Thesis (Ph. D.)--University of Texas at Austin, 2002. / Vita. Includes bibliographical references. Available also from UMI Company.

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Thesis (Ph. D.)--University of Texas at Austin, 2002. / Vita. Includes bibliographical references (leaves 259-274). Available also in an electronic version.

The primary health care (PHC) model is being actively promoted as an effective and lower-cost alternative to conventional health care delivery systems in many developing countries. Despite the fact that over 300 PHC projects of varying scale have been implemented and reported on throughout the Third World over the past two decades, there appears to be little evidence available to support the popular hypothesis that the availability and utilization of primary health care services necessarily results in significant improvements in health. The objective of this thesis is to identify alternative strategies for evaluating PHC projects which will establish credible and useful results. The thesis reviews the evolution of both the PHC model and evaluative research methodologies, and then presents a critical analysis of a set of PHC project evaluations. The aim of this exercise is to identify some of the major factors which have limited the validity, utility and significance of the evaluation results. The thesis suggests that less rigorous evaluative research designs and evaluative techniques which use a combination of quantitative and qualitative data be used to enhance the credibility and utility of evaluation results. / Medicine, Faculty of / Population and Public Health (SPPH), School of / Graduate

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Bibliography: leaves 372-389 / 389 leaves : / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Thesis (M.D.)--University of Adelaide, Dept. of Community Medicine, 1984

The purpose for this study was to develop guidelines for the implementation of Goal Attainment Sealing (a mental health measurement technique) in the medical care setting. As a graduate student of social work, I have become involved in the delivery of medical care and am interested in the dynamics of psycho-social variables as they affect the structure, delivery, and outcome of medical services.

Dissertation submitted in partial compliance with the requirements of the Master's Degree in Technology: Homoeopathy, Durban University of Technology, 2010. / In collaboration with Lifeline, Durban University of Technology (DUT) established its first satellite homoeopathic community clinic; Ukuba Nesibindi Homoeopathic Clinic (UNHC). UNHC provides a free homoeopathic primary healthcare service on the third floor of the LifeLine building in Warwick junction, Durban, an area which is classified as being disadvantaged with high crime rates, prostitution, violence, small, informal business and low cost housing. The clinic is run by 4th and 5th year homoeopathic students under the supervision of a qualified homoeopathic practitioner and funded totally by the Department of Homoeopathy – DUT. The purpose of this retrospective clinical audit of UNHC was to determine a patient demographic and disease prevalence profile, as well as identify and describe the major medicines prescribed. Methodology The study used a retrospective, explanatory, and descriptive design method by means of a clinical audit, to determine a patient demographic and disease prevalence profile, as well as identify and describe the various homoeopathic treatment modalities. All the patient files from June 2004 – June 2008 were included for analysis and the data collection spreadsheet (Appendix D) was compiled respectively. IV The data collection form was divided into patient demographics, information on number of consultations and follow-ups, clinical diagnoses, urine dipstick analysis, patient referral information and medicines prescribed. The researcher captured the data, which was analysed and various means of descriptive statistics applied using Excel from Microsoft Office® 2007. Results UNHC opened in 2004 and initially only operated two afternoons per week; in order to cope with the demand for this service which grew rapidly in 2006 an additional consultation afternoon was added. A total number of 862 patients were seen between June 2004 and June 2008, 497 being new patients and 365 being follow up patients. On average 56% of patients came back for more than one follow up consultation during the study period. The majority of patients who attended UNHC during the study period were African females between 40 and 64 years of age who were unemployed and single. Of the 5 most prevalent systemic disorders encountered at UNHC infectious disorders were the most frequent along with cardiovascular, dermatological, psychological and musculoskeletal disorders. Conclusion The significant increase in patient numbers at UNHC and the relatively high percentage of patients who returned for more than one follow up consultation are positive trends and suggestive of UNHC’s success in providing homoeopathic primary healthcare as well as the positive impact it has had on the surrounding community. With additional funding UNHC can improve service provision further; dedicated translators as well as various equipment to facilitate administration will streamline the consultation process significantly and allow for more patients to be seen. Expansion of the scope of diagnostic services provided such as pregnancy and glucose testing will reduce the need for referral for such basic services. V Future studies should formally measure patient benefit in response to treatment in the form of a patient benefit survey; qualitative measures of patient satisfaction with the service provided by UNHC are also warranted.

Submitted in partial compliance with the requirements of the Master’s Degree in Technology: Homeopathy, Durban University of Technology, Durban, South Africa, 2016. / Introduction The Durban University of Technology (DUT) homoeopathic satellite clinic in Redhill was established in 2005. It was started by private homoeopathic practitioners who wanted to provide healthcare services to members of the community. This satellite clinic is very distinct from other DUT homoeopathic satellite clinics as it occupies space in an eThekwini Municipality public health care clinic. The homoeopathic clinic offers free homoeopathic treatment to the local community, as it is a training facility for 5th year homoeopathy students of the DUT. Students consult at this clinic under the direct supervision of a qualified homoeopathic clinician. This descriptive and retrospective study aimed to determine the patient demographics, the disease prevalence, the forms of homoeopathic treatment modalities utilised and to assess the financial implications of operating the clinic. Data was collected by conducting an audit of new and follow up appointments at the Redhill clinic over a five year period from 2010 to 2014. Methodology This descriptive and investigative clinical audit was conducted retrospectively at the Redhill Clinic. A data collection sheet was completed for each patient file which included demographic data such as race, age and gender, the year of the consultation, the date of each visit, the number of visits, the diagnoses and treatment protocols, materials used, prices of medicines and the cost of the clinician. The researcher captured the relevant data of each patient file at the DUT premises under the direct supervision of the supervisor. Each patient file was examined individually. Any patient file that was found to have missing information was not included on the data collection sheet or entered into the Microsoft Excel® spread sheet. The results were then analysed by using various forms of descriptive statistics such as pivot tables, pivot charts, pie charts and bar-charts. Results The Redhill Clinic was open once a week from 2010 to 2012 thereafter it was open every second week until September 2014 due to unavailability of rooms. A total number of 841 patient files which met the inclusion criteria were investigated. There were a total number of 1573 visits over a five year period. The majority of patients who attended the Redhill clinic during the study period were Africans, females and between the age group 21 – 30 years old. The five most prevalent conditions that were seen at the Redhill clinic were respiratory, musculoskeletal, infections, dermatological and gastro-intestinal conditions. The operational expenditure of a homoeopathic satellite clinic included the cost of medicines and materials used. The total cost was calculated to be less than R130 000 over a five year period. Conclusion The patient numbers decreased from 2010 to 2014. The number of follow up visits increased from 2010 to 2012. The number of patient visits has been consistent with more than 50 new and follow up visits each year. This suggests that there has been patient satisfaction with homoeopathic treatment over the years. The homoeopathic satellite clinic is unique as it is enclosed within the Redhill municipality clinic where allopathic doctors also practice medicine. This setting is advantageous because the nursing sisters at the clinic often refer patients to the homoeopathic satellite clinic on a weekly basis and students are able to refer their patients to the municipal clinic as appropriate. Patients were treated with homoeopathic remedies, herbal tinctures and creams and tissue salts. The low operational expenditure of the homoeopathic satellite clinic shows that it is very cost effective and inexpensive to maintain such a clinic. The results that were obtained from this study imply that the inclusion of homoeopathic satellite clinics in disadvantaged communities such as Redhill is beneficial and viable. The practice of homoeopathy is viable especially because of the current challenges that the health system of South Africa is exposed to. One of the significant concerns is that there is a shortage of health care workers in the public health care system. This study did not aim to investigate the possibility of incorporating homoeopathy into public health care at present but results can serve as a model for the inclusion of homoeopathy into other public health care facilities. The disease profile and treatment protocols that were obtained from this study can be used in planning the establishment of other homoeopathic satellite clinics in the future. / M