Tesis sobre el tema "Rural health – Western Australia"
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Speldewinde, Peter Christiaan. "Ecosystem health : the relationship between dryland salinity and human health". University of Western Australia. School of Population Health, 2008. http://theses.library.uwa.edu.au/adt-WU2008.0127.
Texto completoLoh, Poh Kooi. "Innovations in health for older people in Western Australia". University of Western Australia. School of Medicine and Pharmacology, 2009. http://theses.library.uwa.edu.au/adt-WU2010.0051.
Texto completoLewis, Janice A. "The clinician manager in rural Western Australia: a sensemaking perspective of the role". Curtin University of Technology, Graduate School of Business, 2001. http://espace.library.curtin.edu.au:80/R/?func=dbin-jump-full&object_id=13059.
Texto completoclinician manager was mediated by the interaction with the stakeholders - the most influential factors being the clinician manager's perceptions of the trustworthiness of the stakeholders, the political behaviour that characterised the interactions with the stakeholder and role stress. In particular, role conflict, role ambiguity and role overload emerged. Personal elements were the personal characteristics of the clinician manager - the most salient being the experience of role strain, self-efficacy (i.e. their belief in their ability to do the job) and their commitment to the sensemaking process.Circumstances in the environment constrained their reliance on others for validation of their explanations of events and the actions they took. Most made decisions based on intuition and "gut feeling" - validating these decisions with subjective evaluations of outcomes and retrospective explanations. These processes were further mediated by the characteristics of the individual, particularly perceptions of self-efficacy. The ways in which the clinician managers adapted to and interpreted their role was diverse, which made the role more an expression of individual preferences than a coherent part of a larger organisational structure. Findings indicated that the clinician managers relied on their sensemaking processes in order to explain the ambiguous nature of their practice environment and to plan actions within the context of a role that was poorly defined by the organisation.
Mostafanejad, Karola. "Young adults' experience of living with a mental illness in rural Western Australia : a grounded theory approach /". Curtin University of Technology, School of Nursing and Midwifery, 2005. http://espace.library.curtin.edu.au:80/R/?func=dbin-jump-full&object_id=16160.
Texto completoParticipants' experience of being shut out was not related to the duration of their illness but to their experience of seeking normality and the three conditions identified as influencing that experience. The findings, while supporting existing scientific literature, also present a new insight into young adults' experience of living with a mental illness in rural Western Australia. The findings of this study highlight the importance of health professionals' understanding young adults' experience of being shut out and to incorporate the increased knowledge and understanding into their clinical practice. Finally, the findings have implications on public education, healthcare services and healthcare policy in relation to young adults living with a mental illness.
au, martinia@westnet com y Angelita Martini. "Community participation in government and private sector planning: a case study of health and telecommunications planning for rural and remote Western Australia". Murdoch University, 2006. http://wwwlib.murdoch.edu.au/adt/browse/view/adt-MU20081002.100047.
Texto completoMartini, Angelita. "Community participation in government and private sector planning: a case study of health and telecommunications planning for rural and remote Western Australia". Martini, Angelita (2006) Community participation in government and private sector planning: a case study of health and telecommunications planning for rural and remote Western Australia. PhD thesis, Murdoch University, 2006. http://researchrepository.murdoch.edu.au/184/.
Texto completoau, jmaxwell@katel net y John Alexander Loftus Maxwell. "Rural veterinary practice in Western Australia 1964 to 2007". Murdoch University, 2008. http://wwwlib.murdoch.edu.au/adt/browse/view/adt-MU20081113.142241.
Texto completoMaxwell, John Alexander Loftus. "Rural veterinary practice in Western Australia 1964 to 2007". Access via Murdoch University Digital Theses Project, 2008. http://wwwlib.murdoch.edu.au/adt/browse/view/adt-MU20081113.142241.
Texto completoTonts, Matthew A. "Rural restructuring, policy change and uneven development in the central wheatbelt of Western Australia". Curtin University of Technology, School of Social Sciences and Asian Languages, 1998. http://espace.library.curtin.edu.au:80/R/?func=dbin-jump-full&object_id=9689.
Texto completoeconomic rationalism have increased levels of uncertainty and socio-economic disadvantage in a region already adversely affected by the economic pressures associated with restructuring. The thesis concludes by arguing that a more integrated policy framework, based to a greater extent on the principles of social equity, is critical to ensuring the social and economic welfare of rural people.
Wilson, Sally B. "Family Centred Care: A Descriptive Study of the Situation in Rural Western Australia". Curtin University of Technology, School of Nursing and Midwifery, 2004. http://espace.library.curtin.edu.au:80/R/?func=dbin-jump-full&object_id=15170.
Texto completoParents and nurses both perceived that parents wanted to continue parenting their hospitalised child, however parents wanted to provide more nursing care than was perceived by nurses. Nurses' perceptions of delivering family centred care were greater than the perceptions of parents receiving it, however they were consistent in items that were scored low. Nurses did ask parents about the amount of participation they wanted in their child's care on admission however, it was not done on a regular basis. Parents perceived that nurses were unaware of other things that parents needed to attend to while their child was hospitalised and therefore did not enable parents to attend to these needs. More frequent negotiation of roles between parents and nurses by communicating each shift, or at least daily, could narrow the gap between differing perceptions in care provision and also enable parents to attend to their other roles thereby reducing their levels of physical and emotional stress.
Sharplin, Elaine Denise. "Quality of worklife for rural and remote teachers : perspectives of novice, interstate and overseas-qualified teachers". University of Western Australia. Graduate School of Education, 2008. http://theses.library.uwa.edu.au/adt-WU2008.0211.
Texto completoMcCarron, Robyn Janelle. "Performing arts and regional communities : the case of Bunbury, Western Australia /". Access via Murdoch University Digital Theses Project, 2004. http://wwwlib.murdoch.edu.au/adt/browse/view/adt-MU20050501.153348.
Texto completoau, Editech@iinet net y Pamela-Anne Shanks. "A critical policy analysis of the Crossroads Review: Implications for higher education in regional Western Australia". Murdoch University, 2006. http://wwwlib.murdoch.edu.au/adt/browse/view/adt-MU20061019.134304.
Texto completoWood, Lisa Jane. "Social capital, neighbourhood environments and health : development of measurement tools and exploration of links through qualitative and quantitative research". University of Western Australia. School of Population Health, 2006. http://theses.library.uwa.edu.au/adt-WU2006.0111.
Texto completoDe, Vos Johanna B. M. "Respiratory health effects of occupational exposure to bushfire smoke in Western Australia". University of Western Australia. School of Population Health, 2008. http://theses.library.uwa.edu.au/adt-WU2009.0001.
Texto completoNorrie, Philip Anthony. "Wine and health through the ages with special reference to Australia /". View thesis, 2005. http://library.uws.edu.au/adt-NUWS/public/adt-NUWS20060420.102152/index.html.
Texto completo"A thesis submitted in fulfillment of the requirements for the degree of Doctor of Philosophy, School of Social Ecology and Lifelong Learning, University of Western Sydney." Includes bibliographical references and index.
Gardos, Amy. "The historical archaeology of the Old Farm on Strawberry Hill : a rural estate 1827-1889, Albany, Western Australia". University of Western Australia. Archaeology Discipline Group, 2004. http://theses.library.uwa.edu.au/adt-WU2005.0032.
Texto completoClifford, Susan Amanda. "The effects of fly-in/fly-out commute arrangements and extended working hours on the stress, lifestyle, relationships and health characteristics of Western Australian mining employees and their partners". University of Western Australia. School of Anatomy and Human Biology, 2010. http://theses.library.uwa.edu.au/adt-WU2010.0018.
Texto completoKoo, Fung Kuen. "Disharmony between Chinese and Western views about preventative health : a qualitative investigation of the health beliefs and behaviour of older Hong Kong Chinese people in Australia". University of Sydney, 2005. http://hdl.handle.net/2123/1610.
Texto completoThis study explores the health beliefs and preventive health behaviours of older Hong Kong Chinese people resident in Australia. Participation in physical activity was used as the case study. There were two frameworks used to shape the research. Because of their perceived influence on the health beliefs and practices of Hong Kong Chinese people, the traditional Chinese philosophies of Confucianism, Taoism, and Buddhism provided the philosophical framework. The Theory of Planned Behaviour provided a theoretical framework for understanding the target group's preventive health behaviour. Data was collected by means of in-depth interviews, participant observation and case study. Twenty-two informants were interviewed, their transcripts analysed, summarised and typologised, identifying six states of physical activity participation. Findings demonstrated that this target group possessed a holistic view of health, with food taking a special role in preventive care and self-treatment at times of illness. The Cantonese terms used to denote “physical activity” caused confusion among the target group. Most interpreted it as meaning deliberate planned body movement, strength-enhancing activities or exercise, although some did see it as including mundane daily activities and chores. Lack of time, no interest and laziness were reported as the main reasons for low participation in deliberate planned physical activity. Cultural, social and environmental determinants were the intrinsic and extrinsic factors influencing attitudes toward physical activity, as well as perceived social supports and perceived control over physical activity participation barriers. To a large extent, these interactive determinants of health were rooted in the three traditional Chinese philosophies mentioned above. The thesis concludes by arguing that rather than simply advocating activities designed for other populations, health promotion strategies and education need to create links to the traditions of this target group and also clarify their conception of physical activity.
au, A. Eades@murdoch edu y Anne-Marie Eades. "Factors that influence participation in self-management of wound care in three Indigenous communities in Western Australia: Clients' perspectives". Murdoch University, 2008. http://wwwlib.murdoch.edu.au/adt/browse/view/adt-MU20090702.111437.
Texto completoJardine, Andrew. "The impact of dryland salinity on Ross River virus in south-western Australia : an ecosystem health perspective". University of Western Australia. School of Population Health, 2007. http://theses.library.uwa.edu.au/adt-WU2007.0182.
Texto completoPeer, Nazia. "Factors associated with Contraceptive Use in a rural area in the Western Cape, South Africa". Master's thesis, University of Cape Town, 2012. http://hdl.handle.net/11427/14235.
Texto completoDavies, Marcella. "Women's Perceptions of Malaria in the Western Rural Areas of Sierra Leone". ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/5618.
Texto completoOwen, Julie. "Development of a culturally sensitive program delivering cardiovascular health education to indigenous Australians, in South-West towns of Western Australia with lay educators as community role models". University of Western Australia. School of Population Health, 2006. http://theses.library.uwa.edu.au/adt-WU2006.0061.
Texto completoEnglish, René Glynnis. "Reproductive health effects due to pesticide exposure amongst boys in the rural Western Cape, South Africa". Master's thesis, University of Cape Town, 2011. http://hdl.handle.net/11427/12797.
Texto completoContemporary agricultural pesticides have been shown to possess hormonally-active properties, and have been associated with declining male reproductive health. These chemicals act by disrupting the normal functioning of the male endocrine system, through their actions on the hypothalamic-pituitary-gonadal axis. Reported male reproductive abnormalities are reproductive organ defects, cancers and declining fertility. Cryptorchidism, hypospadias, testicular cancer and poor sperm quality (testicular dysgenesis syndrome) have also been reported to be associated with these endocrine-disrupting chemicals. This study therefore aims to investigate the adverse reproductive health effects of environmental pesticide exposure in male children and adolescents, based on their lifetime residential history (namely, having lived on a farm or not).
Joyce, Sarah Julia. "Demographic, clinical and environmental risk factors for prelabour rupture of membranes in Western Australia". University of Western Australia. School of Population Health, 2009. http://theses.library.uwa.edu.au/adt-WU2009.0126.
Texto completoNakao, Jolene H. "Acceptance and access : home-based HIV counselling and testing and barriers to care in rural Western Kenya". Master's thesis, University of Cape Town, 2009. http://hdl.handle.net/11427/12137.
Texto completoIncludes bibliographical references (leaves 83-94).
Home-based HIV counselling and testing (HBCT) is a wayt to provide confidential HIV testing in a person's home. As home-based testing has not yet been evaluated on a wide scale in Kenya among adult individuals [over age 15], this project is designed to assess in rural Kenya 1) overall acceptance rates and variables that predict differential acceptance rates of home-based HIV testing, 2) reasons for refusal of home-based testing, and 3) barriers to seeking treatment for people who are HIV positive.
Hawley, Georgina. "A phenomenological study of the health-care related spiritual needs of multicultural Western Australians". Curtin University of Technology, Science and Mathematics Education Centre, 2002. http://espace.library.curtin.edu.au:80/R/?func=dbin-jump-full&object_id=13369.
Texto completoFor the second part of the research which involved a case study of health care patients, a qualitative methodology was used. This approach enabled me to explore the phenomenon of spirituality from the perspective of eight participants, which involved identifying their spiritual needs, the care they desired, and the rite of passage they underwent when receiving health care. The qualitative methodology enabled me to explore the subject from a sensitive holistic perspective, and to protect the integrity of the participants. I wanted to know what patients understood about their spirituality and how spiritual care could be implemented not only in clinical practice but also into health care education programs. The participants' detailed subjective experience was especially important, because I wanted to know how they identified their spiritual needs, how they had requested their needs be met by health care professionals, and the extent to which health care professionals had reacted to those cues. I formulated an 'interpretive phenomenology research' design based on the philosophical writings of Heidegger and Bakhtin. Heidegger argued that people gain knowledge of a subject from their own subjective experience, and of the person being in their world (simultaneous past, present and future thoughts). Bakhtin stated that to bring about social change, the researcher needed to understand the social context of the people's language including their culture, politics, government-provided amenities (such as education and health care), employment and social interaction, both within and outside their communities in which they live. The eight participants were interviewed a number of times in order to explore the phenomenon of spirituality beyond the notions already published in the literature (i.e. from multicultural Australian's perspective).
They told of hospital or health care experiences that included: health care for childbirth, mental and psychiatric illnesses (depression, manic-depression, and anxiety), immunology (lymphoma), stroke, detoxification of alcohol, arthritis, coronary occlusion, hypertension, and peritonitis; surgical procedured/s such as repair of hernia, bowel obstruction, eye surgery, orchiopexy (removal of testes from inguinal canal into the scrotal sac), caesarian birth, appendectomy, and oophorectomy (removal of ovaries); treatments such as radiotherapy, chemotherapy, and physiotherapy; and hospital experiences in both large and small public and private acute hospitals, private and public mental health/psychiatric hospitals, intensive care and coronary care units. These situations demonstrate the diversity of contexts which people want their spiritual needs met. The study revealed that it is not only dying patients who have spiritual need; spiritual needs exist in widespread ordinary conditions and across a wide range of health care services. The eight participants - Ann, Athika, Garry, Red, Rosie, Scarlet, Sophie, and Tom (pseudonyms) - were drawn from many of the multicultural groups resident in Western Australia including Aboriginal, Chinese, English, European, Indian, and Irish peoples. Their spiritualities encompassed Judeo-Christian, Buddhist, Hindu, Pagan Romany, Society of Friends (Quaker), Humanist, Socialist, and Communist values and beliefs. The results of the research give insight into the eight participants' perspectives on being a person, their understanding of spirituality, perceived spiritual needs, their desired levels of spiritual care, and the rite of passage they experienced when undergoing health care treatment in hospital.
The participants' spiritual needs comprised of four categories: 'mutual trust', 'hope', 'peace' and 'love'. The levels of spiritual care spoke of desiring were: 'acknowledgement', 'empathy', and 'valuing'. Recommendations are given for health care professionals to provide spiritual care for the eight participants, and implications are considered for the spiritual education of future health care professionals in order to sensitise them to the wide range of healthcare related spiritual needs they might encounter in local multicultural communities. It is recognised that the scope of the implications is contingent on further research establishing the incidence of health-care related spiritual needs among the broader population of multi-cultural Western Australians. The richness and depth of the data and the very sensitive nature of the material that came from the eight people who shared their experiences with me has rendered this thesis an important document. The nature of the various incidents and situations they shared with me, I believe, demonstrated their preparedness to tell their story so that health care can be improved. On many occasions, I felt honoured that they had sufficient trust in me to enable them to report such deep and personal suffering. For example, Rosie told me of her mental torment and of not knowing if she was alive or dead; of how she burnt her legs to try to feel pain in order to see if she was alive. It was stories such as this that gave me the passion to write this thesis well in order to do justice to all people who want spirituality included in health care treatment.
Blue, Ian A. "The professional working relationship of rural nurses and doctors : four South Australian case studies". Title page, table of contents and abstract only, 2002. http://web4.library.adelaide.edu.au/theses/09PH/09phb6582.pdf.
Texto completoKatzenellenbogen, Judith Masha. "Use of data linkage to enhance burden of disease estimates in Western Australia : the example of stroke". University of Western Australia. School of Population Health, 2009. http://theses.library.uwa.edu.au/adt-WU2009.0117.
Texto completoWildschutt, Phillip Jacobus. "The effect of accumulative physical activity on the fitness and health status of rural school children". Thesis, University of the Western Cape, 2005. http://etd.uwc.ac.za/index.php?module=etd&.
Texto completoWilks, Kathryn. "Canine zoonoses in Aboriginal communities : the effects of a canine breeding program in the Kimberley Region, Western Australia". Murdoch University, 1999. http://wwwlib.murdoch.edu.au/adt/browse/view/adt-MU20060829.145909.
Texto completoKendall, Garth Edward. "Children in families in communities : a modified conceptual framework and an analytic strategy for identifying patterns of factors associated with developmental health outcomes in childhood". University of Western Australia. School of Paediatrics and Child Health, 2003. http://theses.library.uwa.edu.au/adt-WU2004.0006.
Texto completoBeyers, Belinda. "Experiences of community service practitioners who are deployed at a rural health facility in the Western Cape". Thesis, University of Western Cape, 2013. http://hdl.handle.net/11394/3321.
Texto completoSouth Africa has a general shortage of most categories of health professionals, which include nurses, doctors, dentists and pharmacists. However, the problem is exacerbated by the fact that most of these professionals either work in the private health sector or have migrated to more affluent countries. Shortages of nurses in the rural setting continue to pose a problem for the Department of Health. The community service policy is stated in Section 40 of the Nursing Act, of 2005, and in the Regulations relating to Performance of Community Service published in the Government Notice No. 765 of 24 August 2005. In 2008, the first professional nurses started with their community service. Community service for health professionals is a policy proposal of the Department of Health that reacts to the lack of meeting the health requirements in poor communities, particularly in rural areas. It offers graduating health professionals with the prospect of gaining first-hand working experience in conditions of poverty and underdevelopment. South Africa is implementing community service for health professionals as a plan to manage the difficulties of human resources in the health sector. The transition period for community service practitioners in a rural setting is different, which implies that most support may need to be strengthened due to the remoteness of the rural setting. The purpose of this study was to describe the experiences of community service practitioners during their community service at a rural health facility. From the findings, guidelines were described for the operational managers who are responsible for supporting the community service practitioners at a health facility in a rural area. A qualitative, exploratory, and descriptive design was applied, using individual unstructured interviews and field notes. Each interview took around 30-45 minutes to complete. The purposively selected sample consisted of community service practitioners (n = 10) who were practicing at rural health facilities. The process of inductive coding of Thomas (2003:5) was used to analyse the data. The results of this study indicate that a process is needed for community service practitioners fresh from university and an urban environment to adapt to a remote rural health facility. Some of the participants did receive an orientation programme at the beginning of their community service year. However, most of the community service practitioners that took part in the study learned from their experience during the year of their placements. For some, the learning opportunities were more available in the rural setting than when they had worked as students at the urban hospital during their training.
Macfarlane, Chelsea Elizabeth. "A comparison of the predictors of hepatitis B vaccination acceptance amongst health care and public safety workers in Australia /". View thesis, 2001. http://library.uws.edu.au/adt-NUWS/public/adt-NUWS20031222.150943/index.html.
Texto completo"A thesis submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy, University of Western Sydney" Bibliography : leaves 193-208.
McLoughlin, Jo-Ann. "Papsak consumption and problem drinking amongst farm workers in the rural Western Cape : prevalence and risk factors". Master's thesis, University of Cape Town, 2007. http://hdl.handle.net/11427/9331.
Texto completo[Motivation] A high prevalence of alcohol consumption and the negative impact of alcohol on rural communities in the Western Cape have been linked to coercive labour practices and the ease of availability of cheap, low quality white wine, typically packaged in foil bags (papsakke). A process is underway to regulate papsakke out of the market. However, limited research has been conducted on the use and impact of papsakke. [Aims and objectives] This study aims to determine the prevalence of, and risk factors for papsak consumption and problem amongst farm workers in the rural Western Cape. It also explores the attitudes of drinkers with respect to their choice of alcohol type and the practices of papsak drinkers, in order to identify target groups for community level interventions and to inform the consent and monitoring of developmental and/or restrictive interventions. [Study design] A cross sectional analytical study performed as a post hoc analysis of data obtained from a larger study on papsakke which included a farm worker survey. [Subjects] 461 female and male farm workers resident on predominantly wine grape producing farms in Stellenbosch, Franschoek and Vredendal in the rural Western Cape Province from February to May of 2004.
Dahari, Zainurin. "The effect of price and health information in shifting young children [sic] preference towards healthier food". UWA Business School, 2007. http://theses.library.uwa.edu.au/adt-WU2008.0011.
Texto completoRukundo, Emmanuel Nshakira [Verfasser]. "Effects of community-based health insurance on child health outcomes and utilisation of preventive health services : Evidence from rural south-western Uganda / Emmanuel Nshakira Rukundo". Bonn : Universitäts- und Landesbibliothek Bonn, 2018. http://d-nb.info/1173898611/34.
Texto completoHanna, Elizabeth Gayle (Liz) y lizhanna@netc net au. "Environmental health and primary health care: towards a new workforce model". La Trobe University. School of Public Health, 2005. http://www.lib.latrobe.edu.au./thesis/public/adt-LTU20061110.152550.
Texto completoGriffin, Sandra Lenore. "Interactions between zooplankton grazers and phytoplankton as part of the energy and nutrient dynamics in the Swan River Estuary, Western Australia". Curtin University of Technology, School of Chemical and Biological Sciences, 2003. http://espace.library.curtin.edu.au:80/R/?func=dbin-jump-full&object_id=14320.
Texto completoHowever, an absence or reduction in abundance of copepods in areas of very high algal biomass (>80 pg chlorophyll a.L-1) suggests that local loss of water quality may have an impact on copepods over a small spatial scale within the estuary. Different aspects of the interactions between zooplankton grazers and phytoplankton were studied. Zooplankton grazing rates were measured in situ during algal blooms and in the laboratory under controlled conditions to determine the potential for zooplankton grazers to reduce algal biomass. Field and laboratory experiments supported the hypothesis that copepods and other zooplankton can exert 'top-down control' over phytoplankton biomass, but that the type and biomass of phytoplankton present affected their ability to exert this control. The results of the field and laboratory grazing experiments, along with literature data, were used to provide input data for a model of zooplankton and phytoplankton dynamics during a dinoflagellate bloom in the Swan River estuary. The model was tested against biomass measurements of zooplankton and phytoplankton to determine how well it predicted actual changes in the plankton community. The simulated output closely followed the measured Page x field data and fitted regression curves and provided information about diurnal patterns of phytoplankton production, respiration and migration and hydrodynamic transport, which was not available from field data. It was shown that zooplankton grazing, particularly grazing by microzooplankton, was the process contributing most to the observed decline in dinoflagellate biomass. Nutrient availability is one of several factors determining productivity of phytoplankton. Nutrients within copepod faecal pellets are relocated by faecal deposition to sediments, where microbial activity leads to the remineralisation of these nutrients.
Quantification of metabolic excretion of nutrients by copepods and the rate at which pellets are produced by copepod grazers, the concentration of nutrients within faecal pellets and the rate at which these nutrients are released indicated that copepods may play an important role in nutrient regeneration during summer and autumn when allochthonous nutrients are unavailable. At other times of the year, it is unlikely that copepods play an important role in nutrient regeneration. The research has provided a more detailed level of understanding of the interactions between zooplankton, phytoplankton and their environment. The data is ideally suited for use in a computer model to predict the effects of management actions on the Swan River estuary. This would allow pre-emptive management strategies to be developed and lessen the focus on reactive management.
Hurter, Theunis. "The culture of data use in the management structures of a rural health district in the Western Cape Province". Master's thesis, University of Cape Town, 2015. http://hdl.handle.net/11427/15545.
Texto completoRörich, Eben Eugéne. "An economic evaluation of the winelands health worker programme". Thesis, Stellenbosch : Stellenbosch University, 2002. http://hdl.handle.net/10019.1/52664.
Texto completoENGLISH ABSTRACT: Historically health care in South Africa has been an area of great inequity. Health care was inequitable, inadequate and racially based. In order to redress the gap in the delivery of health care services, created by the previous dispensation of separate development, the National Department of Health has adopted a Primary Health Care (PHC) approach as the guiding principle for the reconstruction of the health system in South Africa. One of the pillars of this approach is the empowerment of communities to participate, thus moving from facility based- to community based health care. The aim of the National Health System (NRS) is to promote health and health knowledge, to provide an equitable, accessible, and appropriate health service, and to empower people to take greater responsibility for their own health. It is constructed around the belief that health for all cannot be achieved simply by improving the formal health system, but that a holistic and multi-sectoral approach is required. This thesis explores the community health worker (CRW) as a possible cost-effective and efficient supplementary service, to the current formal health system, to bridge the gap in the formal health system through the provision of PHC services in a rural setting. This was done through the economic evaluation of a CHW programme operating in the Winelands are of the Western Cape. The aim of this study was to evaluate and analyse the nature, performance, and costs of the programme and place it in context by comparison to other similar programmes. This comparison focused on physical characteristics, goals, and cost structures. It also aims to measure the direct and indirect impact of this type of intervention on the agribusiness sector as well as the local health authorities. The evaluation proceeded from the premise that the CHW programme, if implemented correctly with proper and appropriate training, and adequate post training support, will be a cost-effective and efficient model for the provision ofPHC services in this rural/farming area. The economic evaluation of this CHW programme required it to be viewed from two perspectives. The first component viewed the implementation of the programme from the perspective of the agribusiness sector. This aspect of the study included both a qualitative as well as a quantitative VIew of the costs, benefits (perceived or otherwise), and perceptions of the CHW intervention. The second component assessed the CHW programme within the context of a resource constrained public sector health budget. Since the implementation of this programme implies certain expenditures on the part of the local health authorities, these cost had to be identified and quantified to gauge the effectiveness of that expenditure.
AFRIKAANSE OPSOMMING: Geskikte en doeltreffende gesondheidsdienste in Suid-Afrika se onlangse geskiedenis was nog gereserveer vir 'n uitgesoekte groep mense. Die gesondheidstelsel was ontoereikend, onvoldoende en gebaseer op ras. Daar het 'n gaping ontstaan tussen die dienste wat gelewer is en die werklike behoeftes van die mense wat dit moes gebruik. Ten einde hierdie gaping aan te spreek het die Nasionale Departement van Gesondheid besluit om 'n Primêre Gesondheidsorg (PRe) benadering te volg wat klem plaas op die bemagtiging van plaaslike gemeenskappe deur deelname. Dit was 'n duidelike skuifvanaffasiliteit- na gemeenskap gebaseerde gesondheidsdienste. Die oorkoepelende doel van hierdie verskuiwing in fokus was om voorheen benadeelde gemeenskappe voldoende toegang te gee tot gesondheidsdienste en ook om hierdie dienste aan te pas by die behoeftes van sodanige gemeenskappe. Hierdie tesis ondersoek die Wynland distriksraad se Gemeenskap Gesondheidswerker Program as 'n moontlike koste-effektiewe stelsel vir die lewering van toepaslike primêre gesondheidsdienste in landelike areas. Die doel van die studie was die sistematiese ontleding van die werking en omvang van, en die kostes verbonde aan die implementering en onderhoud van hierdie program. Die studie poog om die impak van hierdie program op die formele landbou sektor asook die plaaslike gesondheidsowerhede te identifiseer en, waar moontlik en prakties wenslik, te kwantifiseer. Die ondersoek sluit in die stelselmatige ontleding van kostes en voordele vir die formele landbou sektor sowel as die plaaslike gesondheidsowerhede. Die kostes asook die kliniese uitkomste geassosieer met die implementasie van die Gesondheidswerker program sal dan in konteks geplaas word deur dit te vergelyk met ander soortgelyke programme wat in die verlede aangepak is. Die vergelyking sal fokus op die fisiese eienskappe, koste struktuur, bronne van ondersteuning en die primêre doel van die intervensie.
Van, Zyl Marjorie Alice. "Factors influencing community integrated management to childhood illness in rural areas". Thesis, Stellenbosch : Stellenbosch University, 2013. http://hdl.handle.net/10019.1/80383.
Texto completoENGLISH ABSTRACT: Child mortality is a worldwide problem and, according to the World Health Organization (WHO), 8,1 million children under the age of five years die each year. The Millennium Development Goals focus on the worldwide reduction in child mortality by two-thirds between 2000 and 2015. Several studies show that worldwide Community Integrated Management of Childhood Illness (CIMCI) interventions by community care workers (CCWs) have a positive effect on child health. The goal of this study was to determine the factors influencing CIMCI in the rural areas of the West Coast District in the Western Cape of South Africa. The objectives for this study were to determine the factors influencing CIMCI carried out in rural areas by the CCWs, which were identified as: • having working hours that are adequate for such a comprehensive service package; • being adequately trained; • having adequate knowledge of the “16 Key Family Practices” of CIMCI; • having equipment that is adequate for the execution of their daily duties; • being able to cope with the challenges of working in rural and remote areas; and • receiving adequate supervision and support related to CIMCI. A descriptive, non-experimental exploratory research design with a quantitative approach was applied. The target population (N = 270) consisted of CCWs who are funded by the Provincial Government of the Western Cape (PGWC) in the West Coast District. For this study a response rate of 257 (95,18%) was obtained. Data was collected personally by the researcher with a self-administered questionnaire. The data was analysed with the assistance of a statistician and are presented in histograms and frequency tables. The participants were tested on their knowledge of CIMCI, and more than half of them achieved an average score that was not satisfactory. Statistically significant correlations were found between the participants’ total score achieved and highest school grade passed (p < 0. 01); their level of Expanded Public Works Programme (EPWP) training (p < 0.01); their attendance of the CIMCI five-day course (p < 0.00); and if they had done a refresher course on CIMCI (p < 0.00). The total score was also shown by the Mann-Whitney U test (p < 0.01) to have a direct relationship with whether they had received any health-related training after school. The conclusion that can be drawn is that the higher the level of education of the CCWs, the better their knowledge of CIMCI. This could also improve their work performance. The recommendations arising from this study include that CIMCI training should be standardised to ensure that the CCWs have adequate knowledge. The current policy on community-based services (CBS) of the Provincial Government Western Cape Department of Health should also be standardised to ensure adequate working hours, training, equipment and supervision, and to take into consideration the challenges of working in rural areas. In conclusion, should these recommendations be implemented, CIMCI will have a huge, positive impact on child morbidity and mortality. CCWs will be ensured adequate working hours in relation to their workload, and will receive adequate training, equipment and supervision. This will reduce the challenges CCWs face and strengthen their services in rural areas.
AFRIKAANSE OPSOMMING: Kindersterftes is wêreldwyd ’n probleem en volgens die Wêreldgesondheidsorganisasie sterf 8,1 miljoen kinders onder die ouderdom van vyf jaar elke jaar. Die Millenniumontwikkelings-doelwitte fokus daarop om kindersterftes tussen 2000 en 2015 met twee-derdes te verminder. Verskeie studies toon dat intervensies deur middel van Gemeenskapsgeïntegreerde Bestuur van Kindersiektes deur gemeenskapsorgwerkers die wêreld oor ’n positiewe effek op kindergesondheid het. Die doel van hierdie studie was om die faktore te bepaal wat Gemeenskapsgeïntegreerde Bestuur van Kindersiektes in die landelike gebiede van die Weskusdistrik in die Wes-Kaap van Suid-Afrika beïnvloed. Die doelwitte vir hierdie studie was om die faktore te bepaal wat beïnvloed hoe Gemeenskapsgeïntegreerde Bestuur van Kindersiektes in die landelike gebiede deur gemeenskapsorgwerkers uitgevoer word, wat soos volg uiteengesit is: • werksure wat voldoende is vir die omvattende pakket dienste wat aangebied word; • dat hulle voldoende opgelei is; • dat hulle voldoende kennis het van die “16 Sleutel Familiepraktyke” van Gemeenskapsgeïntegreerde Bestuur van Kindersiektes; • dat hulle die nodige toerusting besit wat voldoende is vir die uitvoer van hulle daaglikse pligte; • dat hulle raad weet met die uitdagings van werk in landelike en afgeleë gebiede; en • dat hulle voldoende toesig en ondersteuning met betrekking tot Gemeenskapsgeïntegreerde Bestuur van Kindersiektes ontvang. ’n Beskrywende, nie-eksperimentele verkennende navorsingsontwerp met ’n kwantitatiewe benadering is gebruik. Die teikenbevolking (N = 270) het bestaan uit gemeenskapsorgwerkers wat deur die Provinsiale Regering van die Wes-Kaap in die Weskusdistrik befonds word. Vir hierdie studie is ’n responstempo van 257 (95,18%) verkry. Die data is persoonlik deur die navorser deur middel van ’n selftoepastoets ingesamel. Die data is met behulp van ’n statistikus geanaliseer en word deur middel van histogramme en frekwensietabelle voorgestel. Die deelnemers is getoets op grond van hulle kennis van Gemeenskapsgeïntegreerde Bestuur van Kindersiektes, en meer as die helfte het ’n gemiddelde telling behaal wat nie bevredigend is nie. Statisties beduidende korrelasies is verkry tussen die deelnemers se totale telling en die hoogste skoolgraad behaal (p < 0.01); hulle vlak van Expanded Public Works Programme (EPWP) opleiding (p < 0.01); hulle bywoning van die vyfdaagse Gemeenskapsgeïntegreerde Bestuur van Kindersiektes kursus (p < 0.00); en of hulle ’n opknappingskursus oor Gemeenskapsgeïntegreerde Bestuur van Kindersiektes gedoen het (p < 0.00). Die totale telling is deur die Mann-Whitney U-toets (p < 0.01) gewys om ’n direkte verwantskap te hê met of hulle enige gesondheidsverwante opleiding ná skool ondergaan het. Die gevolgtrekking is dat hoe hoër die gemeenskapsorgwerkers se vlak van opvoeding, hoe beter hulle kennis van Gemeenskapsgeïntegreerde Bestuur van Kindersiektes. Dit sou ook hulle werkverrigting kon verbeter. Die aanbevelings wat uit hierdie studie spruit, sluit in dat Gemeenskapsgeïntegreerde Bestuur van Kindersiektes-opleiding gestandaardiseer moet word om te verseker dat gemeenskapsorgwerkrs voldoende kennis het. Die huidige beleid van die Provinsiale Regering van die Wes-Kaap oor gemeenskapsgebaseerde dienste moet ook gestandaardiseer word om te verseker dat hulle toereikende werksure, opleiding, toerusting en toesig het, en om die uitdagings van werk in landelike gebiede in ag te neem. Ter afsluiting: sou hierdie aanbevelings geïmplementeer word, sal Gemeenskapsgeïntegreerde Bestuur van Kindersiektes ‘n groot, positiewe impak op kindermorbiditeit en kindersterftes hê. Gemeenskapsorgwerkers sal van voldoende werksure met betrekking tot hulle werklas verseker wees, en sal voldoende opleiding, toerusting en toesig ontvang. Dit sal die uitdagings verminder waarvoor hulle te staan kom en hulle dienste in landelike gebiede versterk.
Smith, Kathryn Elizabeth. "Assessment and prevalence of dementia in indigenous Australians". University of Western Australia. School of Primary, Aboriginal and Rural Health Care, 2009. http://theses.library.uwa.edu.au/adt-WU2009.0062.
Texto completoMannan, Haider Rashid. "Development and use of a Monte Carlo-Markov cycle tree model for coronary heart disease incidence-mortality and health service usage with explicit recognition of coronary artery revascularization procedures (CARPs)". University of Western Australia. School of Population Health, 2008. http://theses.library.uwa.edu.au/adt-WU2008.0101.
Texto completoLeighton, Kim. "Improving enhanced surveillance of notifiable enteric illnesses". University of Western Australia. School of Population Health, 2005. http://theses.library.uwa.edu.au/adt-WU2005.0074.
Texto completoMills, David. "The role of goal setting in the diabetes case management of aboriginal and non-aboriginal populations in rural South Australia /". Title page, table of contents and abstract only, 2005. http://web4.library.adelaide.edu.au/theses/09MD/09mdm6571.pdf.
Texto completoIncludes publications published as a result of ideas developed in this thesis, inserted at end. "April 2005" Includes bibliographical references (leaves 210-242).
Schoevers, J. F. "Factors influencing specialist outreach and support services to rural populations in the Eden and Central Karoo districts of the Western Cape : a Delphi study". Thesis, Stellenbosch : Stellenbosch University, 2012. http://hdl.handle.net/10019.1/80461.
Texto completoINTRODUCTION: Access to health care, like childhood survival, often depends on where one lives. The infant mortality rate in rural South Africa (SA) is 52.6 per 1000 births, compared to 32.6 per 1000 births in urban areas. Furthermore, three of the four districts in SA with the highest HIV prevalence are rural. These being two commonly used health indicators, it is clear that rural populations have significantly poorer health outcomes than their urban counterparts. About half the world’s population live outside major urban centres, where health services and specialist medical services are concentrated. Rural SA are home to 43.6% of the population, but are served by only 12% of doctors and 19% of nurses. Of the 1200 medical students graduating in the country annually, only about 35 work in rural areas in the long term. There are 30 generalists and 30 specialists/100 000 people in urban areas, compared to an average of 13 generalists and two specialists/100 000 people in rural areas. The question arises whether the poorer access to particularly specialist services is a contributing factor towards poorer outcomes. Specialist outreach to rural communities is one way of improving access to care. In the Eden and Central-Karoo districts of the Western Cape of SA there are one level 2 (regional) hospital and ten level 1 (district) hospitals. All clinical disciplines reach out, with varying frequencies. On average, the four main district hospitals receive 17 specialist outreach visits per month; while the smaller district hospitals receive three specialist visits per month (Appendix 1). A typical outreach visit includes a problem ward round, outpatient session, theatre list for some surgical disciplines and formal/informal educational sessions. In principle, stakeholders agree that specialist outreach and support (O&S) to rural populations is necessary, as it improves access to specialized health care services. In practise however, there are factors that influence whether or not O&S reaches its goals. This in turn affects the sustainability of O&S projects. Understanding these factors would aid recommendations for a suitable model for O&S.
Loots, Reginald. "Factors associated with malnutrition amongst children six months to five years of age in a semi-rural area of the Western Cape". Thesis, Cape Peninsula University of Technology, 2019. http://hdl.handle.net/20.500.11838/3079.
Texto completoMalnutrition is a global concern and particularly in children. It impacts negatively on mortality, morbidity, educability and productivity, and it affects millions of children in South Africa. As part of our Millennium Development Goals set by the Department of Health and WHO, it is vital to combat malnutrition by eradicating extreme poverty and hunger. Malnutrition is regarded as a change in nutritional status that carries the penalty of illness, dysfunction or death. Child malnutrition poses one of the biggest challenges in South Africa according to the WHO and has been well documented over the past 20 years. A lack of knowledge from parents or caregivers on the nutritional needs of children and the levels of poverty contribute to childhood malnutrition; the extent of hunger has also been associated with low energy intake, low micronutrient intake and poor income levels. This affects growth patterns negatively. Thus, this study aims to examine the key factors that are causing malnutrition in children in a semi-rural community in the Western Cape. A combination of both qualitative and quantitative research approaches were used. Qualitative data were collected through group interviews and quantitative data were collected through a self-administered questionnaire from 105 parents and caregivers. Thematic content analysis was used for qualitative data analysis and SPSS was used to analyse the quantitative data. The results revealed that the associated factors to malnutrition amongst children six months to five years of age included obesity, underweight, stunting, severe acute malnutrition and moderate acute malnutrition. The results further indicated that the majority of households were single mothers with low income and a poor educational background. This study recommended that health education and health promotion should be done at all heath facilities with regular intervals as well as within the community. Authorities should provide a platform for all clinicians to go for regular updates and to participate in continuous development programmes to combat malnutrition. The findings of this study could contribute to the existing body of knowledge with regard to the factors that contribute to malnutrition. The results could improve health care practices in the communities of the Western Cape and the South African context at large.
Ochieng, Anne Achieng. "The relationship between environmental exposures to pesticides measured by means of environmental exposure indices and the anthropomentric outcomes of boys living on farms in the rural Western Cape". Master's thesis, University of Cape Town, 2011. http://hdl.handle.net/11427/12169.
Texto completoIncludes bibliographical references.
Few epidemiological studies have investigated the effect of pesticides on growth of boys and results are conflicting. Pesticide environmental exposure indices have not previously been developed. To investigate the effect of pesticide exposure using environmental exposure indices on pubertal growth of boys...