M.Cur. / It is evident that the current political changes presently taking place in South Africa need to be accompanied by a dramatic transformation to accommodate the economic, social, technological and health changes amongst others. The nursing discipline is no exception. For a change to be felt by nursing staff and by health consumers, effective management strategies need to be developed to accommodate transformation guidelines as outlined by the Reconstruction and Development Programme, the National Health Plan and the Constitution which all emphasize the right to health, hence this study. This study focuses on a primary health care clinics. This is a qualitative, contextual, exploratory and descriptive study with the overall aim of exploring and describing a nursing service strategy for change in Soweto Primary Health clinics where the researcher is employed. To accomplish this aim, the following objectives were formulated: to explore and describe the expectations of the managers and the functional nurses concerning the required nursing service strategy for change within Soweto Primary Health Clinics; to explore and describe the expectations of health consumers concerning the required nursing service strategy for change in Soweto Primary Health Clinics; to describe the required nursing service strategy for Soweto Primary Health Clinics. Through purposive sampling, three focus groups were selected from the role players within Soweto who represent the nursing managers, the functional nurses' and the health consumers in order to infer the required change strategy for the nursing service. i. Data was collected through these focus groups interviews using semi-structured questions. Data management and data analysis was done using the methods of content analysis according to Kerlinger (1986: 480). An research expert, was utilised as a reliability measure to identify and categorise themes separately from the researcher. The categories that emerged were subsequently refined through consensus discussions between the researcher and the independent researcher. Woods and Catanzaro' s measures (1988: 136) to ensure validity and reliability were applied in this study.

Thesis(MPH.) -- University of Limpopo, 2019 / Background: Community service health professionals working in rural areas experience challenges such poor accommodation, poor supervision, unavailability of equipment and medication. The majority of studies focussed on doctors, with a few including dentists and pharmacists. This study intended to establish the experiences of community service health professionals in all professions. Objective(s): The objectives of the study were to describe and explore the experiences of community service health professionals. Methods: A qualitative, exploratory and descriptive study was conducted. Purposive sampling was used to select community service health professionals for the study. Face to face interviews with community service health professionals were conducted to collect data. Community service health professionals were interviewed until data saturation was reached. The Tesch‘s eight steps were used to analyze data. Results: The study findings indicated that community service health professionals experienced challenges relating to accommodation, supervision and unavailability of equipment and medication. Conclusions: Community service health professionals are experiencing challenges regarding working in Limpopo province rural hospitals. It is recommended that the government should allocate more funds to health care services to address the challenges faced by community service health professionals

The purpose of the study was to explore the perceptions nurses have regarding PHC in rural communities in Kasoa, Ghana.The study was carried out in Kasoa in the Central Region of Ghana. The data were collected purposively using individual in-depth interview; the data were analysed using thematic data analysis approach. A total of 24 nurses were interviewed. This sample size was attained at saturation. The population for this study included all the nurses irrespective of category, qualification and experience and who are working in the PHC facilities in Kasoa rural areas. The categories of nurses were registered general nurses, enrolled nurses, midwives and community health nurses. The thematic analysis yielded 5 themes as follows: Participants’ interpretation of the meaning of Primary Health Care.The participants further perceived health education and patients’ rights provided at PHC facilities as helpful in achieving health outcomes. The participants had the perception that the provision of outreach services seems to be acceptable to communities and there are referral systems at PHC facilities, which are well-structured, clear and acceptable. The participants also perceive the CHPS zones as helpful to provide PHC services / Health Studies / M.A. (Public Health)

This dissertation examines the fiscal and ideological deployments of community in publicly-funded yet independent nonprofit social service and healthcare provision. As at-risk youth leave families-of-origin in two American cities, they encounter a network of nonprofit providers conducting tailored and targeted outreach and managing access to benefits, services, and housing. Clients and outreach workers describe the ways they are monetized in an interconnected system of welfare and service provision and point to an expanding, entrapping, and extractive public health, housing, and benefits structure where community-building is the nonprofit profit mechanism. Following recent work on the “grow and hide” model of the American health care state (Grogan 2023), this fieldwork investigates on-the-ground impacts of hidden public funding and financing routed through private industry for nonprofit hospitals, clinics, community-based outreach arms, and public health-funded housing that has increased out of sight and without accountability to the public. Through fieldwork inside hospital-based clinics, nonprofit-adjacent “grassroots” campaigns, trade associations, and interviews with agency officials, bankers, nonprofit consultants, executives, and providers, this research untangles a skein of legislation and benefits policies that traps clients in proliferating categories of vulnerability. The material and psychological consequences of these policies for clients and their providers unspool inside nonprofit hospitals and clinics and their outreach arms—the site of public health intervention research, benefits navigation, and primary care provision in youth public health programs across the country. Within funding eddies enabled by municipal, state, and federal agency contracts with nonprofit service providers across healthcare and housing, a certain kind of client-subject is made who must either perform community or embrace mercenariness in policy-related underground economies. The municipal Community-Based Organization (CBO) and not the family (Cooper 2017) emerges as the unit propped up in the late devolutionary structure of welfare and service provision. State-funded independent nonprofits and their trade associations emerge as key architects from below of an expansive, hidden, and extractive healthcare-welfare state.

Extensive research suggests linkages among low income, erratic or ineffective parenting behaviors, and impaired health and development among children. Family support programs, offering a range of comprehensive services to low income families, have demonstrated positive health and life performance outcomes, both for children and parents. One such program, the Comprehensive Health Investment Project (CHIP) in Roanoke, Virginia, works to provide primary physician care to low income young children. One of CHIP's objectives is to enhance parenting skills so that parents can help maintain good health among their children. This study attempted to assess parents' beliefs about child development among a sample of CHIP parents and a sample of parents from a similar SES group (drawn from CHIP's waiting list) using a Likert-style opinionnaire. Results from both between-group tests and within-group (CHIP sample) tests indicate homogenous and favorable reported beliefs about child development. Very little association was found between demographic variables and responses. Suggestions regarding the practical use of these findings and recommendations for future research are made. / Master of Science

Educational literature distributed by the Child Health Investment Partnership (CHIP) staff to CHIP parents was identified and evaluated in terms of readability level and availability of information to assist with meeting the identified needs of CHIP parents. One-hundred percent (n=137) of the educational material available to CHIP staff through their library was analyzed. Readability levels were calculated by using the SMOG Readability Formula and the FRY Graph Reading Level Index. A previous study (Brindle, 1992) was used to determine whether CHIP had adequate material to meet the educational needs of CHIP families. Forty-eight percent of CHIP parents cited health as their primary concern. Almost one-half of an educational literature stocked in CHIP's library relates to health. Thus, results indicate that CHIP has a more than adequate amount of educational literature relating to topics CHIP parents believed they needed assistance with the most. It was found, however, that other areas such as financial and job assistance were underrepresented in CHIP's library. While 36 percent and 35 percent of CHIP parents believed they needed assistance with finances and jobs, respectively, only 6 percent of CHIP's library was devoted to financial assistance and two percent was devoted to job assistance. The apparent need for assistance in these areas greatly outweighs CHIP's educational resources. Results also indicate that the average CHIP parents (one who has completed high school) has the education equivalent to or more than was required for reading the majority of CHIP's educational literature. While the mean Reading Level of educational materials was at the tenth grade level sixty percent of CHIP families surveyed had completed high school. Results and conclusions are discussed in detail. / Master of Science

A wide range of people are interested in how local factors influence patient choice among hospitals. Administrators need to know why patients are admitted to their hospitals so they can develop more sophisticated marketing of their services in an increasingly competitive environment. Planners concerned with issues of patient accessibility need know the geographic patterns of hospital use To meet these needs, it becomes necessary to develop methods to estimate the probability that patients will be admitted to a particular hospital using models that incorporate location and size of competing hospitals. In this paper, the focus of econometric investigation and prediction is the probability that a patient will select e particular hospital. Four different service areas were delineated and studied in West Virginia to test the Huff Consumer Spatial Behavior model for estimating demand at four hospitals that may be facing closure. It was found that through application of the Huff model that in a small system of hospitals and patients, each patient location (i.e., zip code) will send patients to nearly every hospital. The model predicted sufficient demand for two of the four hospitals studied. Conventional methodologies were then compared to the Huff model. The model did not test for financial feasibility of any of the facilities nor did the model adequately address the issue of how patients select a particular facility. / Master of Science

This study investigated factors influencing the quality of data for the Tuberculosis (TB) control programme in Oshakati District in Namibia. A quantitative, cross-sectional descriptive survey was conducted using 50 nurses who were sampled from five departments in Oshakati State Hospital. Data was collected by means of a self-administered questionnaire. The results indicated that the majority (90%) of the respondents agreed that TB training improved correct recording and reporting. Sixty percent of the respondents agreed that TB trainings influenced the rate of incomplete records in the unit, while 26% of the respondents disagreed with this statement. This indicates that TB trainings influence the quality of data reported in the TB programme as it influences correct recording and completeness of data at operational level. Participants’ knowledge on TB control guidelines, in particular the use of TB records to, used to capture the core TB indicators influenced the quality of data in the programme. The attitudes and practises of respondents affected implementation of TB guidelines hence, influencing the quality of data in the programme. The findings related to the influence of the quality of data in the TB programme and its effect to decision-making demonstrated a positive relationship (p=0.0023) between the attitudes of study participant on the use of data collected for decision-making. Knowledge, attitudes and practice are the main factors influencing the quality of data in the TB control programme in Oshakati District. / Health Studies / M.A. (Public Health)

The purpose of this study was to explore the lived experiences of the newly qualified professional nurses in midwifery section doing community service. A qualitative descriptive, interpretative phenomenological research was conducted to determine the experiences. The sample included newly qualified professional nurses doing community service. Data collection was conducted by means of unstructured interviews from ten (n=10) informants. Each interview was approximately 45 minutes. Ethical issues were considered. Hussel and Heidergadian’s data analysis steps were followed. Four (4) themes and eleven (11) sub-themes emerged from the data collected. The findings revealed that the newly qualified professional nurses were in a state of reality shock, demonstrated by challenges such as shortage of human and material resources; overcrowding; lack of support; and the placement of Midwifery Nursing Science in the curriculum has impacted negatively on midwives’ registration as professional nurses. Based on the current practical nursing education environment and further research, this study concludes by presenting its recommendations and limitations. / Health Studies / M. A. (Health Studies)

Submitted to the faculty of Health Sciences in fulfilment of the requirements for M.Tech.: Nursing, Durban University of Technology, 2011. / Background The South African health care system is guided by the primary health care approach (PHC), which is based on the principles of accessibility, availability, affordability, equity and acceptability which are the cornerstone of primary health care. The Comprehensive PHC Service Package for South Africa is the guiding document for transforming PHC in South Africa standardizing services and increasing access to PHC services. This study will focus on the “Clinic: Fast Queue/Repeats” component of the Package. This is the protocol which guides the management of chronic disease care for adults, geriatrics and paediatrics. According to the Package, this service is for patients who have been assessed previously either at a CHC or at a clinic. For repeat medicines no assessment is required except after three months, and waiting time is minimized through the use of pre-packaged drugs. Methods A cross sectional qualitative design using a descriptive method was used to explore the experiences of the clinic users of the fast queue. A two stage sampling technique was used namely cluster and purposive sampling. In the first instance cluster sampling technique was used to sample clinics in each of the three sub-districts namely south, north and west sub districts of eThekwini municipality and purposive sampling was used to select PHC facilities, those with the highest number of attendees seen over a period of three months and the users of fast queue. Results The findings of the study revealed that there were positive factors which contributed to the satisfaction of participants and negative factors which caused dissatisfaction among participants.