Thesis (M.S.)--University of Wisconsin, 1965. / Extension Repository Collection. Typescript (carbon copy). Includes autobiographical sketch. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 94-97).

Magister Public Health - MPH / Introduction: The Health Extension Program (HEP) is an innovative, community based comprehensive primary health care program that Ethiopia introduced in 2003. It gives special emphasis to the provision of preventive and promotive services at community and household level. However, utilization of the HEP packages is low and reasons for this underutilization are not well known. Aim: The aim of this study is to assess the availability and utilization of the Health Extension Program Service in Akaki District of Oromia Region, Ethiopia. Methodology: Quantitative study using a cross-sectional survey design. The study was conducted in Akaki District of Oromia Regional State in Ethiopia with 79,162 inhabitants. Random sampling was used to select 355 households. A structured data collection tool/ questionnaire was employed to collect data from the study participants. Data were analyzed using SPSS for Windows version 19. Descriptive statistics were used to analyze socio demographic characteristics of the study participants and to assess the availability and utilization of each service component. Result: The response rate of the study was 100% with complete data obtained from 335 (94.4%) of the households. The majority (93.1%) of respondents were women. The availability of HEP services as described by the household visit of Health Extension Workers (HEWs) is very high with 86.6% visiting at least monthly and 11.3% visited sometimes. There was a highly significant association between the health extension workers’ visit to households and health extension service utilization during pregnancy (OR=16.913, 95% CI 8.074-35.427 at p<0.001). HIV testing utilization showed a tenfold increase among households who received education. Participation of households in the Model family initiative was another key factor associated with high levels of HEP services utilization. Conclusion and Recommendations: Though HEP services are available for most households, the frequency of household visits by HEWs and the involvement of Households in model family training greatly influenced service utilization. Improving frequency of services availability at household level and consistent health education will greatly improve services utilization.

The purpose of this study was to determine what job responsibilities Extension 4-H youth development professionals (n = 241) chose to spend their work time doing and how the workload related to their job satisfaction and burnout. They were asked to rank order seven common, predetermined job responsibilities, based on the 4-H Professional, Research, Knowledge, and Competencies ( 4-H PRKC), and to identify their level of job satisfaction and burnout. The study utilized quantitative methods for gathering data from 4-H youth development Extension professionals from 6 land-grant universities. Over the past 25 years, there has been an increase in research investigating burnout and job satisfaction. Burnout is a serious issue that can lead to decreased productivity for the employee and increased costs for the employer. Finding the connections among burnout, job satisfaction, and work environment is important to help reduce problems, including work overload. Based on the previous research on workload, burnout, and job satisfaction, 4-H youth development professionals are prime candidates for experiencing low job satisfaction and increased burnout, which may lead to professionals leaving the organization early. To determine the workload, 4-H youth development professionals were asked to rank seven job responsibilities for each of the domains that are common to the youth development profession. The job responsibility that had the lowest mean of any from the six domains was #1 "using volunteer committees" in the volunteerism domain, with 71.9% of the respondents ranking it as one of the top two job responsibilities within the domain. Determining job satisfaction related to the individual job responsibilities was the first measurement used in identifying the level of job satisfaction in the survey. The youth development domain's job responsibility #6 "develop programs to practice life skills" provided the respondents the greatest degree of job satisfaction (M = 1.93, SD= 0.72) of any of the responsibilities with the six 4-H PRKC domains. The second instrument used to assess job satisfaction for 4-H youth development professionals was the Job Satisfaction Survey (JSS), in which the mean score was 3.72 (SD= 0. 79). The third and final measurement used to determine job satisfaction was the self-reported overall level of job satisfaction. The mean for the self-reported overall job satisfaction was 2.20 (SD= 0.83). The greatest degree of burnout (M = 3 .21, SD= 1.26) within any of the domains was in the youth development domain with job responsibility #7 "dealing with conflict management." This job responsibility also indicated a negative relationship between the workload rank score and job responsibility burnout (r = -0.250). The overall mean for the Burnout survey was 3.84 (SD= 0.86). The greatest burnout came from the work within the youth development domain. The 4-H youth development professionals reported feeling very little overall burnout related to their job. The overall self-reported mean for burnout was 2.75 (SD=1.17). They also reported being satisfied with their current job (M= 2.20, SD= 0.83).

Thesis (M.Sc. (Agricultural Extension)) -- University of Limpopo, 2016 / Agriculture is regarded as one of the pillars for economic development for most developing countries including South Africa; however youth participation in the sector is minimal. Similar to the situation in many other developing countries both commercial and subsistence agriculture are practiced in South Africa. Agriculture is the primary employer and has the potential to contribute significantly towards youth employment and poverty reduction especially in rural areas of Limpopo province. However this might not be seen to be the case by the youth in rural areas of the Limpopo Province of South Africa. The study aimed at evaluating the extent of out of school youth participation in agricultural activities. the focus of the study was to (a) Identify and determine the roles and responsibilities of stakeholders involved in agricultural out-of-school youth projects;(b) determine the socio economic factors that influence out-of-school youth participation in the agricultural sector;(c) determine and document the skills possessed by out-of-school youth participating in the agricultural sector and (d) determine strategies that can be used to attract and sustain youth participation in the agricultural sector. Both qualitative and quantitative methods of data collection tools were used to collect data. These included semi-structured questionnaires, resource maps, transect walks and focus group interviews. The study revealed that out of school youth have the potential to contribute positively towards developing the agricultural sector as well as their local rural areas through agricultural activities. It was also shown that male youths were dominating in decision making of most of the projects even though their female counterparts generally played major roles in implementing agricultural activities. Although male youths dominated decision making in the projects, they were outnumbered in the projects by their female counterparts, more so for those in the early thirties (31-35). As revealed by the study, there was limited training in terms of skills development for out of school youths participating in agricultural projects. Also institutional factors such as access to land, funding and information flow influenced youth participation in agricultural activities. Partnerships between the state and other stakeholders were identified by all participants as crucial for attracting and sustaining youth in the sector and for addressing the constraints faced by the youths, e.g. Financial, technical and marketing problems. Several socio-economic factors that affect participation of out of school youth in agricultural activities were significant at different level of significance. Youth participation in agricultural activities in the study area varied from district to district. v Youth projects consist mainly of primary production activities with few supporting actors alongside the value chain. As such there are several constraints that prevent youth projects from accessing the high value chain markets. Therefore the study recommends the formulation and implementation of policies that are aimed specifically at youth in agriculture. Such policies can include subsidized inputs to youth projects and access to fund without demanding collaterals. Improved access to extension support and information centres will improve participation of youth in agricultural activities. Establishment of linkages alongside the agricultural value chain will allow youth projects to access high value markets. Multistakeholder partnership between government and all actors in the value chain will ensure effective and efficient demand drive service delivery

The study determined the level of agreement between ASEAs and their administrators and subject-matter specialists as to the competency areas considered most important to the effectiveness of the agents. The study also determined the specific items within the competency areas that ASEAs would like to have included in their in-service training. Selected demographic characteristics were collected to determine characteristics such as agents' age, race, gender, level of education, and years of experience. The population for this study consisted of 66 ASEAs, 49 administrators, and 18 subject-matter specialists employed by the North Carolina Cooperative Extension Service. Data were collected by mailing the questionnaire accompanied by a letter from the director of the North Carolina Cooperative Extension Service announcing the study and providing details on its nature, use of the data, and instructions for completing the questionnaire. The data were analyzed using the Statistical Package for the Social Sciences (SPSS-X). Frequencies and means were used to describe the research objectives. Demographics were surveyed using an instrument developed for that purpose by the researcher. Major findings included several items. In terms of importance, ASEAs, administrators, and specialists rated program planning highest. In rating the need for training, ASEAs, administrators, and specialists also rated program planning highest. Specific items in the program planning competency area that were rated important, 3.0 on a 4.0 scale, were the role of area agents, involving lay people, long-term program development, area agent programming, developing programs, and evaluation. The only important differences among groups--ASEAs, administrators, and specialists-~regarding specific items were in their ratings of the need for training of the items of history, philosophy, University USDA-partner, and county responsibilities in the general competency area of organization and administration. An important differences among groups was also observed in ratings of need for training in the program planning competency area for the specific item program planning. No other important differences were found. The majority of ASEAs held master's degrees. Over 50% of ASEAs had a tenure as ASEA of 5 years or less, and over 50% had a tenure with the Extension Service of 6 years or less. The majority of ASEAs were male; only 18% were female. The majority of ASEAs were Caucasian; only 5% were minorities. From the data gathered in this study, a proposed Area Specialized Extension Agent Development Institute was developed. / Ed. D.

The purpose of this study was to develop a systematic method to determine the in-service needs of agricultural education teachers and cooperative extension agricultural agents. The sample of this study consisted of 152 randomly selected program leaders, unit chairpersons, agricultural agents, assistant supervisors, department heads, and teachers from throughout the state. An 85.4 percent usable response was realized from the randomly selected group. The data collection instrument included a two part questionnaire developed by the researcher; one part to obtain biographic information and one part (a Likert type scale) to determine the projections of in-service needs. The data collection procedure consisted of mailing the questionnaires to program leaders, unit chairpersons, agricultural agents, assistant supervisors, department heads, and teachers using a three round Delphi technique. Included with the questionnaire was a cover letter explaining the purpose of the study and a stamped envelope, addressed to the investigator. Analysis of data was accomplished by using frequency counts, percentages, and measures of central tendency to calculate the biographic data from the group. The t-test was used to test the research questions for statistical significance. All three research questions tested at the .05 alpha level were statistically significant. The three research questions were: Was there a difference in the perceived needs for in-service education between agricultural education teachers and cooperative extension agricultural agents in Virginia; Was there a difference in the level of participation in in-service activities between agricultural education teachers and cooperative extension agricultural agents in Virginia, and; Was there a difference in the professional opinions of agricultural education teachers and cooperative extension agricultural agents toward in-service education in Virginia. Major recommendations generated from the findings of the study were: (1) that the Joint Agricultural Education Staff in Virginia coordinate in-service education opportunities off-campus; (2) that the Virginia Cooperative Extension Service provide in-service opportunities for cooperative extension agricultural agents in the area of agricultural production and horticulture; (3) that the Joint Agricultural Education Staff in Virginia coordinate in-service opportunities for agricultural teachers in the area of agricultural production and agricultural mechanics; (4) that in-service educational programs for agricultural education teachers should include provisions for release time for the in-service activities, visits to employers of prospective students, and credit for attendance at workshops; (5) that in-service educational programs for cooperative extension agricultural agents should be scheduled during the work day, should receive support from administration, and should give participants an opportunity to select the kind of educational activities; (6) that the Virginia Cooperative Extension Service work closely with beginning cooperative extension agricultural agents to aid them in developing a more favorable attitude toward in-service activities; and, (7) that a joint venture between the Virginia Cooperative Extension Service and the Agricultural Education Staff be explored for providing in-service opportunities. / Ed. D.

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Introduction: Ensuring access to universal primary health care is essential to secure a safe and pleasant motherhood and to provide compassionate care for mothers and newborns.However, inequalities in the access to maternal health services still remain a prominent problem in many countries. As part of reducing inequalities, Ethiopia launched the Health Extension Program (HEP) in 2003. The HEP is a community based program designed with a defined package of essential promotive, preventive and basic curative services targeting households, particularly mothers and children. Despite the construction of over 600 health posts and deploying more than 1200 Health Extension Workers (HEWs), preliminary data suggests a low utilization of maternal health care services. This thesis explores the HEP contribution in improving women’s access to maternal health care, and the reasons for the low use of maternal health care services from the perspectives of the involved actors in the Tigray region in Ethiopia. The five dimensions of access were used as a framework to explore the access to maternal health care utilization in this setting. Methods: A total of four districts were included in the study. Both quantitative and qualitative methods were applied. In the first sub-study, we assessed the HEP and its association with change in the utilization of antenatal, delivery and postnatal care services. Retrospective longitudinal data for 10 years was extracted from three selected districts and checked for accuracy. Segmented linear regression technique was used to control the secular trends adjusted for correlation of the data. For the second sub-study, we conducted a cross sectional survey with 1115 women (aged 15-49 years who had given birth within five years prior to the survey period) to determine the prevalence of antenatal care and institutional delivery utilization and explore their determinant factors of low utilization. For the third sub-study, we conducted six focus group discussions (FGDs) with a total of 51 women to explore women’s experiences of childbirth and maternal care. An interview with eight HEWs and four midwives were carried out to capture health workers’ perspective on access to maternal health care services in the fourth sub-study. Grounded theory for the former, and thematic analysis for the latter were used for the analysis. Main findings: The finding of the first sub-study showed a statistically significant upward trend for delivery care (DC) and postnatal care (PNC) in all facilities during the HEP late implementation period (July 2008-June 2012). In addition, a substantial trend of antenatal care (ANC) service use was observed at health centres after the intervention. In the second sub-study, the determinant predictors for ANC utilization were: proximity to health facilities, to be married, ≥5 years of education and having non-farming husbands. The last three factors were also significantly associated with institutional delivery, but also lower parity, previous history of obstructed/prolonged labour and ANC counselling. Findings from the qualitative studies pointed out that elderly women influenced women’s decision making about where to give birth. Women were mostly positive about giving birth at health facilities, but were concerned about the poor quality of care, inaccessibility and unavailability of transport. From the health workers’ perspective: specialized performance of hospital services, community assistance during referral and an increased awareness among women regarding the benefits of giving birth at a health facility were perceived as facilitators for institutional deliveries. Poor perceived competence of HEWs, poor conditions of health care facilities and inaccessibility of transportation, among others, were perceived as barriers for giving birth at health facilities. Conclusion: Overall, this research revealed a considerable contribution of the HEP in improving the access and coverage of maternal health services (ANC, DC and PNC). However, cultural traditions, scattered localities, mountainous roads without adequate transportation and low quality of care are still the major obstacles to accessing the services. Mechanisms need to be designed to enable health facility access of safe delivery for women in hard to reach areas, improving the proficiency of health workers and introducing a women centered approach that enhances acceptability of the services. / ሽፋን መሰረታዊ ክንክን ጥዕና ምዕባይ ድሕንነት ኣዴታትን ህፃናትን ንኽረጋገፅ ዝለዓለ ተራ ከምዘለዎ ይፍለጥ፡፡ ይኹንደኣምበር ግልጋሎት ጥዕና ኣዴታት ብማዕረ ኣብ ምብፃሕን ብምዕሩይ ኣገባብ ኣብ ምሃብን ብዙሓት ሃገራት እናተፀገማ እየን፡፡ ነዚ ዘይምዕሩይን ማዕረ ዘይኾነን ኣዋህባ ግልጋሎት ጥዕና ንምምሕያሽ ኣብ ሃገርና (ኢትዮጵያ) ብ1994-1995 (ብአቆፃፅራ ግእዝ) ዝተኣታተወ ፕሮግራም ምግፋሕ ጥሙር ጥዕና ቤተሰብ (Health Extension Program/HEP) 10 ዓመታት ኣሕሊፉ ይርከብ፡፡ ፕሮግራም ምግፋሕ ጥሙር ጥዕና (HEP)፣ ሕብረተሰብ መሰረት ዝገበረ-ምክልኻል ሕማማትን ምስጓም ጥዕናን - ምትእትታው ግልጋሎት ሕክምና ቀለልቲ ሕማማትን ብፍላይ ድማ ንኣዴታትን ህፃናትን ትኹረት ብምግባር ስድራ ቤት ብምሕቋፍ ዝንቀሳቐስ ፕሮግራም እዩ፡፡ እዚ ፕሮግራም ንምትግባር ኣብ ክልል ትግራይ ልዕሊ 600 ኬላታት ጥዕና ተሃኒፀን፡፡ ልዕሊ 1200 ሞያተኛታት ጥሙር ጥዕና እውን ሰልጢነን እየን፡፡ ክልተ ሞያተኛታት ኣብ ሓደ ኬላ ጥዕና ተመዲበን ካብ 5000-7000 በዝሒ ንዘለዎ ሕብረተሰብ ግልጋሎት እናሃባ ይርከባ፡፡ እንተኾነ ግን ዝተፈላለዩ መፅናዕታታት ከምዘመላኽትዎ ግልጋሎት ኣዴታት ጥዕና (ወሊድን ድሕሪ ወሊድን) ትሑት ሽፋን ከምዘለዎ ይሕበር፡፡ ዕላማ እዚ ዝገበርናዮ መፅናዕቲ እውን ኩነታት እቲ ግልጋሎት ብኣሃዝ ንምዕቃንን ከምኡ እውን ምኽንያታት እቲ ትሑት ግልጋሎት ንምድህሳስን እዩ፡፡ ኣብዚ መፅናዕቲ እዚ ምኽንያታት ትሑት ሽፋን ግልጋሎት ክንክን ጥንሲ ወሊድን ድሕረ ወሊድን እንታይ ምዃኑ ካብ ሕሉፍ ልምዲ (ተሞክሮ) ኣዴታትን ሰብ ሞያ ጥዕናን ብዝርዝር ብምድህሳስ - ፕሮግራም ምግፋሕ ጥሙር ጥዕና ንቐረብ ግልጋሎት ኣዴታት ጥዕና ንምምሕያሽ ዘለዎ ኣስተዋፅኦ እንታይ ከምዝመስል ተተንቲኑ ቐሪቡ ኣሎ፡፡ እቲ ቀረብ ግልጋሎት ጥዕና ሓሙሽተ መዐቀኒታት ብዘለዎ ፍሬም ዎርክ እዩ ተዳህሲሱ እቶም ሓሙሽተ መመዘኒታት 1. ቅርበት ትካል ጥዕናን ሰብ ሞያ ጥዕናን ንተገልገልቲ 2. ህልውነት ሰብ ሞያ ጥዕናን ናውትን ድሌት ተገልገልትን 3. ሰብ ሞያ ጥዕና ብተገልገልቲ ዘለዎም ተቐባልነት 4. ትካል ጥዕና ንድሌት ተገልገልቲ ንምዕጋብ ዘለዎ ድልውነት 5. ተገልገልቲ ወፃኢታት ሕክምና ንምሽፋን/ንምኽፋል ዘለዎም ድሌትን ዓቕምን እዮም፡፡ እዞም ሓሙሽተ መዐቀኒታት መሰረት ዝገበሩ ኣርባዕተ ዓይነታዊን አሃዛዊን ሜላታት ብምጥቃም ዝተኻየዱ መፅናዕትታት ኣብ ኣብ 4ተ ወረዳታት ትግራይ እዮም ተኻይዶም፡፡ ኣብቲ ቀዳማይ መፅናዕቲ ፕሮግራም ምግፋሕ ጥሙር ጥዕና ቤተሰብ (HEP) ኣብ ምምሕያሽ ክንክን ጥንሲ-ወሊድን-ድሕረ ወሊድን ግልጋሎት ዘምፅኦ ለውጢ ኣብ ሰለስተ ወረዳታት (ጋንታአፈሹም፤ ክልተ ኣውላዕሎ፣ ሕንጣሎ ዋጅራት) ንዝሓለፉ 10 ዓመታት ኣብ ዝተዋህበ ግልጋሎት ብምድራኽ እዩ ዳህሰሳ ተኻይዱ፡፡ ትኽክለኛነት እቲ ፀብፃብ እውን ካብ ትካላት ጥዕና ዝተልኣኸ ወርሓዊ ኣብ ወረዳ ምስ ዘሎ ፀብፃብ ብምንፅፃር ንኽረጋግፅ ተገይሩ እዩ፡፡ እቲ ካልኣይ መፅናዕቲ ኣብ ወረዳ ሰሓርቲ ሳምረ ካብ 19 ጣብያታት ካብ ዝተመረፃ 30 ቑሸታት ዕድሚአን ካብ 15-49 ዓመት ምስ ዝኾና 1115 ደቂኣንስትዮ ኣስታት 30 ደቓይቕ ዝወደአ ቃለ መሕትት ብምኽያድ እዩ ዳህሰሳ ተኻይዱ፡፡ ኣብ ወሊድ ግልጋሎት ዘሎ ልምድን ተሞክሮን ንምድህሳስ 51 ኣዴታት ዝተሳተፋሉ ሽዱሽተ ጉጅላዊ ምይይጥ በቲ ሳልሳይ መፅናዕቲ ምርምር ዝተፈፀመ እንትኾን ምስ ሸሞንተ ሞያተኛታት ጥሙር ጥዕናን ኣርባዕተ ነርስ መዋልዳንን ቃለ መሕትት ብምኽያድ እቲ 4ይ ምርምር/መፅናዕቲ ተፈፂሙ እዩ፡፡ ውፅኢት ቀዳማይ መፅናዕታዊ ፅሑፍ ኣብዚ ቐዳማይ መፅናዕቲ እቶም ዝተአከቡ መረዳእታት ኣብ ሰለስተ ደረጃታት - ቅድመ ፕሮግራም-ፕሮግራም-ድሕረ ፕሮግራም ብዝብል ዝተመቐሉ እዮም፡፡ እቲ ቐንዲ ዕላማ ፕሮግራም ምግፋሕ ጥሙር ጥዕና ድሕሪ ምጅማር ዝተራእየ ለውጢ ንምፍታሽ እዩ፡፡ ኣብ ድሕሪ እቲ ፕሮግራም ካብ 2001-2004 ዓ/ም ብዝተኻየዱ ንጥፈታት ጥዕና ግልጋሎት ወሊድን ድሕረ ወሊድን ኣብ ኩለን ትካላት ጥዕና ካብ ዓመት ናብ ዓመት ልዑል ኣዝማሚያ እናርኣየ ከምዝኸደ ብስታቲስቲካዊ መረዳእታ ንምርግጋፅ ተኻኢሉ እዩ፡፡ ብተመሳሳሊ ኣብዚ ወቕቲ እዚ ኣዝማሚያ ግልጋሎት ክንክን ጥንሲ ኣብ ጥዕና ጣቢያታት ጥራሕ እናለዓለ ከምዝኸደ ውፅኢት እቲ መፅናዕቲ የረድእ፡፡ እቲ መፅናዕቲ ከም ዘረድኦ ሽፋን ክንክን ጥንሲ ብ1995 ካብ ዝነበሮ 28.2% ብ2004 ናብ 46.7 ክምዝለዓለ፤ ግልጋሎት ወሊድ ብ1995 ካብ ዝነበሮ 5% ዝነበረ ናብ 23% ከምዝደየበ ድሕረ ወሊድ ግልጋሎት እውን 11% ዝነበረ ናብ 41% ከምዝለዓለ ንምርዳእ ተኻኢሉ ኣሎ፡፡ ውፅኢት ካልኣይ መፅናዕታዊ ፅሑፍ ኣዴታት ግልጋሎት ክንክን ጥንሲ ኣብ ጥዕና ጣቢያ ንኽጥቀማ ቅርበት ትካላት ጥዕና ንመንበሪ ገዛውቲ፣ ሓዳር ምግባር፣ ልዕሊ 5 ዓመት ስሩዕ ትምህርቲ ምምሃርን ካብ ሕርሻ ወፃኢ ኣብ ካልእ ስራሕቲ ዝተዋፈሩ ሰብ ሓዳር ምህላው ወሰንቲ ኣካላት ምዃኖም በቲ ዝተገብረ ካልኣይ መፅናዕቲ ተረጋጊፁ፡፡ ብተመሳሳሊ ኣብ እዋን ክንክን ጥንሲ ንኣዴታት ምኽሪ ግልጋሎት ምሃብ ቅድመ ታሪኽ ዝንጉዕ ሕርሲ ወይ ሃልኪ ምንባር እውን ኣብ ትካላት ጥዕና ወሊድ ግልጋሎት ንኽመሓየሽ ወሰንቲ ኩነታት ከምዝኾኑ በቲ መፅናዕቲ ተረጋጊፁ፡፡ ብሓፈሻ ፕሮግራም ምግፋሕ ጥሙር ጥዕና ቤተሰብ (HEP) ቀረብ ግልጋሎት ጥዕናን ሽፋን ክንክን ጥንሲ ወሊድን ድሕረ ወሊድ ግልጋሎትን ኣብ ምምሕያሽ ዝተፃወቶ ተራ ትርጉም ዘለዎ ምዃኑ በቲ ዝገበርናዮ መፅናዕቲ ንምርዳእ ተኻኢሉ ኣሎ፡፡ እንተኾነ ግን ባህላዊን ልማዳዊን ኩነታት (ኣብ ገዛ ክትወልድ ምድላይ- ነፍሰፁር ዓይኒሰብ ከይረኽባ ኢልካ ምእማን) - ተበቲኖም ዝሰፈሩ ነበርቲ ምህላው - ኣፀገምቲን ዓቐብ ቁልቁልን ጎቦታትን ዝበዝሖም መንገድታትን እኹል መጉዓዝያ ዘይምህላውን ቀንዲ ሃልኪታትን ዕንቅፋታትን እቲ ዝወሃብ ግልጋሎት ምዃኖም ኣብዚ መፅናዕቲ ተገሊፁ እዩ፡፡ ብተወሳኺ ኣብ ላዕለዎት ትካላት ጥዕና ዘይብሩህ ገፅን ሰሓባይ ኣቀራርባ ሰብ ሞያ ጥዕና ዘይምህላውን ተቐባልነት ዘይብሎም ባህሪያት ምንፅብራቕን ነቲ ግልጋሎት ዝዓዘዘ ዕንቅፋት ከምዘለዎ በቲ መፅናዕቲ ንምርዳእ ተኻኢሉ እዩ፡፡ ማይን መብራህትን ዝኣመሰሉ ትሕቲ ቕርፂ ኣብ ኬላታት ጥዕና ዘይምህላዉ ኣዴታት ኣብ ቀረበአን ዘሎ ትካል ጥዕና ንኽወልዳ ዘየተባብዕ ከምዝኾነ እውን ተሓቢሩ እዩ፡፡ ውፅኢት ሳልሳይን ራብዓይን መፅናዕታዊ ፅሑፍ ኣብ ሳልሳይ መፅናዕቲ ምስ ኣዴታት ብዝተገበረ ምይይጥ - ኣደ እትወልደሉ ቦታ ባዕላ ንኽትውስን ከምእነሓጎታት ዝመሰላ ዕድመ ዝደፍኣ ኣዴታትን ፀቕጢ (ተፅእኖ) ከምዝግበረላ እቶም መፅናዕቲታት ይሕብሩ፡፡ ዋላ አኳ ኣብ ትካል ጥዕና ብዛዕባ ምውላድ ኣዎንታዊ ኣረኣእያ ኣዴታት ዝዓዘዘ እንተኾነ ብዛዕባ ድኹም ኣዋህባ አገልግሎት ጥዕና ኣዝዩ ከምዘተሓሳስበን እቲ መፅናዕቲ ይገልፅ፡፡ ትካል ጥዕና ናብ መንበሪ ኣዴታት ዘለዎ ርሕቐትን መጓዓዓዚ ዘይምርካብ ዝኣመሰሉ ፀገማት ከምዘገድስወን እውን እቲ መፅናዕቲ ይሕብር፡፡ ኣብቲ ራብዓይ መፅናዕቲ ብወገን ሞያተኛታት ጥሙር ጥዕናን ነርስ መዋልዳንን ብዝተገበረ ምይይጥ - ኣብ ሆስፒታል ዝዋሃቡ ዝሐሹ ግልጋሎት ኣዴታት ካብ ታሕተዋይ ትካል ጥዕና ናብ ሆስፒታላት ሪፈር እንትበሃላ ኣብ ምጉዕዓዝ ብሕብረተሰብ ዝግበር ምትሕግጋዝ ከምኡ እውን እናዓበየ ዝኸይድ ዘሎ ግንዛበ ሕብረተሰብ ኣዴታት ኣብ ትካል ጥዕና ንኽወልዳ መሳለጢ ከምዝኾነ እቲ ፅንዓት የረድእ፡፡ ዓቕሚ ምንኣስ ሞያተኛታት ጥሙር ሞያተኛታት ጥሙር ጥዕናን ነርስ መዋልዳንን - ድኹም ኩነታት ትካል ጥዕናን (ሕፅረት ናውቲ ጥዕና ምህላዉ - ትሕቲ ቅርፂ ዘይምምላእ) ፀገም መጉዓዝያን እውን ኣዴታት ኣብ ትካል ጥዕና ንኸይወልዳ ዕንቅፋታት ከምዝኾነ እቲ ፅንዓት የመላኽት፡፡ መጠቓለሊ እቶም ዝተጠቐሱ ዕንቅፋታትን ፀገማትን ብምንካይ ቀረብ ወሊድ ግልጋሎት ጥዕና ንምዕባይ እዞም ዝስዕቡ ፃዕሪታት ምክያድ ይግባእ፡፡ ኣብ ጎቦታትን ኣዝዩ ርሑቕን ኣፀገምትን ዝሰፈረ ሕብረተሰብ ካብቲ ልሙድ ዝተፈለየ ቀረብ ግልጋሎት ጥዕና ምሃብ (ንኣብነት ካብ ጥዕና ጣቢያ ኣዝየን ዝርሕቓ ኬላታት ጥዕና ክእለት ዘለወን ነርስ መዋልዳን (midwives) ምምዳብ - ኣደ ማእኸል ዝገበረ ግልጋሎት ንኽወሃብ ሰብ ሞያ ጥዕና ብዓቕሚ ንኽዓብዩ ምግባርን ነቶም ሓሙሽተ መዐቀኒታት ቀረብ ግልጋሎት ብምምላእ ኣብቲ ሕብረተሰብ ተቐባልነት እቲ ግልጋሎት ክዓቢ ምግባርን፡፡

Thesis (PhD) -- University of Western Sydney, Nepean, 1999. / "A thesis submitted in fulfillment of the requirement for the degree of Doctor of Philosophy" Bibliography : leaves 218-224.