Thesis--Yale University. / eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references.

Thesis--Yale University. / Includes bibliographical references.

A Thesis submitted to The University of Arizona College of Medicine - Phoenix in partial fulfillment of the requirements for the Degree of Doctor of Medicine. / Purpose To understand the reasons why physicians volunteer their time to provide healthcare to the uninsured and to educate future physicians. Another goal is to define the barriers that prevent physicians from volunteering. Background Physician volunteers play an integral role in educating medical students and providing health care to the uninsured. Therefore, understanding the reasons why physicians volunteer their time can possibly improve recruitment procedures. It may help clinics and medical schools advertise to prospective volunteer physicians by emphasizing the positives and directly addressing the main concerns in volunteering. Materials and Methods A survey was distributed to physicians from multiple specialties who work at the University of Arizona College of Medicine – Phoenix and Banner University Medical Center – Phoenix. The survey consisted of questions regarding physicians’ background information, volunteer experience, barriers to volunteerism, and motivation behind their volunteerism. Motivation was evaluated utilizing a validated and widely used survey called the Volunteer Functions Inventory (VFI). Results A total of 100 physicians responded to the survey. 84% of physicians cited “lack of time” as being the primary barrier to volunteerism. 25% and 22% of the physicians cited “Financial Costs” and “Unaware of Opportunity” as barriers, respectively. With respect to VIF components, the “Values” category showed the highest score of 30.38 out of a possible 35 ,while “career factors” observed the lowest score of 14.09 Conclusions Medical schools and clinics could possibly improve their recruitment efforts by making it less time consuming for physicians to volunteer and by minimizing the financial costs to physicians. They could also benefit by advertising the altruistic and humanitarian nature of the volunteer activity.

Thesis (M. Med. Sc.)--University of Hong Kong, 2002. / Includes bibliographical references (leaves 84-86).

Thesis (M.S.P.H.)--University of Michigan, 1940.

Thesis (M.S.P.H.)--University of Michigan, 1940.

Thesis (M.Med.Sc.)--University of Hong Kong, 2002. / Includes bibliographical references (leaves 84-86). Also available in print.

Introduction The study aimed at determining health workers’ prescription patterns using selected WHO/INRUD core drug-use indicators and investigated determinants of appropriate antibiotic prescribing in public Zambian primary health care facilities. Methods The study was a secondary data analysis of a cross sectional survey of health facility data collected in four districts of Zambia. This study extracted patients’ diagnoses and treatments and linked them to the health worker demographics and health facility characteristics in order to determine prescription patterns and factors influencing appropriate antibiotic prescribing. Results A total of 2206 prescriptions were analysed. An average of 2.5 drugs per encounter was prescribed. Injections were prescribed in 4% of the encounters. While over 95% of drugs were from the essential drug list fewer drugs were prescribed by their generic names. Only 1.5% of encounters did not result in a prescription. Antimalarial drugs and antipyretics were prescribed in at least 70% of encounters while antibiotics were prescribed in close to 40% of encounters. Of all encounters in which a systemic antibiotic was prescribed, just above a quarter were of appropriate indication and dosage. Determinants of appropriate antibiotic prescribing included patient’s age, presence of clinical wall charts and treatment guidelines; and the health worker cadre. Under-5s were more likely to receive antibiotics when indicated, though at wrong dosages. Health workers with access to guidelines were more likely to prescribe antibiotics only when indicated. Health worker cadre iv without pre-service clinical training were more likely to prescribe antibiotics when not indicated and at wrong dosages. Discussion This study showed that health workers’ performance for most of the WHO drug-use core indicators was similar to findings in other developing countries. The study also revealed overuse of antibiotics for diseases that do not require antibiotics as treatment. Increasing access to guidelines and other clinical job aids, continuous medical education for all health workers and targeted training of health worker cadres without prior medical training will contribute to better prescribing of antibiotics.

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No description available.