Although social capital had been found to solve collective action problems, social capital at work or workplace social capital has only recently begun to be researched. This is noteworthy given that most of our waking hours are spent in the workplace. While workplace social capital is suggested to improve workplace performance, job satisfaction had been found to improve workplace performance. However, workplace social capital and job satisfaction have never been examined together with regard to workplace performance. Furthermore, most studies on workplace performance have focused on developed countries with evidence from developing countries is lacking. The aims of this thesis were to investigate 1) whether workplace social capital affects job satisfaction; 2) the relationship of social capital, job satisfaction and workplace performance; 3) whether individual characteristics differ in determining job satisfaction in developed and developing countries; and 4) whether context of organisations in developed and developing countries differ in determining the relationship of social capital, job satisfaction and workplace performance. To achieve those aims, this thesis selects two sets of secondary data representing developed countries: EWCS2010 in Europe combining workers with their regions and countries and WERS2011 in Britain linking workers to their workplaces; while primary data froma developing country have been gathered from public hospitals in Indonesia associating workers with workplaces. As such, this thesis exploits two approaches using structural equation modelling in multilevel models. First, the customary Macro-micro approach is used to examine the relationship between workplace social capital and job satisfaction treating both variables as latent constructs. Second, the less common micro-Macro approach is exercised to investigate the relationship between workplace social capital, job satisfaction and workplace performance. Results from developed countries show that workplace social capital is positively associated with individual outcomes such as job satisfaction and well-being even in times of financial crisis. Comparing the results between developed and developing countries, workplace social capital is positively significantly associated with job satisfaction in Britain and in Indonesia. With regard to higher level outcomes, workplace social capital is associated with better financial performance, while job satisfaction is associated with higher quality in British general industry. Turning to results from Indonesia, workplace social capital is associated with lower expenditure per bed; job satisfaction, however, failed to be associated with any workplace performance measures. Several individual and workplace characteristics in both developed and developing countries have similar influences on job satisfaction and workplace performance. Nevertheless, there are some contrasting results regarding the influence of those characteristics in developed and developing countries.

Clinical practice is the core of nursing education during which the student is socialized into the nursing profession. During this period, there is transfer of knowledge and skill from qualified nurses and other members of the multidisciplinary team to student nurses. The purpose of this study is to describe and explore student nurse’s experiences of clinical accompaniment in a public hospital in Gauteng Province by means of a qualitative approach that included the exploratory, descriptive and contextual study. Three focus group interviews were conducted with students and one with clinical accompanists. Qualitative methods included categorizing and coding. The major findings of the research revealed that participants regarded relationships and communication as important for clinical accompaniment. Both student nurses and unit supervisors expected nurse facilitators to accompany students in clinical settings; but some hospital staff members did not perceive clinical accompaniment to be their task. / Health Studies / M.A. (Public Health)

Submitted in fulfilment of the requirements of the Degree of Master of Technology: Biomedical Technology, Durban University of Technology, 2013. / The purpose of the study was to evaluate knowledge and effects of Haemolytic Disease of the Newborn (HDN) in postnatal women from the Umgungundlovu District. Although the prevalence of HDN has declined because of prophylaxis from 45 cases per 10,000 births to 10.2 cases per 10,000 births but it is still a cause of infant and neonatal morbidity and mortality. The effects of the disease range from jaundice, kernicterus and in severe cases death. Methodology : An interviewer-administered questionnaire was used to obtain information about the knowledge and effects of HDN amongst postnatal women. The incidence rate was calculated using the number of cases that were found divided by the total number of deliveries during the study period. A total of 300 women were interviewed. SPSS version 19.0 was used to analyse data. Findings : Fifteen (15) of the 300 women had babies with confirmed HDN and only four of the 15 (26%) women had knowledge of HDN. Two hundred and eighty five women had babies with jaundice but were not affected by HDN and, of these women, 12 (4.2%) of them knew what HDN was. Overall, only 16 (5.3%) knew what HDN was. All 15 women who had babies with HDN indicated financial and emotional effects because of HDN. The total incidence was 0.09% for the first 12 months of the study period. Conclusion : Postnatal women with jaundiced babies lack knowledge of HDN and HDN has financial and emotional effects on these women. Although the incidence rate of HDN was found to be even smaller than previously reported, it still exists and threatens the lives of infants and neonates.

Thesis (MPA (School of Public Management and Planning))--University of Stellenbosch, 2005. / South Africa, as a young and emerging democracy, faces many challenges regarding the transformation of the socio-economic landscape of the South African society. The provision of better health care services and the overall development and empowerment of society are some of the many challenges government has to resolve. This research focuses specifically on service delivery in public hospitals with special emphasis on: 􀂙 An assessment of financial management outcomes within the context of the implementation of the Public Finance Management Act (Act 1 of 1999, as amended) [PFMA] in public hospitals; and 􀂙 An assessment of supply chain management (SCM) outcomes in relation to the achievement of empowerment and equity of disadvantaged communities within the context of Black Economic Empowerment (BEE). The PFMA is the result of financial reform in South Africa. The PFMA emphasises effective, efficient, economic and transparent use of public funds. This research assessed the financial management at the Head Office of the Western Cape Health Department, as well as at Karl Bremer, Lentegeur and Swellendam Hospitals for the financial years 1998/99 to 2002/03. The Western Cape Tender Board ceased to exist in December 2003. The procurement and provisioning processes have now been decentralised to the various departments with effect 1 January 2004 and have become the responsibility of supply chain units within departments. BEE and the preferential procurement policy are government initiatives that had to be executed on SCM as platform. The three hospitals were also used to assess progress on the implementation of SCM, as well as the realisation of BEE objectives. Annual Reports, Audit Reports and Strategic Planning documentation were used to extract the relevant information necessary for the research. Interviews with nineteen (19) officials were conducted. Good progress has been made with the implementation of the PFMA. All those officials that were interviewed displayed sensitivity for the responsible management of public funds. A lack of internal control measures was identified in almost all audit reports. The absence of a risk management plan and a functional internal audit unit is hampering the realisation of the objectives of the PFMA. With health care service delivery and black economic empowerment being topical issues in SA, this research endeavours to make recommendations that could assist the Western Cape government with the realisation of the intended objectives of better health care services delivery by public hospitals, transformation of the economy, equity and empowerment of the disadvantaged through SCM processes and eventually to secure “a better life for all”.

Submitted in fulfillment of the requirements for the Degree in Masters of Technology in Nursing, Durban University of Technology, Durban, South Africa, 2016. / Introduction Registered midwives are expected to practice their duties within the parameters of their scope of practice. Pregnant women have certain expectations about the midwife and their skills. If such expectations are not met, substandard care occurs. Such substandard care has a negative impact for both the pregnant woman and the Department of Health. Aim of the study The aim of this study was to explore and describe the experiences of midwives working in maternity units, concerning midwifery practice breakdown in maternity units at a public hospital in KZN. Methodology A qualitative research study that was exploratory, descriptive and contextual in nature was conducted. Semi-structured interviews were conducted with 13 midwives. Data was transcribed verbatim then organised into codes. Results The study revealed that the majority of the participants faced practice breakdown almost daily and most of the midwifery practice breakdowns start during antenatal care visits. Midwives who attended to pregnant women during antenatal care did not follow set protocols and guidelines and this resulted in complications during delivery. Most midwives were emotionally stressed and did not wish to continue practicing midwifery. Midwives were of the opinion that the management did not care about their challenges and did nothing to resolve the challenges. / M

Comme dans la plupart des pays développés, l’hôpital public français fait face à de nombreux défis : démographie médicale défavorable, évolution des modes de prise en charge des patients, accumulation de réformes introduisant de nouvelles règles de financement ou de gouvernance, etc. L’organisation encore très éclatée du maillage hospitalier, qui compte près d’un millier d’établissements publics, rend difficile une transformation d’ampleur qui réponde à ces multiples contraintes.Dans ce contexte, la loi de modernisation de notre système de Santé de 2016 impose désormais à tous les hôpitaux publics de France d’adhérer à un Groupement Hospitalier de Territoire (GHT). Le GHT s’inscrit à la suite de nombreux instruments d’action publique visant à réorganiser le paysage hospitalier, mais dont les effets ont été souvent modestes. De multiples interrogations entourent cette nouvelle réforme, aussi bien à propos de ses finalités que de ses conditions de mise en œuvre. En effet, elle tranche avec le mouvement de reprise en main par l’Etat qui prévalait jusqu’à présent, en laissant une large autonomie aux acteurs de terrain dans son application.La thèse repose sur l’analyse de cette mesure, à travers l’étude de trois cas de construction de GHT. La principale ambition de notre travail est de s’interroger sur l’inscription de la réforme des GHT dans un nouveau paradigme de l’action publique.Nous montrons que malgré ses objectifs en apparence relativement vagues, cette réforme marque une véritable rupture dans l’action de l’Etat, visant à amorcer des dynamiques locales d’exploration de nouvelles modalités d’orga-nisation territoriale de l’offre de soins. Cette approche correspond à un nouveau régime de gouvernementalité, qui offre aux acteurs des objets de gouvernement, comme les parcours des patients, capables d’enclencher des apprentis-sages collectifs à travers la mise en place de partenariats d’exploration. Toutefois, en raison de plusieurs incohérences persistant dans l’action de l’Etat, les trajectoires de ces GHT s’annoncent hétérogène. Nous formulons donc quelques préconisations pour le management de ces dynamiques exploratoires, ainsi que pour une ingénierie de l’action publique plus cohérente, afin de mener à bien ces nouvelles orientations. / As in most of developed countries, French public hospitals are facing several challenges: shortage of medical resources, development of new care practices, 
as well as recurrent reforms introducing new financing or governance rules. The fragmented organization of the hospital network, which is made up of nearly a thousand public institutions, makes it difficult to implement a large-scale transformation that would meet these multiple constraints.In such a context, the latest healthcare law (2016) now requires all public hospitals in France to join a Territorial Hospital Group (THG). THGs come after a series of instruments that aimed at reorganizing the territorial hospital organisation, with mixed results up to now. This new reform has aroused many questions regarding its objectives and implementation conditions. Indeed, it contrasts with the strong state-control trend that had prevailed so far, by giving local actors a large amount of autonomy.The thesis is based on the analysis of this reform through a multiple case study. The main ambition of this work is to question the inclusion of the THG law in a new public action paradigm.Despite its apparently relatively vague objectives, I show that this reform is a real break in public action, as it aims at initiating local exploration dynamics around new territorial organizations. This approach corresponds to a new governmentality regime, providing actors with specific objects of government, such as care pathways, capable of triggering collective learning through the creation of exploration partnerships. However, due to remaining inconsistencies in the government’s action, the trajectories of these THGs appear to be very heterogeneous. Therefore, I suggest several recommendations for the management of these exploration dynamics, as well as for consistent public action engineering, in order to carry out such new orientations.

Cette thèse est consacrée à une analyse synoptique de la légitimité des hôpitaux publics tunisiens. Cette légitimité de l’hôpital étant construite en interne et en externe par le personnel qui y travaille et les patients qui le fréquentent, nous l’avons soumise à une catégorisation spatiale en légitimité « intra-organisationnelle » et en légitimité « extra-organisationnelle ». Au niveau intra-organisationnel, les hôpitaux publics tunisiens, ayant fait l’objet d’une réforme débutée depuis un peu plus de deux décennies, l’étude de leur légitimité ne pouvait se faire à l’insu de cet évènement. Par ailleurs, étant donné le caractère professionnel des hôpitaux publics et leur organisation en plusieurs services spécialisés, nous avons procédé à une scission de leur légitimité en légitimité « professionnelle » et en légitimité de « service ». Ces « sous-légitimités » agrégées ensemble ont permis de reconstituer la légitimité globale de l’hôpital. L’analyse de la légitimité « intra organisationnelle » s’est faite au moyen d’une analyse qualitative par étude de cas dans deux EPS tunisiens. Pour le cas de la légitimité de la réforme hospitalière et des mécanismes qui lui ont servi de support, nous avons postulé l’existence d’une relation de causalité circulaire entre institutionnalisation et légitimation, la deuxième étant un préalable à la première. Les analyses menées sur l’ensemble des mécanismes de la réforme ont conclu à une faible institutionnalisation, laissant augurer d’une faible légitimation. Pour le cas des légitimités au niveau professionnel et de service, les résultats ont affiché une grande diversité des légitimités en jeu entre les services hospitaliers et une plus grande homogénéité au sein des mêmes groupes professionnels. Ces résultats attestent du caractère discriminant de l’appartenance au service et professionnelle pour juger de la légitimité de l’hôpital. Au niveau extra-organisationnel, la légitimité de l’hôpital renvoie à celle développée par les patients en externe. Nous avons considéré deux catégories de patients : des patients appelés « classiques » qui s’adressent à l’hôpital pour l’obtention de soins et des patients personnel de l’hôpital, qui en leur qualité de citoyens peuvent s’y présenter pour se soigner. C’est ainsi que nous avons distingué entre légitimité extra-organisationnelle « profane » et entre légitimité extra-organisationnelle « expertale ». Ces deux sous-légitimités relèvent d’une légitimité « expérientielle ». Les patients « profanes » et « experts » vont juger de la légitimité de l’hôpital en s’appuyant sur leur expérience personnelle. Ces deux catégories de légitimité, soumises à une classification hiérarchique ascendante, ont affiché des divergences considérables, les patients étant plus portés vers des aspects moraux pour juger de la légitimité contrairement au personnel, qui maintient intact son ancrage professionnel, en accordant plus d’importance aux aspects techniques et financiers. / This dissertation aims to analyze synoptically the legitimacy of Tunisian public hospitals. This hospital’s legitimacy is constructed internally and externally by both the employees and the patients, has been submitted to a spatial categorization in “intra-organizational legitimacy” and “extra- organizational legitimacy”. At intra-organizational level, Tunisian public hospitals have been subject of a reform that started a little over two decades; the study of their legitimacy could not be done without the knowledge of this event. In addition, given the professional characteristic of the public hospitals and their organization in several specialized services, we conducted a split of their legitimacy in “professional legitimacy” and “service’s legitimacy”. These sub legitimacies aggregated together helped restore the overall legitimacy of the hospital. The analysis of “intra organizational” was made using a qualitative analysis, by case studies in two Tunisian public hospitals. In the case of the reform’s legitimacy and the mechanisms that have served as support, we postulated the existence of a circular causality between institutionalization and legitimization, the second is a prerequisite to the first. The analysis conducted on all the mechanisms of reform have concluded to a weak institutionalization revealing a weak legitimacy. In the case of “professional legitimacy” and “service’s legitimacy”, the results showed a wide range of legitimacy at stake between and hospital services and a greater homogeneity within the same professional groups. These results attest to the discriminatory nature of the professional and service membership to judge the hospital’s legitimacy. At extra-organizational level, the hospital’s legitimacy refers to that developed by the patients. We considered two categories of patients: patients called “classic” that go to the hospital to obtain medical care and others hospital staff patients, who in their capacity as citizens may present themselves for treatment. Thus we distinguished between “profane extra-organizational legitimacy” and “expertal extra organizational legitimacy”. These two sub-legitimacies refer to “experiential legitimacy”. Both profane and expert patients will judge hospital’s legitimacy based on their personal experience. These two categories of extra-organizational legitimacy submitted to a hierarchical cluster analysis, showed significant differences, patients are more likely to judge legitimacy based on moral aspects, unlike staff who maintain intact their professional anchor paying more attention to technical and financial aspects.

Abstract This thesis set out to achieve the following objectives: (1) To identify the priorities and expectations that the Geelong community has of its public health care system. (2) To determine if there is a common view on the attributes of a just health system. (3) To consider a method of utilising the data in the determination of health care priority setting in Barwon Health. (4) To determine a model of community participation which enables ongoing input into the decision making processes of Barwon Health. The methodology involved a combination of qualitative and quantitative research. The qualitative work involved the use of focus groups that were conducted with 64 members of the Geelong community. The issues raised informed the development of the interview schedule that was the basis of the quantitative study, which surveyed a representative sample of 400 members of the Geelong community. Prior to reporting on this work, the areas of distributive justice, scarcity and community participation in health care were considered. The research found that timely access to public hospitals, emergency care and aged care services were the major priorities; for many people, the cost was less relevant than a quality service. Shorter waiting times and increased staffing levels were strongly supported. Increased taxes were nominated as the best means of financing the health system they sought. Community based services were less relevant than hospital services but health education was supported. An egalitarian approach to resource distribution was favoured although the community was prepared to discriminate in favour of younger people and against older people. There was strong support for the community to be involved in decision making in the public health care system through surveys or focus groups but very little support was given to priorities being determined by politicians, administrators and to a lesser extent, medical professionals.

No description available.

<p>Broad access to healthcare services is a key factor of human development in any country. The current health care situation in South Africa can be diagnosed as critical. The hospitals are understaffed, over-occupied and the diseases like Human Immunodeficiency Virus (HIV) give health care workers additional challenges. The demand for management skills in the health sector including those for nurse managers is high. A recent World Health Organization (WHO) study of nurses working in maternal health services identified good management as more important than salary, unless the remuneration was dramatically higher. In South Africa, little empirical research exists about the management skills of nurse managers, even though proper management of human resources is vital to achieve better outcomes and access to health care around the world. In South Africa, a greater focus on human resource management in health care and more research is needed to develop new policies that will help to address the skills gap of nurse managers. The object of this research project was to identify the gaps between required and existing management skills of senior nurse managers in South Africa in private and public hospitals. Once identified, this skills gap assessment can be used by employers and policy-makers to define the management education that nurse managers require. The research is based on a survey of nurse managers in private and public hospitals using a questionnaire. The survey instrument was based on prior research of hospital managers&rsquo / competencies in South Africa, and a review of the related theoretical literature.</p>