mitigating market saturation in urban areas.2 0Item Embargo From Oil to Identity: Place branding for urban transformation in a top-down society (A case study of Saudi Arabia)(Erasmus University Rotterdam, 2024-12-11) Alsayel, Abdulrhman; Edelenbos, Jurian; De Jong, Martin; Fransen, JanThis dissertation investigates the transformation of Saudi Arabian cities under the ambitious Vision 2030 framework, focusing on the role of place branding within a centralized governance system. The research seeks to understand how cultural, institutional, and governance factors influence the effectiveness of place branding strategies in Saudi Arabia, offering a departure from Western-centric models that emphasize participatory and bottom-up approaches. By using Riyadh as a principal case study, the thesis sheds light on the implications of top-down city branding on urban development, cultural preservation, and social inclusivity. The research is structured into four interconnected papers. The first paper explores the tension between economic growth and social inclusivity through a comparative analysis involving Dubai, Amsterdam, and Toronto. The findings reveal that while creative city branding can drive innovation and attract investment, it often neglects inclusivity, leading to social exclusion. The second paper examines how various multi-level governance models impact the success of place branding in Saudi Arabia, demonstrating that cities directly aligned with central government resources tend to achieve more effective branding, though this can exacerbate regional disparities. The third paper delves into the cultural and institutional factors affecting place branding, emphasizing that while central government involvement can streamline efforts, it may limit local stakeholder engagement. The final paper focuses on the rebranding of Riyadh, drawing comparisons with global cities like Barcelona and Tokyo to reveal both the opportunities and social challenges associated with rapid urban transformation, such as gentrification and cultural homogenization. This thesis concludes that while centralized governance can expedite urban development and enhance city branding, maintaining cultural integrity and fostering social equity are essential to sustainable growth. The research advocates for future studies to employ mixed-method approaches for broader applicability and to explore comparative case studies in other centralized systems, such as China and the UAE, to enrich the understanding of place branding in non-Western contexts.10 0Item Restricted Exploring How Social Media Advertising Shape Cultural Saudi Identity in Saudi Arabia(University of Sheffield, 2024-08-29) Alaydaa, Sarah; Ogunmuyiwa, HakeemInvestigating how social media advertising shapes Saudi cultural identity is the goal of this study. The research reviewed the previous studies that conducted in the last decade to derive its results and conclusions. Social media platforms have fundamentally changed how people interact and communicate. Thus it's important to understand how these virtual social phenomena are affecting our feelings and ideas about ourselves and each other. Finding out how social media advertising affects cultural identity in a good and bad way is the goal of the research. The benefits can be seen in the freedom to engage with others, pick up new information, and deal with the outside world, as well as in the education of other people about their cultures. The negative consequences could manifest as a person adopting Western values, breaking free from the dominant social norms, or acquiring values and customs that are incompatible with Arab culture. Thus, the researcher thinks that the social media has positive effects on cultural identity and on society.13 0Item Restricted Large-System Transformation in Healthcare and the Roles of Senior Leaders: A Case Study from Saudi Arabia(University of Manchester, 2024) Bawhab, Omar; Nelson, Adrian; Coleman, Anna; Mahon, AnnThe implementation of large-system transformation in healthcare is complex and multi-faceted, requiring effective leadership at all levels, particularly from senior leaders. However, there is limited conceptual clarity around large-system transformations in healthcare and the roles senior leaders play in driving such transformations, especially in a non-Western context. This thesis addresses these knowledge gaps by exploring senior leaders' perceptions of large-system transformation and their role in its implementation in Saudi Arabia. Using a qualitative single case study design, this research gathered insights from 22 senior leaders at national and regional levels of the Saudi healthcare system through semi-structured interviews. The study employed an inductive-deductive thematic analysis approach, guided by the Health System Dynamics Framework, sensemaking theory, and systems leadership perspectives. Two conceptual frameworks were developed: one delineating ten key components of large-system transformation in healthcare, and another outlining seven critical roles of senior leaders during such transformations, six categories of enablers, and eight types of challenges. The large-system transformation framework highlights the interconnected nature of contextual triggers, climate for change, vision, leadership, governance, actors, resources, processes, social forces (e.g., resistance to change), and information flow. The senior leaders’ roles, enablers, and challenges framework emphasizes leaders' responsibilities in creating a climate for change, communicating and learning, managing resources, engaging stakeholders, setting strategic direction, managing social dynamics, and developing key leadership attributes. The framework also indicates multiple enablers and challenges relevant to the roles of senior leaders, providing a nuanced understanding of the complexities involved in healthcare system transformations. This research contributes to the theoretical understanding of large-system transformation in healthcare and senior leaders' roles, enablers, and challenges, particularly in a non-Western context. It offers practical implications for healthcare leaders and policymakers engaged in system-wide transformations. Future research directions are suggested to further validate and expand upon these findings.12 0Item Restricted How has Saudi Arabia maintained political stability, monarchical survival and curtailed the traditional patronage system while implementing economic and social reforms under Vision 2030?(The London School of Economics and Political Science, 2024-08) Alenazi, Jenna Hamid; Hertog, SteffenThis dissertation investigates the impact of Saudi Vision 2030's comprehensive socio-economic reforms on the political stability and monarchical survival of Saudi Arabia. By examining specific economic and social reforms, implemented since 2016, it focuses on how these changes have contributed to the monarchy’s resilience. Also, it examines the reforming and curtailment of the traditional patronage system, highlighting how through Vision 2030, Saudi Arabia has developed an updated social contract. Key economic reforms analysed include the introduction of VAT, deregulation of oil and gas prices and the increase in renewable energy. Social reforms include youth unemployment, female labour force participation and housing subsidies. This study employs a qualitative approach, utilising process-tracing to analyse key data from 2016 to early 2024, including GDP growth, labour force participation, unemployment rates and Key Performance Indicators (KPIs), supplemented by government documents, to measure the progress, effectiveness and implementation levels of the reforms. The findings reveal that the economic and social reforms under Vision 2030 have mitigated potential political instability through economic diversification, job creation for women and youth and the strategic balancing of austerity measures with compensatory programs. By aligning social reforms with societal expectations and addressing public concerns, the government has demonstrated its capacity to meet modern demands lessening potential for unrest. Furthermore, this study suggests that these reforms, despite curtailing the traditional patronage system, have reinforced the monarchy’s legitimacy. The concept of monarchical survival is used to demonstrate how Saudi’s monarchy has successfully navigated turbulent political, economic and social challenges, ensuring its continued survival in a rapidly changing landscape.7 0Item Restricted Safe Return to Driving after Sustaining Road Traffic Injuries: Driver Assessment and Rehabilitation in Saudi Arabia(Monash University, 2024) Alhashmi, Doha Hassan; Oxley, Jennie; Fossey, Ellie; Lalor, AislinnBackground: In Saudi Arabia, motor vehicle crashes are a major cause of injury and disability. Rehabilitation is essential to reduce the severity and long-term disabilities resulting from road traffic injuries and to ensure successful reintegration of individuals into society. Occupational therapy plays a crucial role in this rehabilitation process. Since the occupational therapy profession is relatively new in Saudi Arabia, this thesis aimed to explore utilising occupational therapy services within post-crash rehabilitation and addressing safe return to driving. It also aimed to identify suitable interventions and policies that could enhance rehabilitation practices in the Saudi context. Methods: This research used a mixed methods approach involving quantitative and qualitative methods. Initially, a systematic review of methods to evaluate at-risk drivers was conducted. This was followed by two complementary studies: a quantitative observational retrospective cohort review and a descriptive qualitative study. The quantitative study used existing registry data from a Saudi major trauma centre. Data for 475 trauma registry patients was analysed using descriptive and regression analyses. Then qualitative semi-structured interviews with 13 occupational therapists explored their perspectives on post-crash rehabilitation practices and assessment of at-risk drivers. Data were analysed using reflexive thematic analysis. Results: The systematic review revealed the main approaches used internationally to assess at-risk drivers. Over two-thirds of the reviewed studies used on-road driving performance tests to ii determine driving competence independently or in combination with another method. The quantitative study data revealed that following RTIs, occupational therapy is utilised for several reasons and that the only significant predictor of occupational therapy referral (df=1, p=.049, CI=1.011- 75.27) was combined rehabilitation services use. The qualitative study identified themes highlighting the inaccessibility of post-crash rehabilitation due to multiple factors, including service centralisation and high demand. The rehabilitation pathway was described; there was also a lack of clarity on the occupational therapists’ role among other health professionals. Current limitations of rehabilitation services include insufficient experienced and specialised therapists, the predominance of the biomedical framework and the impairment focus in the current practice. The therapists in this study also reported their lack of knowledge and practical skills for driver assessment and rehabilitation practices, and their need for support and infrastructure to develop this practice area in Saudi Arabia. They also recommended the need for more research and engagement with stakeholders to establish this specialised practice area. Conclusions: This thesis highlighted the current practice challenges for rehabilitation following road traffic injuries in Saudi Arabia and emphasised the importance of a multidisciplinary approach in post-crash care. The thesis advocates a collaborative, participative approach to developing a driver assessment and rehabilitation policy by involving stakeholders, including at-risk drivers, healthcare professionals, and licensing authorities, so as to create a tailored and effective policy for Saudi Arabia. This is a crucial first step toward establishing a safe and sustainable practice framework that can enable therapists to 1) provide needed service to at risk drivers, 2) support at-risk drivers to resume driving safely and have meaningful and fulfilled lives, 3) protect all road users from preventable car crashes, and 4) alleviate the country’s burden from further road traffic injuries.14 0Item Restricted Large-System Transformation in Healthcare and the Roles of Senior Leaders: A Case Study from Saudi Arabia(University of Manchester, 2024) Bawhab, Omar; Nelson, Adrian; Coleman, Anna; Mahon, AnnThe implementation of large-system transformation in healthcare is complex and multi-faceted, requiring effective leadership at all levels, particularly from senior leaders. However, there is limited conceptual clarity around large-system transformations in healthcare and the roles senior leaders play in driving such transformations, especially in a non-Western context. This thesis addresses these knowledge gaps by exploring senior leaders' perceptions of large-system transformation and their role in its implementation in Saudi Arabia. Using a qualitative single case study design, this research gathered insights from 22 senior leaders at national and regional levels of the Saudi healthcare system through semi-structured interviews. The study employed an inductive-deductive thematic analysis approach, guided by the Health System Dynamics Framework, sensemaking theory, and systems leadership perspectives. Two conceptual frameworks were developed: one delineating ten key components of large-system transformation in healthcare, and another outlining seven critical roles of senior leaders during such transformations, six categories of enablers, and eight types of challenges. The large-system transformation framework highlights the interconnected nature of contextual triggers, climate for change, vision, leadership, governance, actors, resources, processes, social forces (e.g., resistance to change), and information flow. The senior leaders’ roles, enablers, and challenges framework emphasizes leaders' responsibilities in creating a climate for change, communicating and learning, managing resources, engaging stakeholders, setting strategic direction, managing social dynamics, and developing key leadership attributes. The framework also indicates multiple enablers and challenges relevant to the roles of senior leaders, providing a nuanced understanding of the complexities involved in healthcare system transformations. This research contributes to the theoretical understanding of large-system transformation in healthcare and senior leaders' roles, enablers, and challenges, particularly in a non-Western context. It offers practical implications for healthcare leaders and policymakers engaged in system-wide transformations. Future research directions are suggested to further validate and expand upon these findings.9 0