殖民時期的香港一直被丛书新自由主義的經典例子。加上香港殖民政府的剝削本質，它一般不會提供廉價醫療服務給予普羅大眾。然而，儘管有「積極不干預主義」這口號，殖民政府仍然於香港留下了龐大公營醫療系統。為什麼龐大公營醫療系統與放任自由主義並存於二次世界大戰後的香港社會？ / 為了解答以上疑問，本研究將從一九六四年醫療改革，探討香港戰後醫療政策。本文認為，香港研究忽視了冷戰對香港公共衛生的影響。文獻回顧後，實證研究分為三部分。第一部分提出「衛生關注」(Sanitary Concern)不足以構成醫療改革的原因。第二部分通過文本分析，發現六十年代的主流報章不重視醫療改革，由此可見改革並非基於公眾的訴求。最後的部分從戰後政府檔案，發現長遠的公營醫療規劃沿於五十年代後期。同時，戰後公營醫療系統的擴張，更可能是因為殖民政府為了確保足夠的戰時緊急醫療服務，及防止左派利用社區診所滲透入基層。 / Hong Kong has been regarded as a textbook example of Neo Liberalism. The exploitative nature of a colonial government makes it unlikely for the colonial state to make commitment for low-cost medical services to the general public. However, the slogan of “positive non-interventionism notwithstanding, the strong public health sector in Hong Kong is also a colonial legacy. Why was such a state-centered medical system established in a laissez-faire society after the Second World War? / This thesis aims at investigating the 1964 hospital reform in Hong Kong to study the colonial governance and arguing that the Cold War factor has been neglected in the analysis of the medical-institutional change. After the literature review, there are three empirical sections to support this explanation. The first part finds that sanitary concern was not a strong reason for the reform. In the second part, a context analysis on newspaper during the 1960s shows that the hospital reform was simply neglected by most newspapers, which implies that the reform was not the direct result of public pressure. The final part looks into the long-term medical planning since the late 1950 and several related medical policies through different archives in order to demonstrate the impacts of Cold War’s politics on Hong Kong’s medical services provision. Evidences suggest that self-sufficiency of military-emergency medical services and control over the growing influence of left-wing community clinics could be a more convincing explanation for the reform. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Tang, Kai Yi. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2012. / Includes bibliographical references (leaves 156-165). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts also in Chinese. / Thesis/Assessment Committee --- p.i / Abstract --- p.ii / Acknowledgments --- p.iv / List of tables, graphs and figures --- p.v / Acknowledgments --- p.vii / Chapter Chapter One --- Introduction --- p.1 / Chapter 1.1 --- The 1964 medical white paper: the first commitment in the colonial history --- p.2 / Chapter 1.2 --- A state-centred medical system as a colonial legacy --- p.6 / Chapter 1.3 --- The research question --- p.8 / Chapter 1.4 --- Methodology --- p.10 / Chapter 1.5 --- The central argument and outline of the thesis --- p.12 / Chapter Chapter Two --- Literature Review --- p.14 / Chapter 2.1. --- Politics of health in Hong Kong: a sudden change from the voluntary sector to the state? --- p.14 / Chapter 2.2 --- The origin of public health in Britain, India and Singapore --- p.17 / Chapter 2.3 --- Inadequate explanations for the 1964 hospital reform --- p.19 / Chapter 2.4 --- The nature of the Colonial governance: laissez-faire or Interventionist? --- p.21 / Chapter 2.5 --- British Hong Kong: Lacking commitments to local community --- p.24 / Chapter 2.6 --- The partial vision of public health in the colony --- p.25 / Chapter 2.7 --- Financial conservatism, the Pound crisis and social reforms in Hong Kong --- p.29 / Chapter 2.8 --- “1967 riot“ and “MacLehose“ as a explanation for the post-War social reforms --- p.33 / Chapter 2.9 --- An alternative: Cold War, the colonial governance and social service provision --- p.37 / Chapter Chapter Three --- Sanitary concern, diseases and state interventions in Hong Kong: Did the epidemic matter again? --- p.44 / Chapter 3.1 --- The origin of sanitary concern in Victorian Britain --- p.44 / Chapter 3.2 --- Impacts and limitations of sanitary concern in Hong Kong --- p.48 / Chapter 3.3 --- The 1894 Plague as a turning point: the first expansion in the colonial medical system --- p.50 / Chapter 3.4 --- Shadow of sanitary concern after the War --- p.53 / Chapter 3.5 --- Health profile in Hong Kong: a gradual improvement? --- p.56 / Chapter 3.6 --- A epidemiological transition in infectious diseases since 1945 --- p.59 / Chapter 3.7 --- Conclusion: Did diseases really matter? --- p.64 / Chapter Chapter Four --- Public opinion on public health: a driving force to the reform? --- p.65 / Chapter 4.1. --- The political culture in post-war Hong Kong --- p.66 / Chapter 4.2 --- From the rise in telephone fees to a social event in newspapers --- p.69 / Chapter 4.3 --- A content analysis on newspapers in 1964 --- p.72 / Chapter 4.4 --- Most medical news: informative but not critical --- p.73 / Chapter 4.5 --- Hospital reform: simply ignored? --- p.77 / Chapter 4.6 --- Reform: a result of public pressure? --- p.81 / Chapter 4.7 --- A social event: “charity clinics problem“? --- p.84 / Chapter 4.8 --- Conclusion: an ignored reform by an active Chinese community? --- p.88 / Chapter Chapter Five --- Politics of public health in post-war Hong Kong: clinics, hospitals and the Cold War --- p.89 / Chapter 5.1 --- British in Cold War: to defend a valuable but vulnerable port --- p.90 / Chapter 5.2 --- Coincidence: A growing government medical sector since 1957 --- p.97 / Chapter 5.3 --- Planning since 1957: reserved lands, standard clinic design and Executive Council --- p.108 / Chapter 5.4 --- Planning in New Territories: a Heung Yee Kuk’s petition for a new hospital --- p.113 / Chapter 5.5 --- A forgotten alternative in medical financing: medical insurance schemes --- p.117 / Chapter 5.6 --- Politics between Hong Kong and London: Mayo Clinic --- p.120 / Chapter 5.7 --- Incinerators and generators: the role of civil hospitals in defence --- p.123 / Chapter 5.8 --- Civil hospitals in M.D.S.: to defend the indefensible Colony --- p.124 / Chapter 5.9 --- “Inconsistent planning: to defend Hong Kong without military hospitals? --- p.135 / Chapter 5.10 --- Threats from the communist: regulations on refugee doctors and charity clinics --- p.138 / Chapter 5.11 --- Conclusion: 1964, a year of no significance? --- p.144 / Chapter Chapter Six --- Conclusion --- p.145 / Chapter 6.1 --- Summary of arguments --- p.145 / Chapter 6.2 --- A reference point: Cold War’s politics and the medical reform in Singapore --- p.148 / Chapter 6.3 --- Implications on public health and Hong Kong studies --- p.152 / Chapter 6.4 --- Limitations and directions of further study --- p.153 / Reference --- p.156

Findings suggest that: (1) Public hospitals are turned into state-owned enterprises as they are encouraged to grow into larger size by management autonomy and financial regulatory reform, and the abandonment of the government on the control over management and hospital assets; (2) government abandons its financial responsibility towards public hospital workers and the latter need to use market mechanism to earn their income by cross-reimbursement of price and that devalues professionalism of these workers; (3) government abandons the subsidy to public hospitals through the reform of public hospital financial system; (4) the large higher-tiered public hospitals obtain their preferential rights through political advantageous position; (5) the reform of public hospitals is not at all one dimensional: public hospitals respond by active actions, aggregate breaking of rules and regulations, individual break-through, and no response. In summary, marketization, de-professionalization, diswelfare and market diversification contribute to the reverse triangle model of China's public healthcare system. / Key words: social policy, public hospital, marketization, de-professionalization, discriminated market. / Reform of China's public healthcare system is an extension of China's reform of its social welfare provision system. The above findings provide evidences on the economic rules, social relationships, and government actions in social welfare services as illustrated in the provision of health care by public hospitals in China. It is important reference for decision-makers in the new round of public service reform in the coming future. / Service providers are indispensable components of a social welfare system. Their performance is influenced by government policies and how service providers are active agents. Therefore, attaining the goals of social welfare services needs to consider the institutional arrangements for service providers. / Taking public health service in China as an example, this research answers why the public healthcare provision system in China turns out to be a reverse triangle structure, which is an anti-welfare model suggested by the World Health Organization. With a new institutionalism perspective, policy documents are used to study the effect of government intervention on public hospitals, and the interaction of government and public hospitals. / 馮文. / Submitted: 2010年12月. / Submitted: 2010 nian 12 yue. / Adviser: Chack-kie Wong. / Source: Dissertation Abstracts International, Volume: 73-04, Section: A, page: . / Thesis (Ph.D.)--Chinese University of Hong Kong, 2011. / Includes bibliographical references (p. 272-329). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [201-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts in Chinese and English. / Feng Wen.

Abstract not available

Several factors are driving the transition from paper-based health records to electronic health record systems. In the United States, the adoption rate of electronic health record systems significantly increased after "Meaningful Use" incentive program was started in 2009. While increased use of electronic health record systems could improve the efficiency and quality of healthcare services, it can also lead to a number of security and privacy issues, such as identity theft and healthcare fraud. Such incidents could have negative impact on trustworthiness of electronic health record technology itself and thereby could limit its benefits. In this dissertation, we tackle three challenges that we believe are important to improve the security and privacy in electronic health record systems. Our approach is based on an analysis of real-world incidents, namely theft and misuse of patient identity, unauthorized usage and update of electronic health records, and threats from insiders in healthcare organizations. Our contributions include design and development of a user-centric monitoring agent system that works on behalf of a patient (i.e., an end user) and securely monitors usage of the patient's identity credentials as well as access to her electronic health records. Such a monitoring agent can enhance patient's awareness and control and improve accountability for health records even in a distributed, multi-domain environment, which is typical in an e-healthcare setting. This will reduce the risk and loss caused by misuse of stolen data. In addition to the solution from a patient's perspective, we also propose a secure system architecture that can be used in healthcare organizations to enable robust auditing and management over client devices. This helps us further enhance patients' confidence in secure use of their health data.

This study examines the factors that have contributed to the success of some Central and Eastern European countries to improve their health care sector in the post communist period, while leaving others to its demise. While most literature has been focused on the political and economic transition of Eastern Europe, very little research has been done about the welfare aspects of the transition process, especially the health care sector. While the focus on political consequences and main macroeconomic reforms has shed light on many important processes, the lack of research of health care issues has lead to consequences on our ability to understand its impact on the future of the new democracies and their sustainability. This model looks at the impact of international (World Bank) and domestic institutions, corruption and public support and how they affect the ability of some countries to improve and reform their health care sector in the post-transition period.

The issue of national health care has actively plagued the 20th century political spectrum in both the U.S. and the United Kingdom. It has been an issue of astounding resilience and vexation, alluding almost all simple-quick answers while consuming an ever increasing amount of public resources. There have been three principal time periods when both the United States and Great Britain have actively addressed universal coverage: the 1910s; the 194Os; and the 1990s. This dissertation extends John Kingdon's theory on policy agenda formation by examining the aforementioned debates. The conclusions that come from this study are four fold. (1) Contemporaneous interactions can occur between nations. (2) Century-long longitudinal development of a single policy area is possible and is illustrated. (3) Kingdon's policy streams approach can be utilized to conduct a comparative analysis of the policy agenda formation process. (4) Kingdon's conceptual model is more accurate at depicting the policy agenda formation process of the British parliamentary system than it is for the divided government structure of the U.S. / Ph. D.

Thesis (MPA)--University of Stellenbosch, 2003. / ENGLISH ABSTRACT: The implementation of national policies is a key function of government through its various departments. This is very crucial in the health sector where lives of individuals are involved. The implementation of the national HIV/AIDS policy is very important in dealing with the epidemic. This study combined both quantitative and qualitative methods to analyse the implementation of the South African government’s national HIV/AIDS policy in the Vhembe District of the Limpopo Province. The quantitative phase involved the stratified sampling process, resulting in identifying 2 health workers from each of the 25 health units in the district comprising of 22 community clinics, the infection control unit, the counselling unit at the hospital and 2 from among the doctors. A total of fifty respondents were selected from a workforce of about 500. The staff profile indicates that 76 % of the health workers interviewed were below 40 years of age and 28% of them were chief professional nurses. Of the health workers, 78 % had been in the current position for between 1 and 5 years, 6 % for 6 to 10 years, 6 % for 16 or more years and 10 % for less than one year. All of them had a diploma as a minimum qualification, 8 % had 2 diplomas, 2 % had 3 or more diplomas, 2% had degrees and 2 % had a degree plus diplomas. In terms of HIV/AIDS policy implementation, 100% of all the facilities provided HIV prevention information to clients, 60% of these facilities worked with other organisations in HIV prevention, but only 4% had voluntary counselling and testing (VCT) services. In these health units only 28% had had staff trained regarding HIV/AIDS issues. In addition 96 % of the health units had the male condom stocked at any one time and only 12 % stocked the female condom. In terms of sexually transmitted diseases (STD) control, all clinics were using the syndromic approach in management of STDs and also claimed to have youth-friendly services. On the other hand only 80 % of the facilities had had staff trained in STD management using the syndromic approach. In the area of prevention of mother-to-child transmission of HIV, (PMTCT) none of the clinics had VCT services for pregnant women and only 8% of them had PMTCT counsellors. Because of the lack of VCT services only 4% of the clinics had known HIV positive mothers attending the antenatal care services. On the issue of post-exposure prophylaxis (P.E.P.) all clinics had protocols for this and 88% of them had antiretroviral drugs (ARVs) stocked for post-exposure treatment for health workers. However, only 8% of these clinics had a betadine douche as the only post-exposure intervention for raped women. In the area of treatment care and support for patients none of these clinics offered ARVs, 24 % had protocols for prevention and management of opportunistic infections, 4% were involved in any form of home-based care, 4% had HIV/AIDS dedicated services and 24% collaborated with community non-governmental organisations (NGOs) in HIV/AIDS care. The qualitative phase of the study highlighted what health workers perceived as prominent features of the national HIV/AIDS policy and these included prevention of HIV by use of condoms, faithfulness and pre-test counselling. The respondents also interpreted the social response by government to include provision of home-based care, care of orphans, food provision and safe guarding rights of victims. Other issues that were perceived to be part of the national HIV/AIDS policy were STD management, health education, provision of training to health workers in HIV/AIDS issues, provision of home-based care and occupational health and safety for health workers. The government was also perceived to have a negative attitude towards AIDS NGOs, not providing adequate numbers of the female condom and denying patients antiretroviral drugs (ARVs). The recommendations made on the basis of the study therefore include strengthening the training of health workers in HIV/AIDS care and management, improved provision of VCT services, wider distribution of the female condom, provision of prevention of mother-to-child transmission of HIV (PMTCT) services and the linking of research and care to provide evidence-based practice. Other recommendations are that there should be support programmes for health workers with HIV, addressing gender issues in implementation and provision of ARVs especially where it is already known that they help. / AFRIKAANSE OPSOMMING: Die implementering van nasionale beleid is ‘n sleutelfunksie van die regering, verrig deur sy onderskeie departemente. Dit is veral deurslaggewend in die gesondheidsektor waar die lewens van individue op die spel is en die implementering van die nasionale MIV/VIGS- beleid is baie belangrik in die hantering van die epidemie. In hierdie studie is beide kwalitatiewe en kwantitatiewe metodes gekombineer om implementering van die Suid-Afrikaanse regering se nasionale MIV/VIGS -beleid in die Vhembe-distrik van die Limpopo-provinsie te analiseer. Die kwantitatiewe fase het ‘n gestratifiseerde steekproefproses behels, wat gelei het tot die identifisering van 2 gesondheidswerkers uit elk van die 25 gesondheidseenhede in die distrik, bestaande uit 22 gemeenskapsklinieke, die infeksie-beheereenheid, die beradingseenheid by die hospitaal en die geledere van die dokters. So is ‘n totaal van 50 respondente geselekteer uit ‘n arbeidmag van ongeveer 500. Die personeelprofiel dui aan dat 76% van die gesondheidswerkers wat ondervra is jonger as 40 jaar was en dat 28% van hulle hoof professionele verpleegsters was. Van die gesondheidswerkers was 78% vir 1 tot 5 jaar in hul bestaande posisie , 6% vir 6 tot 10 jaar, 6% vir 16 of meer jare en 10% vir minder as 1 jaar. Almal van hulle het ‘n diploma as ‘n minimum kwalifikasie gehad, 8% het 2 diplomas, 2% het 3 of meer diplomas, 2% het grade en 2% het ‘n graad plus diplomas gehad. In terme van die MIV/VIGS beleidsimplementering het 100% van die fasiliteite MIV- voorkomingsinligting aan kliënte verskaf, 60% van hierdie fasiliteite in samewerking met ander organisasies , terwyl slegs 4% vrywillige berading en toetsdienste verskaf het. Slegs 28% van die gesondheidseenhede het oor personeel beskik met opleiding in MIV/VIGSkwessies. Verder het 96% van die gesondheidseenhede die manlike kondoom in voorraad gehad teenoor slegs 12% eenhede die vroulike kondoom. In terme van die seksueel-oordraagbare siektebeheer, het al die klinieke die sindroom-benadering in die bestuur van seksueel- oordraagbare siektes toegepas en het beweer dat hulle dienste jeugvriendelik is. Daarteenoor het slegs 80% van die fasiliteite beskik oor personeel wat opgelei was in seksueel- oordraagbare siektebestuur met toepassing van die sindroombenadering. Op die terrein van voorkoming van moeder- na- kind- oordraging van HIV het geen van die klinieke oor vrywillige berading en toetsdienste vir swanger vroue beskik nie en slegs 8% van hulle het wel moeder-na-kind– oordragingsberaders gehad. As gevolg van die gebrek aan vrywillige berading en toetsdienste het slegs 4% van die klinieke kennis gedra van HIV- positiewe moeders wat voorgeboortelike sorgdienste bygewoon het. Wat na-blootstellingsvoorbehoeding aanbetref, het alle klinieke protokolle gehad en 88% het antiretrovirale medisyne in voorraad gehad vir nablootstellingsbehandeling van gesondheidswerkers. Slegs 8% van hierdie klinieke het egter ‘n betadine-spoeling(“douche”) as die enigste nablootstelling intervensie vir verkragte vroue gehad. Op die gebied van die behandeling van en ondersteuning aan pasiënte het geen van hierdie klinieke die antiretrovirale medisyne aangebied nie, 24% het protokolle vir die voorkoming en bestuur van geleentheidsinfeksies gehad, 4% was betrokke in enige vorm van tuisgebaseerde sorg, 4% het oor MIV/VIGS -gerigte dienste beskik en 24% het met gemeenskapsvrywilligerorganisasies saamgewerk in die voorsiening van MIV/VIGS-sorg. Die kwalitatiewe fase van die studie fokus op wat gesondheidswerkers beskou as prominente kenmerke van die nasionale MIV/VIGS- beleid en wat insluit die voorkoming van HIV deur die gebruik van kondome, getrouheid en voortoets- berading. Die respondente vertolk die regering se sosiale reaksie as insluitend die verskaffing van tuisgebaseerde sorg, die versorging van weeskinders, voedselvoorsiening en die beveiliging van slagoffers se regte. Ander kwessies wat ook gesien word as deel van die nasionale MIV/VIGS beleid is seksueel- oordraagbare siektebeheer, gesondheidopvoeding, die verskaffing van opleiding aan gesondheidswerkers in MIV/VIGS-probleme, die voorsiening van tuisgebaseerde sorg en beroepsgesondheid en veiligheid vir gesondheids werkers. Die regering se houding teenoor VIGS vrywilligerorganisasies is ook as negatief vertolk deur onvoldoende hoeveelhede van die vroulike kondoom te verskaf en antiretrovirale medisyne te weerhou van pasiënte. Die aanbevelings wat op grond van die studie gemaak is, sluit in die verbeterde opleiding van gesonheidswerkers in MIV/VIGS-sorg en -bestuur, verbeterde verskaffing van vrywillige berading en toetsdienste, wyer verspreiding van die vroulike kondoom, verskaffing van MIV-dienste vir die voorkoming van moeder-na-kind-oordraging en die konnektering van navorsing en sorg om ‘n inligtingsbaseerde praktyk te skep. Ander aanbevelings is dat daar ondersteuningsprogramme vir gesondheidswerkers met MIV behoort te wees wat geslagskwessies aanspreek in die implementering en verskaffing van antiretrovirale medisyne waar dit reeds bekend is dat dit wel help.

Thesis (DPhil (Philosophy))--University of Stellenbosch, 2010. / ENGLISH ABSTRACT: This dissertation has two quite separate and rather different starting points. The first centres on the significant renaissance of virtue ethics as a moral theory that has occurred in the last 50 years. The second starting point is embedded in the recent discourse about the need for an ethical framework for public-health policymaking. (Up until now the ethical theories of deontology, manifested as either a ‘principlebased’ or ‘human-rights’ approach, and utilitarianism, have provided the theoretical background to this discourse.) When these two starting points fuse, the question arising – can character or virtue ethics contribute positively to the moral debates surrounding many vexing public-health issues? – seeks an answer. Broadly speaking, the ethics of public-health policymaking deals with ethical issues that occur within the macro-environment and that arise out of relationships between entities other than individuals, for example, states, regions, institutions, etcetera, and the policies in terms of which these interactions are regulated. Public health ethics ‘seeks to find a balance between the notions of ‘common good’ or ‘public interest’ and individual autonomy. I plan to investigate whether a virtue-based ethics, -which is concerned with a notion of human flourishing that is not primarily atomistic but intricately linked to the mutual well being of others and to notions of what the ‘good life for man’ means within the context of a shared history and connectedness with fellow human beings,- could contribute positively to current ‘public health ethics’ discourse. I believe that an exploration of the ethical basis of public health decision-making, focusing particularly on virtue ethics, but also examining other approaches like utilitarianism, principlebased approaches and the human-rights approach, will make a positive and original contribution to this area of philosophical discourse. Chapter one is an introduction which provides the rationale and motivation for the dissertation and briefly introduces the layout of each subsequent chapter. Chapter two is a concept analysis of ‘public health’ and justifies why I argue that the concept of public health is contingent, and ought to be contingent on an inextricably linked, and context appropriate concept of social justice. In this chapter I clarify the scope of the concept of public health used for this dissertation. Chapter three is an in-depth literature review of virtue ethics and similarly the next chapter is a literature review of the current status of public health ethics. Chapter five is entitled “Virtue Ethics, Social Justice and Public health”. My overall aim in this dissertation is to consider if virtue ethics as a moral theory can contribute positively to the practice of public health and thus by inference to an underlying concept of social justice. This receives in-depth consideration in this chapter. In chapter six I explore virtue theory in relation to public health from various other perspectives. In particular I return to MacIntyre to consider his concept of a ‘practice’1 which I apply specifically to the domain of public health, exploring the concepts of “extrinsic goods” and “intrinsic goods”, and how they translate to the practice of public health. Chapter VII is entitled “Theory and Practice: Critical Perspectives”. In this chapter I explore the challenges of adapting philosophical theory to actual context. I focus particularly on the problems of public health policy within a Southern African context. I conclude this dissertation by conceding that while virtue ethics can indeed make a positive contribution in some respects, its applicability is largely limited to public health problems that pertain to specific localised contexts. It has very limited applicability as an ethical theory or framework for trans-global public health issues, and public health issues influenced by global politics and economics. / AFRIKAANSE OPSOMMING: Hierdie verhandeling het twee heeltemal afsonderlike en taamlik uiteenlopende uitgangspunte. Die eerste handel oor die beduidende oplewing in deugde-etiek as 'n morele teorie oor die afgelope 50 jaar. Die tweede uitgangspunt is veranker in die onlangse diskoers oor die behoefte aan 'n etiese raamwerk vir die bepaling van openbaregesondheidsbeleid. (Tot dusver het die etiese teoriee van deontologie, hetsy in die vorm van . 'beginselgegronde' of 'menseregte'-benadering, en utilitarisme as teoretiese grondslag vir hierdie diskoers gedien.) Wanneer hierdie twee uitgangspunte egter byeenkom, ontstaan die vraag: Kan karakter- of deugdeetiek 'n positiewe bydrae tot die morele debatte oor talle netelige openbaregesondheidskwessies lewer? Oor die algemeen handel etiek in die bepaling van openbaregesondheidsbeleid oor etiese kwessies in die makro-omgewing wat ontstaan vanuit die wisselwerking tussen entiteite anders as individue, soos state, streke en instellings, en die beleid wat hierdie wisselwerking reguleer. Openbaregesondheidsetiek is daarop uit om 'n balans te vind tussen die konsepte 'algemene welsyn' of 'openbare belang', en individuele outonomie. Hierdie ondersoek beoog om vas te stel of 'n deugdegegronde etiek 'n wat gemoeid is met 'n konsep van menslike welstand wat nie grootliks atomisties is nie, maar ten nouste verband hou met die onderlinge welstand van ander, en 'n begrip van 'die goeie lewe' in die konteks van 'n gedeelde geskiedenis en verbondenheid met ander mense 'n positief tot die huidige diskoers oor 'openbaregesondheidsetiek' kan bydra. Die navorser argumenteer dat 'n ondersoek van die etiese grondslag van besluitneming oor openbare gesondheid, met 'n bepaalde klem op deugde-etiek, dog ook 'n nuwe bydrae tot ander benaderings soos 'n utilitaristiese benadering, beginselgegronde benaderings en die menseregtebenadering, 'n positiewe en oorspronklike bydrae tot hierdie filosofiese diskoers (kan) lewer. Hoofstuk 1 bied 'n inleiding wat die beweegrede en motivering vir die verhandeling uiteensit, en verduidelik kortliks die uitleg van elke daaropvolgende hoofstuk. Hoofstuk 2 is 'n konseptuele ontleding van 'openbare gesondheid', en ondersteun die navorser se betoog dat die konsep van openbare gesondheid afhanklik is en afhanklik behoort te wees van . kontekstoepaslike begrip van sosiale geregtigheid wat onlosmaaklik daarmee verbind is. In hierdie hoofstuk word die betekenis en omvang van die begrip 'openbare gesondheid' soos dit in hierdie verhandeling gebruik word, ook verduidelik. Hoofstuk 3 bevat 'n omvattende literatuuroorsig van deugde-etiek, terwyl die daaropvolgende hoofstuk eweneens 'n literatuuroorsig van die huidige stand van openbaregesondheidsetiek behels. Hoofstuk 5 is getiteld 'Deugde-etiek, sosiale geregtigheid en openbare gesondheid'. Die oorkoepelende doelwit van hierdie verhandeling is om daaroor te besin of deugde-etiek as 'n morele teorie positief tot die praktyk van openbare gesondheid, en dus ook tot 'n onderliggende konsep van maatskaplike geregtigheid, kan bydra. Dit word omvattend in hierdie hoofstuk bespreek. In hoofstuk 6 ondersoek die navorser deugde-teorie met betrekking tot openbare gesondheid uit verskeie ander oogpunte. Die studie konsentreer in besonder op MacIntyre se konsep van . 'praktyk',2 wat bepaald op die gebied van openbare gesondheid toegepas word om so die begrippe 'ekstrinsieke goedere' en 'intrinsieke goedere', en hoe dit in die praktyk van openbare gesondheid omgesit word, te bestudeer. Hoofstuk 7, getiteld 'Teorie en praktyk: Kritiese perspektiewe', bevat . ondersoek van die uitdagings om filosofiese teorie by die werklike konteks aan te pas. Die navorser konsentreer veral op die probleme van openbaregesondheidsbeleid in Suider-Afrikaanse verband. Die verhandeling sluit af deur toe te gee dat, hoewel deugde-etiek inderdaad in sommige opsigte 'n positiewe bydrae kan lewer, die toepaslikheid daarvan grootliks tot openbaregesondheidsprobleme in bepaalde gelokaliseerde kontekste beperk is. Dit het 'n uiters beperkte nut as 'n etiek-teorie of raamwerk vir globale openbaregesondheidskwessies, en openbaregesondheidskwessies wat deur die wereldpolitiek en -ekonomie geraak word.

Policy is a rule to guide decisions and achieve rational outcomes while advocacy is a strategy to influence architects of decision making or policy makers when they make regulations and laws, distribute resources, and make other decisions that affect peoples' lives. The principal aims of policy advocacy as postulated by Kervatin in 1998 are to create policies, reform policies, and ensure policies are implemented. This study examines the role of civil society in policy advocacy, using the Treatment Action Campaign (TAC) as an example. Therefore, the study uses a content analysis method of data collection and analysis to explicate the various advocacy strategies employed by the Treatment Action Campaign to advocate for access to HIV/AIDs treatment in post-apartheid South Africa. The policy advocacy strategies of the TAC were investigated pertaining to the implementation of health policy on HIV/AIDS in South Africa. There are a variety of advocacy strategies employed by civil society organisations, such as discussing problems directly with policy makers, delivering messages through the media, or strengthening the ability of local organisations to advocate. These strategies are known as advocacy tools for planning successful advocacy initiatives. Most of them are clearly reflected in the case of the TAC organisation, which employed these strategies and others to advocate for HIV/AIDS policy change. / Thesis (M.Soc.Sc.)-University of KwaZulu-Natal, Pietermaritzburg, 2013.

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