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INTRODUCTION: achieving the healthcare components of the United Nations' Millennium Development Goals is significantly premised on effective service delivery by civil society organisations (CSOs).However, many CSOs across Africalack the necessary capacity to perform this role robustly. This paper reports on an evaluation of the use, and perceived impact, of aknowledge management tool upon institutional strengthening among CSOs working in Kenya's health sector. METHODS: three methods were used: analytics data; user satisfaction surveys; and a furtherkey informant survey. RESULTS: satisfaction with the portal was consistently high, with 99% finding the quality and relevance of the content very good or good for institutional strengthening standards, governance, and planning and resource mobilisation. Critical facilitators to the success of knowledge management for CSO institutional strengthening were identified as people/culture (developed resources and organisational narratives) and technology (easily accessible, enabling information exchange, tools/resources available, access to consultants/partners).Critical barriers were identified as people/culture (database limitations, materials limitations, and lack of active users), and process (limited access, limited interactions, and limited approval process). CONCLUSION: this pilot study demonstrated the perceived utility of a web-based knowledge management portal among developing nations' CSOs, with widespread satisfaction across multiple domains, which increased over time. Providing increased opportunities for collective mutual learning, promoting a culture of data use for decision making, and encouraging all health organisations to be learning institutions should be a priority for those interested in promoting sustainable long-term solutions for Africa.

La décision d'amputation pour traumatisme grave de membre n'est pas toujours facile à prendre. Les auteurs rapportent le cas d'un traumatisme ouvert de la cheville gauche avec luxation tibiotalienne complète, référé pour amputation. Il s'agit d'une passagère d'une moto-taxi percutée par une voiture. A l'admission, le pouls tibial postérieur était présent et le score dit MESS (Mangled Extremity Severity Score) côté à 5, ce qui a permis et d'éviter l'amputation. Après débridement et réduction, une broche transplantaire a permis d'immobiliser la cheville et de faire les pansements. L'amputation a été évitée. La cicatrisation dirigée de la peau a été suivie par la kinésithérapie. La mobilité de la cheville autorise une marche avec cannes au quatrième mois post-opératoire. Les auteurs recommandent l'utilisation du MESS dans la décision d'amputation après traumatisme grave de membre.

A variety of researchers have carried out job satisfaction studies in fisheries during the last decades. Results have shown the significant role of self-actualization in the determination of job satisfaction which backs the reasoning that fishing is more than just a livelihood. This paper is based in a job satisfaction study carried out in three lobster fisheries in the Caribbean. Lobster fishing (Panulirus argus) is an important economic activity throughout the Caribbean Basin, both as a source of income and employment for the local population as well as foreign exchange for national governments. These countries differ significantly in structure of the fishery as well as governance arrangements. In this paper we wish to address the relation between these structural differences and fishers’ job satisfaction across the three countries. Results indicate fishers’ job satisfaction is significantly higher in small-scale fisheries.