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Dissertations / Theses on the topic 'Rural health services Thailand'

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Published: 10 December 2022
Last updated: 29 January 2023

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1

Sermsri, Daovilay Banchongphanithpha hpani Santhat. "Utilization of health center service among the villagers in rural areas of Khonkaen Province, Thailand /." Abstract, 2005. http://mulinet3.li.mahidol.ac.th/thesis/2548/cd375/4737954.pdf.

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2

Chaiyakae, Sonngan, Nobuyuki Hamajima, Pajjuban Hemhongsa, Yoshitoku Yoshida, and Tawatchai Yingtaweesak. "ACCESSIBILITY OF HEALTH CARE SERVICE IN THASONGYANG, TAK PROVINCE, THAILAND." Nagoya University School of Medicine, 2013. http://hdl.handle.net/2237/18473.

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3

Kwanhatai, Chaiyasuk Boonyong Keiwkarnka. "Dental health service utilization among the elderly people in Chiang Dao district, Chiang Mai province, Thailand /." Abstract, 2008. http://mulinet3.li.mahidol.ac.th/thesis/2551/cd415/5038001.pdf.

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4

Singkaew, Songphan. "Policy options for health insurance in Thailand." Thesis, London School of Economics and Political Science (University of London), 1991. http://etheses.lse.ac.uk/1112/.

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This study explores the policy options for health insurance in Thailand, considering the present structure of the country and taking account of international experiences. The development of health insurance in Thailand is analysed from the supply side i.e. health services. The problem of inefficiency and inequity in the health care system has led to the search for better alternatives for organizing and financing. This coincides with the overall growth in the country's socio-economic situation and the policy of health insurance laid down in the Sixth Five Year Health Development Plan (1987-1991). These factors provide positive conditions for establishing health insurance in Thailand. The demand for health insurance from employers who are likely to join the scheme is investigated. A survey of 200 private establishments in Thailand was conducted. This investigation provides essential national baseline data for the organization of health insurance, particularly on the health care fringe benefits provided by employers, and the methods of paying health care providers. Methods of organizing health insurance are formulated from international experience. The historical development of voluntary health insurance and its modified forms, as well as that of compulsory health insurance, are examined. The arguments for and against each form of health insurance are analysed. The study also highlights salient issues of health care reforms which attract the world's attention. International experience has shown that methods of paying providers is a major issue in providing viable health insurance. The study comprehensively analyses the advantages and disadvantages of each method of paying the doctor and the hospital under health insurance systems. Finally, it explores the policy options for the future development of national health insurance in Thailand.
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5

Sun, Xiao Ming. "Health access and health financing in rural China." Thesis, Keele University, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.263121.

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6

Sandbulte, Natalie J. "Rural communities and mental health care." Theological Research Exchange Network (TREN), 2007. http://www.tren.com/search.cfm?p088-0180.

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7

Beatty, Kate, Michael Meit, Emily Phillips, and Megan Heffernan. "Rural Health Departments: Capacity to Improve Communities' Health." Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/etsu-works/6838.

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Local health departments (LHD) serve a critical role in leveraging internal and community assets to improve health and equity in their communities; however, geography is an important factor when understanding LHD capacity and perspective. LHDs serve a critical role in leveraging internal and community assets to improve health and equity in their communities; however, geography is an important factor when understanding LHD capacity and perspective. Data were obtained from the NACCHO 2013 National Profile of Local Health Departments Study. LHDs were coded as “urban”, “micropolitan”, or “rural” based on Rural/Urban Commuting Area codes. Results demonstrate that rural LHDs differed from their urban counterparts. Specifically, rural LHDs relied more heavily on state and federal resources and have less access to local resources making them more sensitive to budget cuts. Rural LHDs also rely more heavily on clinical services as a revenue source. Larger rural LHDs provide more clinical services while urban health departments work more closely with community partners to provide important safety net services. Small rural LHDs have less partners and are unable to provide as many direct services due to their lack of human and financial resources. LHDs residing in urban communities were 16.6 times (95% confidence interval [CI], 5.3-52.3) and micropolitan LHDs were 3.4 times (95% CI, 1.1-11.3) more likely to seek PHAB accreditation than rural LHDs.
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8

Morrisey, Karyn Marie. "Access to health care services in rural ireland." Thesis, University of Leeds, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.502767.

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9

Eastman, Martha Anne. ""All for Health for All": The Local Dynamics of Rural Public Health in Maine, 1885-1950." Fogler Library, University of Maine, 2006. http://www.library.umaine.edu/theses/pdf/EastmanMA2006.pdf.

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10

Yan, Nicole, and 甄錦樺. "Exploring health in China's rural villages: apublic health field exercise." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2011. http://hub.hku.hk/bib/B46943821.

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11

Billmeyer, Tina W. "Evaluation of a behavioral health integration program in a rural primary care facility." Huntington, WV : [Marshall University Libraries], 2007. http://www.marshall.edu/etd/descript.asp?ref=755.

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12

Prior, Maria E. "Added-value roles and remote communities an exploration of the contribution of health services to remote communities and of a method for measuring the contribution of institutions and individuals to community stocks of capital /." Thesis, Available from the University of Aberdeen Library and Historic Collections Digital Resources, 2009. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?application=DIGITOOL-3&owner=resourcediscovery&custom_att_2=simple_viewer&pid=33408.

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13

Hale, Nathan, Tamar Klaiman, Kate E. Beatty, and Michael Meit. "Rural Health Departments and Clinical Services: Transition to Whom?" Digital Commons @ East Tennessee State University, 2016. https://dc.etsu.edu/etsu-works/6845.

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14

Weber, Amy Judith, Olubunmi Kuku, and Edward Leinaar. "Differences in Access to Contraceptive Services Between Rural and Non-Rural Clinics in South Carolina." Digital Commons @ East Tennessee State University, 2018. https://dc.etsu.edu/asrf/2018/schedule/125.

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Unintended pregnancies, defined as either being unwanted or mistimed, represent a major public health challenge. Roughly half of all pregnancies in the United States are unintended, and have been associated with poor health and economic outcomes for infants, children, women, and families. Modern contraceptives have been proven to be both safe and effective in reducing unintended pregnancy. This is particularly true for long-acting reversible contraceptive (LARC) methods, which are associated with both higher user satisfaction and overall efficacy as compared to short-acting methods. We therefore investigated types of contraceptive services offered among rural and non-rural clinics in South Carolina. A survey was developed; all clinics in South Carolina who offer contraceptive services were invited to participate. Completion of the survey was voluntary and an incentive was provided. The survey was multi-faceted, covering several aspects of contraceptive care including scope of services provided, availability of resources, and training received. Of primary interest to this research, is the extent to which highly effective contraception methods, such as LARCs, are available in both urban and rural clinics. Findings suggest that access to highly effective LARCs is not equitable among rural and urban clinics. Approximately 62% of urban clinics offered LARC methods, compared to 36% among rural clinics (p=0.0015). These data indicate that women who reside in a rural locale have significantly lower access to these more effective contraceptive methods. As nearly 25% of women within the United States reside in a rural locale, the need to address barriers to access to contraceptive care is essential. This work will be a useful tool in understanding barriers to contraceptive care utilization and can lead to the development of novel programs to reduce the rate of unintended pregnancy, births and abortions, and corresponding savings in health care costs.
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Hoang, Le Thanh Som-arch Wongkhomthong. "Satisfaction of mothers towards child health services at health center 58 ratburana district, bma, Thailand /." Abstract, 1999. http://mulinet3.li.mahidol.ac.th/thesis/2542/42E-LeThanhHoang.pdf.

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16

Wungchun, Kittipadakul Nonglak Pancharuniti. "Client satisfaction towards oral health services under universal health coverage project in Singburi province, Thailand /." Abstract, 2004. http://mulinet3.li.mahidol.ac.th/thesis/2547/cd363/4637905.pdf.

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17

Harris, Jenine K., Kate E. Beatty, J. P. Leider, Alana Knudson, Britta L. Anderson, and Michael Meit. "The Double Disparity Facing Rural Local Health Departments." Digital Commons @ East Tennessee State University, 2016. https://dc.etsu.edu/etsu-works/6825.

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Residents of rural jurisdictions face significant health challenges, including some of the highest rates of risky health behaviors and worst health outcomes of any group in the country. Rural communities are served by smaller local health departments (LHDs) that are more understaffed and underfunded than their suburban and urban peers. As a result of history and current need, rural LHDs are more likely than their urban peers to be providers of direct health services, leading to relatively lower levels of population-focused activities. This review examines the double disparity faced by rural LHDs and their constituents: pervasively poorer health behaviors and outcomes and a historical lack of investment by local, state, and federal public health entities.
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18

Guo, Sufang Oratai Rauyajin. "Health service utilization of women with reproductive tract infections in rural China /." Abstract, 1999. http://mulinet3.li.mahidol.ac.th/thesis/2542/42E-GuoSufang.pdf.

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19

Nguyen, Khanh Long Nonglak Pancharuniti. "Adoption of fluoride use among primary school teachers in Nakhon Pathom province, Thailand /." Abstract, 2003. http://mulinet3.li.mahidol.ac.th/thesis/2546/4537470.pdf.

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20

Lackey, Douglas Eugene. "Participation in rural health development : a case study in Kenya." Thesis, London School of Economics and Political Science (University of London), 1997. http://etheses.lse.ac.uk/2479/.

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Achieving active participation of community members in community-based health care programmes (CBHC) is a challenging and complex task. It is also a criterion for successful programming and is promoted as a universal truth and requirement for primary health care development. Nevertheless, most CBHC programmes admit that more needs to be done to achieve satisfactory levels of community involvement. Thus, a better understanding is required as to why success in community involvement has been in most part, elusive. The thesis uses a historical perspective to examine the emergence of participation in the period prior to and during the community development era in Africa and the post-independent period in Kenya. The emergence of participation and it's progression as an international health strategy in the 1980's and 1990's within WHO, a leading international organisation promoting community involvement in health is critically examined. At the community level, people's perception and understanding of community participation and an analysis of how they participated in the case study CBHC programme provided an operational assessment of community participation. A particular focus was community contributions as a mechanism of participation. Thus, the primary aim of this thesis was to examine in rural Kenya the socio-economic and institutional support factors which can potentially enhance or limit participation of community members in rural community-based health development programmes. The main socio-economic factors examined were education, income, group membership and domestic factors such as harmony in the household and women's time. The roles of local structures and support personnel such as community health volunteers (CHVs), health committee members (HCMs) and local leaders in promoting participation were also analysed. The method used was interviews with a sample of these respondents. Based on the case study research results, the thesis draws conclusions on the factors that appear to be most significant in relation to community participation. The importance of education, group membership and regular monthly visits by CHVs were identified as particularly significant factors. A more informed understanding of these relationships will enable health planners in designing integrated programme strategies which can help promote broader community participation in health development programmes. An awareness of these factors and their inter-relationships by operational-level health staff will enable them to enhance community participation when developing and implementing community-based health care programmes.
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21

Beatty, Kate, Michael Meit, Tyler Carpenter, Amal Khoury, and Paula Masters. "Clinical Service Delivery Disparities along the Urban/Rural Continuum." Digital Commons @ East Tennessee State University, 2015. https://dc.etsu.edu/etsu-works/6847.

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background: Rural communities face numerous health disparities related to health behaviors, health outcomes, and access to medical care. LHDs serving rural communities have fewer resources to meet their community needs. The number and types of community organizations (hospitals, health clinics, not-for-profits), available to partner with may be limited geographically. These factors may affect availability of clinical services in rural communities. This study will assess LHD clinical service delivery levels based on rurality. data sets and sources: Data were obtained from the NACCHO 2013 National Profile of Local Health Departments Study. LHDs were coded as “urban”, “micropolitan”, or “rural” based on Rural/Urban Commuting Area (RUCA) Both “micropolitan” and “rural” categories are considered rural by the Federal Office of Rural Health Policy. analysis: Bivariate analysis for 25 clinical services offered by rurality . For each service, we compared the proportions of LHDs that: 1) directly performed, 2) contracted with organizations, and 3) reported that the service was provided independently by organizations in the community. principal findings: Analyses show significant differences in patterns of clinical services offered, contracted or provided by third parties based on rurality. LHDs in micropolitan areas provided more services directly than urban and rural LHDs (p≤0.001). Urban LHDs were more likely to contract with other organizations (p≤0.001). conclusions: Rural LHDs are less likely to offer, contract, or have services provided by another organization in the community, whereas larger rural (i.e., micropolitan) jurisdictions are more likely to directly provide these services. implications for public health practice and policy: Lower levels of clinical service delivery by rural LHDs may contribute to the access issues facing rural communities. Health care reform brings threats and opportunities for LHD clinical service delivery. Further analyses to assess impacts on rural LHDs and identify strategies to ensure access to clinical services is encouraged.
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22

Pannarunothai, Supasit. "Equity in health : the need for, and the use of, public and private health services in an urban area in Thailand." Thesis, London School of Hygiene and Tropical Medicine (University of London), 1993. http://researchonline.lshtm.ac.uk/4646511/.

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The 'sun-rise' industry of private health care, especially private hospitals, in Thailand throws many questions to the health policy forum. Will the growth of the private health sector reduce public health expenditure, or will it increase total expenditure on health? The focus of this study is on equity in health and health care: in a country where private expenditure dominates total health expenditure and the government lets the private health sector flourish, in this scenario, are the poor or the underprivileged the victims of this limited privatisation policy? The main research objective was to assess the equity of coverage of public and private health in an urban area in order to identify policies of promotion and regulation which would lead to an equitable and efficient health service system. The study used Phitsanulok municipal area as a model to develop policy recommendations for other urban areas. There were three main methods of data collection: general household survey, health diary plus household health interview and a one-day bed census of patients in public and private hospitals in the municipality. The first two methods employed multi-stage random sampling with clusters of 12 and 3 households, respectively, as smallest sampling units and these neighbourhood households were divided into three groups to represent each season in a year. The main findings were that inequalities in health existed among different household income, education and occupational groups, including these attributes of the education and occupational groups adjusted according to the household head. Unequal accessibility to health care seemed to affect both reported rates of illness within the past two weeks and hospitalisation during the past 12 months. Inequity of health care financing was obvious in that the underprivileged (the poor, the uninsured and underinsured) paid out of pocket as a percentage of their household income higher sums than the privileged groups. The private health sector (private clinics and private hospitals) was the major provider of health care to urban dwellers for both outpatient and inpatient services. Users of public facilities were the lower income groups and civil servants, while users of the private health sector were the higher income groups, the higher occupational groups and the younger age groups. Inpatients of private hospitals were more likely to be covered by health benefit schemes (civil servant benefit, private insurance, etc.) than inpatients of public hospitals. Information on the utilisation and financing pattern of private health services reconfirmed inequity of health care financing. It is obvious that the Thai health care system needs changes to reduce inequity in health and health care. Universal coverage is a way towards more equitable health care financing. While Thai citizens (in urban areas) have enjoyed a wide choice of health utilisation, a public competition model could be applied to the public health sector to make public services more competitive and more efficient.
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23

Casey, Kathleen Barbara. "HIV counselling, mental health and psychosocial care in Thailand." School of Psychology - Faculty of Health and Behavioural Sciences, 2007. http://ro.uow.edu.au/theses/73.

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Rationale: International research has demonstrated that in order to retain a skilled and healthy cadre of willing health-workers there is a need to monitor and develop strategies to mitigate adverse impact of this work and improve the quality and effectiveness of client and patient mental health care. Aims: (i) Monitor and evaluate Thailand’s national HIV mental health and psychosocial care program. (ii) Measure the impact of HIV mental and psychological care on health care providers. (iii) Examine the relationship between occupation-related psychological morbidity and the recruitment, training, clinical supervision and work-practices of HIV mental health service providers. (iv) Develop, implement and evaluate a training curriculum that addresses the demands of the HIV client population in Thailand. Method: In Study 1, 826 government hospitals, 1000 government health centres, and 1135 non-government organisations and private providers participated in: semi-structured, key informant interviews; focussed group discussions; and criterion-referenced appraisals of health policy and service delivery. Study 2, a small exploratory, qualitative study, utilised a schema of five key stressors commonly associated with HIV care to analyse responses gained from HIV counsellors and employed semi-structured interviews and focussed discussion groups. Study 3, a cross-sectional study, explored the relationship between training, work practices, Locus of Control of Behaviour and the self-reporting of signs and symptoms of psychological distress. 803 HIV counsellors completed a series of questionnaires including the Thai version of the General Health Questionnaire (GHQ-28), the Locus of Control of Behaviour Questionnaire and the Thai HIV Counsellors Survey (THCS). Study 4 involved the development, delivery and evaluation of a series of short courses designed to train 79 health workers to provide HIV counselling. The training was evaluated by pre and post knowledge examinations and anonymous evaluations. Results: Study 1 found that policy and legislation failed to adequately guide the practitioner in a number of key areas including: testing and counselling of minors; testing without informed consent; confidentiality of medical records and disclosure of HIV status; and “duty of care” in terms of threatened suicide or harm to others. Furthermore, it was found that epidemiological data had not been adequately considered in terms of providing specific psychological support services, and developing counselling curriculum, and that the conduct of Thai based psychological and operations research had been limited. Whilst there was good national coverage of HIV testing counselling services, psychological services to address HIV issues across the disease continuum were limited and frequently provided by individuals without adequate training. There does not appear to be any systematic mechanism for monitoring and evaluating HIV mental health and psychosocial care. This study also revealed that Thailand is limited in its ability to provide adequate HIV field-experienced, trained mental health care personnel who can teach in the necessary languages that would enable sharing of the Thai health sector experience within the region. Study 2: The respondents identified a number of workplace stressors including: fear of contagion; client-professional boundary issues; difficulties with being identified as working in the sphere of a highly stigmatised disease; the experience of multiple losses, in a context of perceived inadequate training; role expansion; and perceived lack of recognition and reward. Participants also identified a number of work and socio-cultural influences which were perceived to mitigate the impact of the work. Study 3: Failure to take up counselling duties after training was primarily associated with counsellors having too many competing non-counselling duties (31.2%; n=108), and being deployed to other workplaces in a non-counselling capacity (22.8%,n=79). Over 81% (n=441) of respondents who indicated that they were continuing to work as counsellors reported signs and symptoms of psychological disturbance on the GHQ-28 screening at a level that warranted further mental health assessment. There was a significant positive correlation between GHQ-28 “caseness” and Locus of Control of Behaviour scores (r =.118; p<.001). Decisions to leave counselling were positively associated with self reported psychological disturbance (r =.324; p<.001) and the perception that their work was not helpful to clients (r =.108; p<.001). Study 4: The results clearly showed that the curriculum, and method of training resulted in both perceived and measured change in knowledge and skills and were reported to have resulted in improvements in the trainees’ perceived self confidence to meet the demands of their clients. Conclusion: The studies identified the many challenges inherent in providing effective HIV counselling, mental health and psychosocial services in Thailand. This research suggests that delivering HIV psychosocial care services in Thailand has potentially an adverse impact on: the health and well being of care providers; the quality of care received by clients and patients; and ultimately on the ability of the health system to retain its skilled personnel.
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24

Lilly, C. E., Jodi Polaha, Stacey Williams, and M. Schrift. "Rural Parents’ Perspectives on Mental Health Services: A Qualitative Study." Digital Commons @ East Tennessee State University, 2013. https://dc.etsu.edu/etsu-works/6594.

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25

Gangai, Bharti. "Patient satisfaction with health services in a rural district hospital." University of the Western Cape, 2015. http://hdl.handle.net/11394/5216.

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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.
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Beatty, Kate, and Michael Meit. "Opportunities and Challenges Facing Rural Public Health Agencies." Digital Commons @ East Tennessee State University, 2018. https://dc.etsu.edu/etsu-works/6835.

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27

Chaudhuri, Anoshua. "Intended and unintended consequences of a maternal and child health program in rural Bangladesh /." Thesis, Connect to this title online; UW restricted, 2003. http://hdl.handle.net/1773/7411.

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28

Kanoknat, Pancharoen Nonglak Pancharuniti. "Oral health services utilization among government empolyees under social security scheme in Maehongson Province, Thailand /." Abstract, 2005. http://mulinet3.li.mahidol.ac.th/thesis/2548/cd376/4737963.pdf.

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Whitener, Louise M. "Using Hongvivatana's model to evaluate health care access : a field study of adolescent women's access to reproductive health care services in rural Missouri counties /." free to MU campus, to others for purchase, 2000. http://wwwlib.umi.com/cr/mo/fullcit?p9974703.

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30

Prohmmo, Aree. "Factors affecting incidence of childhood diarrhoea and its household management by rural mothers in Khonkaen Province, Thailand." Thesis, Canberra, ACT : The Australian National University, 1989. http://hdl.handle.net/1885/142450.

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31

Domapielle, Maximillian K. "Extending health services to rural residents in Jirapa District : analyses of national health insurance enrolment and access to health care services." Thesis, University of Bradford, 2015. http://hdl.handle.net/10454/14803.

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This thesis sheds light on differences in health insurance enrolment determinants and uptake barriers between urban and rural areas in the Jirapa district of Ghana. The National Health Insurance Scheme in Ghana has made significant progress in terms of enrolment, which has had a commensurate increase in utilization of health care services. However, there are challenges that pose a threat to the scheme’s transition to universal coverage; enrolment in the scheme has not progressed according to plan, and there are many barriers known to impede uptake of health care. Interestingly, these barriers vary in relation to locality, and rural residents appear to carry a disproportionate portion of the burden. A mixed method approach was employed to collect and analyse the data. On the basis of the primary qualitative and quantitative results, the thesis argues that the costs of enrolling and accessing health care is disproportionately higher for rural residents than it is their urban counterparts. It also highlights that the distribution of service benefits both in terms of the NHIS and health care in the Jirapa district favours urban residents. Lastly, the thesis found that whereas rural residents prefer health care provision to be social in nature, urban residents were more interested in the technical quality aspects of care. These findings suggest that rural residents are not benefitting from, or may not be accessing health services to the extent as their urban counterparts. Affordability, long distance to health facilities, availability and acceptability barriers were found to influence the resultant pro-urban distribution of the overall health care benefit.
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32

Nimegeer, Amy. "Considering community engagement for remote and rural healthcare design in Scotland : exploring the journey from rhetoric to reality." Thesis, University of the Highlands and Islands, 2013. https://pure.uhi.ac.uk/portal/en/studentthesis/considering-community-engagement-for-remote-and-rural-healthcare-design-in-scotland(9418ba56-720c-41b6-b97f-f345cfad0ffa).html.

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The way healthcare services are delivered in remote and rural Scottish communities is in a state of reconfiguration. At the same time the NHS faces pressure to plan these new services in partnership with communities themselves. Evidence, however, suggests that this is not necessarily being done well. This study considered the contextual aspects of remote and rural Scottish communities that may impact on healthcare-related engagement, and examined current understanding of what constitutes a ‘good’ engagement process. It then went on to consider a two-year action research project (RSF) that took place in four remote and rural Scottish communities to engage local residents in an anticipatory process co-designing their own future healthcare services. Finally, this study examined ways in which individuals were able to wield power within the engagement described in the RSF project, by using a combination of participant observation and Foucauldian Discourse Analysis. As well as making a number of practical recommendations for future engagement practice in a remote and rural context, this study makes three key contributions. Firstly, it contributes further contextual knowledge about the challenges of engaging with remote and rural Scottish communities for local healthcare service design; a topic about which little has been written. Secondly, it contributes a novel method for anticipatory healthcare budgeting aimed at a remote and rural Scottish context, namely the RSF Game. Thirdly, it draws the conclusion that individual (non-elite) community members have the ability to use French and Raven’s bases of social power to impact the engagement process at all stages, and also posits that discourse can be used within rural engagement as a new ‘base of power’, which contributes to the debate around individual power and agency within remote and rural community engagement for healthcare, which few studies have examined.
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Sullivan, Kendra. "Simulating rural Emergency Medical Services during mass casualty disasters." Thesis, Manhattan, Kan. : Kansas State University, 2008. http://hdl.handle.net/2097/779.

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Kessomboon, Nusaraporn. "Patient's willingness to pay for pharmaceutical care from community pharmacies in the North East of Thailand." Thesis, Robert Gordon University, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.365426.

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35

Khe, Nguyen Duy. "Socioeconomic differences in a rural district in Vietnam : effects on health and use of health services /." Stockholm, 2004. http://diss.kib.ki.se/2004/91-7349-984-6/.

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36

Vaughan, David James. "Acceptability of primary care a study of one community in Montana /." Thesis, Montana State University, 2007. http://etd.lib.montana.edu/etd/2007/vaughan/VaughanD0507.pdf.

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37

Phung, Quang Vinh. "Health services utilization among mothers of children under 5 years old in Muang district of Sakaeo province, Thailand /." Abstract, 2006. http://mulinet3.li.mahidol.ac.th/thesis/2549/cd387/4837999.pdf.

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38

Jian, Hu Chai Podhisita. "Differential utilization of health care services among ethnic groups on the Thailand-Myanmar Border : a case study of Kanchanaburi province, Thailand /." Abstract, 2007. http://mulinet3.li.mahidol.ac.th/thesis/2550/cd409/4737938.pdf.

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39

Meit, Michael, Kate E. Beatty, and Megan Heffernan. "Exploring Service Composition and Financing Among Rural LHDs." Digital Commons @ East Tennessee State University, 2018. https://dc.etsu.edu/etsu-works/6836.

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40

Arhin, Dyna Carol. "Willingness to pay for rural health insurance : evidence from three African countries." Thesis, London School of Economics and Political Science (University of London), 1998. http://etheses.lse.ac.uk/2863/.

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The vast majority of Africans living in rural areas do not have access to health insurance and policy related questions to assist health planners design and implement financially viable rural health insurance schemes have yet to be fully addressed. This thesis seeks to fill some existing gaps in the knowledge about the performance of existing schemes and methods of assessing "willingness to pay" (WTP) and financial feasibility. It begins with a review of the literature on the theory of insurance and its practice in rural areas in Sub-Saharan Africa, that contributed to the research conceptual framework and implementation. Two health insurance schemes (La Carte d'Assurance Maladie and the Abota in Burundi and Guinea Bissau), were evaluated regarding their social and financial performance in rural areas. The research instruments were household surveys, focus group discussions and health facility costing. In both schemes access to health care appeared to have improved and the findings suggested that were quality of care improved, the schemes would considerably reduce financial concerns faced by people at the time of illness. They would also raise significant revenue. In the third study country, Ghana, a study of preferred benefit options, WTP, and community rated premiums for a proposed health insurance scheme was undertaken in a rural area. In undertaking this feasibility study, the research developed a WTP instrument and used a contingent valuation approach. Eight hundred households participated in the study. Eighty percent of households said they would be willing to pay the premium required to recover 100% of the non-salary recurrent costs of providing OPD care in a local clinic and inpatient care in a hospital. The stated WTP was conditional on; a) the insurance scheme giving access to health care in which drugs and basic laboratory investigations would be available, b) health staff being professionally qualified and respectful, and c) a local solidarity association having a role in administering the participating health facilities. Econometric analysis of households' WTP for outpatient insurance cover supported the hypothesis that WTP is influenced by a) the experience of frequent difficulties in paying for health care in the past; b) the perception that adults in the household are healthier than those in other households; and c) the household head's sex, education and religion.
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41

Fox, Janice M. "Rural ills and community health care : a case study 1989 to 1992." Thesis, University of East Anglia, 1994. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.384942.

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42

Beam, Nancy K. "Women and men's preferences for delivery services in rural Ethiopia." Thesis, University of California, San Francisco, 2016. http://pqdtopen.proquest.com/#viewpdf?dispub=10133409.

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Women and men’s preferences for delivery services in rural Ethiopia Nancy Beam Aims: This study aims to determine the combination of facility-based delivery care attributes preferred by women and men; if gender differences exist in attribute preferences; and key demographic factors associated with attribute preferences.

Background: Despite programs to promote facility-based delivery, which has been shown to decrease maternal and neonatal mortality, 80% of women in rural Ethiopia deliver at home without a skilled birth attendant.

A review of the Ethiopian literature on factors associated with delivery location revealed several weaknesses in research methods that need to be addressed. First, research participants were almost exclusively women, although male partners often make decisions about delivery location. Second, most quantitative study designs are similar in content to the Ethiopian Demographic Health Survey, limiting the generation of new knowledge. Third, cultural practices identified in qualitative studies as barriers to facility-based delivery have not been included in quantitative studies. This study addressed these weaknesses by using discrete choice experiment methodology to elicit preferences for delivery service attributes, including support persons in the delivery room, staff training and attitude, cost, distance and transportation availability.

Methods: A cross-sectional, discrete choice experiment was conducted in 109 randomly selected households in rural Ethiopia in September-October 2015. Women, who were pregnant or who had a child < 2 years old, and their male partners were interviewed. After completing a demographic questionnaire, male and female respondents were asked separately to choose between facility-based scenarios that reflected various attributes for delivering their next baby. Data were analyzed using a multilevel mixed-effects logistic regression model.

Results: Both women and men preferred health facilities where medications and supplies were available, a support person was allowed in the delivery room, cost was low, and doctors performed the delivery. Women also valued free ambulance service, while men favored nearby facilities with friendly providers. Men are disproportionately involved in making household decisions, including decisions about whether their wives seek health care. Yet, men are often unaware of their partners’ prenatal care attendance.

Implications: The Ethiopian government and health facilities could increase facility births in rural areas by responding to families’ delivery service preferences.

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43

McLendon, Pamela Ann. "Opening Doors for Excellent Maternal Health Services: Perceptions Regarding Maternal Health in Rural Tanzania." Thesis, University of North Texas, 2014. https://digital.library.unt.edu/ark:/67531/metadc500156/.

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The worldwide maternal mortality rate is excessive. Developing countries such as Tanzania experience the highest maternal mortality rates. The continued exploration of issues to create ease of access for women to quality maternal health care is a significant concern. A central strategy for reducing maternal mortality is that every birth be attended by a skilled birth attendant, therefore special attention was placed on motivations and factors that might lead to an increased utilization of health facilities. This qualitative study assessed the perceptions of local population concerning maternal health services and their recommendations for improved quality of care. The study was conducted in the Karatu District of Tanzania and gathered data through 66 in-depth interviews with participants from 20 villages. The following components were identified as essential for perceived quality care: medical professionals that demonstrate a caring attitude and share information about procedures; a supportive and nurturing environment during labor and delivery; meaningful and informative maternal health education for the entire community; promotion of men’s involvement as an essential part of the system of maternal health; knowledgeable, skilled medical staff with supplies and equipment needed for a safe delivery. By providing these elements, the community will gain trust in health facilities and staff. The alignment the maternal health services offered to the perceived expectation of quality care will create an environment for increased attendance at health facilities by the local population.
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44

Polaha, Jodi. "Telehealth Services for Rural Behavioral Health: Directions for Development and Research." Digital Commons @ East Tennessee State University, 2007. https://dc.etsu.edu/etsu-works/6704.

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45

Wingate, Deborah. "Accessing Children's Mental Health Services In A Rural Northern California County." CSUSB ScholarWorks, 2019. https://scholarworks.lib.csusb.edu/etd/819.

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When children are detained and enter the foster care system, social workers screen them to determine if mental health services are needed. Formal referrals to mental health providers are made, however there is a significant wait time between referral and service delivery. The focus of this study was to explore these barriers to mental health services in an effort to identify approaches that might improve service access. Qualitative face-to-face interviews were conducted with key stakeholders using an Ecological Systems Theory to fashion a hermeneutic dialect and a joint construct toward a shared action plan. Data was collected from the interviews and thematically analyzed. The project informs service delivery systems of mental health for children and adults, both for micro and macro practice, by highlighting the need for increased collaboration between agencies and growing family engagement and empowerment to reduce stigma. These efforts will improve communication, define expectations, and diminish silos. The project also contributes to child welfare practices and policies for referrals of children’s mental health services by noting the need for an embedded mental health therapist within child welfare to accept referrals for services; the addition of one study site contractual children’s mental health service provider in the rural county that will accept referrals for children and families. In summary, the study identifies strategies to reduce wait time for service delivery, how those services are best accessed, as well as efforts to better engage families in treatment.
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46

Beatty, Kate E., Nathan Hale, Michael Meit, Paula Masters, and Amal Khoury. "Clinical Service Delivery along the Urban/Rural Continuum." Digital Commons @ East Tennessee State University, 2016. https://dc.etsu.edu/etsu-works/6870.

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Background: Engagement in the core public health functions and ten essential services remains the standard for measuring local health department (LHD) performance; their role as providers of clinical services remains uncertain, particularly in rural and underserved communities. Purpose: To examine the role of LHDs as clinical service providers and how this role varies among rural and nonrural communities. Methods: The 2013 National Association of County and City Health Officials (NACCHO) Profile was used to examine the geographic distribution of clinical service provision among LHDs. LHDs were coded as urban, large rural, or small rural based on Rural/Urban Commuting Area codes. Bivariate analysis for clinical services was conducted by rural/urban status. For each service, the proportions of LHDs that directly performed the service, contracted with other organizations to provide the service, or reported provision of the service by independent organizations in the community was compared. Results: Analyses show significant differences in patterns of clinical services offered, contracted, or provided by others, based on rurality. LHDs serving rural communities, especially large rural LHDs, tend to provide more direct services than urban LHDs. Among rural LHDs, larger rural LHDs provided a broader array of services and reported more community capacity for delivery than small rural LHDs- particularly maternal and child health services. Implications: There are capacity differences between large and small rural LHDs. Limited capacity within small rural LHDs may result in providing less services, regardless of the availability of other providers within their communities. These findings provide valuable information on clinical service provision among LHDs, particularly in rural and underserved communities.
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47

King, Wade Robert. "The demographics, health related characteristics, and primary care utilization of assisted living facility residents in Montana." Thesis, Montana State University, 2006. http://etd.lib.montana.edu/etd/2006/king/KingW0506.pdf.

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48

LeGrow, Tracy L. "Access to health information and health care decision-making of women in a rural Appalachian community." Huntington, WV : [Marshall University Libraries], 2007. http://www.marshall.edu/etd/descript.asp?ref=746.

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49

Jongudomkarn, Darunee. "Nursing perspectives on women, health and work in the socio-cultural context of poor communities in Northeast Thailand." Thesis, Robert Gordon University, 2001. http://hdl.handle.net/10059/603.

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Women from poor communities in Northeast Thailand can be considered as a disadvantaged group who have struggled against several problems in their daily living and who have worked hard to sustain their lives through unskilled labour. In such a strong Buddhist culture these women have vital roles within the household and in earning money. The combination of which it is suggested, has had an impact on their physical and psychological health. In Thailand, there is limited data available about such women's health, life experience and work. A better understanding of their situation is required in order to inform and redesign effective health intervention programmes to promote the health and well-being of women from these communities. An holistic nursing perspective was used to inform the design of this research. Only by understanding the context, the living experiences and the understandings of the women themselves is it possible to construct effective health intervention programmes. Thus the purpose of the study was to understand women's health and work in the sociocultural context of poverty in Northeast Thailand. A combination of quantitative and qualitative techniques were used in the overall data collection process. The study was conducted in two distinct phases. Phase 1 provided an overall of baseline account of the socio-cultural context of six communities and the health of a sample of women who live therein. It involved focus group interviews (N=102) with residents and a survey (N=209) of households. Phase 2 was a more focused case study (N=49) of women's life experiences, their health and work in one selected community. Phase 1 of the study found that the majority of women had a substantial role in household economics. Coping strategies that women frequently used were `Tam Chai' (accept and not think too much about it). The majority of women in the communities were primary breadwinners and were self-employed as vendors. Regarding women's health, the findings showed a high level of musculoskeletal and psychological complaints. The study showed that nearly all of the women were optimists and felt happy. In the second phase of the study. Buddhism and the Thai way of living emerged as the major factors which influenced women's views on health and well being. The data illustrated that women struggled to survive in the community and that they had to work hard to make ends meet. Women used networks in the community as resources for coping. They saw `health in terms of being strong enough to work and earn a living'. Health per se is the lowest priority in their life. To work and earn money to support their families is the highest. Indeed, the Buddhist teaching of `self-reliance' has a great impact on them. The conclusions reached suggest that nursing interventions and health campaigns could be used to promote and maintain the optimum health of women and their families. Finally recommendations are made with regard to further research; development of services; development of nurse-education and health promotion for women in low-income communities.
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50

Hosegood, Victoria. "Anthropometry and mortality : a cohort study of rural Bangladeshi women." Thesis, London School of Hygiene and Tropical Medicine (University of London), 1997. http://researchonline.lshtm.ac.uk/682248/.

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Many authors suggest that low anthropometric levels are associated with higher mortality risk in adults, In developing countries however there have been few opportunities to test this hypothesis. In addition, there is increasing interest in the role of women's nutritional status in their own health and survival as distinct from its impact on infant outcomes. This thesis describes the results obtained from a longitudinal historical follow-up of a cohort of 2,314 rural Bangladeshi women over a period of 19 years (1975-1993). The demographic, socio-economic, and anthropometric characteristics of the study cohort are described with reference to the methods of data extraction, preparation and validation. The risk of mortality associated with different levels of the anthropometric indicators (height, weight, arm circumference and body mass index) were analysed using Cox's proportional hazards models. In addition to the basic survival models, the effects of confounding, early mortality, missing data, and young subjects, on the estimates are discussed. A significant association between BMI and mortality (p=0.009) was found in adjusted analyses which used categories that distinguished the women in the highest and lowest 10% of the cohort BMI distribution. Women with BMI levels between 10% and 90% and >90% had hazard ratios of 0.45 (95% confidence intervals 0.27,0.73) and 0.55 (0.25,1.22) respectively, when compared to women with BMI <10%. The strength of the association between BMI and mortality risk was reduced after adjusting the models for early mortality (<4 years), (p=0.068). No significant associations were found between height, arm circumference and mortality risk. In conclusion, these data provide no evidence that these anthropometric indicators would be useful in population-based screening programmes in rural Bangladesh to identify women at higher mortality risk. The findings are considered with respect to the study's methodological constraints and comparisons with other studies in order to produce recommendations for those working in research and health programmes in women's nutrition.
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