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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
1

The presence and architecture of Islamic health providers in Egypt

Abdulhady, Sarah 10 February 2020 (has links)
Weakening health systems in the Middle East and North Africa (MENA) region has led to a shift towards a greater acknowledgement of the involvement of non-state providers in health care services and delivery. A wide range of non-state health providers exist in the region, one type being Islamic health providers (IHPs) which fall under the category of non-state, not-for profit health providers. There is very little information available about the non-state sector in the MENA region, and almost nothing about IHPs, although anecdotally they are described as providers of choice, said to provide high quality services at low cost. This research aims to explore the public/private mix in the MENA region, delving into the types of collaborations that occur between the public and non-state sector. It will then narrow down in a single case study focusing on looking at IHPs in on MENA country (Egypt), and consider how IHPs 'fit’ within their national health system. Egypt was chosen for this study as IHPs have a long presence there, as Egypt is the birthplace of many Islamic groups such as the Muslim Brotherhood, which then migrated to neighboring countries. Common themes found in the case study was the lack of regulations for both the non-state sector and IHPs, competition in service provision with the public sector, and inequality in provision of health services (the latter issue observed in the broader non-state sector in the MENA region, but not specifically in IHPs). With regards to IHPs in Egypt, they were found to serve nearly 20% of the population. Exact numbers of the presence of IHPs in the country is difficult to obtain, as they are largely invisible in literature and are often categorized as non-governmental organizations (NGOs). Estimates show that there are around 5000 NGOs providing primary health care (PHC) and other health services. Most of these facilities are concentrated in urban areas. It was found that the 'Islamic’ label of IHPs is utilised either to gain donations, to denote the fact that this is a charitable institution, or because the facility is attached to a mosque. Most of the IHPs in the country practice a form of social rather than political Islam, making them not that different from other non-state secular facilities.
2

Trust and motivation in the health sector : a systematic review

Okello, Dickson R O January 2014 (has links)
Supporting improved performance of health workers is vital in health system strengthening. There are several factors that have been identified as playing key roles in influencing health worker performance. Motivation of HWs is one of the areas for improving delivery of health care services, yet it is under investigated. Moreover, the mechanisms underlying the interactions between motivation and other variables such as workplace trust relations are largely unknown. This dissertation is organised into three parts. Part A is the review protocol which outlines the background and the review methodology. A qualitative systematic review approach is adopted and literature search of the five chosen databases is conducted using keywords and phrases derived from the review question. Defined inclusion and exclusion criteria are used to identify and select suitable articles. An appropriate tool is then used to appraise selected articles which are then subjected to thematic analysis. Part B is a literature review of existing empirical and theoretical work on health worker motivation. It provides the background to the systematic review in Part C. It defines the word motivation as used in the health sector, and then explores empirical work on health worker motivation using an appropriate conceptual framework. The literature review further summarises and concludes on the possible link between trust and motivation in the health sector.
3

Exploring the influence of intersecting social identities on the leadership experience of female managers in the South African health system

Reddy, Mishka January 2020 (has links)
In the transition from the Millennium Development Goals to the Sustainable Development Goals, the importance of an integrated health system in which all health activities interact - including the multiple actors within the system - has gained greater recognition. In light of these transitions, the World Health Organisation and the Alliance for Health Policy and System Research called for a participatory leadership model, which engages with multiple health system actors in and out of the health system. It is a leadership model, which seeks to be inclusive of diverse and currently underrepresented stakeholders such as women. This leadership model is aligned with the gender equality movement in health leadership, which has rightfully gained global prominence over the last decade. However, it would be an oversimplification to assume all women in leadership positions have had to overcome similar obstacles. Treating women as a homogenous group tends to leave people out given the evidence that social identities culminate to produce unique experiences and therefore challenge feminist notions of the homogeneity of women. Drawing on data from a primary study on gender and leadership in South Africa, this study sought to explore the influence of gender, as it intersects with race and professional cadre, on the experiences of female health managers in the South African health system. The primary study noted that black females felt as though they were "left behind" throughout their leadership journey. This secondary analysis was undertaken using Bilge's intersectionality approach. It is a two-step qualitative analysis approach, which uses an understanding of intersectionality to extract data related to social identity and intersecting social identities. The analysis assessed 1) how gender, race and professional cadre discretely inform each participant's account and 2) how gender intersects with other social identities to create unique barriers for different women. It explored how intersecting identities might leave certain people behind - and how then to conduct health policy and systems research that can produce qualitative data necessary for creating formalised initiatives that address potential barriers. While recognising the enormous potential of participatory leadership, this study focused on the experiences of formally designated health managers who were able to reflect on their journey towards their current position and explain the barriers in this journey, related to their entangled social identities.
4

Assessing palliative care policies in Africa: Implication for paediatric palliative care

Ngowi, Epiphania 23 February 2021 (has links)
Around the world, there are millions of children who need palliative care from the moment they are diagnosed with life-threatening and life-limiting illnesses, yet very few children have access to palliative care services. In many African countries, where palliative care is still new, many children with chronic illnesses continue to experience needless pain and suffering. The World Health Assembly Resolution 67.19 made a clear call for governments around the world to implement palliative care policies. Such policies should support the “comprehensive strengthening of health systems to integrate evidence-based, costeffective and equitable palliative care services in the continuum of care, across all levels of care”. However, despite these frequent calls, no specific policies target the provision of paediatric palliative care in Africa. This dissertation consists of three parts. Part A is the study protocol, which consists of the introduction and the study methodology. The study is qualitative in nature and it adopted the Walt and Gilson framework for extraction of data and analysis of palliative care policies in Africa. The study used publicly available policy documents, which were identified and obtained from government websites, international agencies' websites and through communication with palliative care experts. An excel spreadsheet was used to extract data, which was analysed thematically. Part B is a literature review of available published and unpublished work pertaining to paediatric palliative care in Africa. It provides the historical background of palliative care and defines palliative care and paediatric palliative care as well as exploring the general literature on paediatric palliative care, and the evidence on the existence of palliative care policies in Africa. Part C is a journal manuscript. It follows the structure and guidelines of the journal of the Health Policy and Planning. The manuscript begins with introduction and the study methods. Further, the study used publicly available policy documents on palliative care in Africa published from 2002 until 2018. An appropriate conceptual framework was chosen, and the results of the policy analysis are provided and followed by the discussion section and conclusions. The study findings indicate that few palliative care policies exist in Africa, and children's palliative care needs are not adequately included and addressed. The findings further show that there was no single policy targeting paediatric palliative care, and children were included among the larger population. As such, palliative care needs were not sufficiently addressed. Only three policies (South Africa, Zimbabwe, and Malawi) clearly address paediatric palliative care needs. The study, therefore, argues that for children with life threatening and life-limiting conditions to be free from pain, African governments need to formulate specific policies that will guide the provision of paediatric palliative care. This study is likely contribute to policy making processes, acts as a reference document for academics and students and provides an advocacy tool for activists, nongovernmental organizations (NGOs), and civil society organizations (CSOs) working on children's welfare and human rights issues more broadly. Further, the findings of the study may contribute to formulating specific palliative care policies for children, particularly in African countries that lack such policies.
5

Attitudes and perception of healthcare workers in health facilities with regards to the 'Intention to Use' of the Road to Health Booklet (RtHB)

Khumalo, Nanziwe Kelly January 2016 (has links)
Introduction: That low and middle income countries (LMICs) are plagued with high burdens of disease and limited health resources is well documented in the literature. These two realities necessitate the availability of good quality and reliable information to enable the efficient distribution of recourses and services. Growing recognition of the importance of health information has seen the introduction of numerous health information systems (HIS). The goal of these HIS is to attain preventative and curative treatment for those that need them, in adequate quantities, promptly, reliably and at equitable cost. Amongst the variety of HIS is the Road-to-Health Booklet (RtHB) in South Africa. This is a paper-based, patient-held medical record given to new mothers, intended to monitor all contact children have with the healthcare system. Due to the dearth of local research and increasing need for strong HIS, more research is needed in the implementation of the HIS and its use by healthcare workers (HCWs) in the African context. Methods: The aim of this study is to explore and understand the influence HCWs' attitudes and perceptions have on the implementation of the RtHB within the Khayelitsha Sub-District of Cape Town, South Africa. A qualitative case study was conducted utilising in-depth interviews, naturalistic observations, document review and mind mapping to explore HCWs' attitudes and perceptions on the RtHB. A combination of purposive and snowball sampling was used to identify participants with insights on the RtHB.
6

A qualitative study on the experiences and perspectives of public sector patients in Cape Town in managing the workload of demands of HIV and type 2 diabetes co-morbidity

Matima, Rangarirai January 2016 (has links)
Health systems' strengthening is essential in South Africa in an era of the convergence of communicable and non-communicable diseases. Whilst TB is ranked first in all-cause mortality, non-communicable diseases which include cerebrovascular disease and diabetes mellitus follow; with HIV/AIDS in fourth place. In the Western Cape, diabetes mellitus and HIV are the top two causes of death accounting for 6.8% and 5.8% respectively (StatsSA, 2015b). As the burden of non-communicable disease continues to increase significantly due to more South Africans presenting these co-morbid conditions, the complexity of managing these chronic conditions has increased. The reorganisation of primary health services to better cater for patients with multiple chronic conditions has become an imperative in South Africa but still in its infancy. However, how chronic patients with multi-morbidities experience the current services and what their perceived needs are in order to enhance the management of their conditions both at point of healthcare and in their daily lives is not widely understood. Below, is an outline of the three parts presented in this dissertation. Part A is the study protocol, which gives a background of the intersection of communicable and noncommunicable diseases in South Africa, focusing on HIV and type two diabetes (hereafter HIV/T2D) co-morbidity. A qualitative design was employed. In-depth interviews were conducted with ten patients living with HIV/T2D co-morbidity and six health workers who interacted with these patients. Ethical considerations such as potential risks and benefits; confidentiality, autonomy and informed consent are also highlighted in the protocol. Part B is the structured literature review on chronic care in low and middle-income countries (LMICs). Two sub-sections are presented with the first focusing on LMICs excluding South Africa; and the second for South Africa only. Theoretical frameworks, which were applied to managing chronic conditions and empirical studies on HIV/T2D in these LMICs, are reviewed. Reference to the Cumulative Complexity Model (CCM), will also provide an indepth understanding of the prospects of strengthening the primary healthcare system in South Africa to address chronic conditions more effectively. Part C is the journal-ready manuscript of the data collected in the qualitative study. It consists of the background, methods, results, discussion and conclusions. Findings describe patients' experiences of the primary healthcare services and the daily challenges of living with and managing HIV and T2D among a sample of ten patients attending a clinic in Cape Town. Health worker perspectives on managing HIV/T2D co-morbidity are also presented. Both patients and healthworkers also shared strategies on how health interventions could be more responsive to HIV/T2D co-morbidity. Hence, further contributions are made in the knowledge base of strengthening chronic conditions. However, further research with different subsets of patients living with not only HIV/T2D but also other co-morbid or multi-morbid conditions is important for improvements in health policy-making in South Africa.
7

The impact of withdrawal of international non-governmental organisations from public health facilities: A case study of Tsholotsho district, Matabeleland North Province, Zimbabwe

Hamisi, Rashid 16 February 2022 (has links)
International non-governmental organisations (INGOs) play a critical role in improving the capacity of health systems to deliver services in sub-Saharan Africa (SSA), especially in fragile and conflict affected states (FCAS). Nonetheless, the sustainability of public private engagement (PPE) initiatives between health systems and INGOs is threatened by various factors including, decline in developmental and humanitarian assistance and a shift in policies and priorities. Consequently, many INGOs are exiting PPE initiatives. There is a lack of evidence about the process of withdrawal of INGOs from low- and middle-income countries and FCAS settings, in particular, how the nature of the withdrawal (beyond the basic loss of funds) affects the functioning of the health system, especially at lower levels of primary care. This mini dissertation presents a research protocol (Section A), and a journal formatted manuscript (Section B) for a case study of the impact of withdrawal of INGOs from public health facilities in Tsholotsho district, Matabeleland North Province, Zimbabwe. This study describes the process of withdrawal by three INGOs from PPE initiatives with Tsholotsho District Hospital (TDH). Understanding this process better and learning how public health facilities cope with the withdrawal of partner support, provides lessons on how to efficiently sustain the gains from PPE initiatives. In these three cases, PPEs were ended because of an ending of funds. Despite the existence of exit and sustainability plans, in all cases, the withdrawal process was fraught and difficult to navigate. There was a discrepancy between plans and what transpired during and after funding-withdrawal. The common issues that affected exit implementation included abruptness of the withdrawal by INGOs; lack of resources to sustain the intervention after withdrawal of funding; and design, depth and scope of intervention. In addition, lack of clear regulatory mechanisms that shape PPE initiatives and govern the withdrawal of partners from public facilities also affected the process. Due to these factors, the interventions either stopped or continued at a drastically reduced scale. Withdrawal of partners, especially in FCAS, has dire implications for the health system, and need to be managed with much greater attention given to (unintended) consequences to the health system and its resilience. Health system assessments and analytics should be performed by expert independent parties prior to the ending of PPEs, which would enable context-specific withdrawal plans that might aid in mitigating future difficulties.
8

Mapping the multiple intersectoral spaces for civil society participation and responsiveness strengthening in the South African health system – focusing on the Western Cape

Whiting, Amy 22 March 2022 (has links)
Since the Alma Ata Declaration of 1978, community participation in health policy development and health system functioning has called for a collaborative intersectoral approach, engaging civil society as a pivotal agent for improving policy-makers' responsiveness in the public health system. Intersectoral approaches are widely accepted and research has shown the value in engaging communities in the improvement of their health. However, astonishingly little is known about the overall configuration, nature, and focus of the ‘spaces' where civil society are participating in health system-relevant engagement, or their contribution towards improved system responsiveness. This study describes a local provincial health system, the Western Cape province in South Africa, mapping the intersectoral spaces where civil society participates in the health system, provides feedback to the system (towards responsiveness), and contributes to health system improvement decisions. A mixed method case study was conducted, integrating desk-based review of multiple forms of openly available data, with verification from experts in the field. Sixteen intersectoral spaces in the Western Cape health system were mapped and compared, with analysis focussing on current governance practices in these spaces, evidence of accountability measures and civil society participation within the broader goal of improving health system responsiveness. Multiple spaces exist for intersectoral engagement in the Western Cape of South Africa, but there is a lack of any ‘system-wide' integrative approach – which creates overlap, a focus on vertical programming, and parts of civil society remain ‘disconnected' from the system. Feedback from civil society back into national or provincial policy-making processes is sporadic due to fragmented tiered governance. New efforts towards ‘whole-system' intersectoral collaboration need to be initiated and actively protected, if they are to succeed. This study demonstrates that while ‘intersectoral action for responsiveness strengthening' is broadly encouraged in this health system, it needs to be more fully assessed and operationalised in terms of multilevel governance, accountability and civil society empowerment. In doing so avenues can be identified for improving civil society's feedback into the public health system, and ensuring adequate system's response to this feedback, in health policy and practice.
9

Factors that affect uptake of community-based health insurance in low- and middle- income countries: a systematic review

Adebayo, Esther January 2014 (has links)
Includes abstract. Includes bibliographical references.
10

The effectiveness of school-based interventions addressing adolescent mental health in Low- and Middle-Income Countries: A Systematic Review and Meta Analysis

Albertus, Cleo Alyssa 09 September 2020 (has links)
Mental health is fundamental to a person's wellbeing and quality of life, as well as, influences social and economic outcomes across an individual's lifespan (Barry, Clarke, Jenkins, & Patel, 2013). The World Health Organization (WHO) defines mental health as a “state of well-being in which an individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and is able to make a contribution to his or her community” (WHO, 2018). Mental health is considered integral to a person's overall wellbeing and can be determined by a variety of factors such as socioeconomic, environmental and biological (WHO, 2018). Mental health disorders are considered one of the most common causes of disability worldwide, thus resulting in the disease burden of mental illness being an important public health concern (ODPHP, 2019). Mental illness refers to all diagnoseable mental disorders and conditions, which result in significant emotional, social and behavioural changes that cause distress and hamper the individual's ability to function in everyday life (Pareketh, 2018).

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