Thesis (M.Sc.)--Memorial University of Newfoundland, Faculty of Medicine, 1998. / Typescript. Bibliography: leaves 122-125.

No / Objectives: Poor knowledge of eye health, concerns about the cost of spectacles, mistrust of optometrists and limited geographical access in socio-economically deprived areas are barriers to accessing regular eye examinations and result in low uptake and subsequent late presentation to ophthalmology clinics. Personal Medical Services (PMS) were introduced in the late 1990s to provide locally negotiated solutions to problems associated with inequalities in access to primary care. An equivalent approach to delivery of optometric services could address inequalities in the uptake of eye examinations. Study design: One-way and multiway sensitivity analyses. Methods: Variations in assumptions were included in the models for equipment and accommodation costs, uptake and length of appointments. The sensitivity analyses thresholds were cost-per-person tested below the GOS1 fee paid by the NHS and achieving breakeven between income and expenditure, assuming no cross-subsidy from profits from sales of optical appliances. Results: Cost per test ranged from £24.01 to £64.80 and subsidy required varied from £14,490 to £108,046. Unused capacity utilised for local enhanced service schemes such as glaucoma referral refinement reduced the subsidy needed. / Yorkshire Eye Research, NHS Leeds, RNIB

Background: This thesis presents an empirical investigation into the efficacy, types, and performance of community health workers (CHWs)-trained lay people to whom simple medical procedures can be "task shifted" from doctors. It has three objectives: (1) assess the effects of CHW delivered interventions for primary health outcomes in low-and middle-income countries (LMICs), (2) develop a comprehensive taxonomy of CHW characteristics and programme design features, and (3) assess the relative efficacy of different types of CHW programme designs and how they can be used to optimise CHW performance. Structure and Methods: Following the logic of early stage intervention development, this thesis has an iterative and developmental structure in which each section flows out of and builds on the previous section. Objective one is addressed in Chapters 2-4: scoping review, systematic review, and meta-analytic methods are applied to establish the efficacy and effectiveness of CHW-led interventions in LMICs. Objective two is addressed in Chapter 5: inductive, thematic analysis of systematically identified trials, influential papers, and existing information classification systems is used to develop a formal CHW taxonomy for intervention reporting and coding. Objective three is addressed in Chapter 6: systematic review methods are employed to identify interventions for improving the performance of community health workers in LMICs. Results: Objective one: a systematic review of 155 papers reporting 86 trials found high quality evidence that CHW delivered interventions reduce perinatal mortality, improve child nutritional status, and improve tuberculosis completion rates versus facility-based care. There is also moderate quality evidence that CHW delivered interventions improve certain mental, infectious disease, paediatric, and maternal health outcomes. In undertaking this process, an additional, methodological contribution was made in the form of a tool to reduce risk of bias in overviews of reviews. This tool may facilitate early stage intervention development in the future. Objective two: 253 records were used to establish, in a faceted taxonomy, the definitional clarity required for theory building and knowledge accumulation. Two categories (CHW Characteristics and CHW Programme Features) and six dimensions (Integration, Recruitment, Training, Supervision, Incentives, and Equipment) emerged. Objective three: a systematic review of 14 trials identified moderate quality evidence of the efficacy of CHW performance interventions in improving certain behavioural outcomes for patients, utilisation of services, and CHW quality of care. There was no effect on the biological outcomes of interest. Conclusion: In bringing the tools of evidence based practice to bear on community health worker interventions, this dissertation has contributed to the theoretical, methodological, and empirical evidence base from which the field can continue to advance.

Thesis (Ph. D.)--University of Texas at Austin, 2000. / Vita. Includes bibliographical references (leaves 185-220). Available also in a digital version from Dissertation Abstracts.

Thesis (M. Soc. Sc.)--University of Hong Kong, 1983.

Victoria’s first Baby Health Centre opened in June 1917 in the inner Melbourne suburb of Richmond. By 1950, 398 centres including fifteen mobile circuits, were available to mothers across Victoria. This study documents and analyses the combination of influences that underpinned the growth of Victoria’s Baby Health Centres. / Firstly, concern about infant mortality rates encouraged the growth of the international welfare movement. The international movement provided legitimacy for local concerns and motivated and sustained the women who acted locally. In addition, the changing role of women following the achievement of suffrage and the rise of voluntarism combined to establish a combination of professionalism and voluntarism which was socially acceptable for the women involved. Baby Health Centres were instigated through municipal councils by local groups such as the Country Womens Association, and with the centralized support of the Victorian Baby Health Centres Association and the Society for the Health of the Women and Children of Victoria. The development of two dedicated voluntary associations caused both friction and competition and a dynamic which created a model of service provision still in existence today. / Secondly, the study looks at the role of several individual women in the growth of Victoria’s centres and circuits. Both voluntary and professional workers made significant contributions to the development of a model of universal service provision for mothers and babies. / Thirdly, the study records the voices of eight mothers and two Infant Welfare sisters of the 1940s. Their comments and stories illuminate the relationship between baby health centre sisters and mothers and the mother’s willingness to incorporate the advice into daily practice. / The history of Victoria’s Baby Health Centres is one of a unique combination of professional and voluntary activism. This recipe led to the development of a well utilized statewide service which has become part of Victoria’s societal and health framework.

Thesis (Ph. D.)--University of Virginia, 1988. / Includes bibliographical references (leaves 122-129). Also available online through Digital Dissertations

Thesis (Ph. D.)--University of Washington, 1994. / Vita. Includes bibliographical references (leaves [116]-128).

Thesis (M.S.P.H.)--University of Michigan, 1945.

Thesis (M.S.P.H.)--University of Michigan, 1941.