No abstract available. / Dissertation (MPhyst)--University of Pretoria, 2006. / Physiotherapy / Unrestricted

MPH / Department of Public Health / See the attached abstract below

Results Based Financing (RBF) models are results oriented, linking performance indicators to incentives to motivate health workers to deliver quality care in anticipation of rewards attached to service delivery. The study sought to explore nurses’ views and experiences regarding the implementation of RBF in Zimbabwe with the aim of recommending measures to strengthen the programme. The researcher used a qualitative, exploratory and descriptive design in this study. The population of this study comprised 21 nurses. Non-probability purposive sampling was used to select professional nurses involved in implementing RBF in Mrewa District, Mashonaland East Province, Zimbabwe. Data were collected through focus group discussions using an interview guide. Three (3) focus group discussions were conducted during this study, following a pilot study consisting of six (6) conveniently sampled nurses in Mashonaland East Province. Interviews were tape recorded and transcribed verbatim. Permission to proceed with this study was granted by the Ministry of Health and Child Care and the University of South Africa. Measures to ensure credibility, dependability, conformability and transferability were followed. Data were analysed using Creswell’s data analysis steps. Data were transcribed and thematically analysed, and emerging patterns were noted. The researcher examined these categories closely and compared them for similarities and differences, identifying the most frequent or significant codes in order to develop the main categories. These were summarised in narrative form. Four themes emerged from data: interpretation of RBF; role of nurses in the implementation of RBF; evaluation of RBF; and strengthening implementation of RBF. The study revealed various interpretations of RBF that converged to definitions of RBF in literature. Nurses viewed themselves as key and important players in the successful implementation of RBF. The successes and challenges of RBF were presented. Several measures that could strengthen the implementation of donor funds were highlighted, including subsidisation of low catchment health facilities, inclusion of district hospitals on the RBF programme, increasing financial autonomy of health facilities and the review of procurement guidelines. The study assumed that these measures will enhance nurses’ work experience in donor funded health care delivery, and improve health outcomes. / Health Studies / M.P.H.

Employee involvement and participation in HIV-prevention interventions at the workplace remains a barrier to effective programme implementation, which contributes significantly to programme failure and the consequent continued spread of HIV among employees at the workplace. This study explores employee involvement and participation in HIV-prevention interventions at a Bulawayo tyre manufacturing firm. It assesses factors affecting employee involvement and participation in these interventions, and examines the implications of these findings for programme implementation. I used a semi-standardised interview schedule to conduct in-depth, face-to-face qualitative interviews and a self-administered questionnaire to collect quantitative data. The responses showed the nature of employee involvement in HIV-prevention at the firm was at a co-option level, and the type of participation was mere token participation. I recommended that the firm should develop a clear understanding of the importance of stakeholder involvement in HIV-prevention programmes. / Sociology / M.A. (Social Behaviour Studies in HIV/AIDS)

MHealth is an upcoming area promising to contribute benefits to health service delivery. The purpose of this study was to identify and describe the rate of mHealth utilisation as well as opportunities for mHealth and the barriers to use at one central hospital in Zimbabwe. A quantitative, descriptive, cross-sectional study was undertaken at the central hospital. Data collection was done using structured questionnaires. The entire population of medical doctors at the hospital (N=42) were the respondents of the research. The 18 mHealth activities were chosen from a possible of 101 available. The most used as well as the least used mHealth activities were identified and the reasons for use or lack of use were identified. The study revealed that 75% of the activities were currently being used and 95% had the potential of future use by medical doctors. This study highlights the potential of mHealth from medical doctors’ perspective. / Health Studies / M. A. (Public Health)

Background: Accessibility to health care in rural areas is globally impeded by physical, material, human, financial and managerial resources and societal barriers in the health care system. The Systems Model formed the backbone to developing a strategic action plan to address the challenges experienced by all stakeholders involved. Purpose: The purpose of this study was to describe accessibility to health care in rural areas to develop a strategic action plan to enhance accessibility to health care in these areas of Zimbabwe. Methods: A multiple methods approach combining qualitative and quantitative components during 4 phases. Phase 1 collected quantitative data with questionnaires from professional nurses and health care users who were conveniently sampled. Phase 2 collected qualitative data with a nominal group from national health directors who were conveniently sampled. Phase 3 was based on the findings from Phases 1 and 2 with a literature control to develop a draft strategic action plan. During phase 4 the strategic plan was amended and validated with a validation tool by members of the parliamentary portfolio committee on health in Zimbabwe with all-inclusive sampling. Framework: The Systems Model Framework was adopted for this study as outcomes and impact on people’s health is determined by inputs, processes and outputs. This model was relevant and applicable to accessibility to health care. Research findings: Accessibility to health care in rural areas of Zimbabwe is affected by inadequate distribution of physical resources, shortage of material and human resources, and a lack of financial resources. The strategies identified contributed to the strategic action plan which was amended and validated. The strategic action plan includes improving the health infrastructure, providing appropriate medical drugs, training and retention of health workers, providing medical equipment at the rural health facilities, reviewing the health worker workload and addressing staff shortages, providing free health care services in rural areas, and improving the capacity of the health care system. Conclusion: The strategic action plan was developed based on the inputs of the relevant stakeholders and the System Model. The inclusion of the parliamentary portfolio committee on health (members of parliament of Zimbabwe) might enhance the possibility for implementation which can enhance the accessibility to health care in rural areas of Zimbabwe. / Health Studies / D. Litt. et. Phil. (Health Studies)

Employee involvement and participation in HIV-prevention interventions at the workplace remains a barrier to effective programme implementation, which contributes significantly to programme failure and the consequent continued spread of HIV among employees at the workplace. This study explores employee involvement and participation in HIV-prevention interventions at a Bulawayo tyre manufacturing firm. It assesses factors affecting employee involvement and participation in these interventions, and examines the implications of these findings for programme implementation. I used a semi-standardised interview schedule to conduct in-depth, face-to-face qualitative interviews and a self-administered questionnaire to collect quantitative data. The responses showed the nature of employee involvement in HIV-prevention at the firm was at a co-option level, and the type of participation was mere token participation. I recommended that the firm should develop a clear understanding of the importance of stakeholder involvement in HIV-prevention programmes. / Sociology / M.A. (Social Behaviour Studies in HIV/AIDS)

MHealth is an upcoming area promising to contribute benefits to health service delivery. The purpose of this study was to identify and describe the rate of mHealth utilisation as well as opportunities for mHealth and the barriers to use at one central hospital in Zimbabwe. A quantitative, descriptive, cross-sectional study was undertaken at the central hospital. Data collection was done using structured questionnaires. The entire population of medical doctors at the hospital (N=42) were the respondents of the research. The 18 mHealth activities were chosen from a possible of 101 available. The most used as well as the least used mHealth activities were identified and the reasons for use or lack of use were identified. The study revealed that 75% of the activities were currently being used and 95% had the potential of future use by medical doctors. This study highlights the potential of mHealth from medical doctors’ perspective. / Health Studies / M. A. (Public Health)

MPH / Department of Public Health / The high maternal mortality ratio is caused by various factors, including avoidable complications which can be reduced by attendance to antenatal care visits. The utilisation of antenatal care has been low in rural areas, especially in Africa. The purpose of this study was to explore the utilisation of antenatal care in Mutasa District of Zimbabwe. This study used a qualitative study approach, adopting the descriptive, explorative design that presented an active image of the research participants’ reality and capture live experiences. Participants of the study were pregnant women and women with children under the age of one. The participant were sampled using purposive and snow-ball sampling techniques. In-depth interviews were conducted. The participants were interviewed in their native language, Shona. The main question was: Can you explain in your own words how you use antenatal care services from the primary health care facility? The researcher clarified questions which the participant failed to understand. The researcher wrote down all responses and used a tape recorder to capture the responses. The researcher analysed data using thematic content analysis where themes and sub-themes were discussed. The main theme was low uptake of antenatal care in rural primary health care facilities. From the main theme there were factors influencing and perceptions of women on uptake of antenatal care services in primary health care facilities. Trustworthiness was ensured through credibility, dependability, transferability and conformability. Permission from the relevant authorities, such as the University of Venda Higher Degrees Committee, the Provincial Medical Director and the District Administrator was sought before conducting this study. Informed consent was also sought before interviewing the participants. The study concluded that socio-demography of participants affected antenatal care attendance. These are age, level of education, low income, high parity and distance to facility. Other hindering factors to utilization of antenatal care were lack of knowledge, religion and acceptability of antenatal care by the women in rural primary health care facilities. Findings will be disseminated through a research report and published in relevant accredited journals with the help of the supervisors. The study recommended that the Ministry of Health and Child Care of Zimbabwe review Antenatal Care policies to ensure friendliness and to increase awareness through health education and continuous dissemination of antenatal care information. / NRF

The study was an assessment to determine the health rehabilitation interventions employed by Zimbabwe health actors between 2009 and 2011. It also was to ascertain the extent to which the interventions met criteria for effective rehabilitation, and that includes, health rehabilitation should ease the transition between health humanitarian and health development. Data was collected through interviewing health actors and review of policy documents while a vulnerability analysis approach was applied. The study revealed that, while the implemented health recovery interventions resulted in halting the health crisis, their role in facilitating progress towards health development was marginal. There were clear humanitarian residual issues and evidence of weak areas of the health system. A clear pathway needed to be mapped by actors, particularly policy makers to ensure effective rehabilitation. However, this seemed to lack in some areas. There were numerous overlapping and repetitive policies with little detailed guidelines. / Development Studies / M.A. (Development Studies)