Magister Philosophiae - MPhil / Background: In the Democratic Republic of Congo, 22.2% of the total population is in the age group of 15 to 24 years. In this country, this population group faces a large number of reproductive health problems. Even though the concerned health officials have implemented several health care programs, the youth particularly girls still have many problems particularly lack of sexual health information, poor health care, inability to avoid early and unprotected sexual relationships, early marriage, early pregnancies, early childbearing, etc. Objectives: The aim of this study is to examine reproductive health issues among young women and to understand how they utilise the health care systems in their respective socio-economic and demographic characteristic. Data and Methods: Descriptive and multivariate analyses were used. Cross tabulation, Chi-square, Phi coefficient and Cramer‘s V were applied to test for association between independents and outcome variables. At multivariate level of analysis, binary logistic regression was performed. All analyses were performed using the Statistical Package for Social Sciences (SPSS) version 23.0. Results: The study found that young women who faced early sexual intercourse (OR=73.5) and those who experienced it at 16-17 (OR= 42.3) are more at risk of early marriage than those who initiated at the age 18-24. Meanwhile, young women with no education (OR=14.1), primary and secondary education (OR=10.7 and OR=8.6 respectively) have a higher risk of early union than their higher educated counterparts. Furthermore, respondents who married in their early adolescence (OR=38.3) and middle (OR=20.0) adolescence are more at risk of early childbearing than those who married in their emerging adulthood. Moreover, young women from Maniema, Equateur and Bas Congo provinces are 95%, 62% and 58% (respectively) less likely to have had at least four ANC visits than those from Kinshasa. Conclusion: There is an urgent need for formal sex education before first sexual initiation to give better options than early marriage to adolescent girls. Also, the disparities in the antenatal care services utilization between provinces should be addressed. The concerned authorities should balance the distribution of health facilities and qualified personal among provinces.

Magister Scientiae Dentium - MSc(Dent) / BACKGROUND: The concept of consumer satisfaction is gaining momentum across all business sectors worldwide. In keeping with this trend, health care systems are now also being reviewed to assess patient satisfaction with regard to the quality of care provided. Patient satisfaction is an instrumental tool for identifying shortcomings and challenges of the health system, and provides patients with a constructive outlet to rate their hospital experience. AIM: To determine the perceived levels of patient satisfaction with health care services. METHODOLOGY: A descriptive cross-sectional study was conducted using patients who attended the Outpatients Department of Untunjambili Hospital in Kwa-Zulu Natal. A sample of 250 patients was selected using systematic random sampling. The research instrument, a structured questionnaire consisted of 23 questions which were subdivided into five categories, namely: biographical data; accessibility to the hospital; infrastructure; overall satisfaction and general comments. The 5-Point Likert Scale was used to determine the perceived levels of patient satisfaction. Data collected from the responses was analysed using the SPSS Programme, Version 22.0. A Significance level of (p=0.05) was applied. RESULTS: The response rate of the study was 99.2% (n=248).The majority of the respondents were female (75.4%) and aged between 20-30 years old. The relative ratio of males to females was approximately 1:3. Nearly half of the participants (48.4%) had a secondary education, and a high degree of illiteracy was noted (21.8%). The majority of patients relied on taxis as the mode of transport to reach the hospital (71.4%), with 55.2% having to pay more than R15.00 for travel costs. While statements relating to personality such as staff friendliness, and doctors treating patients respectfully scored highly (93.5%), more than two thirds reported dissatisfaction with the lengthy waiting times (71.8%). In terms of infrastructure, respondents were mainly satisfied with the seating arrangements, cleanliness and air circulation, but were unhappy with the state of the toilet facilities and the unavailability of drinking water. Overall, 90.3% of patients were satisfied with the level of care they received at Untunjambili Hospital, with 89.5% suggesting that they would recommend the institution to others.

No description available.

Thesis (MA)--Stellenbosch University, 2011. / ENGLISH ABSTRACT: The deaf community face similar access barriers to health care services and information as do other linguistic minority groups. Amongst others, this includes limited access to English communication, misunderstanding of medical terminology, irregular contact with health care professionals of the same language and cultural background and the need to overcome the challenges experienced by using others as interpreters in a health care setting. Barriers to the written and spoken word limit access to health care information as deaf people cannot overhear conversations, have limited access to mass media and present with low literacy rates. The South African Constitution stipulates that every citizen has an equal right to health care services and should not be unfairly discriminated against, on the basis of language. Unfortunately, despite what is written in the Constitution, the reality is that many South Africans are denied equal access or receive compromised access to health care services because of language barriers. The lack of access to interpreters at health care facilities across South Africa inhibits patients from expressing themselves correctly and limits the providers’ professional ability to make a correct diagnosis and provide relevant information. The current study explores the barriers and facilitators to accessing health care services and health care information for people who are deaf in a relatively well-resourced setting. A sample of deaf participants from the National Institute for the Deaf in Worcester were interviewed to gain an understanding of problems experienced with accessing health care services and health care information. Participants reported communication and socio-economic factors as barriers to accessing health care services. The main barrier to accessing health care information was considered to be the inaccessibility of the mass media. Recommendations were made by participants on ways to improve access to health care services and health care information for the deaf population of South Africa. Keywords: Health care acces, Health care information, Deaf, Worcester, Barriers and facilitators to health care services. / AFRIKAANSE OPSOMMING: Die dowe gemeenskap ervaar soortgelyke struikelblokke as ander linguistiese minderheidsgroepe met toegang tot gesondheidsdienste en inligting. Dit sluit onder andere in beperkte toegang tot Engelse kommunikasie, wanbegrip van mediese terminologie, ongereelde kontak met mediese dienspraktisyne van dieselfde taal en kulturele agtergrond, en die uitdaging wat oorkom moet word om ander mense te gebruik as tussenganger en tolk in ’n mediese situasie. Hindernisse met geskrewe- en spreektaal beperk die toegang tot gesondheidsinligting. Dowe mense kan nie na gesprekke luister nie, het beperkte toegang tot massamedia en vertoon oor die algemeen 'n laer geletterdheidsprofiel. Die Suid Afrikaanse Grondwet stipuleer dat elke burger ’n gelyke reg tot gesondheidsdienste het en verbied onregverdige diskriminasie op grond van taal. Ten spyte van die Grondwet is die realiteit dat baie Suid Afrikaners nie gelyke toegang het nie en ’n laer vlak van mediese dienslewering ervaar as gevolg van taalprobleme. Die ontoereikende beskikbaarheid van tolke by gesondheidsfasiliteite reg oor Suid Afrika beperk die vermoë van pasiënte om hulself behoorlik uit te druk. Dit beperk daarom ook die mediese praktisyn se vermoë om ’n korrekte diagnose te maak en relevante inligting rakende die diagnose aan die pasiënt oor te dra. In die huidige studie is die struikelblokke en fasiliteerders vir toegang tot gesondheidsdienste en inligting ondersoek vir dowe mense in ’n relatief goed toegeruste omgewing. ’n Steekproef van dowe deelnemers is by die Nasionale Instituut vir Dowes in Worcester geselekteer. Deur middel van onderhoude is die probleme wat ondervind word met toegang tot gesondheidsdienste en gesondheidsinformasie geïdentifiseer. Deelnemers het kommunikasie en sosio-ekonomiese faktore as struikelblokke tot die toegang van gesondheidsdienste geïdentifiseer. Die grootste struikelblok met toegang tot mediese inligting was die beperkte toegang tot massamedia. Voorstelle is deur die deelnemers gemaak vir die verbetering van die toeganklikheid tot mediese dienslewering en gesondheidsinligting vir die dowe populasie in Suid Afrika.

Thesis (LLM. (Labour Law)) -- University of Limpopo, 2013 / In the 18th years of our young but thriving democracy, several programmes were established to improve access to health care for disadvantaged groups in South Africa. Although numerous studies have been conducted examining trends on access to health care, considerable controversy remains. Nearly all authors concur that important progress has been made, and that gaps in access to health care narrowed considerably. Some however, go further and conclude that the evidence indicates that all significant gaps have been eliminated and access to health care is universally shared. Evidence on access to health care has important policy implications. If the task of assuming access to health care has been largely accomplished, further expansion of South African health care programmes to promote access would be unwarranted. If selected population groups lag behind others in access to health care, targeted policies to close remaining gaps may be warranted. The introduction of the National Health Insurance Scheme call for the health reform in South Africa and it will change the whole health sector and offers equal benefits on access to quality health care services to everyone in South Africa.

Company health care services Abstract The thesis deals with the legal regulation of the company health care services. The thesis' aim is to describe and evaluate the current legislation of the basic institutes of the company health care services and to point out the changes brought by the amendment to the Act on Specific Health Services, which became effective on 1st November 2017. The main chapters of this work are dedicated to the parties of the company health care services and medical documentation/patients' summaries. The thesis is divided into five chapters. The first chapter provides a brief overview of the legislation, which governs the area of company health care services. This legislation includes not only the national legislation but also the international and European law. The second chapter explains the term of health care services. It further divides company health care services into expert care, advisory and supervisory activities. The third chapter deals with the parties of the company health care services, which are the company health care services provider, the employer and the employee, and also points out their rights and obligations in the provision of company health care services. The largest part of this chapter is devoted to the company health care services provider, who has an...

This thesis focused on the situation of family members of persons with psychotic illness, particular on their experience of the approach of the healthcare professionals and of their feelings of alienation regarding the professional care of their family member. A further aim was to explore how siblings who have participated in a support group for siblings experienced their situation. A questionnaire was developed that enabled the aims of this thesis to be investigated (I). Seventy family members from various parts of Sweden participated, and data were collected via the questionnaire developed in study I (II-III). Thirteen siblings who previously had participated in a support group participated in follow-up focus groups interviews (IV). The questionnaire developed was shown to be reliable and valid in these studies (I). In many cases, the participants had experienced an approach from professionals that indicated that they did not experience openness, confirmation and cooperation, and that they felt powerless and socially isolated in relation to the care. There was also found to be a certain degree of association between how the participants experienced the approach and whether they felt alienation (II). The majority of the participants considered openness, confirmation, and cooperation to be important aspects of professional’s approach. The result also identified a low level of agreement between the participants’ experience and what they considered to be significant in the professional’s approach (III). The findings revealed the complexity of being a sibling of an individual with psychotic illness. Participating in a support group for siblings can be of importance in gaining knowledge and minimizing feelings of being alone (IV). Although the psychiatric care services in Sweden have been aware of the importance of cooperating with family members, the results indicated that there is a need for further research in this area.

The criminal defences are of a very high importance especially in the context of health care services. They set the conditions under which health care services may be provided without any criminal sanction. Legislation regarding the criminal defences has been under constant development and the topic remains very actual nowadays. The thesis is divided into five chapters. First chapter introduces the reader the issue and explains the importance of dealing with criminal defences. Second chapter concerns general aspects of criminal defences and is divided into three parts. First of them deals with the term of unlawfulness, since the circumstances which are subject to this research, exclude the unlawfulness. Next part is dedicated to the legal regulation of defences and relations between them. Last part of first chapter explains philosophical and moral principles of acting within the scope of defences. Such principles are introduced both on a theoretical level and practical cases. Third chapter deals with particular criminal defences, including the defences which are not explicitly stated in the criminal code, and thoroughly explains issues related to them in its five parts. First part offers detailed overview of conditions of necessity and its impact on providing of health care services. Attention is paid also...

Student Number 9705165A Master of Arts in Forced Migration Studies Faculty of Humanities / Objective: To identify and investigate barriers faced by Somali forced migrants when accessing health care in Johannesburg. In particular, the study seeks to compare perceptions of health personnel and migrants as to the nature of such access constraints. Design and Methods: The study made use of semi-structured and in-depth interviews with a snowball sample of health personnel and migrants. Ten health personnel were interviewed and twenty migrants (ten male and ten female). Results: Constraints of language and xenophobia were identified by both health personnel and forced migrant interviewed. Constraints related to the shortage of resources and the poor functioning of the referral system are experienced by all users of the public health system, irrespective of their nationality. No mention was made of traditional or allopathic medicine. Conclusions: There exists a gap between the access to health care guaranteed in the Refugees Act and practices at facility level. There are many similarities across interviews in the constraints identified by migrants and some agreement in the constraints identified by migrants and health personnel. These results confirm that migrants experience a fairly severe level of constraint when attempting to utilize formal health care services in Johannesburg.

Introdução: A legislação brasileira prioriza a atenção às crianças, aos portadores de deficiência, às gestantes, lactantes, pessoas acompanhadas por crianças de colo e pessoas idosas em serviços públicos e privados. No entanto, não é claro o que diferencia a priorização entre esses grupos ou dentro do mesmo grupo. Com o progressivo aumento da população idosa, faz-se necessária a adequação das políticas públicas de forma a atender as novas e crescentes demandas econômicas, sociais e de saúde. Em situações nas quais os recursos assistenciais existentes podem não ser suficientes para o atendimento global, torna-se necessária a hierarquização dos mesmos a partir de critérios objetivos e claros que reorganizem o fluxo assistencial dos serviços de acordo com as suas reais necessidades e demandas. Objetivo: Identificar os critérios relacionados à priorização de atendimento em saúde de pessoas idosas, considerando aspectos biomédicos/clínicos, epidemiológicos, etários e bioéticos. Método: Trata-se de um estudo de revisão bibliográfica realizada nas bases de dados CINAHL, EMBASE, LILACS e PubMed. Foram encontrados 1.973 artigos e, após análises, mantiveram-se 11 artigos. Resultados: Os trabalhos encontrados apresentaram-se de forma bem diversa em relação aos objetivos e metodologias utilizadas diante de diferentes formas de classificação, hierarquização e seleção de idosos de acordo com os riscos de gravidade, declínio ou morte. De acordo com os estudos, foram selecionados pacientes com maior necessidade ou risco de acordo com instrumentos ou por avaliação dos profissionais. Os principais motivos foram: idosos acima de 85 anos, homens, uso de polifarmácia, isolamento social, necessidade de ajuda para realizar as atividades cotidianas, comprometimento cognitivo e problema respiratório. Conclusão: A priorização dos cuidados de saúde dos idosos deve ser embasada em fatores que mais impactam essa população e em critérios que destaquem casos mais susceptíveis a riscos, mediante escolhas hierarquizadas entre alternativas de cuidados e recursos disponíveis. É necessário garantir o acesso aos idosos nos diferentes níveis de atenção à saúde de forma eficiente, permitindo o efetivo monitoramento e gerenciamento de sua condição clínica. / Introduction: Brazilian law prioritizes care for children, people with disabilities, pregnant women, nursing women, people carrying infants and elderly people in several public and private services. However, it is not clear what differentiates the prioritization between these groups or within each group. With the progressive increasing of the elderly population, it is necessary to adapt public policy in a way that suits the new and growing economic, social and health demands. In situations which the available care resources may not be sufficient to provide medical attention globally, it is necessary to hierarchize care through objective and clear criteria that allows a reorganization of the care flux according to the actual needs and demands of each case. Objective: To identify criteria related to the prioritization of health care for elderly people, considering biomedic/clinic, epidemiologic, age-related and bioethical aspects. Method: The following is a bibliography review study. The bibliographical search was done on the CINAHL, EMBASE, LILACS and PubMed databases. 1973 articles were identified and, after multiple analysis, 11 articles were kept. Results: The papers identified presented diverse objectives and methodologies, which were utilized to identify diferente forms of classification, hierarchization and elderly selection, accordingly to risks related to severity, decline or death. According to these studies, patients with more needs or in more risk were selected either through instruments or through professional evaluation. The main causes were: elderly over the age of 85, male, polypharmacy, social isolation, needing help to perform daily activities, cognitive impairment and respiratory issues. Conclusion: The prioritization of health care for the elderly must be based in the factors that cause the most impact on this population and in criteria that highlights cases more susceptible to risks, through hierarchized choices between care alternatives and the available resources. It is necessary to ensure access to elderly people on every different level of health care in an efficient way, allowing the effective monitoring and management of their clinical condition.