The objective of the diploma thesis is to study the systems of health care and hygienic prevention in České Budějovice from the second half of the 19th century to the end of the Second World War on the basis of an analysis of still existing archival materials concerning health care issues. The thesis also includes an inventory of selected archival documents, a diagram related to health care administration on the national level and pictorial materials. The diploma thesis is divided to two extensive sections, the first of which deals with the organisation of the health care system on the national level, summarizing the knowledge obtained from literature from the reforms introduced by Maria Theresia and Joseph the Second till the communist putsch in 1948. The content of these chapters covers legislation of the public health care system, the history of the Faculty of Medicine in Prague, and development of social care in the studied period. The other section already focuses on the city of České Budějovice and the organisation of the health care system managed by local authorities. Individual subchapters deal with public bodies participating in organisation of the medical care in the city and continuous improvement of the state of health of local population. This includes activities of the municipal committee and the health council and health commission attached to the municipal committee, obligations of doctors and other medical staff appointed by the municipal authority, and also the history of the hospital in České Budějovice and other medical and health and social institutions. The antiepidemic work of the aforementioned bodies and the process of improvement of the city for the benefit of health of population in České Budějovice are also reconstructed in the thesis on the basis of still existing sources. The last subchapter deals with funeral administration with emphasis put on newly developing cremation which was very difficult to promote at the beginning of the 20th century. For illustration purposes, the annex section presents three diagrams of development of the state health care system as it was changing in the course of time, furthermore, a thematic inventory of the documented archival materials and selected photographs of the time for illustration.

Hearing loss is considered a global health concern with 466 million people affected worldwide. Current hearing health care delivery models are based on several consecutive face-to-face consultations that occur in-person. Information and communications technology, and especially mobile technology, can be used to support or enhance health care delivery. This can be employed in addition, or as an alternative to, current patient treatment pathways. This project developed a hybrid hearing health care approach by combining online and face-to-face services. The services were offered using a five-step approach: (1) online hearing screening, (2) motivational engagement by voice/video calling, messaging, or emailing, (3) diagnostic hearing testing in a face-to-face appointment, (4) counseling, hearing aid trial and fitting using face-to-face and online methods, and (5) online aural rehabilitation, counseling and ongoing coaching using face-to-face and online methods. Three studies were conducted. Study I investigated the readiness, characteristics and behaviors of patients who sought hybrid hearing health care. Over three months (June–September 2017), 462 individuals completed the online hearing screening test: 59% (271/462) of those failed (age M = 60; SD = 12), indicating that further assessment and treatment might be required. These patients had been aware of their hearing loss for a period of between 5 to 16 years. A significant positive correlation was observed between age and speech reception threshold (r = 0.21; p < .001), where older participants presented with poorer scores. Five participants completed readiness measurement scales and attended a face-to-face diagnostic hearing evaluation during this time. Study II investigated patient uptake, experience and satisfaction with hybrid hearing health care using a process evaluation. The process evaluation study was conducted over a three-month period for patients who sought services from the clinic over a period of 19 months (June 2017–January 2019). A total of 46 patients seen at the clinic were invited to complete an online questionnaire regarding their experiences and satisfaction with the steps completed and services provided. Of those, 31 (67%) patients responded (age M = 66; SD = 16). Of the 61% of patients who had previously sought hearing services, 95% reported the hybrid clinic services as superior. Two main themes emerged from the patient’s comparison of their experience with the hybrid clinic versus previous experiences: clinician engagement (personal attention, patience, dedication, thorough explanations, professional behavior, exceeding expectations, friendliness and trust) and technology (latest technology, advanced equipment and hearing aid trial). Patients who completed all five steps, including acquiring hearing aids and taking part in an online aural rehabilitation program (continued with hearing health care), were significantly older and had significantly poorer speech reception thresholds compared to those who did not acquire hearing aids after the diagnostic hearing test and hearing aid trial (discontinued hearing health care). A significant positive correlation was found between age and the number of face-to-face appointments attended per patient (r = 0.37; p = .007). Study III investigated whether digital proficiency (proficiency with mobile devices and computers) was a predictor of the uptake of hybrid hearing health care. A total of 931 individuals failed the online hearing screening test and had submitted their details to the clinic for further care over a 24-month period (June 2017–June 2019). Of the 931 online test takers, 53 persons (age M = 64; SD = 15) who attended a face-to-face diagnostic hearing testing completed a mobile device and computer proficiency questionnaire. An exact regression model identified age as the factor associated with patients completing all five steps, including acquiring hearing aids and taking part in an online aural rehabilitation program (continued with hearing health care) from a hybrid model (β = .07; p = .018). Older patients were more likely to continue to seek hearing health care. Digital proficiency was not significantly associated with adults with hearing loss taking up services through a hybrid hearing health care model. The results from these three studies demonstrate that asynchronous internet-based services such as an online hearing screening test can be used to create awareness of hearing health care. It is possible to provide online support to patients during the initial stages of seeking hearing health care online prior to the first face-to-face visit. Patient uptake, satisfaction and experience of using hybrid hearing health care services are positive when compared to traditional methods of service delivery. Hearing health care models that combine face-to-face and online methods hold promise for audiologists willing to incorporate online modalities into current treatment pathways. This research project highlights the opportunity for audiologists to provide services and personalized support to patients using a combination of face-to-face and online modalities. / Thesis (PhD)--University of Pretoria, 2020. / This work was supported by the National Research Foundation (NRF) of South Africa under the grant number 107728. / Speech-Language Pathology and Audiology / PhD (Audiology) / Unrestricted

Primary health care (PHC) is an effective way to "optimize and reorganize the health care service system" and solve the "difficulty in obtaining expensive medical services". In the process of China's promotion of health care reform, PHC has been placed at the core part. In this paper, by tracing the history of the development of China's PHC, and evaluating, analyzing and comparing the current similar policies in the field of PHC in China and Britain, a certain understanding of the effects of China's current PHC policies has been presented. In the end, some suggestions inspired by UK experiences been proposed for the future development of PHC in China. Keywords Primary health care; China; health care reform; UK primary health care

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The World Health Organization (WHO) (WHO, 2004:20) describes a community as a social group of any size, with its members residing in a specific locality, sharing government and a common cultural and historical heritage. In the context of health, a community can be considered as those who are affected by similar health issues, or it can simply be defined as stakeholders, such as health professionals or patients. Community participation is collaboration in which people voluntarily, or due to some incentive, collaborate with externally determined projects, either contributing their labour and/or resources for some expected benefit. Within the health system community participation can either be guided by law or regulations, for instance, the White Paper for Transformation of the Health System in South Africa and the South African patients' bill of rights charter, or it can be on a voluntary basis without any guidelines. The researcher believes that the focus should be on how the community can participate in the decisions that affect their health. The research was aimed at exploring and describing a rural community’s perceptions on community participation in Primary Health Care (PHC) services rendered to improve the quality of the current PHC services. The main question asked was: What does effective community participation in PHC services entails to improve the quality of health care according to the community members’ perspectives in a rural community? A qualitative research approach was used to conduct the research on the perceptions of community members on community participation in PHC services. The research took place in Dewetsdorp, a rural area situated in the Xhariep district of the Free State province in South Africa. Data was collected by means of focus groups, making use of a semi-structured interview schedule consisting of four questions in an endeavour to reach an answer on the research question. Three focus groups realised; one consisting of the community leaders as members of the community, another consisting of members from Non-Governmental Organisations (NGOs) and the last consisting of community members utilising the PHC services in Dewetsdorp. Digitally voice recorded focus groups were transcribed for data analysis. Data saturation occurred after three focus groups, with an average of seven participants per group. The themes that emerged from the focus groups are discussed with literature integration. The findings of the research suggest that the community members of Dewetsdorp have a strong sense that community participation should form part of the PHC services. They expressed the view that they play an important role that should be acknowledged and they want to be respected as partners who are willing to take ownership of the PHC services in their community through participation. From the research results and conclusions, the researcher compiled recommendations for nursing education, nursing research and primary health care nursing practice. / MCur, North-West University, Potchefstroom Campus, 2015

The World Health Organization (WHO) (WHO, 2004:20) describes a community as a social group of any size, with its members residing in a specific locality, sharing government and a common cultural and historical heritage. In the context of health, a community can be considered as those who are affected by similar health issues, or it can simply be defined as stakeholders, such as health professionals or patients. Community participation is collaboration in which people voluntarily, or due to some incentive, collaborate with externally determined projects, either contributing their labour and/or resources for some expected benefit. Within the health system community participation can either be guided by law or regulations, for instance, the White Paper for Transformation of the Health System in South Africa and the South African patients' bill of rights charter, or it can be on a voluntary basis without any guidelines. The researcher believes that the focus should be on how the community can participate in the decisions that affect their health. The research was aimed at exploring and describing a rural community’s perceptions on community participation in Primary Health Care (PHC) services rendered to improve the quality of the current PHC services. The main question asked was: What does effective community participation in PHC services entails to improve the quality of health care according to the community members’ perspectives in a rural community? A qualitative research approach was used to conduct the research on the perceptions of community members on community participation in PHC services. The research took place in Dewetsdorp, a rural area situated in the Xhariep district of the Free State province in South Africa. Data was collected by means of focus groups, making use of a semi-structured interview schedule consisting of four questions in an endeavour to reach an answer on the research question. Three focus groups realised; one consisting of the community leaders as members of the community, another consisting of members from Non-Governmental Organisations (NGOs) and the last consisting of community members utilising the PHC services in Dewetsdorp. Digitally voice recorded focus groups were transcribed for data analysis. Data saturation occurred after three focus groups, with an average of seven participants per group. The themes that emerged from the focus groups are discussed with literature integration. The findings of the research suggest that the community members of Dewetsdorp have a strong sense that community participation should form part of the PHC services. They expressed the view that they play an important role that should be acknowledged and they want to be respected as partners who are willing to take ownership of the PHC services in their community through participation. From the research results and conclusions, the researcher compiled recommendations for nursing education, nursing research and primary health care nursing practice. / MCur, North-West University, Potchefstroom Campus, 2015

The purpose of this study was to explore and describe the factors that motivate the Primary Health Care Nurses to render quality care in the Ekurhuleni Metropolitan Municipality Health Care Facilities (in the Northern Region). The Ekurhuleni Metropolitan Municipality is located in Gauteng, South Africa. To achieve this, a quantitative, descriptive research study was undertaken. A purposive and voluntary sample of (n=54) Primary Health Care Nurses with two or more years’ experience of working in the Ekurhuleni Metropolitan Municipality, in the Northern Region, participated in the study. Data was collected using structured questionnaires. Findings from the study indicated those factors that enhance the motivation of the Primary Health Care Nurses and those factors which may demotivate them. The findings further revealed the need for greater motivation for the Primary Health Care Nurses. Based on the study results, guidelines and recommendations were formulated according to the manner in which these nurses’ motivation may be implemented and improved / Health Studies / M. A. (Health Studies)

ABSTRACT Aim: To assess the overall quality of child health services provided at primary health care facilities in the Johannesburg metropolitan area. Objectives: Primary Objective To evaluate the quality of clinical care provided by health care workers caring for children; including an assessment of the treatment of common childhood illnesses, counselling and health promotion. Secondary Objectives 1. To assess the quality of well baby services such as immunisation, growth promotion and developmental monitoring. 2. To assess the availability of drug supplies and equipment. 3. To assess the quality of record keeping. 4. To describe the infrastructure available at health facilities and the availability of services provided to children, including appropriate referral services. Design: This was a cross-sectional, observational study over a two-month period conducted at 16 primary health care facilities in the Johannesburg Metropolitan area; four community health centres (CHC) and 12 primary health care (PHC) clinics. A researcher-developed structured checklist, based on national guidelines and protocols was utilised. Results: A total of 141 sick child and 149 well child visits were observed. Caregivers experienced long waiting hours (mean [SD] of 135±72 minutes). Many routine examination procedures were poorly performed, with an appropriate diagnosis established in only 77% of consultations. Almost half of the children (46%) received antibiotics; their use was unwarranted in one-third of instances. Health promotion activities (such as growth monitoring) were consistently ignored during sick child visits. The mother or sick child’s HIV status was seldom considered or investigated. At least a third of children requiring cotrimoxazole prophylaxis were not prescribed the antibiotic. Growth promotion and nutritional counselling at well child visits was generally inadequate with not one of 11 children requiring food supplementation receiving it. The majority of facilities were adequately equipped and well-stocked with drugs. A lack of capacity to manage children with chronic conditions (such as asthma), mental health problems and disabilities exists. Conclusion: The poor quality of care offered to children in the richest city in Africa is a sad indictment of the inability of health service providers in the city to meaningfully address children’s health needs. Nothing short of a deliberate and radical overhaul in the way that health care is organised for children, with clearly defined and monitored standard clinical practice routines, is likely to significantly change the status quo.