Thesis (Ph. D.)--University of Wisconsin--Madison, 1968. / Typescript. Vita. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references.

Early diagnosis and prompt treatment is one of the malaria control strategies used to minimize malaria morbidity and mortality. One of the mechanisms to implement early diagnosis and prompt treatment is community access to diagnostic services and effective antimalarial drugs. However, in Ethiopia the health system is underdeveloped and much of the rural population has limited access to modern health services. Therefore, the Ethiopian government introduced the Health Extension Programme(HEP) which is a community-based health care delivery system aimed at accessing essential health services through its health extension workers (HEWs). Involvement of the HEWs in prescribing and dispensing antimalarial drugs is shown to have improved community access to antimalarial drugs. However, there is insufficient knowledge of HEWs compliance to malaria treatment guidelines and patient adherence of patients treated by HEWs. The objectives of this study has been to describe the HEWs practice in malaria treatment, to evaluate adherence of patients to antimalarial drugs, to explore the factors influencing the HEWs malaria treatment practice and patient adherence, and to develop the guidelines to support the HEWs in malaria treatment practice. A qualitative study design was used to study the HEWs practice in malaria treatment along with patient adherence. Data were collected using in-depth face-to-face interviews, focus group discussion and patient medical record review and were analysed according to Tesch’s steps. The study revealed that the HEWs adequately comply with malaria treatment guidelines during diagnosis of malaria, as well as during the prescribing and dispensing of antimalarial drugs. However, there are some factors influencing the performance of HEWs. These are: shortage of diagnostic kit/RDT, shortage of antimalarial drugs, patient pressure to obtain coartem, work load, and community beliefs with regard to antimalarial drugs effectiveness. This study also revealed that the HEWs follow up after treatment of patients and good community support systems improved patient adherence to antimalarial drug use. Factors negatively influencing patient adherence were identified to include: forgetfulness, fear of shortage of drugs, adverse drug effects, duration of treatment, rapid relief of malaria symptoms and inadequate awareness of the consequence of incomplete dosage. Guidelines were developed to support the HEWs in malaria treatment practice with the aim to improve patient adherence to antimalarial drugs / Health Studies / D. Litt. et Phil. (Health Studies)

Thesis (Ph. D.)--University of Tennessee, Knoxville, 2008. / Title from title page screen (viewed on Sept. 17, 2009). Thesis advisor: George M. Hopper. Vita. Includes bibliographical references.

Early diagnosis and prompt treatment is one of the malaria control strategies used to minimize malaria morbidity and mortality. One of the mechanisms to implement early diagnosis and prompt treatment is community access to diagnostic services and effective antimalarial drugs. However, in Ethiopia the health system is underdeveloped and much of the rural population has limited access to modern health services. Therefore, the Ethiopian government introduced the Health Extension Programme(HEP) which is a community-based health care delivery system aimed at accessing essential health services through its health extension workers (HEWs). Involvement of the HEWs in prescribing and dispensing antimalarial drugs is shown to have improved community access to antimalarial drugs. However, there is insufficient knowledge of HEWs compliance to malaria treatment guidelines and patient adherence of patients treated by HEWs. The objectives of this study has been to describe the HEWs practice in malaria treatment, to evaluate adherence of patients to antimalarial drugs, to explore the factors influencing the HEWs malaria treatment practice and patient adherence, and to develop the guidelines to support the HEWs in malaria treatment practice. A qualitative study design was used to study the HEWs practice in malaria treatment along with patient adherence. Data were collected using in-depth face-to-face interviews, focus group discussion and patient medical record review and were analysed according to Tesch’s steps. The study revealed that the HEWs adequately comply with malaria treatment guidelines during diagnosis of malaria, as well as during the prescribing and dispensing of antimalarial drugs. However, there are some factors influencing the performance of HEWs. These are: shortage of diagnostic kit/RDT, shortage of antimalarial drugs, patient pressure to obtain coartem, work load, and community beliefs with regard to antimalarial drugs effectiveness. This study also revealed that the HEWs follow up after treatment of patients and good community support systems improved patient adherence to antimalarial drug use. Factors negatively influencing patient adherence were identified to include: forgetfulness, fear of shortage of drugs, adverse drug effects, duration of treatment, rapid relief of malaria symptoms and inadequate awareness of the consequence of incomplete dosage. Guidelines were developed to support the HEWs in malaria treatment practice with the aim to improve patient adherence to antimalarial drugs / Health Studies / D. Litt. et Phil. (Health Studies)

Orientador: Maria Angela Fagnani / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Engenharia Agricola / Made available in DSpace on 2018-08-15T07:59:32Z (GMT). No. of bitstreams: 1 Galvao_DeniseCristinaBortolani_M.pdf: 1518757 bytes, checksum: ac5884c456e1578d2e2230588c2040f6 (MD5) Previous issue date: 2009 / Resumo: A Assistência Técnica e Extensão Rural no Brasil, reestruturada em 2003, traz novas conceituações de base ideológica e estrutural, recriando formas de atuação, inclusive quanto à capacitação de seus profissionais de extensão. Esse contexto trouxe uma abertura para o desenvolvimento de novos trabalhos que contemplem o agricultor e sua família, a partir do seu desenvolvimento pessoal. Estratégias como planejamento e diagnóstico participativo, o papel do extensionista como facilitador, trouxe a necessidade do desenvolvimento do agente de extensão com técnicas de comunicação, liderança, estímulo, motivação, instrumentos que fossem capazes de auxiliá-los em seu trabalho no campo. Diante desta proposta surge a Programação Neurolinguística (PNL), tecnologia de comunicação que utiliza a linguagem do cérebro e do comportamento para estudar a subjetividade humana. Ainda analisa como as experiências vividas programam o cérebro e afetam o sistema de crenças e valores dos indivíduos. Trabalhar com desenvolvimento é contribuir para que ele tenha qualidade de vida. Como a Programação Neurolinguística poderia ser utilizada no mundo rural? Por meio da capacitação dos agentes de extensão com técnicas de PNL. Com esse objetivo, foi ministrado um Curso Básico de Programação Neurolinguística, destinado a extensionistas para desenvolver habilidades de comunicação; perspectivas de liderança; flexibilidade comportamental; capacidade de formular e identificar metas e objetivos, metamodelo de linguagem, desenvolvimento da criatividade e poder de observação. Como resultados os participantes descreveram ter desenvolvido habilidades de comunicação e noção clara da aplicação das técnicas de PNL nos ambientes pessoais e profissionais, na avaliação do curso / Abstract: The Technical Assistance and Rural Extension in Brazil, restructured in 2003, bring new concepts of structural and ideological basis, thus recreating forms of work, including on the training of its extension professionals. This context brought an opening for the development of new works that includ the farmer and his family, from his personal development. Techniques such as participatory appraisal and planning, the extension worker's role as facilitator, has throught the need of necessitated the development of the extension agent with communication skills, leadership, encouragement, motivation and tools to be able to assist them in their work in the field. Due to this proposal, there is a neurolinguistic programming (NLP), communication technology that uses the brain and behavior to study the human subjectivity. Also it studies how the experiences program the brain and affect the system of beliefs and individual values. Working with the human being development is to contribute to their entire success. The notion that NLP brings is expanded to the extent that its benefits are enjoyed by those who participate in the training and all those around them. How can NLP be used in rural areas? Through the training of extension agents with NLP techniques. With this goal, we applied a Basic Course in NLP, for the extension professionals to develop communication skills, leadership perspectives, working with beliefs and values, behavioral flexibility, ability to formulate and identify goals, metamodel of language development creativity and power of observation / Mestrado / Planejamento e Desenvolvimento Rural Sustentável / Mestre em Engenharia Agrícola

Thesis (M. Tech. Agriculture) -- Central University of Technology, Free state, 2012 / Small-scale and subsistence farmers in general lack knowledge and information as a result of limited personal contact at grassroots level with extension workers. Therefore, the formation of farmer groups needs to be encouraged in most rural areas as tools of extension delivery. The value of farmer groups for quality decision making and generating of new ideas is well known, and therefore, the use of group contact may accelerate capacity building and empowerment to subsistence farmers. The problem under investigation is the effectiveness of farmer groups as tools of extension delivery in Makhuduthamaga in Sekhukhune District. The investigation seeks to establish the factors that influence the effectiveness of the farmer group in Makhuduthamaga local municipality. This study was conducted in the Makhuduthamaga local municipality in Sekhukhune District. Data was gathered through two questionnaires, one for farmers and one for extension workers. The study applied quantitative methodology, cluster sampling and non-probability sampling methods, and used field interviews with structured questionnaires. The study found that there are many stakeholders involved in the formation of farmer groups, such as NGOs, social welfare and extension workers, and the initiation by the different stakeholders has an influence on the development of the groups. Most of the farmer groups were initiated by NGOs, the reason being the financial support offered. The effectiveness of the selected farmer groups on Makhuduthamaga municipality is influenced by group dynamic factors. These factors include group size and gender composition, updating of the constitution, and the frequency of group meetings. The respondents highlighted the fact that there is a poor relationship within the groups, poor leadership, misuse of funds, lack of knowledge and division in the groups. There is a culture of not believing and/or not trusting the local people, and it is difficult to disclose information. The number of extension workers is still small in relation to the size of the farming population to be served. Stakeholders will learn from the study that the formation of farmer groups should serve the interests of the farmers, not of the institutions. The training institutions should base the training of extension workers on the needs of the farmers. The farmers should strive for self-reliance in order to sustain their farming enterprises. Extension workers should be formally trained on group dynamics, because agriculture in rural areas is about people working together. Government should minimise the top down approach and institutionalise the participatory extension approach methodology.

BACKGROUND: Ethiopia adopted a new strategy called integrated community case management to address common childhood illness (ICCM). This strategy has been introduced in some rural districts of Bale zone. It has multiple functions, involving assessment of sick children at community health post levels. Despite this, the efficacy of this strategy has not been investigated. Aim: This study aimed to assess the level of ICCM service utilisation and factors influencing this at health posts in Agarfa district. METHODS: Cross sectional and phenomenological methodologies were employed in this study. Data were collected from 401 mothers using questionnaires and 29 participants using in-depth interviews. Quantitative data were analysed using both descriptive and inferential statistical approaches. Thematic analysis was used for the qualitative data. RESULT: The utilsation of ICCM services is limited among caregivers in rural communities. There is a range of factors responsible for the limited utilisation. Examples of these include absence of health extension workers at health posts, caregivers’ negative perception of ICCM service, socio-cultural factors, level of education and household finance. The most common childhood illnesses noted were diarrhoea, followed by fever and cough. Caregivers seek help from HEWs at health posts two or more days after idenfying signs and symptoms of these illnesses. CONCLUSION: Behavioural messages to address prevailing negative attitudes and socio-economic barriers to accessing health care would help improve uptake of ICCM services / Health Studies / M.A. (Public Health)

Ethiopia adopted a new strategy called integrated community case management to address common childhood illness (ICCM). This strategy has been introduced in some rural districts of Bale zone. It has multiple functions, involving assessment of sick children at community health post levels. Despite this, the efficacy of this strategy has not been investigated. Aim: This study aimed to assess the level of ICCM service utilisation and factors influencing this at health posts in Agarfa district. METHODS: Cross sectional and phenomenological methodologies were employed in this study. Data were collected from 401 mothers using questionnaires and 29 participants using in-depth interviews. Quantitative data were analysed using both descriptive and inferential statistical approaches. Thematic analysis was used for the qualitative data. RESULT: The utilsation of ICCM services is limited among caregivers in rural communities. There is a range of factors responsible for the limited utilisation. Examples of these include absence of health extension workers at health posts, caregivers’ negative perception of ICCM service, socio-cultural factors, level of education and household finance. The most common childhood illnesses noted were diarrhoea, followed by fever and cough. Caregivers seek help from HEWs at health posts two or more days after idenfying signs and symptoms of these illnesses. CONCLUSION: Behavioural messages to address prevailing negative attitudes and socio-economic barriers to accessing health care would help improve uptake of ICCM services / Health Studies / M. A. (Public Health)

The Agricultural Extension, within the context of Mozambique, is an important force· towards agricultural and rural development. Practically, the agricultural policy and programme of the government is implemented through these services. Mozambique has accepted agriculture as the foundation for the development of the country given that this activity sustains the livelihoods of almost the entire population. Moreover, Mozambique is a potential natural resource country, in where, its potential ranges from terrestrial to marine resources. For the purpose of this study, natural resource management refers mainly to the adequate management of the land, water, forests and wildlife by local communities. These facts imply that if the policy goals of the government are the agricultural and the rural development, than the Agricultural Extension role must be redefined to include promoting natural resource management. A most effective way of redefining this role is through supporting the relationship between agricultural extension and natural resource management. This relationship would provide stakeholders involved in the agricultural development scenario in Mozambique with a clear picture of the environment surrounding the Agricultural Extension service for future sound decisions. The relationship between Agricultural Extension and natural resource management was investigated through a survey conducted with extension workers and farmers in Cabo Delgado province in north of Mozambique. Key informants at district, provincial and national level assisted the study. The survey results are presented as three articles submitted for publication in the South African Journal of Agricultural Extension. It became evident that the relationship between agricultural extension and natural resource management is a prerequisite for agricultural and rural development in Mozambique. Further, several limiting factors adjoined. to the policy framework in agricultural development, Agricultural Extension approaches and farmers behaviour were identified as hampering that relationship, and therefore, need to be shifted or improved. / Thesis (M.Env.Dev.)-University of KwaZulu-Natal, Pietermaritzburg, 2005.

Master of Public Health - MPH / 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. 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. 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. 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. 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.