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Implementation of Anti-Retroviral Therapy (ART) pharmacy management information system in health facilities in EthiopiaMekdes Alemayehu Derseh 11 1900 (has links)
Health Management Information System (HMIS) in developing countries lags seriously behind as compared to the developed countries; and the existing HMIS in many countries is insufficient to support health management functions. The purpose of this study was to describe the implementation of Anti-retroviral Therapy (ART) pharmacy management information system in public health facilities.
Quantitative, descriptive research was conducted at 38 public health facilities. The participants of the study were Pharmacists and Druggists those are working at ART Pharmacy. Data collection was done by using structure questionnaire. 76 respondents were recruited to participate in the study.
The participants ages ranged from 26-50 years and all had more than 2 years’ work experience.
The study indicated that even if there is a system at most health facilities their utilization of information technology (IT) for pharmacy practice were not appreciated. The findings indicated that the need for creating awareness among professionals in giving more skill oriented and also a formal in-service information technology related trainings for the professionals. To achieve better utilization of information technology at health care delivery system particularly pharmacy practice, government and stakeholder should consider capacity building activities through proper training and it should also viewed as a long term socio-cultural and technical development process. / Health Studies / M.A. (Public Health with specialization in Medical Informatics)
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A comparison of the effectiveness of protease inhibitor-based highly active anti-retroviral treatment regiments in Trinidad and TobagoZiregbe, Elohor 21 October 2014 (has links)
Few studies have assessed the optimum second line highly active anti-retroviral therapy
(HAART) regimen in patients who had failed on the first-line HAART in resource-limited
settings. This study aimed to compare the Protease inhibitor (PI)-based second line
HAART regimens used in one clinic in Trinidad by comparing immunological, virological
and clinical outcomes of patients on the different second line HAART regimens.
The records of 35 treatment-experienced patients, over 21years of age and on PI-based
regimens for at least six months, were analysed using SPSS version 20.
The regimen containing TDF/FTC/AZT/LPV/r proved to produce superior outcomes
compared to the other second line regimens.
Due the small number of usable patients’ records, the findings cannot be generalised
but indicate directions for future studies attempting to compare the treatment outcomes
of different second line HAART regimens / Health Studies / M. A. (Public Health)
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HIV and AIDS in the workplace : the role of the employee assistant practitionersMatarose-Molehe, Martha Mpuseng 12 January 2015 (has links)
The purpose of this study is to explore the EAP environment and provide a better understanding of the related roles of the Employee Assistant Practitioners/Professionals (EAPs) in respect of their treatment of various forms of illnesses in the workplace – particularly HIV and AIDS. The EAP role is not aligned to any individual profession, as it is designed to match employees’ holistic needs. It is in this context that the repertoire of EAP roles would include caring, psycho-social, therapeutic and technical skills. The EAP role is therefore endowed with the potential to meet a range of inter-departmental and multi-disciplinary needs – such as Nursing, Allied Health Professions, and Healthcare Sciences.
A generic Assistant Practitioners Performance Management system (scorecard) had to be developed and agreed to with the City of Johannesburg’s (CoJ) Management in order to maintain consistency when developing APE programmes and roles. Notwithstanding the fact that the Employee Assistant Practitioners do also address the growing HIV/AIDS concerns in the workplace – including psycho-social problems of employees and their families – there is minimal acknowledgment of the EAPs’ roles, and little recognition of their welfare and well-being programmes.
Drawing eclectically from various inter-related disciplinary terrains, the study centripetally explores the roles of EAPs as well as HIV/AIDS frameworks in the workplace. Quantitative and qualitative descriptive research methods were employed to assess challenges encountered by the City of Johannesburg (C.o.J) employees and their dependants. Questionnaires were used for the data collection of this study. The repertoire of participants in the study (n=55) comprised of doctors, social workers, nurses, HR officers, and other CoJ employees themselves.
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The questionnaire became the pivotal quantitative data analysis reference point ias it focused on numbers or quantities, and less on the qualitative analysis, which focused on differences in quality. The results of the study are based on numeric analysis and statistics to quantify the qualitative analysis. The prevalence of fewer participants was largely influenced by the depth of the data collection process, which did not allow for large numbers of research participants.
The findings of the study revealed, amongst other factors, that there was an unsurpassed need to integrate different HIV/AIDS frameworks in order that the roles of EAPs becomes more effectively and efficiently defined and executed. The roles of EAPs were hitherto not well defined, resulting in duplication and confusion of service delivery to some employees utilising the EAP services. However, some of the EAP roles are highly appreciated and increasingly supported by managers and employees. Based on the findings of the study, recommendations were made for clarifying and extending the criticality of EAP roles and functions. / Health Studies / Ph. D. (Health Studies)
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Evaluation of the impact of the information-motivation-behavioural skills model of adherence to antiretroviral therapy in EthiopiaZeleke, Amsalu Belew 06 1900 (has links)
The purpose of the study was to evaluate the IMB skills model for its relevance to the
Ethiopian context. According to the model, adherence-related information and
motivation work through adherence-related behavioural skills to affect adherence to
ART. Quantitative, analytical, observational, cross-sectional, institution-based study was
conducted to evaluate the model by assessing those patients who have and do not
have the right information, motivation, and behavioural skills whether they have or do
not have good adherence to ART. Data was collected using structured questionnaires
where a total of 400 randomly selected participants provided data on adherence-related
information, motivation and behavioral skills as well as adherence behavior per se. Data
was analysed using the Statistical Package for Social Sciences (SPSS) version 20.0.
Both descriptive and inferential statistics used in the study. Only 90.75 % of the total
sample population reported ART adherence rate of more than or equal to 95% in this
study. Free and restricted model tests, through bivariate and multivariate analyses,
used to assess the propositions of the IMB model of ART adherence and provided
support for the interrelations between the elements proposed by the model. The study
has supported the applicability of the IMB model of adherence to the Ethiopian context
highlighting its application in adherence-promotion intervention efforts. The findings
revealed the need for on-going educational, informational and other interventions to
address the knowledge, motivation and adherence behavioural skills of patients in order
to improve the current levels of ART adherence behaviour. / Health Studies / D. Litt. et. Phil. (Health Studies)
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An evaluation of an HIV and AIDS management system (HAMS) in a Richards Bay company, KwaZulu-Natal : a case studyOdetokun, Joseph 03 September 2012 (has links)
Dissertation submitted in fulfilment of the requirements for the Degree in Masters of
Technology: Nursing, Durban University of Technology, 2012. / In South Africa, HIV and AIDS workplace programmes have been implemented for more
than two decades without any audited and certifiable standards. In 2007, the South
African National Standard launched South African National Standard (SANS 16001)
16001 to assist, encourage and support companies to implement minimum standards
for HAMS. Companies are now expected to use this standard to improve HIV and AIDS
Management System. It therefore, becomes imperative for companies to establish
workplace HAMS in line with the set standard. To determine to what extent the
company‟s HAMS has been aligned to the SANS 16001, an evaluation of the current
management system in relation to the new SANS 16001 system is needed.
Aim of the study
The aim of the study was to evaluate the implementation of the HIV and AIDS
Management System in a Richards Bay Company.
Methodology
A single case study using a quantitative research design was used to evaluate HAMS in
a Richards Bay Company. The sample consisted of all consenting participants who
were selected from key position holders in accordance with the requirements of SANS
16001: 2007 and the general workers. These key position holders were comprised of
senior managers, middle managers and those employees who play an important role in
implementing HAMS. Two different sets of questionnaires were used to collect data.
One questionnaire was used to collect data from the managers because they were key
role players in HAMS. The second questionnaire was used to collect data from the
general workforce. The data from the questionnaire was captured and subsequently
analysed using the version 9 of SPSS.
Results
There was evidence that the company was committed to continuous improvement
regarding HIV and AIDS management as indicated by both key position holders and the
general workforce.
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An evaluation of the efficacy of a HIV and AIDS management system in a multinational manufacturing organisation in KwaZulu-NatalPillay, Annezt Louise 25 April 2013 (has links)
Submitted in fulfilment of the requirements of the full Degree of Master of Technology: Nursing, Durban University of Technology, 2011. / South Africa is currently at the epicentre of the AIDS epidemic with 5.6 million
people living with HIV disease.
The province of KwaZulu-Natal has the
biggest burden with an antenatal HIV prevalence of 39.5% in 2010. It is
estimated that 24.5% of South Africa‟s working age population is HIV positive.
Most infected people living with HIV in Africa are between ages 15 and 50
years which is the peak working age. AIDS now causes more deaths and
suffering among the 18-44 year age group than any other disease.
Organisations clearly present as one of the most effective and significant
settings in which to respond to the epidemic. The effective management of
HIV and AIDS within organisations is critical in order to reduce the negative
consequences of the epidemic on the economy.
HIV and AIDS Management Systems (HAMS) within organisations have been
implemented for approximately twenty years but they have been largely
ineffective, mainly due to poor uptake of services. Therefore, there is a need
for HAMS practice to be evaluated in relation to current best practice
standards to ensure quality management, continual improvement and
successful uptake of services.
This qualitative study evaluated one organisation‟s HAMS in relation to SANS
16001 and described employees‟ experiences of HAMS in this setting. The
theoretical framework underpinning this study is the Deming cycle which is a
well known quality management system methodology.
From the results of the study it was apparent that the organisation was aligned
with most of SANS 16001 general requirements for HAMS. Employees experienced the intended benefits of prevention, treatment and support from
the organisation‟s HAMS.
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Factors associated with delayed entry into HIV medical care among HIV positive people who are aware of their status in Bulawayo ZimbabweMakasi, Tasara 02 1900 (has links)
Using non-experimental descriptive exploratory survey, this study sought to find out factors associated with delayed entry into HIV medical care among HIV positive people who are aware of their status. A quantitative design was used and a structured questionnaire was used as the data collection instrument. Respondents were patients in a hospital’s Opportunistic Infection Department whose hospital records indicated that they were HIV positive during the time of the study. The study found out that as much as 71.6% (n =43) first entered HIV medical care more than 12 months after testing HIV positive while 40% (n = 24) did so as a result of illness. Low education levels, unemployment and being single are associated with delayed entry into HIV medical care. A percentage of the population uses and trusts non-biomedical approaches to dealing with HIV/AIDS. Being diagnosed HIV positive is therefore not necessarily a strong reason enough for one to immediately enter into medical care. Intensive health education needs to be done at work places, health facilities, schools, through print and electronic media, churches and other community settings to equip the population with knowledge of the advantages of early entry into HIV care. / Health Studies / M.A. (Public Health)
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Pre-antiretroviral services in rural Ethiopia: patient retention, factors associated with loss to follow up, and reasons for discontinuationRobi, Zinash Dewo 06 1900 (has links)
This study was conducted to determine retention rate and factors associated with loss to follow-up (LTFU) of adult pre-ART patients in St. Luke hospital, Ethiopia. Cross-sectional study with quantitative and qualitative data collection techniques was used. Review of patient records, focus group discussions and review of program guidelines was conducted to determine level of adherence among pre-ART patients. In addition, pre-ART service quality and perceived reasons for discontinuation was explored. The study revealed that only 38.2% of the 335 patients enrolled in the pre-ART care were retained after 12 months of follow-up in the program. More than half (55.6%), of the LTFU occurred during the first 6 months of follow-up. Fear of discrimination, high transportation cost and mistrust in the pre-ART service were perceived reasons for LTFU. Absences of clear pre-ART service package and implementation guideline were also identified as important factors that may be related to LTFU. The findings call for improved quality of care and a better pre-ART service packaging that will address the gaps identified in order to increase patient retention. / Health Studies / MA (Public Health)
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Modelling the effects of deep brain stimulation in the pedunculopontine tegmental nucleus in Parkinson's diseaseGut, Nadine Katrin January 2014 (has links)
Based on the belief that it is a locomotor control structure, the pedunculopontine tegmental nucleus (PPTg) has been considered a potential target for deep brain stimulation (DBS) for Parkinson's disease (PD) patients with symptoms refractory to medication and/or stimulation of established target sites. To date, a number of patients have been implanted with PPTg electrodes with mostly disappointing results. Exact target site in PPTg, possible mechanisms of PPTg-DBS and likely potential benefits need to be systematically explored before consideration of further clinical application. The research described here approaches these questions by (i) investigating the role of the PPTg in gait per se; (ii) developing a refined model of PD that mimics the underlying pathophysiology by including partial loss of the PPTg itself; (iii) adapting a wireless device to let rats move freely while receiving DBS; and (iv) investigating the effect of DBS at different sites in the PPTg on gait and posture in the traditional and refined model of PD. Underlining the concern that understanding the PPTg as a locomotor control structure is inadequate, the experiments showed that neither partial nor complete lesions of PPTg caused gait deficits. The refined model showed hardly any differences compared to the standard one, but the effect of DBS in each was very different, highlighting the need to take degeneration in the PPTg into consideration when investigating it as a DBS target. The differential results of anterior and posterior PPTg-DBS show the critical importance of intra-PPTg DBS location: Anterior PPTg electrodes caused severe freezing and worsened gait while some gait parameters improved with stimulation of posterior PPTg. The results suggest mechanisms of PPTg-DBS beyond the proposed activation of over-inhibited PPTg neurons, including aggravation of already dysfunctional inhibitory input by anterior PPTg-DBS and activation of ascending projections from posterior PPTg to the forebrain.
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ART-related body composition changes in adult women in a semi-rural South African contextDe Bruto, Petro C. 12 1900 (has links)
Assignment (MPhil)--University of Stellenbosch, 2006. / ENGLISH ABSTRACT: The aim of this study was to investigate practical methods of monitoring AIDS related
wasting and lipodystrophy in a resource-poor clinical setting with HIV infected women as
the population group of interest. Measurement of body composition changes using
anthropometry is both cost- and time-efficient. Various different skinfolds were taken and
two different equations (the equations of Pollock et al. (1975) and Durnin and Womersley
(1974) for calculating body fat were used to determine the most promising method or
methods of monitoring body composition changes in a clinical setting.
Detailed anthropometric measurements were performed, as well as selected measurements
for haematological parameters and quality of life (QoL) for a group of 8 participants on
antiretroviral medication (ART group) and 6 participants who were not on treatment (TN
group). New variables namely, intra-abdominal indicator (IAI) and a percent of ideal body
mass to percent of ideal arm circumference ratio (%IBW:%IAC) were investigated as
possible indicators of lipodystrophy. Although measurements were taken at various timepoints,
three specific time-points were chosen for data-analysis for the ART group and two
time points for the TN group. These three time-points were, baseline (on the day of
recruitment for TN participants and within one month before the initiation of treatment for
ART participants), short-term (2 to 12 weeks after treatment initiation or the baseline
measurement or for the ART and the TN participants) and long-term (within one and a half
year of treatment initiation for the ART group).
ART and TN participants did not differ for many variables at baseline. The major
differences between ART and TN were in measured and derived variables of the arm,
especially percent of ideal arm circumference (%IAC) and upper arm fat area (UAFA),
which were significantly lower in the ART group.
CD4+ and QoL improved significantly for the ART participants from baseline to long-term.
This was not associated with changes in muscle mass, but rather some fat mass variables.
Participants on antiretroviral medication exhibited changes relating to abdominal obesity.
It was concluded that antiretroviral therapy contributed greatly to the QoL of the participants and it probably aided in the recovery from wasting for at least one participant
in this study. Measures of the arm can be used in a rural clinical setting to effectively
monitor patients with regard to AIDS related wasting. The new variables IAI and
%IBW:%IAC could be helpful in the monitoring of lipodystrophy and should be
investigated in future research. / AFRIKAANSE OPSOMMING: Die doelwit van hierdie studie is om praktiese metodes te ondersoek om VIGS-verwante
uittering en lipodistrofie te meet in ‘n plattelandse kliniese omgewing (waar hulpbronne
dikwels beperk is) met MIV ge-infekteerde vroue as populasiegroep. Die gebruik van
antropometrie om veranderinge in liggaamssamestelling te meet is beide koste- en
tydeffektief. Verskeie velvoumetings is geneem en twee verskillende vergelykings (die
vergelykings van Pollock et al. (1975) en Durnin en Womersley (1974)) is gebruik om
liggaamsvetinhoud te bereken, met die doel om ‘n belowende metode te vind om
veranderinge in liggaamssamestelling te meet in ‘n kliniese omgewing.
Verskeie antropometriese metings is geneem, sowel as uitgesoekte hematologiese en
lewenskwaliteitmetings (QoL) vir ‘n groep van agt deelnemers wat antiretrovirale
medikasie ontvang het (ART groep) en ses deelnemers wat nie hierdie behandeling ontvang
het nie (TN groep). Nuwe veranderlikes (binnebuikindikator (IAI) en die verhouding van
persentasie van ideale liggaamsmassa tot persentasie van ideale armomtrek
(%IBW:%IAC)) is ondersoek as moontlike aanwysers van lipodistrofie. Drie spesifieke
tydpunte vir die ART groep en twee tydpunte vir die TN groep is gekies uit die verskeie
tydpunte waarby metings geneem is, nl. basislyn (gedefinieer as die dag wat TN deelnemers
in die studie opgeneem is en 0 tot 4 weke voor die begin van behandeling vir die ART
deelnemers), korttermyn (2 tot 12 weke nadat behandeling begin is of na die basislyn
meting) en lang-termyn (binne een en ‘n half jaar nadat behandeling begin is vir die ART
groep).
By die basislyn tydpunt het min van die ART en TN deelnemers se gemete veranderlikes
verskil. Die ART en TN groepe het hoofsaaklik verskil ten opsigte van veranderlikes wat
betrekking het op die arm, veral persentasie van ideale armomtrek (%IAC) en bo-arm vetarea
(UAFA). Hierdie twee veranderlikes was beduidend laer in die ART groep as in die
TN groep.
CD4+ seltelling en lewenskwaliteit tellings het beduidend verbeter vir die ART deelnemers
van die basislyn tot die lang-termyn tydpunt. Hierdie veranderinge is nie samehangend met veranderinge in spiermassa nie, maar eerder met sommige vetmassa veranderlikes.
Deelnemers wat antiretrovirale medikasie ontvang het, het veranderinge getoon wat gedui
het op ‘n verhoogde neerlegging van vet in die buikarea. Ten slotte is bevind dat
antiretrovirale medikasie bygedra het tot die verbeterde lewenskwaliteit van die deelnemers
en dat dit waarskynlik ook die omkeer van uittering van ten minste een deelnemer
aangehelp het. Daar is ook bevind dat armverwante metinge gebruik kan word in die
plattelandse kliniese omgewing om pasiënte suksesvol te monitor ten opsigte van VIGSverwante
uittering. Die nuwe veranderlikes, IAI en %IBW:%IAC kan moontlik gebruik
word om lipodistrofie-verwante veranderings te meet en die gebruik van hierdie
veranderlikes behoort ondersoek te word in verdere navorsing.
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