The available evidence on housing conditions reveals that housing conditions are relatively worse in rural areas (especially in remote districts) in Scotland, and that improvement policies have been relatively more successful in urban areas. The central theme that this thesis attempts to address is, therefore, to examine the reasons why housing in rural Scotland is in such a poor condition, relative to urban areas. Since rehabilitation policies have been so effective in eradicating urban housing problems, a focus of the research is an examination of the implementation and effectiveness of rehabilitation policy in Rural Scotland. Indeed, although there is a national improvement policy framework, there is a great deal of potential for local variation. The research aims, therefore, to highlight features that contribute to the variations in the implementation of improvement policy, particularly between urban and rural areas in Scotland. The research examines the implementation of rehabilitation policy by local authorities through an analysis of six case-study rural districts: Argyll and Bute, Clydesdale, Gordon, Skye and Lochalsh, Sutherland, and Tweeddale. It also examines the involvement of housing associations in rural areas, both generally, and in terms of their rehabilitation activities. A subsidiary aim is to elucidate the factors which relate to an individual household's propensity to repair and improve the home in Rural Scotland. This is achieved through analysis of a questionnaire carried out with 364 households living in Rural Scotland.

No description available.

Executive Summary Non-communicable disease currently accounts for 59% of global deaths and 46% of the global burden of disease. In 2000, 38% of all male deaths and 43% of all female deaths, in South Africa, were due to non-communicable disease. Like all health systems, the South African health system is not adequately equipped to deal with these types of diseases. The burden of chronic disease will grow over time due to factors such as urbanisation and associated behaviours regarding food consumption and physical activity. The World Health Organisation has developed the Innovative Care for Chronic Conditions (ICCC) framework for resource-constrained settings. The ICCC framework is structured into three levels: macro (positive policy environment), meso (community and health care organisation) and micro (health care interactions) levels. Using diabetes and hypertension as examples of chronic disease, this research drew upon portions of this framework to examine service provision for chronic diseases in the Gauteng Province. The overall aim of the study was to document the resources available to manage chronic disease in the Gauteng Province by investigating primary health care clinics, community organisations, and provincial and district support. The objectives were to describe the following: health services offered by primary health care clinics in the city of iv Johannesburg for the management of patients with diabetes and hypertension; the role of district and provincial management in chronic disease care; and the role of community based organisations within the city of Johannesburg in promoting good health, preventing chronic illness, and providing curative and rehabilitative services. The micro level is represented by primary health care (PHC) clinics, the meso level is represented by community-based organisations (CBOs), and the macro level is represented by provincial and regional managers. This is a qualitative, cross-sectional descriptive study. The study population is PHC clinics, associated CBOs, and managers operating in Metropolitan Johannesburg, which is managed by the provincial government. One Gauteng province sub-district was selected by simple random sampling from a list of sub-districts containing at least five provincial PHC clinics. The selected sub-district was located in Soweto and the four PHC clinics and two community health centres were included in the study. Snowball sampling was used to select the CBOs after contacting the PHC clinics. Chronic disease managers at the regional and provincial level were also selected for the study. Data was collected entirely through interviews. One key respondent was selected at each site after contacting the site via telephone. The interview was in-depth and guided by a pre-determined list of questions. The issues probed included topics common to all three levels such as: challenges in chronic disease management, goals for chronic disease management, financial and human resource issues and patient information. Interviews were tape recorded, transcribed and analysed thematically. Ethics approval for the study was obtained from the University of the Witwatersrand’s Human Research Ethics Committee and authorisation to conduct the research was acquired from the Gauteng Provincial Department of Health. A total of 13 people were interviewed. At the micro level (PHC clinics), health care workers believed there was an adequate skill mix for chronic disease care but felt unsupported and understaffed. They did not feel motivated by the incentives currently offered. No health information was maintained at the clinic and all patient information was kept on cards. These cards were used to track patients’ progress, clinic attendance and compliance. The only information collected, and sent for analysis, was a patient headcount. Clinics primarily focused on curative treatment. Patients were deemed to be ‘controlled’ or ‘uncontrolled’ based on their ability to return to the clinic for monthly check-ups and consistently achieve acceptable clinical indicators such as blood pressure and/or blood glucose level. Medical doctors, the only health care workers permitted to initiate insulin therapy, are present only at the community health centres. Patients at PHC clinics must therefore receive referrals and travel to CHC to receive such treatment. PHC sisters did not express an interest in being able to begin insulin therapy, suggesting it is too dangerous and should only be performed by a medical doctor. Five CBO representatives were interviewed. Only two community-based organisations could be identified as having dealt specifically with chronic disease. Both of which focused on diabetes but were inclusive of hypertension due to the number of patients with both conditions. These organisations operated with no budget, paid staff or dedicated office space. They maintained close relationships with clinic staff and ran support groups at the clinic, many times with the help of sisters at the clinic. The other CBOs included in the study were home-based care in nature and dealt primarily with HIV/AIDS. They began treating these chronic disease patients when they realised the stigma of HIV/AIDS was ultimately affecting their outreach. In contrast to the two chronic disease CBOs, the AIDS related organisations all received government training and funding, which included stipends. It was felt that the government training did not provide enough information regarding noncommunicable chronic disease such as hypertension, and instead focused almost exclusively on HIV/AIDS. A monthly meeting was held for all Soweto-based CBOs to discuss issues and receive information from government representatives. There exist dedicated chronic disease programme managers at both regional (covering two districts) and provincial levels. Both levels support one another as they work with the PHC clinics in managing chronic disease. Managers felt free to communicate ‘upwards’ from region to province and province to the national level on an as-needed basis. With respect to PHC services, they saw their role largely as conduits. They provided guidelines to the clinics that were created at the national level and then subsequently monitored their guideline implementation by conducting random site visits. Managers felt that health care worker support was to be accomplished at the clinic level, rather than being their personal responsibility. Chronic disease services, in the study area, held the primarily focus on curative care rather than on health promotion, prevention and early diagnosis through screening. Nearly all patient education was delivered to individuals who had already developed one or more chronic conditions. Community-based organisations motivated those with chronic disease to adhere to treatment protocols, make positive lifestyle choices, and provide patients with a forum to discuss their conditions and learn from one another. They also worked with the government to implement awareness campaigns each month. These campaigns included the community and provided education to those whom had not yet developed a chronic disease. All three levels of the ICCC are functional and communicate with each other, though to varying degrees. While communication between levels is present, there exists a top-down management style where workers feel unsupported. The government is heavily involved in all three levels of chronic disease management. They train and pay PHC clinic staff and CBO workers. The government produces and disseminates all guidelines and protocols and monitor their implementation. The government accomplishes all these tasks while collecting only monthly patient headcounts from each clinic. Patients retain all clinical data and managers see no need to collect any data other than a monthly headcount from each clinic. Nurses are unable to initiate insulin therapy and are unhappy with the current incentive program. There are only two CBOs dedicated to chronic disease, all the rest focus primarily on HIV/AIDS. CBO workers do not feel there is enough training regarding chronic diseases. Each level cite various challenges to successfully managing chronic disease. These include, but are not limited to, low patient compliance, finances, lack of family support, and human resource issues. The research applied only a portion of the ICCC framework to one group of government clinics - provincial PHC clinics and CHCs. Examining a larger number of clinics and managers and applying a greater portion of the ICCC framework would be valuable further research. The following recommendations are a partial list of those generated by this research: • Increase the amount of chronic disease information presented in the mandatory government training of all CBO health care workers. • Construct a comprehensive list of all CBOs that includes: contact information, where they operate, services provided, current client addresses, etc. This will strengthen their ability to partner with one another and reduce overlap in patient care. • Educate patients better regarding how insulin works. This will decrease the usage of herbal medicines that mask health problems and lessen patients’ fear of insulin. • PHC nurses could be trained and permitted to administer and/or initiate insulin therapy. • Enable managers to realise they can affect change in clinic staff, rather than feeling this responsibility belongs solely to the clinic manager.

No description available.

When romantic partners provide support to one another, their attempts are not always successful in relieving the distress of the support recipient. While unsuccessful support transactions are sometimes caused by insufficient skills on the caregiver’s part, research has also shown that certain individuals struggle to feel better regardless of the quality of support that they receive. The overall goal of the present set of studies was to examine how individuals who are inconsolable (i.e., who typically do not feel better when they receive support) impact the self-esteem and relationship satisfaction of their romantic partners, as well as the likelihood that their romantic partners will continue to provide support to them in the future. Study 1 showed that individuals who perceived their romantic partners to be more inconsolable were less likely to be satisfied with their romantic relationships, particularly if they were male, or high in rejection sensitivity. These individuals were also less likely to report engaging in actual support behaviours toward their romantic partners, and in contrast to the finding pertaining to relationship satisfaction, this result was stronger among individuals low in rejection sensitivity. Study 2 showed that when individuals imagined themselves as the support provider in a vignette where the support recipient was inconsolable, they predicted that they would experience lower state self-esteem and romantic relationship satisfaction, and that they would be less likely to provide the partner with support in the future. Conversely, in Study 3 participants who recalled and wrote about a time in which their romantic partner was inconsolable did not predict providing their partners with less support in the future, however, they did report lower state self-esteem, and among individuals who were high in rejection sensitivity, lower relationship satisfaction. Overall, these findings suggest that inconsolable individuals negatively impact the self-esteem and romantic relationship satisfaction of their partners, particularly if their partners are high in rejection sensitivity. Further, inconsolable individuals may also be at risk for receiving less support over time.

This thesis deals with the systems of housing and housing finance around the world with special reference to Lahore, Pakistan. Formal systems are predominantly functioning in the developed countries and informal systems are prevalent in the developing countries. The formal systems are very well established in the developed countries, but help only a fraction of the people in the developing countries. Informal systems of housing finance (such as personal savings, help from the family and friends, rotary credit system and borrowing from private money lenders) are the main source of financing a home in the developing countries and playa minor role in the developed countries. Four case studies of India, Kenya, Turkey and Brazil demonstrate that the formal systems are developing in these countries. Governments in the developing countries are trying to cope with the shortage of housing without viable housing finance systems. This thesis includes an investigation of the housing finance system in Pakistan and the field work looks at how the inhabitants of middleclass areas in Lahore finance the construction, purchase and improvements made to their homes. Households have used both formal and informal methods of saving such as personal savings, money from relatives and friends, HBFC, Commercial Banks, Rotary Credit System, remittances from abroad, also by selling jewellery and other assets, loans from their employers and from private money lenders. The access to the fonnal housing finance system is very difficult and time consuming and the people who borrowed money from this system contribute only a little as compared to the total price of the house. A contributory factor is also the breaking up of the joint family system increasing the demand for housing. The study of nine different middle-class localities in Lahore shows that the existing fonnal housing finance system does not reach the middle classes. The study also establishes that people have enough savings to put towards the deposit for the house and their incomes can support the monthly instalments if a housing loan is available to them. There is need of a viable housing finance system with which savings can be mobilised and then utilised for loans to house purchasers. If the government wishes to ease the housing shortage they should alter the system of land transfer (land registrations) by reducing the taxes which would encourage the market.

This thesis examines low-income housing policies adopted by Developing Countries in the last forty years and compares them with the economic development models implemented in these countries. The study argues that the changes in the housing policies adopted are a part of the general debate about the dualistic nature of underdeveloped economies. An attempt is made to place the issue of housing within the formal/informal and petty commodity sector polemic. The potential and limitations of Self-Help Principal of Housing as a concept and its practicalities are discussed. The centrepiece of the concept, that the users (in this case, the urban poor) are the best judges of dwelling requirements and that they strike a balance between their resources and their housing priorities, is seen as portraying only a partial view of the argument. Low-income earners are not only consumers but also producers of housing and most of the problems they face while housing themselves in the city are related with the production process of housing. Within this general context, attention is focused on the production process of low-income housing, and its relationship with the construction sector, the real estate market and the construction labour market. This study investigates the low-income housing production process in Lahore, Pakistan. A historical-structural approach is used to review the state of the local economy, the role of the urban poor and the low-income housing policies of the state. It is seen that the homelessness of the poor has become a major political issue and that Pakistani politicians try to gain popular support by offering token concessions to squatter households. The investigation into the house and land exchange process, type of building materials, and kind of construction labour used by the low-income households shows that the low-income housing production process, found to be existing in Lahore, is highly dependent on the formal sector of economy. The prospects of resolving the issue of housing the poor in Developing Nations, like Pakistan, by pursuing the housing policies based on the Self-HelpConcept, are limited. The ability of the urban poor to build their own dwellings rests on the access which they have to income-earning opportunities. Policies, therefore, should be framed to increase their employment opportunities in various sectors of the economy

No description available.

This thesis examines tile development of the urban housing. market in Britain during the late nineteenth and early twentieth centuries. During this period it was transformed from an essentially laissezfaire market based on private landlordism to one in which state housing and owner-occupation came to dominate the provision of new accommodation . The thesis looks in some detail at the form this transformation took and examines how and why it occurred . The pre-1914 structure of housing provision - which was based on private landlordism - was a small scale, localized system involving numerous actors within a fragmented social division of labour. This dominant structure of provision underwent a severe crisis during the Edwardian years - before the introduction of rent controls and state housing . The 1914-18 war saw a transformation in social relations within the housing market that ensured both the collapse of private landlordism and the intervention of the state in housing provisions After the war, two ' new structures of provision emerged involving a rationalized social division of labour and a larger scale of operations, based. on state housing and owner-occupation. ýLt the same time , the second-hand housing market was transformed: from 1915 much of the pre-war stock of dwellings was subject to rent and mortgage interest controls, while many landlords began to sell their dwellings to owner-occupiers. While many of these developments were a reflection of changes within the wider economy and society) the transformation was both accelerated and in part shaped by the effects of the 1914-18 war

On 4 February 1976 the Federal Military Government of Nigeria promulgated Decree No. 6, initiating the removal of the national capital from Lagos to Abuja. Thus Nigeria followed Brazil, Botswana, Malawi, Pakistan, and Tanzania to become the most recent developing country to arrange for a transfer of its centre of government. Abuja is now a city of 60,000 people where the citizens experience considerable crowding especially in public housing estates. Occupancy rates of three people per room are now the norm. Recent setbacks in oil revenues and soaring trade deficits have slowed down the overall construction programme of the Federal Capital and have led to a lack of new houses to relieve the growing congestion. The water and sanitation services can be seen to be severely overused especially in areas outside Phase One and there is an evident need for urgent action in housing supply. Policies developed by John Turner and others, and adopted by International Agencies, have been used in some African cities to secure substantial increases in housing stock through self-help both for new building and for improvement of existing housing environments. Through an examination of traditional Hausa culture, which can be seen to have survived almost intact to the present day, it was found that most of the assumptions which underlie such policies as slum upgrading and site and services are absent from, or in conflict with, Hausa culture. An advocative strategy has been developed which attempts to avoid the problems imposed by the sacral nature of housing and to benefit from the resources which are present in the culture and in the present characteristics of Abuja. It is aimed at providing a hospitable environment in which the more prosperous low-income households will be encouraged to build houses for themselves and some tenants. The existing Local Government Authorities in the Federal Capital Territory would be involved in planning and implementation, the economic potential of rental housing would be restored and the building of compounds in traditional materials would be encouraged.