<p>Ethiopia is exercising decentralisation of the health system and thus this study assesses lessons learned about the experiences of the decentralization of institutions in heoretical terms. The problem investigated in this study concerns the lack of institutional capacity to effectively provide services, lack of transparency, responsibility and accountability. Decision making is also very remote from the people with regard to resource allocation and public health service delivery. The scope of this study covers the Southern Nations, Nationalities and People&rsquo / s Regional State of Ethiopia and its relationship with the Cheha District in the area of health service decentralization. The objective of this study was to identify fundamental elements of decentralization of health institutions and the impact on the performance of the health system at local government level in the Cheha District in Ethiopia.</p>

The world’s understanding of HIV/AIDS is grounded in biomedicine and shaped by cognitive psychology. Both biomedicine and cognitive psychology bonded with historically top-down development mechanisms to create ‘prevention’ strategies that obscured from vision the root causes of the pandemic. Within this hierarchy, bio-medicine and the cognitive psychological conception of human beings silenced indigenous voices and experiences of communities fighting HIV/AIDS. This is most certainly true in the case of Sub-Saharan Africa. This research explores the emergence of the Community Capacity Enhancement – Community Conversations prevention approach that places community dialogue, and the voices of communities, at the forefront of the battle to end HIV/AIDS and deconstruct and challenge the forms of structural violence that hold prevalence rates in their place. Within these spaces, oral traditions, indigenous knowledge, and resistance illustrate new and complex pictures of the viruses’ socio-economic impact and provide new foundations for community generated movements to curb the virus.

The world’s understanding of HIV/AIDS is grounded in biomedicine and shaped by cognitive psychology. Both biomedicine and cognitive psychology bonded with historically top-down development mechanisms to create ‘prevention’ strategies that obscured from vision the root causes of the pandemic. Within this hierarchy, bio-medicine and the cognitive psychological conception of human beings silenced indigenous voices and experiences of communities fighting HIV/AIDS. This is most certainly true in the case of Sub-Saharan Africa. This research explores the emergence of the Community Capacity Enhancement – Community Conversations prevention approach that places community dialogue, and the voices of communities, at the forefront of the battle to end HIV/AIDS and deconstruct and challenge the forms of structural violence that hold prevalence rates in their place. Within these spaces, oral traditions, indigenous knowledge, and resistance illustrate new and complex pictures of the viruses’ socio-economic impact and provide new foundations for community generated movements to curb the virus.

<p>Ethiopia is exercising decentralisation of the health system and thus this study assesses lessons learned about the experiences of the decentralization of institutions in heoretical terms. The problem investigated in this study concerns the lack of institutional capacity to effectively provide services, lack of transparency, responsibility and accountability. Decision making is also very remote from the people with regard to resource allocation and public health service delivery. The scope of this study covers the Southern Nations, Nationalities and People&rsquo / s Regional State of Ethiopia and its relationship with the Cheha District in the area of health service decentralization. The objective of this study was to identify fundamental elements of decentralization of health institutions and the impact on the performance of the health system at local government level in the Cheha District in Ethiopia.</p>

Magister Administrationis - MAdmin / Ethiopia is exercising decentralisation of the health system and thus this study assesses lessons learned about the experiences of the decentralization of institutions in heoretical terms. The problem investigated in this study concerns the lack of institutional capacity to effectively provide services, lack of transparency, responsibility and accountability. Decision making is also very remote from the people with regard to resource allocation and public health service delivery. The scope of this study covers the Southern Nations, Nationalities and People’s Regional State of Ethiopia and its relationship with the Cheha District in the area of health service decentralization. The objective of this study was to identify fundamental elements of decentralization of health institutions and the impact on the performance of the health system at local government level in the Cheha District in Ethiopia. / South Africa

The primary purpose of this research project was to explain how Korean immigrants develop acculturation attitudes toward Korean and American culture and how these attitudes are related to their experiences within their community in America. In order to achieve this goal, this project consisted of two empirical studies. In Study 1, the model of community capacity and acculturation was tested using structural equation modeling and the model fit the data very well. The results of the hypotheses tests in Study 1 were as follows: Sense of Community, Community Provisions, and Community Engagement were positively correlated with each other. Sense of Community and Community Provisions directly influenced acculturation attitudes toward American culture. Community Capacity directly influenced acculturation attitudes toward Korean culture. Sense of community and Community Provisions had significant indirect effects on acculturation attitudes toward Korean culture. In Study 2, using structural equation modeling, the model of community adjustment was tested across three groups (INTEGRATION, ASSIMILATION, and SEPARATION) who had developed different acculturation attitudes and the model fit the data well except for ASSIMILATION. The results of the tests of the hypotheses in Study 2 were as follows: Sense of Community and Community Capacity were positively correlated with each other in all groups. Only INTEGRATION did Sense of Community directly influence Community Provisions. However, Community Capacity directly influenced community provisions in all three groups. In INTEGRATION and SEPARATION, Community Engagement directly influenced Community Provisions. Community Capacity indirectly influenced Community Provisions in both INTEGRATION and SEPARATION. Finally, I concluded that Korean immigrants experienced the process of community adjustment differently regarding acculturation attitudes. Results from these investigations explicitly reveal that the application of community capacity in research on acculturation was valuable for explaining some individual and contextual variations in acculturation. Acculturation was a complex, multi-dimensional process. Korean immigrants developed different attitudes and their attitudes impacted differently on their lives within their larger community. The theoretical concept of community capacity has much promise as a guide for future theory and research on acculturation. / Ph. D.

This study explores how local community economic development actors in rural settings view prospects for bottom-up (i.e., endogenous) development through a case study of the Keremeos area in British Columbia. The study involved a basic descriptive analysis of the case study site drawing upon Statistics Canada data, historical records and local policy documents along with 11 semi-structured interviews of local development actors representing the varied geographic, jurisdictional and organizational interests comprising the Keremeos area development landscape. The findings indicate that not only do predominant institutional arrangements presuppose and eventuate rural inferiority and decline, they also tend to impose externalities for rural communities to contend with while failing to provide similar measures of in-kind support to mitigate such impacts. This stokes an erroneous sentiment that local government is responsible for precipitating endogenous development, limiting the extent to which community members work to actively operationalize it as a result. Such conditions ultimately lead rural communities to have no choice but to challenge predominant institutional arrangements in order to forge their own paths for realizing endogenous development. Indigenous communities offer hope for rural areas through increased guardianship programs and industry partnerships which help to challenge and rearticulate these arrangements to the advantage of their communities and interests. It is advisable that senior government work to provide rural communities with capacity to facilitate their own economic viability – reflecting local values, knowledge, identity and autonomy – thus working to counter the externalities and parameters which they and prevailing market forces have conceived for rural communities to persist within. / Graduate

ABSTRACT Lifestyle factors related to overweight, obesity, and Type 2 diabetes are currently in the forefront of health issues affecting children and adolescents. Schools have been considered important venues for disseminating health education and promotion programs. Some investigators, however, contend that school-based programs have only seen modest success over the last two decades. Typically short-term, school-based interventions do not address program sustainability or larger social issues such as socioeconomic status (SES). A growing body of literature suggests there is value in collaborative efforts between university researchers and communities as these relationships can help build the capacity of the school and community. The Coordinated School Health Program (CSHP) model was developed as a mechanism to build the organizational capacity of schools to facilitate, integrate and sustain health education and promotion efforts to improve the health of youth in our nation. The purpose of the current study was to assess a mid-western middle school's capacity to sustain a previously implemented Type 2 diabetes prevention program. An instrumental case study design was utilized. A total of 19 interviews were conducted. Additionally, observations and documents related to school policies and procedures were reviewed. The four infrastructures of the CSHP framework were used as predetermined categories into which data were coded. This study found that there was potential for the school to sustain the Type 2 diabetes program within the framework of the CSHP Model. The school already had in place five of the eight CSHP components. The three remaining components could be implemented if several issues were addressed. First, there were many myths and misconceptions regarding the purpose and costs of a CSHP. Education for district administrators, school faculty and staff, as well as the community, would be vital. Concerns regarding personnel to implement a CSHP were expressed. A dedicated health course would also need to be implemented. When planning health related interventions that will be implemented in school-based settings researchers should seriously consider implementing a CSHP prior to employing their short-term programs. If programs can be planned with sustainability in mind, there is potential for greater health outcomes for school-aged children and adolescents.

The primary purposes of this dissertation were to (i) assess and identify post-industrial urban neighborhoods with food-insecure and vulnerable populations, and (ii) explore and analyze the role of nonprofit organizations (NPOs) in addressing place-based food insecurity. The study used mixed-methods, including qualitative GIS, statistical tests, surveys, interviews, and field observations. A food justice theoretical framework was used to develop a Place-Based Food Insecurity and Vulnerability Index (PFIVI), which factored together 33 variables to measure six indicators. The study applied this index in the City of Philadelphia and then examined three types of interventions that NPOs embark on - providing hunger relief, providing healthy and affordable food through the alternative food movement, and offering food-based programs and events tied with community capacity building efforts. Statistical relationships between PFIVI scores and NPO-driven programs showed spatial mismatch issues between the programs and community needs in some neighborhoods. This research also highlighted other limitations of these programs and the challenges that NPOs face both on- and above-the-ground. While the NPOs are trying hard to promote food justice through their mission statements, advocacy, outreach, and on-the-ground programs, the city may have only partially achieved this goal. A lot more needs to be done by strengthening organizational networks, strengthening social networks with community residents, and offering healthy but affordable food in disadvantaged neighborhoods, and NPOs alone should not bear these responsibilities. / Geography

This thesis analyzes the impact of the political decision to broaden the scope of the Government of Canada's 3-year National Homelessness Initiative (Human Resource Development Canada, NHI, 2002) from an urban focus to one that includes smaller communities. This change provided the opportunity to study the phenomenon of homelessness and how rural responses are formed. This author postulates that this focus of attention on an almost invisible phenomenon—rural homelessness—and the accompanying community planning processes funded by the Supportive Community Partnership Initiative (SCPI) will impact local social policy development. A multi-dimensional analytical approach was adopted and considered three components: first, a policy review, a broad look at the policy agenda framework in Canada; then, a case study to illustrate implementation issues related to the National Homelessness Initiative; and, finally, a reflection on current practice in order to realize a holistic critique of public policy. The influence of socio-economic, political, and cultural factors on local planning and capacity building will be highlighted. Various models of governance were adopted across the country and guided the collaborative processes. This thesis presents an in-depth look at the community action plans and activities of the Simcoe County Alliance to End Homelessness (SCATEH) in both the rural and urban settings of Simcoe County. The processes adopted, capacity building components identified, and outcomes over the 7 years covered by the SCPI agreement are examined. The limitations of using participatory local action planning to respond to complex issues such as homelessness are detailed along with a modified community-based policy development model recommended as a learning tool to be used by those volunteers acting as agents of change. It is widely recognized that safe, affordable social housing is a fundamental need, and one that is extremely difficult to meet. The contribution this research makes is to reveal how effective government-community partnerships can be in a rural setting.