In Sweden, it is prohibited to discriminate because of transgender identity or expression. However, research shows that transgender people often face discrimination in society including the health care sector. The aim of this work is to increase the understanding of the transgender experience in the meeting with caregivers. In the study some basic concepts are reviewed, such as different ways of defining sex. Sexuality, transgender, gender identity and expression are defined and discussed and the transgender health situation is described. As theoretical basis the term life world is introduced. The problem statement shows that transgender people are largely suffering from mental illness and that they, because of the risk of being offended or badly treated, refrain from seeking medical care. The methodology used in the study is a literature review of previously conducted qualitative research in the field. This research is compiled into a new entirety with the intent to increase the understanding of the phenomenon and translate it into practical knowledge in health care work. The result of the literature review of the transgender experience when meeting with health care can be summarized in three main groups: Standing outside the norm, Getting inadequate care and Being discriminated. In conclusion, the results indicate that the conception that there are only two genders together with the heteronormativity prevent transgender to get a good treatment and adequate care. The result and the method are discussed in the report.

Master of Public Health - MPH / Introduction: Tuberculosis (TB) is one of the most infectious diseases globally and is a huge public health concern. In 2016, the Western Cape Province had the fourth highest incidence of TB in South Africa, with 728 new cases per 100 000 population. Effective management of TB includes screening, diagnosis, treatment, control and elimination. The local health authority (municipality) has historically managed tuberculosis in the Cape Metropole but due to the increased TB burden, primary health care (PHC) facilities managed by Metro Health Services (MHS) (provincial government) have recently commenced providing TB services. The challenge that the Cape Metropole is facing, is whether the clinicians in MHS facilities are equipped to manage these patients effectively. Aim: To determine the knowledge, attitude and practices of clinicians in the screening, diagnosis and treatment of tuberculosis in the MHS PHC facilities in the Northern Tygerberg Sub-structure, Cape Town between mid-March 2018 and mid- June 2018.

A research report submitted to the Faculty of Management, University of the Witwatersrand, in partial fulfilment of the requirements for the degree of Master of Management / Rapid Appraisal has gained popularity amongst policy makers, and is used in strategic planning of primary health care services. This study aimed at determining whether Rapid Appraisal is an appropriate planning tool for primary health care services in South Africa. This study compares Rapid Appraisal with a Regional Health Management Information System (ReHMIS), using the Northern Province as a case study, In comparison, Rapid Appraisal took half the time of ReHMIS for data collection, and used less resources in the process, There is significant difference between the two data sets and this is explained by the fact that Rapid Appraisal does not only determine whether the facility is there or not but it also identifies management issues. Rapid Appraisal is an innovative method that engages all the relevant stakeholders in planning their primary health care services, The findings proved that Rapid Appraisal is an appropriate planning tool for primary health care services. / AC2017

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Magister Scientiae (Physiotherapy) - MSc(Physio) / BACKGROUND: Access to basic health care services through the primary health care (PHC) settings, was affirmed as a fundamental human right by the World health organisation (WHO) in 1978 in Alma Ata (Kazakhstan). Internationally, interdisciplinary collaboration among health care professionals (HCPs) have been the preferred approach to addressing the health and psychosocial needs of the populace. The PHC being the first point of contact for most Nigerians and the cornerstone of health care policies in Nigeria, covers promotive, preventative, curative and rehabilitative services. Although, Physiotherapy has ideally qualified personnel to contribute to the attainment of the goals and objectives of the PHC policies, these services are mostly carried out by other HCP’s subdivided as clinicians (medical doctors, dentists, nurses/midwives, optometrists, pharmacists, radiographers, laboratory scientists) and clinical assistants (pharmacy technicians, radiography technicians, laboratory technicians and community health extension workers). Physiotherapy services are mostly concentrated at tertiary and secondary health care settings. AIM: To determine the awareness and explore the perceptions of clinicians and clinical assistants employed in the type 3 primary health care (PHC) settings of Rivers East Senatorial district of Rivers State, Nigeria, regarding the roles of Physiotherapy in a PHC setting.

The core process is responsible for internal business development and is the process that runs through the organization and the results which creates a value for the customer. Some research suggests that identification of the client's conscious or unconscious needs clarifying the so-called core process in the organization and operations can thus be more effective. The study aims to identify and analyze the experience of the core process within child health care. The method has been interviews with nine managers and 10 clinic nurses in a county. The results show a lack of knowledge regarding core process and process work. However, the respondents have a sense of what the core process is, although the experience of the core process differs between managers and child health nurses in the study. The discussion describes the obstacles and supporting factors for a common core process.   Keywords: core process, child health care, core process management, process in health care, process management / Kärnprocessen står för verksamhetens inre utveckling och är den process som löper tvärs igenom organisationen och vars resultat skapar ett värde för kunden. Det finns forskning som tyder på att identifikation av kundens medvetna eller omedvetna behov tydliggör den så kallade kärnprocessen i organisationen. Genom processledning får medarbetarna en helhetssyn och kunskap om både interna och externa kunders behov. Det har en positiv inverkan på medarbetarnas arbetstrivsel och verksamhetens utveckling. Syftet med studien är att identifiera och analysera upplevelsen av kärnprocessen inom barnhälsovården. Metoden har varit kvalitativa intervjuer med nio verksamhetschefer och 10 BVC-sköterskor i ett av landets län. Resultatet visar på en kunskapsbrist beträffande kärnprocess och processarbete. Däremot har respondenterna en upplevelse av vad kärnprocessen är, även om upplevelsen av kärnprocessen skiljer sig mellan verksamhetscheferna och BVC-sköterskorna i studien. I diskussionen beskrivs hindrande och stödjande faktorer för en gemensam kärnprocess.

This research investigates the applicability of thin client in a hospital environment. First, a set of thin client application criteria in terms of hardware, function characteristics, network, and application platform are identified. Second, we analyze the healthcare delivery process in terms of operation process, hardware, and application platform. Third, we evaluate the fitness of thin client application by matching the above two sets of criteria. A case study was conducted to valid the applicability of this approach. These results provide great insight for practitioners and scholars for enhancing their understanding of thin client implementation and provide implication guidelines to help practitioners adapt thin client in health care industry.

Chronic liver disease is an important disease which affects national healthy in Taiwan. Hepatitis B or C virus infection is strongly relative to chronic hepatitis, liver cirrhosis and hepatocellular carcinoma. However, the early effective treatment can decrease the progression of liver cirrhosis and hepatocellular carcinoma and increase the recovery rate. In order to promote the health care quality for the patients with hepatitis, Bureau of National Health Insurance (BNHI) implemented the ¡§Enhance Hepatitis B or C Health Care Program¡¨ in October of 2003. The new policy sets up the standard treatment models and pay medical costs to encourage the patients to participate this program and fit cost-effectiveness. Therefore, aims of the study are to estimate the effects of the new policy on health care utilization and expenditures for the patients with hepatitis B or C. The study used the database from Bureau of National Health Insurance (BNHI) in 2002 and 2004. The study sample is the patients with hepatitis B or C who enrolled the program from January to June in 2004. We compared the differences of health care utilization and expenditures with these statistics in 2002. Besides, we also analyzed the difference in the characteristics of the patients and hospitals. In health care utilization, we found that number of visits was increased but interval between visits was decreased. Total costs, costs of treatments, prescriptions, total claim amount, and averages of prescription costs in health care expenditures were all increased significantly after the new policy implemented. Otherwise, there were not different on health care utilization and expenditures between different gender and level of the hospitals. On the other hand, there were significantly correlation of ages and number of comorbility. It means that the patients¡¦ ages are older, and their number of visits and total costs are higher but interval between visits is shorter than younger. Furthermore, number of comorbility increases and then interval between visits become short. The new policy certainly affects the health care utilization and expenditures of patients with hepatitis B or C. Implementing the new program can encourage patients adopt treatment actively and physicians have standard treatment protocols to follow. Understanding the changes on health care utilization and expenditures can give a health care guideline of cost-effectiveness. In conclusion, the results can provide the information about payments on patients with hepatitis to BNHI and then use it to be a basis after the new program implemented. Moreover, other countries also can evaluate the implementation of the new policy based on our results.