Access to affordable high-quality health care solutions is a global challenge, especially in emerging markets where health care systems are the most resource constrained. The socio-economic benefits of investing in health care are considerable, especially in terms of improvement of life quality and economic development. This creates a strong demand for efficient health care delivery models with good health outcomes. In particular, health programs targeting children in their formative years can have a longlasting effect on the children’s and their families’ lives. In India, which has one of the highest burdens of disease in the world, many states lack adequate school health programs. To address this need, the NICE Foundation has developed a school health program that provides free health care to over 200,000 children. The NICE Foundation has experienced a great interest in their school health model and thus aims to expand their operations. This study analyses the characteristics of the school health program in order to identify future opportunities and to provide strategic advice for the expansion of the NICE Foundation School Health Program. / Tillgång till prisvärd och högkvalitativ sjukvård är en global utmaning, i synnerhet i tillväxtländer där sjukvårdssystemen  är mycket  resursbegränsade.  De socio-ekonomiska  fördelarna  av att investera  i sjukvård  är avsevärda,  med förbättrad  livskvalitet  och ekonomisk  utveckling  som följd.  Det  finns  därför  en  stor  efterfrågan  på  effektiva  hälsomodeller  som  renderar  goda hälsoresultat.   Särskilt  hälsoprogram   som  är  inriktade  på  barn  i  deras  formativa  år  har dokumenterats ge långtgående positiva effekter för individerna och samhället. I Indien, som har en  av  de  högsta  nivåerna   av  sjukdomsbörda   i  världen,   saknar  många  av  delstaterna skolhälsoprogram.   För   att   addressera   detta   behov   har   NICE   Foundation   utvecklat   ett skolhälsoprogram   som  i  nuläget  erbjuder  gratis  sjukvård  för  över  200  000  barn.  NICE Foundation  skolhälsomodell  har  fått  mycket  positiv  respons  och  organisationen  ämnar  att expandera  programmet.  Denna  studie  analyserar  NICE  Foundation  skolhälsomodell  för  att identifiera framtida möjligheter samt för att tillhandahålla strategiska råd för expansion.

Thesis (MBA)--University of Stellenbosch, 2009. / ENGLISH ABSTRACT: The aim of the study was to assess the adult patients' perception of the quality of care received, following a visit to a doctor at Mthatha General Hospital Outpatients Department to establish whether it meets the patients' expectations, and to derive recommendations to improve the quality and assure that it is maintained. A cross-sectional survey was used to obtain the relevant data. A structured interview questionnaire was administered to a systemic sample of 204 adult patients attending the General Outpatients clinic at Mthatha General Hospital after a consultation with a doctor. Data was gathered and analyzed on the 204 patients' records using a Statistical package for Social sciences. This study has revealed that most patients are female (59%), aged between 16 and 70 years, with the majority in the 41 to 50 year age group. The majority of patients are unemployed (55.4%), with grade 1-8 level of education, have presence of long-standing illness or disability (54.9%), and are married (53.4%). The patients' perception of the quality of care was positive. The interpersonal aspects of care was judged by patients to be the most important, followed by technical aspects. Socio-demographic influences on perception of care were significant in those patients with long-standing illness or disability in respect of outcome aspects of care. It is recommended that patients' perception of the care provided to them be periodically assessed to ascertain if it meets their needs. / AFRIKAANSE OPSOMMING: Die doel van die studie was om die volwasse pasient se persepsie van die kwaliteit van versorgingsdiens, soos ervaar na 'n besoek aan 'n dokter by die Mthatha Algemene Hospitaal Buitepasiente Afdeling, te bepaal om gevolglik vas te stel of aan die pasient se verwagtinge voldoen is en om aanbevelings hiervan af te lei om kwaliteit te verbeter en te verseker dat dit volgehou word. 'n Deursnee peiling is gebruik om toepaslike data te bekom. 'n Gestruktureerde onderhoud-vraelys is aan 'n sistemiese monster van 204 volwasse pasiente by die algemene buitepasiente kliniek van die Mthatha Algemene Hospitaai gedoen na 'n besoek aan 'n dokter. Data uit die 204 pasienterekords is versamel en analiseer deur middel van 'n statistiese pakket vir die sosiale wetenskappe. Resultate toon dat die meerderheid pasiente vroulik (59%) en tussen 16 en 70 jaar oud is en oorwegend in die 41 tot 50 jaar ouderdomsgroep val. Die meerderheid pasiente is werkloos (55.4%), het 'n graad 1-8 vlak-opvoeding, vertoon met 'n langtermyn siekte toestand of ongeskiktheid (54.9%) en is getroud (53.4%). Die pasiente se persepsie van die kwaliteit van versorging was positief. Interpersoonlike aspekte van versorging is deur pasiente as die belangrikste beskou, gevolg deur tegniese aspekte. Sosiodemografiese invloede op die persepsie van uitkoms-verwante aspekte van versorging was betekenisvol by pasiente met langtermyn siekte toestande of ongeskikthede. Daar word aanbeveel dat pasiente se persepsie aangaande die versorging wat hulle ontvang periodiek beoordeel word om vas te stel of aan hulle behoeftes voldoen word.

La tesi è una raccolta di tre saggi sul processo di invecchiamento, salute e disabilità in Italia. Il primo capitolo esplora la relazione tra gli indicatori di salute. Il secondo guarda all'associazione tra condizioni di cattiva salute e la qualità del lavoro in un'ottica multidimensionale e di genere. Infine il terzo studia la disabilità in Italia con l'ausilio del capability approach. / The thesis is a collection of three essays on ageing, health and disability for Italy. The first chapter explores the complex structure of un-health among older people in Italy. The second investigates the connection of un-health and quality of work by adopting a multidimensional view and a gender perspective. The third explores disability by adopting the capability approach.

The United States is ranked 27th in the world for maternal mortality, yet spends twice as much on maternity care services as countries with better maternal health indicators. Stuck in a technocratic and physician-dominated maternity care system, the U.S. depends on expensive technologies to control birth out of fear of pain and litigation, costing Americans billions of dollars and depriving women of the opportunity to have a transformative birth experience. Through an analysis of the medicalization of birth and the current biomedical model in birth, in conjunction with open-ended interviews with 5 hospital midwives and 3 homebirth midwives, the benefits and challenges of incorporating a midwifery model of care into our maternity services are explored. The midwifery model emphasizes that birth is not pathology and that psychosocial factors play a large role in birth outcomes. Basing their practice on collaboration, education, and support, midwives empower women, avoid unnecessary interventions, and offer a lower cost and higher quality care alternative. The current monopoly of women’s health services by physicians is unsustainable. Incorporating midwives into the maternity care team could provide a sustainable alternative with the caliber of maternity care services that U.S. women and families deserve.

<p><font size="3"> <p>Namibia has recorded an ascending trend of maternal and neonatal mortality rate from 225 &ndash / 449 per 100 000 women from 1992 to 2006, and 38 &ndash / 46 per 1000 live births from 2000 to 2006 respectively. Kavango Region in Namibia is one among the top seven regions with high maternal and infant mortality rate. Most pregnant women in peri-urban areas of Rundu District in the Kavango region, where this study was conducted, attend ante-natal care services but do not use public health facilities for delivery. The health records from the public health facilities in Rundu, especially from Nkarapamwe clinic and Rundu Hospital maternity section, reveal that although the pregnant women comply with the required standard policy of a minimum of three visits per pregnancy or more, over 40% of women who attend public ante-natal care clinics do not deliver in the public health facility. The aim of this study was to explore the perceptions of women regarding obstetric care in public health facilities in Kehemu settlement, a peri-urban area of Rundu town. The objectives of the study were to explore the perceptions of women on accessibility and acceptability of maternity services in public health facilities. An explorative qualitative study design using focus group discussion as a data collection method was conducted with three groups of women. A purposeful sampling procedure was used to select participants. Ethical approval was obtained from the High Degree Committee of University of the Western Cape and permission to use data from local facilities was obtained from the Ministry of Health and Social Services. Participants were recruited on their own free will and they signed an agreement on confidentiality. A data reduction process was used for analysis. The study findings indicate that women wish to use public health facilities for deliveries due to perceived benefits, in particular, safety for the mother and the baby and that those services are<font size="3"> affordable. However a number of reasons hinder women to access services including the attitudes of health care providers, inability to afford transport at night and cultural influences. The study recommends that delivery services at the local clinic be expanded from eight to twenty-four hours / an information campaign on pregnancy and birth complications as well as the benefits of delivering in a public facility be implemented / refresher training for nurses to improve their caring practices during delivery should be considered and that a similar research be conducted with care providers to ascertain ways to improve maternity services in the public health facility in the area. </font></p> </font></p>

<p><font size="3"> <p>Namibia has recorded an ascending trend of maternal and neonatal mortality rate from 225 &ndash / 449 per 100 000 women from 1992 to 2006, and 38 &ndash / 46 per 1000 live births from 2000 to 2006 respectively. Kavango Region in Namibia is one among the top seven regions with high maternal and infant mortality rate. Most pregnant women in peri-urban areas of Rundu District in the Kavango region, where this study was conducted, attend ante-natal care services but do not use public health facilities for delivery. The health records from the public health facilities in Rundu, especially from Nkarapamwe clinic and Rundu Hospital maternity section, reveal that although the pregnant women comply with the required standard policy of a minimum of three visits per pregnancy or more, over 40% of women who attend public ante-natal care clinics do not deliver in the public health facility. The aim of this study was to explore the perceptions of women regarding obstetric care in public health facilities in Kehemu settlement, a peri-urban area of Rundu town. The objectives of the study were to explore the perceptions of women on accessibility and acceptability of maternity services in public health facilities. An explorative qualitative study design using focus group discussion as a data collection method was conducted with three groups of women. A purposeful sampling procedure was used to select participants. Ethical approval was obtained from the High Degree Committee of University of the Western Cape and permission to use data from local facilities was obtained from the Ministry of Health and Social Services. Participants were recruited on their own free will and they signed an agreement on confidentiality. A data reduction process was used for analysis. The study findings indicate that women wish to use public health facilities for deliveries due to perceived benefits, in particular, safety for the mother and the baby and that those services are<font size="3"> affordable. However a number of reasons hinder women to access services including the attitudes of health care providers, inability to afford transport at night and cultural influences. The study recommends that delivery services at the local clinic be expanded from eight to twenty-four hours / an information campaign on pregnancy and birth complications as well as the benefits of delivering in a public facility be implemented / refresher training for nurses to improve their caring practices during delivery should be considered and that a similar research be conducted with care providers to ascertain ways to improve maternity services in the public health facility in the area. </font></p> </font></p>

Potential determinants of exposure to culturable airborne fungal and bacterial aerosols and carbon dioxide were examined as an aid to the interpretation and evaluation of indoor air quality assessments. Concentration measurments for culturable bioaerosols and CO2 were evaluated against published standards and guidelines. METHOD: All 39 schools from one British Columbia school district were enrolled in the study to ensure different building ages and construction materials, but the same maintenance protocols, were included. Schools were randomly assigned to winter, spring or fall sampling. Data collected included: number of occupants and patterns of occupancy, CO2 levels, temperature and relative humidity, total suspended particles, and air exchange rates using tracer gas (SF6) decay. Other characteristics of the classrooms included the presence or absence of forced air heat, carpets, live animals or aquaria, plants, and the siting of the school or portable classroom. Culturable indoor and outdoor aerosols of fungi and bacteria were collected. Determinants of exposure were modelled by constructing multiple linear regression equations for indoor fungi, indoor bacteria and indoor carbon dioxide. RESULTS: The multiple regression models were able to explain a considerable proportion of the variance for the outcomes of interest (total R2 = 0.59 for mesophilic fungi, 0.61 for bacteria, and 0.68 for CO2). Increased outdoor temperature and outdoor fungal counts were associated with higher concentrations for indoor fungi. Variables describing ventilation and conditions of occupancy were significant to all outcomes of interest but functioned differently in the models. For example, fungal concentration was higher in the presence of natural ventilation, but lower with increased mechanical ventilation. In contrast, CO2 was lower with both ventilation types, and lower with higher outdoor temperature. CONCLUSIONS: Using variables measured during an indoor air quality investigation, predictive models can be constructed which are useful in identifying determinants of bioaerosol and bioeffluent concentrations. Ranges of bioaerosol and bioeffluent concentrations for high occupancy buildings in a coastal temperate zone may differ from guidelines written for other indoor settings and climate zones.

Thesis (M.Sc.)--University of Alberta, 2009. / A thesis submitted to the Faculty of Graduate Studies and Research in partial fulfillment of the requirements for the degree of Master of Science in Agricultural and Resource Economics, Department of Rural Economy. Title from pdf file main screen (viewed on September 20, 2009). Includes bibliographical references.

Magister Public Health - MPH / Namibia has recorded an ascending trend of maternal and neonatal mortality rate from 225 – 449 per 100 000 women from 1992 to 2006, and 38 – 46 per 1000 live births from 2000 to 2006 respectively. Kavango Region in Namibia is one among the top seven regions with high maternal and infant mortality rate. Most pregnant women in peri-urban areas of Rundu District in the Kavango region, where this study was conducted, attend ante-natal care services but do not use public health facilities for delivery. The health records from the public health facilities in Rundu, especially from Nkarapamwe clinic and Rundu Hospital maternity section, reveal that although the pregnant women comply with the required standard policy of a minimum of three visits per pregnancy or more, over 40% of women who attend public ante-natal care clinics do not deliver in the public health facility.The aim of this study was to explore the perceptions of women regarding obstetric care in public health facilities in Kehemu settlement, a peri-urban area of Rundu town. The objectives of the study were to explore the perceptions of women on accessibility and acceptability of maternity services in public health facilities.An explorative qualitative study design using focus group discussion as a data collection method was conducted with three groups of women. A purposeful sampling procedure was used to select participants. Ethical approval was obtained from the High Degree Committee of University of the Western Cape and permission to use data from local facilities was obtained from the Ministry of Health and Social Services. Participants were recruited on their own free will and they signed an agreement on confidentiality. A data reduction process was used for analysis.The study findings indicate that women wish to use public health facilities for deliveries due to perceived benefits, in particular, safety for the mother and the baby and that those services are affordable. However a number of reasons hinder women to access services including the attitudes of health care providers, inability to afford transport at night and cultural influences.The study recommends that delivery services at the local clinic be expanded from eight to twenty-four hours; an information campaign on pregnancy and birth complications as well as the benefits of delivering in a public facility be implemented; refresher training for nurses to improve their caring practices during delivery should be considered and that a similar research be conducted with care providers to ascertain ways to improve maternity services in the public health facility in the area.

Beef constitutes an important part of many consumers’ diets. Beef is the most consumed red meat in South Africa. Consumer perceptions can affect the whole supply or value chain of beef. Recently there has been increased interest in food safety; greater concern for environmental and animal welfare issues, increased importance of eating quality and healthy food as well as the greater role of food services. The demand for beef is no longer limited to economic factors alone but to non-economic factors as well. Consumers of beef in Alice have become more concerned about meat-borne risks and personal health. This research prioritized the exploration of the beef consumers’ (i) self-perception (ii) price perception (iii) benefit perception [in the form of – (a) value perception and (b) quality perception]. The study was conducted in the Eastern Cape Province specifically in Alice town and the surrounding rural areas (Ntselamanzi, Gaga, Hillcrest, Gqumashe, and Dyamala) of the Nkonkobe municipality. Anyone who admitted to eating beef and at the point of data collection bought beef for their own consumption or family consumption was deemed as a unit of analysis. Non – probabilistic sampling techniques which included accidental and random sampling were used to collect data from 100 interviewees. A semi structured questionnaire was used to analyse the perceptions and attitudes of beef consumers. The respondents were asked to indicate their agreement or disagreement with 47 statements or items presented on either five alternatives in a Likert scale scored from 1 (strongly disagree) to 5 (strongly agree) or a six Likert scale ranging from 1 (very low) through 5 (very high) to 6 (I do not know).The data was analysed using SPSS. It was discovered that beef consumers did not consider either intrinsic or extrinsic cues in isolation when purchasing beef but rather all characteristics contribute to the final perception. The Alice consumer market is heterogeneous and consists of different races with different cultures and market segments with varying needs and preferences. The results showed that five factors were extracted from forty seven items Factor 1: Information reliance and quality indication; Factor 2: convenience; Factor 3: Traceability and animal Welfare; Factor 4: Health and safety Conscious and Factor 5: Price and Branding. Furthermore, four main consumer segments emerged as - Segment 1: Informed buyers; Segment 2: Elite buyers; Segment 3: Health & safety conscious buyers and Segment 4: Apathetic buyers. The cluster analysis shows that quality is a subjective concept that is informed by a consumer’s personal taste and preferences. Taste and preferences inform the consumer’s effective demand which in retrospect is informed by the consumer’s socioeconomic status.