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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
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Políticas públicas de acesso ao crédito como ferramenta de combate à pobreza e inclusão social: o microcrédito no Brasil / Credit acess of public policies like a poverty and social inclusion tools: the microcredit in Brazil

Francisco Marcelo Garritano Barone do Nascimento 06 June 2008 (has links)
O combate à pobreza e a inclusão social são temas recorrentes quando se analisam as políticas públicas implementadas na América Latina nas últimas duas décadas. No Brasil, a partir do Plano Real, em 1994, a economia foi estabilizada através da eliminação da inércia inflacionária de preços e salários. O fim do imposto inflacionário foi um alívio para a base da pirâmide social e empresarial brasileira, porém não foi suficiente para conter o processo de empobrecimento da população, como conseqüência direta da reestruturação produtiva e distributiva provocada pela globalização e seus impactos no mercado de trabalho (desemprego, subemprego) e no setor produtivo (aumento da informalidade e elevadas taxas de mortalidade das micro e pequenas empresas formais). A partir de 1995 o governo federal assumiu o papel de formulador e indutor de uma série de políticas públicas voltadas para a minimização desta situação. Dentre elas, o acesso ao crédito, não como política isolada, mas dentro de um contexto de desenvolvimento local integrado e sustentado que ocupou papel de suma importância. A partir de 2003, o conceito de acesso ao crédito foi modificado, incorporando também o crédito para o consumo e a bancarização das camadas mais baixas da população. O objetivo desta tese é evidenciar o microcrédito no Brasil, como política pública de acesso ao crédito, combate à pobreza e inclusão social, implementada nos últimos 15 anos no Brasil, tendo o governo federal como indutor e ator mais relevante. / The poverty battle and social inclusion are appellant themes, when analyzing public politics implemented in Latin America over the two last decades. In Brazil, since Plano Real, in 1994, the economy was established thru elimination of inactivity inflation due to prices and wages. The end of inflation taxes was a relief to the social and business Brazilian base pyramid, but it did not stop the poverty population process, as a consequence of the direct productive readjust and distributive challenged by the globalization and it impacts on the job market (unemployment/underemployment) and the productive sector (increase the informal work and high level of breaking small and micro formal business). Since 1995 the federal government assumes the power of formulate and inductor several public politics facing minimize this situation. Some of than is, the credit access, not as an isolated politics but as a development local context unite into one whole and maintained that assume a very important roll. Since 2003, the concept of credit access changed, including, as well, credit for consume and bank access of the lowest social level of the population. The object of this these is to evidence the microcredit in Brazil as a public politics of credit access, poverty elimination and social inclusion implemented over the last 15 years in brazil, having the federal government as a inductor and actor with more relevancy.
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Acesso à justiça: diagnóstico, reflexões e propostas / Acess to justice: analysis, reflections and proposals

Debora Leal de Oliveira 10 June 2013 (has links)
O presente estudo tem por objetivo, demonstrar a evolução e a expansão do conceito de acesso à justiça, ocorrida principalmente a partir da metade do século XX, além de elucidar os impactos gerados na sociedade e no Poder Judiciário. Ademais, propõe soluções alternativas a fim de alcançar a pacificação social e de contribuir para o fim da atual crise Judiciária. Para isso, analisa minuciosamente, o conceito universal de acesso à justiça, bem como todos os aspectos que originaram a sua expansão, tais como: os movimentos políticos, sociais, o crescimento da ideologia de cidadania, a introdução de inúmeros mecanismos e instrumentos legais (questões ambientais, consumeristas, eletrônicas) a ideologia do Estado como principal provedor do bem estar social. Buscou-se contribuir para o desenvolvimento de uma inovadora visão sobre o acesso à justiça, demonstrando que a autonomia privada deve ser respeitada e incentivada pelo Estado-Juiz. Sabe-se que os cidadãos têm o livre arbítrio de renunciar ao tradicional exercício de ação, optando por um acesso à justiça por via alternativa para solucionar seus conflitos, e é essa ideologia que se quer disseminar. O presente tema é de suma importância para o aperfeiçoamento do direito brasileiro, pois, se o conceito de acesso à justiça for devidamente interpretado, pode-se evitar grande parte dos problemas enfrentados hoje pelo Poder judiciário pátrio. Serão propostas novas formas de operacionalização dos métodos alternativos de resolução de conflitos. Demonstrando que a via judicial deverá ser tratada como mais uma opção de alcance da pacificação social e não como a única forma de atingi-la. / The objective of the current study is to demonstrate the expansion of the access to justice concept and its relevant impacts on society and the judiciary branch, especially around the second half period of century XX. Although the concept of access to justice encourages the access to the legal system it still keeps the alternative methods to reach social peace and contribute to the end of the current legal system crises. Therefore, this paper will analize the universe concept of access to justice, as well as all the aspects that contributed to its creation and expansion such as: political and social movements, the meaning of the citizenship ideology, the introduction to a number of mechanisms and legal tools (environmental, consumer and electronic legal issues) and the theory of the State as the main provider of the social well-being. The present paper will reveal how the access to justice has been considered, especially by the judiciary branch, as well as the solutions that have been applied internationally in order to avoid or minimize the regular crises of the legal power. Therefore, this research will help make it possible to suggest adjustments in the Brazilians legal system in order to try to achieve the desired level of efficient in the legal services of Brazil. This research will try to contribute to develop an innovative perspective regarding the access to justice, demonstrating that the initiative and pro activeness of the private individuals shall be respected and motivated by the State. It is well known that every citizen has the right of free choice either to file a lawsuit or to reject the traditional path of the legal public system. Since the matter is related to an assets or property rights the citizen has the choice to use the assistance of private entities to solve the existing conflict and it is this option that this paper seeks to disseminate. The chosen subject is extremely important to the improvement of Brazilian legal system, due to the fact that if the access to justice concept be interpreted as it should be a significant part of the current issues that Brazil is currently dealing with will be solved, and consequently the burden of the judiciary branch will be greatly minimized.
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[en] RESOURCE ESTIMATION AND CALL ADMISSION IN COMMUNICATION NETWORKS / [pt] ESTIMAÇÃO DE RECURSOS E ADMISSÃO DE CHAMADAS EM REDES DE COMUNICAÇÕES

RENATO MAGALHAES DUMONT 12 March 2002 (has links)
[pt] Este trabalho propõe um modelo de cálculo das probabilidades de mobilidade dinâmica e um modelo de mobilidade, que é aplicado a um método de controle de admissão de chamadas para sistemas móveis celulares, denominado shadows cluster. Este método busca priorizar chamadas que estejam em handoff em relação a novas chamadas. O objetivo desta técnica é uma melhor qualidade para uma chamada em andamento, evitando-se a queda da ligação. O objetivo do modelo proposto é reduzir a carga de sinalização do sistema celular, comparada à obtida na ausência desse modelo. Resultados de simulações mostram que este objetivo do método do shadow cluster pode ser atingido para vários cenários de mobildade. / [en] This work proposes a Dynamic Mobile Probability model and a mobility model, which is applied for a call admission control scheme for mobile cellular systems, called shadow cluster. This scheme gives priority to calls that are in handoff procedure. The objective of this scheme is a better call in progress quality, avoiding the call dropping. The objective of the proposed model is to reduce signalling load of cellular system. Simulation results show that indeed those objectives can be achived.
14

Síť FTTx / FTTx networks

Hradílek, Pavel January 2009 (has links)
The aim of this thesis is to clarify the issue of optical access networks, and to acquaint the reader with problems of their design and implementation. The introductory chapter describes the technologies and topologies, which are the most experienced in dealing with optical access network. There are a comparison of their basic parameters and limiting factors. Another part of the work is dedicated to progressive methods of construction such as microtubes and solution using the hanging cables, which due to the efficiency of construction, rapidity, economic and facilitate implementation. In conclusion the theoretical part there is issues of measurement. It describes a Optical Loss Test Set, OTDR method and method of measuring dispersion. Increasing demands on the capacity of the transmission paths, and their quality are caused of monitoring optical access networks, which can evaluate the failure on a route, target problems and inform service. The practical part compares EPON and GPON. In program OptiSystem was created model which these technologies are evaluated in terms of performance parameters, noise, jitter and eye diagram quality. The common feature of technology is transmission TDM frames, where EPON uses Ethernet and GPON technologies ATM. The outcome of simulation don´t show which technology is better, but result shows the conditions of the proposal of these technologies. At the end of work there are created several models for solving the optical access network with pricing per user. The most developed technology is FTTB in urban areas, when transmission in last mile uses copper circuit. This solution causing a rapid return on investment. Other technologies such as point-to-point FTTH or PON are implemented as individual proposals. Each of these solutions has advantages and disadvantages, so each project is unique and the solution is dependent on the project site and the requirements of customers.
15

OBESIDADE MÓRBIDA: QUALIDADE DE VIDA E ACESSIBILIDADE. / Morbid obesity: quality of life and accessibility.

Chagas, Marina Oliveira 22 March 2013 (has links)
Made available in DSpace on 2016-08-10T10:53:47Z (GMT). No. of bitstreams: 1 MARINA OLIVEIRA CHAGAS.pdf: 2337992 bytes, checksum: 50fdf9968ba71fafd15df448593fb9ca (MD5) Previous issue date: 2013-03-22 / Obesity is, nowadays, one of the major epidemiological challenges of the XXI century. It is considered a chronic disease, characterized by the excessive accumulation of body fat.The morbid obesity defined by the BMI greater than or equal to 40 kg/m2 is related to the occurrence of comorbities, which can cause losses in quality of life (QOL).The present study aimed to assess the quality of life and investigate accessibility issues faced by people with morbid obesity, users of the Unified Health System, in Jataí, Goias. This research was divided into two studies, the first to evaluate the QOL of morbidly obese people, characterize the socioeconomic profile, and analyze the influence of the variables age, gender, BMI classification, education and economic class quality life, and the second to understand the experience lived by morbidly obese people as accessibility, exploring aspects related to the environment, autonomy and security. Fifty people attended to the research, mostly female, aged 20 to 69 years, high school education level and economic class C. The instruments used were the Economic Classification Criterion Brazil, the questionnaires WHOQOL-Brefand SF-36, the semi-structured interview and clinical records. The results for the quantitative analysis indicated that the lowest mean score of QOL scores were the domains general health (50.94%) of the SF-36 and the environment (53.06%) of the WHOQOL-Bref. In the analysis of the influence of the variables age, gender, BMI classification, education and economic status in quality of life were found statistically significant differences, through the WHOQOLBref, the field environment both for the analysis of quality of life and education (p = 0.008) and for quality of life and economic class (p = 0.004).In the SF-36, significant differences were found between quality of life and functional capacity in the field age (p = 0.003), and between quality of life and physical domains in gender (p = 0.027), pain (p = 0.007), social aspects (p = 0.040) and mental health (p = 0.007).In the other variables significant associations were not found (p> .05). Regarding the qualitative data emerged five final categories: impaired daily activities, problems with the environmental space and services, impacts of spatial restrictions on inter-social relationships, coping with stress and demands for social inclusion. Knowing the difficulties of these people is important for improving public policy, providing behavior change, define projects of more accessible environments, thus offering equal opportunity recreation, transportation, healthcare, enabling improvements in quality of life. / A obesidade é atualmente um dos grandes desafios epidemiológicos do século XXI. É considerada uma doença crônica, caracterizada pelo acúmulo excessivo de gordura corporal. A obesidade mórbida definida pelo IMC maior ou igual a 40 kg/m2 está relacionada com a ocorrência de comorbidades, que pode ocasionar prejuízos na Qualidade de Vida (QV). O presente estudo teve como objetivo geral avaliar a qualidade de vida e investigar problemas de acessibilidade enfrentados por pessoas com obesidade mórbida, usuários do Sistema Único de Saúde, no município de Jataí, Goiás. A presente investigação foi dividida em dois estudos, sendo o primeiro com objetivo de avaliar a QV de pessoas com obesidade mórbida, caracterizar o perfil socioeconômico, e analisar a influência das variáveis, idade, sexo, classificação do IMC, escolaridade e classe econômica na qualidade de vida, e o segundo objetivou compreender a experiência vivenciada por pessoas com obesidade mórbida, quanto à acessibilidade, explorando os aspectos referentes ao ambiente, a autonomia e a segurança. Participaram cinquenta indivíduos, sendo a maioria do sexo feminino, com idade entre 20 a 69 anos, nível de escolaridade ensino médio e classe econômica C. Os instrumentos utilizados foram o Critério de Classificação Econômica Brasil, os questionários WHOQOL-Bref e SF-36, a entrevista semiestruturada e Prontuários Clínicos. Os resultados para a análise quantitativa indicaram que as menores médias da pontuação dos escores de QV foram os domínios estado geral de saúde (50,94%) do SF-36 e meio ambiente (53,06%) do WHOQOL-Bref. Na análise da influência das variáveis, idade, sexo, classificação do IMC, escolaridade e classe econômica na qualidade de vida, foram encontradas diferenças estatisticamente significativas, pelo WHOQOL-Bref, no domínio meio ambiente tanto para a análise entre qualidade de vida e escolaridade (p=0,008) quanto para qualidade de vida e classe econômica (p=0,004). No SF-36, foram encontradas diferenças significativas entre qualidade de vida e idade no domínio capacidade funcional (p=0,003), e entre qualidade de vida e sexo nos domínios aspectos físicos (p=0,027), dor (p=0,007), aspectos sociais (p=0,040) e saúde mental (p=0,007). Nas demais variáveis não foram encontradas associações significativas (p>0,05). Quanto aos dados qualitativos emergiram cinco categorias finais: atividades diárias prejudicadas, problemas com o espaço ambiental e os serviços, impactos das restrições espaciais nas inter-relações sociais, enfrentamento do estresse e cobranças para a inclusão social. Conhecer as dificuldades dessas pessoas é importante para melhorar as políticas públicas, propiciar mudanças de comportamento, definir projetos de ambientes mais acessíveis, oferecendo desta forma oportunidades igualitárias de lazer, transporte, saúde, possibilitando melhorias na qualidade de vida.
16

Instrumentação virtual aplicada ao ensino experimental de engenharia elétrica. / Virtual instrumentation applied to electrical engineering education.

Lopes, Vinícius José Santos 20 September 2007 (has links)
A proposta deste trabalho é apresentar algumas potenciais aplicações do software LabVIEW da National Instruments, associado a um hardware de aquisição de dados, aplicado em experiências ligadas à área de sistemas de energia elétrica como ferramenta de apoio ao ensino presencial. Esta dissertação mostra o desenvolvimento de uma experiência em um laboratório de sistemas de energia elétrica que utilizam sensores Hall de tensão e corrente, uma placa A/ D e o software LabVIEW para monitorar variáveis elétricas, calcular e analisar potência, energia e fator de potência de um minissistema de energia em baixa tensão, que contém geradores síncronos trifásicos de 2kVA-220 V, um modelo de uma linha de transmissão com reatores e capacitores, e uma caixa de resistência para representar uma carga passiva. Uma placa A/ D permite saídas digitais, que por sua vez podem controlar contatores que ligam ou desligam elementos do circuito em análise. Um programa foi desenvolvido para servir como ferramenta de apoio no processo ensino-aprendizagem. Este programa possibilita monitorar e atuar na montagem experimental, disponibilizando três instrumentos virtuais básicos para o desenvolvimento da experiência. Estes três instrumentos são: uma primeira tela que mostra o diagrama dos fasores de todos os sinais de tensão e corrente simultaneamente; uma segunda tela, que mostra a forma de onda dos sinais de tensão e corrente no minissistema com as suas respectivas defasagens; e a terceira e última tela que fornece um sincronoscópio virtual possibilitando analisar os ajustes de tensão e freqüência necessários na operação de paralelismo do minissistema com a concessionária de energia. Este programa possibilita o acesso à montagem experimental do minissistema de energia pelo computador instalado na bancada do laboratório, permitindo também aos alunos, o monitoramento e controle do experimento a partir de seus próprios computadores, visualizando e reforçando no laboratório, os conceitos vistos na teoria. / The proposal of this work is to present some potential applications of the software LabVIEW, from National Instruments, associated with data acquisition hardware, applied to experiments in the Electric Energy Systems area as a tool to support the presential education. This dissertation shows the developing of an experience in a electric energy system laboratory, which use Hall Effect sensors, A/D data acquisition board, connected to a PC, and the software LabVIEW (National Instruments) in order to monitor electrical parameters, calculate and analyze power, energy and power factor in a low-voltage power system, which contains synchronous three-phase generators of 2 kVA-220V, with a transmission line model provided with reactors and capacitors, and a resistance box representing a passive load. The A/D board allows controlling digital outputs that can control counters that switch on or off the circuit elements in the analysis. A program was developed in order to act a tool to support the process teaching-learning. This program allows to monitor and to act in the experimental assembly providing three basic virtual tools for the experiment development. These three tools are: one screen that simultaneously shows the phasor diagram with current and voltage; a second screen that shows voltage and current waveform of the mini-system with its respective imbalances; and the third and last screen, that provides a virtual synchronoscope which makes possible the analysis of the necessary adjustments of voltage and frequency in the operation of parallelism between the mini-system and the energy power supplier. This program allows the access to the experimental assembly of the energy mini-system through a computer installed in a bench of the laboratory. As a result, the students can also monitor and control the experiments through their own computers, allowing them to visualize and to reinforce in the laboratory, the concepts taught in theory.
17

Assistência jurídica aos necessitados: concepção contemporânea e análise de efetividade / Legal aid to the needy: contemporary study and analisys of effectiveness

Kuniochi, Hamilton Kenji 03 June 2013 (has links)
Assistência Jurídica aos Necessitados: Concepção Contemporânea e Análise de Efetividade. Dissertação de Mestrado. Aborda os conceitos de justiça gratuita, assistência judiciária e assistência jurídica. Verifica o tratamento atual quanto ao atendimento das pessoas físicas e jurídicas pela Defensoria Pública, entidades não governamentais, universitárias e pelos advogados liberais. Apresenta parâmetros para atendimento do interessado. Analisa o entendimento dos tribunais quanto à comprovação da pobreza em juízo e a questão do abuso do direito. / Legal Aid to the needy: Contemporary Study and Analysis of Effectiveness. Thesis. The study focuses the concepts of free justice, legal aid and legal assistance. It takes into consideration the current treatment about the care of individuals and corporations by the Public Defender Office, the non-governmental entities, universities and the liberal lawyers. Presents parameters for the service concerned. Analyzes the understanding of the courts as to prove poverty in legal proceedings and the issue of abuse of rights.
18

Kamratkulturer i förskolan : En observationsstudie av några leksituationer / Peercultures in pre-school : A observationsstudy about a few playsituations

Murelius, Helen January 2010 (has links)
<p><strong>Abstract</strong></p><p>In this essay, I have performed a study on peer cultures and how these peer cultures are expressed in a group of pre-school children. My questions are as following:</p><ul><li>What positions/power positions can be seen in children’s play, and how will these be expressed?</li><li>How do the children gain access to play?</li><li>How do children act when they want to exclude other children?</li></ul><p>In order to understand this I have chosen to do observations as a method. In order to investigate these questions I chose to spend six whole mornings with a group of pre-school children, closely observing their behavior. The focus was on children, three years of age or older. The results show that children are very resourceful, when it comes to making up strategies for either giving access to, or excluding, other children from their play. For example they could make up a rule which would make it impossible for another child to be a part of the game. One rule could be that you in order to be able to play with the others must possessed a particular toy that the children used in the game, which the new child did not own. But there are also many strategies for children to be a part of a game. For example, if they had a toy that the other children wanted as well, this could be a way of joining in on the play.</p><p>We as adults must be aware of that these cultures exist everywhere. Sometimes we are not even aware of that a child is not being allowed to play with the others. It is not fun for those children who always have to stand beside the play. We need to try and discover who these children are and help them to be a part of the group.</p><p>Keywords: Pre-school Peer culture, Access play, Excluding play</p> / <p><strong>Sammanfattning</strong></p><p>I mitt examensarbete har jag genomfört en undersökning, med syfte att bidra med kunskaper om kamratkulturer och hur dessa kulturer uttrycks i en förskolegrupp. Mina frågeställningar är följande:</p><ul><li>Vilka positioner/maktpositioner finns i barns lek och hur synliggörs de?</li><li>Hur får barn tillträde till leken? </li><li>Hur gör barnen när de utesluter andra barn?</li></ul><p>Frågeställningarna har jag valt att undersöka, genom att observera barnen i en barngrupp under sex förmiddagar. Fokus har varit på barn som är tre år och äldre.  Resultatet visar att barnen är väldigt påhittiga vad gäller olika strategier, både för att ge tillträde till eller att utesluta andra barn från att vara med i leken. Bland annat kunde de hitta på regler, som gjorde att det nya barnet inte kunde vara med. En regel kunde vara att man var tvungen att ha någon leksak som barnen använde, som det nya barnet inte hade. Men det finns också många strategier för att få vara med i leken. Till exempel om de hade en leksak, som de andra barnen också ville ha kunde detta vara ett sätt för att få vara med i leken.</p><p>Vi vuxna måste vara medvetna om att kamratkulturer existerar. Ibland är vi inte ens medvetna om att det finns något barn som inte får vara med och leka. Det är inte roligt för de barnen som alltid blir uteslutna. Vi måste försöka upptäcka dessa barn och hjälpa dem att bli en del av gruppen.</p><p>Nyckelord: Förskola, Kamratkultur, Tillträde lek, Uteslutning lek</p>
19

Kamratkulturer i förskolan : En observationsstudie av några leksituationer / Peercultures in pre-school : A observationsstudy about a few playsituations

Murelius, Helen January 2010 (has links)
Abstract In this essay, I have performed a study on peer cultures and how these peer cultures are expressed in a group of pre-school children. My questions are as following: What positions/power positions can be seen in children’s play, and how will these be expressed? How do the children gain access to play? How do children act when they want to exclude other children? In order to understand this I have chosen to do observations as a method. In order to investigate these questions I chose to spend six whole mornings with a group of pre-school children, closely observing their behavior. The focus was on children, three years of age or older. The results show that children are very resourceful, when it comes to making up strategies for either giving access to, or excluding, other children from their play. For example they could make up a rule which would make it impossible for another child to be a part of the game. One rule could be that you in order to be able to play with the others must possessed a particular toy that the children used in the game, which the new child did not own. But there are also many strategies for children to be a part of a game. For example, if they had a toy that the other children wanted as well, this could be a way of joining in on the play. We as adults must be aware of that these cultures exist everywhere. Sometimes we are not even aware of that a child is not being allowed to play with the others. It is not fun for those children who always have to stand beside the play. We need to try and discover who these children are and help them to be a part of the group. Keywords: Pre-school Peer culture, Access play, Excluding play / Sammanfattning I mitt examensarbete har jag genomfört en undersökning, med syfte att bidra med kunskaper om kamratkulturer och hur dessa kulturer uttrycks i en förskolegrupp. Mina frågeställningar är följande: Vilka positioner/maktpositioner finns i barns lek och hur synliggörs de? Hur får barn tillträde till leken? Hur gör barnen när de utesluter andra barn? Frågeställningarna har jag valt att undersöka, genom att observera barnen i en barngrupp under sex förmiddagar. Fokus har varit på barn som är tre år och äldre.  Resultatet visar att barnen är väldigt påhittiga vad gäller olika strategier, både för att ge tillträde till eller att utesluta andra barn från att vara med i leken. Bland annat kunde de hitta på regler, som gjorde att det nya barnet inte kunde vara med. En regel kunde vara att man var tvungen att ha någon leksak som barnen använde, som det nya barnet inte hade. Men det finns också många strategier för att få vara med i leken. Till exempel om de hade en leksak, som de andra barnen också ville ha kunde detta vara ett sätt för att få vara med i leken. Vi vuxna måste vara medvetna om att kamratkulturer existerar. Ibland är vi inte ens medvetna om att det finns något barn som inte får vara med och leka. Det är inte roligt för de barnen som alltid blir uteslutna. Vi måste försöka upptäcka dessa barn och hjälpa dem att bli en del av gruppen. Nyckelord: Förskola, Kamratkultur, Tillträde lek, Uteslutning lek
20

Improving efficiency, access to and quality of the rural health extension programme in Tigray, Ethiopia : the case of malaria diagnosis and treatment

Lemma, Hailemariam January 2012 (has links)
Introduction: Ensuring universal access to primary health care (PHC) is a key component of the Ethiopian nationalhealth policy. The policy also emphasises promoting and enhancing national self-reliance in health development bymobilizing and efficiently utilizing resources including community participation. To this end, the government introducedthe accelerated expansion of the PHC strategy through a comprehensive health extension programme (HEP). HEP is afamily and community-based health care delivery system institutionalised at health post level which combines carefullyselected high impact promotive, preventive and basic curative interventions. All HEP interventions are promotive and preventive except the malaria intervention which, in addition, incorporates a curative service. In the country, malaria is a leading disease. Unlike most Sub-Saharan African countries where P. falciparum accounts for almost all malaria infections, in Ethiopia both P. falciparum and P. vivax are co-dominant. Considering this peculiar epidemiological nature, the national guideline recommends alternative diagnosis and treatment strategies. Rationale: The lack of adequate resources and the efficiency with which available resources are being utilised are the main challenges in any health care setting. Therefore, if the HEP which consumes consideral amount of resource desires to reach its intended goal, monitoring and improving its efficiency is of great public heath importance. HEP has been successful in improving access to PHC including the malaria diagnosis and treatment service. Though this is a crucial measure, its quality ought to be considered. For the malaria curative service, studying the cost-effectiveness of the available strategy and patients’ adherence to the treatment regimen can be considered as proxy measures of quality for which local evidence is lacking. However, none of the existing studies in this field of research has addressed the Ethiopian malaria epidemiological context and its diagnosis and treatment guideline. In Tigray, for more than two decades, access to malaria early diagnosis and prompt treatment was facilitated by volunteer community healthworkers (CHWs). However, with the introduction of artemether-lumefantrine (AL) the service was compromised mainly for reasons of cost, safety and logistic. Therefore, it was important to explore the feasibility and the impact of community deployment of AL with rapid diagnostic tests (RDTs). The aim: to explore the overall performance of HEP and particularly the access to and quality of malaria early diagnosis and prompt treatment in the Tigray region of Ethiopia. Methods: Different study designs and populations were used for each of the four specific objectives. Data envelop analysis (DEA) was applied to assess the HEP efficiency. For this, register data for the output variables and primary data for the input and the environmental factors were collected. A health provider perspective cost-effectiveness analysis was used to determine which among the currently available diagnostic and treatment strategies is best for the country. Effectiveness data were generated from a stratified cross-sectional survey and secondary data were used to calculate the cost. For measuring adherence to the six-dose AL regimen, an assessment questionnaire and pill count was employed at patients´ home. To determine whether deploying AL with RDT at community level was feasible and effective, a number of designs were used: longitudinal follow-up, cross-sectional surveys, cost analysis, verbal autopsyquestionnaires and focal group discussions. Main findings: More than three-quarters of the health posts were found to be technically inefficient with an average score of 42%, which implies potentially they could improve their efficiency by 58%. Scale of operation was not a cause of inefficiency. None of the considered environmental factors was associated with efficiency. The Parascreen-based strategy (multispecies RDT-BS) was found to be the most cost-effective strategy, which allowed treating correctly an additional 65% of patients with less cost than the paracheck-BS. Presumptive-BS was highly dominated. Among P.falciparum positive patients to whom AL was prescribed, more than a quarter did not finish their treatment. The main reasons for interrupting the dose were ‘too many tablets’ and ‘felt better before finishing the dose’. The ownership of aradio, the belief that malaria cannot be treated traditionally and a delay of more than one day in seeking treatment after the onset of fever were significantly associated with being adherent. Deploying AL with RDT at community level was demonstrated to be effective and feasible. In the intervention district, almost 60% of suspected cases were managed by CHWs. Malaria transmission was lower at least threefold and malaria mortality risk by around 40% compared to the control district. The use of RDTs reduced cost and possibly the risk of drug resistance development. Conclusion: Though improving access to health care is important, it should be considered a means, not an end. Themore accessible a system is the more people could utilise it to improve their health. Thus, ensuring the access obtainedthrough HEP is maintained, its quality is improved and efficiently utilised to its optimal productivity level is a necessarytask. The DEA study revealed a high level of inefficiency where majority of the health posts needed improvement.This thesis also found parascreen-BS to be the most cost-effective strategy and that there is no epidemiological andeconomical contextual justification to keep both, the presumptive-BS and the RDT-BS specific only to P.falciparum.The high poor adherence levels raises great concern as it leads to recurrent malaria attacks of the patient, speed upthe development and spread of drug resistance strains and reduces the effect of the drug on the transmission. Therefore,providing effective drug alone is not sufficient; assessing and monitoring adherence to the treatment is by faressential. Deployment of AL with RDT through a community-based service has shown an enormous impact in termsof cost, transmission, morbidity and mortality. However, it is worth noting that this results came from an area wherea community-based service has been involved in the PHC system for more than three decades.

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