The purpose of this study was to show how information from the District Health Information System can be used to empower managers to make evidence-based decisions that will strengthen the health care system to reduce the under-five mortality rate. A quantitative, contextual, exploratory evaluative and descriptive approach was followed and a data extraction framework, based on systems theory, was developed to guide the process of extracting existing routine data. A results-based approach was used to measure under-five mortality related health care in terms of impact, outcomes, outputs, processes and inputs. The study has highlighted that proxy indicators obtained this way places health care managers in the position to monitor progress towards achieving the Millennium Development Goal for child mortality in the interim periods between large population surveys. The findings displayed in the diagnostic performance profile revealed that drastic interventions are required to reduce the under-five mortality rate. / Health Studies / M.A. (Health Studies)

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)

Introdução: Voluntário é termo polissêmico, mas, de forma geral, designa o cidadão que doa tempo, trabalho e talento, espontaneamente e sem remuneração, para causas de interesse comum. As motivações para o voluntariado são variadas, apesar de esta ação ser vista, socialmente, como altruísmo. Objetivo: Analisar as motivações para o voluntariado em um hospital público da cidade de São Paulo, especializado em HIV/Aids. Método: Estudo de caso descritivo-analítico, com base em Método Misto. A coleta de dados foi feita por entrevista semiestruturada e aplicação dos instrumentos, adaptados e validados para a população brasileira: Critério de Classificação Econômica Brasil; Inventário de Funções do Voluntariado e Questionário de Perfis de Valores Refinada. Fez-se a análise de conteúdo dos discursos e os questionários foram analisados estatisticamente. Resultados: A maioria do voluntariado é feminina, branca, solteira, natural de São Paulo, praticante de religião. Houve igual proporção de assalariados e aposentados e todos eram das classes sociais A, B ou C. Os relacionamentos sociais se mostraram importantes na motivação e vínculo com os pacientes foi, ao mesmo tempo, fonte de motivação e satisfação. Encontraram-se indícios de motivação altruísta: benevolência, como cuidado; universalismo, como compromisso; entendimento; engrandecimento social. Conclusão: A convergência das análises quantitativa e qualitativa pode indicar a coerência interna dos participantes, fortalencendo os indícios de altruísmo como motivação do grupo para o voluntariado. / Introduction: Volunteer is a polysemy word, but, in general, refers to the citizen who donates, spontaneously and without payment, time, effort and talent for causes of common interest. The motivation for volunteering is varied, although, socially, this action is considered as altruism. Objective: To analyse the motivations for volunteering in a public hospital in São Paulo, specialized on HIV / AIDS. Method: Descriptive and analytical case study, based on Mixed Method. For data collection we used semi-structured interviews and scales which are adapted and validated for Brazilian population: Economic Classification Criterion Brazil Volunteer Functions Inventory, and Refined Portrait Values Questionnaire. Data was analysed by content analysis and statistically. Results: Most of the volunteers are female, white, single, and native of Sao Paulo, religious practitioner. There were equal proportions of active workers and retirees and all participants were from social classes A, B or C. The social relationships are very important to motivation and the affective bonding with patients was, at the same time, a source of motivation and satisfaction. The results pointed out evidence of altruistic motivation: benevolence, as care; universalism, as commitment; understanding; social aggrandizement. Conclusion: The convergence of quantitative and qualitative analysis might indicate the internal coherence of the participants, what reinforces the evidence of altruism as the group\'s motivation for volunteering.

Este estudo tem como objetivo identificar e discutir condições e riscos no trabalho dos Agentes Comunitários de Saúde que atuam em uma Área Programática da cidade do Rio de Janeiro. O referencial teórico foi o da saúde do trabalhador, e as normativas relativas à formação do ACS e de seu processo de profissionalização. O estudo foi realizado em equipes que atuam em duas comunidades, por meio de um estudo de observação sistemática, não-participante, utilizando um roteiro prévio com conteúdo de riscos ocupacionais. Os dados foram coletados a partir do acompanhamento de 23 ACS que realizaram 74 visitas domiciliares nos meses de março a junho de 2008, e organizados sob a forma de um diário de campo descritivo. A organização e análise basearam-se na abordagem qualitativa da análise de conteúdo. Os resultados são apresentados e discutidos segundo a seguinte organização: i) atividades realizadas pelos ACS; ii) comparação entre atividades prescritas e atividades reais e iii) principais riscos identificados e suas possíveis repercussões na saúde do ACS. Nas considerações finais, são discutidas as implicações para o SUS e para a enfermagem, que tem supervisionado os ACS, e a importância de se aprofundar, por meio de estudos posteriores, as situações e condições de trabalho desenvolvido na Atenção Básica. / This study aims to identify and discuss occupational risks and word conditions on Community Health Agents (CHA) that work in an area of Rio de Janeiro city. Theoretical discussion was based on workers health field, and on educational and profesional legislation. The research was carried on two communities, using systematic, non-participant observation, and a previous guideline with occupational risks content. Data collection was developed by observation of 23 CHA that made 74 domiciliary visits from March to July of 2008, and organized in a descriptive diary. Organization and analysis were based on Content Analysis technique. Results are presented and discussed as follows: i) activities developed by HCA; ii) comparison between prescribed and real activities and iii) main occupational risks identified and their possible repercussions on workers health. In final considerations, implications to health care system and nurses that supervise the HCA are discussed, as also the necessity to develop further studies to analyze work conditions and situation in Primary Health Care level.

The purpose of this single case study was to describe community perspectives of a service learning (SL) partnership with a single university conferring a baccalaureate nursing degree. The longevity of the partnership extended the study purpose to explain why the partnership continued and worked well. A review of nursing literature revealed descriptive accounts of programs designed to meet needs of underserved populations and student learners. However, the review also revealed a knowledge gap in nursing education science regarding the community perspectives of successful SL partnerships. This study focused on relationships with the academe partner, interactions with students and faculty, and benefits of services rendered. Using a case study approach, the investigator sought disparate sources of information including interviews with 21 community members, the primary nursing professor, and the university administrator for rural health and community partnerships. The investigator reviewed relevant documents and made observations during nine days in the community. Triangulation of multiple data sources illuminated a relationship in which key players remained committed to mutual goals beyond immediate projects. Compelling findings were the a) immersed accessibility of the primary nursing professor who lived in the community, b) competency of community members to be expert teachers and set the agenda for the university’s involvement, and c) increased social connectedness that empowered a community to improve its health. The American Association of Critical Care Nurses Synergy Model (Hardin, 2009) was useful for understanding the synergistic relationship involving community partners, student learners, and nursing faculty. However, the broader themes of a community empowered through full integration into a partnership fit with social theories explaining interactions at the macro level as well as behaviors along a pathway of shared commitment. This case demonstrated that sustained interpersonal relationships were critical to developing the community’s integral role as full partner, and the primary nursing professor was a trusted link advocating judiciously for all parties. As SL pedagogy is integrated into nursing education with an emphasis on community-based education and health at the population level, findings of this study can assist nurse educators in the development and maintenance of successful community-academe partnerships.

Background: South Africa, similar to most developing countries is faced with ever increasing demands for health care emanating from various reasons, which include a quadruple burden of disease. More appropriate health policies have been developed since the new government dispensation post-1994. Most of these have been implemented. These include, inter alia, the District Health System (DHS) as a vehicle to deliver Primary Health Care services. The decentralization principle was key to the implementation of the DHS and was intended to shift decision making to the periphery to improve overall responsiveness to local health needs. Study Aim: The study aimed at exploring the management roles and functions of the Registered Nurse-In-Charge of Primary Health Care clinics in eThekwini District, both from a policy and operational perspective. It is envisaged that this body of knowledge will contribute to policy development for effective, efficient and economical management of PHC service delivery at clinic level. Methodology: The study was conducted in eThekwini District and adopted a qualitative design. The target population was the Registered Nurses-In-Charge of clinics. The sampling method employed was purposive, a priori heterogeneous sampling. Data collection methods used included in-depth interviews with key informants and focus group discussions. Eight indepth interviews were conducted on key informants. Two were from a municipal clinic, two were from a provincial clinic and two were from a state subsidized clinic. One was conducted on the District Programme Manager and one on the District Primary Health Care Coordinator. Three focus group discussions were conducted: one with clinic nurses, one with Registered Nurses-In-Charge, and one with Primary Health Care Clinic Supervisors. Data analysis was undertaken using the deductive content analysis which was done according to the predetermined categories guided by the objectives. Within these broad groupings of responses, themes, sub-themes and patterns were established, noting particular similarities and differences between respondents. The patterns were aligned to the study objectives in order to keep focus on the research question Findings: The study revealed that although the Registered Nurses-ln-Charge of clinics possessed certain particular theoretical knowledge on the management roles and functions required of them at clinic level, most of these functions were not being performed. The policy documents, including the Registered Nurses-In-Charge's job descriptions, indicated gaps in relation to the management roles and functions required of Registered Nurses-In- Charge. In certain instances the policy omitted functions that were in the job descriptions and vice versa. This showed that the policy documents were not considered in the development of job descriptions. Major gaps were in leadership and planning, human resource management, financial management and information management. The gaps in the policy documents and job descriptions were attributed to the narrow decision space transferred to the clinics. Most management functions of clinics are still held at support institutions be it at a hospital or community health centre. Some of the reasons reported by the Registered Nurses-In-Charge themselves, as limiting the fulfillment of management roles and functions, were lack of orientation and training on management, lack of dedicated clinic managers, staff shortage and lack of support from clinic supervisors and the support institution. Conclusion: The recommendations include building management capacity, and reviewing the degree of decision space transferred to clinics if they are to succeed in fulfilling the function of being the first entry point into the health system. / Thesis (M.Med.)-University of KwaZulu-Natal, Durban, 2008.

The purpose of the study was to do a task analysis.of PHC nurse practice by identifying the skills required by nurses working at the primary health care clinic in order to plan staff development programmes. The objectives were: to compile ; an extensive list of possible tasks; engage Primary Health Care Nurses in identifying the frequency of tasks executed; and engage Primary Health Care Nurses in determining how important are the tasks in their practice. This was a descriptive survey. A mail survey was used to collect data. Two stratified random samples of nurses were drawn from the sample frame of Uthukela Health District. The sample consisted of 84 Primary Health Care Nurses; 59 registered nurses, 17 enrolled nurses, and 8 enrolled nursing auxiliaries. The questionnaire was developed based on PHC core package, other literature and services provided at PHC clinics. It had three sections; section one and dealt with demographic data, section two consisted of the list of activities that describe the nursing practice and the respondents had to indicate the frequency of performing the activity and importance of the activity and section three dealt with the activities that the respondent perform but were not included in the list provided. The response from mailed questionnaires was 72%. The results show that . I eleven items were rated very frequent by 70% of the nurses, forty-four items rated frequent by more than 50% of the nurses. Twenty-seven tasks were rated as important by 50% or more of the nurses. In frequency and importance, nineteen items score above 1 standard deviation on this index. In the clinical tasks, promotive and preventive service predominated. A high percentage of these tasks were done very frequently and were seen as important. / Thesis (M.Cur.)-University of Natal, Durban, 2002.

Diss. (sammanfattning) Stockholm : Karol. inst., 2003. / Härtill 5 uppsatser.

Thesis (Ed.D.)--Teachers College, Columbia University, 1992. / Includes tables. Typescript; issued also on microfilm. Sponsor: Elizabeth Tucker. Dissertation Committee: Douglas S. Sloan. Includes bibliographical references (leaves 157-175).

An exploratory, qualitative research design was used to explore the role, attitude, views and competence of the community nurse to integrate children with disabilities into the community of the Mafikeng district, in the North West Province. Barriers to the integration of children with disabilities into the community as well as strategies to address these barriers were identified. Focus group discussions were conducted to collect data from the community nurses and parents of children with disabilities. Interviews were also conducted to collect data from the clinic health managers. The findings of this study reveal that the community nurse is instrumental in integrating children with disabilities into the community. However, barriers related to the family, community and health system are challenges to the integration process. The recommendations of this study deal with addressing these barriers. / Health Studies / M. A. (Health Studies)