In the 21st century, the mobility of world population has posed greater challenges to healthcare practitioners, since they are facing an increasingly diverse patient population from all over the world. At the same time, patients also find it difficult to access and utilize quality health care services in a culturally diverse context. This study examines the role of culture in Chinese international students’ health-seeking behaviours in Canada. The study explores any barriers/perceived barriers that Chinese international students may confront when accessing health care which can prevent them from obtaining quality health care services in Canada. To this end, an intercultural health communication model was employed as a theoretical framework, and semi-structured interviews were used as a data collection tool. While contributing to existing literature on health communication and culture, this study also hopes to contribute to providing Canadian universities and institutions important information regarding Chinese international students’ access to and utilization of health care services with the hope of enhancing the quality of ethnic health care and promoting better health outcomes.

The results of this study indicate that two groups of mothers share a relatively similar socioeconomic status, knowledge of health and hygiene, and have similar health-seeking behaviors. The mothers' lack of knowledge and their local view of illnesses seemed to embody questionable newborn care related to breastfeeding practices and oil applications to newborns. Three psychosocial factors that appeared to contribute to the mother's health-seeking behaviors were attitudinal factors (this consisted of favorable or unfavorable perceptions toward services based on the mother's prior experiences or familiarity with service), social pressures (opinions from others and the mother's competing responsibilities), and self-efficacies accessibility, availability, and affordability). In addition, the external factor of poverty in the slum settlements was also a significant factor which determined the mother's health seeking behaviors. The implications of these findings are discussed in further detail, which are then followed by a set of recommendations for future health interventions designed to reduce the risk of sepsis neonatorum in urban communities. This study underscores the benefits of integrating the perspectives of anthropology and public health to further the understanding of the neonatal health problem. Finally, the need for future studies is addressed as it is necessary to further understand the existing local practices and beliefs in relation to the risks of sepsis neonatorum.

<p>This study is aimed at empirically examining health seeking behaviours in terms of illness response on household level at South Africa using 2007 General Household Survey and other<br /> relevant secondary sources. It provides an assessment of health seeking behaviours at the household level using individuals as unit of analysis by exploring the type of health care provider sought, the reason for delay in health seeking and the cause for not consulting. This study also assesses the extent of dissatisfaction among households using medical centres and this factor in health care utilisation is considered as the main reason for not consulting health care services. All the demographic and health seeking variables utilised in this study are controlled for medical aid cover because it is a critical variable in health care seeking. Therefore this study makes distinction on illness reporting and they type of health care consulted by medical aid holders and non medical aid holders. Statistical analyses are conducted to explore and predict the way in which demographic variables and socio economic variables affect health care seeking behaviours.</p>

Online Health Seeking (OHS) is widespread and widely studied, but its ideal fit in healthcare is still unclear. OHS is seemingly emblematic of patient self-interest and control and is an intuitive fit with the tenets of patient-centered care (PCC). Researchers have made only a few attempts to evidence or leverage this connection, focusing instead on describing the figures and typical characteristics of OHS. Finding, consuming and sharing online health and wellness information is one of the common online activities, and consumers are generally satisfied with their results despite using simple and error-prone search strategies. Physicians are interested in their patients' OHS, but for a variety of constraints including time, compensation and traditional roles in medicine, most patient OHS goes unshared with doctors. Healthcare facilitators, a relatively new class of health professional that works to bridge the gap between their client's health and personal life, may be an ideal partner for patients in OHS. In this dissertation I share my investigation of the OHS-PCC connection, presenting a case study of a type of healthcare facilitator that has embraced OHS. By studying OHS, I was also able to contribute to the collaborative information seeking (CIS) community. CIS theory and social search tools have pointed to social factors that can influence the entire process of information seeking. In this dissertation I argue that nearly any social search design can be seen as situated or embedded in a unique socio-environmental context. I suggest that social search tools can be used as probes to understand the environment, and that interactions with a search tool can illustrate phenomena far beyond direct search motivations and goals. I also hypothesize that social search field studies can produce changes in their environment, producing changes in user relationships outside of the experimental search system. My study of OHS is an opportunity to test these hypotheses by creating a collaborative search tool that seeks to use OHS as a tool to improve patient-provider relationships. In this dissertation I present the results of a series of field studies at a local clinic that centers on a unique form of health facilitator. Drawing on several formative investigations and related work I synthesize design guidelines for a collaborative OHS tool and describe Snack, a collaborative search tool for OHS customized to my field site. I also present results from Snack's field study and an analysis of email messages between advisors and clients at the clinic. My results show that these health facilitators embraced OHS as a tool to guide and connect with their clients, but fell from this practice after a change at their clinic. After analyzing these results I discuss what makes health facilitators good OHS partners and cover implications for future OHS-based interventions. I also report the positive connections I found between OHS and other quality of care indicators like patient-centered care and the Multidimensional Health Locus of Control. Finally, I consider social search's utility as a probe and intervention in light of my results.

In the 21st century, the mobility of world population has posed greater challenges to healthcare practitioners, since they are facing an increasingly diverse patient population from all over the world. At the same time, patients also find it difficult to access and utilize quality health care services in a culturally diverse context. This study examines the role of culture in Chinese international students’ health-seeking behaviours in Canada. The study explores any barriers/perceived barriers that Chinese international students may confront when accessing health care which can prevent them from obtaining quality health care services in Canada. To this end, an intercultural health communication model was employed as a theoretical framework, and semi-structured interviews were used as a data collection tool. While contributing to existing literature on health communication and culture, this study also hopes to contribute to providing Canadian universities and institutions important information regarding Chinese international students’ access to and utilization of health care services with the hope of enhancing the quality of ethnic health care and promoting better health outcomes.

Southeast Asia carries a large burden of endemic zoonotic diseases, in livestock and humans, especially in countries where livestock production is increasing among rural households for income generation and poverty reduction. This thesis explores the risk factors for transmission of pig-associated zoonoses – particularly Q fever, brucellosis, hepatitis E, and Japanese encephalitis – in northern Lao PDR, with a view to development of recommendations for “catch-all” control measures to impact on multiple diseases, improving biosecurity and preventing disease transmission to the human population. Research included (i) a qualitative assessment of the knowledge, attitudes, and practices of villagers related to pig-associated zoonoses and their risk factors using focus group methodology; (ii) an assessment of health seeking behaviour at hospital/health centre and village level to examine factors that influence choice of health care provider and determine the impact of health seeking behaviour on illness and treatment costs, and an examination of non-conventional health care sources to understand the complexity of health seeking behaviour and influences on choice of health care provider and, lastly, (iii) health care provider and service delivery assessments to determine healthcare facility routine service delivery procedures and assess capability in diagnosing and treating illness. In terms of disease, the most common illnesses reportedly seen by all those interviewed were respiratory illness, acute febrile illness and diarrhoea, confirming them as the leading causes of morbidity. Knowledge and awareness of the etiological agent of pig-associated zoonoses among villagers, patients, and health care providers was very poor for brucellosis and Q fever, with limited awareness of hepatitis E. Most were aware of Japanese encephalitis. Clinical diagnosis and symptomatic treatment of illness is the normal practice and identification of causative agents in human illness does not often occur. All three empirical assessments identified poor diagnostic capability as a major concern. Focus group discussions revealed that knowledge and awareness of disease risk factors, and of zoonoses in general, was low among villagers. Practices related to food consumption, latrine usage, hand hygiene and sanitation, which are known disease risk factors, were found to be a concern in study villages. Attitudes and practices adopted by villagers in relation to human and animal health and health seeking behaviours were strongly influenced by financial circumstances, access to appropriate healthcare facilities, spiritual beliefs, and a lack of knowledge and resources to maintain the health of both animals and humans. The first point of care when experiencing illness was often the health centre or a local traditional healer or spiritual healer or pharmacist/drug seller, depending on location. This was followed by the district hospital, if nearby. Many villagers described going back and forth between traditional medicine and modern medicine service providers, with 76% (19/25) of participants reportedly seeing more than one type of healthcare provider for a given episode of illness. Self-medication was the most common practice (84% of all participants) irrespective of the care provider consulted. Attendance at a healthcare facility was dependent on available funds and the perceived severity of illness. Overall household costs ranged between no cost, because of the “poor patient” policy that exempts vulnerable groups from paying for care, and $2500 USD for medical treatment, hospital stay, transportation and sometimes food. Healthcare workers at all facility levels (from health centre to provincial hospital) expressed a lack of confidence in making an accurate diagnosis for these pig associated zoonoses due to poor diagnostic capability in their respective facilities. A One Health approach to zoonotic disease surveillance that incorporates transdisciplinary methods and partnerships will lead to improved understanding of the underlining social determinants of health and their impact on health-seeking behaviours, disease transmission and ultimately disease reporting.

There is ample academic evidence indicating high levels of HIV stigma among BSSA communities. The research suggests that disadvantaged and marginalised social groups like the BSSA communities experience high levels of HIV and sexually transmitted infections. There is a significant amount of quantitative research in the public domain on HIV and stigma. Quantitative research has shown that BSSA communities present late with HIV and sexually transmitted infections often owing to HIV stigma. Currently there is limited published qualitative information on the factors influencing HIV stigma and sexual health seeking behaviour among BSSA communities, particularly from the perspective of the communities themselves. This research study explored beliefs and perceptions in the construction of HIV stigma and sexual health seeking behaviour among Black sub-Sahara African (BSSA) communities in one city in the UK. The Silences Framework, which sits within aspects of feminism, criticalist and ethnicity-based approaches, provided the theoretical underpinning for this study. An exploratory qualitative study methodology was used to identify and explore the key factors influencing the construction of HIV stigma and sexual health seeking behaviour among BSSA communities. Five focus groups and fifteen one-to-one semi-structured follow-up interviews were conducted to collect the data. The institution of Marriage, Religion, Reported HIV statistics, Politics and Immigration, HIV as a Sensitive subject, sexual health professionals Cultural competence, gender stereotyping, Sexual Orientation and Social Media emerged as key pillars underpinning the social scripts associated with the construction of HIV stigma and sexual health seeking behaviour. The experiences emanating from the pillars of HIV stigma, identified in this study, showed the impact of social, political and personal contexts associated with specific sexual scripts among the participants impacting on the construction of HIV stigma and sexual health seeking behaviour. The 'silences' contained in the socially determined scripts were important in understanding the phenomenon under investigation. The findings from this study were reviewed in light of current sexual health policies and strategies to consider how sexual health professionals and services can best meet the health care needs of BSSA communities. This thesis contributes to current knowledge of HIV stigma and ethnicity, by concluding that the construction of HIV stigma and sexual health seeking behaviour among BSSA communities takes place during different contexts of socialization, in a bid to conform to the perceived expectations of society which may be real or imagined. Furthermore, conformity is also influenced by commonly shared and personal appraisal of socially determined relevant issues. These contexts form the bases on which sexual scripts are given meaning and HIV stigma is constructed alongside a socially sanctioned pattern of sexual health seeking behaviour. This study makes an additional contribution in that it is the first time that The Silences Framework has been used to research HIV and stigma among BSSA communities. This research study compliments the currently available pool of quantitative data linking issues of HIV stigma and ethnicity in the United Kingdom. The findings from this exploratory qualitative research study reveal a wide range of critical issues to encourage further qualitative research in the area, while indicating new issues to consider in developing UK based interventions to address HIV stigma and sexual health seeking behaviour among BSSA communities.

Magister Curationis - Mcur / According to Brown (2010), influenza kills and hospitalises thousands of people every year, about thirty-five thousand and two hundred thousand respectively. Some studies have shown that one of the major reasons that people do not take part in preventative behaviour concerning influenza would be some misconceptions and lack of knowledge. The purpose of this study was to investigate perceptions and attitudes of nursing students at a University in the Western Cape about influenza and their prevention and health seeking behaviour against influenza infection. This topic is important as nursing students are a part of the population group that is frequently exposed to influenza, either at their institutions of learning or in the hospitals and clinics, where they come into contact with patients in their roles as health care workers. A comprehensive review of the literature around perceptions and attitudes and health seeking behaviours regarding influenza was undertaken and considered by the researcher. Most of the literature reviewed came from Western countries as not much research has been done in Africa on the topic. From the literature reviewed, the researcher decided to use the Health Belief Model as a conceptual framework for this study as it has proven to be relatively effective in previous studies of this nature as well as in predicting people's health seeking behaviours.

Magister Philosophiae - MPhil / This study is aimed at empirically examining health seeking behaviours in terms of illness response on household level at South Africa using 2007 General Household Survey and other relevant secondary sources. It provides an assessment of health seeking behaviours at the household level using individuals as unit of analysis by exploring the type of health care provider sought, the reason for delay in health seeking and the cause for not consulting. This study also assesses the extent of dissatisfaction among households using medical centres and this factor in health care utilisation is considered as the main reason for not consulting health care services. All the demographic and health seeking variables utilised in this study are controlled for medical aid cover because it is a critical variable in health care seeking. Therefore this study makes distinction on illness reporting and they type of health care consulted by medical aid holders and non medical aid holders. Statistical analyses are conducted to explore and predict the way in which demographic variables and socio economic variables affect health care seeking behaviours. / South Africa

Master of Public Health - MPH / Background: The Western Cape's Comprehensive Service Plan (CSP) is committed to "treating the right patient at the right level right, with the right skills and at the right cost" (Page 1, Tygerberg Hospital Annual Report, 2007). Occupational therapy (OT) Managers in the Metro District, Western Cape Province are in the process of aligning the OT services to the new CSP document. A major problem is the high default rate (non attendance) and irregular attendance (patient attends but skips sessions) amongst paediatric out-patients. In order to properly improve the OT paediatric services, it is vital for the OT managers to know the reasons for the poor utilisation of the OT services at the paediatric out-patient units. Purpose of study: The irregular attendance and high default rates (where patients stop attending the OT sessions completely) among children are a major problem at three OT out-patient units in Cape Town, Western Cape Province. The occupational therapists who work at these units are adamant that this impacts negatively on the child's progress. This study sought to explore the factors influencing the utilisation of the OT service in these three OT paediatric out-patient units in the hope of providing relevant information to the OT managers of these units in order to rethink the current service and make appropriate changes to improve adherence and treatment progress. Study design: This was an exploratory study using qualitative research methods. In-depth interviews were conducted with ten parents of children who have to attend the OT out-patient services. One group discussion was conducted with the occupational therapists that provide the services at the out-patient units. Sampling: Purposive sampling methods were employed to select four occupational therapists (at least one from each unit) and ten parents (at least three from each unit, with at least two who attended poorly and one that attended regularly). Analysis: Thematic analysis was used to interpret the data. The data was coded and categorised according to themes that emerged during data analysis. Results: The results of this study revealed that the factors that impact the utilisation of the OT service at the three OT units is complex. Factors that influenced the utilisation of the OT services in this study were related to the OT service such as staff attitude, relationship between the occupational therapist and the mothers as well as their child, communication between the mother and the occupational therapist, treatment progress, parent involvement in the OT programme and access to the OT service. Other factors such as the mothers' perception of the severity of the child's health condition, family support, work factors and family support were important factors related to the mother. The findings also revealed that environmental factors namely stigma, discrimination and travelling to the OT units impacted utilisation of the OT service. The participants made recommendations on how to improve the service. Conclusion: This study describes the complexity of what impacted the utilisation of the OT services and how closely interlinked these different factors are. It is evident from the findings of this study that a comprehensive, client centred approach is required to properly deal with the factors that negatively impact the utilisation of this service. Recommendations: A multi-faceted approach is required. Important issues to address are the shortage of occupational therapists across the levels of health care in the Western Cape Province; improving on the client centred approach in OT intervention programmes; advancing advocacy against stigma and discrimination against children with disabilities; and making public transport more accessible to children and their mothers.