Thesis (M.Dev. (Management and Law)) -- University of Limpopo, 2013 / Section 27 of the Constitution of the Republic of South Africa, 1996 provides that everyone has a right to have access to health care. South Africa embraces the concept of universal health care coverage. Access to health care has four dimensions: geographic accessibility, availability, financial accessibility and acceptability. If there were barriers to access to health care, the stake-holders would be duty-bound to design interventions requisite to address those barriers. The aim of the study was to establish whether health care users enjoy the right to have access to health services at Ratshaatsha Community Health Centre (RCHC). The study used a combination of quantitative and qualitative research designs. While a questionnaire was used to collect quantitative data, focused group discussions and participant observations were employed to collect qualitative data. The following are the main findings of the study. Human rights instruments clearly spell out the indivisible and mutually supportive rights that persons have. There are barriers that often affect the rights to have access to health services at RCHC. For instance, the RCHC is not within a 25 km radius of some of the consumers of health care. The roads that link up the health care users and RCHC are in poor condition. The community is generally poverty-stricken. Many cannot afford, among others, the costs of basic needs, transport fares and opportunity costs. Travelling distance and time, scarce skills and lack of medication and equipment rank among demand-side and supply-side barriers to access to health care. Health care users often choose to consult churches and traditional healers. It is recommended that government should, among others, co-ordinate primary health care services in collaboration with churches and traditional healers; commission research into traditional health medicine and healing procedures and protocols of other health care providers; develop policy on cross-referral of patients; improve community participation; set minimum norms and standards for the delivery of alternative health care services; establish health care management guidelines for churches and traditional healers; integrate health care provisioning into IDPs; and provide health care in an integrated intergovernmental manner.

Thesis (M.Sc. (Statistics)) -- University of Limpopo, 2014 / The health and survival of children are important measures of the social wellbeing and health status of the community. The World Community made a commitment to reduce under-five mortality by two-thirds between 1990 and 2015. The purpose of this study was to identify factors that have influence on child survival. The Dikgale Health and Demographic Surveillance System (HDSS) data for children born between 01 January 1996 and 31 December 2010 were analysed using cross-tabulation, logistic regression and survival analysis to determine factors that have influence on child survival. The findings revealed that mother’s survival status and child birth weight are significantly associated with child survival. The results showed that the odds that children born to mothers who are alive survive beyond five years are almost four times the odds that children born to mothers who are not alive survive beyond five years. The study also found that the odds that children born with birth weight 2.5kg or more survive beyond five years are almost two times that of children born with birth weight less than 2.5kg. The results of this study may help in formulating strategies and interventions that improve the lifespan of children and assist in the reduction of child mortality. KEY CONCEPTS Child survival, Health Demographic Surveillance System, Cross-tabulation, Logistic regression, Survival analysis, Mother’s survival status, Birth weight.

<p>From 2004 the Eastern Cape Department of Health (ECDoH) started implementing the new community health worker (CHW) programme in all its clinics, but so far little is known about its implementation process, its successes and challenges. The aim of this study was to assess the implementation of the new government funded CHW programme at three clinics of the Eastern Cape Province.</p>

Thailand has faced under-nutrition and yet, paradoxically, the prevalence of diseases of over-nutrition, such as obesity and diabetes, has escalated. Since access to diabetes prevention programs is limited in Thailand, especially in rural areas, it becomes critical to develop a health information delivery system that is relevant, cost-effective and sustainable. Therefore, the main objective of this program is to build capacity for chronic disease prevention in Thailand through application of learning technologies in the education, support and accreditation of community health care workers (CHCWs). This program stems from established partnerships among: The University of Waterloo (UW), Department of Health Studies and Gerontology; Institute of Nutrition, Mahidol University (INMU); The Office of Disease Prevention and Control 10 Chiang Mai province; Ministry of Public Health (MOPH), Thailand and UW, Centre for Teaching Excellence (CTE) . The development of the community-based diabetes prevention education program in Chiang Mai, Thailand was informed by in-depth interviews with health care professionals (n=12) and interviews (n=8) and focus groups (n = 4 groups, 23 participants) with community volunteers, screened as at-risk for diabetes. Coded transcripts from audio-taped interviews or focus groups underwent qualitative analysis by hand and using NVivo software. Health care professionals identified opportunities to integrate health promotion/ disease prevention into CHCWs’ duties. However, they also identified potential barriers to program success as motivation for regular participation, and lack of health policy support for program sustainability. Health care professionals supported an education program for CHCWs and recommended small-group workshops, hands-on learning activities, case studies and video presentations that bring knowledge to practice within their cultural context; CHCWs should receive a credit for continuing study. Community volunteers lacked knowledge of nutrition, diabetes risk factors and resources to access health information. They desired two-way communication with CHCWs. A tailored diabetes prevention education program was designed based on this formative research. Learning modules were delivered over eight group classes (n=5/class) and eight self-directed E-learning sessions (www.FitThai.org). The program incorporated problem-based learning, discussion, reflection, community-based application, self-evaluation and on-line support. The frequency that students accessed on-line materials, including video-taped lectures, readings, monthly newsletters, and community resources, was documented. Participant satisfaction was assessed through three questionnaires. Knowledge was assessed through pre-post testing based on an exam that was pilot tested with 32 CHCWs from a district outside of the 5 districts in semi-urban Chiang Mai province from which the 69 participating CHCWs (35 intervention, 34 control) were randomly selected. The program was implemented over four months. Three quarters of participants attended all eight classes and no participant attended fewer than six. Online support and materials were accessed 3 – 38 times (median 13). Participants reported that program information and activities were fun, useful, culturally relevant, and applicable to diabetes prevention in their specific communities. Participants also appreciated the innovative technology support for their work. Comfort with E-learning varied among participants. Scores on pre-post knowledge test increased from a mean (SD) of 56.5% (6.26) to 75.5% (6.01) (P < .001). The effect of the program on knowledge of CHCWs was compared between intervention and control communities at baseline and the end of the program. Overall, the knowledge at baseline of both groups was not significantly different (56.5% (6.26) intervention versus 54.9% (6.98) control) and all CHCWs scored lower than 70%. The lowest scores were found in the “understanding of nutritional recommendations” section (mean score = 28% in intervention and 30% in control CHCWs). After 4 months, CHCWs in the intervention group demonstrated improvement relative to the control group (75.5% (6.01) versus 57.4% (5.59), respectively, p <.001, n=69). The percent of CHCWs achieving a total score of 70% was 77% (27/35) in intervention and 0% in control groups. The diabetes prevention education program was effective in improving CHCWs’ health knowledge relevant diabetes prevention. The innovative learning model has potential to expand chronic disease prevention training of CHCWs to other parts of Thailand. Ultimately, prevention of chronic diseases and associated risk factors should be enhanced.

Thailand has faced under-nutrition and yet, paradoxically, the prevalence of diseases of over-nutrition, such as obesity and diabetes, has escalated. Since access to diabetes prevention programs is limited in Thailand, especially in rural areas, it becomes critical to develop a health information delivery system that is relevant, cost-effective and sustainable. Therefore, the main objective of this program is to build capacity for chronic disease prevention in Thailand through application of learning technologies in the education, support and accreditation of community health care workers (CHCWs). This program stems from established partnerships among: The University of Waterloo (UW), Department of Health Studies and Gerontology; Institute of Nutrition, Mahidol University (INMU); The Office of Disease Prevention and Control 10 Chiang Mai province; Ministry of Public Health (MOPH), Thailand and UW, Centre for Teaching Excellence (CTE) . The development of the community-based diabetes prevention education program in Chiang Mai, Thailand was informed by in-depth interviews with health care professionals (n=12) and interviews (n=8) and focus groups (n = 4 groups, 23 participants) with community volunteers, screened as at-risk for diabetes. Coded transcripts from audio-taped interviews or focus groups underwent qualitative analysis by hand and using NVivo software. Health care professionals identified opportunities to integrate health promotion/ disease prevention into CHCWs’ duties. However, they also identified potential barriers to program success as motivation for regular participation, and lack of health policy support for program sustainability. Health care professionals supported an education program for CHCWs and recommended small-group workshops, hands-on learning activities, case studies and video presentations that bring knowledge to practice within their cultural context; CHCWs should receive a credit for continuing study. Community volunteers lacked knowledge of nutrition, diabetes risk factors and resources to access health information. They desired two-way communication with CHCWs. A tailored diabetes prevention education program was designed based on this formative research. Learning modules were delivered over eight group classes (n=5/class) and eight self-directed E-learning sessions (www.FitThai.org). The program incorporated problem-based learning, discussion, reflection, community-based application, self-evaluation and on-line support. The frequency that students accessed on-line materials, including video-taped lectures, readings, monthly newsletters, and community resources, was documented. Participant satisfaction was assessed through three questionnaires. Knowledge was assessed through pre-post testing based on an exam that was pilot tested with 32 CHCWs from a district outside of the 5 districts in semi-urban Chiang Mai province from which the 69 participating CHCWs (35 intervention, 34 control) were randomly selected. The program was implemented over four months. Three quarters of participants attended all eight classes and no participant attended fewer than six. Online support and materials were accessed 3 – 38 times (median 13). Participants reported that program information and activities were fun, useful, culturally relevant, and applicable to diabetes prevention in their specific communities. Participants also appreciated the innovative technology support for their work. Comfort with E-learning varied among participants. Scores on pre-post knowledge test increased from a mean (SD) of 56.5% (6.26) to 75.5% (6.01) (P < .001). The effect of the program on knowledge of CHCWs was compared between intervention and control communities at baseline and the end of the program. Overall, the knowledge at baseline of both groups was not significantly different (56.5% (6.26) intervention versus 54.9% (6.98) control) and all CHCWs scored lower than 70%. The lowest scores were found in the “understanding of nutritional recommendations” section (mean score = 28% in intervention and 30% in control CHCWs). After 4 months, CHCWs in the intervention group demonstrated improvement relative to the control group (75.5% (6.01) versus 57.4% (5.59), respectively, p <.001, n=69). The percent of CHCWs achieving a total score of 70% was 77% (27/35) in intervention and 0% in control groups. The diabetes prevention education program was effective in improving CHCWs’ health knowledge relevant diabetes prevention. The innovative learning model has potential to expand chronic disease prevention training of CHCWs to other parts of Thailand. Ultimately, prevention of chronic diseases and associated risk factors should be enhanced.

The aim of this dissertation is to explore how informal caregivers for people with dementia (PWD), who are community dwelling (i.e., not in nursing homes), prepare and plan for disasters. The research site is a particularly hurricane-prone region of Florida, second only to New Orleans in its vulnerability. An underlying assumption of this research is that caregivers for PWD have to plan and anticipate problems that are unique to their role. The rationale for the study described here is that disaster planning and mitigation save lives (Tengs et al. 1995), but there is little or no literature on disaster planning for the frail elderly and their caregivers. Mixed methods design which includes: 1) participant observation; 2) staff interviews (n=8);3) preliminary caregiver interviews (n=5); 4) baseline chart/disaster plan review (n=290);5) intervention (presentation to staff and administration) and form revision; 6) follow-up chart/ disaster plan review (n=259); 7) caregiver survey(n=253);8) final caregiver interviews (N=15- total number of caregiver interviews 20); 9) disaster literacy testing (n=20); 10) final group interview with ACC administration. This work documents the way that caregivers talk about disaster planning and say they will do if a hurricane strikes and reflects on their past hurricane experiences. Major findings include gaps in the county run Special Needs Shelter services available in Florida for people with dementia. The response and difficulty that caregivers might face can depend on the stage of the disease.

<p>From 2004 the Eastern Cape Department of Health (ECDoH) started implementing the new community health worker (CHW) programme in all its clinics, but so far little is known about its implementation process, its successes and challenges. The aim of this study was to assess the implementation of the new government funded CHW programme at three clinics of the Eastern Cape Province.</p>

The incidence of HIV and AIDS is rising rapidly and has become a serious concern in South Africa. In order to address the HIV and AIDS problem, Community Based Care was introduced to render an effective service to the HIV and AIDS patient. The volunteers receive training to equip them to render a holistic service to the HIV and AIDS patient. The researcher’s concern is that despite the training programme offered, there are still problems regarding the service delivery by the volunteers. Volunteers focus on the physical needs of the HIV and AIDS patient only and do not attend to their psychosocial needs, despite the fact that they are trained to take care of the needs of the HIV and AIDS patient from a holistic approach. Due to this problem, the researcher decided to explore the experiences of the volunteers regarding the implementation of the training programme on HIV and AIDS Community Based Care in order to find answers as to why they do not attend to the psychosocial needs of the HIV and AIDS patient, although they were holistically trained. The research question was formulated as follows: What is the experience of volunteers in the Potchefstroom Municipality regarding the implementation of the training programme on HIV and AIDS Community Based Care? The researcher used a quantitative approach to explore the research question. Twenty (20) volunteers from the two Community Based Care programmes, namely Baptist Children’s Centre and Bambanani Youth Project, were randomly selected for inclusion in the study. The data collection method used was a group questionnaire. Three themes were explored, namely, the content of the training programme, presentation of the training programme and empowerment of the volunteers to render an effective service to the HIV and AIDS patient. The findings showed that volunteers experienced limitations regarding the content and the presentation of the training programme, and much so in the area of attending to the psychosocial needs of the HIV and AIDS patient. They recommended changes to the training programme, based on their experiences in practice. / Dissertation (MSW)--University of Pretoria, 2008. / Social Work and Criminology / unrestricted

Institute for Rural Development / PhDRDV

No description available.