Thesis (M.H.S.A.)--University of Michigan, 1980.

Thesis (M.H.S.A.)--University of Michigan, 1980.

BACKGROUND : Cervical cancer is the second most common malignancy in women worldwide, and the leading cause of mortality among women. It affects approximately 500 000 women each year with about 270 000 deaths. Almost 80% of the mortalities occur in developing countries. The National Department of Health in South Africa introduced a cervical cancer screening policy in the year 2000. The aim of the policy was to screen more that 70% of the women aged 30 – 59 by the end of 10 years. Women aged 30 – 59 years are offered 3 Pap smears per life time, with an interval of 10 years between the smears. AIM: The aim of the study was to determine the uptake of cervical cancer screening among eligible women (age 30 – 59 years), their practice, knowledge and attitude, as well as the capacity of the facility and the service providers to offer cervical cancer screening service. METHODS: A health systems descriptive study. A two stage sampling technique was done. Purposeful sampling of the healthcare facilities in the defined area was done, targeting the Provincial Health clinics. Records were reviewed at the facility to determine the percent of women aged 30 – 39 years, who used the facility and had Pap smears over the period: August 2003 to July 2007. Facility managers at the Holani clinic and Stanza Bopape Community Health Center were interviewed. Self administered questionnaires were distributed to doctors and professional nurses at both facilities. Questionnaires were also distributed to the women aged 30 – 59 years who visited the facilities during data collection to determine the knowledge, attitude and practice of these women concerning Pap smear. Data entry was done using Epi-Info and Microsoft Excel. Data was analyzed using STATA version 9. Methods applied were frequencies, percentages and cross tabulations. Differences between groups were examined using Fisher’s exact test and Chi-square test. Results were presented in tables and graphs. RESULTS : Record review at Holani clinic indicated that the percent of women aged 30 – 59 years who had undergone Pap smears while attending clinic from January 2004 to July 2007 was 8%. Stanza Bopape had incomplete records. Only about 50% of the women interviewed had undergone Pap smear. Socio-demographic factors like age, education and employment did not have a significant effect on the knowledge, attitude and practice of cervical cancer screening by the targeted service users. Women of lower parity had undergone more Pap smears than those of higher parity. Women of lower parity had more knowledge about Pap smear (p-value=0.05). The knowledge and practice of Pap smear among women aged 30 – 59 years who attended the clinics were significantly associated with getting information from the nurse (p=0.01). Knowledge of the National Cervical Cancer Screening Policy by the service providers was limited. Both facilities had adequate resources for performing the procedure. The number of trained staff per facility was adequate for the performance of the procedure. There was enough privacy to do the procedure. Specimen transportation was adequate, and turn around time was acceptable. CONCLUSION : The extent of Pap smear investigation at the facilities is inadequate. The Service Providers need to calculate the minimum number of Pap smears needed per day to reach the required targets. Nurses at the primary healthcare setting play a major role in improving the uptake of cervical cancer screening. There is a need to actively recruit women to come for Pap smear, while at the same time strengthening health education. Copyright / Dissertation (MMed)--University of Pretoria, 2010. / School of Health Systems and Public Health (SHSPH) / Unrestricted

The essence of this study is to review and to assess the extent to which transformation has materialized in the South African public service. Transformation has implied a fundamental reframing of the South African public service, replacing an old system with a new one. Through different legislations, objectives to improve the lives of the South Africans were set. The Department of Health, amongst others, was selected to pilot service delivery initiative because an improved health system would contribute directly to the improvement and expansion of human resource potential of the country. After a decade, it is still essential to assess a government’s performance in order to observe if there is progress in terms of services delivered to the people. The purpose is not really to pass or fail a particular initiative but to identify weaknesses and to suggest how these can be remedied and also to inform the community about the developments made. / Dissertation (MAdmin (Public Administration))--University of Pretoria, 2007. / School of Public Management and Administration (SPMA) / unrestricted

This is a study of the relationship between consumer credit scoring and the resolution of a patient's account for hospital services. Accounts studied were classified as Good accounts or Bad accounts based upon their final resolution. Bad accounts were those written-off to bad debt with Good accounts being all others. The probability of predicting a patient's account being either Good or Bad was based upon a consumer credit scoring process. The null hypothesis of this study was that the consumer credit scoring process would not provide any indication about the outcome or resolution of the account. Analysis of the credit score and the outcome of the hospital account suggested the consumer credit score would indicate the patient's reliability in taking responsibility for the account. Based on the confidence given to credit scoring in consumer markets and the results of this study, the consumer credit score would have value for the health care industry.

This pilot study examined the feasibility of computer aided instruction (CAI) as supplemental interactive nutrition education for patients requiring chronic dialysis. The CAI prototype was developed using Gagne's Model of Instructional Design and the Theory of Planned Behavior. Forty-two patients were enlisted from a chronic dialysis clinic and assigned randomly to either treatment or comparison group. All subjects completed pre- and post-test questionnaires regarding their phosphorus-rich food consumption habits. Each group received the usual phosphorus control education adjunct to the monthly lab review. The experimental group also received supplemental education by CAI. Serum phosphorus lab results were assessed for change after use of the CAI. Near significance was observed between the study group's phosphorus lab results difference means, t = 1.79, df= 40, p = .08. Comparison of pre-test and post-test data assessed changes in the dependent variables, attitude, perceived control, intent and behavior. The differences for the behavioral dependent variables means were not significant as determined by t-tests. The CAI was well accepted (m = 1.47 ± 0.95) by the subjects without respect to gender or age. Interactive CAI nutrition education was acceptable. Replication with a larger sample would allow opportunity to determine the significance of differences.

Thesis (M.Pharm.(Pharmacology)) --University of Limpopo, 2014. / Management of Sexually Transmitted Infections (STIs) in Private Pharmacies in Limpopo Province: Practice and Knowledge of Pharmacists Background: In 2001, the South African Pharmacy Council (SAPC) developed a strategic plan, which recognised the crucial role that pharmacists could play in controlling sexually transmitted infections (STIs) and the spread of HIV infection. In South Africa, patients seek and receive treatment for STIs from pharmacies despite a legal restriction (Ward, Pharm, Butler, Mugao, Klausner, Mcfarland, Chen & Schwarcz, 2003). Current legislation bars people to seek treatment from the pharmacists for certain acute illnesses, thus significantly influencing the spread of some infections with the view that the longer infections remain untreated, the more opportunities for transmissions to occur. The perceived lack of treatment options in private pharmacies may even prevent patients from accessing advice or preventative measures at the pharmacy level (Gupta, Sane, Gurbani, Bollinger, Mehendale & Godbole, 2010). It is against this background that the study was carried out with the aim of assessing the knowledge and practice of private pharmacists in management of sexually transmitted infections (STIs) in the Limpopo Province and ultimately assist in the reduction of the spread of HIV infections. Objectives: The objectives of the study were; to identify areas of weakness in services provided by pharmacists in management of STIs in private pharmacies; to identify possible pharmaceutical care of HIV; to determine the level of use of Department of Health Standard Treatment Guidelines of sexually transmitted infections by private pharmacy; to determine the availability of sexually transmitted infection drugs for treatment of STIs; and to identify the type of information given to clients with STI. Method: A cross-sectional design was used in this study. The study was carried out in the Limpopo Province, South Africa. Out of the population of 130 pharmacies registered with the SAPC in Limpopo, a sample of 23 was selected. The pharmacies were stratified according to where they were located. This study used a questionnaire designed as an instrument of data collection. The data was collected through a face-to-face interview with the responsible pharmacist in each pharmacy outlet. This study used Simulated Client Method to evaluate the practice. In this method, simulated male and female clients visited randomly selected Pharmacies. Two scenarios were developed for a male patient with urethral discharge and a female patient with vaginal discharge. The simulated clients on a standardised reporting form, outside the pharmacy, carefully recorded all observations made during the simulated scenario. Data analysis: The data were analysed using cross-tabulation techniques and chi-square test was used to check existence of association. Compliance with Standard Treatment Guidelines in terms of treating STI syndrome was used as dependent variable. Location (Rural and urban) of private pharmacies, the gender of the client in the simulated client method, treating genital ulcer syndrome (GUS), treating male urethritis syndrome (MUS) and treating female vaginal discharge syndrome were used as independent variables. The existence of association between the dependent and variable was tested using the Chi-square test of independence. Result: The results showed that 27% of private pharmacies in Limpopo treated and managed STIs clients in accordance with Standard Treatment Guidelines. The structured interviews results showed that 78% of private pharmacists in Limpopo knew the linkage between HIV and STIs. Only 39% of the private pharmacists knew about the existence of Standard Treatment Guidelines and used them in daily client consultations. Cross tabulation of data on compliance with Standard Treatment Guidelines in terms of treating STI syndrome (the dependent variable) and the location of private pharmacies (the independent variable) produced a Chi-square value of 1.31. This showed that the dependent variable had no association with location of independent private pharmacies. The study found that the treatment and management of GUS, MUS and female discharge varied according to location of the private pharmacies. The medicines stocked were in line with the Standard Treatment Guidelines in both rural and urban pharmacies in the Limpopo Province. There was very high demand for STI medication without a prescription averaging of 150 clients per week. Private pharmacies in both areas gave the necessary information to their clients focused on use condom with 54%, partner notification with 38% and only 27% of pharmacists advised client to consult the physician. The simulated client visits showed the discrepancy between knowledge and actual practice of the private pharmacists. Conclusion: The majority of private pharmacies operating in the Limpopo Province do not comply with the Standard Treatment Guidelines for treatment and management of STIs due to inadequate knowledge. While there is a need to train some pharmacists in the provision of primary health care for syndromic STI treatment in order to reduce STIs and HIV transmission, the lifting of current legal restriction in South Africa that prevents pharmacists from prescribing STI medication may be necessary. The knowledge and practice of incidence of specific infections in communities served by the specific pharmacy should be part of the pharmaceutical care provision.

The research group was also anxious to take on this study because it was just following the first welfare worker’s strike in California. This had occurred at the agency in question and provided a situation in which the team would receive maximum cooperation. It was expected that the agency would be more likely to implement the team’s suggestions. As the study progressed the questions which became of most interest were those which related to the issues of whether or not the organization could function well, where the sources of power and goal-setting lay, and what could be done. After a review of the literature in related fields, it was decided that Amitai Etzioni’s work would be the most helpful to us in understanding organizations. For the purpose of the present study there will be no discussion of the practical application of specific recommendations. This article will concern itself only with the theoretical issue which surrounded the original study.

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