This thesis analyses the policy of curative health service delivery in North Darfur State, Sudan. Several authors have analyzed health service delivery issues, mainly focusing on controlling the spread of common diseases. No work has been done that focuses on the health policy aspect and its contribution to improving curative health service delivery, especially in areas affected by conflict since 2003. This study contributes to the body of knowledge on the nature and the evolution of health service delivery systems management, as well as policy implementation, thereby widening the discussion about the further projections of this field of study. The main purpose of this thesis is to investigate how to enhance the effectiveness and efficiency of curative health service delivery systems management, as well as policy implementation, in fostering socio-economic development in North Darfur State. The study focuses on how the national health system and national health policy of Sudan have been managed and implemented in North Darfur State. This thesis identifies the different health sectors, public, private and international NGOs, that provide curative health services in North Darfur State, and the difficulties that have been facing the population in accessing these health facilities. Investigations showed that curative health services are not adequate in the public sector, and that they are very expensive in the private sector. The exception is the NGO sector but it is not guaranteed to be sustainable in providing curative health services to poor and conflict-affected people. This thesis also identifies the mechanisms of health system management and policy implementation, by means of co-ordination and collaboration between the various government sectors, federal, state and district, in a decentralized system working in concert with international NGOs. The results show that there is poor co-ordination between the three levels of government, especially at district level, as well as poor collaboration between government and international NGOs, caused by government‟s lack of human and financial capacity. The potential for improvement in curative health service delivery are explored, particularly at district level. This is essential so that quality curative health services can be delivered to the population, thereby contributing to socio-economic development in North Darfur State. / Thesis (Ph.D.)-University of KwaZulu-Natal, Pietermaritzburg, 2012.

Introduction: Appalachian women have high rates of preterm birth and low birth weight infants. A new format of group prenatal care, known as CenteringPregnancy, decreases the rate of preterm birth and low birth weight when compared with individual care. However, clinics in Appalachia often struggle to recruit women into group care. Theory & Methods: Using critical realism and the middle-range theory of motivation-ease as frameworks, this qualitative study had two research questions: ‘What influences Appalachian women’s choice of traditional prenatal care instead of CenteringPregnancy care?’ and ‘What are Appalachian women’s perceptions of prenatal care and their access to prenatal care?’. Twenty-nine Appalachian women, who had declined CenteringPregnancy care, were interviewed about their perceptions of prenatal care, what facilitated care, and their decision to decline CenteringPregnancy. Verbatim transcripts of these semi-structured interviews, in-depth demographic questionnaires, and field notes were coded and analyzed using conventional (inductive) content analysis. Findings: Two meaning units were identified, information concerning women’s reason(s) for declining CenteringPregnancy and facilitators of prenatal care access. The reasons women provided for declining CenteringPregnancy care fell into three overarching categories, preferred one-to-one care, experienced barriers to Centering, and did not know Centering was an option. The most common reason for declining Centering was a preference for individual care. This category had three subcategories: do not like groups, don’t want to put everything out there with other women, and no need for change from existing care. Women predominately named two facilitators of prenatal care access, insurance and compassionate care. Conclusions: Clinicians should decrease barriers to CenteringPregnancy utilization and should partner with the local community to better market this new model of care. In addition, small modifications in Centering may make the model more appealing and accessible. However, clinicians should continue to provide individual care for women who cannot access group care. Participants stated state-provided insurance greatly facilitated prenatal care which supports the need for ongoing Medicaid funding. Women also stated compassionate care enhanced their ability and desire to get prenatal care. Healthcare providers should renew efforts to provide personalized and unrushed clinical environments to assist women in obtaining needed prenatal care.

Decentralization of health services in Uganda, driven by the structural adjustment programme of the World Bank, was embraced by government as a means to change the health institutional structure and process delivery of health services in the country. Arising from the decentralization process, the transfer of power concerning functions from the top administrative hierachy in health service provision to lower levels, constitutes a major shift in management, philosophy, infrastructure development, communication as well as other functional roles by actors at various levels of health care. This study focused its investigation on ways and levels to which the process of decentralization of health service delivery has attained efficient and effective provision of health services. The study also examined the extent to which the shift of health service provision has influenced the role of local jurisdictions and communities. Challenges faced by local government leaders in planning and raising funds in response to decentralized health serdelivery were examined.

Thesis (Ph. D.)--University of Washington, 2007. / Vita. Includes bibliographical references (leaves 88-109).

Thesis (M.A.)--University of Toronto, 2006. / Source: Dissertation Abstracts International, Volume: 67-07, Section: A, page: 2764. Includes bibliographical references (leaves 282-307).

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2007. / Härtill 4 uppsatser.

Diss. (sammanfattning) Stockholm : Karol. inst., 2004. / Härtill 4 uppsatser.

Thesis (Ph.D.)--University of Adelaide, Dept. of Public Health, 2000. / Bibliography: leaves 203-219.

Diss. (sammanfattning) Stockholm : Karol. inst., 2006. / Härtill 5 uppsatser.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2006. / Härtill 4 uppsatser.