Thesis (M.S.)--West Virginia University, 2006. / Title from document title page. Document formatted into pages; contains viii, 102 p. : ill. Vita. Includes abstract. Includes bibliographical references (p. 94-99).

Magister Pharmaceuticae - Mpharm / The epidemiology of drugs is 'defined as the manner in which drugs are used by doctors, nurses, pharmacists and patients. As such epidemiology of antimicrobial drugs is the manner in which this class of drugs is used by healthcare professional, patients or caregivers. Antimicrobial drugs have a pivotal role worldwide in preventing infections and treating infectious diseases. The challenge that lies in the health sector is to maintain antimicrobials' effectiveness by using them appropriately to avoid toxicity, adverse reactions and resistance among other problems. The world faces a future in which ten million people could die annually due to infections that are resistant to available antibiotics. Despite people already dying of drug-resistant infections in private and public hospitals, doctors are still prescribing antibiotics for viral infections, for which they have no effect. The aim of this research is to study the epidemiology of antimicrobial drugs and factors that lead to the inappropriate use of antimicrobials, which is resulting in a steep rise of antimicrobial resistance in the private sector from a community pharmacy perspective.

M.Cur. / The study on ‘Sustainability of midwifery practice within the South African healthcare system’ is stimulated by the lack of research that influences policy to support midwifery practice in South Africa. The poor database and health information systems for midwives result in the poor performance of maternal healthcare in the public sector (Parkhurst, Penn- Kekana, Blaauw, Balabanova, Danishevski, Rahman, Onama, & Ssengooba 2005) in spite of meeting the Safe Motherhood Initiative of the World Health Organisation’s criteria for skilled attendance and facilities (Penn-Kekana & Blaauw 2004). Generally, midwives remain the main provider of maternal healthcare, including South Africa, where only 3 in 10 women in the public sector see a medical doctor once in pregnancy (South African Demographic Health Survey 1998). The norms and standards recommended by the Saving Mothers Reports 1998 – 2006 for staffing and resources to improve outcomes of maternal deaths have not realised. The public sector needs help from the private sector for improved care. The Nursing Strategy for South Africa 2008 endorses Public-Private Partnerships (PPP) to support nursing and midwifery. There is no Public- Private Partnership in South Africa to support or sustain midwifery practice. The purpose of the study is to develop a model for a Public-Private Partnership for midwifery practice sustainability in the South African healthcare system. This study follows adapted explorative, descriptive, model generating research guidelines of Chinn and Jacobs (1983 & 1987), Chinn and Kramer (1991 to 2008) and Walker and Avant (1995). Analysis of the South African maternal healthcare context uses the open-system theory for sustainability of Olsen and a team of researchers (1998) and several frameworks for healthcare human resources. The main concepts of the model are identified and analysed. The main concepts are Public-Private Partnership, midwifery practice, sustainability and the related concepts are governance, task environment and quality service. The model for a Public-Private Partnership is synthesised through the relation of concepts. The 45 statements of the context empirically ground the study. The model depicts the South African healthcare context and all the factors that impact on midwifery and its context. The model and its functions are explained within a constituted framework. The Global standards for practice of the International Council for Nursing and Midwifery, the definition and core competencies of midwives of the Confederation of Midwives, the Millennium Development Goals for Sub-Sahara Africa 2020 and the newly formed World Health Organisation Partnership for Africa for maternal, newborn and child care 2008 are factors of the global (macro) context that influence the model. The South African healthcare system (meso context) factors include economics, legal-ethical, professional, service delivery and civil society dimensions that impact on policy for service delivery on micro level, where the PPP formally exists. The PPP for maternal healthcare is developed within this framework. The stakeholders of the formal PPP are the public sector, the private sector, the midwifery profession and civil society. The PPP governs the task environment for midwifery through the risk assessment strategies that include financial risk based on clinical risk and the development of norms and standards for staff and resources as expressed in service level agreements for quality service delivery. Governance implies policy standards and the accountability of the PPP to the consumer for service delivery quality and performance. The stakeholders of the PPP ensure sustainability in this model through collaboration and shared responsibility, risk and decision-making between the institution, midwifery profession and practice and civil society for a balance of interest.

A mi-chemin entre le droit et la pratique, le droit de grève demeure principalement le produit d’une jurisprudence ouverte aux influences extérieures. Loin d’être enfermé dans une morale théorique et immobile, le droit de grève rayonne donc par son dynamisme et sa facilité à répondre aux défis conjoncturels et structurels auxquels doit faire face l’entreprise. Dans ces conditions, comment est juridiquement façonné l’exercice du droit de grève ? Quelles sont les interactions réciproques et permanentes entre la jurisprudence et la pratique, qui confèrent à ce droit toute son effectivité ? Quelles sont les influences, juridiques et a-juridiques, qui viennent guider son exercice au quotidien ? / Half way between the law and common practice , the right to strike is the result of a case law open to external influences. Far from being stuck in a theoritical and fixed ideology, the right to strike lies on dynamic grounds and on its ability to challenge the temporary and structural contexts that a company must cope with. In these conditions, how can the right to strike be legally shaped? What are the mutual permanent interactions between a case law and common practice which confers to this right its total effectiveness ? What are the legal and contextual influences that guides its daily practice ?

D.Litt et Phil. (Public Management and Governance) / Public Private Partnerships (PPPs) are contractual arrangements between the public and private sector, which are generally long-term in nature. If correctly implemented PPPs can mobilise socio-economic goals. The implementation of PPPs is to permit the delivery of continued, lucrative public organisation or services, by mobilising private sector proficiency and conveying a substantial amount of risk to the private sector, towards value for money. The incentive of the research is centred on the guiding principles of PPPs and the challenge of risk-sharing. The aim of this study is to encourage the systematic management and strategic control of PPPs in South Africa. In doing so, this study aims to determine how the PPP model can be improved to necessitate effective risk management in PPPs, and to provide for improved strategic control. The study supplies recommendations for improved practice, in both the public and private sectors, through strategic planning and shared apparata in PPP arrangements. Furthermore, the study suggests guidelines for effective risk sharing and management in PPPs, through integrated systems management. Integrated systems management proposes that the strategy, structures, systems and culture of PPPs are entrenched in organisational settings, in both the private and public sector, as well as in the PPP arrangement, to encourage capacity development and more developed institutions in South Africa. Effective risk management in PPPs necessitates the anticipation of risks; sufficient planning to address these risks and achieve project objectives; and, lastly, the entrenching of risk management within the organisation and project structures. The study commences with an overview of the development of public management and conceptual approaches of governance, providing a contextual synthesis of past and current theoretical perspectives. The study conceptualises the theoretical standpoints relevant to PPPs and the labelling of peripheral approaches. The research provides a synopsis of the role and functions of PPPs, international best practices in PPPs, and the nature of risk management in PPPs. This affords a foundation for investigating the trials and issues associated with PPPs and the challenges experienced in managing risks in PPPs. This is augmented with a systematic breakdown of the research design and methodology, to structure the research. In addition, a preliminary quantitative survey assessment is conducted, in order to derive preliminary findings for the primary analysis in the research.

The purpose of this thesis is to disseminate research work done towards a higher degree and report on the findings of the research that was conducted relative to South African Public Private Partnership (PPP) projects. The research investigated perceptions of PPP actors on the performance of operational PPP projects. The aim of the research was to fulfil the requirements for the award of the degree of philosophiae doctor in construction management; contribute to the PPP body of knowledge; contribute further understanding of the performance of PPP projects in South Africa; and develop a systemic model for a sustainable PPP system within the country and beyond. All the aforementioned have been achieved, despite the research limitations as indicated in Chapter 1. A case study approach was adopted to examine various performance aspects of operational South African PPP projects. The research was a multi-case study design. Each individual case study consisted of a ‘whole’ study, in which facts were gathered from the selected PPP projects and conclusions drawn on those facts. A web-based questionnaire was used to capture the experiences and perceptions of various actors involved directly, or indirectly in selected PPP projects. The sample stratum consisted of all operational PPP projects registered in accordance with Treasury Regulations as of December 2005 and other projects that reached financial closure before the Public Finance Management Act of 1999 became effective. PPPs involve highly complex procurement processes, are relatively new in South Africa and to date have attracted limited investigation to refine our understanding of the operational performance of PPP projects. This is notable, as significant financial and other resources are involved, and the perception exists that service delivery in most parts of the country is poor. Key empirical evidence from the research indicates that South Africa has developed a robust policy and regulatory framework for PPPs; has an inadequate level of PPP awareness and training; and lacks the project management capacity to facilitate deal flow. It is suggested that further research be conducted on a yearly basis, preferably every six months, so that trends can be established concerning various aspects of other operational PPPs. Further, it is recommended that the PPP Unit commission sector-specific studies that will conduct further research, to compare research across PPP and non-PPP contracts. The choice to conduct a multi-case study required extensive resources and time beyond the means available to the researcher. Further, the sensitive nature of PPP projects made it difficult to obtain required data at the first attempt. However, the researcher made several follow up calls and reminders before eventually obtaining the required data from the respondents. A systemic PPP model has been developed for PPP implementation and management. This model was tested for appropriateness by conducting a further survey on PPP participants attending an international conference on 'Financing of Infrastructure Development in Africa through Public Private Partnerships’ staged in August 2007, in the St. George Hotel, Johannesburg, South Africa. The findings from this research make an invaluable and original contribution to the PPP body of knowledge, provide insight for further research in this important field, refine the understanding of operational PPP projects, and provide direction for policy and decision makers in the public and private sectors, within South Africa and beyond.

The mainstream investment climate literature often fails to take account the methods that firms in developing countries adopt in order to mitigate the effects of a poor investment climate. A better understanding of these informal “coping strategies” may add to the body of knowledge on what is important, and what isn’t, when it comes to prioritising investment climate reforms in developing and transitional economies. Original research from Vietnam, a country which is growing rapidly and in the midst of its transition from plan to market, shows how firms have been able to adapt their business operations given an unstable and partially reformed institutional enabling environment. By comparing the behaviour of manufacturing enterprises across a number of differing local jurisdictions, we are able to discern just how firm level coping strategies adapt. We find evidence that entrepreneurs are able to use a variety of informal institutional mechanisms to invest and operate in an inhospitable business environment where private property rights are not well protected and develop “second best” response mechanisms. These mechanisms include establishing formal and informal networks and linkages, seeking patronage and protection, and by sharing ownership with potential expropriators. We also find evidence that in the face of weak property rights protection, firms adopt approaches to reduce the costs to the original investors if third party expropriation is attempted and are less likely to reinvest retained earnings. Where they do invest, it is principally in dissolvable and/or movable assets, and adopting a higher discount rate or risk adjusted time value of money for capital investments. Similarly, we find evidence of linkages between measures of firm confidence in the local investment climate, and the extent to which firms are willing to employ outside salaried management. Thus, the thesis provides a contribution to the growing literature reviewing the development of formal and informal investment climate institutions in transitional and developing economies. The principle research finding, namely that the establishment and use of informal or second best institutional arrangements can offset some of the costs and risks associated with an otherwise weak and unstable business environment, has important implications for policymakers when it comes to the prioritization of investment climate reforms in developing countries.

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published_or_final_version / abstract / Civil Engineering / Master / Master of Philosophy

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