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1
Snell, Lauren. "A comparative study of the clinical competence of community service practitioners: degree and diploma nursing programmes". University of the Western Cape, 2013. http://hdl.handle.net/11394/8248.
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Magister Curationis - MCurAccording to Benner (2001 ), an individual moves through five stages: novice, advanced beginner, competent, proficient and expert. Competence is the measure or degree of a person's ability to cope with all aspects of the environment. It is expected that when an individual achieves competence, they possess the necessary knowledge, skills, abilities, attitudes and professionalism required to perform a certain function. The purpose of the study was to compare the perceptions of the Community Service Practitioners (Degree versus Diploma) regarding their clinical competence in providing nursing care and to establish and compare the perceptions of Professional Nurses regarding the clinical competence of the Community Service Practitioners they supervise (Degree versus Diploma) in providing nursing care. The null-hypothesis stated that there is no difference in the clinical competence of Community Service Practitioners who completed a Degree nursing programme as compared to those who completed a Diploma nursing programme leading to registration as a Professional Nurse (R425). The research methodology was quantitative, using a comparative, descriptive, cross-sectional design. The target population of the study included a sample of all Community Service Practitioners who worked in Regional Hospitals in the Western Cape and the Professional Nurses who supervised them. Convenience sampling was used to select the sample for this research and data were collected by means of a five-point Likert-scale questionnaire for the Professional Nurses supervising the Community Service Practitioners and a three-point Likert-scale questionnaire for the Community Service Practitioners. Data was organized and analyzed by using Statistical Package for Social Sciences (SPSS), Version 21. Descriptive statistics were used and findings were illustrated by means of descriptive tables and figures. The Mann-Whitney U test was used to calculate the null-hypothesis, which was retained. The results of the study indicated that there is no difference in the clinical competence, which included knowledge, skills and attitude, of Community Service Practitioners who completed an undergraduate Degree compared to those who completed a Diploma in nursing.
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Reed, Luke Terrence, i res cand@acu edu au. "The Effect of Participation in School-Facilitated Community Service Programmes on Students’ Self-Esteem, Sense of Community Engagement and Attitudes to Christianity". Australian Catholic University. School of Education, 2006. http://dlibrary.acu.edu.au/digitaltheses/public/adt-acuvp142.17052007.
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Increasingly, student orientated service outreach programmes (community service) are being incorporated into the broad curriculum of Australian High Schools. The assumption made is that such programmes have tangible benefits for students, the community and the schools themselves. Schools that operate out of a Christian paradigm have the added incentive of seeking to assist students give personal expression to religious commitment through the service of others. This study tests the assumption that participation in community service or service outreach activities has positive benefits for the students involved. It explores the effect that student involvement in school-facilitated community service programmes has on three personal domains; self-esteem, sense of engagement with community, and attitude to Christianity. This is a quantitative study utilising a questionnaire instrument to collect data from participants. The questionnaire is a compilation of three pre-existing and previously validated instruments, each of which focus on one of the three research areas. Combined, they provide 74 items which are answered using a Likert scale with response choices ranging along a six point continuum from ‘strongly disagree’ to ‘strongly agree’. The sample consists of a total of 225 participants drawn from students across years 10 to 12 from five Catholic High Schools in the Brisbane metropolitan area. All of these schools have single sex enrolment. Male and female participants are equally represented in the sample. In total, 80% of the sample participated in their school’s community service/service outreach programme. Information related to students’ community service involvement, the type of service undertaken, the duration of such service, and prior community service experience, was also collected from participants. No treatment is being introduced or manipulated in this study; rather, the research examines ‘between-participant’ and ‘within-sample’ differences associated with students’ participation (or non-participation) in existing community service/service outreach programmes in their schools. As such, the research is ex post factor in nature. Initial confirmatory factor analysis is undertaken to validate the integrity of the combined instrument. This is followed by a Cronbach’s alpha reliability study of the 12 component scales of the combined instrument; the results of which prove to be consistent with those previously reported. In subsequent analysis of the data, significant correlations are identified between six pairs of dependent variables. With statistical significance set at the 95% level, MANOVA is then utilised to determine the effect of a number of factors on scale scores. In addition to the primary focus on the effect that participation/non-participation in school community service programmes has on student selfesteem, engagement with community and attitude to Christianity, other influencing conditions explored include; type of community service, duration of community service, prior community service involvement, and gender. The principal finding of this research is that a statistically significant relationship is evident only between students’ participation in school-facilitated community service programmes and their attitude to social justice. Attitude to social justice is a constitutive element of the larger construct, ‘sense of engagement with community’. Analysis of the data reveals no significant association between community service participation and either self-esteem nor attitude to Christianity. The paper concludes with a discussion of the findings in the light of the earlier review of relevant literature.
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Iturralde, Diego. "People's perceptions of government in terms of the assessment and feasibility of development programmes". Thesis, Pretoria : [s.n.], 2001. http://upetd.up.ac.za/thesis/available/etd-08012002-114136.
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Andersson, Camilla. "Challenges of studying complex community health promotion programmes : experiences from Stockholm diabetes prevention programme /". Stockholm, 2006. http://diss.kib.ki.se/2006/91-7140-703-0/.
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Phala, Arnold Victor Mamonyane. "Service delivery at Itsoseng psychology clinic a programme evaluation /". Pretoria : [s.n.], 2008. http://upetd.up.ac.za/thesis/available/etd-11252009-232622.
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Rawat, Sherona. "Evaluation of the experiences of clinical psychologists providing community services within the community service psychology program in KwaZulu-Natal, South Africa". Thesis, University of Zululand, 2011. http://hdl.handle.net/10530/1201.
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Submitted to the Faculty of Human Sciences in partial fulfilment of the requirements for the degree of PhD in Community Psychology in the Department of Psychology at the
University of Zululand, South Africa, 2011.This study investigated the differences and similarities in the experiences of community service psychologists placed within the KwaZulu-Natal region. It comprised of eight (8) community service psychologists, seven (7) females and one male, placed at some point within a two year period at different sites within the region. Seven (7) community service psychologists were still in community service while one (1) had already completed their stipulated year of service. A single, structured interview was used to collect the data. Grounded theory was utilized in the analysis of the qualitative data. Comparisons were drawn between the experiences of the community service psychologists in relation to their individual experiences in order to extract common themes. Significant individual experiences where noted and discussed. The findings indicate dissatisfaction with the management and implementation of the Community Service Psychology Program amount the participants. In addition, psychological trauma in regard to fear over safety and abusive or alienating management structures within the environments serviced by the Community Service Psychologists was noted. The implications and applications of this study can be far-reaching as research is direly lacking in the arena of Community Service structures and facilitation within the South African context.
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Suksiriserekul, Somchai. "The cost-utility analysis of some Thai public health programmes". Thesis, University of York, 1994. http://etheses.whiterose.ac.uk/9822/.
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Bradley, Dominique K. F. "The 'Productive Community Services' programme : implementing change in a community healthcare organisation". Thesis, University of Essex, 2015. http://repository.essex.ac.uk/15475/.
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The Productive Community Services (PCS) is a change programme which aims to engage frontline healthcare staff in improving quality and productivity. PCS draws on tested improvement methodologies such as Lean, however there has been little research specifically carried out on PCS in practice. The aims of this study were to explore the perceptions of the healthcare staff that implemented the programme, to identify the enabling and constraining contexts of the programme’s mechanisms of change, and to examine the meaningfulness and reliability of quantitative data generated during a PCS implementation. It also sought to explore the implications of these findings for managers, implementation teams, and commissioners in healthcare. To achieve this, an implementation of PCS was investigated using methods of participant observation, analysis of qualitative and quantitative data, semi-structured interviews and a focus group. A mixed methods approach was taken using the principles of Realist Evaluation. The results indicate that perspectives of the implementation varied widely, and that pay-for-performance targets contributed towards staff perceiving that the programme was irrelevant. Stock value was reduced by over £42,500, the time taken to find patient information was reduced by 62%, and services spent on average 36% of their time with patients. However, these figures lacked reliability and meaningfulness as the data were not validated or were produced using apparently flawed experimental designs. Contexts that constrained or enabled the mechanisms of change included staff attitudes, available resources, the effectiveness of communication, and whether technology could be used to resolve problems identified. The findings indicate that managers in healthcare should challenge implementation teams if the purpose of an innovation is unclear, that implementation teams need to be equipped with knowledge about technological solutions to efficiency in healthcare, and Commissioners need to ensure that pay-for-performance targets promote continuous quality improvement rather than temporary solutions.
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Brocklehurst, Neil John. "An evaluation study of clinical supervision programmes in six NHS trusts". Thesis, University of Birmingham, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.322382.
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Nilsen, Per. "Opening the Black Box of Community-Based Injury Prevention Programmes : Towards Improved Understanding of Factors that Influence Programme Effectiveness". Doctoral thesis, Linköping : Univ, 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-7001.
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Rickard, Colin John. "A study of the community reprovision programmes of the psychiatric institutions in England 1993-1995". Thesis, University College London (University of London), 1997. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.267763.
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Jordaan, Rene. "Attitudes and perceptions about community service learning among students in a teacher training programme". Pretoria : [s.n.], 2006. http://upetd.up.ac.za/thesis/available/etd-10102007-122841/.
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Allam, Jayne. "Community-based treatment for child sex offenders : an evaluation". Thesis, University of Birmingham, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.368739.
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Davies, J. Bryn. "The experience of Community Programme, unemployment and employment : mental health and individual differences". Thesis, University of Sheffield, 1992. http://etheses.whiterose.ac.uk/3471/.
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This thesis explores some theoretical, conceptual, empirical and methodological issues concerning psychological research into unemployment. A review of the literature revealed some important limitations in the approach which has hitherto been taken to examine this phenomenon. Specific weaknesses included an undervaluation of the role of theory, a dearth of empirical research on intervention programmes or other responses to unemployment, as well as oversimplification, overgeneralisation, imprecision and unfalsifiability in the theoretical contributions which have been offered. Moreover, it was noted that there had been a lack of attention to dispositional factors in empirical research or theory, and inadequate (particularly undifferentiated) conceptualisation and operationalisation of mental health variables. The empirical part of the study, therefore, was developed as an initial exploration of (a) Individual differences in the mental health of unemployed adults, and (b) the experience of participation on Community Programme (CP), a UK government intervention for long-term unemployed adults. A multi-method, multivariate design was used adopting a theoretically grounded, guiding conceptual framework. Qualitative in-depth interviews (N = 60) were conducted with CP participants from two CP managing agencies. In addition, a large scale cross-sectional quantitative survey (N=484) was undertaken incorporating individuals who were: (a) Participating on CP (b) Employed (c) Unemployed. The findings of the stud demonstrated a number of relationships between personal characteristics (i. e. demographic and personality related variables), intervening variables and dimensions of mental health. Some theoretical and empirical implications of these findings were discussed and directions for future empirical research and theoretical development were suggested. With respect to the experience of Community Programme, the findings suggested that within these two managing agencies, the content of the scheme (i. e. the nature of the work) was evaluated positively by the respondents, but that the context of the scheme and its temporary nature were perceived in a negative light. Some suggestions are made as to how these different aspects of the scheme impacted upon the mental health of the participants.
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McEwan, Robert Thompson. "Screening the elderly in general practice : evaluation of a comprehensive functional assessment programme". Thesis, University of Newcastle Upon Tyne, 1991. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.240982.
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Hutchings, Paul. "Supporting community management : a synthesis of successful rural water services programmes in India". Thesis, Cranfield University, 2016. http://dspace.lib.cranfield.ac.uk/handle/1826/11314.
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For the past 30 years the dominant approach to managing rural water services in low and lower middle income countries has been the community management approach. Yet there is increasing evidence the model is not fit for purpose as too many services fail. The next generation ideas for community management emphasise the need for continuous on-going support to communities – an approach known as the community management plus approach. This thesis tests and develops this next generation community management plus paradigm. It analyses field data from twenty case studies of ‘reportedly successful’ community management programmes across seventeen states in India. Bringing together data from 2,355 household surveys, 272 interviews and 130 focus groups it provides a synthesis that assesses the type and level of support found in successful examples of community management. The evidence from these case studies demonstrates that communities receive significant recurrent subsidy covering between 7-48% of operational expenditure. This is in marked contrast to the conventional principles of community management whereby communities cover 100% of these costs. Analysis of organisation types also shows how community management has been shaped by the devolution of governance in rural India. Many community management programmes involve a structural overlap between the local self- government institution of the Gram Panchayat and water committees. The thesis argues this represents a shift to the ‘institutionalised co-production’ of rural water services, involving both the state and private citizens in public service delivery. Overall, the research shows that successful community management in India involves continuous on-going support as per the community management plus paradigm. However this has required the nesting of the model within the broader system of local self-government which blurs the lines between public and community management.
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Higgs, Eluned R. "A screening programme for the complications of diabetes in a rural community - need, requirements and benefits". Thesis, University of Oxford, 1994. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.260754.
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Freeman, Marnie. "Evaluation of a training programme for carers working in community homes for those with learning difficulties". Thesis, University of Sussex, 1992. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.334831.
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Hutton, Guy Peter Coats. "Can the costs of the World Health Organisation antenatal care programme be predicted in developing countries?" Thesis, London School of Hygiene and Tropical Medicine (University of London), 2001. http://researchonline.lshtm.ac.uk/4646512/.
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The aims of this thesis are to identify and test alternative methods for analysing and predicting health care costs, to construct a framework for guiding analysts in making better cost predictions, and to identify future areas of research in this area. The thesis uses costs collected from a multi-country trial measuring the cost-effectiveness of an evidence-based programme of antenatal care. Detailed costing studies of maternity services (antenatal care, childbirth and postpartum care) were done in two trial countries (Cuba and Thailand), and also a nontrial country, South Africa. Costs are broken down and reviewed by cost components: prices, resource use, and health service use. The review initially considers the application of economic theory to public health care institutions, to identify factors likely to cause cost variation between setting. Then the review seeks empirical evidence proving or disproving the existence of these factors from the health care literature, as well as a review of the methods for analysing health care costs. The empirical analysis first compares health service use, unit costs and cost per pregnancy between settings (between: women with different case-mix, health facilities, trial arms and 'study countries) and examines the causes of variation, before testing alternative cost prediction methods. Variations in unit cost are found to be due to several factors, including different levels of resource productivity, occupancy levels, staffing patterns, prices and exchange rates (between country), input mix and health facility size. Also, uncertainty and measurement error are considered likely to cause some variation in unit costs. Variations in health service use are due to case-mix, clinical practice, and accessibility differences. Again, not all variation is explained. Finally, a range of different cost predictions methods are tested, and their results compared with observed costs in each country. The most accurate cost prediction method is to build costs based on expected changes in resource use, health service use and morbidity rates (called the incremental cost impact approach). The direct and adjusted cross-country transfer methods (transfering costs between countries), although accurate on occasions, are less reliable. Cost predictions using predictors from a regression analysis are highly unreliable for cross-country predictions. Methodological issues and policy implications in relation to cost prediction and generalisability are discussed, including the choice of cost-prediction approach, the valuation methods (opportunity cost and currency conversion methods for cross-country predictions), the measures used for comparing the performance of cost prediction methods, and the limitations· of cost analyses to understand costs. It was concluded that caution is needed in predicting costs both within study countries due to cost variability, and in lower-resourced settings where u,nit costs and health service use are lower. Further cost analyses and testing of cost prediction methods are needed in other areas of health care to compare with the results from this thesis, and build a fuller picture of cost behaviour as well as strengths and weaknesses of alternative cost prediction methods.
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Mills, Anne Jane. "The application of cost-effectiveness analysis to disease control programmes in developing countries, with special reference to malaria control in Nepal". Thesis, London School of Hygiene and Tropical Medicine (University of London), 1989. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.284197.
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Silva, Madalena Gomes da. "The effects of an exercise programme on function and quality of life of elderly women in rural Portugal". Thesis, King's College London (University of London), 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.248882.
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Kgaphola, Kholofelo Lebogang. "The effectiveness of home community based care programmes in Victor Khanye sub-district in Nkangala district, Mpumalanga". Thesis, Nelson Mandela Metropolitan University, 2015. http://hdl.handle.net/10948/3909.
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The Home and Community Based Care (HCBC) and Support programme has been established as a cost effective response for communities to tackle HIV and AIDS and many other chronic conditions and vulnerabilities which are faced by individuals, families and communities. In terms of the Framework for Home and Community Based Care and Support Programme (2012: 4) HCBCs create an enabling platform for “individuals, families and communities to have access to holistic and comprehensive services nearest to home, which encourages participations by people, responds to the needs of the people, encourages traditional community life and strengthens mutual support opportunity and social responsibility”. Victor Khanye Local Municipality, IDP (2010-2011: 116) states that VKLM is faced with: a high incidence of HIV and AIDS due to poverty, ignorance and a lack of proper entertainment facilities; shortage of clinics and professional staff members, which makes it difficult for patients to access treatment and maximum care and support; and an increase in the number of OVCs which results in a lack of parental care and guidance, poverty, illiteracy, lack of access to medical care, school drop-outs and ultimately an increase in criminal activity and the further spread of HIV and AIDS. The research will assess the effectiveness of Home Community Based Care programmes (HCBCs) on orphaned and vulnerable children with specific reference to the Victor Khanye sub-district in Nkangala District, Mpumalanga Province. The research was conducted in Delmas and its surrounding farming areas. Victor Khanye sub-District has nine wards, most of which are predominantly farming rural areas. The field research took place during June and August 2013 and represents observations recorded at the field interviews, the local AIDS committee and one-on-one interviews with beneficiaries The study is concluded with conclusions drawn from the field study and recommendations.
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Ketley, Clare Elizabeth. "Urinary fluoride excretion as a marker for fluoride exposure in children participating in the UK School Milk Fluoridation Programme". Thesis, University of Liverpool, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.367865.
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Murphy, Anthony Michael. "World Health Organisation's Expanded Programme on Immunization (EPI) : an in-depth study of Hillingdon and West Berkshire Health Authorities, England". Thesis, University of Oxford, 1989. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.305831.
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Han, Ik-Hee. "Health care policy, equity and the welfare state : the case of national health insurance programme in the Republic of Korea". Thesis, University of Bristol, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.302096.
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Taruvinga, Kudakwashe. "Establishing a new home based care programme for the community of Swakopmund". Thesis, Stellenbosch : University of Stellenbosch, 2010. http://hdl.handle.net/10019.1/8539.
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Thesis (MBA)--University of Stellenbosch, 2010.Since the first case was discovered in Africa in the late 80s, the HIV/AIDS epidemic has gradually increased at alarming proportions worldwide especially in sub-Saharan Africa which prompted the United Nations' World Health Organisation to declare it a global pandemic. This research undertakes to highlight the current composition of care given for HIV and Aids, and the strengths and weaknesses of such programmes. The aim of this is to establish a better home based care programme in Swakopmund, Namibia, for improving the quality of care as well as living conditions for the infected and affected. For this initiative to be of the highest quality there is need to pay special attention to various regional and national HIV/AIDS programmes and policies. As the HIV/AIDS epidemic continues to spread, organisations and communities are now considering engaging more programmatic approaches as sub-Saharan countries are looking for scaled-up responses and national strategies for home based care. Policy-makers and senior administrators must be involved in developing and monitoring home based care programmes, and the people who manage and run the programmes must share information and feedback with senior administrators. In this sense, policy and action are interrelated as each partner learns from and guides the other. The researcher saw the need to involve community members and home based care-givers in a participatory process to research this topic and engage them in a process on how to improve the programmes that already exist. 52 Pages.
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Clark, Graham. "Rehabilitation care workers perceptions of the outcomes of a pilot training programme". Master's thesis, University of Cape Town, 2015. http://hdl.handle.net/11427/15488.
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The South African National Development Plan (NDP) (National Planning Commission, 2011, p. 1) provides the road map for a reformed public health system by 2030. The proposed health system will be facilitated by, amongst others, training an appropriate balance of healthcare professional s including a cadre of community health workers (CHWs) that have a broad skills mix suited to reaching a larger number of people with first level intervention. With this in mind, a pilot group of CHWs were up-skilled as Rehabilitation Care Worker s (RCWs). The training program was a joint project between the Division of Disability Studies and the Departments of Occupational Therapy, Physiotherapy and Speech and Language Therapy at UCT. Problem: Little is known about the perspectives of RCWs on the benefits and challenges of additional training in rehabilitation and disability related skills. Rationale: To inform the curriculum for a rehabilitation care worker (RCW) training program and the Western Cape Department of Health (WCDoH) of ways in which this cadre of worker could contribute to the realization of the 2030 Healthcare Plan. Aim: To describe the outcomes of a pilot RCW training program from the perspective of the pilot group of graduates. The objectives were to identify the areas of practice where RCWs feel competent/incompetent, to identify aspects of the health services where RCWs believe they can contribute the most/the least and to identify the facilitators/barriers they experienced when deployed in the health field. Methodology: A qualitative descriptive study was conducted. Method: Focus groups were carried out with three groups of six participants. Findings: The plot that permeated the participants’ perspectives revolved around how the RCWs were pioneers in breaking new ground for the Western Cape Department of Health (WCDoH). Two themes informed the plot: "we move health services to a new level" and "we manage change in new ways". Discussion: It is argued that the pilot RCW curriculum achieved its’ objective of equipping a cadre of worker with basic rehabilitation, care and disability inclusion skills. While the envisaged role of RCWs in the health service and in making the NDP a reality is supported, it is argued that attention needs to be given to supervision structures and to training of all other health workers in order to promote inter professional practice. Conclusions: The pilot group of RCWs believe that they have acquired a new and large variety of skills that have enabled them to make a broad and positive impact in their places of work, at home and in the broader community.
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Lelubre, Melanie. "Implementation Study of Professional Pharmacy Services in Community Pharmacies". Doctoral thesis, Universite Libre de Bruxelles, 2018. http://hdl.handle.net/2013/ULB-DIPOT:oai:dipot.ulb.ac.be:2013/268974.
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Introduction: In recent year, the role of the pharmacist has evolved from product-focused to patient-focused activities. Following this evolution, new professional pharmacy services were simultaneously developed by researchers and started to be legally implemented and remunerated for community pharmacists around the world. Implementation, essential to ensure a good programme delivery and therefore its effectiveness, was seen as a passive process for which diffusion and dissemination were sufficient to translate research into practice. However, the transition from theory to practice is often difficult as different factors hinder or facilitate the implementation of such services. In consequence of that, implementation research started to be developed in the community pharmacy field to understand and fil the gap between theory and practice.Objectives of the thesis: Three projects were conducted in Belgium and Switzerland; (1) to understand the implementation of an existing programme in Belgium; the isotretinoin pregnancy prevention programme (PPP) (Chapter IV, point 4.1), and (2) to study the implementation of two new developed pharmaceutical services, which include an interview between the pharmacist and the patient and require interprofessional collaboration; the medication adherence program in Switzerland and the medication review in Belgium (Chapter IV, point 4.2). Methods: To understand the implementation of the isotretinoin PPP, two studies were conducted. The first study was a survey sent to health care professionals (pharmacists, general practitioners and dermatologists) and patients. The outcomes of the survey were the PPP awareness and compliance to safety recommendations related to the teratogenic risk of isotretinoin. The second study was cross-sectional and analysed the reimbursed prescription data of the Belgian population taking isotretinoin between January 2012 and August 2015. The outcomes were medication adherence to isotretinoin and to contraception, and the concomitant use of contraception and isotretinoin. Medication adherence was measured using the medication possession ratio (MPR), dividing the total days of medication supplied within the refill interval by the number of days in the refill interval. The concomitant use of isotretinoin and contraception was realised in combining prescription database of both isotretinoin and contraception of women between 12 and 21 years old, who received at least one prescription of isotretinoin during the study period.To study the implementation of the medication adherence program in Switzerland and the medication review service in Belgium, two prospective and observational studies were conducted with a mixed method approach (quantitative and qualitative outcomes). The defined outcomes, based on the RE-AIM model, were; reach of the target patients, adoption of the service by health care professionals providing the service, implementation (facilitators, barriers and fidelity or the extent to which the intervention is delivered as intended), and maintenance (the extent to which the intervention become institutionalized or part of the routine activity). Outcomes were collected through web platforms for quantitative data, and interviews and focus groups for qualitative data.Results and discussion: The study of the isotretinoin PPP implementation showed that two safety recommendations related to the teratogenic risk were particularly poorly applied by interviewed health care professionals. These two recommendations were the use of a second contraceptive method (like condoms) and the monthly pregnancy test. They considered these two recommendations as unnecessary for women taking an effective contraceptive method. Through the prescription refill data analysis, we observed that 46.1% of patients were adherent to isotretinoin (MPR ≥ 0.8) and 74.0% of women taking isotretinoin to their prescribed contraception (oral contraceptive, rings and patches). Lastly, 83.4% of women between 12 and 21 years taking isotretinoin did not receive an effective contraceptive method one month before, during and one month after isotretinoin treatment. However, the proportion of women receiving at least one prescription of contraception during (74.1%) and after (72.1%) isotretinoin treatment was higher than one month before isotretinoin treatment (35.7%). Regarding these results, less adopted recommendations should be reviewed by an expert committee and interventions focused on the improvement of the use of contraception during isotretinoin treatment could be developed.The two studies related to two new developed pharmaceutical services showed that their implementation was feasible in community pharmacy practice. Most of pharmacists participating in both projects had positive attitude regarding the implementation of these services in their daily practice. They considered it as professionally satisfying and important for patients and perceived the benefits of the programs. However, similar barriers were observed; difficulties to include patients and lack of interprofessional collaboration, and lack of time (related to lack of staff, administrative burden and lack of team adoption). According to participating health care professionals, the development of new strategies to overcome these barriers is necessary to anticipate the future implementation and the maintenance of these services at the national level. Following these results, the proposed strategies are for example the development of broad based media campaigns (for health care professionals and patients), or the development of specific trainings focusing on interprofessional collaboration, service-process, practice change management and leadership. Conclusion: The legal evolution of the pharmacists’ role is a positive progress but insufficient to ensure a full implementation in practice. Implementation strategies should be considered at different implementation stages (exploration, preparation, testing, operation and maintenance) and levels (individual, pharmacy, local setting, and system). The use of implementation science would allow a quicker and more effective implementation of these new professional pharmacy services. The anticipation of change and the selection of appropriate strategies would allow a higher fidelity level to the different components of the service by health care professionals and therefore a higher effectiveness, e.g. clinical and economic outcomes. Health care professionals, professional associations, academics and policy makers should be aware of implementation science and integrate it in the development of the new pharmacists’ role. As shown in our results, it should also be considered for existing programmes such as the isotretinoin PPP.Doctorat en Sciences biomédicales et pharmaceutiques (Pharmacie)
info:eu-repo/semantics/nonPublished
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Chambers, Cynthia R., E. Wedel, A. McCloud i S. Collier. "Students Impacting the Community through Service-Based Programs". Digital Commons @ East Tennessee State University, 2010. https://dc.etsu.edu/etsu-works/3894.
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Maher, Dermot. "Evaluation of community contribution to tuberculosis programme service delivery at district level in sub-Saharan Africa". Thesis, University of Oxford, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.400050.
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Walton, Wade B. "An exploration of the development of Berkscable's community service efforts and programs an historical case study /". Instructions for remote access. Click here to access this electronic resource. Access available to Kutztown University faculty, staff, and students only, 1991. http://www.kutztown.edu/library/services/remote_access.asp.
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Thesis (M.S.)--Kutztown University of Pennsylvania, 1991.Source: Masters Abstracts International, Volume: 45-06, page: 2724. Abstract precedes thesis as 3 preliminary leaves. Typescript. Includes bibliographical references (leaf 48).
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Al-Kahtani, Masoud Saeed. "Community development in Saudi Arabia : a study of local participation in the rural community development centres' programmes and services in Asir region". Thesis, Cardiff University, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.369822.
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Keating, Michael R. "What are the factors for success in a community programming center". Instructions for remote access. Click here to access this electronic resource. Access available to Kutztown University faculty, staff, and students only, 1992. http://www.kutztown.edu/library/services/remote_access.asp.
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Thesis (M.S.)--Kutztown University of Pennsylvania, 1992.Source: Masters Abstracts International, Volume: 45-06, page: 2712. Abstract precedes thesis as 2 preliminary leaves. Typescript. Includes bibliographical references (leaves 96-98).
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Westover, Jay Allen. "Integrating environmental education into the curriculum through environmental community service learning". CSUSB ScholarWorks, 2001. https://scholarworks.lib.csusb.edu/etd-project/2083.
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The goal of environmental education is to increase individuals' ecological knowledge, awareness of associated environmental problems, and motivation to evaluate and implement solutions. This project combined the concepts of environmental education with community service learning to create a new method of curriculum integration: environmental community service learning. The California state standards for environmental education, service learning, language arts, mathematics, science, and social studies were integrated into four thematic units using the teaching methodologies of cooperative learning, authentic assessment, and reflection. The integrated, thematic units of this project could be used by educators in a multi-disciplinary, team teaching scenario on in a single classroom setting as either sequential, thematic units of study or independent activities.
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Rörich, Eben Eugéne. "An economic evaluation of the winelands health worker programme". Thesis, Stellenbosch : Stellenbosch University, 2002. http://hdl.handle.net/10019.1/52664.
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Thesis (MComm)--Stellenbosch University, 2002.ENGLISH 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.
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O'Brien, Martin Anthony. "The correctional programme : a sociological analysis of the community dimension in health, policing and social welfare services". Thesis, Lancaster University, 1989. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.277277.
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Sinanovic, Edina. "A cost analysis of community-based distribution programmes and clinic-based services for contraceptives in selected areas in Khayelitsha". Master's thesis, University of Cape Town, 1997. http://hdl.handle.net/11427/9548.
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Bibliography: leaves 37-38.Family planning services in South Africa are now provided by the provincial and local authorities through clinics, hospitals, day hospitals, and mobile clinics. Both service providers and recipients have identified a range of problems with the current family planning service delivery system. Community-based distribution of contraceptives (CBD) has become a generally accepted alternative to clinic-based programmes for the distribution of contraceptives in many developing countries. The piloting of community-based distribution of contraceptives project in Khayelitsha, Cape Town / South Africa, is being undertaken by The Planned Parenthood Association of South Africa (a non-governmental organization), in collaboration with two other NGOs who run preventive and promotive health projects, SACLA and Zibonele. The objective of this study was to perform a cost analysis of alternative methods for providing effective contraceptive services. Clinic-based services for contraceptives, day hospital-based contraceptive services, and community-based distribution (CBD) of contraceptives programmes were evaluated. The following items were costed: salaries, contraceptives, buildings, equipment, vehicle, transport, repairs & maintenance, utilities, initial training, short-in-service training, and consultancy.
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Paul, Unathi Mecia. "Challenges faced by midwives in implementing the prevention of mother to child transmission programme during the post-natal period at Khayelitsha Community Health Clinic, Western Cape Province". University of the Western Cape, 2016. http://hdl.handle.net/11394/4903.
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Magister Curationis - MCurBackground: In the South Africa, the number of HIV- positive pregnant women is rising and has resulted in more than 70,000 babies being born with HIV infection annually since the year 2000. In response to the escalating number of HIV-positive pregnant women, the Department of Health of South Africa, decided, in 2002, to implement the Prevention of Mother to Child Transmission (PMTCT) programme at 18 pilot sites in the country. An effective PMTCT programme could reduce the incidences of maternal and child mortalities in the country. An evaluation of the effectiveness of the PMTCT programme that was done in 2010 showed that, although the programme was rendered effectively during pregnancy and labour, there were still irregularities that appeared, especially during the postnatal period. Khayelitsha was the first pilot site in South Africa to provide Antiretroviral Therapy and initiate the Nurse Initiated Management of Antiretroviral Therapy (NIMART) at primary care level in the public sector. Midwives are the health professionals who render the PMTCT services to HIV-positive mothers and their babies until six weeks post-delivery. They have managed to test almost 100% of pregnant women during the antenatal period and the HIV-positive women were started on the PMTCT programme during their first visit. Aim: The aim of this study was to explore the challenges that midwives faced in rendering care to postnatal HIV-positive mothers enrolled in the PMTCT programme at the Khayelitsha Community Health Clinic in the Western Province of South Africa. Method: An exploratory design and qualitative approach was followed. The study population consisted of midwives who were rendering PMTCT services to HIV-positive mothers and their infants during the postnatal period. Purposive sampling was conducted until data saturation was reached. Six participants were included in the sample. The participants were informed about the study by means of an Information Sheet, advised that the study was voluntary and reminded that they could withdraw from the study at any time, without prejudice. In-depth, unstructured individual interviews were conducted with each of the participants. With the permission of participants, an audio tape recorder was used during the interviews to collect data, while the researcher took field notes to supplement and verify the voice recordings, after the interviews. The seven steps of Colaizzi were used to analyse the data. Six themes and sixteen sub-themes emerged during the data analysis. Trustworthinesswas maintained by using the criteria of Guba’s model, i.e. credibility, transferability, conformability and dependability. Permission to conduct the study was obtained from the appropriate ethical committees; the Department of Health, the Khayelitsha Community Health Clinic, as well as, the Senate Research Committee of the University of the Western Cape. Participants were asked to sign Informed Consent forms before participating in the study. The ethical principles of privacy, anonymity, withdrawal, confidentiality and consent were strictly adhered to. Findings: The study found several challenges faced by midwives while implementing the PMTCT programme during the postnatal period. These challenges included: the shortage of NIMART-trained staff attending to the high number of clients per day; the lack of manpower with data base systems to trace mothers who did not come back after delivery; and mothers who did not come back for postnatal appointments because of denial, non-disclosed HIV status and socioeconomic reasons. Furthermore, the participants also reported on midwives experiencing ‘burnout’ as a result of the hectic working environment at the Khayelitsha Community Health Clinic. Recommendations: There is an urgent need for all midwives in the MOU’s to be NIMART-trained. NIMART should be standardize and be the part of the curriculum that taught in all the tertiary institutions and be updated in a yearly basis as part of the in-service training or education for all practising midwives. The South African Government should introduce home visits in the PMTCT programme. Data-bases of all MOU’s and facilities that offer PMTCT services need to be synchronized and these MOU’s and facilities should all follow the same PMTCT guidelines. Further research should be done on the same topic at other clinics and MOU’s that render the PMTCT programme in the Western Cape.
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Gamieldien, Fadia. "Perspectives of male mental health service users on their community integration following participation in a residential-based rehabilitation programme". Master's thesis, University of Cape Town, 2015. http://hdl.handle.net/11427/15604.
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Current re-engineering of primary mental health care in South Africa is directed towards providing a continuum of care for people with serious mental disorders in order to relieve the cost and resource burden of longterm hospitalisation. In the Western Cape, Healthcare 2030 has been adopted as the guiding vision for health system reform. Residential-based rehabilitation programmes have been introduced to assist mental health service users to improve their functioning in occupations of daily life so that they are better equipped to cope with community living. Problem: There is limited South African occupational therapy research into male mental health service users' perspectives on the contribution that residential-based rehabilitation programmes makes to their community integration, despite the high numbers of males using the service. Purpose: To inform public mental health services on the contribution of a residential-based rehabilitation programme to the community integration of men with serious mental disorders. Research question: How does participation in a residential-based rehabilitation programme contribute to the community integration of men with serious mental disorders? Objectives of the study: To identify what men with serious mental disorders consider community integration to be, and to describe the key elements within the residential-based rehabilitation programme that influenced their community integration. Research design and methodology: An instrumental case study design was used to guide the research methodology and five male participants were identified through purposive sampling. Observations, semi-structured interviews, community maps and document analysis w ere used as data collection tools. Data was audio-recorded and transcribed f or inductive and thematic cross-case analysis. Ethical principles of beneficence, autonomy and non-maleficence were upheld throughout the research process. Findings: One theme and three categories emerged in the findings. The theme, 'It's a catch-22 situation', comprises three categories, namely: 'It's not just what you call it'; 'There's no one size for all'; and 'It's tricky choosing between places to go and things to do'. Conclusion: Male mental health service users who participate in a residential-based rehabilitation programme will be better prepared for community integration if they are involved in co-constructing their recovery plan so that it is more personalised.
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Penn, Charles E. "A study of local television programming with respect to the African-American community the conception, development and production of "Harambe" /". Instructions for remote access. Click here to access this electronic resource. Access available to Kutztown University faculty, staff, and students only, 1993. http://www.kutztown.edu/library/services/remote_access.asp.
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Thesis (M.S.)--Kutztown University of Pennsylvania, 1993.Source: Masters Abstracts International, Volume: 45-06, page: 2718. Abstract precedes thesis as title page [6] preliminary leaves. Typescript. Includes bibliographical references (leaves 202-206).
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Grigsby, Lindle D. (Lindle Dean). "An Analysis of the Continuing Education-Community Service Programs in the Public Junior-Community Colleges of the State of Texas". Thesis, North Texas State University, 1985. https://digital.library.unt.edu/ark:/67531/metadc331703/.
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The problem with which this study is concerned is the analysis of the status of continuing education-community service programs within the public junior-community colleges of the state of Texas as these programs are viewed (1) from the areas of funding, faculty and facility allocations, (2) from the areas of the educational and professional preparation and responsibility of the leaders who are assigned to direct these programs, and (3) from the area of community involvement in program planning. Based on the problem a survey was developed; 142 administrators responded (61.2 per cent).
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Sin, Sukkyung. "THE RELATIONSHIP BETWEEN BURNOUT AND ROLE STRESSORS AMONG DIRECT SERVICE PROVIDERS AT CENTERS FOR INDEPENDENT LIVING IN REGION V". OpenSIUC, 2012. https://opensiuc.lib.siu.edu/dissertations/561.
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The purpose of this study is to determine the levels of burnout and role stresses among direct service providers at centers for independent living in Region V, and investigate the relationship between burnout and role stressors among the population. Results showed that the respondents have average level of emotional exhaustion, high level of depersonalization, and low level of personal accomplishment in categorization of MBI scores. When comparing with the MBI-HSS normative samples, it indicated that these providers experience higher burnout than overall samples and the sample in social services. The obtained results supported the previous view that CIL management problems including low salaries, high staff turnover, insufficient resources, excessive caseload, unsatisfactory reward, or general lack of control over job tasks and responsibilities that may effect to high burnout.
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Barker, Kimberley. "A grounded theory study of the role of interpersonal processes in community sexual offending group work programmes from a counselling psychology perspective". Thesis, London Metropolitan University, 2015. http://repository.londonmet.ac.uk/1101/.
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The effectiveness of Sexual Offending Treatment programmes has generally been measured through evaluating intervention content and reoffending rates. In response to the growing call to explore the role of therapeutic process in facilitating meaningful change on these programmes, this thesis considers how interpersonal dynamics may influence programme effectiveness from the perspective of the group member. This offers the opportunity to consider the impact of how we work, rather than what we do. The critical literature review uses a pluralistic framework to present relevant existing research and identify gaps in practice-based knowledge in the field of sexual offending intervention from a Counselling Psychology perspective. While the literature suggests interpersonal ingredients important to this process, it offers little information regarding where, when and how these qualities are effective. Furthermore, little is understood about the impact of relational dynamics between the facilitators and group members in creating a facilitative environment. This reveals broad gaps in research relating to a neglect of the client’s experience of these interactions and how they are conceptualised in their change process. This research therefore uses a social constructivist grounded theory method to generate data exploring these process issues. The results highlight the value of facilitators fostering a dynamic and balanced core interpersonal process that is sensitive to the unique context of these group interventions. This offers a foundation for group member engagement and effective group functioning relevant to subjective change. The implications for theory and practice are discussed, highlighting how a Counselling Psychology presence in this field has the potential to enhance practice. The study is concluded with reflections of the study’s limitations and areas in need of further research.
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Kachimanga, Chiyembekezo. "Improving utilisation of maternal health related services: the impact of a community health worker pilot programme in Neno Malawi". Master's thesis, University of Cape Town, 2018. http://hdl.handle.net/11427/29196.
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Malawi has one of the highest maternal mortality ratio (MMR) in sub-Saharan Africa (SSA). Despite investments in family planning and emergency obstetric care (EmOC), Malawi’s Millennium Development Goal (MDG) target of reducing maternal deaths to 155 deaths per 100,000 live births was not met by the end of 2015. Between 2010 and 2015, Malawi was only able to reduce the MMR from 675 to 439 per 100,000 live births. Inadequate utilisation of perinatal services is the contributing factor to the MMR target not being achieved. One approach for improving the utilisation of perinatal services is to invest in community health workers (CHWs). CHWs can be trained to: identify women of child bearing age (WCBA) who need perinatal services; provide community education; encourage timely referral of clients to the nearest health facility; and undertake community follow up for WCBA who are pregnant and/or have recently given birth. We evaluated changes in utilisation of antenatal care (ANC), facility based births, and postnatal care (PNC) after CHW deployment to conduct monthly home visits to WCBA for pregnancy identification and escorting women to ANC, labour and facility birth and PNC clinics in Neno district, Malawi. The CHW programme was implemented in two catchment areas from March 2015 to June 2016. Methodology: We employed a retrospective quasi-experimental study design to evaluate the impact of CHWs on changes in the utilisation of ANC, facility based births, and PNC in Neno district, Malawi between March 2014 and June 2016 (pre-intervention period: March 2014 to February 2015, and post-intervention period: March 2015 to June 2016). Monthly outcomes were compared between a combined CHW intervention area and its synthetic control area using the synthetic control method. The synthetic control area (or synthetic counterfactual of the CHW) 14 was the control area that was created from multiple available control sites where the CHW programme was not implemented to allow the comparison of outcomes between the sites where CHWs were implemented and the sites where CHWs was not implemented. Two hundred and eleven CHWs (128 existing CHWs plus 83 new CHWs from the community) were trained in maternal health and deployed to cover an estimated 5,132 WCBA living in a catchment area of about 20,530 people. The primary focus of the CHWs was to conduct monthly household visits to identify pregnant women, and then escort pregnant women to their initial and subsequent ANC appointments, facility births, and to PNC check-ups. As part of package of care, community mobilisation and improvements in services to achieve a minimum package of services at the local health centres were also added. Using the synthetic control method, as developed by Abadie and Gardeazabal (2003) and Abadie, Diamond and Hainmueller (2010) and a Bayesian approach of synthetic control developed by Brodersen (2015), a synthetic counterfactual of the CHW intervention was created based on six available public control facilities. The synthetic counterfactual trend was created to have similar pre-intervention characteristics as the CHW intervention trend. The impact of the CHW intervention was the difference between the CHW intervention site and its synthetic counterfactual Results: CHWs in the intervention areas visited an average of 3,147 (range 3,036 – 3,218) of WCBA monthly, covering 61.0% of WCBA. During these visit 3.6% (97 women per month) of WCBA were suspected to be pregnant every month. Of those women suspected to be pregnant, 67.8% (66 women per month) were escorted to health facilities immediately every month. CHWs 15 visited an average of 254 pregnant women enrolled in ANC and 64 women in postpartum period monthly. ANC and facility births utilisation in the CHW intervention site increased in comparison to the control site. Firstly, the number of new pregnant women enrolled in ANC per month increased by 18.0 % (95% Credible Interval (CrI) 8.0%, 28.0%), from 83 to 98 per pregnant women. Secondly, the proportion of women starting ANC in first trimester increased by 200.0% (95% CrI 162.0%, 234.0%), from 9.5% to 29.0% per month. Thirdly, the number of women attending four or more ANC visits increased by 37.0% (95% CrI 31.0%, 43.0%), from to 28.0% to 39.0%. Lastly, the number of facility births increases by 20% (CrI 13.0%, 28.0%), from 85 women to 102 per month. However, there was no net difference on PNC visits between the CHW intervention site and its counterfactual unit (-37.0%, 95% CrI -224.0%, 170.0%). Conclusions: CHW intervention significantly increased the utilisation of ANC and facility based births in Neno, Malawi. However, CHWs had no net difference on PNC utilisation.
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Kachimanga, Chiyembekezo. "Improving utilization of maternal health related services: the impact of a community health worker pilot programme in Neno Malawi". Master's thesis, University of Cape Town, 2018. http://hdl.handle.net/11427/29240.
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Introduction: Malawi has one of the highest maternal mortality ratio (MMR) in sub-Saharan Africa (SSA). Despite investments in family planning and emergency obstetric care (EmOC), Malawi’s Millennium Development Goal (MDG) target of reducing maternal deaths to 155 deaths per 100,000 live births was not met by the end of 2015. Between 2010 and 2015, Malawi was only able to reduce the MMR from 675 to 439 per 100,000 live births. Inadequate utilisation of perinatal services is the contributing factor to the MMR target not being achieved. One approach for improving the utilisation of perinatal services is to invest in community health workers (CHWs). CHWs can be trained to: identify women of child bearing age (WCBA) who need perinatal services; provide community education; encourage timely referral of clients to the nearest health facility; and undertake community follow up for WCBA who are pregnant and/or have recently given birth. We evaluated changes in utilisation of antenatal care (ANC), facility based births, and postnatal care (PNC) after CHW deployment to conduct monthly home visits to WCBA for pregnancy identification and escorting women to ANC, labour and facility birth and PNC clinics in Neno district, Malawi. The CHW programme was implemented in two catchment areas from March 2015 to June 2016.
Methodology: We employed a retrospective quasi-experimental study design to evaluate the impact of CHWs on changes in the utilisation of ANC, facility based births, and PNC in Neno district, Malawi between March 2014 and June 2016 (pre-intervention period: March 2014 to February 2015, and post- intervention period: March 2015 to June 2016). Monthly outcomes were compared between a combined CHW intervention area and its synthetic control area using the synthetic control method. The synthetic control area (or synthetic counterfactual of the CHW) was the control area that was created from multiple available control sites where the CHW programme was not implemented to allow the comparison of outcomes between the sites where CHWs were implemented and the sites where CHWs was not implemented. Two hundred and eleven CHWs (128 existing CHWs plus 83 new CHWs from the community) were trained in maternal health and deployed to cover an estimated 5,132 WCBA living in a catchment area of about 20,530 people. The primary focus of the CHWs was to conduct monthly household visits to identify pregnant women, and then escort pregnant women to their initial and subsequent ANC appointments, facility births, and to PNC check-ups. As part of package of care, community mobilisation and improvements in services to achieve a minimum package of services at the local health centres were also added. Using the synthetic control method, as developed by Abadie and Gardeazabal (2003) and Abadie, Diamond and Hainmueller (2010) and a Bayesian approach of synthetic control developed by Brodersen (2015), a synthetic counterfactual of the CHW intervention was created based on six available public control facilities. The synthetic counterfactual trend was created to have similar preintervention characteristics as the CHW intervention trend. The impact of the CHW intervention was the difference between the CHW intervention site and its synthetic counterfactual
Results: CHWs in the intervention areas visited an average of 3,147 (range 3,036 – 3,218) of WCBA monthly, covering 61.0% of WCBA. During these visit 3.6% (97 women per month) of WCBA were suspected to be pregnant every month. Of those women suspected to be pregnant, 67.8% (66 women per month) were escorted to health facilities immediately every month. CHWs visited an average of 254 pregnant women enrolled in ANC and 64 women in postpartum period monthly. ANC and facility births utilisation in the CHW intervention site increased in comparison to the control site. Firstly, the number of new pregnant women enrolled in ANC per month increased by 18.0 % (95% Credible Interval (CrI) 8.0%, 28.0%), from 83 to 98 per pregnant women. Secondly, the proportion of women starting ANC in first trimester increased by 200.0% (95% CrI 162.0%, 234.0%), from 9.5% to 29.0% per month. Thirdly, the number of women attending four or more ANC visits increased by 37.0% (95% CrI 31.0%, 43.0%), from to 28.0% to 39.0%. Lastly, the number of facility births increases by 20% (CrI 13.0%, 28.0%), from 85 women to 102 per month. However, there was no net difference on PNC visits between the CHW intervention site and its counterfactual unit (-37.0%, 95% CrI -224.0%, 170.0%).
Conclusions: CHW intervention significantly increased the utilisation of ANC and facility based births in Neno, Malawi. However, CHWs had no net difference on PNC utilisation.
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Modikwane, Mmatladi Octavia. "Assessment of the quality of services provided by the home community based care programme to people infected and affected by HIV/AIDS / M.O. Modikwane". Thesis, North-West University, 2007. http://hdl.handle.net/10394/1827.
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The North-West Province has the fifth highest prevalence of HIV/AIDS in the country and has an estimated HIV prevalence of 22.9%. On the 24th November 1999 cabinet approved a special allocation of funds to finance a National integrated programme in the fight against the HIV/AIDS pandemic. They involved Departments of Social Services, Health, Education and Agriculture. The plan comprised three main components, which included the implementation of Home Community Based Care models for children and youth infected and affected by HIV/AIDS. The North-West Province was one of the provinces identified to pilot the programme and funds were allocated for the establishment of the programme.
This study was undertaken with the aim of assessing the quality of services provided by the Home Community Based Care Programme to people infected and affected by HIV/AIDS. An empirical survey as well as a literature study was undertaken to determine whether the caregivers that are part of the Home community based care programme play their set role. Forty-five beneficiaries of the programme were randomly selected as respondents. An evaluative research design was utilised to test the progress of the Programme and check whether the programme is consistent with programme design specifications. A structured self-administered coded questionnaire with descriptive questions was developed and self administered to 45 respondents in Ikageleng Location in Zeerust who were randomly selected from a list of beneficiaries. The findings of the study indicated that caregivers who are part of the Home Community Based Care Programme play their set role. The programme provides good quality services to beneficiaries. The programme provides palliative care services, material support, care and support services, awareness and education and income generation.Thesis (M.A. (MW))--North-West University, Potchefstroom Campus, 2008.
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Rikhotso, Rhandzavanhu Harris. "The challenges of community development workers in the implementation of the Community Development Workers’ Programme in Makhado Local Municipality, Limpopo Province". Thesis, Stellenbosch : Stellenbosch University, 2013. http://hdl.handle.net/10019.1/85656.
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Thesis (MPA)--Stellenbosch University, 2013.ENGLISH ABSTRACT: The community development workers’ programme (CDWP) is a strategic policy intervention by government to address challenges of service delivery to communities. The purpose of the CDWP is to facilitate the removal of obstacles in the course of providing services to communities. The CDWP is located in local government. Its purpose is often misunderstood by the stakeholders, because of the perception that the programme is meant to deliver services like provision of water, electricity and other social services. In essence, the CDWP is meant to facilitate communication between government and communities in order to ensure that services are delivered effectively and efficiently. Some of the challenges faced in the Makhado Local Municipality relate to the lack of infrastructure maintenance initiatives, including expansion plans that are well funded. Massive backlogs of infrastructure and services remain in the areas of water and sanitation, energy provision, housing, social security and others. If these problems relating to infrastructure and access to services are not adequately addressed, it will be impossible for the implementation of the CDWP to be successful. It is, therefore, critical that the government as a whole, and working with the private sector, should develop a comprehensive programme that mobilises society through both public and private initiatives. The purpose of this study was to investigate the challenges faced by community development workers (CDWs) in the implementation of the CDWP in Makhado Local Municipality. A qualitative research paradigm was adopted for the study. A literature review, focus groups and interviews were employed within the context of structured questions formulated in line with the framework of the study. The above were meant to facilitate a response to the research question of the study, which sought to find out what the challenges was faced by CDWs in the implementation of the CDWP in Makhado Local Municipality. One of the recommendations of the study is that the CDWP should be integrated with the Makhado Local Municipality plans and budget in order to ensure that it is sustainable and meets its stated objectives. Once this is achieved, it will be possible to confidently say that: The introduction of CDWs is succeeding in addressing challenges of service delivery in the implementation of the CDWP Challenges of CDWs in municipalities are being resolved through the effective implementation of the CDWP If the CDWP can be implemented fully in the Makhado Local Municipality, challenges of service delivery can be resolved over a reasonable period. It is, therefore, critical that the CDWP should remain an intergovernmental programme that fosters planning and partnership between the public, as beneficiary, and the government as service provider.
AFRIKAANSE OPSOMMING: Die Gemeenskapsontwikkelingswerkers Program (GOWP) is ‘n strategiese beleidsintervensie deur die regering om uitdagings met betrekking tot dienslewering aan gemeenskappe aan te spreek. Die doel van die GOWP is om hindernisse tot dienslewering aan gemeenskappe uit die weg te ruim, en die program is binne die plaaslike regering gesetel. Misverstand oor die doel daarvan kom dikwels onder belanghebbendes voor vanweë die veronderstelling dat die program bedoel is om dienste soos die voorsiening van water, elektrisiteit en ander maatskaplike dienste te lewer. In wese is die GOWP bedoel om kommunikasie tussen die regering en gemeenskappe te bewerkstellig om te verseker dat dienste doeltreffend en effektief gelewer word. Uitdagings vir die Plaaslike Munisipaliteit van Makhado staan in verband met die gebrek aan inisiatiewe om infrastruktuur in stand te hou, insluitend goed befondste uitbreidingsplanne. ’n Massiewe agterstand van infrastruktuur en dienste bestaan steeds op die gebied van water en sanitasie, kragvoorsiening, behuising en sosiale sekerheid. Indien hierdie probleem met betrekking tot infrastruktuur en toegang tot dienste nie voldoende aangespreek word nie, sal die implementering van die GOWP geen sukses behaal nie. Dit is dus van uiterste belang dat die regering, in geheel, en met die samewerking van die private sektor, ‘n omvattende program ontwikkel wat die gemeenskap deur middel van openbare en private inisiatiewe mobiliseer. Die doel van die huidige studie was om die uitdagings waarvoor gemeenskapswerkers met die implementering van die gemeenskaps- ontwikkelingswerkers program in die Plaaslike Munisipaliteit van Makhado te staan kom, te ondersoek. ’n Kwalitatiewe navorsingsplan is vir die studie gebruik. ‘n Oorsig van die literatuur, fokusgroep en onderhoude is gebruik, met gestruktureerde vrae wat binne die raamwerk van die studie geformuleer is. Die vrae was bedoel om ‘n respons tot die navorsingsvraag oor die uitdagings wat deur die gemeenskapsontwikkelingswerkers met die implementering van die GOWP in Makhado ondervind word, te fasiliteer. Een van die aanbevelings van die studie is dat die GOWP by die planne en begroting van die Plaaslike Munisipaliteit van Makhado geïntegreer moet word om die onderhoubaarheid van die program te verseker en dat die gestelde doelwitte bereik word. Wanneer dit geskied, sal dit moontlik wees om te sê dat: Die instelling van die gemeenskapsontwikkerlingswerkers behaal sukses ten opsigte van die uitdagings van dienslewering binne die Gemeenskapsontwikkelingswerkers program. Die uitdagings aan gemeenskapsontwikkelingswerkers in die munisipaliteite word deur die effektiewe implementering van die GOWP oorkom. Indien die GOWP ten volle in die Makhado Munisipaliteit geïmplementeer kan word, kan die probleem rondom dienslewering binne ‘n redelike tydperk opgelos word. Dit is dus belangrik dat ‘n onderneming soos die program vir die gemeenskapsontwikkelingswerkers behoue bly as ‘n inter-regeringsprojek wat die vennootskap tussen mense en die regering ondersteun.
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Sibiya, Gillian. "Students’ perspectives of the relationship between the university and a community partner in the context of a service learning psycho-education programme". Thesis, Rhodes University, 2017. http://hdl.handle.net/10962/6968.
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This qualitative case study aims to understand students’ perspectives of the relationship between the university and a community partner in the context of a service-learning programme. The study explores the experiences of three postgraduate psychology students that were involved in a service-learning programme at an under resourced school in the Eastern Cape. The data gathered was analysed thematically and major analytic themes were identified. The findings highlight the usefulness of service-learning for the student participants. However, student participants also argued that structural difficulties can make it harder for the community partner to enjoy the same benefits. The analysis brings forth the students’ concerns about managing stakeholder perceptions and the importance of broad-based participation and constant communication to ensure a good working relationship between partners. The findings highlight the students’ awareness of some of the difficulties of working in resource-constrained settings.
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Chiu, Grace May. "Why not share the knowledge? how after-school community technology centers nurture community and agency among urban adolescent peer support networks /". Diss., Restricted to subscribing institutions, 2008. http://proquest.umi.com/pqdweb?did=1666165081&sid=7&Fmt=2&clientId=1564&RQT=309&VName=PQD.
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Setianegara, Billy Som-Arch Wongkhomthong. "Assessment of knowledge, attitude and communication practice of the health personnel in health card programme /". abstract, 1988. http://mulinet3.li.mahidol.ac.th/thesis/2531/31E-Billy-S.pdf.
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