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.

Waste from healthcare facilities or similar facilities includes components of various physical, chemical and biological character that require special approaches during the handling, specifically with regard to possible risks to human health and the environment. Nowadays a challenge for waste management system becomes waste produced in healthcare facilities and contributes too many reasons, such as population growth and rising life expectancy. The rate of waste production from healthcare facilities depends on the facility type, its specialty, inpatient capacity, level of amenities and location. Waste from healthcare facilities need to be sorted and removed to avoid endangering the health of patients, healthcare workers and the environment. The aim of the study was to describe and compare the waste management systems in healthcare facilities between Czech Republic and Kazakhstan. Within the work was performed statistical analysis of the healthcare waste generation in the selected region of Kazakhstan. The results show that the only factor that affects the rate of waste generation is inpatient capacity of healthcare facility. It was also found that the production of healthcare waste differs significantly between ambulatory and stationary care facilities. The research results show that public...

Tuberculosis is a health threat, globally, in Africa, South Africa as well as in the North West Province. Although a number of positive interventions have been implemented, like the introduction of direct observation treatment strategy, still tuberculosis remains a threat. This may be due to the fact that while interventions to fight tuberculosis have been formulated and implemented, the most important resource in the Department of Health, which are nurses. Nurses working in the tuberculosis programme who play a vital role in the implementation of the health strategy are left behind and not given the proper support that they need to ensure the implementation of the health strategy. Nurses need to receive physical, emotional and social support from management so that they can give quality care to their patients. The purpose of this study was to explore the support from management to nurses working in the tuberculosis programme in the primary health care facilities at the Matlosana sub-district so as to make recommendations to management with the aim of improving the nurses’ work life and consequently rendering quality care to the tuberculosis patients. The research was conducted in the Matlosana sub-district in the North West Province of South Africa. A qualitative research design was used to explore and describe the support by management to nurses working in the tuberculosis programme in the primary health care facilities. A purposive voluntary sampling method was used to select participants who met the set criteria. In depth Semi structured interviews were conducted. Data was captured on an audio recorder, and transcribed verbatim. The researcher and the co-coder analysed the data after data saturation was reached. A consensus was reached on the categories that emerged. The results showed that most facility managers lack knowledge about tuberculosis making it difficult for them to support nurses working in the tuberculosis programme. The lack of support resulted in the arousal of feelings such as frustration, feeling undermined, feeling unnoticed and unappreciated. It also resulted in resistant behaviours such as underperformance, loss of interest in their work, wanting to leave to where they will be supported and reluctance to take annual leave due to fear of piling work. However, few participants reported supportive experiences from both their facility managers and from the tuberculosis coordinator. Recommendations were made for the field of nursing education, community health nursing practice and nursing research with the aim of improving the nurses’ work life and consequently rendering quality care to the tuberculosis patients. / MCur, North-West University, Potchefstroom Campus, 2013

Tuberculosis is a health threat, globally, in Africa, South Africa as well as in the North West Province. Although a number of positive interventions have been implemented, like the introduction of direct observation treatment strategy, still tuberculosis remains a threat. This may be due to the fact that while interventions to fight tuberculosis have been formulated and implemented, the most important resource in the Department of Health, which are nurses. Nurses working in the tuberculosis programme who play a vital role in the implementation of the health strategy are left behind and not given the proper support that they need to ensure the implementation of the health strategy. Nurses need to receive physical, emotional and social support from management so that they can give quality care to their patients. The purpose of this study was to explore the support from management to nurses working in the tuberculosis programme in the primary health care facilities at the Matlosana sub-district so as to make recommendations to management with the aim of improving the nurses’ work life and consequently rendering quality care to the tuberculosis patients. The research was conducted in the Matlosana sub-district in the North West Province of South Africa. A qualitative research design was used to explore and describe the support by management to nurses working in the tuberculosis programme in the primary health care facilities. A purposive voluntary sampling method was used to select participants who met the set criteria. In depth Semi structured interviews were conducted. Data was captured on an audio recorder, and transcribed verbatim. The researcher and the co-coder analysed the data after data saturation was reached. A consensus was reached on the categories that emerged. The results showed that most facility managers lack knowledge about tuberculosis making it difficult for them to support nurses working in the tuberculosis programme. The lack of support resulted in the arousal of feelings such as frustration, feeling undermined, feeling unnoticed and unappreciated. It also resulted in resistant behaviours such as underperformance, loss of interest in their work, wanting to leave to where they will be supported and reluctance to take annual leave due to fear of piling work. However, few participants reported supportive experiences from both their facility managers and from the tuberculosis coordinator. Recommendations were made for the field of nursing education, community health nursing practice and nursing research with the aim of improving the nurses’ work life and consequently rendering quality care to the tuberculosis patients. / MCur, North-West University, Potchefstroom Campus, 2013

Thesis(M.P.H.M.(Primary Health Care Management))--Mahidol University, 2005.

Thesis (M.P.H.M. (Primary Health Care Management))--Mahidol University, 2005.

Die Bedeutung von Prävention und somit die Vorbeugung von Erkrankungen hat in den letzten Jahren nochmals deutlich zugenommen. Die Krankheitslast beruht dabei erheblich auf beruflich bedingten Ursachen. Als die häufigsten betrieblichen Gesundheitsgefahren gelten Hauterkrankungen. Die Versorgung mit Hautschutz in den Betrieben stellt immer noch eine Herausforderung dar. In besonderem Maße betrifft die Problematik der berufsbedingten Hauterkrankungen die Gesundheitseinrichtungen, da dort typische Berufsgruppen mit hautbelastenden Tätigkeiten beschäftigt sind und dieser Sektor außerdem überdurchschnittlich hohe Krankenstände aufweist. Deshalb ist der langfristige Erhalt der Arbeitsfähigkeit von Mitarbeitern durch eine professionalisierte betriebliche Prävention zwingend notwendig. Es herrscht Einigkeit darüber, dass die Realisierbarkeit sowie das Ausmaß der Anwendung von Präventionsaktivitäten maßgeblich von der Grundhaltung der Entscheidungsträger/innen abhängen. Gegenstand der vorliegenden Arbeit ist demnach die Generierung eines umfassenden Einblicks in die Einstellungen von Entscheidungsträgern in Einrichtungen der Gesundheitswirtschaft, bezüglich der Bedeutung und des Einsatzes betrieblicher Präventionsmaßnahmen am Beispiel von Fällen beruflicher Hauterkrankungen. Die Studie fokussiert sich grundsätzlich auf zwei Analysebereiche: Zum einen wird ermittelt, wie der bisherige „Status quo“ in den Gesundheitseinrichtungen aussieht und was künftig seitens der Entscheidungsträger/innen wünschenswert und als wichtig erachtet wird. Zum anderen erfolgt im Anschluss an diese Ergebnisdarstellung die Hypothesenbildung und -prüfung, um zu eruieren, welche Einflussfaktoren auf die Einsatzintensität von einschlägigen Präventionsmaßnahmen wirken. Es lässt sich als Fazit ziehen, dass die Entscheidungsträger/innen maßgeblichen Einfluss auf die zum Teil durchaus komplexen Herausforderungen bezüglich der eingesetzten Präventions- und Arbeitsschutzmaßnahmen in den Gesundheitsbetrieben haben. Als Handlungsempfehlung kann daher festgehalten werden, dass hinsichtlich der Erreichbarkeit von Präventionsmaßnahmen zwingend diese Zielgruppe hiervon überzeugt werden muss. Die Befragungsergebnisse zeigen, dass die Intensität des Präventionseinsatzes im Hautbereich dabei in großem Maße von der individuellen Persönlichkeit und des Eigenengangement des jeweiligen Personalverantwortlichen abhängt. Auch wird deutlich, dass verstärkte Anstrengungen und Kooperationen mit verschiedenen Stakeholdern durchaus lohnenswert und erfolgsversprechend sind. Des Weiteren wird aus den erzielten Resultaten ersichtlich, dass die beteiligten Anspruchsgruppen der Gesundheitsunternehmen bei der Gestaltung und Implementierung der hautpräventive Maßnahmen die Einfachheit in das Blickfeld rücken sollten. Präventionsanstrengungen werden seitens der Unternehmensverantwortlichen nur dann zunehmend akzeptiert, wenn sie einen zielgerichteten Einsatz ihrer finanziellen Mittel für einschlägige Maßnahmen sehen und sich deren Durchführung nicht zu komplex gestaltet. Abschließend kann zusammenfassend konstatiert werden, dass der Einsatz professioneller Präventionsmaßnahmen für heutige Einrichtungen essentiell ist und in Zukunft sicherlich noch mehr an Bedeutungszuwachs erfährt. Hierfür spricht vor allem die absehbare Entwicklung des künftig noch stärker werdenden Personalmangels im Gesundheits- und Sozialwesen. Außerdem sollte der Optimierung des persönlichen Hautschutzes in den Gesundheitsbetrieben eine größere Bedeutung beigemessen werden, da häufig eine hinreichende Sensibilität für beruflich bedingte Hauterkrankungen noch nicht vorhanden ist sowie das Problem der zunehmenden Erkrankungen im Hautbereich aus Sicht des einzelnen Betriebes nicht evident erscheint.

The purpose of this study was to explore and describe the factors that motivate the Primary Health Care Nurses to render quality care in the Ekurhuleni Metropolitan Municipality Health Care Facilities (in the Northern Region). The Ekurhuleni Metropolitan Municipality is located in Gauteng, South Africa. To achieve this, a quantitative, descriptive research study was undertaken. A purposive and voluntary sample of (n=54) Primary Health Care Nurses with two or more years’ experience of working in the Ekurhuleni Metropolitan Municipality, in the Northern Region, participated in the study. Data was collected using structured questionnaires. Findings from the study indicated those factors that enhance the motivation of the Primary Health Care Nurses and those factors which may demotivate them. The findings further revealed the need for greater motivation for the Primary Health Care Nurses. Based on the study results, guidelines and recommendations were formulated according to the manner in which these nurses’ motivation may be implemented and improved / Health Studies / M. A. (Health Studies)

Health care associated infections cause major challenges to the provision of health care. This isdue to the burden placed on individuals, their families, and health services. Hand hygiene actions are cost effective measures towards reducing the spread of health care associated infections and have proven very effective in preventing microbial transmission during patient care. It has beenproven that health care workers hands are the main routes of transmission of health care associated infections. Despite this, hand hygiene is still frequently overlooked by health careworkers especially in settings with limited resources. This paper therefore explores hand hygieneknowledge and behaviours of public and private health care workers in The Gambia with focuson the health belief model. The required information has been gathered from 4 public and 2 private health care facilities through the use of a questionnaire based on the WHO evaluation toolkit. Hand hygiene knowledge of health care workers corresponded with their hand hygiene behaviour. Inadequate hand hygiene performance was noted in many health care workers as wellas limited availability of hand hygiene resources from health care facilities. Private health care facilities provided better hand hygiene opportunities for their health care workers yet neither private nor public health care facilities offered adequate hand hygiene training and feedback on hand hygiene performances to their health care workers.

Em todos os segmentos da sociedade, a utilização de equipamentos eletrônicos projetados e construídos com avançadas tecnologias eletrônicas e controlados por microprocessadores aumenta a cada dia. Na área de saúde, denominados de equipamentos eletromédicos, dão suporte aos setores de diagnóstico, tratamento ou, procedimento cirúrgico, melhorando a qualidade dos serviços e o atendimento aos pacientes. No entanto, o sucesso global do processo deverá considerar a qualidade das instalações elétricas nesses ambientes, bem como a qualidade da energia elétrica fornecida a esses equipamentos. Este trabalho tem como objetivo comprovar, por meio de pesquisa em laboratório, o risco de diagnósticos médicos baseados em informações fornecidas por equipamentos eletromédicos, alimentados em redes elétricas que não atendem às normas vigentes ou, totalmente perturbadas por outros equipamentos típicos dos ambientes médico-hospitalares. A metodologia aplicada consistiu em medições dos parâmetros referentes à qualidade de energia elétrica nos estabelecimentos assistenciais de saúde. Atenção especial foi dada ao conteúdo harmônico de tensão e aos afundamentos de tensão de curta duração produzidos por equipamentos de raios X, mamografia, tomografia computadorizada, ressonância magnética nuclear e motores elétricos de indução. Em seguida, essas perturbações foram reproduzidas em fontes de tensão específicas para essa finalidade, instaladas no Laboratório do Centro Tecnológico de Qualidade de Energia da Escola Politécnica da Universidade de São Paulo, conhecido como Enerq-ct. Equipamentos eletromédicos portáteis, gentilmente cedidos por diversos fabricantes nacionais, foram submetidos a esses sinais para verificação do seu desempenho. Os resultados obtidos demonstram a importância da qualidade de energia elétrica bem como, a qualidade dos serviços de manutenção nas instalações elétricas desses ambientes. / Through all segments of our society, there is a daily increase in the use of electronic equipment designed and built with advanced electronic technology and computerized control. In the health-medical area, designated electromedical equipment, they provide support to sectors in charge of diagnosis, treatment or surgical procedures, improving the quality of services and the manner patients are cared for. However, the global success of this process must take into consideration the quality of electrical installations at these facilities, as well as the electrical power supplied to the equipment. The aim of this work is to attest through laboratory research the risk of medical diagnoses based on information provided by electromedical equipment powered through electrical networks which do not meet the standards in effect, or which are completely disturbed by other equipment typical of electromedical environments. The methodology applied consisted of measurements of the parameters referring to the quality of electrical power in health care facilities. Especial attention was given to the voltage harmonic content and to short duration voltage sags caused by X-ray, mammography, computerized tomography and nuclear magnetic resonance equipment or by induction motors. Later, these disturbances were reproduced in power supplies which are specific to this objective, installed at Laboratório do Centro Tecnológico de Qualidade de Energia da Escola Politécnica da Universidade de São Paulo- Energy Quality Technological Center of the Technical School of the University of Sao Paulo , known as Enerq-ct. Portable electromedical equipment, kindly supplied by national manufacturers, were subjected to these signals for assessment of their performance. The results obtained demonstrate the importance of the quality of electrical power as well as the quality of maintenance of electrical installations within these environments.