No description available.

O perfil de morbidade infantil é um parâmetro importante para a definição das políticas de saúde. Os estudos sobre mortalidade infantil são mais numerosos do que os sobre morbidade e, em especial, os que enfocam as internações hospitalares. Esse estudo teve como objetivo descrever as causas de internação das crianças de 0 a 9 anos de idade, no município de São Paulo, no período de 2002 a 2006, comparando-as aos dados nacionais. Os dados foram obtidos no Sistema de Informações Hospitalares, disponíveis no DATASUS. Nos 5 anos do estudo, ocorreram 451.303 internações de crianças de 0 a 9 anos de idade (16% do total de internações), com predomínio dos menores de 1 ano de idade (74%), seguido pelas crianças de 1 a 4 anos (16%) e, menos frequentemente, as crianças de 5 a 9 anos (10%). A média de permanência hospitalar foi de 7,3 dias no município e de 6 dias, no Brasil. Enquanto no município o coeficiente de internação aumentou 11%, no Brasil diminuiu 14%. As doenças respiratórias foram as principais causas de hospitalização, tanto no município como no Brasil. Em São Paulo a segunda causa de internação foram as afecções originadas no período perinatal (15,9%) e, no Brasil, as doenças infecto-parasitárias (21,7%). As dez causas principais corresponderam a praticamente metade das internações no município de São Paulo. As internações por doenças respiratórias aumentaram, no município, 31% entre os menores de 1 ano de idade, 26% entre 1 e 4 anos e 34% entre 5 e 9 anos e diminuíram, no Brasil, nas 3 faixas etárias. As hospitalizações por doenças perinatais aumentaram 32% em São Paulo e 6% no Brasil. Enquanto as hospitalizações por diarréia diminuíram no Brasil, registrou-se aumento no município nos menores de 5 anos. As internações decorrentes de causas externas, mais frequentes entre 5 e 9 anos de idade, aumentaram em São Paulo e mantiveram-se inalteradas no Brasil. No período estudado aconteceram significativas mudanças nas políticas de saúde do município, com a adesão ao Sistema Único de Saúde (SUS) e fortalecimento da Atenção Básica, tendo a Estratégia de Saúde da Família como eixo estruturante. Os fatores determinantes das hospitalizações são múltiplos e interagem de maneira complexa. São discutidos os principais fatores, identificados no município, que podem ter contribuído para o perfil de internações observado / Childs morbidity profile is an important parameter for the definition of health policies. Studies on infant mortality are more numerous than those on morbidity and, in particular, those focused on hospitalization. This study aimed to describe the causes of 0 to 9 years old children hospitalization in São Paulo during 2002 to 2006 and to compare them to the national ones. The data were obtained in the Brazilian Hospital Database, available in DATASUS. In the 5 years period analyzed in this study, there were 451.303 hospitalizations for 0 to 9 years old children (16% of total admissions). There was a predominance of children under 1 year of age (74%), followed by 1 to 4 years years old children (6%) and less often, children with 5 to 9 years of age (10%). The average hospital stay was 7.3 days in the Sao Paulo and 6 days in Brazil. While the coefficient of hospitalization increased in the municipality by 11%, in Brazil it fell 14%. Respiratory diseases were the leading causes of hospitalization, both in Sao Paulo as in Brazil. In Sao Paulo, the second leading cause of hospitalization was diseases originating in the perinatal period (15.9%) while in Brazil it was infectious and parasitic diseases (21.7%). In São Paulo, the ten leading causes accounted for almost half of all hospitalization. In the municipality the respiratory illnessess admissions increased, 31% of children under 1 year of age, 26% between 1 and 4 years of age, and 34% between 5 and 9 years of age while it decreased in Brazil in the 3 age groups. The hospitalization for perinatal diseases increased 32% in São Paulo and 6% in Brazil. Although hospitalizations for diarrhea decreased in Brazil, in Sao Paulo they increased in chlidren less than 5 years old. The admissions due to external causes, most frequent between 5 and 9 years old children, rose in Sao Paulo and remained unchanged in Brazil. In the period studied there were significant changes in health policies of the municipality. The Brazilian national health system (SUS) was implemented in the city, with strengthening of Primary Healthcare and the Family Health Strategy. The determinants of hospital admissions are multiple and interact in complex ways. The main factors which may have contributed to the observed profile of admissions identified in the municipality were discussed

No description available.

Background and Purpose: Just over 15% of children under 18 years of age in the UnitedStates, or approximately 11.2 million children, are estimated to have special healthcare needs.Although children with special healthcare needs (CSHCN) make up a small percentage of thepediatric population, they account for over one third of pediatric medical care. Parental attitudesregarding immunization play a significant role in vaccination rates among children. The purposeof this research is to explore parental attitudes regarding immunization of CSHCN.Methods: This qualitative study focused on parental perceptions and beliefs aboutimmunizations for CSHCN. Sixteen participants, who were parents of CSHCN from onepediatric specialty care clinic participated in focus groups. Institutional review board approvalwas received prior to data collection.Results: While the purpose of this study was to determine the attitudes of parents ofCSHCN regarding immunizations, analysis revealed parents simply wanted to share their lifeexperiences rearing these children, with issues of immunization being secondary. Participantsdescribed the experience of caring for their CSHCN related to isolationism and the weight ofresponsibility as leader of their childs care. Additionally, the majority of parents thatparticipated viewed childhood vaccinations in a positive light. Parents acknowledged that it wasimportant for their own children to receive vaccines. Participants also recognized that it wasimportant for the community to be vaccinated in order to protect their child. However, the desirefor individualized care, at times, caused parents to disregard the immunization schedulerecommended by Center for Disease Control and Prevention.Conclusions: Health care providers can be effective and influential members of the healthcare team by engaging in community based education about vaccines, building trustingrelationships with parents and helping parents understand the need to follow the recommendedschedule for immunizations.

Bakgrund: Amningsfrekvensen sjunker i Halland, Sverige och globalt. Barnsjuksköterskan inom barnhälsovården i Sverige utgör en del av det stöd som erbjuds till kvinnan och familjen vid amning. Barnsjuksköterskan erhåller erfarenheter av hur stödet från partnern och omgivningen kan se ut och hur det kan påverka kvinnan på olika sätt. Stöd från partner och andra personer i kvinnans omgivning är betydelsefullt för initiering och etablering av amning. Forskning på området är begränsad. Syfte: Syftet med studien var att undersöka barnsjuksköterskans erfarenheter av kvinnans behov av stöd vid amning i barnhälsovården. Metod: En intervjustudie med induktiv ansats och bekvämlighetsurval. Nio barnsjuksköterskor från olika BVC (barnavårdscentral) runt om i Halland deltog. Resultat: Studien resulterade i tre kategorier: behov av varierat stöd från barnsjuksköterskan, omgivningens stöd påverkar amningen och partnerns stöd och delaktighet påverkar amningen. Konklusion: Stödet från barnsjuksköterskan på BVC ansågs betydelsefullt för de flesta kvinnor som ammar. Det var viktigt att barnsjuksköterskan erbjöd ett person- och familjecentrerat stöd vid amning. Partnerns stöd och delaktighet var viktigt för den ammande kvinnan, både emotionellt och praktiskt. Även omgivningens stöd var betydelsefullt för kvinnan vid amning. / Background: Breastfeeding rates are declining in Halland, Sweden and globally. The pediatric nurse that works at the child health services (CHS) in Sweden, forms part of the support offered to the woman and the family during breastfeeding. The pediatric nurse often obtains experience of how support from partners and surroundings might look like. The support from partners and others in the woman's surroundings is important for a well- established breastfeeding. But research in the area is limited. Aim: The aim of the study was to examine the pediatric nurse's experiences of the woman's need for support during breastfeeding in child health care. Method: An interview study with an inductive approach and convenience sampling. Nine pediatric nurses from different CHS around Halland participated. Results: The study is presented in three categories: the need of varied support from the pediatric nurse, the support from the surroundings affects breastfeeding, partner's support and participation affect breastfeeding. Conclusion: The support of the pediatric nurses at the CHS was considered essential for most women who breastfeed. A patient-centered care and family nursing was considered central to support the woman. The partner's support and participation both emotionally and practically were important for the breastfeeding woman. Support from the surroundings was also important for the woman.

The demographics and perceived needs of the Comprehensive Health Investment Project participants were studied along with the interventions provided by the CHIP staff. Demographic information and perceived needs were calculated on 397 household heads. These families were followed for a year and the interventions provided to them during that year were recorded. Intervention records were collected quarterly and analyzed for comparisons with the family profile grid.Results show a unique demographic makeup of CHIP participants. Sixty percent of household heads had one or more years of college; 66 percent were employed at the time of the study; 73 percent were receiving federal financial assistance of some kind. Health and nutrition of the family were the main concerns of the clients. Other needs included financial assistance, employment, and housing. Eleven percent of interventions provided by CHIP throughout the study year were directed towards financial assistance. Ten percent of services were employment oriented. CHIP participants were also shown to use physicians during well times - not just during emergencies. Results and conclusions are discussed in detail. / Master of Science

背景: 公共健康護理在香港的演變可以追溯到二十世紀三十年代，但公共衛生護士的培訓卻自一九五四年才正式開始。由於在此領域工作的護士人數相對比醫院護士少，因而令公共衛生護士的貢獻較不明顯。本研究旨在揭示公共衛生護士於一九五四年至二零一零年期間經歷了文化，社會，經濟和政治的變化後在母嬰健康院的發展。研究目的: 檢視公共健康護理的特點，並對公共健康護理在母嬰健康院的工作和改變進行分析，以確定對公共健康護理在母嬰健康院的發展有重大影響的事件和原因。研究方法: 使用研究歷史的方法，重新審視公共衛生護士的經驗。主要研究數據來源是收集退休公共衛生護士和醫療及護理行政人員的口述歷史。輔助數據來源則包括政府文件，個人筆記，照片和剪報。共有37名受訪者同意接受訪問，其中包括六名行政人員和三十一名退休公共衛生護士，年齡由五十多歲到九十歲。研究員以面對面訪談方法收集口述歷史。並以內容分析法處理所得資料。研究結果: 研究結果描繪公共健康護理有六大特點，包括其分類，護理文化，服務重點，健康教育和健康促進的功能，以及展現出護理的藝術和科學。研究結果表明，文化，社會，經濟，政治因素和社會上的重大事件影響了公共健康護理。其中不明顯和被貶值的公共健康護理服務，醫療優勢和行政影響，公共衛生和公共健康護理的意識形態，作為政府人員和公共健康護士的培訓等專業問題影響了公共衛生護士在香港的地位和護理專業。在這項研究中收集的數據也揭露了香港公共健康護理的發展是密切跟隨公共健康的變化，其發展可分為三個階段:從一九五四年到一九七零年是公共健康護理的演化期一九七零年至一九八零年間是靜態期，而一九九零年至二零一零年則是變化期。研究結論和含義: 公共健康護士需要擴大知識和技能，促進專業自主，推行以實證為基礎的護理並記錄護理成果。歷史研究可以幫助解釋過去和加強理解現狀；而歷史對護理亦提供了重大貢獻。 / Background: The evolution of public health nursing in Hong Kong can be traced back to the 1930s but formal training of public health nurses only commenced in 1954. However, as the number of nurses working in this field was small in comparison with hospital nurses, their practice and contribution is largely unknown. Aim: This study aims to reveal the developments in public health nursing practice in Maternal and Child Health Centres (MCHC) from 1954 to 2010. Objectives of this study include examining the characteristics of public health nursing practice and analysing the changes in public health nursing practice in MCHC, as well as identifying the significant events and factors that influenced its development. Methods: The historical research method was adopted to examine the public health nurses’ experiences. The primary data source was derived from the collected oral histories of retired public health nurses and medical and nursing administrators. The secondary data source was obtained from a review of government documents, personal notes, photographs and newspaper cuttings. In total, thirty-seven informants, including six administrators and thirty-one retired public health nurses were interviewed, ranging in age from late 50s to early 90s. Oral histories were taken from face-to-face interviews with these informants. Content analysis was used to analyse the collected information. Results: The study findings depict six characteristics of public health nursing, including its category, nursing culture, focus of service, health education and health promotion function, and the presentation of art and science in practice. Findings also demonstrate the developments and practice of the public health nursing was influenced by cultural, social, economical and political factors and events. In addition, several important professional issues affect the status and professional identity of public health nurses, among them the invisibility of the service and its devalued status, medical dominance and administrative influence, the ideology of public health and public health nursing in Hong Kong, the impact of working for the government and the preparation of public health nurses. Data collected in this study also disclose how developments in public health nursing in Hong Kong closely followed the changes in public health in which the development can be divided in three phases: the evolution of public health nursing from 1954 to 1970s, the static period from 1970s to 1980s and the period of changes from 1990s to 2010. Implications and Conclusions: Public health nurses are suggested to expand their knowledge and skills to further their autonomy, promote evidence-based practice and document nursing outcomes. The study also demonstrates that historical study can help to interpret the past and enhance understanding of the present. History has much to contribute to nursing. / Detailed summary in vernacular field only. / Foong, Mary. / Thesis (D.Nurs.)--Chinese University of Hong Kong, 2013. / Includes bibliographical references (leaves 293-310). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts also in Chinese; appendix H in Chinese. / APPENDICES --- p.xiii / LIST OF TABLES --- p.xiv / LIST OF FIGURES --- p.xv / CHAPTER ONE / INTRODUCTION --- p.1 / Chapter 1.1 --- Aims and objectives of the study --- p.3 / Chapter 1.2 --- Significance of the study --- p.3 / Chapter 1.3 --- Overview of this thesis --- p.4 / CHAPTER TWO / LITERATURE REVIEW --- p.7 / Chapter 2.1 --- Literature search --- p.8 / Chapter 2.2 --- Public health and related terms --- p.9 / Chapter 2.2.1 --- Definition of public health --- p.9 / Chapter 2.2.1.1 --- Characteristics of public health --- p.10 / Chapter 2.2.2 --- Public health in Hong Kong --- p.11 / Chapter 2.2.3 --- Definition of community health --- p.11 / Chapter 2.3 --- Public health nursing and related terms --- p.12 / Chapter 2.3.1 --- Definition and characteristics of public health nursing --- p.12 / Chapter 2.3.2 --- Definition of community health nursing --- p.13 / Chapter 2.3.3 --- Public health nursing versus community health nursing --- p.13 / Chapter 2.3.3.1 --- Differentiation from setting of practice --- p.15 / Chapter 2.3.3.2 --- Differentiation from focus of practice --- p.15 / Chapter 2.3.3.3 --- Differentiation from context --- p.16 / Chapter 2.4 --- Public health nursing and community health nursing in different countries --- p.17 / Chapter 2.4.1 --- Public health nursing and community health nursing in the United States --- p.18 / Chapter 2.4.2 --- Public health nursing and community health nursing in Canada --- p.19 / Chapter 2.4.3 --- Public health nursing and community health nursing in the United Kingdom --- p.19 / Chapter 2.4.4 --- Public health nursing and community health nursing in Asia --- p.20 / Chapter 2.4.5 --- Public health nursing in Hong Kong --- p.23 / Chapter 2.4.6 --- Lesson learned from the differences of public health nursing practice around the world --- p.24 / Chapter 2.5 --- Nursing, history and the history of nursing --- p.25 / Chapter 2.5.1 --- The value of history and nursing history --- p.26 / Chapter 2.5.2 --- The general value of history --- p.26 / Chapter 2.5.3 --- The general value of nursing history --- p.27 / Chapter 2.5.4 --- The value of studying nursing history --- p.27 / Chapter 2.5.5 --- The value of nursing history as suggested by scholars --- p.28 / Chapter 2.5.6 --- The tools to study history --- p.29 / Chapter 2.5.6.1 --- The use of historical research to study history --- p.30 / Chapter 2.5.6.2 --- Standard of historical research --- p.31 / Chapter 2.6 --- Literature review and critique of the previous historical studies --- p.32 / Chapter 2.6.1 --- Summary of the review --- p.45 / Chapter 2.7 --- Conclusion of this chapter --- p.48 / CHAPTER THREE / METHODOLOGY --- p.50 / Chapter 3.1 --- Rationale of selecting a qualitative research method --- p.50 / Chapter 3.2 --- The choice of qualitative method historical research --- p.51 / Chapter 3.3 --- The importance of primary and secondary data sources --- p.52 / Chapter 3.4 --- The relevancy of adopting oral history as the main research strategy and its issues --- p.52 / Chapter 3.4.1 --- An overview of oral history --- p.53 / Chapter 3.4.2 --- Definitions on oral history --- p.53 / Chapter 3.4.3 --- Virtues of oral history --- p.54 / Chapter 3.4.4 --- Issues related to oral history --- p.55 / Chapter 3.4.5 --- Differences between oral history and other qualitative studies --- p.58 / Chapter 3.5 --- Secondary data sources --- p.59 / Chapter 3.6 --- Research procedures --- p.61 / Chapter 3.6.1 --- Ethical consideration and ethical review --- p.61 / Chapter 3.6.2 --- Informed consent --- p.61 / Chapter 3.6.3 --- Sampling method --- p.62 / Chapter 3.6.3.1 --- The use of purposive sampling in qualitative research --- p.63 / Chapter 3.6.3.2 --- The determination of sample size and sample units --- p.63 / Chapter 3.6.3.3 --- Selection of participants --- p.65 / Chapter 3.6.3.3.1 --- Consideration of choosing the retired participants. --- p.66 / Chapter 3.6.3.4 --- Recruitment of participants --- p.66 / Chapter 3.6.3.4.1 --- The sampling process --- p.67 / Chapter 3.6.4 --- Data collection method --- p.67 / Chapter 3.6.4.1 --- Collection of primary data --- p.67 / Chapter 3.6.4.1.1 --- Sequence of interview --- p.68 / Chapter 3.6.4.1.2 --- Setting for interview --- p.68 / Chapter 3.6.4.1.3 --- The process of collecting oral histories --- p.69 / Chapter 3.6.4.1.4 --- Strategies for avoiding personal bias --- p.72 / Chapter 3.6.4.2 --- Collection of secondary data --- p.72 / Chapter 3.6.4.3 --- Data handling and record keeping --- p.73 / Chapter 3.6.4.3.1 --- Handling of primary data --- p.74 / Chapter 3.6.4.3.2 --- Handling of secondary data --- p.74 / Chapter 3.6.5 --- Data analysis --- p.75 / Chapter 3.6.5.1 --- The adoption of content analysis --- p.75 / Chapter 3.6.5.2 --- Process of content analysis --- p.76 / Chapter 3.6.5.2.1 --- Analysis of the primary data --- p.76 / Chapter 3.6.5.2.2 --- Analysis of secondary data --- p.78 / Chapter 3.6.5.2.3 --- Linking the primary and secondary data --- p.79 / Chapter 3.7 --- Rigour of the study --- p.80 / Chapter 3.7.1 --- Quality issues related to qualitative research --- p.80 / Chapter 3.7.2 --- Strategies to enhance the rigour of the study --- p.81 / Chapter 3.7.2.1 --- Strategies applied to ensure credibility --- p.82 / Chapter 3.7.2.2 --- Strategies applied to ensure confirmability --- p.83 / Chapter 3.7.2.3 --- Strategies applied to ensure dependability --- p.84 / Chapter 3.7.2.4 --- Strategies applied to ensure transferability --- p.85 / Chapter 3.8 --- The pilot study --- p.85 / Chapter 3.9 --- Conclusion of this chapter --- p.87 / CHAPTER FOUR / FINDINGS --- p.89 / Chapter 4.1 --- Framework of data handling and presentation --- p.90 / Chapter 4.2 --- Characteristics of the participants --- p.93 / Chapter 4.3 --- The evolution of public health nurses - 1950s --- p.96 / Chapter 4.3.1 --- Data collected from secondary data source --- p.97 / Chapter 4.3.1.1 --- Significant events in the community --- p.97 / Chapter 4.3.1.2 --- The MCHC service --- p.97 / Chapter 4.3.1.3 --- The public health nurses --- p.98 / Chapter 4.3.2 --- Oral histories from the public health nurses --- p.102 / Chapter 4.3.2.1 --- Training of public health nurses --- p.103 / Chapter 4.3.2.1.1 --- Scope of training --- p.103 / Chapter 4.3.2.2 --- Selection of the public health field --- p.105 / Chapter 4.3.2.3 --- Perception of public health nursing duties --- p.106 / Chapter 4.3.2.4 --- Public health nursing practice in IWC --- p.108 / Chapter 4.3.2.5 --- Identifying factors which influenced public health nursing development --- p.112 / Chapter 4.3.2.6 --- Qualities of good public health nurses --- p.114 / Chapter 4.4 --- Challenges from socio-cultural and economical influences 1960 -1969 --- p.114 / Chapter 4.4.1 --- Data collected from secondary data source --- p.114 / Chapter 4.4.1.1 --- Significant events in the community --- p.116 / Chapter 4.4.1.2 --- The MCHC service --- p.117 / Chapter 4.4.1.3 --- The public health nurses --- p.118 / Chapter 4.4.2 --- Oral histories from the public health nurses --- p.119 / Chapter 4.4.2.1 --- Training of public health nurses --- p.119 / Chapter 4.4.2.1.1 --- Scope of training --- p.120 / Chapter 4.4.2.2 --- Selection of the public health field --- p.121 / Chapter 4.4.2.3 --- Perception of public health nursing duties --- p.121 / Chapter 4.4.2.4 --- Public health nursing practice in MCHC --- p.122 / Chapter 4.4.2.5 --- Identifying factors which influenced public health nursing development --- p.125 / Chapter 4.4.2.6 --- Qualities of good public health nurses --- p.129 / Chapter 4.5 --- The increasingly affluent period 1970 -1979 --- p.130 / Chapter 4.5.1 --- Data collected from secondary data source --- p.130 / Chapter 4.5.1.1 --- Significant events in the community --- p.132 / Chapter 4.5.1.2 --- The MCHC service --- p.133 / Chapter 4.5.1.3 --- The public health nurses --- p.134 / Chapter 4.5.2 --- Oral histories from the public health nurses --- p.134 / Chapter 4.5.2.1 --- Training of public health nurses --- p.135 / Chapter 4.5.2.1.1 --- Scope of training --- p.135 / Chapter 4.5.2.2 --- Selection of the public health field --- p.136 / Chapter 4.5.2.3 --- Perception of public health nursing duties --- p.136 / Chapter 4.5.2.4 --- Public health nursing practice in MCHC --- p.139 / Chapter 4.5.2.4.1 --- Health education activities --- p.139 / Chapter 4.5.2.4.2 --- Home visiting --- p.140 / Chapter 4.5.2.4.3 --- Serving clients with different backgrounds --- p.141 / Chapter 4.5.2.5 --- Identifying factors which influenced public health nursing development --- p.145 / Chapter 4.5.2.6 --- Qualities of good public health nurses --- p.145 / Chapter 4.6 --- The impact of the political scenes 1980 1989 --- p.147 / Chapter 4.6.1 --- Data collected from secondary data source --- p.147 / Chapter 4.6.1.1 --- Significant events in the community --- p.147 / Chapter 4.6.1.2 --- The MCHC service --- p.148 / Chapter 4.6.1.3 --- The public health nurses --- p.149 / Chapter 4.6.2 --- Oral histories from the public health nurses --- p.150 / Chapter 4.6.2.1 --- Training of public health nurses --- p.150 / Chapter 4.6.2.1.1 --- Scope of training --- p.151 / Chapter 4.6.2.2 --- Selection of the public health field --- p.152 / Chapter 4.6.2.3 --- Perception of public health nursing duties --- p.153 / Chapter 4.6.2.4 --- Public health nursing practice in MCHC --- p.154 / Chapter 4.6.2.5 --- Identifying factors which influenced public health nursing development --- p.156 / Chapter 4.6.2.5.1 --- Factors not influencing public health nursing --- p.156 / Chapter 4.6.2.5.2 --- Factors influencing public health nursing --- p.157 / Chapter 4.6.2.6 --- Qualities of good public health nurses --- p.161 / Chapter 4.7 --- 1990- 1999 Before and after the new era; the transition of political parties --- p.162 / Chapter 4.7.1 --- Data collected from secondary data source --- p.162 / Chapter 4.7.1.1 --- Significant events in the community --- p.162 / Chapter 4.7.1.2 --- The MCHC Service --- p.164 / Chapter 4.7.1.3 --- The public health nurses --- p.164 / Chapter 4.7.2 --- Oral histories from the public health nurses --- p.166 / Chapter 4.7.2.1 --- Training of public health nurses --- p.166 / Chapter 4.7.2.1.1 --- Scope of training --- p.167 / Chapter 4.7.2.2 --- Selection of the public health field --- p.168 / Chapter 4.7.2.3 --- Perception of public health nursing duties --- p.170 / Chapter 4.7.2.4 --- Public health nursing practice in MCHC --- p.172 / Chapter 4.7.2.4.1 --- Health education activities --- p.172 / Chapter 4.7.2.4.2 --- Home visiting --- p.173 / Chapter 4.7.2.4.3 --- Serving clients with different backgrounds --- p.175 / Chapter 4.7.2.4.4 --- Child developmental screening service --- p.176 / Chapter 4.7.2.4.5 --- Trail of various service delivery approaches --- p.177 / Chapter 4.7.2.5 --- Identifying factors which influenced public health nursing development --- p.178 / Chapter 4.7.2.5.1 --- Factors not influencing public health nursing --- p.178 / Chapter 4.7.2.5.2 --- Factors influencing public health nursing --- p.179 / Chapter 4.7.2.6 --- Qualities of good public health nurses --- p.184 / Chapter 4.8 --- Years of change after 2000 --- p.185 / Chapter 4.8.1 --- Data collected from secondary data source --- p.185 / Chapter 4.8.1.1 --- Significant events in the community --- p.185 / Chapter 4.8.1.2 --- The MCHC service --- p.188 / Chapter 4.8.1.3 --- The public health nurses --- p.190 / Chapter 4.8.2 --- Oral histories from the public health nurses --- p.193 / Chapter 4.8.2.1 --- Training of public health nurses --- p.193 / Chapter 4.8.2.1.1 --- Scope of training --- p.194 / Chapter 4.8.2.2 --- Selection of the public health field --- p.194 / Chapter 4.8.2.3 --- Perception of public health nursing duties --- p.195 / Chapter 4.8.2.4 --- Public health nursing practice in MCHC --- p.196 / Chapter 4.8.2.5 --- Identifying factors which influenced public health nursing development --- p.198 / Chapter 4.8.2.5.1 --- Factors not influencing public health nursing --- p.198 / Chapter 4.8.2.5.2 --- Factors influencing public health nursing --- p.199 / Chapter 4.8.2.6 --- Qualities of good public health nurses --- p.206 / Chapter 4.9 --- Oral histories from the administrators --- p.207 / Chapter 4.9.1 --- Training of public health nurses --- p.207 / Chapter 4.9.1.1 --- Scope of training --- p.209 / Chapter 4.9.1.2 --- Perception of public health nursing duties --- p.211 / Chapter 4.9.1.3 --- Public health nursing practice in MCHC --- p.213 / Chapter 4.9.1.4 --- Identifying factors which influenced public health nursing development --- p.216 / Chapter 4.9.1.5 --- Qualities of good public health nurses --- p.221 / Chapter 4.10 --- Conclusion of this chapter --- p.222 / CHAPTER FIVE / DISCUSSION --- p.225 / Chapter 5.1 --- A sketch of the working life of public health nurses --- p.225 / Chapter 5.2 --- The three research objectives --- p.227 / Chapter 5.2.1 --- Research objective one: The characteristics of public health nursing in Hong Kong --- p.229 / Chapter 5.2.1.1 --- Categories of public health nurses in Hong Kong --- p.229 / Chapter 5.2.1.1.1 --- Public health nurse title as defined by organisation --- p.229 / Chapter 5.2.1.1.2 --- Public health nurse title as defined from training --- p.231 / Chapter 5.2.1.1.3 --- Ranking of public health nurses --- p.232 / Chapter 5.2.1.2 --- Nursing culture --- p.233 / Chapter 5.2.1.3 --- Population-focused service in MCHC --- p.234 / Chapter 5.2.1.4 --- Nursing practice on health education, health promotion and direct care --- p.237 / Chapter 5.2.1.5 --- The invisible service --- p.238 / Chapter 5.2.1.6 --- The presentation of art and science in public health nursing --- p.239 / Chapter 5.2.2 --- Research objectives two: the changes of public health nursing practice during the study period --- p.241 / Chapter 5.2.2.1 --- The delineation of the development of public health nursing practice in MCHC from 1954 to 2010 --- p.241 / Chapter 5.2.2.1.1 --- The first phase of development: 1954 to the 1970s and the evolution of public health nurses --- p.242 / Chapter 5.2.2.1.2 --- The second phase of development: 1970s to 1980s a static period in the public health nursing service --- p.243 / Chapter 5.2.2.1.3 --- The third phase of development: 1990s to 2010s a period of changes --- p.244 / Chapter 5.2.2.2 --- Predominant features in the development --- p.246 / Chapter 5.2.2.2.1 --- Perceived decrease of autonomy --- p.246 / Chapter 5.2.2.2.2 --- Generational differences among nurses influence job satisfaction --- p.247 / Chapter 5.2.2.2.3 --- The cessation of home visits --- p.248 / Chapter 5.2.3 --- Research objective three: significant events and factors influencing public health nursing development --- p.250 / Chapter 5.2.3.1 --- The influence of significant events happened in the community --- p.251 / Chapter 5.2.3.2 --- Devaluation of the service and the invisibility of the practice --- p.254 / Chapter 5.2.3.3 --- Medical dominance, administrative influences and manpower factors --- p.257 / Chapter 5.2.3.4 --- Impact of working for a government organisation --- p.260 / Chapter 5.2.3.5 --- The ideology of public health and public health nurses in Hong Kong --- p.262 / Chapter 5.2.3.6 --- The good practice model initiated by the earlier public health nurses --- p.265 / Chapter 5.2.3.7 --- Training of public health nurses --- p.267 / Chapter 5.3 --- History, historical research and nursing --- p.271 / Chapter 5.4 --- Conclusion of this chapter --- p.276 / CHAPTER SIX / CONCLUSIONS --- p.278 / Chapter 6.1 --- Strengths of the study --- p.278 / Chapter 6.2 --- Limitations of the study --- p.279 / Chapter 6.2.1 --- Shortcomings of historical research --- p.280 / Chapter 6.2.2 --- Threats to internal and external criticism --- p.280 / Chapter 6.3 --- Implications for nursing research, practice and education --- p.282 / Chapter 6.3.1 --- Research --- p.282 / Chapter 6.3.1.1 --- Methodology --- p.282 / Chapter 6.3.1.2 --- Further research questions and new interpretations on history --- p.284 / Chapter 6.3.2 --- Education --- p.287 / Chapter 6.3.2.1 --- Content of nursing curricula related to nursing history --- p.287 / Chapter 6.3.2.2 --- Teaching historical research methodology --- p.288 / Chapter 6.3.2.3 --- Strengthen training on public health nursing --- p.288 / Chapter 6.3.3 --- Practice --- p.289 / Chapter 6.4 --- Conclusion of this chapter --- p.291 / REFERENCES --- p.293

Ethiopia has two stories to tell: a fast progress and unfair distribution of the gains in child health care. Despite Ethiopia’s achievement in meeting MDG4, wealth-related mortality inequality increased by 1.5 for every 1,000 live births between 2000 and 2011. Two major dividing lines contribute to child health inequality in Ethiopia: place of residence and wealth status. Lack of proper studies on health inequality policy making is affecting the comprehensiveness and quality of inequality reduction in Ethiopia. This study wished to assess child health inequality and policy factors that affect progress in inequality reduction. Accordingly, the study explored policy-makers’ attitude and interest; policy contents, and institutions to make recommendations that promote child health equity in Ethiopia. The research is mainly a qualitative policy research. Conducted between 2013 and 2017, it was design based on health policy researching and health inequality theories. The researcher conducted semi-structured interviews among health policy makers; policy analysis; and a review of the literature. Twenty policy-makers, 15 policy documents, over 350 literatures were selected through purposing and theoretical open sampling methods. Data was synthesised and analysed with ATLAS.ti 7.1.4 through applying the tools of critical interpretive synthesis and ground theory. The study found that Ethiopia is in an early state of recognizing and intervening against health inequalities. The quality and level of knowledge is mixed and gets reduced as one goes far from the centre. Consensus is still growing on the major underlying causes of child health inequalities in Ethiopia. Most of the policy makers focus on down-stream factors than broader determinants of health. Wealth inequality is less discussed and intervened than geographical inequalities. The production of a new Plan of Action can helped to resolve the challenges of lack of detailed approaches that can help reduce the gap in Ethiopia. However, the content of the health policy documents is not comprehensive and based on global lessons. Policy makers from the central government in Ethiopia tend to reject the use of redistribute justice intervention as policy options. There were multiple reasons including: fear of sustainability, ethics and effectiveness were used to reject these interventions. However, leaders from DRS and DPs broadly support the proper adaption of these interventions. The recent surge of interest to address health inequalities is mainly led by small groups from the top leaders. The engagement of the middle level leaders, Developing Regional States (DRSs), civil society and development partners has been limited. The relation between different institutes is very important in the Ethiopian federal state to reduce inequality. Without an improved level of awareness; change in attitude; broader engagement of citizens; use of independent data source and review of resource distribution Ethiopia’s progress towards Universal Health Coverage in 2030 could get delayed. Finally, this research provided a list of recommend interventions that Ethiopia might take in its plan, to narrow down health inequalities among children by 2030. / Health Studies / D. Litt. et Phil. (Health Studies)

PURPOSE Explore the competencies required by the child nurse practitioners in the child nursing practice in order to refine the current competencies in a programme for Child Nursing Science presented at a Nursing Education Institution in Gauteng. DESIGN AND METHOD A quantitative, non-experimental, descriptive, exploratory and applied research design was used. A structured self reported questionnaire was constructed based on the competencies derived from the current programme for Child Nursing Science used at the Nursing Education Institution, the Specialist Paediatric and Child Health Nurse by the Australian Confederation of Paediatric and Child Health Nurses and the World Health Organization Children’s Nursing Curriculum. The structured self reported questionnaire was distributed to 110 child nurse practitioners working in child nursing practices in Gauteng and a total of 82 responded. FINDINGS All competencies were regarded as important, except for competencies related to research, family-centred child care, complementary and traditional child care practices, evidence-based practice, mentoring and play activities. CONCLUSION Findings were used to refine the current competencies in a programme for Child Nursing Science / Health Studies / M.A. (Health Studies)

The study was a descriptive quantitative survey which endeavoured to identify challenges experienced by IMCI trained registered nurses in implementing the guidelines and procedures of the strategy when tending children under 5 years in Gaborone health district. The study also solicited for recommendations on how to address the identified challenges. The research population comprised of all the IMCI-1 trained registered nurses and systematic sampling was employed to randomly select study participants. Data were collected using a questionnaire and was analysed using Excel Advanced software package. Study findings identified challenges related to political support, cost of IMCI training, training coverage, health systems and features of the IMCI strategy. Recommendations for improving use of the strategy included garnering for more political support, adopting short duration training courses, scaling up both pre-service and in-service training as well as addressing the challenges related to health systems and the unique features of the strategy / Health Studies / M.A. (Public Health)