Thesis (M.S.)--West Virginia University, 2003. / Title from document title page. Document formatted into pages; contains x, 108 p. : ill. (some col.), maps. Vita. Includes abstract. Includes bibliographical references (p. 71-73).

Thesis (M.N.)--Victoria University of Wellington, 2008. / Includes bibliographical references.

Theses (Ed.S.)--Marshall University, 2007. / Title from document title page. Includes abstract. Document formatted into pages: contains iii, 23 pages. Bibliography: p. 22-23.

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The Patient Protection and Affordable Care Act of 2010 expanded rural Medicaid and Medicare coverage. However, different vehicles of delivering care (e.g., hospitals, health clinics, etc.) have differing organizational capacity that may or may not enable them to overcome the challenges of expanded provision. Consequently, this research employed structural contingency and organizational performance models to investigate the impact of organizational factors on productivity growth, while recognizing that contextual factors also affect the delivery of care. Latent growth curve modeling was used to study a national panel of 708 U.S. hospitalbased Rural Health Clinics for the years 2005 to 2008. Productivity was measured through dynamic slacks-based data envelopment analyses. Unconditional and conditional linear growth curve models were fitted to data. Findings revealed that 1) hospital-based clinics with higher baseline levels of productivity in 2005 had a slower rate of growth in productivity for the years 2006 to 2008, 2) hospital-based clinics with physicians had significantly higher productivity, 3) hospital-based clinics in urban focused areas had significantly higher productivity, 4) newer hospital-based clinics had significantly higher productivity, and 5) prospective payment system was negatively related to the rate of change in productivity growth. Organizational and contextual factors included in this study significantly explained initial differences in productivity but were unable to explain productivity growth. Future research could improve the study by 1) including additional explanatory variables, such as the use of technology and disease management programs, 2) adjusting productivity measures by case mix measures, and 3) conducting truncated panel data regression with Monte Carlo simulation.

The study explored professional nurses' experience of working in a remote rural hospital in the Eastern Cape Province. A qualitative phenomenological design was used and the study was conducted in a remote rural hospital in region `D'. Eight professional nurses were selected non-randomly from a population of professional nurses who had been working in the hospital for more than one year. Purposive sampling was used to select the participants and semi-structured phenomenological interviews were conducted to collect data. Colaizzi's eight-step method was used for data analysis. The themes that emerged from the data analysis were shortage of human and material resources, poor access, communication problems and lack of safety and insecurity. The study found that the professional nurses at the remote rural hospital experience many obstacles to quality service delivery. / Health Studies / M.A. (Health Studies)

The purpose of the study was to explore and describe the professional nurse's perception of working in remote rural clinics in Limpopo Province. The research design was qualitative, exploratory, descriptive and contextual. The research population was the professional nurses working in remote rural clinics in Limpopo Province. Purposive sampling was used and data collected by means of tape-recorded in-depth semi-structured individual interviews. The study revealed that the professional nurses perceived working in the remote rural clinics both positively and negatively and had concerns. / Health Studies / M.A. (Health Studies)

The purpose of the study was to explore and describe the professional nurse's perception of working in remote rural clinics in Limpopo Province. The research design was qualitative, exploratory, descriptive and contextual. The research population was the professional nurses working in remote rural clinics in Limpopo Province. Purposive sampling was used and data collected by means of tape-recorded in-depth semi-structured individual interviews. The study revealed that the professional nurses perceived working in the remote rural clinics both positively and negatively and had concerns. / Health Studies / M.A. (Health Studies)

The study explored professional nurses' experience of working in a remote rural hospital in the Eastern Cape Province. A qualitative phenomenological design was used and the study was conducted in a remote rural hospital in region `D'. Eight professional nurses were selected non-randomly from a population of professional nurses who had been working in the hospital for more than one year. Purposive sampling was used to select the participants and semi-structured phenomenological interviews were conducted to collect data. Colaizzi's eight-step method was used for data analysis. The themes that emerged from the data analysis were shortage of human and material resources, poor access, communication problems and lack of safety and insecurity. The study found that the professional nurses at the remote rural hospital experience many obstacles to quality service delivery. / Health Studies / M.A. (Health Studies)

Background. The study objective was to determine how the population located in five remote rural areas responded to HIV testing offered by mobile clinics operating under Family Health International, an international NGO that provides health services, especially HIV prevention and family planning. The study sought to identify how different segments of the population, classified according to their socio-demographic characteristics, responded to HIV testing. The analysis is based on secondary data, collected between October 2009 and September 2010, on clients who came to seek health services at mobile clinics. The population is geographically located in five districts: OR Tambo in Eastern Cape, Amajuba in KwaZulu-Natal, Gert Sibande and Ehlanzeni in Mpumalanga, and Sekhukhune in Limpopo. Although these mobile clincs provided comprehensive health services, HIV prevention and family planning were the main focus of attention. Methods. A total number of 9015 individuals aged 18 years and older visited the mobile clinics during the period October 2009 to September 2010. Eight socio-demographic characteristics were collected and used to determine the association between HIV testing and the aforementioned eight variables. The association between the independent variables (sex, age, level of education, marital status, occupation, number of living children, district of residence and area of residence) and HIV testing (the dependent variables) was first investigated using a descriptive analysis and then performing a logistic regression. Results. More than 88% of individuals aged 18 years and older who visited the mobile clinics in the areas covered by the FHI project are from rural areas. HIV testing is still low in these areas, even though the services are provided close to their homes by the mobile clinics. It was found that only 34.7% of the mobile clinic’s clients tested for HIV during the period from October 2009 to September 2010. Out of eight independent variables included in the logistic regression model, five were found to have a statistically significant association with HIV testing, being: sex, age, education, occupation and area of residence Although the majority of these mobile clinics’ clients are females (77.1%), males tested in higher proportion than females accross all areas. The results showed that HIV testing decreases with age, with the age category 18 - 24 years testing for HIV in higher proportion than the age group 25 - 34 years and decreasing further when people become older. Individuals are more likely to take an HIV test when their level of education is higher than matric and tend to respond the same to a HIV testing offer when they have no education, primary or secondary level. Employment was found to be an enabling factor to test for HIV. People who are employed tested for HIV in a higher proportion than people who were unemployed or still in school. The area of residence (classified as rural, semi-urban and urban) showed that HIV testing is higher in urban than in semi-urban areas, and low in rural areas. The analysis by sex showed that education is important for women because women who had either primary, secondary or a higher level of education tested for HIV better than women who do not have any level of education. For males, education was not statistically significant regarding HIV testing. The different age groups showed the same pattern for both sexes regarding HIV testing, but young males in the category 18-24 years showed higher odds of testing for HIV than females in the same age category. With occupation variable, females who are either students or employed tested for HIV almost in the same proportion and their odds of testing for HIV were double that of unemployed females. Employed males showed a notably higher difference in testing for HIV than males who were either in school or unemployed. The area of residence showed the same pattern for males and females, with both testing in higher proportions in urban and semi-urban areas than in rural areas. Conclusion. Women from rural areas, with no education, were found to test for HIV less than any other individual in the areas under study. Women tested better when they had been exposed to any form of education. The provision of education to women in the form of an extensive and aggressive door to door HIV awareness campaign should therefore make a difference in increasing the uptake of HIV testing in the five areas covered by the mobile clinics. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2012.