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1
Nnajiofor, Chinyere Fidelia. "HIV/AIDS-Related Stigma and Discrimination Toward Women Living With HIV/AIDS in Enugu, Nigeria." Thesis, Walden University, 2016. http://pqdtopen.proquest.com/#viewpdf?dispub=10143549.
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HIV/AIDS-related stigma and discrimination (S&D), lack of social support, poverty, and gender inequalities have been identified as factors in the increased prevalence rate of HIV transmission in Enugu, Nigeria, especially among women ages 15 to 49 years. Despite the funding of reduction programs, HIV/AIDS-related S&D remain a major driving force in the increased rate of new HIV cases in Enugu. This study addressed a perceived need for behavioral change intervention approaches that span all societal factors to reduce the HIV infection rate in Enugu Nigeria. The study was guided by Goffman’s (1963) social S&D theory. The sample was composed of 132 women living with HIV/AIDS WLWHA ages 21 to 54 years, purposefully sampled from the 4 HIV and AIDS comprehensive initiatives care centers in Enugu, Nigeria. Fifteen WLWHA were interviewed and 114 participated in an online survey. The descriptive statistics and a multiple linear regression analysis and comparison revealed a convergent significant relationship between the S&D determinants (social, political, psychological, environmental, and cultural) and HIV/AIDS-related S&D towards WLWHA in Enugu F (4,109) = 45.09, p <.001). It also revealed that the cultural determinant of S&D was a significant predictor of HIV/AIDS-related S&D towards WLWHA in Enugu (? = 0.81, p < 0.001). The implications for positive social change include providing public health professionals evidence-based data to inform policy change, plan and to implement programs that will change societal attitudes and mobilize broad-based community actions to eradicate HIV/AIDS–related S&D toward WLWHA in Enugu, Nigeria, and in Sub-Saharan African Countries.
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Blanchard, Janice C. "Discrimination and health care utilization." Santa Monica, CA : RAND, 2006. http://www.rand.org/pubs/rgs_dissertations/RGSD198/.
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Mokoboto, Dipalesa. "The impact of dual loyalty on health care practitioners' decisions." Diss., University of Pretoria, 2019. http://hdl.handle.net/2263/76725.
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While ethical codes have been established for practitioners, there is a possibility that dual loyalty affects occupational medical practitioners’ (OMPs) decisions in determining fitness status of employees. Literature indicates dual loyalty of OMPs leads to ethical dilemmas. The study’s main objective is to determine if dual loyalty participates in OMPs’ decisions and influences OMPs to breach medical ethics required in their profession, resulting in employees unfairly losing their jobs.
The study interrogates literature review on dual loyalty and adopts a multi-layered approach focussing on the Constitution; relevant Acts and guidelines; case law and ethical principles. Case studies from the Medical Inspector’s archives are interrogated to determine the influence dual loyalty has on OMPs’ decision-making.
Case law indicates that conflict of interest is the source of dual loyalty. Occupational medical practitioners have fiduciary duties and need to serve the best interests of the employees. From case studies discussed, the study shows that OMPs are affected by dual loyalty and tend to disregard medical ethics. They may be conflicted when making decisions concerning employees’ fitness to work, especially when individualised assessments are not conducted.
A guideline addressing ethical obligations and human rights should be drafted for OMPs, guiding them on dealing with dual loyalty. Employers will need awareness training in various institutions so that OMPs are supported and encouraged to have sound medical ethics. This will promote best practice in doctor-patient relationships, avoiding dual loyalty dilemmas.Mini Dissertation (MPhil)--University of Pretoria, 2019.
Public Law
MPhil
Unrestricted
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Sinclair, Andrew James, and n/a. "The primary health care experiences of gay men in Australia." Swinburne University of Technology, 2006. http://adt.lib.swin.edu.au./public/adt-VSWT20060713.084655.
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The present research, consisting of two studies, was designed to examine the
primary health care experiences of gay men in Australia and assess doctors? attitudes and
training with regard to gay men and their health care. In the first study, 195 gay men were
surveyed regarding their health issues and their primary health care experiences. The
most important health concerns of gay men were stress and depression followed by
HIV/AIDS, body image disorder and other sexually transmissible infections. Including
those participants who were unsure, approximately one-half reported experiencing
homophobia and almost one?quarter reported experiencing discrimination in the
provision of health care. Despite this, respondents were generally satisfied with their
primary health care, although respondents felt that all GPs should receive additional
undergraduate medical education regarding gay men?s health. In the second study, 25
doctors (13 gay specialists and 12 non-gay specialists) were surveyed regarding their
knowledge of gay men?s health and their comfort working with gay men. Non-gay
specialist GPs were less comfortable treating gay men, reported poorer communication
and were more homophobic than their gay specialist counterparts. Further, doctors
perceived their medical education regarding gay men?s health has been inadequate.
Together, the results of the two current studies suggest that disclosure of sexuality is an
important issue for both gay men and doctors, and has the potential to impact on the
quality of health care that gay men receive. In order to improve the level of disclosure,
the pervasiveness of homophobia and discrimination in primary health care must be
reduced. Finally, the results indicate that medical education must be updated to reflect
current knowledge regarding the health issues of gay men. Failure to address these issues
will condemn gay men to continued health inequality.
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Prempreeda, Pramoj Na Ayutthaya Pimpawun Boonmongkon. "Fluidity of Thai queer sexualities and their experiences of accessing sexual health care /." Abstract, 2007. http://mulinet3.li.mahidol.ac.th/thesis/2550/cd400/4838738.pdf.
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Adindu, Anthonia U. "The effect of incongruity on quality of health information systems : Bama, Nigeria PHC case study." Thesis, University of Hull, 1995. http://hydra.hull.ac.uk/resources/hull:3692.
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Generally, organisations mobilise information from varying sources on which policies, plans, objectives and organisational management are predicated. indeed, everyone within organisation needs information to perform tasks, it is thus indispensable and its use so pervasive that a methodical approach for collection and processing is imperative. In health care organisations, involved with people and life, this is even of greater significance, in many instances allowable margin of error is narrow and can be devastating.Accurate and reliable information in clinical care for example cannot be compromised.On the other hand, adequate assessment of health services quality,effectiveness and efficiency depends on quality of information generated by the system, that is, accurate, relevant, timely, understandable and complete information. To achieve this, appropriate system design and operation is essential. Adoption of primary health care (PHC), in many developing countries in response to the Global 2000, necessitated establishment of chanisms for monitoring and evaluating effectiveness of services and programmes.Accordingly, in 1986 PHC was adopted in Nigeria, concomitantly, system monitoring and evaluation or the PHC Management Information System was effexted.The information system was envisaged to ameliorate the lack of reliable health information that has persisted since nception of modern health services in Nigeria. Findings in this and other studies indicate that existing health information systems have failed to provide accurate and reliable information, systems of data generation and processing are ineffective.The aim of this was to identify and understand factors that have contributed to the seemingly intractable and insalubrious information problem within the Nigerian health care system. It would be a herculean task for a lone researcher to undertake study of the entire health system, within resource and time limitations, data collection was therefore narrowed to the PHC level. Quality of the PHC management information system was assessed, with Bama Local Government as a case study. Focus was on understanding the information system's structure from a broad perspective to include, policies, objectives,established procedures; physical, material and human resources, in terms of their quality and quantity.Data collection was carried out using both qualitative and quantitative techniques. The structure, process and outcome models provided a framework for in-depth data collection, through observation, interview, review of records and administration of questionnaire, as well as for organisation and analysis of research data. The PHC MIS was followed through, from the village, health facility, local government, state and national levels.Study results suggest general ineffectiveness due to pervasive incongruity in the information system. In the first instance design of the MIS did not reflect information needs of community health workers and the community in general,who to the most part limited appreciation of the MIS structure, objectives to be achieved. Local and regional information need was not delineated, data collected had little relevance to local information needs, resource for systems operation was abysmal, skilled personnel and training provided severely inadequate.Consequently, data collection and processing was hampered, information produced often inaccurate, untimely, immense, irrelevant and unreliable. Data collected were neither analysed nor utilised. The information system was short of being integrated since 60% of functional units within the PHC department as well as related health organisations in the community ran parallel information systems.Research data point to serious incongruity in the organisation and management of the information system. Incongruity that resulted from factors within the organisation as well derived from events within the wider social environment, which however culminated in an effective and dysfunctional information system.Chapters one to three of the thesis deal with conceptual issues related to management information systems, organisational design and quality respectively. In chapter four methodological issues surrounding data collection were discussed. Empirical data and analysis are presented are presented in chapters five to seven. In chapter eight, an attempt was made to develop a model of organisational incongruity, applied to explicate research findings.Chapter nine focuses on measures toward establishment of an effective PHC information system in Nigeria, contributions of this study and suggestions for future research.
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Eze, Patience. "Chronic Kidney Disease Awareness and Quality of Care in Abuja Nigeria." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/4054.
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Chronic kidney disease (CKD) is a non-communicable progressive disease that can lead to kidney failure or end-stage renal disease. In Nigeria, many people do not have access to health care due to extreme poverty, which means that those suffering from diabetes or high blood pressure, or both diseases, which have been identified as the 2 main risk factors, may not know their health status. The purpose of this phenomenological study was to explore the level of CKD awareness among Nigerians and if cultural beliefs affect individuals' health seeking behaviors because of the diverse nature of the Nigerian population. The protection motivation theory provided the framework for the study. Data were collected through semi-structured interviews with 14 participants, and data analysis included traditional coding. Findings indicated that CKD awareness in Nigeria is low. The social change implication is that the findings may be used to increase awareness of the CKD mortality and morbidity rate in Nigeria to facilitate the development and implementation of health policies that could lower the morbidity and mortality rate of CKD.
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Smith, Caroline Kristine. "Racial Disparities in a State Based Workers' Compensation System." PDXScholar, 2019. https://pdxscholar.library.pdx.edu/open_access_etds/4831.
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Racial, ethnic, and linguistic minority workers suffer higher rates of work-related injuries and illnesses in the United States compared to their White counterparts. Explanations for these higher rates include potential socioeconomic causes (education, income, and wealth) and occupational segregation into more dangerous occupations. What is less studied are the post-injury sequelae for minority workers, which is their experiences in the workers' compensation system, as well as their health and return to paid employment. What is known comes primarily from qualitative literature, which includes themes of racial discrimination (from employers, health care providers, and workers' compensation employees), a lack of information on how to navigate the workers' compensation system, and linguistically inappropriate communication with those whose first language is not the majority language. In addition, qualitative studies have found differences in the treatment of minority workers, delays in receiving partial wage payments, and worse health outcomes. Most studies examining minority workers in the workers' compensation system have not provided a theoretical framework from which to test hypotheses as to why differences exist in a social insurance system based on race, ethnicity, and language.
The purpose of this dissertation was to test the role of racial discrimination in creating worse post-injury workers' compensation outcomes for minorities, compared to English speaking Whites. This dissertation utilized fundamental cause theory to frame the hypotheses and analyses in a cross-sectional investigation of differences in workers' compensation system outcomes, using both administrative data from the workers' compensation agency, as well as survey responses from a sample of 488 injured workers in Washington State.
The survey, conducted by Washington State University Social and Economic Science Research Center (SESRC), provided many variables not available in the WC administrative data including measures of perceived racial discrimination to test the hypotheses that racial discrimination is a fundamental cause of worse workers' compensation outcomes for minorities. Fundamental cause theory suggests that there are basic or fundamental reasons for health disparities that are not caused by mechanisms linking the fundamental cause with a health outcome; in fact, these mechanisms can and do change, but the relationship between the primary cause and the health disparity outcome will remain. In addition, a fundamental cause affects multiple outcomes via multiple mechanisms. Access to resources such as income, wealth, prestige, knowledge, and beneficial social connections can reduce the impact of a disease once it occurs.
The analytic chapters in this dissertation are organized first, to address racial discrimination in health care provider outcomes; second, to address racial discrimination in workers' compensation agency outcomes; and third, to address the role of pre-injury racial discrimination in post-injury return to work outcomes. Racial discrimination was tested in this dissertation as the fundamental cause of health-care provider disparities in timeliness of follow-up care, adequacy of care, and patient satisfaction. Racial discrimination was tested in the workers' compensation agency as the fundamental cause of administrative delays and difficulties: delays in diagnostic approval and wage replacement payments, as well as language appropriate communication, and higher counts of independent medical exams.
Racial discrimination was also tested as the fundamental cause of poor return-to-work outcomes (feeling a worker returned to work too early and overall general health). Workplace support, as a possible resource (social connection), was tested as a mediator in the relationship between racial discrimination and workplace outcomes.
Due to the survey nature of the study design, replicate weights were calculated based upon information available in both the surveyed and not-surveyed population to account for non-response bias, and all analyses were bootstrapped using Stata survey software. The results support the role of racial discrimination as a fundamental cause of outcomes for hypotheses in the workers' compensation agency with clear differences in delays for diagnostic services, a higher number of independent medical exams, as well as linguistically inappropriate communication for language minorities. Racial discrimination (prior to injury) was found to be significant in overall general health for minority workers, and for feeling they had returned to work too early. Workplace support (a potential social resource), was found to mitigate the role of racial discrimination in the workplace return-to-work outcomes. This study is an initial effort to examine racial discrimination as a fundamental cause of disparities in occupational health after an injury. As the majority of adults will spend one-fifth to one-third of their lives in paid employment, the ability to heal and return to full and active employment after a work-related injury is critical to ones' self-worth, as well as to the economic stability of individuals, families, and societies. If racial, ethnic, and language minorities suffer worse outcomes in their post-injury sequelae, these results will have long-lasting implications in any quest for a more equitable society.
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Gidado, Mustapha. "Assessment of Tuberculosis Underreporting by Level of Reporting System in Lagos, Nigeria." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7543.
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Tuberculosis (TB) is the leading cause of death from a single infectious disease. Unfortunately, 4.1 million cases were missed in 2017 globally, and Nigeria contributes 9% of the missing TB cases. At least 73% of the estimated TB cases in Nigeria were not reported in 2017 to the National TB Program (NTP); therefore, the true burden of TB was not certain, and this affected planning for prevention and control of TB. This quantitative secondary data analysis (NTP Lagos TB Inventory study database) guided by the integrated behavioral model assessed TB underreporting based on the TB reporting process in Nigeria. Chi-square and binomial logistic regression were used to assess the association between TB underreporting and the characteristics of health facilities (HFs), health workers' (HWs) awareness, barriers to TB reporting, and patient-related factors. The results indicate at least 60% of all HFs underreported TB, with an average of 7.4% underreporting between HFs records and TB program reports. There was a statistically significant association between NTP nonengaged health facilities (Ï2 (1) = 20.547, p <.05), HWs' awareness of TB reporting (Ï2 (1) = 6.576, p <.05), and barriers for TB reporting (Ï2 (1) = 4.106, p < .05) with TB underreporting. The following patient factors were statistically significant predictors of TB underreporting with over 50% increased odds, p<0.05: previously treated, extrapulmonary, unknown TB site, HIV negative, and HIV unknown. This study supports social change through NTPs ensuring the establishment of a coordinating mechanism for TB reporting within and between HFs and supply of TB reporting tools to all HFs to know the true burden of TB for better planning and monitoring of quality care for TB patients.
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Slade, Catherine Putnam. "Does patient-centered care affect racial disparities in health?" Diss., Atlanta, Ga. : Georgia Institute of Technology, 2008. http://hdl.handle.net/1853/22569.
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Thesis (Ph. D.)--Public Policy, Georgia Institute of Technology, 2008.Committee Chair: Robert J. Eger III, Ph.D.; Committee Member: Christopher M. Weible, Ph.D.; Committee Member: Gregory B. Lewis, Ph.D.; Committee Member: Monica M. Gaughan, Ph.D.; Committee Member: Valerie A. Hepburn, Ph.D.
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Paradies, Yin Carl. "Race, racism, stress and indigenous health /." Connect to thesis, 2006. http://eprints.unimelb.edu.au/archive/00002514.
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Zhang, Yan-Jun. "Racial and ethnic disparities in quality of health care among adults with diabetes in the United States /." Connect to full text in OhioLINK ETD Center, 2009. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=toledo1242473857.
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Thesis (M.S.)--University of Toledo, 2009.Typescript. "Submitted as partial fulfillment of the requirements for The Master of Science in Pharmaceutical Sciences degree, Administrative Pharmacy option." "A thesis entitled"--at head of title. Bibliography: leaves 66-70.
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Singh, Shail. "The effects of perceived discrimination on Samoan health." CSUSB ScholarWorks, 2007. https://scholarworks.lib.csusb.edu/etd-project/3260.
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The purpose of this study was to examine the effect of perceived discrimination on Samoan health. This study employed purposive data collection and was conducted quantitatively using a questionnaire format, which measured everyday perceived discrimination, depression, and physical health.
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Philip, Ajith John. "An assessment of equity in geographical allocation of resources relative to need, in public primary healthcare services in the Northern Cape in South Africa." Thesis, University of the Western Cape, 2004. http://etd.uwc.ac.za/index.php?module=etd&.
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This study aimed to contribute to the current debate around equity in health care resource allocation by measuring the current allocation of resources, relative to need in the Northern Cape. It also discussed the level of inequities in health financing/expenditure and staffing at the primary health care level between different districts of the Northern Cape.
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Thomas, Duane J. "Racist white stereotypes and physician race : factors influencing black health care related responses /." Electronic version (PDF), 2005. http://dl.uncw.edu/etd/2005/thomasd/duanethomas.pdf.
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Oyebola, Folaju Olusegun. "A combined perception and needs assessment study of home based palliative care among patients with life-threatening diseases attending the Federal Medical Centre Abeokuta, Nigeria." Master's thesis, University of Cape Town, 2009. http://hdl.handle.net/11427/11371.
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Includes abstract.Includes bibliographical references (leaves 68-77).
This study aimed to evaluate the perception and needs for Home Based Palliative Care (HBPC) among patients suffering from life-threatening conditions presenting at the Federal Medical Centre Abeo-Ogun State, Nigeria. Needs assessment for this specialized care were investigated among cancer and HIV/AIDS patients receiving treatment in this health institution. Questionnaires were administered to the patients and statistical analysis of the collected data evaluated.
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Baylor, Rita Atkins. "Nurses' attitudes toward caring for patients with AIDS." Virtual Press, 1992. http://liblink.bsu.edu/uhtbin/catkey/845956.
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The main purpose of this study was to examine nurses' attitudes toward caring for patients with Acquired Immune Deficiency Syndrome (AIDS). The study also compared the attitudes of nurses who had cared for AIDS patients with the attitudes of nurses who had not cared for AIDS patients. Educational background was also examined to see if education influences attitudes. The Ajzen-Fishbein Model of Reasoned Action was the framework used for this study.A descriptive design was used for the purpose of gaining more information regarding nurses' attitudes toward caring for patients with AIDS. A random sample of all registered nurses in the state of Indiana was used for this study. The data obtained were analyzed using frequency distributions, independent t-tests, and analysis of variance.Nurses in general are sill uncomfortable with caring for AIDS patients. Between 40% and 50% of nurses are fearful of contracting the AIDS virus and fearful of putting their family at risk. On the other hand, approximately the same percentage are comfortable caring for AIDS patients. Furthermore, nurses believe that health care agencies should care for AIDS patients, but believe that nurses should have the right to refuse to care for AIDS patients.Results of this study indicated that educational background does not influence nurses' attitudes toward caring for patients with AIDS. However, as nurses have more experience caring for patients with AIDS, they appear to develop more positive attitudes.School of Nursing
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Cuevas, Adolfo Gabriel. "Exploring Four Barriers Experienced by African Americans in Healthcare: Perceived Discrimination, Medical Mistrust, Race Discordance, and Poor Communication." PDXScholar, 2013. https://pdxscholar.library.pdx.edu/open_access_etds/615.
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For many health conditions, African Americans bear a disproportionate burden of disease, injury, death, and disability compared to European Americans. African Americans also use health services less frequently than do European Americans and this underuse of services contributes to health disparities in the United States. Studies have shown that some disparities are present not as a result of poor access to care, but, to a certain extent, as a result of the experiences patients have at their doctors' offices. It is, therefore, essential to understand African American patients' perspectives and experiences with healthcare providers. Past studies have shown that four barriers affect the quality of patient-provider relationships for African Americans: perceived discrimination, medical mistrust, race discordance, and poor communication. The studies, however, have not looked at how these barriers manifest when African Americans speak about their perspectives and experiences with health care providers. This project was a secondary data analysis of qualitative data provided by adult African American community members from Portland, Oregon with diabetes or hypertension or both, each of whom participated in one of 10 focus groups. The focus groups were conducted as part of a study that applied community based participatory research (CBPR) principles to understand patients' experiences with their doctors. Using a deductive approach, this analysis enhanced the understanding of how the barriers play a role in patient-provider relationships. Further, the analysis showed how the barriers are interrelated. In learning African American patients' experiences and perspectives on these four key barriers, the investigator proposes recommendations for healthcare providers as to how they can best deliver quality care for African Americans.
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MacLaren, David. "Angels without mercy : the African-American fight against the Red Cross's blood donor discrimination, 1941-1945." Virtual Press, 1998. http://liblink.bsu.edu/uhtbin/catkey/1115760.
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On the eve of World War II, the American Red Cross (ARC) excluded African-American blood donors. The instructions from the Army and the Navy implied that the armed forces did not want the allegedly "inferior" blood of Blacks in the veins of "superior" White soldiers. The ARC's exclusionary policy, as mandated by defense officials in the War Department, continued the tradition of relegating African-Americans to second-class citizenship.Black newspaper editors and individual protest leaders on the national and local levels pressured the armed forces to change its blood donor policy. On January 29, 1942, the ARC started to accept blood donations from Blacks but followed a national policy of segregation. The ARC labeled and stored African-American blood donations apart from those of Whites and maintained Jim Crow blood banks throughout the war even though medical experts found no factual basis to differentiate blood by race.This paper examines how Black newspapers and individuals such as Asa Philip Randolph, Walter Francis White, William Henry Hastie, Mabel Keaton Staupers, and the Black community of Indianapolis responded to the ARC's initial policy of exclusion and then segregating AfricanAmerican blood donations. The paper attempts to modify the popular interpretation that the war constituted a watershed for African-Americans. My research indicates that while many Black leaders and protest organizations on the national and local levels challenged the ARC's blood donor policies, African-Americans did not win a fundamental change in military policy. Thus, while the fight against blood donor discrimination was a manifestation of the wartime "Double V" campaign it also represented its limitations.The paper draws on secondary sources, African-American newspapers, and the manuscript collections of the National Association for the Advancement of Colored People, the National Association of Colored Graduate Nurses, Claude A. Barnett, William Henry Hastie, Asa Philip Randolph, and the Indianapolis Area Chapter of the ARC as well as the papers of African-American physicians in Indianapolis, Walter H. Maddux and Harvey N. Middleton of the Flanner House and the Morgan Health Center.Department of History
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Slade, Catherine Putnam. "Does Patient-Centered Care affect Racial Disparities in Health?" Digital Archive @ GSU, 2007. http://digitalarchive.gsu.edu/pmap_diss/24.
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This thesis presents a challenge to policy initiatives that presume that patient-centered care will reduce racial disparities in health. Data from the Medical Expenditure Panel Survey were used to test patient assessment of provider behavior defined as patient-centered care according to the National Health Disparities Report of the Agency for Healthcare Research and Quality of the Department of Health and Human Services. Results indicated patient-centered care improves self-rated health status, but blacks still report worse health status than whites experiencing comparable patient-centered care. Further, black-white differences in patient-centered care had no affect on health status. Rival theories of black-white differences in health, including social class and health literacy, provided better explanations of disparities than assessment of provider behaviors. These findings suggest that policies designed to financially incentivize patient-centered care practices by providers should be considered with caution. While patient-centered care is better quality care, financial incentives could have a negative effect on minority health if providers are deterred from practices that serve disproportionate numbers of poor and less literate patients and their families. Measurement of the concept of patient-centered care in future health disparities research was also discussed.
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Cuevas, Adolfo Gabriel. "Mistrust: An Exploration of African Americans' Attitudes and Perspectives Toward Healthcare." PDXScholar, 2015. http://pdxscholar.library.pdx.edu/open_access_etds/2459.
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This dissertation explored mistrust through focus group discussions (study 1), responses to standardized laboratory vignettes (study 2), and survey questionnaires (study 3). In the first study, I found that African American community members (N=60) experienced perceived discrimination, medical mistrust, and poor communication in numerous and interrelated ways. For example, medical mistrust occurred when clinicians did not convey respect to patients, leaving patients to wonder whether their clinician's treatment was discriminatory or not. Based on these findings, I wanted to see whether these experiences of perceived discrimination and mistrust were related to other dimensions of Black experience, such as racial identity. I conducted a secondary analysis of data from a laboratory study (Somnath Saha, PI) in which 104 primary care patients viewed video-recorded, standardized vignettes depicting a cardiologist recommending heart bypass surgery to a patient diagnosed with angina and 3-vessel coronary artery disease. In this study, those who viewed a video of European American cardiologist-actors had lower physician mistrust and lower hypothetical likelihood of having bypass surgery compared to those who viewed the video of African American cardiologist-actors. However, racial centrality did not moderate the relationship between ethnicity of the cardiologist-actor and patients' decision making. The third study explored other dimensions of racial identity (e.g., unfavorable public regard for African Americans) and mistrust (e.g., medical mistrust), while also exploring their association with perceived healthcare discrimination among African American community members (N=210). In this study, perceived discrimination was positively associated with racial centrality, but not associated with unfavorable public regard. Perceived discrimination was also positively associated with medical mistrust and physician mistrust. Although racial centrality and unfavorable public regard were not significant moderators between perceived discrimination and the two dimensions of mistrust, they were positively associated with medical mistrust. Together, these studies provide a better understanding of African Americans' healthcare attitudes and experiences, particularly mistrust toward medical institutions and clinicians. For example, the association between racial centrality and perceived discrimination may suggest that past experience of discrimination in healthcare may influence a person to seek others who experience similar stressors, giving way to identifying more with her or his racial group. Racial centrality may influence a person's trust towards healthcare, prior to entering the doctor's office. However, once the person enters the doctor's office, racial centrality may play a less significant role the patient's trust towards her or his provider. These findings generated new questions to explore for future studies. For example, future studies should explore the relationship between racial centrality and African Americans' healthcare behavioral responses. In addition, the current studies only focused only on attitudes and perspectives; future studies should investigate how the construct medical mistrust may influence health-related outcomes such as adherence in race-discordant patient-provider relationships.
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Murphy, Richard. "Health professionals and ethnic Pakistanis in Britain : risk, thalassaemia and audit culture." Thesis, University of St Andrews, 2005. http://hdl.handle.net/10023/2802.
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The central theme or 'red-thread' that I consider in this thesis is the concept of risk as it is perceived by and affects the two sides of the medical encounter -in this instance ethnic Pakistanis and Health Professionals- in Britain. Each side very often perceives risk quite distinctively, relating to the balance between the spiritual and temporal realms. This is particularly germane in matters to do with possible congenital defects within the prenatal realm for the ethnic Pakistani, and predominantly Muslim, side of this encounter. Thus one of the factors considered in this thesis is how senses of Islam impact upon the two sides. By ethnic Pakistanis Islam is seen as central to all life decisions, whilst Health Professionals view Islam with some considerable trepidation, little understanding it or its centrality to the former's decision-making processes. This is particularly significant with regard to attitudes to health and health care. In the initial stages of the project I had thought first cousin marriage (FCM), seen by ethnic Pakistanis as desirable and by Health Professionals as putting ethnic Pakistanis at-risk to be central to the argument, but concluded that concerns around FCM were a 'red herring', merely a trope for the tensions between the two sides -at once both British and at-risk from audit culture. Although no longer central, FCM remains a viable touchstone in consideration of the two sides' perceptions of genetic risk. In this thesis the medical encounter between ethnic Pakistanis and Health Professionals is performed within the realm of the so called New Genetics. Here the respective understandings of the New Genetics are informed by the enculturation processes that shape the two sides' world view. Furthermore, I will agree with Lord Robert Winston's and others' concern that any attempt to eradicate an adaptive genetic mutation, in this instance, thalassaemia, from the gene pool is not only undesirable in the short term, but also that such eradications may have an adverse, and far reaching, effect on whole population groups in the future. The main thrust of my argument is that audit culture not only compounds risk for both sides, but also perpetuates institutional racism within the National Health Service (NHS), by promulgating what I have called the language myth. That is to say that much institutional racism is the unwanted by-product of the NHS's attempts to become more patient centred and its continuing efforts to develop systems of best practice. This professionalisation process within the NHS can be seen to impact most strongly in relation to communication -particularly the claimed language barrier between the two sides. This 'barrier' has worrying policy implications for any meaningful communication between the two sides, notably relating to obtaining informed consent from ethnic Pakistani patients -with a resultant increase in risk for the two sides and clear economic consequences for the NHS.
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Malmström, Felicia. "Hiv/Aids patienters erfarenheter av stigma i mötet med vårdpersonal." Thesis, Malmö universitet, Fakulteten för hälsa och samhälle (HS), 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-26876.
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Bakgrund: Det är en förhållandevis liten andel personer som lever med diagnostiserad hiv-infektion i Sverige, men eftersom flertalet av dessa personer kommer från högendemiska länder är det som blivande sjuksköterska av intresse att undersöka vad stigmatisering kan innebära i mötet med vårdpersonal. Syfte: Syftet med litteraturstudien var att sammanställa hiv/aids-patienters erfarenheter av stigma i mötet med vårdpersonal. Metod: Litteraturstudie är baserad på femton empiriska studier med kvalitativ ansats. Artikelsökningar gjordes i databaserna PubMed och CINAHL. Vid kvalitetsgranskning användes SBU;s kvalitetsgranskningsmall. Som analysmetod användes Graneheim & Lundman 2004. Resultat: Fem kategorier framkom från analysen; bristande integritet, fördomar, rädsla, bortprioritering och okunskap. Konklusion: Hivstigma utgör ett hinder för patienters tillgång till behandling samt riskerar vidare smittspridning. Stigma inom vården kan leda till att patienter undviker att delge sin hiv-status eller undviker att söka vårdtjänster. Detta utgör en risk för såväl patienten som vårdgivaren. Sårbara riskgrupper bland hiv-patienter är framför allt migranter och unga kvinnor, vilket kan vara viktigt att uppmärksamma.Background: There is a relatively small proportion of people living with HIV infection in Sweden, but since most of these people come from high endemic countries, it is interesting as a prospective nurse, to explore what stigmatization can mean in the meeting with healthcare professionals. Aim: The aim of the literature study was to compile HIV/AIDS patients' experiences of stigma in meeting with healthcare professionals. Method: A literature study based on fifteen empirical studies with qualitative approach. Article searches were made through the PubMed and CINAHL databases. Quality review was done with SBU's quality review template. As an analytical method, Graneheim & Lundman 2004 was used. Results: Five categories emerged from the analysis; lack of integrity, prejudice, fear, prioritization and ignorance. Conclusions: HIV stigma constitutes to be a barrier to patients' access to treatment and prevent continued spread of the infection. Stigma in healthcare can lead to patients not willing to disclose their HIV status or avoiding seeking health care services. These are risk factors for both the patient and the healthcare provider. Vulnerable risk groups among HIV patients are mainly migrants and young women.
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Bannister, Tarryn. "The right to have access to health care services for survivors of gender-based violence." Thesis, Stellenbosch : Stellenbosch University, 2012. http://hdl.handle.net/10019.1/71802.
Full textAbstract:
Thesis (LLM)--Stellenbosch University, 2012.Includes bibliography
ENGLISH ABSTRACT: In South Africa gender-based violence (hereafter “GBV”) has reached extreme levels. This violent manifestation of gender inequality is compounded by the fact that women are disproportionately affected by poverty, the HIV/AIDS epidemic and inadequate health care services. This is in spite of South Africa’s progressive constitutional and legislative framework which appears highly conducive to combating gender inequality and GBV. For example, the Constitution protects the right to equality (section 9), human dignity (section 10), life (section 11), freedom and security of the person (section 12) and the right to have access to health care services, including reproductive health (section 27(1)(a)). Extensive legislation has also been enacted for the protection of women. For example, the preamble to the Domestic Violence Act 116 of 1998 (hereafter “DVA”) recognises domestic violence as a serious social evil. While the DVA is notably silent as to the role of the health care sector, the DVA is progressive in that it contains a broad definition of domestic violence, and recognises a wide range of relationships. The Criminal Law (Sexual Offences and Related Matters) Amendment Act 32 of 2007 also seeks to afford complainants of sexual offences “the maximum and least traumatising protection that the law can provide”. In addition to this, South Africa has international law obligations to address GBV and gender inequality. For example, under the Convention on the Elimination of All Forms of Discrimination against Women (1979), States are obliged to address private acts of violence and to remove discrimination against women in all fields, including health. However, despite this progressive framework of rights, some interpretations of these integral rights have been unduly formalistic, in addition to being disengaged from the lived reality of many women. There is also a substantial gap between policy and practice, with the implementation of existing legislation a continuing problem. It is therefore imperative that we analyse the right to have access to health care services through a gender lens so as to transcend a purely legalistic perspective and to interrogate gendered social processes and power relations. This thesis analyses how existing law and policy can be transformed so as to be more responsive to these lived realities and needs of survivors of GBV.
AFRIKAANSE OPSOMMING: Geslagsgebaseerde geweld (hierna ‘GGG’) in Suid-Afrika het uiterste vlakke bereik. Hierdie gewelddadige manifestasie van geslagsongelykheid word vererger deur die feit dat vroue buite verhouding erg deur armoede, die MIV/vigs-epidemie en ontoereikende gesondheidsorgdienste geraak word. Dit is ondanks Suid-Afrika se vooruitstrewende grondwetlike en wetsraamwerk wat op die oog af hoogs bevorderlik vir die bestryding van geslagsongelykheid en GGG voorkom. Die Grondwet verskans, byvoorbeeld, die reg op gelykheid (artikel 9), menswaardigheid (artikel 10), lewe (artikel 11), vryheid en sekerheid van die persoon (artikel 12) en toegang tot gesondheidsorgdienste, met inbegrip van reproduktiewe gesondheidsorg (artikel 27(1)(a)). Omvattende wetgewing oor vrouebeskerming is ook reeds uitgevaardig. Die aanhef tot die Wet op Gesinsgeweld 116 van 1998 (hierna die ‘WGG’) identifiseer, byvoorbeeld, huishoudelike geweld as ’n ernstige maatskaplike euwel. Hoewel die WGG swyg oor die rol van die gesondheidsorgsektor, is dit nietemin vooruitstrewend aangesien dit ’n uitgebreide omskrywing van huishoudelike geweld bevat en ’n wye verskeidenheid verhoudings erken. Die Wysigingswet op die Strafreg (Seksuele Misdrywe en Verwante Aangeleenthede) 32 van 2007 is ook daarop afgestem om klaagsters van seksuele oortredings “die omvattendste en mins traumatiese beskerming te gee wat die wet kan bied”. Daarbenewens verkeer Suid-Afrika onder internasionale regsverpligtinge om GGG en geslagsongelykheid aan te spreek. Ingevolge die Konvensie vir die Uitwissing van Alle Vorme van Diskriminasie teen Vroue (1979), byvoorbeeld, is state verplig om privaat geweldsdade teen te staan en diskriminasie teen vroue op alle gebiede te verwyder, insluitend gesondheid. Nietemin, benewens hierdie vooruitstrewende menseregteraamwerk is sommige interpretasies van hierdie onafskeidbare regte nie net oormatig formalisties nie, maar ook verwyderd van die daaglikse realiteit van baie vroue. Daar is ook ʼn wesenlike gaping tussen beleidsmaatreëls en die praktyk, terwyl die uitvoering van bestaande wetgewing ʼn voortgesette probleem verteenwoordig. Dit is dus gebiedend om die reg op toegang tot gesondheidsorgdienste deur ʼn geslagslens te analiseer om sodoende ʼn bloot regsgedrewe perspektief te bo te gaan en om maatskaplike prosesse en magsverhoudinge in oënskou te neem. Hierdie tesis analiseer hoe bestaande wetsraamwerke en beleidsmaatreëls getransformeer kan word om beter te reageer op die realiteite en behoeftes van oorlewendes van GGG.
Stellenbosch University Hope Project
Bradlow Foundation
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Chouaibi, Meriam. "Droits du patient : étude comparée entre la France et la Tunisie." Thesis, Aix-Marseille, 2016. http://www.theses.fr/2016AIXM1055.
Full textAbstract:
Le système juridique français accorde une grande importance aux droits du patient, essentiellement à travers la loi du 4 mars 2002. Ce texte a été construit de manière à placer le patient au centre du dispositif et à lui attribuer des droits liés à sa qualité de sujet de droit. Cette idée est quasiment absente dans la législation tunisienne. En Tunisie, la législation relative aux droits des patients est insuffisante. Il est vrai que le législateur tunisien a défini certains droits pour le patient. Cependant, ces consécrations législatives ne nous permettent pas de confirmer l’idée selon laquelle le patient est le centre de la relation médicale, particulièrement parce que le paternalisme médical trouve encore une consécration en Tunisie. L’étude comparative a montré certaines convergences entre les deux systèmes juridiques mais aussi d’importantes divergences. Ainsi, pour un pays, comme la Tunisie, dont le système sanitaire confronte des difficultés intenses non seulement sur le plan infra-structurel mais également législatif, le code de la santé publique en général et la loi du 4 mars 2002 pour les droits des malades, en particulier, peuvent constituer une source efficace pour des changements en profondeur. Cependant, si en France la loi du 4 mars 2002 occupe une place primordiale dans le corpus des règles du droit de la santé, on ne peut nier que les droits du patient confrontent aujourd’hui des difficultés de mise en œuvre. En effet, même si le souci du législateur français était de protéger au maximum les droits des patients, certaines failles restent à signalerThe french legal system attaches great importance to patient rights, mainly through the law of 4 March 2002. This text was constructed to place the patient at the center of the device and assigning the rights to as a subject of law. This idea is almost absent in tunisian law. In Tunisia, legislation on the rights of patients is inadequate : the rights of patients are devoted so scattered in several legal texts. It is true that the tunisian legislature has defined certain rights for patients. However, these legislative consecrations do not allow us to confirm the idea that the patient is the center of the medical relationship, particularly because medical paternalism still finds consecration in Tunisia. The comparative study showed some convergence between the two legal systems but also important differences. Thus, for a country like Tunisia, whose health system confronts severe difficulties not only its infrastructure but also the legislative, the code of public health in general and the law of 4 March 2002 for the rights of patients, particular, can be an effective source for in-depth changes. However, if in France the Law of 4 March 2002 occupies a prominent place in the corpus of rules of health law, there is no denying that the patient's rights today facing implementation difficulties. Even if the concern of the french parliament was to maximally protect the rights of patients, some flaws still to report
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Yehualashet, Yared Gettu. "Socio-economic and gender determinants of immunisation coverage in the federal capital territory, Nigeria." Thesis, 2021. http://hdl.handle.net/10500/27353.
Full textAbstract:
Immunisation is a cost-effective public health intervention that contributes to the
attainment of the Sustainable Development Goals (SDGs). About 40% of children
under the age of five years die from vaccine-preventable diseases in Nigeria. Routine
immunisation has been quite low in Nigeria, where national coverage is estimated to
be 33%, according to a 2016–2017 survey. This empirical research was aimed at
determining the key socio-economic and gender determinants of immunisation in the
Federal Capital Territory (FCT), identifying gaps and proffering solutions. Mixed
methods of data collection and analysis were used. Data were gathered from several
secondary sources and from 11 key informants using semi-structured interviews and
501 household and 26 health-facility surveys using questionnaires mounted on Open
Data Kit. Lot quality assurance sampling and probability to population size methodology
were used to size the samples and identify survey locations. Odds ratio analysis and
logistic regression analysis were conducted to gauge the statistical association
between the determinants and the coverage of immunisation. The main finding that
was reached on the basis of the documents reviewed and the feedback received from
the key informants was that they were gender blind at worst and gender neural at best.
Most of the current strategies give little attention to socio-economic and gender
barriers. Over 40 immunisation variables were identified. The analysis, particularly
using the 2x2 odds ratio, yielded mixed results. The majority of the variables exhibited
a close statistical association as far as immunisation indices were concerned. These
variables included urban residency, married couples, literacy, birth at a health facility,
antenatal care experience, vaccination card possession, immunisation knowledge,
child health information, non-farming earnings, socio-economic status and tolerance of
spouse beating. On the other hand, variables that were found to have no statistical
significance included sex, marital status, marriage type, age, religion, tetanus toxoid
(TT) vaccination and adequacy of income. Immunisation and gender are intertwined,
particularly because of mothers’ biological and social attachment to their children. At
the same time, conducting vaccination avails the opportunity to access almost all
households. Moreover, it is important to recognise that socio-economic and gender
determinants are not totally in control of one ministry. Single agenda interventions will
not produce the desired result. A paradigm shift and the concerted effort of various
sectors and partners are required. Therefore, the Nigerian government should
galvanise the relevant stakeholders to bring gender and socio-economic variables into
the mainstream throughout the immunisation ecosystem and to implement integrated
development initiatives by prioritising vulnerable communities.Ugonyo yindlela engcono yokungenela kwezempilo yabantu engathela esivivaneni ekufinyeleleni izinhloso zentuthuko eqhubekela phambili ezaziwa ngelokuthi yi- Sustainable Development Goals (SDGs). Cishe izingane ezifinyelela ku 40% ezingaphansi kweminyaka emihlanu zibulawa yizifo ezivimbelekayo ngomgcabo emitholampilo eNigeria. Ukugonya njalo kusezingeni eliphansi eNigeria, laphokhona ukwengamela kuzwelonke kulinganiselwa ku 33%, ngokuya kocwaningo olwenziwe phakathi kuka 2016-2017. Ucwaningo lokuthola ubufakazi lwalunenhloso yokubona imithelela yezesimo sabantu nomnotho (socio-economic) kanye nobulili ngokugonya kwi-Federal Capital Territory (FCT) ukubona amagebe kanye nokutholakala kwezixazululo. Amamethodi axubene okuqokelela ulwazi kanye nohlaziyo kwasetshenziswa. Ulwazi lwaqokelelwa ngokufunda imithombo yemibhalo (secondary sources) kanye nakubantu ababalulekile abanolwazi (key informants) abangu 11 ngokusebenzisa ama-semi-structured interview kanye nemizi engu 501 kanye namasurvey amafasilithi ezempilo angu 26 ngokusebenzisa uhla lwemibuzo yamaquestionnaire ebifakelwe kwi-Open Data Kit. Kwasetshenziswa nemethodi ye-Lot quality assurance sampling ne-probability, ngemethodoloji yobuningi babantu, ukwenza usayizi wamasampuli kanye nokubona izindawo okumele kwenziwe kuzo ama-survey. Kwenziwa nohlaziyo lwe-Odds ratio analysis kanye ne-logisic regression analysis ukubona ukuhambelana kwamastatistiki phakathi kwezinto eziwumthelela kanye nokunaba kongamelo lokwenziwa kogonyo. Okukhulu okutholakele ngokulandela amadokhumende okufundwe kuwo, kanye nezimpendulo ezivela kulabo abanolwazi ababalulekile (key informants) kube wukuthi bekungaboneleli ubulili (gender blind) kanti futhi bekungachemile ngokulandela ubulili (gender neutral) ngezinga elibi nangokungcono kakhulu. Amasu amaningi amanje awanakekeli kakhulu izihibe ezimayelana nabantu nezomnotho kanye nezobulili. Kwaphawulwa cishe izinto ezehlukene zama-variable ezingu 40 mayelana nogonyo. Uhlaziyo, ikakhulukazi ngokusebenzisa i 2x2 odds ratio, lwaveza imiphumela exubene. Ezinto zama-variable ehlukene eziningi zikhombise ukuhlobana phakathi kwamastatistiki mayelana namaindices ogonyo. Lama variable, abandakanye ukuhlala emadolobheni, abantu abashadile, ikhono lokubhala nokufunda, ukuzalwa kwezingane kumafasilithi ezempilo, izipiliyoni zonakekelo lwengane ngaphambi kokuzalwa, ukuba nekhadi lomgcabo ix wasemitholampilo, ulwazi ngogonyo, ulwazi ngempilo yengane, ukuthola imali ngemisebenzi engeyona eyokulima, isimo sabantu mayelana nezomnotho, kanye nokuqinisela ukuhlukunyezwa ngokushaywa kwabesimame. Kanti ngakolunye uhlangothi, ama-variable atholakale engenakho ukubaluleka ngokwamastatistiki, abandakanya ubulili, isimo ngokomendo, inhlobo yomendo, iminyaka yobudala, inkolo, umgcabo we-tetanus toxoid (TT), kanye nokwenela kwengeniso lemali. Ugonyo kanye nobulili kuyangenelana nokuhambelana, ikakhulukazi ngenxa yokusondelana komama kanye nezingane zabo. Ngaso leso sikhathi, ukwenziwa kogonyo kuhlinzeka ngethuba lokufinyelela cishe kuwo yonke imizi eminingi. Nangaphezu kwalokho, kubalulekile ukwamukela ukuthi isimo sabantu mayelana nezomnotho kanye nobulili kuyizinto ezinomthelela, azinalo ulawulo oluphelele kumnyango kangqongqoshe owodwa. Ungenelo ngento eyodwa ngeke kwaveza imiphumela efiswayo. Ukugudluka ngokomqondo (paradigm shift), kanye nemizamo eqhubekela phambili yemikhakha ehlukene kanye nabasebenzisani kuyadingeka. Ngakho-ke uhulumeni waseNigeria, kumele agqugquzele ababambiqhaza abafanele ukuhlanganisa nokufaka emkhakheni ofanele izinto ezimayelana nabantu nomnotho kanye nobulili, kuyo yonke inqubo yokusebenzisana kwemikhakha okumele isebenzisane nehlangene ukusebenza ngokulandela inqubo yentuthuko ehlangane ngokubonelela imiphakathi ekwizimo ezibucayi
Development Studies
D. Phil. (Development Studies)
27
Mancini, Dominic Joseph. "The effectiveness and cost of health delivery systems in Côte d'Ivoire, Nigeria, and Tanzania private versus public allocation, quality of service provision, and management structure /." 2000. http://books.google.com/books?id=hi_bAAAAMAAJ.
Full text
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Wodajo, Befekadu Sedeta. "HIV and AIDS-related stigma and discrimination reduction-intervention strategy in health care settings of Amahara Region, Ethiopia." Thesis, 2015. http://hdl.handle.net/10500/19886.
Full textAbstract:
Stigma and discrimination (SAD) attached to Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) has been recognised as a major obstacle to HIV prevention, treatment, care and support throughout the world. SAD is more devastating when it occurs in health care settings where it is least expected. Health care providers (HCPs) are supposed to provide physical, social and psychological support to people living with HIV (PLWHA) but HIV and AIDS-related SAD has been extensively documented among the HCPs. Different studies have pointed out that there are three major actionable causes of HIV-related SAD in health care settings. These are lack of awareness among HCPs, fear of casual contacts and associating the SAD to immoral behaviour. The main objective of the current study is to determine the magnitude of HIV and AIDS-related SAD and its associated factors in hospitals and then to propose appropriate SAD reduction-intervention strategy in the health care settings. The study employed pre-test-post-test design with non-equivalent control group. Two paradigms were used in this study including quantitative and qualitative approaches. The sampling method for the quantitative part of the study was probability sampling in which the respondents were randomly selected using stratified sampling technique. The study was able to determine the magnitude of HIV and AIDS-related SAD among the HCPs. Moreover, the study has identified the factors that are attributed to the prevalence of SAD in the hospitals. The major factors identified for causing the SAD in the hospitals were sex, age, work experience, low level of knowledge, negative attitudes and percieved risk of HIV infection of some HCPs toward the PLWHA. The intervention made on the respondents in the treatment group was able to reduce the overall prevalence of the SAD among the HCPs. The study suggests that to reduce the SAD, HIV and AIDS-related trainings before and after graduation is critical to improve the knowledge, attitudes and practices of the HCPs. Besides, ensuring the availability of the protective supplies in hospitals is crucial in reducing the fear of HIV infection among the HCPs while providing care for HIV positive patients. Effective implementation of the hospital policies, strategies, guidelines and protocols along with good institutional support is also vital in creating safe and user-friendly hospitals for PLWHAHealth Studies
D.Litt. et Phil. (Health Studies)
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Nwafor, Gloria Chidimma. "Protection of the right of healthcare of people infected with ebola virus disease (EVD) : a human rights-based approach." Diss., 2016. http://hdl.handle.net/11602/623.
Full textAbstract:
LLMDepartment of Public Law
Human rights are those inalienable rights of an individual by virtue of being a human being. They are guaranteed by various domestic and international instruments. This research argues that despite the existence of these instruments and wide acceptances of international human rights standards that seek to protect the right to healthcare, the people infected with Ebola Virus Disease (EVD) are victims of a wide range of constraints to their right to healthcare as a result of the failure by the governments of the respective nations where the impacts of the EVD are mostly felt to discharge their obligations under those instruments. The rights of the people infected with EVD are often violated because of their presumed or known EVD status, causing them to suffer both the burden of the disease and the social burden of discrimination and stigmatisation which could deter the infected persons from accessing available treatment. This would invariably contribute to the spread of the disease. The research further exposes the dilemma posed by the EVD to the healthcare system, where healthcare providers are caught between the rock of selfpreservation from a highly virulent disease and the hard place of discharging their Hippocratic Oath which prescribes ethical guidelines for the discharge of the duties of the medical profession. The present research, which is novel in the field of medico-legal research, seeks to proffer answers to this conundrum.
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Reynolds, Christopher 1950. "Plagues and prejudice : boundaries, outsiders and public health / Christopher Reynolds." 1992. http://hdl.handle.net/2440/20611.
Full textAbstract:
Bibliography : leaves 375-403.vi, 403 leaves ; 30 cm.
Title page, contents and abstract only. The complete thesis in print form is available from the University Library.
Examines the response to a number of outsiders and marginal social groups, such as Jews, Chinese, and Southern and Eastern Europeans predominantly in England and Australia, and considers the role that public health played in arguments for their exclusion and control. Measures the strength of the public health case, arguing that a health threat was generally not a real issue but, more typically, a badge which labelled the outsider as dangerous to the community.
Thesis (Ph.D.)--University of Adelaide, Dept. of Community Medicine, 1993
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Deka, Ankita. "RACIAL DISPARITIES IN SELF REPORTED HEALTH AND HEALTH CARE UTILIZATION. DOES PRIMARY CARE MATTER?" 2012. http://hdl.handle.net/1805/3044.
Full textAbstract:
Indiana University-Purdue University Indianapolis (IUPUI)A significant body of literature has accumulated in the last decade that provides evidence of the growing health care disparities among racial and ethnic groups in the United States. The literature suggests that Black adults share a disproportionate burden in death, disability, and disease. In 2002, the Institute of Medicine report, Unequal Treatment, showed that racial-ethnic disparities in health cannot be entirely attributed to problems of health care access, clinical performance, or patients’ personal characteristics. Many studies have shown that institutional and individual level discrimination that Blacks face in the health care system impacts their health status. This study used secondary data analysis to examine how primary care experience impacts self-reported health status and health care utilization among Black adults. Data were from the Medical Expenditure Panel Survey (MEPS) implemented by the Agency for Healthcare Research and Quality (AHRQ). Specifically, MEPS Panel 10 (2005-2006) and Panel 11 (2006-2007) data were used in the analyses. The final sample comprised of N=15,295 respondents ages 18 and over. Logistic regression analyses were carried out using Stata Statistical Software, version 11. The study results reflect the disparities among Blacks and Whites on self-reported health and health care utilization. Blacks were 15% less likely to report good health status compared to Whites and had 0.11 less expected office-based doctor visits. Respondents who had better primary care experience had 0.05 times higher expected office-based doctor visits than respondents who did not have good primary care experience. Health care Social Workers should advocate for structural changes in health policy that will take into account the historical marginalization and contemporary inequities that continue to encompass the lives of many Black Americans.
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Nguyen, Norma De Anda Dallo Florence J. Mubasher Mohamed Caetano Raul. "Evaluation of racial and ethnic disparities of glycemic control in the Health and Retirement Study. 2003 Diabetes Survey." 2008. http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&res_dat=xri:pqdiss&rft_dat=xri:pqdiss:1450279.
Full textAbstract:
Thesis (M.P.H.)--University of Texas Health Science Center at Houston, School of Public Health, 2008.Source: Masters Abstracts International, Volume: 46-04, page: 2100. Adviser: Florence J. Dallo. Includes bibliographical references.
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Kola, Ijeoma Beatrice. "“I Can’t Breathe”: The Rise of Asthma in Black Urban America." Thesis, 2019. https://doi.org/10.7916/d8-yy6w-p010.
Full textAbstract:
This dissertation examines how debates about racial susceptibility to asthma changed from 1880 to 1990 alongside a growing disparity in Black and white asthma morbidity. At the turn of the century, doctors believed asthma was exclusive to whites, due to the stresses of urban life on their delicate constitution. But by 1960, the first year the CDC’s National Center for Health Statistics collected asthma data, the rate of asthma mortality in Blacks was nearly twice that in whites. After neglecting asthma in Black communities for sixty years, doctors scrambled to articulate its manifestation in urban communities of color. In those decades, the urban American landscape dramatically evolved, as the Great Migration brought six million African-Americans to Northern cities, but segregation and other racist policies created black metropolises laden with dilapidated public housing, high rates of unemployment, and environmental toxins from garbage dumps, waste plants, train tracks, and bus depots. Growing racial tensions and expanded funding opportunities during the Civil Rights Movement spurred an overwhelming production of research on asthma and race, with explanations ranging from meteorological episodes, environmental pollution, and indoor allergens to biological, genetic, and even psychological factors. Although research primarily focused on psychosomatic, environmental, and genetic causes, Black activists and community leaders used asthma data to mobilize for social equality in housing, neighborhoods, health, and education. At the cross-section of the history of medicine, social history, and environmental justice history, this dissertation examines the changing debates on racial susceptibility to asthma, the effects of the Great Migration and segregation on Black health, and both tensions and alliances between doctors, patients, and activists battling asthma in Black urban communities.
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Travers, Jasmine. "Infection Control and Racial/Ethnic Disparities in Influenza and Pneumococcal Vaccination in Nursing Homes." Thesis, 2016. https://doi.org/10.7916/D8B56JZ9.
Full textAbstract:
Adults over the age of 65 are at increased risk for influenza and pneumococcal infections; particularly those residing in nursing homes (NHs). Despite the efficacy of influenza and pneumococcal vaccinations, vaccination receipt rates among NH residents remain well below federal recommendations and racial/ethnic disparities exist. Minority NH residents (non-Hispanic Blacks and Hispanics) are less likely to be offered either vaccination and are more likely to refuse them compared to their non-minority counterparts (non-Hispanic Whites). In the past decade, requirements have been implemented to increase vaccination coverage in NHs, but there is little documentation regarding current racial/ethnic disparities in vaccination receipt. Furthermore, activities important to resident care delivery and the prevention of care deficiencies such as infections are primarily dependent on the care provided by certified nursing assistants (CNAs). For these reasons, current research examining racial/ethnic disparities in vaccination receipt in NHs is needed and more attention directed towards CNAs is necessary to improve resident care delivery and outcomes related to infection prevention and control.
This dissertation furthers our understanding of racial/ethnic disparities in influenza and pneumococcal vaccination coverage among minority NH residents and the role racial/ethnic diverse CNAs play in infection prevention and control. Chapter One introduces the problem of health disparities in nursing homes (NHs) related to differences in preventative vaccination receipt by racial/ethnic status and the role CNAs play in infection prevention and control. Chapter Two, an integrative literature review on racial/ethnic disparities in NHs, describes racial/ethnic disparities occurring in the NH setting in the context of infection prevention and control and influenza and pneumococcal vaccination receipt along with contributing factors and existing strategies related to policy that have been implemented to address poor care quality. In Chapter Three, facility-level factors related to the CNA’s role and the barriers and facilitators they experience that contribute to infection prevention and control are discussed. In Chapter Four, a systematic review of previous research on racial/ethnic disparities related to influenza and pneumococcal vaccination in NHs, individual, community, and facility-level factors that determine these disparities in influenza and pneumococcal vaccination receipt, along with associated strategies and practices are discussed. In Chapter Five, a national quantitative analysis of vaccination receipt practices (vaccination administered) and reasons for vaccination non-receipt (i.e., not offered versus refused) are presented. The results of this dissertation will inform clinicians and NH administrators as well as future policy and public health interventions and provide evidence needed to improve racial/ethnic minority health and eliminate health disparities.
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Omoruan, Augustine Idowu. "The design and implementation policy of the National Health Insurance Scheme in Oyo State, Nigeria." Thesis, 2018. http://hdl.handle.net/10500/25895.
Full textAbstract:
Given the general poor state of health care and the devastating effect of user fee, the National Health Insurance Scheme (NHIS) was instituted as a health financing policy with the main purpose to ensure universal access for all Nigerians. However, since NHIS became operational in 2005, only members of scheme are able to access health care both in the public and in private sectors, representing about 3% of Nigerian population. The thesis therefore examines the design and implementation policy of NHIS in Oyo state, Nigeria. Key design issues conceptual framework guides the analysis of data. The framework identifies three health interrelated financing functions namely revenue collection, risk pooling and purchasing. Data was collected from the NHIS officials, employees of the Health Maintenance Organisations (HMOs) and the Health Care Providers (HCPs) using key informant interview. In addition, in-depth interview and semi structure questionnaire were used to gather data from the enrolees and the nonenrolees. Empirical findings show that NHIS is fragmented given the existence of several programmes. In addition, there is no risk pooling neither redistribution of funds in the scheme. Revenue generated through contributions from the enrolees was not sufficient to fund health care services received by the beneficiaries because of the small percentage of the Nigerian population that the scheme covers. Further findings indicate that enrolled federal civil servants have not commenced monthly contribution to the NHIS. They pay 10% as co-pay in every consultation while federal government as an employer subsidised by 90%. Majority (76.8%) of the respondents agreed that they were financially protected from catastrophic spending. However, the overall benefit package was rated moderate because of exclusion of some priority and essential health care needs. Although above half (57%) of the respondents concurred that HMOs are accessible, in the overall, (47.6%) of the respondents were not satisfied with their services. In the case of the HCPs, majority (61.9%) of the respondents claimed that there is no excessive waiting time for consultation. Furthermore, (64.3%) rated their interpersonal relationship with the HCPs to be good. However, more than half of the respondents (54%) disagreed on availability of prescribed drugs in NHIS accredited health facilities. For the nonenrolees, findings show that most of the respondents (72.9%) were willing to enrol, but significant proportion (47.5%) indicated financial constraint as impediment to enrolment.Sociology
D. Phil. (Sociology)
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Emenike, Obiageli Ugwumsinachi. "Knowledge and use of intermittent prevention for malaria among pregnant women attending antenatal clinics in health centers in the Federal Capital Territory, Nigeria." Diss., 2016. http://hdl.handle.net/10500/21592.
Full textAbstract:
Background
Plasmodium falciparum malaria during pregnancy poses a substantial risk to mother and foetus. In recent years, convincing evidence has shown that preventive methods such as the use of insecticide treated bed nets (ITNs) and intermittent preventive treatment (IPT) in pregnancy with sulphadoxine-pyrimethamine (IPTp-sp) can greatly reduce the adverse effects of malaria during pregnancy.
Purpose
The main purpose of the study was to assess the knowledge and use of Intermittent Preventive Treatment of Malaria among pregnant women receiving Antenatal Care at the primary health centers of the Federal Capital Territory, Abuja Nigeria.
Methods
A quantitative, descriptive, cross-sectional study was conducted Structured questionnaires were administered to 300 pregnant women aged between 18 and 49 years. Data was analysed using Statistical Package for Social Sciences (SPSS) 22.
Results
The results revealed that most of the respondents had knowledge about IPT, majority of the respondents had received IPT drugs, in the clinic, but unfortunately none of them were supervised by a health worker during taking of the drug. Few of the respondents did not take the drugs at all for fear of complication, some of them did not know exactly how many tablets were given to them and there was poor adherence to the Directly Observed Therapy (DOT) scheme.
Conclusion
Knowledge of malaria and IPT was good and many pregnant women received the drugs and used it, but some of them had challenges and did not use the drugs.Health Studies
M.P.H.
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Gning, Ibrahima. "The effect of immigration status on racial differences in health insurance coverage, access to care, and utilization in the United States." 2008. http://proquest.umi.com.www5.sph.uth.tmc.edu:2048/pqdweb?did=1495950671&sid=1&Fmt=2&clientId=92&RQT=309&VName=PQD.
Full textAbstract:
Thesis (Dr. P.H.)--University of Texas Health Science Center at Houston, School of Public Health, 2008.Source: Dissertation Abstracts International, Volume: 69-02, Section: B, page: 0969. Adviser: Charles E. Begley. Includes bibliographical references.
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Njolomole, Stephen Emilio. "Determinants of HIV related stigma and discrimination among healthcare professionals at a health facility in Malawi." Diss., 2016. http://hdl.handle.net/10500/21184.
Full textAbstract:
Certain individual and institutional factors such as knowledge about stigma and discrimination, fear of infection, social judgement, legal and policy environment act as actionable drivers and facilitators of HIV-related stigma and discrimination. These factors may hinder the utilisation and quality of care provided to people living with HIV.
Purpose: The purpose of the study was to establish the actionable drivers and facilitators that determine the different forms of HIV-related stigma and discrimination among healthcare professionals at a district hospital in Malawi.
Methods: The study used a descriptive correlational study. Data was collected through self-administered questionnaire. Data were analysed using SPPS and STATA 12. Fisher's Exact Test was used to conclude the association and binary logistic regression was used to model the degree of the statistical relationships.
Results: The results showed statistically significant relationship between knowledge of stigma and discrimination, social judgement and awareness of workplace policy and HIV-related stigma and discrimination.
Recommendations: Interventions aimed at increasing knowledge about HIV-related stigma, reducing social judgement, reinforcing HIV-related workplace policies are needed to reduce HIV-related stigma and discrimination in healthcare settings.Health Studies
M. Ph. (Health Studies)
39
Ndou, Badinwaagwaani Joseph. "Challenges regarding the implementation of Employment Equity Act within the Department of Health and the management thereof: a case study of Vhembe District." Diss., 2015. http://hdl.handle.net/11602/196.
Full text
40
Siriwatanamethanon, Jirapa. "From experiencing social disgust to passing as normal : self-care processes among Thai people suffering from AIDS : a thesis presented in fulfillment of the requirements for the degree of Doctor of Philosophy in Nursing at Massey University, Palmerston North, New Zealand." 2008. http://hdl.handle.net/10179/739.
Full textAbstract:
AIDS is a chronic disease that seriously affects health, emotions, social relations and household economy. People living with HIV/AIDS experience great suffering, stigmatisation and discrimination from other people around them because they know that it is incurable, contagious, evokes social disgust and is a complex disease requiring life-long self-care. This researcher explored ways people with HIV/AIDS take care of their health and manage their lives in the context of stigma and discrimination. A grounded theory study was conducted with 30 participants with HIV/AIDS, in Mahasarakham Province, Thailand. Participants were recruited from an HIV/AIDS day care clinic and by snowball sampling. Data were gathered through in-depth interviews, participant observations and field notes made during home visits. Interviews were tape recorded, then transcribed verbatim. “From experiencing social disgust to passing as normal” was generated inductively from the data as the basic social psychological process of Thai people living with HIV/AIDS. From experiencing social disgust to passing as normal comprised four categories: being HIV/AIDS, making choices, keeping well and feeling empowered. The category “being HIV/AIDS”- discovering the meaning of having HIV/AIDS, comprises four concepts: being diagnosed with HIV/AIDS, being stigmatised, suffering, and learning about HIV/AIDS. The category “making choices”- to live a normal life, involves three concepts: avoiding unhappy situations, getting remarried and seeking support. The category “keeping well”- maintaining emotional and physical health, includes eight concepts: religious practices, keeping a cheerful mind, self-treatment, taking care of the body, keeping the environment clean to prevent getting germs, healthy behaviours, getting healthcare services, and attention to, and concern about, medication. The last category “feeling empowered”- personal and social acceptance of illness, includes eight concepts: being encouraged, acknowledging the disease, social acceptance, tamjai, feeling proud of self, feeling good about life, feeling lucky and having hope. In the context of northeastern Thailand, successful management of HIV/AIDS was underpinned by participants making a transition from “experiencing social disgust” to “passing as normal” within their communities. The desire to live a normal life despite having HIV/AIDS motivated participants to undertake effective self-care in order to remain symptom free (thus avoiding visible signs of the disease), and to selectively disclose their illness to avoid the ongoing risk of stigma and discrimination. The findings of this study are useful in that they will provide Thai health professionals with a clearer conceptualisation of self-care among the Thai population. An inductively derived theory of self-care among Thai with HIV/AIDS can be applied and integrated by health professionals into the self-care models for people living with HIV/AIDS including models used in nursing education, research and practice.
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Lawal, Afeez Folorunsho. "Between policy and reality: a study of a community based health insurance programme in Kwara State Nigeria." Thesis, 2020. http://hdl.handle.net/10500/27847.
Full textAbstract:
Bibliography: leaves 268-317The challenge of accessing affordable healthcare services in the developing countries prompted the promotion of community-based health insurance (CBHI) as an effective alternative. CBHI has been implemented in many countries of the South over the last three decades for the purpose of improving access and attaining universal health coverage. However, the sudden stoppage of a CBHI programme in rural Nigeria raised a lot of concerns about the suitability of the health financing scheme. Thus, this thesis examines the stoppage of the CBHI programme in rural Kwara, Nigeria. Premised on the health policy triangle as a conceptual framework, mixed methods approach was adopted for data collection. This involved 12 focus group discussions, 22 in-depth interviews, 32 key informant interviews and 1,583 questionaires. The study participants were community members, community leaders, healthcare providers, policymakers, international partner, health maintenance organisation officials and a researcher. Findings revealed that transnational actors relied on various resources (e.g. fund and ‘expertise’) and formed alliances with local actors to drive the introduction of the programme. As such, the design and implementation of the policy were dominated by international actors. Despite the sustainability challenges faced by the programme, the study found that it benefitted some of the enrolled community members. Though, even at the subsidised amount, enrolment premium was still a challenge for many. The main reasons for the stoppage of the programme are a paucity of fund and poor management. The stoppage of the programme, however, signified a point of reversal in the relative achievements recorded by the CBHI scheme because community members have deserted the healthcare facilities due to high costs of care. In view of these, the thesis notes that short-term policies often lead to temporary outcomes and suggests the need to repurpose the role of the state by introducing a long-term comprehensive healthcare policy – based on the reality of the nation – to provide equitable healthcare services for the citizenry irrespective of their capacity to pay.
Sociology
D. Phil. (Sociology)
42
Pilane-Majake, Chana. "Strategy for optimisation of the integration of HIV/AIDS in the mandate of the commission on gender equality in South Africa." Thesis, 2017. http://hdl.handle.net/10500/23583.
Full textAbstract:
This study was motivated by the commitment of the researcher to contribute towards the agenda for the development of women, in particular women affected and infected with HIV/Aids, through a better understanding and improved knowledge of the national and international legal and policy framework aimed at empowering women in South Africa. This study builds on countless efforts which have been implemented internationally to transform the world and create a peaceful and liveable world for women who have been historically oppressed, unrecognised and, in the case of women affected and infected with HIV, stigmatised. An increasing trend towards recognising the need to advance women and acknowledge their status in the community on the part of the international community was observed and then explored in the literature review which was conducted for the purposes of the study. The development of women is dependent on an enabling environment which is free from all forms of discrimination. Poverty, gender-based violence, cultural perceptions, as well as traditional and religious practices, all contribute to the challenges facing women. In addition, HIV/Aids is a continuous threat and impacts greatly on the lives of both women and their families.
The aim of the study was to explore the contribution that the Commission of Gender Equality (CGE) makes towards a better quality of life for women and also to contribute to the development of a strategy to optimise the integration of HIV/Aids issues into the mandate of the CGE.
The requisite data was collected through an extensive literature study of the research field, a document analysis and personal interviews with Commissioners of the CGE. The data were complemented and supported by the inputs of focus groups in which community members provided inputs about their experiences of the role played by the CGE at a community level.
ii
Data revealed limitations in the effective functioning and the measurable impact of the CGE. These were subsequently addressed in the design of a suggested strategic plan. The limitations included aspects relating to CGE organisational structure; the knowledge and skills of personnel, the lack of role clarification; the lack of a coordinated strategy; as well as a deficient working plan which, in its current format, shows a lack of continuity as a result of high staff turnover, a weak continuity strategy when commissioners’ term of office ends, limitations in terms of financial resources, and the absence of monitoring and control systems.Health Studies
D. Litt. et Phil. (Health Studies)
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Hollingshead, Nicole A. "An investigation of medical trainees' self-insight into their chronic pain management decisions." Thesis, 2014. http://hdl.handle.net/1805/4842.
Full textAbstract:
Indiana University-Purdue University Indianapolis (IUPUI)While the majority of chronic pain patients report receiving inadequate care, there is evidence that female and Black patients receive less analgesic medications and treatment for their chronic pain compared to male and White patients, respectively. While treatment disparities have been evidenced in the literature, there is little understanding of provider-factors, such as their decision-making awareness and attitudes, which may contribute to the differences in treatment. This investigation employed quantitative and qualitative procedures to examine the relationship between patient demographics and chronic pain treatment variability, providers’ awareness of these non-medical influences on their decisions, and the extent to which providers’ gender and racial attitudes associate with their treatment decisions. Twenty healthcare trainees made pain treatment decisions (opioid, antidepressant, physical therapy, pain specialty referral) for 16 computer-simulated patients presenting with chronic low back pain; patient sex and race were manipulated across vignettes. Participants then selected among 9 factors, including patient demographics, to indicate which factors influenced their treatment decisions for the simulated patients and completed gender and racial attitude measures. After online study completion, follow-up semi-structured interviews were conducted to discuss the medical/non-medical factors that influence trainees’ clinical treatment decisions. Quantitative analysis indicated that 5%-25% of trainees were actually influenced (p<0.10) by patient sex and race in their treatments, and on the whole, trainees gave higher antidepressant ratings to White than Black patients (p<.05). Fifty-five percent demonstrated concordance, or awareness, between their actual and reported use of patient demographics. Follow-up McNemar’s test indicated trainees were generally aware of the influence of demographics on their decisions. Overall, gender and racial attitudes did not associate with trainees’ treatment decisions, except trainees’ complementary stereotypes about Black individuals were positively associated with their opioid decisions for White patients. During qualitative interviews, aware and unaware trainees discussed similar themes related to sex and racial/ethnic differences in pain presentation and tailoring treatments. We found that (1) a subset of trainees were influenced by patient sex and race when making chronic pain treatment decisions, (2) trainees were generally aware of the influence of patient demographics, and (3) trainees discussed differences in pain presentation based on patients’ sex and ethnic origin. These findings suggest trainees’ are influenced by patient demographics and hold stereotypes about patient populations, which may play a role in their decision-making.
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Yimmam, Getachew Lenko. "Gender desparity in healthcare leadership in Southern Ethiopia." Diss., 2018. http://hdl.handle.net/10500/27373.
Full textAbstract:
Gender disparity in healthcare sector leadership positions is a major problem among
female healthcare professionals in Southern Ethiopia. This study explored gender
disparities among healthcare professionals in healthcare sector leadership positions.
The findings would be used to develop
guidelines to reduce gender disparities in
healthcare leadership in healthcare sectors to a minimum in Ethiopia. This study used
exploratory and descriptive cross-sectional research design incorporating a mixed
methods research approach to collect both quantitative and qualitative data
simultaneously which were analyzed during the same phase of the research process.
The quantitative survey data was collected using piloted structured questionnaire while
qualitative data was collected using semi-structured interview guide containing open
questions. Quantitative data was collected from a random sample of 414 healthcare
professionals and qualitative data from a purposive sample of 21 healthcare professionals
from seven districts having the experiences of gender disparity in healthcare leadership
positions. Quantitative data had a compliance rate of 98% and it was entered into EpiData
version 3.1 and exported to SPSS (version 24) for further analysis, and the qualitative
data was coded and analyzed manually into thematic content.
Quantitative findings of the study revealed that only 26% (n=108) of the participants
reported that representation of women in healthcare sector leadership positions in the
past few years has been increased. The majority of leadership positions assumed by
study participants were at department head level while only 1.3 % were on chief excutive
officers and 2.3% medical director positions respectively. Of these none was a female
and 67%, n=264 of the participants do not have leadership role in a health service facility.
Study participants having bachelor degree level of education were 2.3 times more likely
to be represented in healthcare sector leadership positions than those participants having
master’s degree and diploma [AOR=2.3, (95% CI: 1.289, 4.252)].
Challenges experienced by women health professionals regarding gender disparity in
leadership positions in health service facility included family responsibilities, lack of
support, lack of self-esteem or self-confidence, lack of career advancement, and cultural
bias. The conclusions derived from the study was that women need all the opportunities,
encouragement and support to allow them access to and success in healthcare sector
leadership positions through informal and formal leadership training.Health Studies
D.Litt. Phil (Health Studies)
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Monnakgotla, Nakedi Margaret. "Evaluation of the implementation of an HIV/AIDS workplace policy for farm workers : a case study of Country Mushrooms." Diss., 2012. http://hdl.handle.net/10500/6776.
Full textAbstract:
Farm workers in South Africa have limited access to health care and health-related information. In this qualitative study, the implementation of a workplace HIV/AIDS policy was evaluated using data gathered through interviews and observation. It was found that, although the farm workers were knowledgeable about HIV and AIDS, this knowledge was insufficient. It was found that the lives of farm workers are deeply affected by HIV and AIDS. It is also suggested that the agricultural sector is not yet able to deal effectively with HIV and AIDS and that, in this regard, urgent planning is needed in respect of HIV and AIDS policies and interventionsSocial Work
M.A. (Social Behaviour Studies in HIV/AIDS)