Thesis (M.S.)--University of Michigan, 1995.

South Africa has been brain drained of nurses and doctors and the Eastern Cape as a Province within South Africa is not an exception. Its rural nature has caused many nurses and doctors loose interest of serving in its facilities. This study sought to describe factors that can influence retention especially of nurses in the rural health facilities of the Eastern Cape Province and develop recommendations for nurse managers on how to retain nurses in rural areas. The major inferences drawn from this study is that nurses are dissatisfied with lack of promotional opportunities, lack of professional support, facing drastic responsibilities but with less income, tremendous workloads, emotional demands and unrealistic salary package. The researcher believes that the nurse managers have a crucial role to play in ensuring nurse retention and the recommendations drawn from this study can contribute in improving the work environment. / Health Studies / M.A. (Health Studies)

The purpose of the study was to assess the coverage and effectiveness of the management of severe acute malnutrition project implemented in Dhas district of Borena zone, Ethiopia, from July 2010 to December 2010. Quantitative, descriptive study was conducted to assess the comparability of the outcome of community-based management of acute malnutrition in a pastoralist area to International Sphere standards using performance indicators. Data collection was done using data capturing sheet. Outpatient therapeutic programme (OPT) registers in all health facilities were the sources of data. Clinical records of children admitted to the programme (n=163) were analysed. Standard nutrition survey result was used to estimate the malnutrition prevalence and programme coverage. International Sphere standard was achieved for mortality rate but not for recovery rate, defaulter rate, length of stay and weight gain / Health Studies / M.A. (Public Health)

Thesis (MPH.) -- University of Limpopo, 2015 / Background: The revised Infant and Young Child Feeding Policy (IYCFP) 2013 encourages HIV-positive mothers to also exclusively breastfeed for six months, and to continue breastfeeding for a year with introduction of appropriate complementary feeding, while their children receive antiretroviral treatment. The aim of this study was to determine knowledge and practices of the Primary Health Care Workers (PHCWs) related to the implementation of the revised IYCFP 2013 in the Blouberg Municipality of Capricorn District, Limpopo Province. Methods: A quantitative descriptive study was conducted on 103 PHCWs. The questionnaire was closed ended. The questionnaire was developed based on the contents of the revised IYCFP 2013. A simple random sampling technique was used to sample nurses irrespective of the category. Data were analyzed through SPSS Software v23.0. Results: Most participants were females (91.3%), category were Professional Nurses (44.7%), aged between 31 and 40 years (44.7%) and also mostly worked for >10 years (56.3%). The results revealed that 97.1% of the participants have good knowledge about infant and young child feeding, 68% of participants were not trained on the revised IYCFP 2013, resulting to only 32% of participants having a good practice of this policy. Also 44.7% of the participants reported that they were not aware if clinics had a copy of this policy. The results further revealed that 92.2% of the participants reported that clinics still receive, keep and issue infant formula to HIV positive mothers, which maybe the reason the dieticians still receive requests for Infant Formulas to be delivered to HIV-positive mothers. Conclusion: There is a need for monitoring and evaluation to ensure availability and vi implementation of the revised IYCFP 2013; and also the need for in-service training on this policy in order to improve the capacity to implement the revised IYCFP 2013. Key Concepts Revised IYCFP 2013; knowledge; practice; implementation; PHCWs; infant and young child feeding.

Thesis (MPH.) -- University of Limpopo, 2015 / Background: The revised Infant and Young Child Feeding Policy (IYCFP) 2013 encourages HIV-positive mothers to also exclusively breastfeed for six months, and to continue breastfeeding for a year with introduction of appropriate complementary feeding, while their children receive antiretroviral treatment. The aim of this study was to determine knowledge and practices of the Primary Health Care Workers (PHCWs) related to the implementation of the revised IYCFP 2013 in the Blouberg Municipality of Capricorn District, Limpopo Province. Methods: A quantitative descriptive study was conducted on 103 PHCWs. The questionnaire was closed ended. The questionnaire was developed based on the contents of the revised IYCFP 2013. A simple random sampling technique was used to sample nurses irrespective of the category. Data were analyzed through SPSS Software v23.0. Results: Most participants were females (91.3%), category were Professional Nurses (44.7%), aged between 31 and 40 years (44.7%) and also mostly worked for >10 years (56.3%). The results revealed that 97.1% of the participants have good knowledge about infant and young child feeding, 68% of participants were not trained on the revised IYCFP 2013, resulting to only 32% of participants having a good practice of this policy. Also 44.7% of the participants reported that they were not aware if clinics had a copy of this policy. The results further revealed that 92.2% of the participants reported that clinics still receive, keep and issue infant formula to HIV positive mothers, which maybe the reason the dieticians still receive requests for Infant Formulas to be delivered to HIV-positive mothers. Conclusion: There is a need for monitoring and evaluation to ensure availability and vi implementation of the revised IYCFP 2013; and also the need for in-service training on this policy in order to improve the capacity to implement the revised IYCFP 2013. Key Concepts Revised IYCFP 2013; knowledge; practice; implementation; PHCWs; infant and young child feeding.

The leadership of several health districts in the rural Appalachian region of northeast Tennessee and southwest Virginia has expressed interest in addressing the educational needs of their employees. The majority of these workers have not completed an undergraduate degree, but they desire to further their education. The College of Public Health at East Tennessee State University has begun preliminary discussions with these leaders to identify potential approaches to address these needs. There appear to be four approaches that should be explored by regions facing similar challenges: on-line or on-line/on-site degree completion programs; course clusters provided for academic credit; partnerships with community colleges; and training programs offered for nonacademic credit.

The aging experience of men and women in rural America is different than that of their urban counterparts. In this study, I identified key disparities in access to health care, mortality, and utilization of health care that result from geographic location. Foundational theories are discussed to illustrate that disparities can originate from historical societal behaviors. Secondary data and literary reviews create a combined qualitative and quantitative approach to explore the rural/urban divide, concluding that the potential for increased disparities as the aging population grows is very real and rural residents remain vulnerable to a poor(er) aging experience. Recommendations for policy and practice, as well as additional research, are made to address the conclusion.

National health care reform proposals advocate Primary Health Care (PHC) and preventive medicine as an efficacious way to control health care costs in the United States. This study examined a community in rural, southwest Virginia and evaluated the potential for PHC success. The study used focus groups to determine how Women Users, as consumers of health care, view their health and health care problems and potential solutions. Views of Community Leaders and Service Providers, as controllers of services, were obtained using semi-structured interviews. The results were compared using the PRECEDE framework of predisposing, enabling, and reinforcing factors influencing health behavior. This study was a component of a larger project - The Dickenson County Women's Health Project. The premise of that project was that women in Dickenson County would respond to a health education intervention program and the goal was to develop such a program. This study shows that Women Users fully comprehend the health behaviors and available services that would make themselves more healthy, but feel constrained by enabling and reinforcing factors that prevent healthy lifestyles. By contrast, Service Providers and Community Leaders focus on predisposing factors and remain convinced that women in Dickenson County need more education about healthy lifestyles and available health services. The study concludes that the women of Dickenson County are valuable resources for health program development. The success of PHC in Dickenson County is wholly dependent upon developing a mechanism whereby women are given a greater voice in program development and implementation. / Master of Urban Affairs

Thesis (MComm)--Stellenbosch University, 2002. / ENGLISH ABSTRACT: Historically health care in South Africa has been an area of great inequity. Health care was inequitable, inadequate and racially based. In order to redress the gap in the delivery of health care services, created by the previous dispensation of separate development, the National Department of Health has adopted a Primary Health Care (PHC) approach as the guiding principle for the reconstruction of the health system in South Africa. One of the pillars of this approach is the empowerment of communities to participate, thus moving from facility based- to community based health care. The aim of the National Health System (NRS) is to promote health and health knowledge, to provide an equitable, accessible, and appropriate health service, and to empower people to take greater responsibility for their own health. It is constructed around the belief that health for all cannot be achieved simply by improving the formal health system, but that a holistic and multi-sectoral approach is required. This thesis explores the community health worker (CRW) as a possible cost-effective and efficient supplementary service, to the current formal health system, to bridge the gap in the formal health system through the provision of PHC services in a rural setting. This was done through the economic evaluation of a CHW programme operating in the Winelands are of the Western Cape. The aim of this study was to evaluate and analyse the nature, performance, and costs of the programme and place it in context by comparison to other similar programmes. This comparison focused on physical characteristics, goals, and cost structures. It also aims to measure the direct and indirect impact of this type of intervention on the agribusiness sector as well as the local health authorities. The evaluation proceeded from the premise that the CHW programme, if implemented correctly with proper and appropriate training, and adequate post training support, will be a cost-effective and efficient model for the provision ofPHC services in this rural/farming area. The economic evaluation of this CHW programme required it to be viewed from two perspectives. The first component viewed the implementation of the programme from the perspective of the agribusiness sector. This aspect of the study included both a qualitative as well as a quantitative VIew of the costs, benefits (perceived or otherwise), and perceptions of the CHW intervention. The second component assessed the CHW programme within the context of a resource constrained public sector health budget. Since the implementation of this programme implies certain expenditures on the part of the local health authorities, these cost had to be identified and quantified to gauge the effectiveness of that expenditure. / AFRIKAANSE OPSOMMING: Geskikte en doeltreffende gesondheidsdienste in Suid-Afrika se onlangse geskiedenis was nog gereserveer vir 'n uitgesoekte groep mense. Die gesondheidstelsel was ontoereikend, onvoldoende en gebaseer op ras. Daar het 'n gaping ontstaan tussen die dienste wat gelewer is en die werklike behoeftes van die mense wat dit moes gebruik. Ten einde hierdie gaping aan te spreek het die Nasionale Departement van Gesondheid besluit om 'n Primêre Gesondheidsorg (PRe) benadering te volg wat klem plaas op die bemagtiging van plaaslike gemeenskappe deur deelname. Dit was 'n duidelike skuifvanaffasiliteit- na gemeenskap gebaseerde gesondheidsdienste. Die oorkoepelende doel van hierdie verskuiwing in fokus was om voorheen benadeelde gemeenskappe voldoende toegang te gee tot gesondheidsdienste en ook om hierdie dienste aan te pas by die behoeftes van sodanige gemeenskappe. Hierdie tesis ondersoek die Wynland distriksraad se Gemeenskap Gesondheidswerker Program as 'n moontlike koste-effektiewe stelsel vir die lewering van toepaslike primêre gesondheidsdienste in landelike areas. Die doel van die studie was die sistematiese ontleding van die werking en omvang van, en die kostes verbonde aan die implementering en onderhoud van hierdie program. Die studie poog om die impak van hierdie program op die formele landbou sektor asook die plaaslike gesondheidsowerhede te identifiseer en, waar moontlik en prakties wenslik, te kwantifiseer. Die ondersoek sluit in die stelselmatige ontleding van kostes en voordele vir die formele landbou sektor sowel as die plaaslike gesondheidsowerhede. Die kostes asook die kliniese uitkomste geassosieer met die implementasie van die Gesondheidswerker program sal dan in konteks geplaas word deur dit te vergelyk met ander soortgelyke programme wat in die verlede aangepak is. Die vergelyking sal fokus op die fisiese eienskappe, koste struktuur, bronne van ondersteuning en die primêre doel van die intervensie.

Since 1994 a number of health reforms took place in furthering democracy. These changes included the decentralisation of Primary Health Care Services. This study is a phenomenological research that chronicles the Primary Health Care decentralisation experiences in the Bophirima District of the North-West Province. Using a descriptive phenomenological orientation, the purpose of this study was to describe the experiences of participants associated with decentralisation in the Bophirima District. Also, to illustrate how the participants perceive these experiences in relation to Primary Health Care services. Furthermore, to provide scientific evidence regarding factors related to the decentralisation of PHC services in the Bophirima District. These and other issues remain of paramount importance given the current state of health care in the South Africa. This study took place in the outskirts of the semi-rural area of Bophirima and Central District in the North-West Province. The investigation followed qualitative research design that was descriptive, exploratory, contextual and phenomenological in nature. The sampling procedure involved non-probability purposive, sampling technique with a sample size of five participants. Data was collected by using an unstructured interview technique. The modified Giorgi method of analysis was used for qualitative data analysis. These are contained in Burns and Grove (2001:596) and Polit and Beck (2004:394) are fully explicated in Chapter Four. Guba model (in Babbie & Mouton, 2001:180) was utilised to ensure the trustworthiness of the study. Ethical requirements were considered throughout and these are reflected in chapter four of the thesis.Three forms of decentralisation: deconcentration, delegation and devolution were identified in the findings. The investigation further indicated that the integration of primary health care services was also underway at the time of decentralisation. This integration triggered different psychological and emotional states amongst research participants. Most importantly, the research revealed that the interest of leadership across three spheres of government played a key role in the decentralisation of PHCs and integration of PHCs, while highlighting the importance of community participation in health service delivery (CP). In conclusion, the decentralisation process was generally perceived as empowering although, nationally, leadership needs to be strengthened to support provinces and districts regarding major policy issues such decentralisation. Key recommendations were made and further research was suggested. / Health Studies / D. Litt. et Phil. (Health Studies)