Thesis (M.S.)--Massachusetts Institute of Technology, Alfred P. Sloan School of Management; and, (M. Arch.)--Massachusetts Institute of Technology, Dept. of Architecture, 1982. / MICROFICHE COPY AVAILABLE IN ARCHIVES AND DEWEY / Includes bibliographical references (leaves 159-160). / by William Aaron Gilchrist. / M.S. / M.Arch.

Thesis (M.A. (Nursing Science)) --University of Limpopo, 2018 / Introduction and background The shortage of human resources in rural areas remains a crisis, especially in subSaharan Africa, affecting rural primary health centres. The purpose of this study was to identify and describe factors influencing the retention of health care workers in rural clinics, in order to develop strategies to improve retention in rural clinics. Methodology A quantitative research method and descriptive design was used in this study. The population was professional nurses and operational managers in rural clinics. Simple random sampling was used to select the clinics, the professional nurses and operational managers. The sample size were 210 professional nurses and operational managers. Only 170 professional nurses and operational managers participated in the study. Data were collected using a questionnaire, and all ethical principles were adhered to. The data was analysed using SPSS version 22.0. Results The study revealed that there are complex interconnecting factors that affect retention. It was further revealed that age is the core factor affecting retention (P= 0.001) with 19 (100%) of those aged < 30 years intending to leave rural practice. Furthermore, more than half of the respondents 118 (87.06%) were dissatisfied with the salary they earned. Only 1 (0.6%) of the respondents had a masters’ degree. Conclusion It is therefore concluded that both financial and non-financial incentives such as education, improving working conditions and relationship with colleagues needs to be incorporated in order to improve nurse retention. Key words: Retention, migration, rural health care workers, job satisfaction

Thesis (MBA.) -- University of Limpopo, 2015 / The health profiles and outcomes in South Africa are unsatisfactory, not seeming to improve appreciably, amid the robust reform efforts, policies and strategies. These health challenges comprise largely of preventable conditions, as demonstrated by the quadruple burden of disease. Community participation, including the use of community governance structures in improving community health profiles and outcomes, are alluded to be beneficial in improving these communities` health profiles and outcomes. The main aim of this study was to understand the current and the potential future role and the factors at play, of the community governance structures in managing their communities` health profiles and outcomes, in the Zebediela sub-district, Limpopo, South Africa. A qualitative study was conducted, using the Zebediela sub-district as a case study, where from six out of the potential nine governance structures were interviewed and recorded in focus groups, using a pre-determined discussion guide. The recordings were analysed in-depth for themes, using the consistency matrix and the N-vivo data analysis. The results indicate that, the community governance structures are aware of the unsatisfactory health profiles and outcomes in their communities, but are not doing anything specific towards intervening to improve the situation. However, they are keen and willing to participate in improving the situation and are able to identify the potential role they can play, the skills and resources in themselves and in the communities, including the factors that facilitate and those that impede, their participation together with the recommendations of what can facilitate their participation and efficiency in improving their communities` health profiles and outcomes. The community governance structures represent a good opportunity to improve community health profiles and outcomes, through a specific strategic focus that would empower, support, motivate, strengthen and reinforce their current level of skills, functioning and participation.

Thesis (M.ED (Continuing care and Training)) --University of Limpopo, 2010. / This report describes the research conducted at Phuthanang Home Based Care in Mankweng Township in the Limpopo Province of South Africa. Mankweng constitute a mixture of both formal and informal settlements, both urban and rural settlements and is situated about 32 km to the east of Polokwane which is the provincial capital for Limpopo. The aim of the research was to investigate the challenges faced by Phuthanang Home Based Care (HBC) in providing care and training in Mankweng Township. Having established the challenges faced by Phuthanang Home Based Care the researcher intended to recommend possible solutions to these problems. In an attempt to meet the above mentioned aims; the following research questions were formulated: Main question: • What are the challenges faced by Phuthanang Home Based Care in providing care and training? The following sub questions were asked derived from the main question above: • What are the aims and objectives of Phuthanang Home Based Care? • What are the existing services and training programmes offered by caregivers at Phuthanang Home Based Care? • What are the experiences of caregivers in relation to training for Home Based Care? • What is the level of community participation in Phuthanang Home Based Care activities? Chapter two outlines the theoretical framework based on relevant literature on the subject under study. I also formulated assumptions about the challenges that could be facing home based care programmes; these include issues such as lack of funds, inadequate training and stigmatisation among others. In this chapter key concepts were defined and operationalised to suit this research and to avoid ambiguity in interpretation. Chapter three outlines the research methodology. It clearly explains the research design used, data collection and data analysis. This study was purely qualitative and took the form of a single case study design. This enabled a detailed and intensive study of the case as it exists in its natural setting. Data was collected according to two streams which are fieldwork and document analysis. In fieldwork the researcher used multiple data collection techniques which include open ended interviews with the Project Coordinator, Administrator and Caregivers. The other technique used was observations. A focus group interview with the Coordinator, Administrator and four caregivers was also employed during fieldwork. A data matrix was used in the analysis of data. Chapter four constitutes the presentation and analysis of findings of the study. In this chapter; I describe the setting of the organisation in terms of location, historical background as well as its aims and services rendered. It outlines the challenges encountered by Phuthanang Home Based Care in providing care and training based on the results from document analysis, interviews, observations and focus group interview with the Caregivers’, the Administrator and the Coordinator of Phuthanang Home Based Care. The findings will suggest recommendations that will help bolster the state of care giving, training, and improve the way care is rendered to people living with HIV/AIDS and other terminal illness. Chapter five presents my conclusions by outlining the challenges faced by Phuthanang Home Based Care in providing care and training. This chapter also presents recommendations that might contribute towards finding solutions to the problems faced by Phuthanang Home Based Care. After the recommendations I presented a section on reflections of the research process. In conclusion to this chapter I recommend further research on the challenges faced by home based care organisations which have an element of training in poor communities such as townships, informal settlements and rural areas.

Doctor of Philosophy / This work was digitised and made available on open access by the University of Sydney, Faculty of Dentistry and Sydney eScholarship . It may only be used for the purposes of research and study. Where possible, the Faculty will try to notify the author of this work. If you have any inquiries or issues regarding this work being made available please contact the Sydney eScholarship Repository Coordinator - ses@library.usyd.edu.au

It is well documented that rural and remote Australian residents have poorer access to medical services than their counterparts in capital cities. According to the Australian Institute of Health and Welfare in 1998 there were 75.3 vocationally registered general practitioners per 100,000 population in rural and remote areas, compared with 103.0 per 100,000 in metropolitan areas. In 1998 28.7% of the Australian population lived in rural and remote areas, so a substantial proportion of the Australian population is adversely affected by the unequal distribution of general practitioners. Australian country communities highly regard the services of general practitioners and they continue to demand residential medical services. Demand is driven by need for access to health services, but also by the intimate inter-relationships between the general practice and community sustainability. For example, the general practice contributes to the viability of the local hospital which is often a major employer in the district. Consequently, many country communities strive to keep their general practice by contributing to practice infrastructure, providing governance, raising funds for medical equipment, and actively helping recruitment. / thesis (PhDHealthSciences)--University of South Australia, 2004.

Remote area staff performing manual patient handling tasks in the absence of patient lifting hoists available in most health care settings are at an elevated risk of musculoskeletal injuries. The objective of this project was to identify the patient handling methods that have the lowest risk of injury. The patient handling task of lifting a patient from floor to a chair or wheelchair is a common task performed in a remote health care setting. The task was performed utilising three methods, these being: (1) heads/tails lift, (2) use of two Blue MEDesign?? slings and (3) use of a drawsheet. The task of the heads/tails lift was broken down into two distinctly separate subtasks: lifting from the (1) head and (2) tail ends of the patient load. These techniques were selected based on criteria including current practice, durability, portability, accessibility, ease of storage and cost to supply. Postural data were obtained using a Vicon 370 three - dimensional motion measurement and analysis system in the Biomechanics & Gait laboratory at the University of New South Wales. Forty reflective markers were placed on the subject to obtain the following joint angles: ankle, knee, hip, torso, shoulder, elbow, and wrist. The raw data were converted into the respective joint angles (Y, X, Z) for further analysis. The postural data was analysed using the University of Michigan???s Three-Dimensional Static Strength Prediction Program (3D SSPP) and the relative risk of injury was based on the following three values: (1) a threshold value of 3,400 N for compression force, (2) a threshold value of 500 N for shear force, and (3) population strength capability data. The effects on changes to the anthropometric data was estimated and analysed using the in-built anthropometric data contained within the 3D SSPP program for 6 separate lifter scenarios, these being male and female 5th, 50th and 95th percentiles. Changes to the patient load were estimated and analysed using the same computer software. Estimated compressive and shear forces were found to be lower with the drawsheet and tail component of the heads/tails lift in comparison to the use of the Blue MEDesign?? straps and head component of the heads/tails lift. The results obtained for the strength capability aspect of each of the lifts indicated a higher percentage of the population capable of both the drawsheet and tail end of the heads/tails lift. The relative risk of back injury for the lifters is distributed more evenly with the drawsheet lift as opposed to the heads/tails (tail) lift where risk is disproportionate with the heavier end being lifted. The use of lifter anthropometrics does not appear to be a realistic variable to base assumptions on which group of the population are capable of safely performing this task in a remote setting. This study advocates the use of the drawsheet lift in a remote setting based on the author???s experience and the biomechanical results obtained in this study. The drawsheet lift is both more accessible and provides a more acceptable risk when more than two patient handlers are involved, in comparison to the other lifts utilised lifting patients from floor to a chair.

The juxtaposition of doing ‘more with less’, and ‘being privileged to be a community welfare worker’ gives some indication of the anomalies present in how community welfare work is conceived and manifested. The original contribution of this thesis is to provide further knowledge and understanding of the nature, level and extent of paucity management models to inform the way that community welfare services are delivered in rural communities. Paucity management relates to the way that managers identify and utilise strategies to counter the anomaly of possessing a deep philosophical underpinning in the value of community work, with the lack of means to meet all the needs and expectations of community members. Fifteen managers from the Central West Region of New South Wales in Australia were asked to share work narratives about the way their activities contributed to sustaining their communities. The research confirms yet again that community services are delivered strategically in spite of, or because of, a resource poor environment that is mainly punctuated by the non-availability of ever-decreasing funds. New ways of seeking resources has resulted in managers and workers navigating competing priorities at ground level, with trying to balance the tensions implicit in a directive provider-purchaser work dynamic that has seen the evolvement of the hybrid government organisation. This qualitative research used a phenomenographic approach to collect the managers’ stories. Data collection methods included individual interviews, focus group discussions, as well as further consultative communication. A complex theoretical framework, incorporating ideas from paucity management, aspects of structuration, and chaos/ complexity, was used to analyse the data through a structure of awareness of variation in the managers’ experiences. The findings show that community welfare managers do work in a resource poor environment, do acknowledge the presence of paucity management, and do address the limit-situations of service delivery through different, but complimentary, paucity management models that are creative, pragmatic, communicatively competent, and ‘auto-managed’. Their combined narrative gives a clearer understanding of the style of management that the managers used, as well as some of the strategies that contributed to ‘chameleon qualities’ of management. / Doctor of Philosophy (PhD)

This study was unique in that it focused on the rural elderly of both Black and White ethnicity's, explored differences between groups by comparing use and knowledge of health services, and controlled for gender, income, educational attainment, health status, age, and health beliefs - the independent variables of the study. Knowledge and use of health services were dependent factors. The Anderson behavioral model (Anderson, 1995) has been extensively used to examine health service utilization. It conceptualizes health care use as the outcome of a complex pattern of interactions between predisposing, enabling, and need-for care characteristics. The literature has supported the utility of the behavioral model for assessing the health care practices of rural older adults. Four questions were posed. These were translated into hypotheses for statistical testing purposes. Black and White elderly residents of one rural county in South Carolina comprised the target population. A sample of 150 elderly residents, 75 Black and 75 White, were randomly selected for participation. The multidimensional health locus of control scales were modified and used in the test instrument to assess health beliefs (both internal and external). Descriptive and background data were gathered from administration of the survey. Data were analyzed using SPSS statistical software. Analysis of variance (ANOVA) and the LSD (least significant differences) test, in addition to regression analysis, were used to compute and identify differences between and among groups of data. This research concluded that there was no correlation between use of services and knowledge of facilities. There were differences in utilization by race, with Whites making greater use of health care facilities. Educational levels, health status, income, household composition, type of insurance, and age influenced health care use. It was not influenced by gender, distance from facilities, and health beliefs. There was a statistically significant difference between knowledge and race, with Blacks having higher knowledge scores. Gender, health status, income, distance from facilities, and health beliefs did not influence knowledge. However, educational attainment, type of insurance, household composition, and age did. Service use and knowledge were adequate, in contrast to findings in the literature. Recommendations for further study were formulated. / Graduation date: 1999

M. Tech. Business Information Systems / The purpose of the study was to develop a framework that could be used to assess e-health readiness for rural South Africa. Data for the study was collected from Moses Kotane Municipality in the North West Province of South Africa. One state hospital and ten clinics were used for data collection. From related literature, six constructs of; core readiness, structural readiness, engagement readiness, societal readiness, performance and effort expectance were used as pillars for e-health readiness assessment. The attributes that were identified in the literature were validated by healthcare administrators at the regional office of the Northwest province.