Thesis (M.G.S.)--Miami University, Dept. of Sociology and Gerontology, 2008. / Title from first page of PDF document. Includes bibliographical references (p.66-68).

Thesis (Ph.D. (Economics)) - Rhodes University, 2009.

Thesis (Ph. D.)--University of California, San Diego, 2005. / Vita. Includes bibliographical references (leaves 296-309).

Thesis (Ph. D.)--University of Sydney, 2008. / Title from title screen (viewed Jan. 19, 2009) Includes tables and questionnaires in English and Farsi. Submitted in fulfilment of the requirements for the degree of Doctor of Philosophy to the School of Behavioural and Community Health Sciences, Faculty of Health Sciences. Includes bibliography. Also available in print form.

Abstract The purpose of the study was to increase understanding of the discussion of values of municipal health services as a phenomenon based on theoretical and empirical material. There has been very little research on organisation-internal discussion of values within health care services. The aim was to generate information about organisation values and discussion on values from the joint perspective of leading health care officials and elected officials. In addition, the aim was to produce a research-based model of value discussion within municipal health care services with the aid of a future research application of soft system methodology. In the theoretical part, Rest’s ethical decision-making model was utilised in conceptualizing value discussions within health care services. In addition, the multifaceted nature of the value environment of municipal health care organisations was analysed, and value discussion was linked to an ethical operational culture as its manifestation. The empirical part was implemented as a qualitative case study in the area of collaboration comprising health care services of three municipalities. Material was collected from those with permanent posts and from elected officials (a total of 25 persons) using interviews and with a three-phase future workshop process (a total of 16 persons). The data collected was systematically analysed. The study produced as a new finding a hypothetical construction of value discussions within health care services. The four main components of the construction were identification of organisation values, a collaboration-based approach to value discussion, encountering value conflicts and a visible value discussion culture. The aim of the components was to describe and aid in understanding the multidimensional nature of value discussions on municipal health care services. In the study, a soft system model of value discussions on municipal health care services was drawn up, combining theoretical and empirical knowledge of the phenomenon under study to form a whole. The novelty value of the theoretical results is a more structured analysis of the phenomenon of value discussion on organisation level, and based on this, a description of the process of change in the area of collaboration within primary health care. For practical-level actors, the study is an example of how values and value discussions within health care services can be examined, and how progress can be made in a defined direction by analysing the problems involved. The study can also be utilised in health care education and research, especially in planning soft system methodology applications. / Tiivistelmä Tutkimuksen tarkoituksena oli lisätä ymmärrystä kunnallisten terveyspalveluiden arvokeskustelusta ilmiönä teoreettisen ja empiiristen aineistojen pohjalta. Organisaation sisäistä arvokeskustelua terveydenhuollossa on tutkittu erittäin vähän. Tavoitteena oli tuottaa tietoa organisaatioarvoista ja arvokeskustelusta kunnallisten terveyspalveluiden johtavien viranhaltijoiden ja luottamushenkilöiden yhteisestä näkökulmasta. Lisäksi tavoitteena oli tuottaa tutkimustietoon perustuva malli kunnallisten terveyspalveluiden arvokeskustelusta pehmeän systeemimetodologian tulevaisuudentutkimussovelluksen avulla. Teoriaosassa hyödynnettiin Restin eettisen toiminnan mallia, jonka avulla terveyspalveluiden arvokeskustelu käsitteellistettiin. Lisäksi analysoitiin kunnallisen terveyspalveluorganisaation arvoympäristön moninaisuutta ja liitettiin arvokeskustelu eettisen toimintakulttuurin ilmentäjäksi. Empiirinen osa toteutettiin laadullisena tapaustutkimuksena kolmen kunnan terveyspalveluiden yhteistoiminta-alueella. Aineistot kerättiin viranhaltijoilta ja luottamushenkilöiltä (yhteensä 25 henkilöä) haastattelemalla ja kolmivaiheisessa tulevaisuusverstasprosessissa (yhteensä 16 henkilöä) tuotetuilla aineistoilla, jotka analysoitiin systemaattisella analyysilla. Tutkimuksessa tuotettiin uutena tietona terveyspalveluiden arvokeskustelusta hypoteettinen konstruktio, jonka neljä komponenttia olivat organisaatioarvojen tunnistaminen, yhteistyölähtöinen tahtotila arvokeskusteluun, arvoristiriitojen kohtaaminen ja näkyvä arvokeskustelukulttuuri. Komponenttien tarkoituksena oli kuvata ja auttaa ymmärtämään kunnallisten terveyspalveluiden arvokeskustelun moniulotteisuutta. Tutkimuksessa muodostettiin kunnallisten terveyspalveluiden arvokeskustelun pehmeä systeemimalli, joka kokosi teoreettisen ja empiirisen tiedon tutkimuksen kohteena olevasta ilmiöstä kokonaisuutena. Teoreettisten tulosten uutuusarvo on terveydenhuollon organisaatiotason arvokeskusteluilmiön aikaisempaa jäsentyneempi tarkastelu ja tämän pohjalta muodostettu muutosprosessin kuvaus perusterveydenhuollon yhteistoiminta-alueella. Käytännön toimijoille tutkimus on esimerkki, miten terveyspalveluiden arvoja ja arvokeskustelua voidaan tarkastella ja siihen liittyviä ongelmia jäsentämällä edistyä määriteltyyn suuntaan. Tutkimusta voidaan hyödyntää myös terveydenhuollon koulutuksessa ja tutkimuksessa, erityisesti pehmeän systeemimetodologian soveltamista suunniteltaessa.

M.A. / Currently there is great emphasis on community development. The researcher was motivated to do the study due to the community centre in Krugersdorp that concentrates on community development. The main goal of this dissertation is to prmulate criteria which community centres can use to function successfully. For the purpose of this study the fallowing objectives were identified: To gather information regarding the functioning qf the community centre in Krugersdorp; to compare this information with the literature on community and social development; from these findings to compile a guideline in connection with the functioning of a community centre based on the development paradigm; and to determine the role of the social worker at the community centre. The role of the social worker at the community centre is determined from information that has been received from interviews as well as a literature study. The community centre works according to R 17 P principles

Philosophiae Doctor - PhD / The existing District Health Information System in South Africa can be described as a facility based Information System, focusing on the clinics and hospitals and not on the community. Consequently, only those who access health services through these facilities are included in the system. Many children do not have access to basic health and social services and consequently, are denied their right to good health. Additionally, they are excluded from the routine Health Information System. Policy and resource decisions made by the District Managers, based on the current health facility information, reinforces the exclusion of these already marginalised children. The premise behind this research is that vulnerability of children can be tackled using two interconnected strategies. The first is through the creation of awareness of the situation of children and the second through mobilising the commitment and action of government and society to address this situation. These strategies can be supported by designing an Information System for action; an Information System that can be used to advocate and influence decisions and policies for the rights of these children; an Information System that includes all children. An interpretive participatory action research approach, using a case study in a rural municipality in South Africa, was adopted for the study of a child-health Community-Based Information System. The context in which the community is placed, as well as the structures which are embedded in it, was examined using Structuration Theory. This theory also influenced the design of the Information System. As the aim of the research is to change the Information System to include vulnerable children, a Critical Social Theoretical and longitudinal perspective was adopted. In particular, concepts from Habermas, such as the creation of a public sphere and the ’Ideal Speech Situation’, informed the methodology chosen and were used to analyse the research undertaken. Based on the research conducted in this municipality, four main changes to the Health Information System were made. These were: • determination of the community’s own indicators; • changes in data collection forms; • creation of forums for analysis and reflection, and; • changes in the information flows for improved feedback. Other practical contributions of the research are the development of local capacities in data collection and analysis, the development of practical guidelines on the design of a child-health Community-Based Information System, and the development of strategies for enabling participation and communication. In line with the action research approach adopted, and the desire to link theory and practice, the research also contributed on a theoretical level. These contributions include extending the use of Structuration Theory, in conjunction with Habermas’ Critical Social Theory, to the empirical context of South Africa; addressing the gap of Community-Based Information Systems in Information System design; extending the debate on participation and communication in Information Systems to ’developing’ countries, and developing generalisations from a qualitative case study. / South Africa

Studies suggest that knowledge, attitudes, and beliefs about domestic violence influence the behaviors of Mexican men. However, few interventions have targeted men in efforts to provide domestic violence awareness and health education to a relevant at-risk community that is also challenged by low literacy. Mexican immigrant men, particularly those less acculturated to the dominant U.S. culture, are significantly less likely to access services and more likely to remain isolated and removed from their communities and, more importantly, from their families. The purpose of this study was to explore and examine how cultural beliefs and behaviors influence the potential of domestic violence from the perspective of the Mexican origin, male immigrant. The research drew on existing community academic partnerships to collaboratively develop a pilot intervention that uses popular education techniques and a Community Based Participatory Research (CBPR) framework. The specific aims were: 1) to use the principles and practices of CBPR to ensure that the issues addressed and results obtained are relevant to Latinos in Multnomah County, 2) to identify the beliefs, attitudes, and culture about domestic violence and male health for a population of men who are immigrants and of Mexican origin, 3) to develop and prioritize intervention strategies that are community defined, 4) to implement and evaluate a four week pilot project that utilizes community defined, literacy independent curriculum and popular education techniques to address male and family wellness and the prevention of domestic violence. Nine men participated in this study who reported inadequate or marginal functional literacy at approximately a 4.5 grade level. The findings also revealed a strong consensus among the participants' that there is confusion surrounding what constitutes domestic violence and/or what behaviors and social barriers place them at risk for health conditions. In summary, we found that the domestic violence in the Latino communities cannot be approached as a single issue; it needs to be embraced from a wellness perspective and the impact of domestic violence and health knowledge is navigated by experiences of one's past and present. Combining the tools of CBPR with the tools of popular education may allow researchers to address the Latino male's concerns with literacy while also examining other, less immediately visible, concerns. When you take the focus off such a delicate subject such as domestic violence and reframe the issue in terms of holistic health, you will then find a more cooperative and less defensive population to work with.

The aim of this study is to explore the introduction of IsiXhosa (iintsomi) as an alternative method in the maternal health education in rural Primary Health Care in the Eastern Cape. An informal preliminary observation of a maternal health lesson by the researcher indicated a further need for maternal health educators to introduce storytelling into the health content themes. To re-inforce the maternal health educator lesson on the causes of teenage pregnancy, lifestyles for pregnant women, causes of miscarriage and termination of pregnancy, the Community Health Workers can undoubtedly use isiXhosa iintsomi in selected clinics and maternal waiting homes. As a readily available resource that cuts across all literacy barriers, iintsomi (isiXhosa) fosters a cross-cultural consultation which enables the healthcare worker to convey messages that make sense to the rural women. While the conventional methods of teaching have a tendency to create tension and lack of participation, use of folktale (iintsomi) have huge potential to bring lesson enjoyment; a meaningful interaction and story sharing by the maternal health educator, the pregnant women and greater community; access to important health messages; and strengthened utilisation of Primary Health Care. The study therefore suggests that there is a place for isiXhosa iintsomi: From the Fireplace into the Workplace.

The Home and Community Based Care (HCBC) and Support programme has been established as a cost effective response for communities to tackle HIV and AIDS and many other chronic conditions and vulnerabilities which are faced by individuals, families and communities. In terms of the Framework for Home and Community Based Care and Support Programme (2012: 4) HCBCs create an enabling platform for “individuals, families and communities to have access to holistic and comprehensive services nearest to home, which encourages participations by people, responds to the needs of the people, encourages traditional community life and strengthens mutual support opportunity and social responsibility”. Victor Khanye Local Municipality, IDP (2010-2011: 116) states that VKLM is faced with: a high incidence of HIV and AIDS due to poverty, ignorance and a lack of proper entertainment facilities; shortage of clinics and professional staff members, which makes it difficult for patients to access treatment and maximum care and support; and an increase in the number of OVCs which results in a lack of parental care and guidance, poverty, illiteracy, lack of access to medical care, school drop-outs and ultimately an increase in criminal activity and the further spread of HIV and AIDS. The research will assess the effectiveness of Home Community Based Care programmes (HCBCs) on orphaned and vulnerable children with specific reference to the Victor Khanye sub-district in Nkangala District, Mpumalanga Province. The research was conducted in Delmas and its surrounding farming areas. Victor Khanye sub-District has nine wards, most of which are predominantly farming rural areas. The field research took place during June and August 2013 and represents observations recorded at the field interviews, the local AIDS committee and one-on-one interviews with beneficiaries The study is concluded with conclusions drawn from the field study and recommendations.