Thesis (M.S.)--Boston University

Boston University. University Professors Program Senior theses. / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / 2031-01-02

Boston University. University Professors Program Senior theses. / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / 2031-01-02

No description available.

Health policy reforms have dominated health systems in African countries for over three decades. However, the impacts of these policies on nurses’ work, as well as the extent to which the nurses are involved in the policy decisions, have not been well documented. As the largest group of health professionals in the workforce, nurses’ services are necessary to achieve population health outcomes. Thus, nurses’ work concerns related to the reform of national policies should be identified and addressed. This study was carried out to examine how the national policy reforms have impacted on nurses’ work in Kenyan district health care systems and how nurses have been involved in policy processes in the health care system. Critical theory and feminist critical policy analysis perspectives guided the study. The study was implemented in two phases. The first phase involved qualitative interviews with 32 decision makers and nurses in the public health care system. The second phase involved a comparative quantitative survey of nurses and nurse managers in two districts. A sample of 169 nurses was interviewed in two district hospitals to generate data for this second phase of the study. This thesis contains three manuscripts. The first manuscript presents a qualitative analysis of the impact of policies on nurses’ work (Chapter 2). The second manuscript presents qualitative results of how nurses were involved in policy processes at various levels of the health care system (Chapter 3). The third manuscript presents results of a quantitative survey of frontline nurses’ experiences with the policy reforms, comparing two districts (Chapter 4). An integrative discussion of key findings from all these manuscripts forms the last chapter of the thesis. The findings revealed that policies meant to enhance access to services like decentralization and primary health care were more enabling to nurses’ work while those aimed at enhancing efficiency like structural adjustment programs were more constraining. The constraints included poor work environments, unchanging work conditions, increased responsibilities and dilemmas in providing care. These constraints were experienced more by nurses in the district that was poorly resourced and had poor health indicators than the district that had better resources and better health indicators. The results suggest that inadequate involvement of nurses in policy processes is a reason why their work concerns have not been addressed. There are recommendations to improve nurses’ work in the context of policy reform and to improve nurses’ abilities to participate in policy processes.

Health policy reforms have dominated health systems in African countries for over three decades. However, the impacts of these policies on nurses’ work, as well as the extent to which the nurses are involved in the policy decisions, have not been well documented. As the largest group of health professionals in the workforce, nurses’ services are necessary to achieve population health outcomes. Thus, nurses’ work concerns related to the reform of national policies should be identified and addressed. This study was carried out to examine how the national policy reforms have impacted on nurses’ work in Kenyan district health care systems and how nurses have been involved in policy processes in the health care system. Critical theory and feminist critical policy analysis perspectives guided the study. The study was implemented in two phases. The first phase involved qualitative interviews with 32 decision makers and nurses in the public health care system. The second phase involved a comparative quantitative survey of nurses and nurse managers in two districts. A sample of 169 nurses was interviewed in two district hospitals to generate data for this second phase of the study. This thesis contains three manuscripts. The first manuscript presents a qualitative analysis of the impact of policies on nurses’ work (Chapter 2). The second manuscript presents qualitative results of how nurses were involved in policy processes at various levels of the health care system (Chapter 3). The third manuscript presents results of a quantitative survey of frontline nurses’ experiences with the policy reforms, comparing two districts (Chapter 4). An integrative discussion of key findings from all these manuscripts forms the last chapter of the thesis. The findings revealed that policies meant to enhance access to services like decentralization and primary health care were more enabling to nurses’ work while those aimed at enhancing efficiency like structural adjustment programs were more constraining. The constraints included poor work environments, unchanging work conditions, increased responsibilities and dilemmas in providing care. These constraints were experienced more by nurses in the district that was poorly resourced and had poor health indicators than the district that had better resources and better health indicators. The results suggest that inadequate involvement of nurses in policy processes is a reason why their work concerns have not been addressed. There are recommendations to improve nurses’ work in the context of policy reform and to improve nurses’ abilities to participate in policy processes.

No description available.

Syftet med denna uppsats var att undersöka hur pedagoger i Kenya använder lek i sin undervisning samt deras syn på användandet av lek i undervisningen. Vi använde oss av observationer och intervjuer för att få svar på våra frågeställningar.  Observationerna gjordes av en pedagogs arbetssätt för att ta del av hennes olika undervisningssätt. Därefter gjorde vi intervjuer med pedagoger för att ta reda på deras tankar och åsikter kring lek i undervisningen.   Vårt resultat visade att pedagogerna använde sig av lek i undervisningen med en variation av olika estetiska undervisningssätt. Bland annat gestaltning, sång och rörelse, variation av röstlägen samt bearbetning av olika begrepp under observationerna. Pedagogerna var överens om att leken är viktig i förskolan och därför användes den kontinuerligt i undervisningen. De var alla enade om att leken hjälper barnen att utvecklas, och att den är nödvändig för lärande.

Diss.--Institut für Afrikanistik--Universität zu Köln, 1995. / Bibliogr. p. [141]-152. Index.

Reproduction de : Thèse de doctorat : Géographie, aménagement et urbanisme : Lyon 2 : 2005. / Titre provenant de l'écran-titre. Bibliogr. Annexes.