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Best practice guidelines to monitor and prevent morbidity and mortality related to gestational diabetes mellitus in Addis Ababa, Ethiopia / Dintlhakaelo tsa tiriso e e gaisang ya go tlhokomela le go thibela ditshwaetsego tsa bomme le dintsho tse di golaganeng le bolwetsi jwa sukiri (diabetis mellitus) jwa baimana kwa Addis Ababa, EthiopiaGetahun Sinetsehay Alemayehu 08 1900 (has links)
Text in English with abstracts and keywords in English and Setswana / Aim: The purpose of the research was to determine the magnitude and factors associated
with gestational diabetes mellitus (GDM), and to explore the experiences of
gynaecologists/obstetricians and midwives in the monitoring and prevention of GDM- related
adverse maternal outcomes in order to propose best practice guidelines which may be
implemented to overcome the problem.
Methods: A concurrent mixed methods design was used. Participants for the quantitative
study were selected using systematic random sampling, with purposive sampling being used
for the qualitative part of the study. A total of 2000 medical records were reviewed using a
checklist, in addition to which 7 gynaecologists/obstetricians and 12 midwives were
interviewed using an in-depth interview guide. Descriptive and inferential statistics were used
for the quantitative part, while Colaizzi’s manual qualitative data analysis method wasused
for the qualitative part of the study.
Findings: The magnitude of GDM was found to be 2.2%. Age and family history of diabetes
mellitus were found to be factors associated with GDM (at p < 0.001). Other factors such as
obesity, previous GDM, previous history of fetal macrosomia and multiple gestations were
identified by respondents as factors related with GDM. In addition, the study explored the
experiences of health professionals (HPs) in the monitoring and prevention of adverse maternal outcomes related to GDM, with the results showing some differences in screening
and diagnostic techniques. It was also shown that lifestyle modification (physical exercise,
diet management) and medication were utilised for managing women with GDM. In this
regard, all the HPs agreed that creating awareness is the best intervention for preventing
GDM as well as its adverse maternal outcomes.
Conclusions: The magnitude of GDM is increasing, and much needs to be done to draw
attention to the burden that GDM places on the health of pregnant women and the public.
Since GDM is not considered a public health problem, little is being done to monitor the
condition and its adverse maternal outcomes. It is hoped that the best practice guidelines
developed from this research study may assist in reducing the adverse maternal outcomes
of GDM in Ethiopia / Maikaelelo: Lebaka la patlisiso e ne e le go tlhotlhomisa go nna teng le mabaka a a
golaganeng le bolwetsi jwa sukiri jwa baimana (GDM), le go tlhotlhomisa maitemogelo a
dingaka tsa malwetsi a basadi (gynaeologists/ obstetricians) le babelegisi mo go
tlhokomeleng le go thibeleng ditlamorago tse di maswe mo baimaneng tse di amanang le
GDM gore go tshitshinngwe dintlhakaelo tse di gaisang tse di ka diragadiwang go fenya
bothata.
Mekgwa: Go dirisitswe thadiso ya mekgwa e e tlhakantsweng. Banni-le-seabe ba
thutopatlisiso e e lebelelang dipalopalo ba ne ba tlhophiwa go diriswa go tlhopha sampole
ka go se latele thulaganyo, mme go tlhopha sampole ka maikaelelo go ne ga diriswa mo
karolong ya thutopatlisiso e e lebelelang mabaka. Go sekasekilwe palogotlhe ya direkoto tsa
kalafi tse 2 000 go diriswa lenanetshekatsheko, mme mo godimo ga moo, go ne ga nna le
dipotsolotso le dingaka tsa malwetsi a basadi di le supa le babelegisi ba le 12 go diriswa
kaedi ya dipotsolotso tse di tseneletseng. Dipalopalo tse di tlhalosang le tse go sweditsweng
ka tsona di ne tsa diriswa mo karolong ya dipalopalo ya thutopatlisiso, fa go dirisitswe
mokgwa wa ga Colaizi wa tokololo ya data ya mabaka mo karolong e e lebelelang mabaka.
Diphitlhelelo: Go nna teng ga GDM go ne ga fitlhelwa e le 2.2%. Dingwaga le hisetori ya bolwetsi jwa sukiri ya baimana mo lelapeng di fitlhetswe e le dintlha tse di golaganeng le
GDM (ka p < 0.001). Dintlha dingwe, jaaka go nona phetelela, GDM mo nakong e e fetileng,
go nna teng ga macrosomia ya masea mo nakong e e fetileng le boimana jwa masea a feta
bongwe di ne tsa supiwa ke batsibogi jaaka dintlha tse di golaganeng le GDM. Go tlaleletsa
foo, thuto e ne ya sekaseka maitemogelo a baporofešenale ba boitekanelo (HPs) mo
tlhokomelong le thibelo ya ditlamorago tse di sa siamang mo baimaneng tse di golaganeng
le GDM, mme dipholo di bontshitse dipharologano dingwe mo dithekeniking tsa
go sekirina le go phekola. Go bonagetse gape gore phetolo ya mokgwa wa botshelo
(katiso ya mmele, tsamaiso ya mokgwa wa go ja) le kalafi di ne tsa diriswa go laola bolwetsi
jwa basadi ba ba nang le GDM. Mo lebakeng le, baporofešenale botlhe ba boitekanelo ba
ne ba dumelana gore go dira temoso ke tsereganyo e e gaisang ya go thibela GDM ga
mmogo le ditlamorago tsa yona tse di sa siamang mo baimaneng.
Ditshwetso: Go nna teng ga GDM go a oketsega, mme go tshwanetse go dirwa go le gontsi
go lemosa ka mokgweleo o bolwetse jono bo o bayang mo boitekanelong jwa baimana le
setšhaba. Ka ntlha ya gore GDM ga e kaiwe jaaka bothata jwa boitekanelo jwa setšhaba,
ga go dirwe go le kalo go tlhokomela bolwetsi le ditlamorago tsa jona tse di sa siamang mo
baimaneng. Go solofelwa gore dintlhakaelo tsa tiriso e e gaisang tse di dirilweng mo
thutopatlisisong eno di ka thusa go fokotsa ditlamorago tse di sa siamang tsa GDM mo
baimaneng kwa Ethiopia. / Health Studies / D. Litt. et Phil. (Public Health)
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Financial accountability and reporting by governing bodies of public schools in South AfricaHlongoane, Moses Thabang 05 1900 (has links)
Abstract in English, Xhosa and Southern Sotho / This study was about the lack of uniform financial reporting guidelines to be used by South African School Governing Bodies (SGBs) in preparing their financial statements and financial records, which resulted in the inconsistencies and the lack of comparability in the financial statements of section 21 schools. The researcher aimed to develop recommended practice guidelines to be used by SGBs of public schools in South Africa when preparing their financial statements.
The research was conducted through a qualitative approach using document analysis, supplemented by individual interviews. Provincial guidelines and selected schools’ financial statements were analysed. Schools’ principals, finance officers, auditors, School Governing Body treasurers, as well as districts officials were interviewed. The participants were selected using a purposive sampling method.
Without generalising, the findings revealed that the existing provincial guidelines as well as the financial statements of the selected schools, are not consistent. The inconsistencies affect the comparability of the financial information negatively and that may also have negative impact on the reliability of financial information. The findings from the interviews, supported by the literature review, revealed that there is a need for uniform guidelines in terms of preparation of schools’ financial statements. The findings also revealed that the majority of SGBs opt for the examination of accounting records and financial statements instead of the audit thereof. Recommended practice guidelines were developed using information acquired through the literature review and the data acquired through document analysis and interviews. The study recommended amongst others that a further study be conducted on the effectiveness of financial management training in addressing the financial reporting challenges of South African public schools and whether the examination (instead of audit) of schools’ financial records and financial statements should still be acceptable. / Thutopatlisiso eno e batlisisitse go tlhokagala ga kaedi e e tshwanang ya dipegelo tsa ditšhelete e e ka dirisiwang ke Makgotlataolo a Dikolo tsa Aforikaborwa (diSGB) fa a baakanya dikanego tsa ona tsa ditšhelete mmogo le direkoto tsa ditšhelete, e leng se se bakileng gore go se nne le go tsamaelana le tlhaelo mo ntlheng ya tshwantshanyego ya dikanego tsa ditšhelete tsa dikolo tsa Karolo 21. Maikaelelo a mmatlisisi e ne e le go tlhama kaedi e e tlaa atlenegisiwang ya tiriso e e tlaa dirisiwang ke diSGB tsa dikolo tsa setšhaba mo Aforikaborwa fa di baakanya dikanego tsa tsona tsa ditšhelete.
Thutopatlisiso e dirilwe ka mokgwatebo o o lebelelang mabaka go dirisiwa tshekatsheko ya dikwalo, e tshegediwa ke dipotsolotso tsa batho bongwe ka bongwe. Go sekasekilwe kaedi ya porofense le dikanego tsa ditšhelete tsa dikolo tse di tlhophilweng. Go botsoloditswe bagokgo ba dikolo, batlhankedi ba ditšhelete, baruni, batshwaratlotlo ba Makgotlataolo a Dikolo, gammogo le batlhankedi ba dikgaolo. Bannileseabe ba tlhophilwe ka go dirisa mokgwa wa go tlhopha sampole ka maikaelelo.
Kwa ntle ga go akaretsa, diphitlhelelo di bontshitse gore kaedi ya ga jaana ya porofense gammogo le dikanego tsa ditšhelete tsa dikolo tse di tlhophilweng, ga di tsamaelane. Go tlhoka go tsamaelana go ama go tshwantshanyega ga tshedimosetso ya ditšhelete ka tsela e e bosula mme seo se ka ama go ikanyega ga tshedimosetso ya ditšhelete. Diphitlhelelo go tswa mo dipotsolotsong, di tshegediwa ke tshekatsheko ya dikwalo, di senotse gore go na le tlhokego ya gore go nne le kaedi e e tshwanang malebana le go baakanngwa ga dikanego tsa ditšhelete tsa dikolo. Gape bontsi jwa diSGB bo itlhophela gore go tlhatlhobiwe direkoto tsa palotlotlo le dikanego tsa ditšhelete go na le gore di runiwe. Go tlhamilwe kaedi ya tiro e e atlenegisiwang go dirisiwa tshedimosetso e e bonweng ka tshekatsheko ya dikwalo le data e e bonweng mo tshekatshekong ya dikwalo le dipotsolotso. Thutopatlisiso e atlenegisitse, gareng ga tse dingwe, gore go nne le thutopatlisiso e nngwe ya nonofo ya katiso ya botsamaisi jwa ditšhelete malebana le go samagana le dikgwetlho tsa dipegelo tsa ditšhelete mo dikolong tsa setšhaba tsa Aforikaborwa gammogo le go bona gore a tlhatlhobo (go na le boruni) ya direkoto tsa ditšhelete le dikanego tsa ditšhelete tsa sekolo e sa ntse e tshwanetse go amogelesega / Ndzavisiso lowu wu lavisise hi makombandlela ya ndlela yo fanana yo endla xiviko xa swa timali leswi swi faneleke ku tirhisiwa hi va Tihuvo ta Vufambisi bya Swikolo eAfrika Dzonga ku nga South African School Governing Bodies (SGBs) ku lulamisela switatimende swa timali na tirhekhodo ta timali, leswi nga vangela leswaku ku va na mafambiselo yo ka ya nga fanani na ku va swilo swi nga pimanyiseki kahle eka switatimende swa timali eka swikolo swa Xiyenge 21. Muendli wa ndzavisiso u ve na xikongomelo xa ku endla xibumabumelo hi maendlelo na makombandlela lama ya faneleke ku tirhisiwa hi ti-SGB ta swikolo swa mfumo eAfrika Dzonga, loko swi lulamisa switatimende swa timali.
Ndzavisiso wu endliwe hi ku landza fambiselo ra qualitative hi ku xopaxopa tidokumente, ku tlhela ku endliwa na mimburisano ya ti-interview na vanhu hi wun'we-wun'we. Makombandlela ya xifundzhankulu na switatimende swa timali swa swikolo swi xopaxopiwile. Ku endliwe mimburisano ya ti-interview na tinhloko ta swikolo (vaprinsipala), vaofisara va swa timali, vakamberi va swa timali (ti-odithara), vatameri va minkwama ya Tihuvo ta Vufambisi bya Swikolo (School Governing Body treasurers) xikan'we na vaofisara va tidistriki na vona ku endliwe mimburisano ya ti-interview na vona. Vokhoma-xiave va hlawuriwe hi ku tirhisa fambiselo ra sampuli ya xikongomelo ku nga purposive sampling method.
Handle ko navisa vuyelo eka hinkwavo, vuyelo byi kume leswo makombandlela ya xifundzhankulu na switatimende swa timali eka swikolo swo karhi, a swi fanani. Ku hambana swi endla leswo ku nga vi na ku fambelana na ku pimanyiseka ka vutivi bya swa timali, na swona swi na vuyelo byo ka byi nga ri kahle na ku tshembeka eka vutivi bya swa timali. Vuyelo eka mimburisano ya ti-interview, hi ku seketeriwa hi ku hlayiwa ka matsalwa, swi kombise leswo ku na xilaveko xa makombandlela ya ku fanana hi ku landza ku lulamisiwa ka switatimende swa ta timali lomu swikoleni. Vunyingi bya ti-SGB byi endla na nkambelo kunene wa tirhekhodi ta timali na switatimende swa timali ku tlula ku lava leswo ku endliwa nxopanxopo lowu fambisanaka na ku xopaxopa vumbhoni bya swa matirhiselo ya timali ku nga auditing ya tibuku ta timali. Makombandlela lama ya bumabumeriwaka ya endliwe hi ku tirhisa vutivi lebyi nga kumeka eka ku hlayiwa ka matsalwa na data leyi nga kumeka hi ku xopaxopa tidokumente na mimburisano ya ti-interview. Ndzavisiso wu bumabumela, exikarhi ka swin'wana leswo ku endliwa ndzavisiso wun'wana hi ku tirheka ka vuleteri bya mafambiselo ya swa timali eka ku langutana na mintlhontlho leyi nga kona hi ku vika hi swa timali eswikolweni swa mfumo eAfrika Dzonga, no kumisisa leswo xana nkambelo kunene (ku nga ri nxopanxopo lowu xopaxopaku na vumbhoni ku nga auditing) ya tirhekhodo ta timali na switatimende swa timali swa ha fanela ku amukeriwa xana / College of Accounting Sciences / D. Phil. (Accounting Sciences)
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