To better understand Anglophone elderly experience in accessing health care services in a Francophone area, it is important to look beyond availability of healthcare services near their homes. This study explored factors such as language competence, preference, motivation, reaching and waiting times, as contributors to elderly people's choice. / A questionnaire designed for this study was administered to 199 males and females, aged 55 years and older, recruited from the only Anglophone Seniors' Centre in East-End Montreal. It was found that elderly people with limited French proficiency were more likely to travel out of their area for healthcare services, resulting in significantly longer average travel and waiting times. Of those who would have liked an interpreter, very few were actually able to get one. The most frequently expressed need was for more English or bilingual workers and services. / To improve access and enhance elderly people's quality of life, training and intervention programs need to be developed in collaboration with the government.

The convergence of compelling evidence that transmission of HIV from a pregnant woman living with HIV to her foetus can be significantly interrupted due to advances in antiretroviral and obstetrical interventions, and worrisome epidemiologic data documenting a rise in HIV infection among Canadian women, spurred the development in Canada and world wide of policies and programmes aimed at increasing the number of pregnant women who are tested for HIV. Responding to innovative therapy reducing perinatal HIV transmission risk by increasing the number of pregnant women who agree to test for HIV is clearly an important prevention objective. However, the process must be accomplished in a way that is of most benefit to the pregnant woman herself and in a way that does not compromise a pregnant woman's rights to the established Canadian principles of HIV counselling and testing. / Working with pregnant women in Ontario, the province with the highest level of HIV infection among Canadian women, this thesis articulates and interprets their experiences of prenatal HIV counselling and testing and details their perspectives on best practices. The pregnant women's evidence-based recommendations for the re-design of prenatal HIV testing programmes are provided. These unique data have important utility for federal and provincial policy makers as HIV counselling and testing policies and programmes that encompass and are grounded in pregnant womens' experiences and perspectives are likely to be maximally acceptable and thereby increase the number of pregnant women who can be apprised of prophylactic treatment to take care of their own health needs as well as those of their unborn children. / In order for pregnant women to increase control over their own health and that of their unborn children, there is clear value in all pregnant women being afforded the opportunity to know their HIV status. However, the voices of the women in this study suggest that the autonomy rights of pregnant women may well be at risk in a programme in which the current emphasis is on potential HIV infection of the foetus rather than on potential or actual infection of the pregnant woman.

Micro Finance Institutions are being advocated as vehicles to provide poor people with loans to start business enterprises. Micro Health Insurance is offered to insure against the risk of ill-health in the enterprise. An interesting aspect of this initiative is that it is donor driven to service the needs of the poor and the 'unbankable.' However, it was the researcher's considered view that it may not be easy to build a sustainable Micro Health Insurance Scheme for poorer people. The study thus sought to explore the possibility of developing a sustainable Micro Health Insurance Scheme in the context of acute poverty, free health care, the burden of HIV/AIDS and other diseases, the growing informal sector, erratic and unreliable incomes and the nature of risks faced by these prospective clients. To develop a thorough understanding of the subject matter, extensive reading was carried out. The researcher then designed an interviewer-administered questionnaire. The study had a total of 34 respondents, most of whom where members of a Financial Service Co-operatives, which are community-banking structures that provide a range of financial products for poorer people and those in the informal economy. It is clear from the study that these people are faced with a number of risks. There are several problems that may affect the possibility of building a sustainable health insurance scheme. The present study does not provide any statistical evidence but explores the theme of using the concept of risk and vulnerability to understand the poverty in which Micro Finance and Micro Health Insurance is located. The study provides an array of policy options that can be explored to provide for the health care needs of poorer people, as well as suggestions for future research. / Thesis (M.Dev. Studies)-University of Natal, Durban, 2003.

No abstract available. / Thesis (M.Med.)-University of Natal, 1986.

Although strategic planning is widely used in industry and has been adopted by many not-for-profit organisations, the Department of Health has been slow to realise the relevance of a strategic approach. This thesis uses a strategic planning approach to assess the Department of Health by examining the three interacting factors which influence organisational outcome, namely the external environment, the internal structure of the organisation and the planning process itself. A composite model or template which incorporates several well-known strategic instruments is proposed as well as an overview of the Australian national health system and these are then used as part of the strategic assessment of the Department's vision and mission. The results and recommendations of the assessment are presented in the thesis. / Thesis (MBA)-University of KwaZulu-Natal, 2005.

This dissertation has been motivated by the prolonged deficiency of access to advanced regimens of Antiretroviral drugs(ARVs) and efficient health services by people living with HIV/AIDS (PLWHA) in Zambia, a least developed Member of the World Trade Organisation (WTO). Zambia‘s reality of dire provision of health services particularly essential medicines persists despite the urgent need for sustainable access to ARV drugs in poor African countries worst affected by HIV/AIDS, having been accentuated in the international declaration on Trade Related Aspects on Intellectual Property Rights (TRIPS) and Public Health. Furthermore, under international human rights law of treaties, access to medicines including ARV drugs, has been recognised as a core component of the right to health and or life which needs to be progressively realised by governments, even in the advent of globalisation of domestic health services including provision of medicines. Whilst the Zambian government has highlighted lack of funds as the foremost impediment to efficient supply of health services particularly essential medicines. Conversely the WTO has pronounced lack of legal adoption of a plethora of flexibilities envisaged in its relevant international agreements by most poor Members, as the foremost impediment to fostering efficient public health service delivery including access to ARV drugs and therapy for PLWHA. Thus to assist in ascertaining whether the issue of deficient access to ARV drugs as a health service is as a result of legal unpreparedness in poor countries specifically Zambia; or whether it is due to provisions in the WTO trade agreements that foster globalisation of health services through liberalised trade in services and pharmaceutical patent protection of essential drugs. This dissertation will analyse the WTO‘s multilateral trade agreements and their legal impact on access to ARV drugs as a health service and a human right to health in Zambia. The foregoing analysis will be conducted through a desk review of literature on the subject, making use of paper and electronic sources. / Thesis (LL.M.)-University of KwaZulu-Natal, Durban, 2012.

This study was undertaken to investigate the practice of Traditional Birth Attendants (TBA) during pregnancy, labor, and the postpartum period. The overall goal of this study was to promote safe motherhood. This study was conducted in Abaqulusi, a sub-district of KwaZulu-Natal, Zululand Health District 26, in four rural communities. A descriptive design with structured interview schedule guided the process. A convenient sample of forty-eight actively practicing trained Traditional Birth Attendants and forty-eight mothers attended by these Traditional Birth Attendants were interviewed. Of these 48 TBAs 47 were women, and one interestingly, was a man. Their age range was from 20 to over 70. Fifty percent of the mothers attended by the TBAs were between 15 and 24 years old. This finding is significant because the result shows that most of the mothers who are attended and delivered by TBAs are a high risk group. Data generated was quantitatively and qualitatively analyzed. The study revealed that the TBAs attended the mothers during the pregnancy, labor, and postpartum periods. All TBAs examined mothers with their hands, gave education on the importance of good nutrition, child spacing, and follow up care. The study showed that during labor 100 % of TBAs deliver babies on the floor with an old blanket, in the lithotomy position and encouraged the mother to empty her bladder before and during labor. They wore gloves or plastic bags. They examined mothers before delivery was done. They measured the umbilical cord, tied it with string and cut it. They cleaned the baby's mouth, nose, and eyes with a clean cloth, and wrapped the baby up and put it near the mother. They delivered the placenta, checked it to see if all was out. They washed the mother and put her on her bed. During the postpartum period, 100 % of the TBAs visited the mother at her home for one week to assess and care for the mother and her baby. The TBAs examined the mother, checked the umbilical cord and bathed the baby. They educated the mother about breastfeeding, caring for her breast, and eating balanced meals to produce adequate breast milk. The study revealed that the mothers perceived the TBAs as caring. The mothers loved the TBAs because the TBAs were easily accessible, even at night. The conclusion reached in this study is that TBAs are of great value to the rural communities of South Africa. They need to be supported by the health professionals so thal tbeir practice can be recognized. They form part of the maternal and child health care. Their practice is indispensable. / Thesis (M.N.)-University of Natal,Durban, 2004.

This dissertation has explored the problem of a yawning gap between policy and the implementation of lay participation in health development activities in Ghana, using data from 577 households in 22 rural communities. / A Health Systems model has been applied to data, to explain relationships and four sets of variables--household need for health services, predisposing attributes, participatory patterns, enabling factors--on household use of available health facilities and services. / Overall, results indicate a complex interdependence of factors which influence modern health services use. A multiple regression procedure identifies the presence of children under 5 years, the household's perception of its influence in the community, household participation in community health-related activities, household socio-economic and educational levels, to be significantly related to services use. Results suggest that Need for services is Not a sufficient condition for the Use of available health services.

This study analyses the development of health care in Haiti as it has emerged from a syncretic cultural background. The historical bases of the social and cultural practices surrounding health and illness are described as four separately developing but interacting strands--domestic medicine, mercantile medicine, official medicine and Creole medicine. The thesis interprets this heterogeneity of health-care beliefs and practices using the theoretical concept of a disemic culture, in which diverse cultural codes interact, to provide occasions for the situational negotiation of health care. / Case studies of domestic groups suggest that the domestic unit is the determining factor of health status, and the necessary focus for health development policy. The resources of the health care system outside the domestic unit are shown to contribute little to the health status of the population.

This thesis considers the rationalization of health care in Canada. It focuses on the conflicting roles modern physicians play in our system, acting as both patient advocate and social agent. It begins by tracing the origin of both of these duties. It then examines the ethical, professional, and legal issues which arise in the limited circumstances where front-line physicians must participate in the rationing of health care. It offers a framework for resolving the double agent dilemma and states five interlocking recommendations which are the building blocks of the resolution.