Rozprawy doktorskie: „Public health workers”

1

Amani, Adidja. "The Health Workers Crises In Cameroon". Digital Archive @ GSU, 2010. http://digitalarchive.gsu.edu/iph_theses/139.

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The physician’s crisis in Cameroon has reached an alarming stage and has the potential to worsen existing health problems including the attainment of millennium development goals. This report emphasized the challenges faced by Cameroonian physicians, and recommended alternative solutions to the current government health workers policies. The report was done through a review of articles and documents covering the topic. At the center of the physician’s crises in Cameroon is the discrepancy between financial, social and professional expectations and what the government offers. The analysis showed that, there is a general dissatisfaction, despite some corrective measures implemented by the government. This suggests that the government needs to aggressively adopt and implement aggressive retention policies, such as improving the remuneration and working conditions of health workers. Beside, there is also need for innovation by adopting and implementing solutions that have been successful in others countries. As in many other countries, establishing powerful unions and lobbying groups by Cameroon physicians may help in negotiating acceptable working conditions that could help in alleviating the challenges of Cameroonian physicians. Despite some limitations, this report can be useful for policy-makers in the formulation of effective human resources for health policies but also to draw attention to the need to publish more on human resources for health issues in Cameroon.

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2

Jachens, Liza J. "Job stress among humanitarian aid workers". Thesis, University of Nottingham, 2018. http://eprints.nottingham.ac.uk/52237/.

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Objective: This thesis examined the prevalence of burnout, alcohol consumption, and psychological distress and their association with stress-related working conditions – defined either in terms of the Effort-Reward Imbalance (ERI) model, or the ERI model combined with the Job Demand-Control-Support (job strain) model (DCS) – in two large-scale international samples of humanitarian aid workers. The studies herein were the first in the extant literature to examine organisational stressors using job stress models in this occupational group. Furthermore, given the paucity of previous research on the subjective stress-related experiences of humanitarian aid workers, this thesis also contains an interview-based study that explored how humanitarian aid workers perceived the transactional stress process. One key characteristic of this thesis was that both quantitative and qualitative approaches were utilised to provide a deep and ecologically valid understanding of the stressor-strain relationship. Identifying the links between stressful aspects of work and both psychological and behavioural health outcomes may help inform the design of sector-specific health interventions. Methods: A mixed-methods approach was adopted to allow for a thorough examination of the prevalence of health and health-related behavioural outcomes, their relationship to stress-related working conditions (psychosocial stressors), and the concept of work-related stress in the population under study. Survey designs were used for Study 1 and 2 and involved the administration of a structured questionnaire. For the first study (Parts 1-2, Organisation A), logistic regression analyses were run based on a cross-sectional survey (N = 1,980) conducted separately for men and women to investigate the relations between ERI and both burnout (Part 1) and heavy alcohol consumption (Part 2) while controlling for demographic and occupational characteristics. In Study 2 (Organisation B), logistic regression analyses were based on a cross-sectional survey (N = 283) conducted separately for men and women to investigate the independent and combined relations between the ERI and DCS models and psychological distress while controlling for demographic and occupational characteristics. The final study was interview-based (Study 3, Organisation B) and it explored how humanitarian aid workers (N = 58) employed by a United Nations-aligned organisation perceived the transactional stress process. Results: The prevalence rates for the burnout components were as follows: high emotional exhaustion—36% for women and 27% for men; high depersonalisation—9% and 10%; and low personal achievement—47% and 31% for women and men, respectively. Intermediate and high ERI scores were associated with a significantly increased risk of high emotional exhaustion, with mixed findings for depersonalisation and personal achievement. The prevalence of heavy alcohol consumption among women (18%) was higher than the corresponding rate for men (10%), lending support for the effort-reward perspective only among women. Intermediate and high ERI scores in women was associated with a three-fold risk of heavy alcohol consumption. The results broadly suggest that occupational stressors from the ERI and DCS models, both individually and in combination, are significantly associated with psychological distress. A thematic analysis undertaken within the qualitative study revealed several main themes. An emergency culture was found where most employees felt compelled to offer an immediate response to humanitarian needs. The rewards of humanitarian work were perceived as motivating and meaningful, and employees experienced a strong identification with humanitarian goals and reported high engagement. Constant change and urgent demands were reported by the participants to result in work overload. Finally, managing work-life boundaries, and receiving positive support from colleagues and managers, helped buffer perceived stress, work overload, and negative health outcomes. Conclusions: The results of the present thesis convincingly demonstrate the usefulness of the ERI model as a framework for investigating burnout and heavy alcohol consumption among humanitarian aid workers. Furthermore, the findings demonstrate the independent and combined predictive effects of components of two alternative job stress models (ERI and DCS) on psychological distress. Taken together, the findings underscore the deleterious associations between work-related psychosocial hazards and mental and behavioural health outcomes. Specifically, unique insights were obtained about the work-related stress process in relation to humanitarian aid workers – for example, the emergency culture shaping organisational norms. The results suggest that interventions based on these two influential theories, and supplemented by knowledge on role-specific stressors evident in the sector, hold promise for reducing health outcomes. The practical implications of the results are discussed and suggestions are made in the light of the present research and stress theory.

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Abie, Zogoe Herve-Brice. "Farm workers in Stellenbosch : a survey of factors affecting health". Master's thesis, University of Cape Town, 2007. http://hdl.handle.net/11427/13442.

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Includes bibliographical references (leaves 52-54).
The study was done to establish a profile of farm workers' health; and to investigate the extent to which the health of farm workers may be impaired by identified factors, both environmental and non-environmental.

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4

Rodriguez, Ailin. "Cross-sectional Predictors of HIV Risk among Latino Migrant Workers". FIU Digital Commons, 2018. https://digitalcommons.fiu.edu/etd/3711.

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The relationship between suspected predictors of current HIV risk, i.e. self-efficacy, social norms, expectancies, alcohol use, past HIV risk, past history sexual abuse, social support, and behavioral intention was investigated in a sample of Latino migrant workers living and working in the United States (N=270) using baseline data from a previous study. A series of multiple regression analyses were performed by adjusting for socio-demographic characteristics such as age, gender, marital status, educational attainment, and length of stay. Zero-inflated Poisson regression analysis showed that self-efficacy was associated with behavioral intention (β= 0.03, p= 0.04) and expectancies was associated with behavioral intention (β= -0.01, p = 0.04). Binary logistic regression analysis showed that past HIV risk was associated with the dependent variable, current HIV risk (β = 0.11, p= 0.01), while behavioral intention was associated with current HIV risk (β= -0.16, p= 0.02). Bayesian path analyses showed behavioral intention to partially mediate the relationship between self-efficacy and current HIV risk (β= 0.24, 95% CI: 0.10, 0.38) and to fully mediate the relationship between AOD use and HIV risk (β= 0.11, 95% CI: -0.05, 0.26). In summary, two socio-psychological factors emerged as significant predictors of HIV risk. Lower levels of behavioral intention and higher levels of past HIV risk were associated with higher current HIV risk. These findings are relevant for informing future studies on Latino migrant workers or similar populations and for planning interventions designed to prevent and/or reduce HIV risk.

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Ayhan, Ekim Deniz. "Workers&#039". Master's thesis, METU, 2006. http://etd.lib.metu.edu.tr/upload/12607437/index.pdf.

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This thesis aims an analysis of early Republican state factory settlements, in terms of their concern for workers&
#8217
health and welfare, within Turkish modernization in the largest extent. State factory settlements are evaluated in terms of their architectural program(s), in terms of concern about the physical and mental health requirements of their future workers at the stage of their foundation. Different types of buildings, like workers&
#8217
houses, cafeterias, health centers and clubs, with respect to their organization and architectural function and also areas spared for sports and recreation are examined in EskiSehir Sugar Factory, as an exemplary case of the state factories. The aim has been to reveal and evaluate the role of the social and architectural construction of state factories on workers&
#8217
(and their families) health, as a part of the modernization project of Turkey.

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6

Njemanze, Ulunma. "Factors Impacting HIV Post Exposure Prophylaxis among Health Care Workers". ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/4086.

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Health care workers are at risk of contracting HIV as a result of occupational exposure while treating infected patients. HIV postexposure prophylaxis (PEP) is an effective antiretroviral treatment course used in preventing potential HIV infection following an accidental occupational exposure to HIV. The objective of this cross sectional study was to identify the factors that impact the practice of HIV PEP among health care workers at the National Hospital, Abuja, Nigeria. A cross-sectional survey using self-administered, structured questionnaires was conducted on 182 health care workers at the National Hospital comprising of medical doctors, nurses, and laboratory scientists. A chi-square test of independence was used to assess the association between knowledge of PEP and PEP use. Logistic regression was used to determine the relationship between PEP use and types of occupational exposure, existing precautionary policies, and fear of stigma. The results of this study were statistically insignificant with variables PEP knowledge (p= 0.274), types of occupational exposures (p= 0.575), awareness of precautionary policies (p= 0.219), and fear of stigma (p=0.282), which could be a result of the small sample surveyed. Nonetheless, this study can lead to positive social change whereby health care workers are well-trained on the practice of PEP after sustaining an occupational injury in order to prevent HIV infection. Factors such as inadequate knowledge on HIV PEP practice, underreporting of occupational injuries, lack of awareness of precautionary guidelines on HIV PEP, and the fear of stigma after an occupational exposure to HIV affect the practice of HIV post exposure prophylaxis. Therefore, more education on PEP for HIV among health care workers is warranted.

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7

Storms, Starr 1948. "An assessment of the mental health of mental health care workers in the public sector". Thesis, The University of Arizona, 1993. http://hdl.handle.net/10150/291732.

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The mental and emotional well-being of mental health care professionals can be jeopardized by burnout, a syndrome similar to depression and other affective disorders in its symptomology and effects. A questionnaire designed to assess mental health and burnout was developed using various assessment tools from the mental health care community to obtain information about health habits, stressors, coping skills, personal history, and length of service. Forty-seven workers at a public mental health facility responded to the questionnaire. The results of this study suggest that approximately 20% of mental health care-givers are experiencing high degrees of burnout and mental disease. Neither personal history or long-term service appears to contribute to the burnout. Workers new to the field seem to be at greatest jeopardy. Control coping mechanisms were found to be more effective than escape coping mechanisms in combating stress and mental illness.

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8

Dousman, Sylvia Morgan. "A handbook for health workers to use in evaluating health literature". CSUSB ScholarWorks, 1997. https://scholarworks.lib.csusb.edu/etd-project/1291.

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9

Sangweni, Nozipho. "Spirit at work and the South African public health workers’ organisational commitment". Diss., University of Pretoria, 2010. http://hdl.handle.net/2263/26038.

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This study makes an empirical examination of the relationship between spirit at work and organisational commitment. It examines the organisational factors that foster spirit at work in individuals. A cross-sectional survey design was used to answer three research questions. The sample consisted of medical professionals. A mail survey was administered at three public hospitals. A positive correlation was found between spirit at work and organizational commitment. Sense of community emerged as central to fostering spirit at work. Copyright
Dissertation (MBA)--University of Pretoria, 2010.
Gordon Institute of Business Science (GIBS)
unrestricted

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10

Swartz, Alison. "Community health workers in Khayelitsha : motivations and challenges as providers of care and players within the health system". Master's thesis, University of Cape Town, 2012. http://hdl.handle.net/11427/12199.

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Community health workers (CHWs) play an important role in health care in South Africa and similar countries, but relatively little is known about CHW motivations and experiences in the provision of care. This thesis considers these issues in three parts: 1. A protocol for a study of community health work in Khayelitsha, an impoverished peri-urban settlement near Cape Town, which is home to a number of ‘flagship’ public health interventions aimed at HIV/AIDS and TB. 2. A review of literature on community health work exploring naturalistic versus economistic discourses around care work, and the complex intersections of these discourses. 3. An ethnographic account of CHWs who provide a wide range of community-based care work in Khayelitsha.

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11

Lilley, Rebbecca Catherine, i n/a. "The development of an occupational health and safety surveillance tool for New Zealand workers". University of Otago. Dunedin School of Medicine, 2007. http://adt.otago.ac.nz./public/adt-NZDU20071011.112802.

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World-wide, working life is undergoing major changes. Established market economies are increasingly characterised by demands for vastly greater market flexibility. New Zealand (NZ) has been no different with rapid changes occurring over the last 2 decades in the organisation of labour, of work and of the work environment. Recent international research suggests that work change significantly impacts upon worker health and safety. Many OECD nations undertake routine cross-sectional surveys to monitor changes in working conditions and environments, assessing the health and safety impact of these changes. Similar monitoring is not undertaken in NZ, with the impact of the work environment on health and injury outcomes poorly understood. This lack of knowledge (monitoring) is considered to be a significant impediment to the progression of health and safety initiatives in NZ. The aim of this thesis was to develop a tool (questionnaire) and methodology suitable for use in the surveillance of working conditions, work environments and health and injury outcomes using workers� surveys. The survey development was undertaken in 3 phases: i) development of tool through critical review; ii) empirical methodological testing and iii) an empirical validation study. Questionnaire development was a stepwise process of content selection. Firstly key dimensional themes were identified via critical review of literature and existing international surveys leading to the establishment of a dimensional framework. Secondly a critical review of questions to measure key dimensions based upon selection criteria occurred. Finally the selected questions and design were pre-tested before piloting. A similar development process was undertaken for the development of a calendar collecting occupational histories. A methodological study was undertaken piloting the questionnaire. Two methods of data collection were evaluated: face-to-face and telephone interviews, and two methods of occupational history collection: calendar and question set. Telephone interviewing was found to be the more efficient and effective data collection method while occupational history collection was found to be less time consuming by question set. Focus groups indicated questions were acceptable and suitable to NZ workers. A validation study was undertaken with a cross-sectional study in distinctly different occupational groups: cleaners and clerical workers. Comparisons were made between the groups with cleaners expected to be identified as employed under more hazardous working conditions and be exposed to more hazards of a physical nature, while clerical workers were expected to be exposed to more psychological hazards of a psychological nature. Results indicated the questionnaire provides data capable of making valid comparisons, identifying work patterns of high risk and provides good predictive validity. The final survey has the potential to generate population data on a wide range of work-related exposure and health variables relevant to contemporary working life. The survey results will contribute to understanding the range of working conditions and work environments NZ workers are currently exposed to and to assessing the health and safety impact of these exposures. Therefore it is recommended this tool initially be used in a national workforce survey to establish baseline surveillance data of working conditions, work environments and health and safety outcomes in NZ.

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12

Schmidt, Bey-Marrie. "Tuberculosis interventions to prevent transmission of infection in health care workers: a systematic review". Master's thesis, University of Cape Town, 2015. http://hdl.handle.net/11427/19906.

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Background: Tuberculosis is a major cause of morbidity and mortality as an estimated 8.6 million people developed TB and 1.3 million died from the disease in 2012. The number of deaths is high given that TB can be prevented. Health care workers are an at - risk group, since they are frequently in contact with infectious patients and/or work with infectious products. The World Health Organisation has declared the importance of finding innovative tools and strategies to prevent TB and implementing them successfully, especially for those with a high risk of TB transmission. Methods: This systematic review aims to undertake a quantitative review of tuberculosis interventions for health care workers in health care settings, so as to assess whether these interventions are effective in reducing the transmission of tuberculosis infection and disease. We will preferably include experimental studies, such as, randomised - controlled trials, but observational studies, such as controlled before and after studies and cohort studies will also be included in the absence of randomised - controlled studies. We will search databases, such as Medline, Scopus, Trip, LILACS and various trial registries. A hand search of reference lists of identified articles, abstracts, conference proceedings and campaign materials will be performed. Grey literature sites will also be used for the search. Data will be extracted using a single form. The quality of each study will be assessed in terms of selection bias, performance bias, attrition bias and detection bias. Thereafter a meta - analysis will be produced and subgroups will be analysed according to the three intervention types. Clinical and statistical significance will be determined for the included studies, and descriptive narratives of heterogeneous studies will be written. Discussion: Our results will be useful to policy - makers and public health officials for the prioritisation of those interventions identified as effective and critical .

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Sathar, Farzana. "Demographic determinants of chemical safety information recall in workers and consumers in South Africa". Master's thesis, University of Cape Town, 2015. http://hdl.handle.net/11427/16865.

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Includes bibliographical references
Chemical hazard communication is intended to alert users of the potential hazards of chemicals. Apart from the fact that hazard information should be understood, it is also important that it should be recalled. Recall of hazard communication is critical when the written form of the information is not available at the time it is required. A cross-sectional study investigating predictors of the recall of chemical safety information on labels and safety data sheets amongst 315 workers (industry, transport and agriculture sectors) and 87 consumers in two provinces of South Africa was conducted. The recall of participants was tested using two modules (module 2 which relates to the demographics, and module 3 which relates to the recall of the participants) from the Hazard Communication Comprehensibility Testing (CT) Tool developed by the Centre for Environmental and Occupational Health at the University of Cape Town. Respondents were predominantly male (67.7%), the median age was 37 years (IQR: 30-46 years) and less than half of the participants completed high school (47.5%). The majority of participants were blue collar workers outside of industry (55.5%). The skull and crossbones symbol was the label element most recalled, both unprompted (79.6%) and prompted (94.8%), and the first aid and treatment measures the least frequently recalled (6.0%-29.9%). Multivariate analysis showed the predictors that were found to increase the recall of all the label elements were, industrial sector, transport sector, agriculture sector, gender, home language English and Afrikaans, reading English and Afrikaans, completing high school and non-industry white collar occupations. The predictors that were found to decrease recall were further education, not wearing glasses and non-industry blue collar occupations. This study found demographic factors to influence the recall of hazard information. Policy should ensure the implementation of procedures that promote the recall of hazard information to protect workers from hazardous exposures.

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羅淑兒 i Suk-yee Lo. "Vulnerability and resilience to workplace violence among health care workers in public hospitals". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2008. http://hub.hku.hk/bib/B41547822.

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Lo, Suk-yee. "Vulnerability and resilience to workplace violence among health care workers in public hospitals". Click to view the E-thesis via HKUTO, 2008. http://sunzi.lib.hku.hk/hkuto/record/B41547822.

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Kokota, Demoubly. "An evaluation of mhGAP training for primary healthcare workers in Mulanje, Malawi". Master's thesis, University of Cape Town, 2015. http://hdl.handle.net/11427/16699.

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Includes bibliographical references
Introduction: There is a large treatment gap for people with mental disorders in Africa and other low resourced countries, estimated to be between 70% and 90%. The treatment gap is mainly due to the lack of trained mental health professionals and inadequate mental health service resources in Africa. There has been a growing global movement championed by the World Health Organisation (WHO) to integrate mental health into primary health care as the most effective way of reducing this treatment gap. This study aimed to investigate the impact of WHO Mental Health Gap Action Programme (mhGAP) training and supervision on primary health workers' knowledge, attitudes, confidence and detection rate of major mental disorders in the district of Mulanje, Malawi. Method: The study was a quantitative evaluation using a quasi-experimental method (single cohort pre- and post-measures) and an interrupted time-series design. Forty-three primary healthcare workers from Mulanje, Malawi completed pre- and post- training questionnaires assessing knowledge, attitudes and confidence regarding the assessment and management of major mental disorders. Rates of diagnosis of major mental disorders were obtained from clinic registers for 5 months prior to and 7 months following training. Results: The results showed a significant change on knowledge and confidence scores but not attitudes. The mean knowledge score showed a statistically significantly increase from 11.8 (standard deviation [SD]: 0.33) before training to 15.1 (SD: 0.38) immediately after training; t(42) = 7.79, p <.01. Mean knowledge score was also significantly higher six month post training (13.9, SD: 2.52) than before training; t(42) = 4.57, p < .01. Similarly, the mean confidence score increased significantly from 39.9 (SD): 7.68) before training to 49.6 (SD: 06.14) immediately after training; t(84) = 8.43, p <.01. Mean confidence score was also significantly higher six month post training (46.8, SD: 6.03) than before training; t(84) = 6.60, p <.01. There was no overall significant difference in mean CAMI scores before, immediately after and 6 months after training in all four of the CAMI components. The F-test statistic and P-value for Authoritarianism, Benevolence, Social Restrictiveness and Community Mental Health Ideology were: F2, 126, 0.05 = 2.5; p =.09, F2, 126, 0.05 = 0.1; p =.9, F2, 126, 0.05 = 0.03; p = 1.0 and F2, 126, 0.05 = 0.04; p = 1.0, respectively. In the months January to May 2014 (before training), median number of cases per month was 77 (inter quartile range [IQR]: 65-87) whereas after training (months June to December) median number of cases was 186 (IQR: 175-197) showing a significant increase in median number of cases before and after the training; p =0.001. Conclusion: The results show clear improvements in the knowledge, confidence and detection of severe mental illness in primary care in Mulanje and demonstrate the potential for narrowing the treatment gap by rolling out mhGAP training nationally in Malawi. The findings of this study add to the growing evidence for policy makers of the effectiveness of mental health training and supervision of primary care workers in a resource-constrained country. Further research is needed to evaluate factors that may lead to change in health worker attitudes, to evaluate training and supervision programmes using more robust evaluation designs, such as randomised controlled trials, and to assess the scale up of mhGAP programmes at larger population levels.

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Singh, Aditya. "Availability and inequality in the distribution of health workers in the public health system in rural India". Thesis, University of Portsmouth, 2016. https://researchportal.port.ac.uk/portal/en/theses/availability-and-inequality-in-the-distribution-of-health-workers-in-the-public-health-system-in-rural-india(3c9be9a2-bfc2-4379-8d77-51482056b582).html.

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After decades of effort, the health outcomes in India are still poor. In addition to the slow socioeconomic development and sluggish progress in poverty eradication, the ongoing poor health status of individuals living in rural India is often attributed to an inefficient and largely dysfunctional public healthcare system. Although India has developed a huge network of public health facilities, the utilization of services at these facilities still remains abysmal. One of the factors underlying this situation is thought to be the poor availability of human resources in healthcare. Recognising the need to overhaul the system, the government launched the National Rural Health Mission (NRHM), an initiative that aimed to increase health worker availability in public health facilities. It has been more than a decade since the launch of the NRHM, and the time is ripe to evaluate the extent to which health worker availability has improved in public health facilities, and how inequalities in the distribution of health workers in public facilities has changed. Related to this is an important question: What factors shape such distributional inequalities? The NRHM introduced new cadres to the public health system – a 2nd nurse midwife at the sub-centres and a traditional medical doctor at the primary health centres. Thus, this study also investigated the effects associated with the implementation of these workers on healthcare utilization. This study largely uses quantitative tools and secondary data from the District Level Household Survey (DLHS) series. It finds that the overall health worker availability has improved slightly, but the availability of a few health worker cadres, such as male health workers, has deteriorated. The study also found that the distribution of health workers has become more unequal over the study period. While the inequality in the distribution of health workers within states remains considerably high, the inequality in the availability of health workers across states has increased. The study finds a mesh of complex factors affecting the availability and distribution of health workers across health facilities, which include the availability of basic amenities, physical infrastructure, work environments, family and personal choices, misuse of transfer, and deployment policies. It also finds that the utilization of health services is lower at those sub-centres run by a 2^nd ANM compared to those run by permanent ANMs. Evidence about the impact of a 2^nd ANM and AYUSH are inconclusive for most indicators. Thus, the findings of this study suggest that there is a need to further improve health worker availability at rural public health facilities. The emphasis should be on reducing the inequality not only across states, but also within states. Special efforts would be required for north and central Indian states that have struggled to improve their health worker availability during this period. The findings also call for policymakers to devise new strategies to retain health workers in rural and remote areas, while implementing transparent and apolitical transfer and deployment policies. The government should also look into issues as to why those sub-centres run by a 2^nd ANM are not performing at par with those sub-centres run by permanent ANMs.

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Morin, Gardarsdottir Benedikta. "Night shift workers´ sleep experience". Thesis, Mittuniversitetet, Institutionen för hälsovetenskap, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:miun:diva-37406.

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Taylor, Rebecca Kate. "An exploration of the mechanism by which community health workers bring health gain to service users in England". Thesis, University of Birmingham, 2016. http://etheses.bham.ac.uk//id/eprint/6552/.

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This thesis presents the findings of a qualitative exploration of how Community Health Workers (CHWs) conceptualise their role in delivering health improvement. The characteristics of CHWs described in the literature, and their role in health improvement, are examined critically. Interview data from 27 CHWs and 15 others across four services is used to explore the health improvement mechanism from the perspective of CHWs. Theory from a range of disciplines is used to explain it. The literature provides incomplete accounts of the mechanism. The empirical work suggests that, in the services sampled, the mechanism may predominantly be one of social support (informational, instrumental, appraisal and emotional support). Three distinct and essential processes emerge (needs assessment, effective service provision, and client engagement). The analysis reports how who CHWs are, and what they do, appear to be important influences on the social support processes, and that CHWs may be better at delivering this kind of support than traditional professional workers, particularly to socially excluded individuals. Overall, this work suggests that CHWs may perform a unique role, as experts in social support. The proposed mechanism can be used to inform service design and evaluation, to maximise CHWs’ potential to deliver effective social support.

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Sondlane, Johan Senias. "The role of community health workers in the HIV/AIDS Programme". Thesis, Stellenbosch : Stellenbosch University, 2008. http://hdl.handle.net/10019.1/3015.

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Thesis (MPA (School of Public Management and Planning))--Stellenbosch University, 2008.
The role of Community Health Workers (CHWs) in the HIV/AIDS Programme is directly dependent on the support systems provided by nurses, NGOs, the community, institutional frameworks, and government funding and stress management institutions. The Home-based caregivers that work in the HIV/AIDS Programme are CHWs who need maximum support from the above- mentioned institutions. The community is also reeling with the aggravating consequences of HIV/AIDS. CHWs play a role in trying to take care of the HIV patients within the home environment. People are cared for by the people they associate with and people who live with them. In order for CHWs to maximise their contribution to the HIV/AIDS Programme, there should be commitment from all stakeholders involved in the programme. Forty-one people from formal and non-formal structures took part in the study. The formal structures refer to clinics and hospitals, whereas informal structures refer to Home-based care (HBC) groups, volunteers, NGOs and international donor agencies. The study was conducted over a period of eight weeks. The study was conducted at Cork, Calcutta and Mkhuhlu clinics, and Mkhuhlu Home-based care and on USAID field officers. The results of the study suggested that with support systems from the relevant institutions, CHWs are able to carry their community obligations in an effective and efficient manner. These findings have positive relationship implications towards the reduction of HIV infections in the community. Hospitals that are faced with overcrowding also benefit in a way, when terminally ill patients are cared for at HBC centres.

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Zenga, Debbie. "Perceived Effects of Microaggression on Peer Support Workers in Mental Health Recovery". Thesis, Alliant International University, 2018. http://pqdtopen.proquest.com/#viewpdf?dispub=10815486.

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This study explored the perceived effects of microaggressions on Peer Support Specialists (PSS). Although some research exists on the perceived effects of microaggression on individuals with lived experience of mental illness, known culturally as a marginalized group (Sue, 2010); none exists on PSS. The mental health movement began in the early 1900’s, which later evolved into mental health recovery and psychiatric rehabilitation. This movement brought forth the development of psychopharmacology, supportive services, and mental health programs. During the early phases of mental health recovery and treatment, individuals with lived experience of mental illness were utilized as peers and eventually as peer support specialists, or liaisons. Peer support specialists (PSS) provide an invaluable resource to individuals struggling with mental illness, as the literature supports. Despite strides towards societal acceptance, individuals with mental illness, continue to experience discrimination, stigma and microaggressions. Research on historical trauma, although beyond the scope of this research will be reviewed to provide an understanding of how microaggressions are passed on and additionally a narrative review of Adverse Childhood Experiences (ACEs) and the Connor-Davidson Resilience Scale (CD-RISC-25), aimed to contribute to the understanding of the history of trauma, engagement, and recovery. This research qualitatively explored the experience of sixteen participants who are PSS and in active recovery of mental illness. Semi structured focus group interviews revealed five major themes: Category 1–Microinvalidation: (1.1) Invalidation; (1.2) Second Class Citizen; Category 2–Resilience: (2.1) Advocacy; (2.2) Belonginess; (2.3) Perseverance.

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Mwanga, Hussein Hassan. "Risk factors for work-related asthma in health workers with exposure to diverse cleaning agents in two African health care settings". Doctoral thesis, Faculty of Health Sciences, 2019. http://hdl.handle.net/11427/30952.

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Background: Health workers (HWs) are exposed to a wide range of chemicals used for cleaning and disinfection. This has been largely attributed to the ever-increasing demand for effective cleaning and disinfection in hospital settings in an effort to prevent healthcare associated infections. Over the last two decades, there has been increasing evidence linking cleaning agents to adverse work-related health effects such as rhinitis, asthma and contact dermatitis. There is however little information on the specific cleaning agents and tasks associated with various asthma-related outcomes. Furthermore, limited information exists regarding exposure-response relationships between the frequency of exposure to specific cleaning agents and asthma-related outcomes. This study investigated the prevalence and risk factors for work-related asthma (WRA) among HWs exposed to diverse cleaning agents in two academic tertiary public hospitals in southern Africa - South Africa and Tanzania. Methods: A cross-sectional study of 699 HWs was conducted. Exposure assessment included systematic workplace observations, environmental sampling for aldehydes (orthophthalaldehyde-OPA, glutaraldehyde and formaldehyde) and urine biomonitoring for chlorhexidine. Environmental sampling for aldehydes was conducted more extensively in the South African hospital (SAH). A pilot sampling in the Tanzanian hospital (TAH) revealed very low detectable levels of OPA and glutaraldehyde and as a result extensive measurements were not done. In the SAH, a total of 269 full-shift passive personal samples were collected from 164 HWs randomly selected from 17 different clinical departments. Passive sampling used TraceAir® AT580 monitors (Assay Technology, Livermore, CA). Biomonitoring for chlorhexidine was only conducted in the SAH since none of the HWs in the TAH used chlorhexidine. For the health outcome assessment, a total of 697 HWs completed interviews using the ECRHS questionnaire adapted for occupational contexts, which contained in-depth information on asthma, as well as detailed information on tasks and chemicals used during the course of their work. Sera was successfully collected from 682 HWs and analysed for specific immunoglobulin E (sIgE) antibody reactivity to common aero-allergens (Phadiatop) and specific occupational allergens (NRL - Hevea brasiliensis (Hev b5, Hev b6.02), chlorhexidine and OPA). Methacholine challenge tests (MCT) were performed on all South African HWs (n=318), based on standard inclusion criteria. Spirometry, accompanied by a post-bronchodilator (post-BD) test was conducted on all Tanzanian HWs (n=329) and a small proportion (n=25) of South African HWs where MCT was contraindicated. All HWs from both hospitals (n=654) underwent fractional exhaled nitric oxide (FeNO) testing during the working day prior to spirometry. Results: The prevalence of current asthma was 10% (atopic asthma 6%, non-atopic asthma 4%), while 2% had WRA. The prevalence of atopy was 43%, with 4% of workers being sensitised to OPA, 2% to NRL and only 1% to chlorhexidine. Environmental sampling demonstrated that OPA was detectable in 6 (2%) samples, all samples (Geometric mean (GM) = 0.010 ppm) being higher than the ACGIH exposure limit (0.0001 ppm). Workers with detectable OPA were found to have a longer duration of OPA use (OR = 1.28; 95% CI: 1.10 – 1.50). Formaldehyde was detectable in 103 (38%) samples (GM = 0.005 ppm), with 1% of samples having levels higher than the NIOSH TWA exposure limit (0.016 ppm). Asthmarelated outcomes (increasing asthma symptom score and FeNO) demonstrated consistent positive associations with certain medical instrument cleaning agents (OPA, QACs and enzymatic cleaners) and tasks (pre-cleaning of medical instruments, changing sterilisation solutions and manual disinfection of medical instruments) as well as certain patient care activities (disinfection prior to procedures, cleaning/disinfecting wounds, application of wound dressing, usage of adhesives and adhesive removing solvents). A particularly pronounced dose-response relationship was observed between work-related ocular-nasal symptoms and medical instrument cleaning agents (OPA, glutaraldehdye, QACs, enzymatic cleaners, alcohols and bleach; OR range: 2.50 – 12.08) and tasks (OR range: 2.58 – 3.97). Furthermore, a strong association was observed between higher asthma symptom scores and use of more sprays than wipes for fixed surface cleaning activities (mean ratio = 3.00; 95% CI: 1.50 – 5.98). Conclusion: This study has demonstrated that detectable exposures to OPA are higher and more isolated to certain departments than the more widespread low-level formaldehyde exposures present throughout the hospitals. Furthermore, cleaning agents have replaced NRL as important causes for WRA in health settings. Finally, specific cleaning agents such as OPA, quaternary ammonium compounds and enzymatic cleaners associated with medical instrument cleaning/disinfection as well as patient care activities and the use of sprays for fixed surface cleaning, are important environmental risk factors for various asthma-related outcomes among HWs in health care settings.

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Nembhard, Richon M. "Workplace consciousness| Enabling obesity voices of the workers (VOW)". Thesis, University of Phoenix, 2013. http://pqdtopen.proquest.com/#viewpdf?dispub=3570375.

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Obesity is a serious global issue and it is increasing in prevalence in the United States. The purpose of this interpretive hermeneutic phenomenological study was to gain insight into the nature of the impact of work on obesity through reflecting on the lived experiences of employed adults. The research study used a van Kaam method as modified by Moustakas with in-depth, semi-structured interviews to explore factors surrounding the impact of work on obesity. Fifteen participants from two industries (Home Health Care and Education) were interviewed for the study. It was theorized that obesity was influenced by an inability to balance the demands and influence of the work environment with healthy weight management practices. The study revealed that the workplace does affect obesity because of food choices available within the organization, lack of health discussions, work hour demands, and lack of streamlined work processes that enables break periods. The most influential factors on the participants’ state of obesity were external to the workplace. The study also found that unhealthy habits and external relationships influence people’s state of obesity. Social policy change leaders should consider the person as the epicenter of the obesity issue because unhealthy habits are passed from generation to generation and a lack of both self-control and motivation exacerbates the obesity issue.

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McKee, Herbert G. Jr. "Wellness programs in police departments and how they effect workers' compensation claims". CSUSB ScholarWorks, 1993. https://scholarworks.lib.csusb.edu/etd-project/873.

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Bayham-Hicks, Shirley Louise. "Continuity of care for migrant farm workers utilizing computer disks". Thesis, The University of Arizona, 2000. http://hdl.handle.net/10150/278747.

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Not much has changed for the migrant farmworker in the last thirty years. In one of the wealthiest countries on earth, migrant farmworker health status remains comparable to that found in Third World countries because of poor sanitation, poor nutrition and exposure. Current estimates show that migrant clinics are serving less than 20% of this population, leaving about 2,000,000 farmworkers without medical care. The barriers to health care for this population are numerous. This study will focus on the barrier to care resulting from lack of continuity in care due to poor inter-clinic communication. In this study it has been shown that computer disks and a standard word-processing program can be used to create a portable medical health history for the migrant to improve inter-clinic communication. In the process of carrying out this study, it was also shown how other barriers to care for this vulnerable population might be removed as well.

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Mihrete, Kifle. "Association Between Fast Food Consumption and Obesity and High Blood Pressure Among Office Workers". ScholarWorks, 2011. https://scholarworks.waldenu.edu/dissertations/1022.

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Fast food consumption among office workers is a common phenomenon. Frequent consumption of fast food is linked to cardiovascular risk factors. The pervasiveness of these risk factors has debilitated the office workers' health and contributed to low performance and absenteeism. However, there remains a significant gap in the current literature regarding the health impacts of frequent fast food consumption behavior of office workers. Consuming large portions of fast food has been associated with obesity. The purpose of this correlation study was to investigate the relationship between fast food consumption and obesity and hypertension among office workers. The theoretical foundations for this study are based on socio ecological model which is concerned with interactions between the individual and the different elements of the environment. Of 145 randomly selected office workers, 55 completed surveys about their food behavior and 36 of them had body mass index and blood pressure measured. Spearman rank-ordered correlations revealed significant correlations of moderate strength between fast food portion size and obesity (rs = .37) and between frequent fast food consumption and hypertension (rs = .40). These results constitute an important contribution to the existing literature and can be used by the health professionals and management to design workplace health intervention which focuses on the office workers and the social environment. Implications for positive social change include reducing the prevalence of obesity and hypertension.

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Wakefield, John Gregory Public Health &amp Community Medicine Faculty of Medicine UNSW. "Patient safety: factors that influence patient safety behaviours of health care workers in the Queensland public health system". Awarded by:University of New South Wales. Public Health & Community Medicine, 2009. http://handle.unsw.edu.au/1959.4/44598.

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ABSTRACT Objectives: To develop and validate in an Australian setting, an instrument to effectively measure patient safety culture; to survey health care workers (HCWs) in a large public healthcare system to establish baseline patient safety culture; and, using the Theory of Planned Behaviour (TPB), to use behavioural modelling to identify the factors that predict and influence Patient Safety Behavioural Intent (PSBI) Eg. Reporting clinical incidents and speaking up when a colleague makes an error. Design: Cross sectional survey analysed with multiple logistic regression (MLR). Setting: Metropolitan, regional and rural public hospitals in Queensland, Australia. Participants: 5294 clinical and managerial staff. Main outcome measures: 1) Behavioural models for high-level Patient Safety Behavioural Intent (PSBI) for senior and junior doctors, senior and junior nurses, and allied health professionals. 2) Odds ratios to compare levels of PSBI between professional groups. Results: 1) The factors that influence high-level PSBI for each professional group give rise to unique predictive models. Two factors stand out as influencing high-level PSBI for all HCWs (R2 0.21). These are: i) Preventive Action Beliefs (Adjusted Odds Ratio (AOR) 2.38) (HCWs??? belief that engaging in the target behaviour(s) will lead to improved patient safety) and ii) Professional Peer Behaviour (AOR 1.79) (HCWs??? perceptions of the safety behaviour(s) of one???s professional peers). 2) There was a six-fold difference in the level of target behaviour (PSBI) across the clinical groups with few (29.6%) junior doctors having a high-level of PSBI. When compared with the junior doctors, the senior doctors were nearly 1.5 times more likely (Odds Ratio (OR) 1.46, 95% Confidence Interval (CI) 1.01-2.13), allied health staff 2.7 times more likely (OR 2.71, 95%CI 1.91-3.73), junior nurses 3.9 times more likely (OR 3.86, 95%CI 2.83-5.26), and senior nurses 6.0 times more likely (OR 6.01, 95%CI 4.78-9.16) to have high-level PSBI. Conclusions: This is the first published study to develop behavioural models of factors that influence HCWs??? intention to engage in behaviours known to be associated with improved patient safety. The findings of this study will greatly assist in the future design and implementation of targeted and cost-effective patient safety improvement initiatives.

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Nsibande, Duduzile. "Assessment of the uptake of referrals by community health workers to public health facilities in Umlazi, Kwazulu-Natal". Thesis, University of the Western Cape, 2011. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_2920_1367481376.

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Background: Globally, neonatal mortality (i.e. deaths occurring during the first month of life) accounts for 44% of the 11 million infants that die every year (Lawn, Cousens &
Zupan, 2005). Early
detection of illness and referral of mothers and infants during the peri-natal period to higher levels of care can lead to substantial reductions in maternal and child mortality in developing
countries. Establishing effective referral systems from the community to health facilities can be achieved through greater utilization of community health workers and improved health seeking
behaviour. Study design: The Good Start Saving Newborn Lives study being conducted in Umlazi, KwaZulu-Natal, is a community randomized trial to assess the effect of an integrated home
visit package delivered to mothers during pregnancy and post delivery on uptake of PMTCT interventions and appropriate newborn care practices. The home visit package is delivered by community health workers in fifteen intervention clusters. Control clusters receive routine health facility antenatal and postpartum care. For any identified danger signs during a home visit,
community health workers write a referral and if necessary refer infants to a local clinic or hospital. The aim of this study was to assess the effectiveness of this referral system by describing
community health worker referral completion rates as well as health-care seeking practices and perceptions of mothers. A cross- sectional survey was undertaken using a structured
questionnaire with all mothers who had been referred to a clinic or hospital by a community health worker since the start of the Good Start Saving Newborn Lives Trial. Data collection: Informed consent was obtained from willing participants. Interviews were conducted by a trained research assistant in the mothers&rsquo
home or at the study
offices. Road to Health Cards were reviewed to confirm referral completion. Data was collected by means of a cell phone (mobile researcher software) and the database was later transferred to Epi-info and STATA IC 11 for analysis.
Descriptive analysis was
conducted so as to establish associations between explanatory factors and referral completion and to describe referral processes experienced by caregivers. Significant
associations between categorical variables were assessed using chi square tests and continuous variables using analysis of variance. Results: A total of 2423 women were
enrolled in the SNL study and 148 had received a referral for a sick infant by a CHW by June 2010. The majority (95%) of infants were referred only once during the time of enrolment, the
highest number of which occurred within
the first 4 weeks of life (62%) with 22% of these being between birth and 2 weeks of age. Almost all mothers (95%) completed the referral by taking
their child to a health facility. Difficulty in breathing and rash accounted for the highest number of referrals (26% and 19% respectively). None of the six mothers who did not complete referral recognised any danger signs in their infants. In only 16% of cases did a health worker give written feedback on the outcome of the referral to the referring CHW.
Conclusion: This study found
high compliance with referrals for sick infants by community health workers in Umlazi. This supports the current primary health care re-engineering process being undertaken by the South
African National Department of Health (SANDOH) which will involve the establishment of family health worker teams
including community health workers. A key function of these workers will
be to conduct antenatal and postnatal visits to women in their homes and to identify and refer ill children. Failure of mothers to identify danger signs in the infant was associated with
non-completion of referral. This highlights the need for thorough counseling of mothers during the antenatal and early postnatal period on neonatal danger signs which can be reinforced by
community health workers. Most of the referrals in this study were
neonates which strengthens the need for home visit packages delivered by community health workers during the antenatal
and post-natal period as currently planned by the South African National Department of Health.Recommendations: This study supports the current plans of the Department of Health for greater involvement of CHWs in Primary Health Care. Attention should be given to improving communication between health facilities and CHWs to ensure continuity of care and greater
realization of a team approach to PHC.

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Ozano, K. A. "Mind the gap! : an investigation into the optimisation of public health skills, knowledge and practices of health workers in Cambodia". Thesis, Liverpool John Moores University, 2017. http://researchonline.ljmu.ac.uk/6975/.

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Universal health coverage (UHC) has been identified as a priority in the sustainable development goals (SDG3), but it is argued here that this is only possible if the health workforce is educated in, and values a public health approach at the primary health care (PHC) level. Encouraging community participation by developing a critical awareness of the social determinants of health and supporting communities to take action is needed. Community health workers (CHWs) have the potential to act as agents for social change to improve the health of rural communities if trained and supported appropriately. This study investigates the optimization of public health skills, knowledge and practices of health workers at the PHC level in rural Cambodia. It is anticipated that this study will afford new insights to inform stakeholders of the factors impacting on the development of public health workforce capacity. The research engaged twenty CHWs over two studies using a participatory action research approach. Over eight participatory workshops and a two-day training session CHWs identified (using photovoice), implemented and reflected on solutions to community health problems. In addition, ten semi-structured interviews were undertaken with key stakeholders from government and non-government organisations (NGOs) to gain an understanding of current methods used to develop the public health capacity of health workers in Cambodia. The public health skills gaps identified at provincial and community levels included planning, communication, community engagement techniques and using initiative to identify and implement solutions. These gaps are intrinsically linked to Cambodian social and political structures, and cultural values which promote a hierarchical working environment. In addition, aid dependency and a lack of ownership has created a new patronage which encourages further disempowerment and an apathetic approach to independently tackling community health issues. Fragmented public health training mainly directed by international agents and a lack of financial support to develop sustainable training, supervision and monitoring negatively impacts public health skill development. Health promotion and prevention training is provided to health facility workers, but there is a ‘know-do’ gap. They view their role as purely curative and removed from the community public health agenda, thus devaluing the application of new public health skills. The implementation of community participation policies in Cambodia is hindered by a reliance on external agencies and cultural norms of respect, obedience and fear of challenging the elite. The capacity for CHWs to act as agents of social change is unlikely given the current policy structure and implementing environment. The health workforce in Cambodia has the potential to contribute significantly to the goal of UHC, however factors affecting their desire and ability to implement a public health approach need addressing. Although many health systems are hierarchical in nature, the degree to which people can innovate, openly analyse processes and procedures and suggest solutions needs to be considered. Identifying ways of supporting CHWs to mobilise and enable communities to be empowered within the contextual environment is required, as is a better understanding of how to close the know-do gap in health facility workers.

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Day, Nancy Ann 1953. "Subjective sleep characteristics of night shift workers". Thesis, The University of Arizona, 1990. http://hdl.handle.net/10150/291336.

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A descriptive design was used to study the subjective sleep characteristics of permanent night shift workers, examine the validity and reliability of the Visual Analog Sleep (VAS) Scales, and to compare the scores to a previously tested non night shift working sample. The VAS Scales, which employ a visual analog format to measure subjective perceptions of sleeps were reworded slightly to apply to this population, giving rise to the VAS/NS (Night Shift) Scales. A sample of 40 night shift workers completed the VAS/NS Scales on two separate days. Descriptive and inferential statistics were used to evaluate this data. The VAS/NS Scales evidence good internal reliability. The factors remained essentially the same with some changes for this sample. The subjective experience of sleep was significantly different from the non night shift working sample for five of the 13 characteristics tested.

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Kootbodien, Tahira. "The association of depression, impulsivity and suicidal ideation with organophosphate pesticide exposure amongst South African farm workers". Master's thesis, University of Cape Town, 2011. http://hdl.handle.net/11427/10752.

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The objectives were to evaluate the validity and reliability of four neurobehavioral instruments used in the study and to test three models hypothesised as possible causal pathways between OP exposure and depression, impulsive behaviour and suicidal ideation.

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Mediatrice, Barengayabo. "A qualitative study assessing the general health problems of street-based female sex workers in Cape Town". Master's thesis, University of Cape Town, 2012. http://hdl.handle.net/11427/11486.

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Includes bibliographical references.
Generally, sex workers are a socially marginalized group with poor physical health. Within the hierarchy of sex workers, street-based sex workers are at the bottom. Street-based sex workers face different kinds of work experiences and exposure, with varying degrees of health problems. Their health problems are more severe and worse than the other classes of sex workers. Street-based sex workers are subjected to considerable risks of physical abuse, beatings and rape. These impact greatly on their health. This study explored the general health problems of street-based female sex workers. The study was carried out in Cape Town among street-based female sex workers aged 18 years and above. It was cross-sectional, conducted over a period of six months using fifteen (15) in-depth interviews and four (4) focus group discussions. The respondents were non-randomly recruited through the Embrace Dignity Project, whose activities involved sex workers. The study discovered that condom use was inconsistent as a result of financial incentives, condom breakage, violence, rape and non-payment from clients when insisting on condom use. But some respondents were not using condoms at all. The majority of respondents reported stigmatization and discrimination by community members and the police. Most of the respondents do not go for routine and other medical checks. Some respondents were not satisfied with health care provision due to discrimination by providers and long waiting times. Notwithstanding, respondents reported a long list of health problems including: flu, cough, HIV/AIDS, TB, headache, vaginal discharge, itchy vagina, sleeplessness, high blood pressure, fever, heart problems, diarrhoea, sweating at night, arthritis, diabetes, alcoholic problems, bad breath, sore throat, and mouth rash. Physical and psychological problems were also mentioned. Most respondents rated their health status as bad. The illegality of sex work in South Africa pushes sex workers to practice the trade in obscure places making them very vulnerable. Street-based female sex workers have numerous general health problems, but with limited access to health services. The law does not also help the course of street-based female sex workers. There is an urgent need to partially criminalize sex work. Reorientation and education of sex workers and providers is also required. All these will help promote the welfare of sex workers.

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Temmers, Lynette. "Factors influencing the collaboration between community health workers and the public primary health care facilities in delivering primary health care services". University of Western Cape, 2019. http://hdl.handle.net/11394/7655.

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Master of Public Health - MPH
Community health workers (CHWs) are integral to improve Primary health care (PHC) coverage, utilising their unique skills within the community to make services accessible and equitable. PHC is the cornerstone of the National Health Insurance (NHI) Bill for the provision of Universal Health Care (UHC). The Department of Health (DOH) in the Western Cape, South Africa, has set priorities and requirements for the provision of funding to Non-profit organisations (NPOs) for forming coalitions with the Health Department to deliver various aspects of health care. The post-2015 agenda of the Sustainable Development Goals (SDGs) are underscored by a strong sense of intersectoral collaboration to work together to attain sufficient and sustainable progress. Collaboration between CHWs and PHC facilities is important in aligning goals and activities to ensure a comprehensive and sustainable approach to ensuring UHC

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Erlank, Lara. "Understanding South African herbicide workers’ residual take-home exposure risks from personal protective equipment cleaning and storing practices". Master's thesis, University of Cape Town, 2018. http://hdl.handle.net/11427/29322.

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Exposure to pesticides has been associated with several adverse health effects. When workers who spray pesticides take contaminated Personal Protective Equipment (PPE) and work clothes home, those items pose a risk of cross-contamination. Agriculture employers are recommended to make facilities available for workers to clean and store contaminated items at the workplace to reduce the risk of cross-contamination. However, little research has been conducted on forestry workers, for whom at-work cleaning and storage facilities may be less feasible. Working for Water (WfW) is a South African programme that focuses on removing invasive alien vegetation and alleviating poverty through providing job opportunities to unemployed individuals in low-income settings. WfW forestry workers use herbicides to remove the invasive vegetation. Unlike agricultural workers, WfW forestry workers undertake projects that are transient and tend to be on mountainous or steep terrain. The work environment poses challenges for at-work access to amenities or facilities to clean and store contaminated PPE. Workers have few alternatives but to take contaminated items home. WfW safety protocols do not currently address the risks associated with take-home residues or indicate how workers should clean and store contaminated items. This study is part of a larger project focusing on developing protocols to reduce the risks of cross-contamination and exposure to residues. This dissertation provides baseline data for improved WfW safety protocols through the exploration of workers’ at-home risks of cross-contamination, and the role that worker perceptions and access to amenities have on cleaning and storing behaviors for contaminated items. The Protocol (Part A) describes the methods used to collect and analyze the data. The Literature Review (Part B) presents the risks of take-home residues associated with cross-contamination and the importance of exploring workers’ perceptions and access to amenities to promote safety compliance. The Article (Part C) explores WfW workers’ cleaning and storing behaviors, what contaminated items are taken home, the workers’ access to amenities in the home, and the workers’ perceived risk of exposure. Questionnaires were administered to 27 WfW workers across three excavation sites (Tokai, Citrusdal and Hermanus) that were selected based on convenience sampling. Findings showed that most of the participants took contaminated items home daily. Many participants (55.2%) did not have access to running water. Access to running water and type of housing influenced whether the contaminated items were washed indoors or outdoors, and how they were washed. WfW participants who lived in a shack were more likely to leave contaminated items on the couch or bed or with other clothing items than those living in permanent dwellings. Those workers were more likely to keep them in a non-permeable transport bag, outside, or separate drawers away from clean items. The majority of subjects (65.5%) perceived exposure to herbicides as dangerous to their health. The participants’ perceived risk was associated with whether they took contaminated PPE items home, but not how they were cleaned or stored. WfW Safety protocols should emphasize the importance of keeping contaminated items contained and reducing contact with household surfaces or clean clothes. Workers’ cleaning and storing practices and their associated risk of crosscontamination are largely determined by the amenities they have access to. For new safety protocols to be effective, they need to be realistic and take into account the constraints workers face.

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Hubbard, Joyce 1934. "A descriptive study of the developing role of village health workers in a remote Tarahumara pueblo". Thesis, The University of Arizona, 1990. http://hdl.handle.net/10150/277794.

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Six young women from a remote Tarahumara pueblo are functioning as village health workers. Through qualitative research techniques informed by symbolic interactionism, the investigator has sought to determine what it is like for these women living in a pre-Columbian society to develop this new role. Some issues guiding the research were; education, families' reactions to the new role, perceived changes in the health status of the pueblo and current attitudes of village health workers toward their new role. Although it was difficult for these women to respond to abstract questions regarding their feelings and emotions, rich descriptive data emerged outlining the women's perceptions of the village health worker role and its effects on their families and the community. The major themes that emerged during this research were; "wanting to learn more;" "less sickness and death among children;" "personal hygiene has changed lives;" and "medicine is gaining acceptance."

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Janssen, Leah M. ""It Hits Me Right Here at My Heart": Understanding Emotional Health of Home Care Workers". Miami University / OhioLINK, 2021. http://rave.ohiolink.edu/etdc/view?acc_num=miami1625570058999724.

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Darbha, Subrahmanyam. "Reproductive Health Trends In Female Sex Workers In Madagascar". The Ohio State University, 2011. http://rave.ohiolink.edu/etdc/view?acc_num=osu1309360596.

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Stuart, Rhonda Lee 1963. "Nosocomial tuberculous infection : assessing the risk among health care workers". Monash University, Dept. of Epidemiology and Preventive Medicine, 2000. http://arrow.monash.edu.au/hdl/1959.1/9004.

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Purnell, Melissa T., i n/a. "Sleep, alertness, performance and fatigue management in extended duration and irregular night shift workers". University of Otago. Dunedin School of Medicine, 2005. http://adt.otago.ac.nz./public/adt-NZDU20061030.085607.

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Extended duration and irregularly planned overnight shifts are becoming frequent features of current working time arrangements. However, there is great concern about the detrimental effect that these shifts are likely to have on the sleep, performance and fatigue levels of workers. To date, the empirical evidence regarding the effects of extended and irregular overnight shifts is sparse and workers have rarely been followed up longer term to assess possible changes over time. Because these types of overnight shifts are being introduced into transport settings such as aviation and shipping where safe and productive operations are paramount, there is a real imperative to examine and trial workplace-based methods aimed at counteracting night shift related fatigue and performance deficits. Taking short duration naps on the nightshift at work is one potential countermeasure that has shown promise in the laboratory but has yet to be examined in any real-world setting under conditions of extended duration or irregular night work. This thesis takes up these issues in a series of four empirical workplace-based studies. The impact of the introduction of regularly planned 12 h day and overnight shifts was examined on three occasions via questionnaire in a group of aircraft maintenance engineers, once before the change, and twice after the change from 8 h shifts. The results showed that high levels of acute fatigue on the 12 h night shifts and high chronic fatigue levels were common, and were strongly associated with poor overall job performance, poor safety of job performance, and longer recovery times, effects that persisted over time. Of major concern was the finding that over half of the engineers reported having nodded off while driving home from their extended overnight shifts. The impact of irregularly planned 8 h overnight shifts worked by cargo handlers in a shipping container terminal was also examined via self-report questionnaire. The findings revealed significant detrimental impacts on sleep, fatigue levels and performance at work. High fatigue levels were strongly associated with poor self-rated performance output and safety of performance at work on the overnight shifts. The primary focus of this thesis was to evaluate the effect of a scheduled 20 min nap opportunity taken in these two fully operational workplaces during the night shift on sleep, performance and alertness. Sleep was achieved by 50 to 59% of workers. Speed of performance in 24 male aircraft maintenance engineers on a vigilance task was significantly faster at the end of a 12 h overnight shift that had contained sleep during the nap compared to the control condition. There was no such effect of the nap on the performance of 22 cargo handlers working impromptu 8 h shifts in a shipping container terminal. However, the duration of sleep obtained by the 8 h workers was shorter in comparison and was likely to have been undermined by the high noise levels around the nap facility and time pressures related to the organisation of work. Actigraphy data recorded from all subjects showed that subsequent daytime sleep was not disrupted by the night shift nap opportunity. Overall, the most interesting findings were that simply being tired and presented with a sleep opportunity during the night shift did not guarantee either sleep, or recovery but that sleep, as opposed to rest, was necessary for the benefits to performance to be fully realised. These findings have shown for the first time that management of fatigue associated with extended duration night work can be achieved in some instances by the use of a short duration nap taken in the workplace on the night shift. However, operationalizing in-situ napping on the night shift has a range of organisational influences that must be considered for the potential of such a strategy to be fully harnessed.

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Yusuf, Abass Babatunde. "Adherence to ART among HIV Infected Female Sex Workers in Nigeria". ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7524.

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A lack of adherence to antiretroviral therapy (ART) increases the risk of onward human immunodeficiency virus (HIV) transmission and mortality. The purpose of this cross-sectional study based on Andersen's conceptual framework was to test the associations between age, marital status, job/occupational status, education, membership in a peer support group, community, and facility ARV drug refill and alcohol and substance use, and adherence to ART among female sex workers (FSWs) who are 15 years and older in Rivers and Cross Rivers states Nigeria. Data were abstracted from existing program data collected between January 2015 and December 2017 by Heartland Alliance International, Nigeria. Results from chi-square statistics showed that age, job/employment, and marital status were not associated with adherence to ART. Binary logistic regression analyses showed that respondents with senior secondary education were 1.385 times more likely to adhere to ART than other education levels (OR = 1.385, 95% CI = 1.203, 1.593). Respondents who had ARV refill in the facility were 1.737 times more likely to adhere to ART than respondents who had community ARV refill (OR= 1.737, 95% CI: 1.297, 2.326). Also, respondents who were a member of a support group were 6.430 times more likely to adhere to ART compared to those not in a support group (OR= 6.430, 95% CI: 4.682, 8.831). Lastly, respondents who did not abuse alcohol or substance were 1.820 times likely to adhere to ART compared to those who did (OR= 1.820, 95%: CI: 1.356, 2.444). All-inclusive key population policies could aid in lessening the barriers the FSWs face in receiving comprehensive health services as well as endorsing interventions such as alcohol and drug rehabilitation, counseling, and incentives to join peer support groups that could benefit FSWs, their clients, and families.

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Chan, Yuen-yan, i 陳遠欣. "Job satisfaction, stress and mental wellbeing of health care workers in a regional public hospital". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2012. http://hub.hku.hk/bib/B48422502.

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Introduction: Amongst all public servants in Hong Kong, health care workers are one of the groups suffering from highest working pressure. They have long working hours and may have overnight shift duties, including Sundays or even public holidays. This may lead to poor job satisfaction, psychological stress and the recent high resignation rate in public hospitals. The aim of this study is to assess the prevalence of the psychological stress, psychological symptoms and job satisfaction of health care workers, the association between stress, psychological symptoms and job satisfaction; and also the factors associated with job satisfaction in a regional hospital in Hong Kong. Method: Health care workers in a large regional hospital of Hong Kong were surveyed by means of a questionnaire assessing basic demographic data, questions of the General Health Questionnaire (GHQ-12), Perceived Stress Scale (PSS), Warr-Cook and Wall job satisfaction scale (JSS). Four groups of health care workers (doctors, nurses, allied health workers and supporting staffs) were surveyed. Summary of descriptive statistics were calculated for each group to compare the prevalence of job dissatisfaction, perceived stress, and psychological symptoms. Two-stage analysis will be used. The first stage analysis will use ANOVA test to access the association between job satisfaction and different variables. The second stage analysis will use multivariate regression model to further assess the coefficient correlation of significant factors drawn from ANOVA test with job satisfaction. Results: There were 674 eligible questionnaires. About half (47%) of the health care workers reported having perceived stress and a third (33.8%) psychological symptoms. Doctors reported the (76.8%, 95% C.I = 69.43%, 84.17%) highest level of job satisfaction amongst all the health care workers surveyed. Among staff reporting a GHQ score equal to or more than three, supportive staff had significantly higher prevalence (38.7%, 95% C.I.=27.96%, 49.44%) and doctors the lowest prevalence (28.1%, 95% C.I.= 15.11%, 41.09%) of psychological symptom but proportions were compatible with their counterparts in other countries. The mean score for GHQ-12 was 2.41+/- S.D. 3.28. The overall mean perceived stress score was 18.14 with SD +/- 5.0. There was no significant difference when different subgroups were compared. The mean PSS scores of all subgroups were lower than their counterparts in other counties but were quite similar to the mean PSS reported during SARS period. Sixty eight percent of all health care workers surveyed were satisfied with their job (respondents indicating “moderately satisfied”, “very satisfied” and “extremely satisfied” on their overall job satisfaction). Values equal to or above 5 reflect being satisfied. The mean value for Job satisfaction was 4.58 +/-S.D. 1.21. The factors including shift duty, perceived stress, and psychological symptoms were negative correlated with job satisfaction. Factors such as clinical work, doctor and secondary school level were positive correlate with job satisfaction. Conclusion: Prevalence of perceived stress and psychological symptoms among health care workers were high when compared with the general population (14-17.6% for perceived stress and 28.1% for psychological symptom), but not as high as expected. In contrast to popular belief, doctors had the lowest perceived stress level, lowest prevalence of psychological symptom and the highest job satisfaction among different groups of health care workers. This may be related to higher income, social status and, education background that might help to protect them from depression and anxiety. Supportive staffs, who felt neglected by management, were found to have the highest prevalence of psychological symptom and higher stress levels. Nurses got highest prevalence of perceived stress. More attentions and resources should be devoted to these groups to cope with their psychological needs and stress.
published_or_final_version
Public Health
Master
Master of Public Health

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Mariana, Monica Utari. "Key Success Factors of Community Health Workers Program in Garut, Indonesia : An investigation of community health workers’ experience regarding the implementation of Saving Next Generation Institute program". Thesis, Uppsala universitet, Institutionen för kvinnors och barns hälsa, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-397035.

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Aim: This study aims to investigate the experience of Indonesian community health workers (CHW) particularly in the aspect of motivation, advantages gained, obstacles and challenges related to the implementation of Saving Next Generation Institute (SNGI) program in Garut, Indonesia Methods: This study is a qualitative study. Semi-structured interviews were conducted with ten (10) community health workers who were enrolled in the program. Data were analyzed by using thematic analysis. Findings: The study reveals that the participating CHWs have positive experiences with the program. Respondents were motivated to gain comprehensive knowledge and skills from joining the program to serve their community better. Also, the CHWs acknowledged their getting more empowerment, skill-building, positive communication, self-satisfaction, and recognition from the program compared to the state program. Conflicts among the CHWs, the sustainability of the program, and the types of incentives such as transport fees and material incentives were mentioned to be the challenges in the program. Conclusion: This study substantiates what CHWs’ consider points of importance from the program. Points included are sharing synchronous common goals between CHWs and the program, having identified and appropriate program which meets the CHWs’ needs, having positive communication with all stakeholders and having suitable incentives. Findings from this study should be considered an insight for both non-state actors and the Indonesian government to ensure future improvement and program upscaling. Future research might expand to analyzing the dynamics of state and non-state interaction and organizational behavior which highlights communication among stakeholders in the program.

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Jalal, Nafeesa. "Agricultural migrant workers navigating the health system: Access, continuity of care and the role of community health workers in De Doorns, Western Cape". University of the Western Cape, 2018. http://hdl.handle.net/11394/6362.

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Philosophiae Doctor - PhD (School of Public Health)
South Africa has an estimated two million documented and undocumented immigrants. In addition, Statistics South Africa (2014) notes very significant internal migration. This mobile population is affected by chronic communicable and non-communicable diseases such as TB, HIV, and diabetes, although it has a Constitutional right to health and healthcare. Their quality of healthcare and disease control also affects the general population and the burden on the health system can be increased by inadequately managed chronic conditions as well as acute health care needs. Access to healthcare and continuity of care reflect both patient agency and the health system. Community Health Workers (CHWs) play an important role in linking communities and patients to health services and vice versa. The aim of this study was to understand how agricultural migrants in the Cape Winelands District of Western Cape Province of South Africa navigated the healthcare system to access healthcare services including securing continuity of care, and in particular the role of CHWs in this process, in order to inform policy and practice.

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Siemon, Mark. "The impact of state certification of community health workers on team climate among registered nurses in the United States". Thesis, The University of New Mexico, 2014. http://pqdtopen.proquest.com/#viewpdf?dispub=3630354.

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A number of states have adopted certification programs for community health workers (CHWs) to increase oversight, allow for direct funding, and improve recognition of CHWs as members of the health care team. More states are considering CHW certification programs to increase the use of CHWs by health care organizations with the hopes of improving health outcomes and decreasing health disparities. There has been little research into the impact of state CHW certification on the adoption and dissemination of CHWs into the existing health care system. This study examined the impact of state CHW certification on the perceptions of team climate among registered nurses (RNs) who work with CHWs in states with and without CHW certification programs. Team climate is defined as the perceptions of team members on how they work together, share a single vision, are open to new ideas, and if they feel safe and supported by other team members. This study recruited RNs using an online purposeful sampling method to compare the perceptions of team climate using the Team Climate Inventory (TCI) short-form. The study found no significant differences in the overall mean TCI score or TCI subscale scores between RNs who work in states with CHW certification programs (n = 81) and those who work in states without CHW certification programs (n = 115). There was a significant difference in one survey question on the RNs views of whether state certification of CHW improved the ability of their health care team to deliver quality care. Further analysis of the results using multiple regression found few significant predictors of overall TCI and TCI subscale scores among the independent variables used in the regression models. Registered nurses are the largest part of the professional health care workforce, and their ability to collaborate and work with CHWs is critical to the integration of CHWs into existing health care organizations. More research on the impact of state certification of CHW and the factors that influence the adoption of innovative health care delivery methods is needed to meet the national goal of eliminating health disparities and improving health in minority and underserved populations.

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Hughes, Roger, i n/a. "Public Health Nutrition Workforce Development: An Intelligence-Based Blueprint for Australia". Griffith University. School of Health Science, 2004. http://www4.gu.edu.au:8080/adt-root/public/adt-QGU20040615.120233.

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Public health nutrition workforce development is a capacity building strategy identified as a priority in the Australian National Public Health Nutrition Strategy (Eat Well Australia). Systematic and scholarly approaches to workforce development that enhance the capacity of the health system and the broader community to effectively address public health nutrition issues, are limited in Australia. The associated lack of intelligence and a range of methodological difficulties similar to those encountered in broader public health workforce research, provide the need for, and motivation for, this study. The specific objectives of this study relate to the development of workforce development intelligence that: Fills gaps in the knowledge base to inform effective workforce development ; Provides baseline data (benchmarks) for ongoing workforce development planning, evaluation, monitoring and surveillance ; and, Contributes to international scholarship regarding public health nutrition workforce development ; and, Enables the development of a strategic framework for workforce development planning in the national context. The case study research strategy used in this study involved an emergent, multi-method design involving methodological triangulation of data and consensus development. The focus of inquiry was based on a problem-based conceptual framework developed to identify intelligence needs for workforce development strategy planning. Quantitative and qualitative data were collected using five different methods including literature review, interviews with advanced-level public health nutritionists in Australia, a national public health nutrition workforce survey, an analysis of position descriptions and consensus assessment and development via a Delphi survey of an international expert panel. The collection, analysis and interpretation of data in this study focused on developing an intelligence base on six main issues pertinent to public health nutrition workforce development, including: Definitions of public health nutrition; Workforce size and composition; Workforce practices; Core workforce functions needed; Competencies required for effective public health nutrition practice; and, Continuing competency development needs. Data from these multiple methods were used to describe and interpret the determinants of workforce capacity, assisted by triangular analysis. This analysis identified a range of determinants limiting the capacity of the Australian public health nutrition workforce including; A small designated specialist public health nutrition workforce; Workforce instability associated with unsecured funding and staff turnover; Limited collaboration and partnership building practices by the existing workforce; Disorganisation of the workforce in terms of location, accountability, service mandates and support; Workforce practices are not consistent with the required work; Limited access to, and use of, public health nutrition intelligence; A workforce practice culture that does not promote research and dissemination; A lack of practice improvement and learning systems; Limited access to public health nutrition mentors; Limited incentives for practice excellence; An absence of consensus about the required work and competencies required for effective public health nutrition practice; Barriers to continuing competency development; and, Inadequate workforce preparation. This interpretive analysis provided the basis for developing a strategic framework that addresses workforce quantity, quality and performance concerns, based on workforce development strategy categories including: Building human resource infrastructure (quantity); Organisational systems and policy (performance); Intelligence support (performance); Learning systems (quality) and; Workforce preparation. This research has also provided data that can for the basis of tools such as definitions, core function statements, position descriptions and competency standards to assist public health nutrition workforce development in Australia and internationally.

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Hughes, Roger. "Public Health Nutrition Workforce Development: An Intelligence-Based Blueprint for Australia". Thesis, Griffith University, 2004. http://hdl.handle.net/10072/366114.

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Public health nutrition workforce development is a capacity building strategy identified as a priority in the Australian National Public Health Nutrition Strategy (Eat Well Australia). Systematic and scholarly approaches to workforce development that enhance the capacity of the health system and the broader community to effectively address public health nutrition issues, are limited in Australia. The associated lack of intelligence and a range of methodological difficulties similar to those encountered in broader public health workforce research, provide the need for, and motivation for, this study. The specific objectives of this study relate to the development of workforce development intelligence that: Fills gaps in the knowledge base to inform effective workforce development ; Provides baseline data (benchmarks) for ongoing workforce development planning, evaluation, monitoring and surveillance ; and, Contributes to international scholarship regarding public health nutrition workforce development ; and, Enables the development of a strategic framework for workforce development planning in the national context. The case study research strategy used in this study involved an emergent, multi-method design involving methodological triangulation of data and consensus development. The focus of inquiry was based on a problem-based conceptual framework developed to identify intelligence needs for workforce development strategy planning. Quantitative and qualitative data were collected using five different methods including literature review, interviews with advanced-level public health nutritionists in Australia, a national public health nutrition workforce survey, an analysis of position descriptions and consensus assessment and development via a Delphi survey of an international expert panel. The collection, analysis and interpretation of data in this study focused on developing an intelligence base on six main issues pertinent to public health nutrition workforce development, including: Definitions of public health nutrition; Workforce size and composition; Workforce practices; Core workforce functions needed; Competencies required for effective public health nutrition practice; and, Continuing competency development needs. Data from these multiple methods were used to describe and interpret the determinants of workforce capacity, assisted by triangular analysis. This analysis identified a range of determinants limiting the capacity of the Australian public health nutrition workforce including; A small designated specialist public health nutrition workforce; Workforce instability associated with unsecured funding and staff turnover; Limited collaboration and partnership building practices by the existing workforce; Disorganisation of the workforce in terms of location, accountability, service mandates and support; Workforce practices are not consistent with the required work; Limited access to, and use of, public health nutrition intelligence; A workforce practice culture that does not promote research and dissemination; A lack of practice improvement and learning systems; Limited access to public health nutrition mentors; Limited incentives for practice excellence; An absence of consensus about the required work and competencies required for effective public health nutrition practice; Barriers to continuing competency development; and, Inadequate workforce preparation. This interpretive analysis provided the basis for developing a strategic framework that addresses workforce quantity, quality and performance concerns, based on workforce development strategy categories including: Building human resource infrastructure (quantity); Organisational systems and policy (performance); Intelligence support (performance); Learning systems (quality) and; Workforce preparation. This research has also provided data that can for the basis of tools such as definitions, core function statements, position descriptions and competency standards to assist public health nutrition workforce development in Australia and internationally.
Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School of Health Sciences
Full Text

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Sherry, Kate. "Occupations of citizenship : the missing layer in empowered engagement between rural people with disabilities and primary healthcare workers in South Africa". Doctoral thesis, University of Cape Town, 2016. http://hdl.handle.net/11427/20370.

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Background: People with disabilities in impoverished rural areas of South Africa struggle to access healthcare, despite the right to health established by the Constitution and the United Nations Convention on the Rights of Persons with Disabilities. Health system challenges and structural conditions of poverty impact this group in specific ways, with implications for households and communities that are not well understood. To date, health systems research and design have largely omitted disability considerations. Primary health care (PHC) calls for community engagement with health systems, to voice local needs, influence service provision, and hold providers to account. However, current models of community engagement rely on certain political, social and economic conditions, which are not present for rural people with disabilities in South Africa. Purpose: This study sought to understand the existing engagement between rural people with disabilities and healthcare workers in the PHC interface, and thus to theorise how this could be strengthened for more responsive and equitable services.

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Zembe, Yanga. "Community participation in the recruitment of community health workers :a case study of the three community health worker programmes in South Africa". Thesis, University of the Western Cape, 2009. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_7266_1299058637.

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This research investigates the nature and extent of community participation and involvement in the recruitment and selection processes for Community Health Workers (CHWs), primarily through detailed case studies of three CHW programmes, one in the Western Cape, another in KwaZulu-Natal, and a third which operates in the Western Cape and KwaZulu-Natal. The first utilizes CHWs in health education and home-based care in Khayelitsha and Nyanga. The second specializes in the training, management and supervision of home-based care CHWs in the rural areas of KwaZulu-Natal. The third utilizes CHWs in addressing maternal and child health issues in targeted peri-urban and rural areas in the three provinces. The mini-thesis is organized into five chapters: the first chapter provides the introduction and background as well as the methodological design of the mini-thesis
the second chapter focuses on providing a detailed literature review of relevant materials that cover the subject matter
the third chapter provides the descriptive background of the history of CHWs, CHW policies and community participation in South Africa, as well as a description of the three case study organizations
the fourth chapter describes and discusses the findings and the last and fifth chapter provides a summary of the findings as well as recommendations and conclusions.

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Helmy, Hannah Louise. "Situating Contraceptive Practices and Public Health Strategy in the Bronx: Perspectives from Female Youth, Healthcare Workers, and Reproductive Health Leaders". Scholar Commons, 2015. http://scholarcommons.usf.edu/etd/5698.

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In the United States, concerns about adolescent childbearing and its perceived corollaries – negative health outcomes for mother and child, the disintegration of the nuclear family, and “over-dependence” on public resources – began to circulate widely in policy spheres and popular media in the 1970’s, resulting in a proliferation of policies, programs, and services designed to address its prevention. Although national birth rates among adolescents are currently at their lowest since peaking in the early 1990’s, this decline masks persistent and significant disparities between groups of young people by race, ethnicity, geography, and poverty level. The concomitant existence of social and economic inequities that contribute to these differences is particularly striking in New York City; an urban center of vast extremes in health, wealth, and opportunity, but which boasts extensive reproductive health services for young people, including confidential care and availability of free or low-cost contraception. Within this setting, the promotion of hormonal and long-acting reversible contraceptive methods, specifically aimed at young women deemed at high risk of pregnancy and with less access to health care, has emerged as a key primary prevention strategy to reduce both overall adolescent pregnancy rates and disparities between adolescent groups. Using ethnographic methods, this research examined the promulgation and interpretation of this strategy by reproductive health leaders and healthcare workers as well as contextualized these perspectives with the reproductive decisions and fertility desires of female youth for whom this strategy is intended. As a result, this study elucidates broader political and socio-cultural contexts in which young women negotiate intimate relationships and contraceptive use. Recommendations are subsequently offered for clinical practices attuned to female youths’ lived experiences, educational programs for healthcare workers, and reproductive health policies reflective of the broader factors that influence contraceptive behaviors.

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Talat, Rehab. "Healthcare for Undocumented Workers in France and The United States". Wright State University / OhioLINK, 2014. http://rave.ohiolink.edu/etdc/view?acc_num=wright1403691584.

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