Magister Scientiae (Physiotherapy) - MSc(Physio) / People with disabilities (PWD) often come from disadvantaged communities and struggle to access health and rehabilitation, education and employment. This leads to poorer health outcomes, lower education achievements, and higher rate of unemployment in comparison to people without disabilities. Therefore there is a need to empower PWD to remove all barriers which prevent them from participating in all aspects of their communities. In South Africa, 5% of the population is disabled and in a worldwide review conducted on access to rehabilitation services, it was reported that South Africa provided 21% to 40% of the disabled population with rehabilitation services. In 2012 the Department of Health (DOH) trained a new cadre of community health worker (CHW) in the field of rehabilitation in order to improve PWDs‘ access to health services. As a result, health professionals in the Western Cape became concerned about the role of this new cadre of rehabilitation care worker in PHC and CBS. The aim of this study was therefore to explore health professionals‘ perceptions of the newly trained rehabilitation care workers (RCWs). Q methodology was selected as an appropriate research design to meet the objectives of this study as it can be used to analyse opinions, perceptions and attitudes. The study population consisted of all the health professionals who engaged with the RCWs in the clinical workplace during their clinical practice module. A convenient sample of sixteen health professionals participated in this study. Ethics approval was obtained to conduct this study and all participants gave written consent to participate in this study. The researcher gathered all the viewpoints of the health professionals regarding the new rehabilitation care workers (RCWs) by conducting focus group discussions and document analysis. Statements were then drawn up based on the health professionals' viewpoints. The participants then ranked these statements from strongly agree to strongly disagree on a Q data score grid, in a process called Q sorting. The completed Q data score grids, called Q sorts, were then entered into PQMethod software programme for statistical and factor analysis. From the results of this Q analysis, two factors emerged which were analysed and interpreted. A factor is representative of participants with similar opinions. The participants loading onto Factor one and Factor two shared similar opinions of the RCWs. The results indicated that the participants were of the opinion that RCWs‘ role would be to strengthen primary health care (PHC) and community-based rehabilitation (CBR) and promote the participation of PWD in society. The results suggested that the RCWs were capable of improving the quality of life of PWD by empowering PWD to become actively involved in all aspects of community life. The participants felt that the RCWs would be included in the health system by working at intermediate care centres (facility-based) and in the community (home-based). However, the participants agreed that the RCWs must work under the direct supervision of qualified health professionals. Participants loading onto Factor one and Factor two further agreed that RCWs worked well in the structured environment of intermediate care health facilities. They felt that it would be beneficial for RCWs to be employed at these health facilities as the RCWs reduced the workload of the health professionals. From the results, it was also found that health professionals were of the opinion that the RCWs displayed positive attitudes and good professional behaviour in the clinical environment. Health professionals however identified gaps in the knowledge of the RCWs and a lack of skills to perform certain tasks. However, health professionals agreed that the RCWs' skills will develop and improve with time and exposure. This study showed that health professionals had positive perceptions of the RCWs and this could indicate that RCWs will be well accepted by health professionals as part of the PHC team. This could lead to the effective utilisation of RCWs in community-based rehabilitation. Recommendations can be made to the developers and implementers of the RCW training curriculum to make adjustments to the curriculum so as to address the lack of knowledge and skills in certain aspects of health and disability. It can further be recommended that South Africa's National DOH capitalise on these positive perceptions and train more RCWs to extend rehabilitation and health services to more underserved communities. This will assist the South African Government in ensuring that more PWD receive rehabilitation and become included in all aspects of their communities as is envisaged in the 2020/2030 health plan.

Orientador: Sérgio Roberto de Lucca / Dissertação (mestrado profissional) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-28T12:15:39Z (GMT). No. of bitstreams: 1 Bezerra_JaironLeiteChaves_M.pdf: 2143572 bytes, checksum: bf18bfcd495c47f3e454991d1429d4f5 (MD5) Previous issue date: 2015 / Resumo: O trabalho em saúde tem sido destacado no meio internacional, devido ao alto nível de adoecimento dos trabalhadores. No Brasil, a Estratégia Saúde da Família configura-se uma reorientação do modelo assistencial de saúde na qual uma equipe multiprofissional acompanha a situação de saúde e promove ações a um número de famílias, dentro de um território. As condições em que estes profissionais vivenciam o seu trabalho podem ser desencadeantes de sofrimento mental, causando o estresse. O agente comunitário de saúde é um dos atores centrais no processo de trabalho em saúde do modelo de atenção à saúde brasileiro. Na cidade de Parnaíba/PI, esses trabalhadores parecem estar expostos a situações de desgaste físico e/ou emocional durante o exercício de suas funções. Isto percebido pelo pesquisador na sua rotina de trabalho no Núcleo de Apoio ao Saúde da Família do município, trouxe o interesse e motivação para realização da pesquisa. Com o objetivo de compreender os fatores psicossociais desencadeadores de estresse no trabalho na percepção dos agentes comunitários, optou-se realizar um estudo epidemiológico de corte transversal. Utilizando-se uma abordagem quanti e qualitativa, buscou-se aplicar um questionário de avaliação de estresse com toda a população pesquisada, além de se realizar um grupo focal para se esclarecer os resultados encontrados. Da amostra final, a sua maioria era de mulheres (73,2%), com idade acima dos 30 anos (74,3%), com formação técnica (26,2%) e pós-graduação (24,4%) e com tempo de exercício na profissão e no SUS superior aos 14 anos. O território do Distrito III (31,55%) foi o mais representado no estudo. Como principais dimensões psicossociais encontradas temos as relacionadas aos relacionamentos, às mudanças e ao controle. As narrativas do grupo focal revelaram que: os agentes entendem bem o cargo que ocupam; o apoio da chefia ocorre menos que o dos colegas; há atribuições excessivas somadas à violência no ambiente de trabalho; a autonomia do agente é limitada ainda à técnica; as carências do serviço e a falta de comunicação prévia promovem descontentamento dos profissionais e da comunidade. A dimensão mais destacada foi a de relacionamentos, pois vínculos estabelecidos com a comunidade a equipe e a gestão municipal não são tão valorizados podendo ser quebrados. Acredita-se que um trabalho mais organizado e pautado na humanização possa trazer espaços de trabalho mais saudáveis, evitando-se o adoecimento e, até mesmo, o Burnout / Abstract: Health work has been featured in the international environment due to the high level of illness of workers. In Brazil, the Family Health Strategy sets up a reorientation of the health care model in which a multidisciplinary team monitors the health status and promotes actions to a number of families within a territory. The conditions under which these professionals have their work may trigger mental suffering causing stress. The Community Health Worker is one of the central actors in the work process in health care to the Brazilian model. In Parnaíba/PI, these workers seem to be exposed to situations of physical and/or emotional stress during the performance of their duties. This perceived by the researcher in his work routine at the municipal Support Center for the Family Health, brought the interest and motivation for the research. In order to understand the psychosocial factors triggering at stress at work in the perception of Community Health Worker, it was decided to conduct an epidemiological cross-sectional study. Using a quantitative and qualitative approach, we attempted to apply a stress assessment questionnaire with all the research population, in addition to conducting a focus group to clarify the results. The final sample, the majority were women (73.2%), over the age of 30 years (74.3%), with technical training (26.2%) and graduate (24.4%) and exercise time in profession and in SUS higher to 14 years. The territory of the Third District (31.55%) was the most represented in the study. The main founded psychosocial dimensions was related to relationships, changes and control. The narratives of the focus group revealed that: workers understand well the position they hold; the support of the head is less than that of colleagues; there excessive assignment added to violence in the workplace; the agent's autonomy is still limited to the technique; the needs of the service and the lack of prior notification promote discontent among professionals and the community. The most prominent was the dimension of relationships beacause the links established with the community, staff and municipal management are not as valued and can be broken. It is believed that a more organized work and guided by the humanization can bring healthier workspaces, avoiding the illness and even the Burnout / Mestrado / Epidemiologia / Mestre em Saude Coletiva

Bakgrund: God munvård är en förutsättning för god hälsa och välbefinnande. Dagens äldre har visats ha kvar sina naturliga tänder i större utsträckning. Den positiva utvecklingen ställer krav på vårdpersonal att ha kunskap om munvård. Tidigare studier har visat att äldres munvård är eftersatt och att äldre har dålig munstatus. Syfte: Att belysa vårdpersonalens erfarenheter att utföra munvård hos äldre patienter. Metod: Litteraturstudie som sammanställde tio kvalitativa vetenskapliga artiklar, som belyste vårdpersonalens erfarenheter att utföra munvård hos äldre patienter. Resultat: Det visade att tidsbrist, personalbrist, patientsvägran, patients beteende och tillstånd, respekt av autonomin och attityder till munvård var faktorer som motverkar utförandet av munvård. Utbildningar, kunskap och organisation upplevdes som faktorer som kunde främja munvårdsutförande. Slutsats: Munvård saknade integrerad plats i omvårdnadsarbetet. För att förbättra området, är det viktig att sjuksköterskor uppmärksammar munvården som en del av omvårdnaden samt att ledningen vidareutbildar vårdpersonalen på arbetsplatsen så att kunskapen om vikten av god munvård finns tillgänglig. Det har framkommit att när det finns en munvårdsansvarig personal på en vårdboende, förbättras vårdpersonalens beteende kring munvården och att samarbetet mellan vårdpersonalalen och äldre patienter främjas. / Background: Good oral care is a prerequisite for good health and well-being. Today's elderly has shown to retain their natural teeth to a greater extent. The positive development places demand on health care professionals to have knowledge of oral care. Previous studies have shown that elderly oral care is lagging and that the elderly have poor oral status. The aim: Was to highlight the experience of healthcare professionals in performing oral care in elderly patients. Method: Literature study that compiled ten qualitative scientific articles, which highlighted the experience of healthcare professionals in performing oral care in elderly patients. Results: The results showed that lack of time, staff shortages, patient refusal, patient behavior and condition, respect of autonomy and attitudes towards oral care were factors that counteract the performance of oral care. Education, knowledge and organization are perceived as factors that could promote oral care performance. Conclusion: Oral care lacked an integrated place in nursing work. In order to improve the area, it is important that nurses pay attention to oral care as part of nursing and that management further educates health care professionals in the workplace so that knowledge of the importance of good oral care is available. It has been proven that when there is a person in charge of mouth care in a nursing home, the behavior of health care professionals around oral care is improved and that cooperation between the nursing staff and elderly patients is promoted

Magister Scientiae (Nutrition Management) - MSc(NM) / Globally, health workers play a critical role in the establishment and sustenance of breastfeeding due to their frequent contacts with mothers at the antenatal clinics, maternity/birthing units, Primary Health Care Centres (PHC) and postpartum clinics. Their knowledge and attitude regarding breastfeeding will affect the quality of information about infant and young child feeding practices passed along to mothers who visit their health facilities.

Master of Public Health - MPH / Community health workers (CHWs) are integral to improve Primary health care (PHC) coverage, utilising their unique skills within the community to make services accessible and equitable. PHC is the cornerstone of the National Health Insurance (NHI) Bill for the provision of Universal Health Care (UHC). The Department of Health (DOH) in the Western Cape, South Africa, has set priorities and requirements for the provision of funding to Non-profit organisations (NPOs) for forming coalitions with the Health Department to deliver various aspects of health care. The post-2015 agenda of the Sustainable Development Goals (SDGs) are underscored by a strong sense of intersectoral collaboration to work together to attain sufficient and sustainable progress. Collaboration between CHWs and PHC facilities is important in aligning goals and activities to ensure a comprehensive and sustainable approach to ensuring UHC

MPH / Department of Public Health / See the attached abstract below

Background: Tobacco use is associated with exacerbation of tuberculosis (TB) and poor TB treatment outcomes. Integrating tobacco use cessation within TB treatment could improve healing among TB patients. The aim was to explore perceptions of health workers on where and how to integrate tobacco use cessation services into TB treatment programs in Uganda. Methods: Between March and April 2019, nine focus group discussions (FGDs) and eight key informant interviews were conducted among health workers attending to patients with tuberculosis on a routine basis in nine facilities from the central, eastern, northern and western parts of Uganda. These facilities were high volume health centres, general hospitals and referral hospitals. The FGD sessions and interviews were tape recorded, transcribed verbatim and analysed using content analysis and the Chronic Care Model as a framework. Results: Respondents highlighted that just like TB prevention starts in the community and TB treatment goes beyond health facility stay, integration of tobacco cessation should be started when people are still healthy and extended to those who have been healed as they go back to communities. There was need to coordinate with different organizations like peers, the media and TB treatment supporters. TB patients needed regular follow up and self-management support for both TB and tobacco cessation. Patients needed to be empowered to know their condition and their caretakers needed to be involved. Effective referral between primary health facilities and specialist facilities was needed. Clinical information systems should identify relevant people for proactive care and follow up. In order to achieve effective integration, the health system needed to be strengthened especially health worker training and provision of more space in some of the facilities. Conclusions: Tobacco cessation activities should be provided in a continuum starting in the community before the TB patients get to hospital, during the patients’ interface with hospital treatment and be given in the community after TB patients have been discharged. This requires collaboration between those who carry out health education in communities, the TB treatment supporters and the health workers who treat patients in health facilities.

Master of Public Health - MPH / Hospital acquired infections are a huge public health concern, contributing to increased hospitalisation and death in developing countries. Infection prevention and control (IPC) is a discipline which relies on practical evidence-based approaches to preventing both patients and health workers from hospital avoidable infections. However, most of these infections, in many developing countries including Zimbabwe can be attributed to lack of compliance with infection prevention and control measures by health care workers. / 2023

Thesis (MPH.) -- University of Limpopo, 2021 / Background Health care facilities are characterised by a high level of exposure to hazardous agents, which significantly endanger the health and life of workers. Occupational hazards, exposure to blood and body fluids accidents and safety precautions constitute an important public health issue. Occupational health is the identification and control of risks arising from physical, chemical, and other workplace hazards in order to establish and maintain a safe and healthy working environment. The high occurrence and burden of occupational hazards in hospitals include sharps/needlestick injuries, contact with blood and body fluids, blood-borne infections, and accidents. Health workers at Letaba Hospital are facing occupational health and safety risk at their workplace. Objectives The objectives of the study were to identify the type of work and related hazards that health workers are exposed to at Letaba Hospital and to find out if health workers at Letaba Hospital are aware of the occupational hazards at the workplace. Methods A quantitative descriptive cross-sectional method was used. The population comprised 649 nurses, doctors, cleaners, kitchen workers, laboratory technicians and laboratory technologists employed at Letaba Hospital. Stratified random sampling was used to select 374 health workers who participated in the study. A self-administered questionnaire was used for data collection. Descriptive and inferential statistics were used for data analysis. Results The study showed that health works, particularly nurses and doctors and nurses are exposed to needle pricks and kitchen workers are exposed to sharps. Cleaners and porters are exposed to slippery floors as well as uneven floors. Laboratory technicians, laboratory technologists and porters are exposed to specimen containers. Health vi workers lack knowledge on the toxic gases available at the hospital. The study also revealed that health workers are aware of the risk of using uneven floors and the risk of using stairs/steps at their workplace. Conclusion The study concluded that health workers at Letaba Hospital experienced physical, biological, chemical as well as psychosocial hazards at their workplace. Keywords Occupational hazards, health workers and occupational health.

The South African National Development Plan (NDP) (National Planning Commission, 2011, p. 1) provides the road map for a reformed public health system by 2030. The proposed health system will be facilitated by, amongst others, training an appropriate balance of healthcare professional s including a cadre of community health workers (CHWs) that have a broad skills mix suited to reaching a larger number of people with first level intervention. With this in mind, a pilot group of CHWs were up-skilled as Rehabilitation Care Worker s (RCWs). The training program was a joint project between the Division of Disability Studies and the Departments of Occupational Therapy, Physiotherapy and Speech and Language Therapy at UCT. Problem: Little is known about the perspectives of RCWs on the benefits and challenges of additional training in rehabilitation and disability related skills. Rationale: To inform the curriculum for a rehabilitation care worker (RCW) training program and the Western Cape Department of Health (WCDoH) of ways in which this cadre of worker could contribute to the realization of the 2030 Healthcare Plan. Aim: To describe the outcomes of a pilot RCW training program from the perspective of the pilot group of graduates. The objectives were to identify the areas of practice where RCWs feel competent/incompetent, to identify aspects of the health services where RCWs believe they can contribute the most/the least and to identify the facilitators/barriers they experienced when deployed in the health field. Methodology: A qualitative descriptive study was conducted. Method: Focus groups were carried out with three groups of six participants. Findings: The plot that permeated the participants’ perspectives revolved around how the RCWs were pioneers in breaking new ground for the Western Cape Department of Health (WCDoH). Two themes informed the plot: "we move health services to a new level" and "we manage change in new ways". Discussion: It is argued that the pilot RCW curriculum achieved its’ objective of equipping a cadre of worker with basic rehabilitation, care and disability inclusion skills. While the envisaged role of RCWs in the health service and in making the NDP a reality is supported, it is argued that attention needs to be given to supervision structures and to training of all other health workers in order to promote inter professional practice. Conclusions: The pilot group of RCWs believe that they have acquired a new and large variety of skills that have enabled them to make a broad and positive impact in their places of work, at home and in the broader community.