Thesis (M.Sc.)--Memorial University of Newfoundland, 2004. / Restricted until October 2005. Bibliography: leaves 45-48.

Indiana University-Purdue University Indianapolis (IUPUI) / Purpose: This study examines whether Indiana physicians’ choices to practice in medically underserved and rural areas of Indiana are associated with select physician characteristics. Methods: Physician data were gathered from the American Medical Association Physician Masterfile. Analysis was limited to primary care physicians currently practicing, whose birth city and/or state were known (if American born) and whose current practice location could be matched to an Indiana ZIP Code. The underserved and rural areas and physician data were mapped using ArcGIS. Chi square and logistic regression analyses were performed to identify significant associations between the physician characteristics and choice of practice location. Results: In instances where a physician was born in a county that fell below its state’s median income level in the decade of birth, there is a significant likelihood of future choice to practice in underserved and rural areas. Attending a medical school in the Midwest and region of birth (subdivided by state) were proven to have no predictive value. Conclusions: This result, when compared with other studies that have found physician hometown to be a predictive factor, seems to confirm and strengthen the argument that factors in a physician’s past, including social and economic setting of his or her upbringing, influence choice to practice in underserved and/or rural areas.

Over the last seven years the recruitment of overseas trained doctors (OTDs) has formed a significant part of Australia’s policy to address the medical workforce issue of geographic maldistribution to ensure that communities in rural and remote Australia have access to adequate general practice (GP) services. This policy has not been without problems, particularly in the areas of assessment of skills and qualifications, appropriate orientation and integration into Australian communities, and retention of these doctors within rural and remote communities. To date there has been little evidence-based research on the role of OTDs in the medical workforce in Australia. This study explores the service provision and quality of care provided by OTDs using the 5 Year OTD Scheme as the case study. In doing so, it assesses the adequacy of this strategy and discusses the implications for future workforce policies and programs. A mixed method design was used in the study. The quantitative component involved secondary analysis of Medicare Australia data for all OTDs participating in the 5 Year OTD Scheme in 2002 and all Australian trained doctors (ATDs) practising in rural and remote Australia in the same year. A log Poisson regression model was used to assess the interactive effect of the various GP characteristics, such as age, sex, experience and practice location with OTD/ATD status on the rate of a particular service item per patient, adjusted for patient age and sex. The qualitative component involved two focus groups with OTDs which were used to help explain the relationships between variables found in the quantitative component of the study. Template analysis was used to identify themes from the focus group. Significantly different rates per patient between OTDs and ATDS were found across most service items and GP characteristics examined. The greatest variation was found among items relating to in-surgery consultations and non-surgery consultations such as nursing home visits. Fewer differences were found between groups relating to pathology, imaging or procedural services. Analysis of surrogate quality items identified few differences between OTDs and ATDs. The focus group identified a number of other factors that influenced their patterns of service and accounted for some of the differences identified in the quantitative analysis. These factors included knowledge of the health care system in Australia, cultural and communication influences, health conditions of patients, patient and community attitudes, remuneration influences and training influences. These had varying degrees of influence on their patterns of service. The reasons for the differences found between OTDs and ATDs are partially explained by the characteristics of the GPs examined and partially explained by other external influences that relate to the particular circumstances of the OTDs, such as knowledge of the Australian health care system and cultural and communication issues. Understanding the nature of practice is central to ensuring appropriate professional support measures. The study findings highlight the need for a targeted training program for OTDs that address the areas that have the greatest influence on patterns of service to ensure that rural and remote communities receive the same quality of service from OTDs as provided by ATDs. / http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1320385 / Thesis (Ph.D.) - University of Adelaide, School of Population Health and Clinical Practice, 2008

The purpose of this study is to determine the extent to which rural nursing content is included in the curricula of baccalaureate and associate degree nursing programs in Texas. Additional purposes include determining the association between the emphasis on rural nursing content perceived by curricular chairpersons as ideal and current content emphasis, examining the difference in rural nursing emphasis between the two program levels, determining variables predictive of rural nursing emphasis and determining efforts to recruit students from rural areas. Data were collected by means of a mailed questionnaire developed by the investigator. Statistical analyses of these data were then conducted. Major findings include the determination of current and perceived ideal emphasis of rural nursing content, the difference in rural nursing emphasis between baccalaureate and associate degree nursing schools in Texas, the association between perceived ideal and actual content emphasis, those variables which are predictive of rural nursing emphasis in undergraduate curricula in Texas and the recruitment efforts from rural areas made by each level of program.

Bibliography: leaves 277-285.

Bibliography: leaves 277-285. / xi, 292 leaves : ill. ; 30 cm. / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Thesis (Ph.D.)--University of Adelaide, Dept. of Clinical Nursing, 2002

MPM / Department of Public Health / The dawn of democracy in 1994 saw huge strides in the adjustment of various statutory instruments that aimed at opening the systems to all South Africans particularly the previously excluded groups. Health care system was one of the ear marked areas by the South African government for post-apartheid transformation. Resultantly, access to health care was declared a right and incorporated into the Constitution of the Republic of South Africa 1996. Numerous legislative and practical steps towards achieving access to health care for all have been made with notable results. However, due the apartheid spatial planning which persuaded separate development left some sections of the community remote and with no infrastructure to support health care delivery. As a result, this has made the realization of the health care for all dreams elusive. Reportedly, the most affected communities were mainly homelands which were largely rural and townships. Despite notable improvements in the delivery of health care services across the Republic, there are still major challenges faced in this sector mainly in the rural areas and townships. Therefore, the study was set to investigate and evaluate the state of health care service delivery in rural Ndengeza Township. The study employed both qualitative and quantitative method following a descriptive design (cross-sectional) and data was collected using a self-administered questionnaire and interview questions. The results revealed that transport, staff-patient relationship, unavailability of medication and medical staff were the major challenges of health care service delivery in rural areas. The respondents alluded that to improve health service delivery in the area, there is need to make available basic medication and trained medical personnel. It is believed, by the participants, that adding the number of staff will go a long way in changing the negative perceptions such as long queues, unavailability of critical services and unprincipled professionals that the public have of the local health care centers / NRF

PhD (Health Studies) / Department of Public Health / Introduction: Quality healthcare provision is a fundamental need in the life of a person since it helps develop a positive self-image. Healthcare has always been an important issue for society, both economically and culturally. Contrary, dissatisfactions and litigations laid by clients/patients and relatives against the government due to poor service provision become unmanageable. The purpose of the study was the development of strategies to facilitate provision of quality healthcare services in public healthcare facilities in Limpopo province, South Africa. Methods: Qualitative and quantitative methods were adopted for the study. Population for the qualitative study was constituted by professional nurses, and stakeholders (Hospital boards and Clinic health Committees) who were, purposively selected from the randomly sampled hospitals and clinics. Focus Group discussion and questionnaires were conducted to collect data. Analysis. The qualitative data was analysed qualitatively. Population for quantitative study consisted of Clients as stakeholders and professional nurses from randomly sampled hospitals and clinics. The qualitative results were used in the development of questions for questionnaire used in the quantitative approach. For the quantitative approach a self-administered questionnaire was used to collect data from the respondents. Data collection was carried out by means of two instruments for clients and professional nurses. Analysis was done using SPSS 25 version with the assistance of a Professional Statistician. The researcher used the Strength, Weaknesses, Opportunities and Threats analysis to develop strategies for enhancing quality healthcare service provision in the Department of health. The interaction between Strengths, Weaknesses, Opportunities and Threats was analysed and used to develop strategies to facilitate provision of quality health care services in public health care facilities in Limpopo Province. Conclusion Findings of this study is expected to inform nursing education and nursing practice to review curricular on what to emphasize when training the nursing students. The findings will also inform senior management when planning for improvement of health care provision improvement. / NRF

The purpose of the study was to explore and describe the existing relationship between traditional healers and nurse practitioners in Maseru Health Service Area in Lesotho and also to determine why people consult traditional healers. Qualitative and quantitative methods were used to investigate the relationship between traditional healers and nurse practitioners and also to determine why people utilize the services of traditional healers. The study was limited to Maseru Health Service Area in Lesotho. Data was collected from twenty-seven (27) nurses from nineteen (19) clinics and from thirty (30) traditional healers from the same health service area. Data from traditional healers was collected using semi-structured interviews while nurse practitioners were given a questionnaire to complete. The study revealed that there was no formal relationship between traditional healers and nurse practitioners. Support for traditional healers was revealed to be limited, for example, only four (14.8%) nurses had a programme for traditional healers while twenty ( 66.7%) traditional healers did not have any contact with nurse practitioners. Involvement of traditional healers in primary health care at grassroots level has therefore been very minimal. The reasons why people utilize traditional healers were found to be as follows: • When people think they have been bewitched. • Traditional healers can tell the actual cause of disease • Failure of modern practice • For social problems According to the study, both traditional healers and nurse practitioners felt that collaboration between traditional healers and nurse practitioners was essential because it would enable planned referral of patients from one group to another where necessary; it would also facilitate exchange of ideas and knowledge for the benefit of the people served. Recommendations on collaboration and on support systems are given in Chapter Six. / Health Studies / D. Litt. et Phil. (Nursing Science)

The purpose of the study was to explore and describe the existing relationship between traditional healers and nurse practitioners in Maseru Health Service Area in Lesotho and also to determine why people consult traditional healers. Qualitative and quantitative methods were used to investigate the relationship between traditional healers and nurse practitioners and also to determine why people utilize the services of traditional healers. The study was limited to Maseru Health Service Area in Lesotho. Data was collected from twenty-seven (27) nurses from nineteen (19) clinics and from thirty (30) traditional healers from the same health service area. Data from traditional healers was collected using semi-structured interviews while nurse practitioners were given a questionnaire to complete. The study revealed that there was no formal relationship between traditional healers and nurse practitioners. Support for traditional healers was revealed to be limited, for example, only four (14.8%) nurses had a programme for traditional healers while twenty ( 66.7%) traditional healers did not have any contact with nurse practitioners. Involvement of traditional healers in primary health care at grassroots level has therefore been very minimal. The reasons why people utilize traditional healers were found to be as follows: • When people think they have been bewitched. • Traditional healers can tell the actual cause of disease • Failure of modern practice • For social problems According to the study, both traditional healers and nurse practitioners felt that collaboration between traditional healers and nurse practitioners was essential because it would enable planned referral of patients from one group to another where necessary; it would also facilitate exchange of ideas and knowledge for the benefit of the people served. Recommendations on collaboration and on support systems are given in Chapter Six. / Health Studies / D. Litt. et Phil. (Nursing Science)