Thesis (Ph.D.)--Indiana University, Dept. of History, 2008. / Title from home page (viewed on May 11, 2009). Source: Dissertation Abstracts International, Volume: 69-08, Section: A, page: 3277. Adviser: John H. Hanson.

The National Health Insurance Policy Paper (NHI) that was promulgated in 2011, marks the beginning of the South African Department of Health’s journey into delivering a health system that offers universal coverage to all it’s citizens, that is free at the point of contact. (NHI, 2011) The implementation of this new health system faces many challenges such as the impact of HIV/AIDS. This research was conducted to ascertain what this impact would be according to subject matter experts in the field.Twenty interviews with experts from the different stakeholder groups were undertaken.The findings revealed that there is dire a need for a new health system to offer financial risk protection and universal coverage to all South African residents. Health Systems strengthening will form a significant part of the reformation that is needed to get the health system to work efficiently. HIV/AIDS must be monitored and managed carefully to avoid multi-drug resistant strains from emerging. An existing model has been adapted for the purposes of this study that allows focus on the various components of the health system. Each component or building block will need attention and strategic direction to ensure that the entire system can function holistically, seamlessly and efficiently. / Dissertation (MBA)--University of Pretoria, 2013. / Gordon Institute of Business Science (GIBS) / unrestricted

Philosophiae Doctor - PhD / The continuum of care is a public health framework for improving maternal health outcomes by providing comprehensive health services, at different levels of the health system and across the lifecycle. The framework emphasizes the importance of interventions to address the social determinants of health as well, alongside healthcare services. Although the framework is useful for visualizing service organization, it has not been adequately integrated into policy and practice in South Africa. In addition, there is currently no comprehensive approach to monitor and evaluate service provision along the continuum of care. The current approach is fragmented across programs and sectors and focuses on only a handful of indicators. This research explores an approach for measurement and monitoring of a comprehensive continuum of care for maternal health in South Africa, with implications for application in other low- and middle-income countries (LMICs).

Magister Artium (Development Studies) - MA(DVS) / South African health professionals’ competencies, especially those of managers have been placed under the spotlight. In the community health centres (CHCs) situated in low socio-economic status areas in Cape Town, a shortage of human resources has been an area of importance, as it exacerbates the impact of competence and service delivery by the healthcare managers.

Indiana University-Purdue University Indianapolis (IUPUI) / In the United States, there is very little knowledge about the health of African immigrants. Although their population exceeds 2 million and still on the rise exponentially, a big gap exists regarding knowledge about health care access and outcomes for this population. Before relocating to the US, many African immigrants face health-threatening conditions, including civil wars and poverty, which are exacerbated by the lack of understanding and attention to their health care needs in the US. Methods: To examine the health care experiences of African immigrants in the US, two distinct studies were conducted. A scoping review examined literature between 1980 and 2016 using four databases, to identify knowledge-gaps concerning African immigrant in the US. A qualitative study comprising 33 semi-structured (one-on-one) interviews and 4 focus groups was conducted using Nigerian immigrant participants in Indianapolis, to assess how discrimination affects their health care experiences and quality of care, and the factors their influence their health care meanings, respectively. Results: For the scoping review, 14 articles were included. All the studies were focused on barriers to the health care access of African immigrants in the US. Along with religion and culture, lack of culturally-competent healthcare and distrust of the US health system, were identified as the major barriers. Both the one-on-one interviews and focus groups revealed provider attitudes, through implicit and open biases, were a key contributing factor to the participants’ health care meanings and healthcare utilization. Additionally, results showed an important intersectionality within the healthcare experiences of the participants, as a result of their perception as “black,” along with African Americans and other physically-related groups. Conclusion: African immigrants in the US grapple with the critical process of reconciling their original identities with their emerging realities, including negative provider attitudes and discrimination, and lack of identify in the US health system. This study highlights the importance of understanding African immigrant health in the US, through the examination of the role of the African framework of understanding of their health in their approaches to healthcare and well-being. / 2021-03-06

Thesis (LLM ( Labour law)) --University of Limpopo, 2013 / Refer to document

Magister Economicae - MEcon / The provision of health care in South Africa is undergoing major restructuring. The aim is to achieve substantial, visible and sustainable improvements to the efficiency and accessibility of primary healthcare (PHC) services for all South Africans. One of the country's most critical problems is the weak and fragmented public sector PHC system. The most critical problems contributing to this are the maldistribution of resources (financial, physical and human) between hospitals and the primary care system, and between rural and urban areas. The health sector, therefore, faces the challenge of a complete restructuring and transformation of the national health care delivery system and related institutions. Choices need to be made about which services to cut, which to streamline and where savings can be made. Ways need to be found to use ALL of South Africa's resources optimally. This process of restructuring would be facilitated by the availability of accurate information on resource utilisation in the health sector. This study estimates the difference in the cost of primary diabetes treatment at dayhospitals and a provincial hospital in the Western Cape in 1992/93. Health economics is in its infancy in South Africa and serious data limitations exist. This study is therefore a pioneering effort in many ways. An appropriate methodological framework in which to conduct the costing had to be developed. The South African health sector, health spending arid the cost of primary diabetes treatment at day-hospitals and the provincial hospital are reviewed. Theoretical perspectives of the health care market and the methodologies of cost analysis are discussed. The cost analysis method of study is chosen, and arguments are advanced for its suitability in the South African context. A simple method of calculating the direct costs to obtain the average cost is proposed for the purpose of the study. Direct costs consist of staff costs and other related costs, such as medical supplies, non-medical supplies, building operations, equipment etc. These costs are then used to calculate the average costs per diabetic patient at the day-hospitals and the provincial hospital. The average cost per diabetic patient at day-hospitals amounted to R18.76, while at the provincial hospital the cost was R59.60.

Magister Pharmaceuticae - Mpharm / The aim of this study was to determine quality control specifications needed for a dossier and an investigator's brochure of A. afra capsules, which can be used to motivate the registration and clinical testing of A. afra capsules in chronic asthma. The specific objectives were: (1) to establish the minimum product quality requirements for registration of A. afra capsules, (2) to prepare and pharmaceutically characterize a capsule product of A. afra freeze dried aqueous extract (FDAE) suitable for registration, and (3) to identify pharmaceutical product quality aspects of an investigator's brochure (IB) that would be appropriate for use in motivating a clinical trial of A. afra capsules in chronic asthma.

Le médicament est un bien de santé ; il est un élément incontournable d’un droit à la santé efficace. Il doit être de bonne qualité et son accès doit se faire selon les besoins. S’interroger sur la sécurité sanitaire et l’accès aux médicaments c’est tenter de concilier, droit, économie, éthique et politique. Dans les PED, les faiblesses des revenus et de la capacité de production de médicaments sont des facteurs qui perturbent la mise sur le marché et la surveillance du médicament. Une fois sur le marché, sa distribution est également perturbée par des circuits parallèles illicites difficilement maîtrisables. Malgré les efforts des autorités politiques pour rendre le médicament accessible, des difficultés subsistent. Ces difficultés sont liées pour partie au droit des brevets. En effet, la protection du médicament confère un monopole d’exploitation à son titulaire qui fixe les prix en dehors de toute concurrence. Ces difficultés ont conduit à l’assouplissement du droit des brevets, mais l’usage de ces flexibilités n’est pas aisé pour les PED. La recherche de la santé pour tous et l’économie procèdent de logiques distinctes et le concept du médicament comme bien public demeure un idéal à réaliser, ce qui appelle sans doute à une relecture du droit des brevets. / Drug is a public good of health and an essential element of the right to effective health. It has to be of good quality and its access should be made according to the needs. By questioning the safety and the access to medicines, we attempt to reconcile, law, economics, ethics and politics. In developing countries, the weaknesses of income and the limited production capacity of drugs are factors that alter the placing on the market and the supervision of medication. Once on the market, illegal parallel circuits that are difficult to control also disturb its distribution. Despite the efforts of the political authorities to make drugs available, many challenges remain. These difficulties are partly related to patent law. Indeed, the protection of the drugs confers a monopoly on its holder, which sets prices without any competition. These difficulties have led to the relaxation of patent law, but the use of these flexibilities is not easy for developing countries. The pursuit of health for all and the economic system respond to different logics and the concept of drug as a public good remains an ideal to be achieved, which probably calls for a rereading of the patent law.

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