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Baldeh, Yero H. J. "Information support for district health care planning and decision making in The Gambia : a holistic approach." Thesis, University of Central Lancashire, 1997. http://clok.uclan.ac.uk/21604/.
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This research builds upon a body of previous research on health informatics in developing countries. Early research on this area was motivated by a desire to understand the role of different health informatics applications for an effective and efficient health care delivery in developing countries. These applications range from the use of medical expert systems for clinical diagnosis to epidemiological systems at the central level. None of these looked at health information systems at the district level, especially in relation to the information needs of district health staff. Therefore, this research differs from earlier studies in three aspects. First, it looks at the planning and decision-making processes at the district level and how information support could play a crucial role in these processes. Second, it provides a critical evaluation of the existing vertical reporting systems, and through action-research demonstrates the use of an integrated health information system at the district level. Third, it applies multiple perspectives to analyse the research findings in relation to information support for district health care planning and decision making. These three perspectives are the functional perspective, organisational perspective, and the political perspective. To achieve this, the research: • uses a systemic approach to examine the health care system in The Gambia; • uses action-research to design, develop and implement an integrated district health information system in The Gambia; • uses an interpretive evaluation framework to evaluate the impact of the system development efforts in this research; • uses the theory of contextualism to reflect on the research findings over the three year period. Various themes emerged during the research. These themes would be introduced here as the contributions to knowledge arising from the completion of this research project. These include: • a demonstration of the suitability of using a systemic approach for the design, development and implementation of an integrated information system for district health care planning and decision making; • the development of a conceptual implementation framework suitable for the unique characteristics of developing countries; • a manifestation of the implications of an integrated information system for management development, decentralisation, intersectoral coordination and community participation at the district level; • suggestions for further work especially on the need to evaluate the socio-political impact of this research on the existing political and cultural structures in The Gambia.
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Irlam, James. "A household survey of maternal and child health in the Mount Frere Health District, Eastern Cape." Master's thesis, University of Cape Town, 1998. http://hdl.handle.net/11427/26987.
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A cross-sectional household survey of maternal and child health was conducted in the Mount Frere health district of the Eastern Cape in August / September 1997. The aim was to describe key aspects of maternal and child health to inform the planning activities of the District Health Management Team (DHMT). A participatory process was followed, in order to develop research capacity within the district, and to facilitate interaction between health workers and the community. Methods: Structured questionnaires were used by local research trainees to gather data from each household on: • household demographics; • deaths in household since April 1994; • household access to water and sanitation; • children under five years; • children aged 5 to 15 years; • deliveries in the past 12 months; • knowledge of prevention and transmission of HIV/AIDS. Focus group discussions around the key findings were conducted with community members and clinic nurses to provide a qualitative component. Results: A high proportion of children under the age of 16, high household density, high unemployment, migrant labour, and absent mothers, are some of the defining demographic characteristics which affect the status of maternal and child health in the district. Access to health services is constrained by distance, lack of transport, and poor roads. Registration of births and deaths is poor, and the crude birth and death rates were found to be significantly higher than the " official" provincial rates. Tuberculosis, diarrhoea, trauma and homicide are notable features of the overall mortality profile, although the majority of deaths were classified "ill-defined / unknown". Diarrhoea and pneumonia accounted for half of all infant deaths. Eight out of ten deaths due to diarrhoea in under-fives occurred at home, but knowledge and use of oral rehydration solution is poor. Access to clean drinking water and sanitation is a major concern, with almost three quarters of homes using unprotected sources, a third more than 30 minutes' walk from the nearest source, and a half having no toilet. Areas of the district with particularly poor environmental health indicators were identified. Immunisation coverage among children 1-4 years is poor. Coverage for all vaccines except BCG falls well short of the national target of 90%, and fewer than 1 in 3 children was fully immunised with valid doses at the age of one year. Long intervals between doses and a high "dropout" rate between subsequent doses was observed. The road to health card (RTHC) could be produced for just over a half of under-five children. The proportion of home deliveries is high (45%), and traditional birth attendants (TBAs) therefore play an important role in this community. Nine out of ten mothers had attended antenatal clinic at least once, but almost half reported receiving no tetanus toxoid and no WR test for syphilis during their antenatal visits. More than a half of all mothers was using no family planning method at the time of the survey. Almost all 15-49 year-olds had heard about HIV/AIDS, but one in five did not know how HIV is transmitted, and a third did not know how it could be prevented. Recommendations: A detailed set of recommendations with action points for the DHMT was developed in a district workshop around the following key issues: 1. Improving access to health care, including road access, mobile clinic coverage, and waiting facilities for expectant mothers. 2. Promoting health in the community, by means of integration of health promotion into all health programmes, and more involvement of communities. 3. Improving the quality of care in the existing health facilities and services, including minimising missed opportunities for immunisation, and promoting home-made oral rehydration (sugar-salt) solution. 4. Improving the district health information system, especially the registration of vital events, and the provision of feedback to district health managers. 5. Identifying areas of further research, including the reasons for home deliveries, management of diarrhoea at home, and the use of traditional healers. Conclusion: The participatory research process that was used has helped to build research capacity in the district, to provide a deeper insight into community health problems, to highlight the value of health workers listening to the people they serve, to further collaboration between the disciplines, and to develop specific action plans. This is a process that should be followed in all research conducted in health districts.
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Aller, Joseph. "Enrolling eligible but uninsured children in Medicaid and the State Children's Health Insurance Program (SCHIP)| A multi-district pilot program in Michigan schools." Thesis, Central Michigan University, 2014. http://pqdtopen.proquest.com/#viewpdf?dispub=3629420.
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According to U.S. Census figures and the Michigan Department of Community Health (2011), there are approximately 5% - 6% of children in the State of Michigan who are uninsured and it is estimated 70% of these uninsured children may be eligible for State subsidized health insurance. While the percent of uninsured children in Michigan consistently rates well below the national average, it is concerning the rate of uninsured children in Michigan is relatively stable. There are strong financial and social incentives to design outreach efforts to reach all children in the State and make these efforts an "everyday event."
This research examines the question of whether or not a school-based outreach program is effective in reaching children who are eligible for State subsidized health insurance but are uninsured and will test the following two hypotheses:
Ho1: Incorporating health status outreach into routine school district operations does not identify a statistically significant number of uninsured children.
Ho2: There is no statistical difference in the number of applications received from a school-based outreach program during the pilot period.
The pilot program takes place in six of the eleven school districts that operate in Van Buren County, MI. School districts were provided two health insurance status collection forms. Form A is designed to be distributed with the Free and Reduced Lunch Application. Form B is designed to be distributed as part of the student registration packet and welcome material. The completed Form A and Form B are sent to a State of Michigan registered application assisting agency for SCHIP application assistance and enrollment.
As a result of the survey, 156 children were identified as not having health insurance. This represents more than 44% of the 358 children who are eligible for State subsidized health insurance, in the participating school districts, but are uninsured. Enrolling these children will help the State of Michigan to meet targeted enrollment gains and earn CHIPRA performance bonus payments. The additional funds from higher CHIPRA bonus payments could be used to provide the resources to fund the following specific recommendations:
1. The Michigan Department of Community Health should lead the effort to work with the Michigan Department of Education to modify the Free and Reduced Lunch Application to capture whether or not the applicant has health insurance.
2. The Michigan Department of Community Health should lead the effort to incorporate into the direct certified free and reduced lunch eligibility process a systematic check as to whether or not the applicant has State subsidized health insurance.
3. The Michigan Department of Community Health should provide resources from the expected performance bonus to work with schools across the State to implement these changes. (Abstract shortened by UMI.)
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Bazunu, Antoinette. "Are Florida's children safer? : a public management perspective of the decision to privatize child welfare services in district 7." Honors in the Major Thesis, University of Central Florida, 2008. http://digital.library.ucf.edu/cdm/ref/collection/ETH/id/1062.
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This item is only available in print in the UCF Libraries. If this is your Honors Thesis, you can help us make it available online for use by researchers around the world by following the instructions on the distribution consent form at http://library.ucf.edu/Systems/DigitalInitiatives/DigitalCollections/InternetDistributionConsentAgreementForm.pdf You may also contact the project coordinator, Kerri Bottorff, at kerri.bottorff@ucf.edu for more information.Bachelors
Health and Public Affairs
Public Administration
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Guedes, Gabriela Nery Faria. "Formulação, aplicação e avaliação de programa de educação em saúde em escola de Visconde de Mauá, distrito de Resende, Rio de Janeiro, RJ." Universidade de São Paulo, 2011. http://www.teses.usp.br/teses/disponiveis/10/10134/tde-27092012-163617/.
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Os cães já fazem parte do cotidiano do homem há milhares de anos. Atualmente, os cães assumem o papel de membros da família, apresentando um forte vínculo com os familiares, incluindo crianças. No entanto, as crianças, assim como a maioria dos adultos, pouco sabem ou aprendem sobre como cuidar de um animal, como prevenir zoonoses ou exercer a Guarda Responsável, propagando uma visão antropocêntrica. O presente trabalho visou mostrar de que maneira a Educação em Saúde pode trazer benefícios na formação ética e psicológica, por melhorar a relação criança-animal, ao mesmo tempo em que reduz a os riscos inerentes às doenças zoonóticas e o abandono de animais. As avaliações foram feitas com a utilização de questionários com questões abertas e fechadas em duas etapas, antes e após o projeto educativo. Para a comparação dos dados quantitativos obtidos nas duas fases, utilizou-se os testes de McNemar e de Homogeneidade Marginal, para análise qualitativa foram realizados grupos focais com crianças e professoras. O projeto educativo proporcionou a aquisição de conhecimento sobre os temas abordados e algumas mudanças de atitudes das crianças com seus animais de companhia, o que pode ser percebido pelo grupo focal e por algumas mudanças estatisticamente significantes entre as fases 1 e 2.Dogs are already part of everyday life of man for thousands of years. Currently, the dogs take on the role of family members, showing a strong bond with them, including children. However, children as well as most adults know and learn little about caring for an animal, how to prevent zoonoses or promote Responsible Ownership, propagating an anthropocentric view. This study aims to show how health education can bring benefits in the ethical and psychological, by improving the child-animal relationship, while reducing the risks inherent in zoonotic diseases and the abandonment of animals. The evaluations were done with the use of questionnaires with open and closed questions in two stages, before and after the educational project. For comparison of quantitative data obtained in the two phases, we used the McNemar and Marginal Homogeneity tests, for the qualitative analysis was conducted focus groups with children and teachers. The educative project provided knowledge on the topics covered and some changes in attitudes of children with their pets, which could be perceived by the focus group and some statistically significant changes between phases 1 and 2.
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Smith, Curtis A. "Forecasting school district fiscal health." The Ohio State University, 1985. http://rave.ohiolink.edu/etdc/view?acc_num=osu1299083055.
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Kennedy, Catherine. "Welfare and health : systems in tension." Thesis, University of Glasgow, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.297521.
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Moser, Michele R., T. Clark, and Andres Pumariega. "Mental Health Disparities in Child Welfare." Digital Commons @ East Tennessee State University, 2004. https://dc.etsu.edu/etsu-works/4973.
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Mayanja, Rehema. "Decentralized health care services delivery in selected districts in Uganda." Thesis, University of the Western Cape, 2005. http://etd.uwc.ac.za/index.php?module=etd&.
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Decentralization of health services in Uganda, driven by the structural adjustment programme of the World Bank, was embraced by government as a means to change the health institutional structure and process delivery of health services in the country. Arising from the decentralization process, the transfer of power concerning functions from the top administrative hierachy in health service provision to lower levels, constitutes a major shift in management, philosophy, infrastructure development, communication as well as other functional roles by actors at various levels of health care. This study focused its investigation on ways and levels to which the process of decentralization of health service delivery has attained efficient and effective provision of health services. The study also examined the extent to which the shift of health service provision has influenced the role of local jurisdictions and communities. Challenges faced by local government leaders in planning and raising funds in response to decentralized health serdelivery were examined.
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Boyer, Stacy Bingham. "The Implementation of Refugee Health Policies and Services in Virginia's Local Health Districts." Thesis, Virginia Tech, 2002. http://hdl.handle.net/10919/36414.
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In 1997, the Virginia Refugee Health Program coordinated a protocol and reimbursement structure to encourage health departments to perform initial health screenings on refugees settling in the Commonwealth by establishing four recommended levels of assessment. This thesis is concerned with these initial health-related services provided to refugees by Virginia's health departments, the quality of these services, and how they vary from one district to another. For this study, I interviewed health department staff representing 13 of Virginia's 19 districts that rendered health screenings in 2000. Information such as the level of assessment provided, and the types of procedures and services offered were the main foci of the interviews. I found that of the 13 districts, three (the cities of Alexandria and Virginia Beach, and Prince William County) offer only the required minimum to refugees. The variations I discovered in the services that health districts provide suggest, conceptually, the workings of both "structure" and "agency." Each health department is formally and informally structured in terms of staffing, services, and resources in accordance with its individual needs and initiatives. The structure of current funding at both the state and local level acts to inhibit some health districts from providing all four levels of assessment. In addition, human agency in the form of personal interest in meeting refugee's health needs as well as district collaboration with local resettlement agencies, also plays an important role in the extent of refugee services rendered.Master of Science
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Ford, Harold E. Lynn Mary Ann Halinski Ronald S. "Medical self-insurance in Illinois public school districts." Normal, Ill. : Illinois State University, 1989. http://wwwlib.umi.com/cr/ilstu/fullcit?p8918611.
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Thesis (Ph. D.)--Illinois State University, 1989.Title from title page screen, viewed Oct. 3, 2005. Dissertation Committee: Mary Ann Lynn, Ronald S. Halinksi (co-chairs), Robert L. Arnold, Calvin C. Jackson, Rodney P. Riegle. Additional title from abstract: Self-insured employee health plans in Illinois public school districts. Includes bibliographical references (leaves 166-171) and abstract. Also available in print.
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Cetin, Didem. "A Study Of Fear Of Crime In Two Districts Of Ankara." Phd thesis, METU, 2010. http://etd.lib.metu.edu.tr/upload/3/12611637/index.pdf.
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The purpose of this study is to understand the fear of crime in the society. The studies in the literature, which focus on sociology of crime in general and the fear of crime in particular, were carried out within the social dynamics of other countries, and mostly the western societies. In this sense, it is clear that there is a need to make evaluations that specifically address our society. In this study, it was aimed to achieve a holistic analysis of fear of crime, based on the question &ldquowhat are the factors that determine fear of crime in individuals?&rdquo
It is assumed that there are many factors that determine fear of crime in individuals. Differences in socio-economic status, which can be counted among these factors, are addressed under the scope of this study. It is assumed that people from different socio-economic statuses can also experience fear of crime in different ways. To this end, a field survey was conducted in the districts of Ç
ankaya and Altindag in the province of Ankara, and a total of 510 individuals were surveyed through a questionnaire. According to the results of the survey, incivilities appear as the most determinant factor of fear of crime in the society, followed by districts, which represent the area of living and which were used as a basis in sample selection for this survey
the third factor that determines fear of crime is gender, and the fifth factor is the indirect victimization. Other findings of the survey are discussed throughout the thesis.
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Walsh, Sheila Marie. "Linking coral reef health and human welfare." Diss., [La Jolla] : University of California, San Diego, 2009. http://wwwlib.umi.com/cr/ucsd/fullcit?p3369722.
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Thesis (Ph. D.)--University of California, San Diego, 2009.Title from first page of PDF file (viewed September 17, 2009). Available via ProQuest Digital Dissertations. Vita. Includes bibliographical references.
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Lowe, James. "Residential mobility, mental health and welfare reform." Thesis, University of Southampton, 2017. https://eprints.soton.ac.uk/411299/.
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This thesis qualitatively examines the interplay between service users’ residential mobility and mental health and assesses the ways in which each is influenced or determined by the other. Twenty-five service users in England were over a period of eighteen months interviewed in depth about their experiences of both residential mobility and mental health. These interviews were conducted against the backdrop of the on-going austerity-driven reforms to the welfare state that have witnessed the rapid promulgation of policies designed to spur service user entry into the formal labour market, via the use of restrictions on continued eligibility for particular sickness, disability, and housing benefits, and reductions in their monetary value. Evidence from the interviews is used to test two of the primary models through which the residential mobility patterns of service users have been explained: displacement from unstable lodgings resulting in circulation through disparate residential settings; and entrapment in low quality accommodation in predominately deprived areas. The thesis finds evidence of both scenarios, and reports on the negative health experiences encountered therein. It demonstrates that the extent to which residential circumstances have a negative impact on mental health rests upon whether service users feel unable to exercise any control over their residential choices. The exercise of which is being further compromised by a hastily reformed system for determining on-going eligibility to welfare benefits and a wider retrenchment of the services and facilities around which users have often orientated their lives. Here, invasive and ineffectual medical assessments destabilise service users and threaten a reduction in income, enforced changes in accommodation, and the rupture of their carefully calibrated wellness strategies which, in the absence of wider service provision, are increasingly emplaced in and around users’ own homes. The findings raise considerable questions about the operation of the welfare system and its impact for service users’ health and residential stability.
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Welchman, D. de B. "The production, health and welfare of veal calves." Thesis, University of Bristol, 1986. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.373858.
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Upjohn, Melissa. "Health and welfare of working horses in Lesotho." Thesis, Royal Veterinary College (University of London), 2012. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.572482.
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Although equine charities’ presence in developing countries is assumed to improve working equine health, little scientifically substantiated information is available on the impact of such projects in targeted communities or about communities’ horse health priorities. This work aims to (i) evaluate and quantify the impact of World Horse Welfare training in farriery, saddlery and nutrition-related interventions on health of Lesotho’s working horses (ii) elicit community priority horse health topics using participatory methods for comparison with topics identified using epidemiological techniques. A baseline cross-sectional survey was conducted before World Horse Welfare’s first training course, with two follow-up surveys 9 and 20 months after first year course completion. Each followed a standardised clinical examination protocol for horses and administered a structured questionnaire on equine husbandry/primary health care knowledge and practices with study horses’ owners. Standardised data on tack used on horses was also collected. Data was analysed quantitatively to assess changes in equine health and tack parameters and owners’ knowledge and practices over the intervening period. Following impact evaluation, owner discussion groups were convened, employing participatory facilitation techniques to elicit owner-specified key horse health-associated issues and their priority order. Limited changes in farriery-related parameters were identified, but few saddlery-related improvements resulted; problems including high prevalence of poor tack and tack-associated injuries persisted. High prevalence of suboptimal body condition score, sharp enamel teeth points, parasite infestation, overgrown hooves and adverse clinical pathology parameters persisted throughout the study. Owners’ basic husbandry knowledge and application remained variable. Community-specified horse health priorities were mouthcare, nutrition, disease management, feet and husbandry. Engaging horse owners to understand country-specific issues and elicit community priorities is essential before designing interventions to improve equine health. A complex change process involving owner knowledge, attitudes and behaviour, underpinned by community support and bespoke step-wise interventions is required to achieve sustainable equine health improvements.
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Easterlow, Donna. "Housing and health : a geography of welfare restructuring." Thesis, University of Edinburgh, 1998. http://hdl.handle.net/1842/21220.
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Current health policy in England emphasises the environmental determinants of health and well-being and the care of chronically sick and vulnerable people in and by the community. A recent resurgence of research interest into the complex links between housing and health provides evidence of the detrimental effect of poor housing design, condition and location on occupants' physical health and mental well-being as well as on their access to care and social support. A new, less documented, line of research argues that the observed relationship between housing and health might also reflect the effect of health status on opportunities in the housing system. In this light it is argued here that the success of national health policy depends both on the availability of 'healthy' homes and on the effective use of housing provision to meet health and care needs. Historically, the only part of the housing system that has actively attempted to operationalise the concept of housing for health has been the social - largely council - rented sector. For the past 25 years this has been achieved through the mechanism of medical priority for rehousing (MPR) - the process of assigning priority in the housing queues on the grounds of medical need. There is evidence, however, that just as health gain has become a legitimate objective for housing policy and practice, the system of medical priority rehousing is under increasing pressure in many areas of the country. The most important challenge comes from the privatisation of the social housing system and its changed character, size and quality, as well as its spatial unevenness. In order to explore the current capacity and future potential of a restructured social housing system to secure health gains through housing interventions, this study includes the ESRC-funded secondary analysis of data collected in the early 1990s as part of a national study into social housing provision for people with health and mobility needs in England. My analysis highlights geographical differences in the operation of medical rehousing and documents the inequitable outcomes that occur both within and between local areas as housing managers implement a range of different rationing methods in the attempt to regulate demand for rehousing. Complementing a large existing literature on the problems of access to council housing for the most marginalised groups in society, I explore the difficulties experienced by those with health needs - a relatively privileged group among the benefit-dependent poor - in mobilising the system of medical priority rehousing and of securing a suitable home through the process of matching applicants to stock. While on the one hand the study shows that medical priority rehousing can secure favourable housing (and health) outcomes for some of those with health needs, an important point to emerge is that the system is increasingly failing to cater for the majority of those in medical need, albeit more so in some areas than others, in most parts of the country. This raises important questions - that are also briefly explored - about how those with health problems fare in the market sector of the housing system. I conclude that, in order to harness housing policy and practice to health aims more effectively, a more tenure-neutral healthy housing policy is required. Thus my recommendations include a number of administrative changes to the operation of medical priority rehousing as well as an increased social investment in all housing sectors.
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Shoja, Amin. "Three Essays in Health, Welfare, and International Economics." FIU Digital Commons, 2018. https://digitalcommons.fiu.edu/etd/3757.
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Both economists and policy makers are interested in understanding the welfare effect of economic policies, especially in small open economies such as Turkey and Iran. This knowledge is crucial for priority setting in any informed policy discussion. This dissertation aims to study the impoverishing effect of high levels of out-of-pocket (OOP) payments in the health sector, referred to as catastrophic health expenditure (CHE), and investigates the impact of exchange rate pass-through (ERPT) on both the microeconomic and macroeconomic indicators of a country. For millions of people worldwide, health payments present a huge financial risk. A high rate of OOP health care payments can lead to CHE, which can force households to cut down their consumption, minimize access to their needs, or face poverty. This makes the design of financial risk protection necessary for governments in order to secure people against the financial hardship at the time of incurring CHE. This thesis comprises three essays. The first investigates financial risk protection indicators related to OOP health care payments through CHE mean positive overshoot and incidence and depth of impoverishment. This research observes that in the absence of universal health care insurance in Iran, together with a high share of OOP spending for health care (more than 52%), the Iranian households facing CHE will eventually face poverty. In the second essay, using a difference-in-differences propensity score matching approach, I seek to analyze the degree to which Iranian universal health care insurance protects households from high rates of OOP health expenditure. In this study, I evaluate the effect of the universal health insurance program on Iranian CHE. The results show that the program was successful in decreasing the rate of OOP health expenditures and CHE in Iran during the sample period. The third essay estimates the ERPT using product-level daily data on wholesale prices of imported agricultural products, where the identification is possible by using daily data on the domestic inflation rate. The results of standard empirical analyses are in line with existing studies that employ lower frequencies of data by showing evidence for incomplete daily ERPT of about 5 percent.
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Robinson, Lauren Marie. "The influence of personality on primate health, welfare, and happiness." Thesis, University of Edinburgh, 2017. http://hdl.handle.net/1842/25767.
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Is personality important for understanding the variation we see in animal welfare? In this thesis, I address that question by studying the association between personality and health, welfare, and happiness in three species of nonhuman primate: rhesus macaques (Macaca mulatta), brown capuchins (Sapajus apella), and chimpanzees (Pan troglodytes). As part of this research I test a newly designed animal welfare questionnaire. In Chapter 1 I review how animal welfare questionnaires can be designed and implemented as an addition tool for assessing animal welfare. In Chapter 2 I present a study of rhesus macaque personality, dominance, behaviour, and health. In Chapter 3 I test the reliability and validity of my animal welfare questionnaire. In Chapter 4 I extended my work on welfare questionnaires to test if they are valid for assessment of chimpanzee welfare and associated with personality. I specifically test if welfare ratings are based on observed behaviour. I conclude my quantitative work in Chapter 5 with a study testing the association between personality and health, welfare, and subjective well-being in rhesus macaques. Finally, Chapter 6 includes my conclusions and future directions for this line of research. Across all four quantitative studies some common trends were found. First, personality is associated with overall welfare and health. Second, welfare questionnaires are reliable and valid way to assess welfare in the studied species. And third, welfare and subjective well-being are measuring the same construct in these species. Overall, I conclude that personality is clearly useful for understanding animal welfare and that questionnaires are a reliable, valid, and valuable method of animal welfare assessment, in additional to traditional methods.
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Mmbando, Zebadia Paul. "Factors influencing men's involvement in reproductive health in Arusha and Arumeru districts, Tanzania." Thesis, University of the Western Cape, 2010. http://hdl.handle.net/11394/2557.
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Magister Public Health - MPHThe study findings were thematically grouped into three themes including the coordination and partnerships, culture and implementation challenges. Poor coordination and failure of systems in place appeared to characterise the many challenges. Gender inequalities and masculine dominated cultural practices like polygamy and widow inheritance are associated with consequences of ill health among women; including high HIV/AIDS prevalence, early marriage, high teenage pregnancies and high maternal mortality. Although these practices are in favor of men, they hardly protect them from the wrath of poor RH like STDS, HIV/AIDS, stressful big families and vast poverty. Hence, Tanzanian men are also victims of their own behavior.
South Africa
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Ireland, Joanne Lesley. "Equine geriatric health and welfare in the United Kingdom." Thesis, University of Liverpool, 2011. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.570228.
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Geriatric medicine is increasingly important in equine veterinary practice, as aged horses now represent a substantial proportion of the equine population. Although older horses may suffer from different health and welfare issues compared to younger animals, there is a paucity of reliable information on the prevalence of medical conditions and causes of mortality in geriatric horses in the UK. Additionally, previous studies have suggested that owner recognition of health and welfare problems in their aged horses may be suboptimal. A cross-sectional postal questionnaire survey of 918 randomly selected owners of veterinary-registered geriatric horses and ponies (aged ~ 15 years) provided detailed information on demographic characteristics, management practices, preventive health care measures, prevalence of owner-reported health problems and quality of life (QoL). Horses aged ~ 15 years represented 29% of the equine population, with 2% > 30 years old. The overall standard of management was high and there were changes in exercise and feeding practices with increasing horse age. However, the provision of several health care measures, including vaccination, farrier care and routine veterinary checks was reduced as geriatric horses increased in age. Owners frequently observed clinical signs of disease in their animals, with 77% reporting at least one sign, yet a considerably smaller proportion of owners reported their animal currently suffered from a known disease or disorder (31%). Detailed veterinary clinical examination of a subset of horses (n=200) enrolled in the cross-sectional survey demonstrated dental disorders (95%), ocular abnormalities (94%), dermatological conditions (71%) and musculoskeletal disease (lameness observed in 51%) were particularly prevalent, with many animals having multiple disease conditions. Owners tended to underestimate body condition and clinical signs of diseases such as orthopaedic conditions or Pituitary Pars Intermedia Dysfunction frequently appeared to be considered as signs of senescence rather than attributed to a disease process. Relatively poor agreement of owner-reported disease compared to that detected on veterinary examination suggests inaccurate or under-recognition of health problems by owners of geriatric horses, which could lead to a delay in presentation for veterinary treatment. Owners reported that the majority of geriatric animals enjoyed a high quality of life (QoL), with 95% rating their horse's QoL as good or excellent. However, increasing age corresponded negatively with many health-related QoL factors. QoL after the procedure, life-threatening disorders, painful/stressful procedures and veterinary advice were the most important factors in influencing owners' choice of treatment options for a severe illness or injury. To investigate mortality rates, causes of death or euthanasia and factors associated with mortality, horses from the cross-sectional study were enrolled in a cohort study in which follow-up information was obtained over an 18-month period via telephone questionnaires. Overall mortality rate was 11.1 (95% C}, 9.2 -13.2) per 100 horse-years at risk, increasing with increasing horse age. Lameness (24%) and colic (21%) were the most common reasons for euthanasia. Multivariable Cox proportional hazards analysis showed that factors associated with increased risk of mortality were breed (Cob/Cob cross and Thoroughbred/Thoroughbred cross), poor body condition, increasing number of owner- reported clinical signs and the degree to which pain limited normal daily activities. This is the first major study of health and welfare in geriatric horses in the United Kingdom. The reduced frequency of routine preventive health care measures, along with suboptimal owner recognition of health problems may lead to compromised welfare in the geriatric population. Owner perceptions of factors affecting QoL of geriatric horses may prove useful in the development of a QoL assessment tool for aging horses. Results presented in this thesis can be used to inform future veterinary involvement in geriatric equine medicine and in the development of targeted owner education programmes for geriatric health and welfare.
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Gelling, Merryl. "Health and welfare in reintroductions : Lessons from small mammals." Thesis, University of Oxford, 2010. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.525311.
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Matheson, Stephanie. "Genetic selection for health and welfare traits in lambs." Thesis, University of Edinburgh, 2012. http://hdl.handle.net/1842/7625.
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Lamb mortality remains a significant welfare and economic issue for sheep production. Two significant causes of mortality are dystocia and low lamb vigour; both requiring high levels of human care to ensure lamb survival. Genetic solutions to reduce lamb mortality and its main causes (dystocia and low vigour lambs) are desirable, with at least two possible solutions available: (i) use of suitable breeds or strains and (ii) intrabreed selection. Approach (i) requires the existence of breed/strain differences in the desired traits and approach (ii) needs sufficient intrabreed genetic variance. Reproductive and behavioural traits are, however, difficult to quantify and measure on farm. On dedicated research farms, lamb vigour has been measured using latencies to perform specific behaviours (e.g. standing and sucking) but this methodology is difficult to transfer to a commercial setting - timed behavioural traits are not as easy to measure on farm when compared with categorical indicator traits. Therefore, proxy methods (categorical scoring systems) are needed to measure behaviour traits in a manner that allows for collection of sufficient data to enable genetic analysis. The main purpose of this thesis was to develop such proxy methods, to estimate the heritability of lamb traits, and thus to investigate whether it is possible to improve the welfare of lambs through selection of parents with superior vigour and lambing ease characteristics. Scoring systems were developed for quantifying neonatal lamb fitness and behaviour traits. Detailed historical behaviour data were analysed to develop criteria for three scores: birth assistance (BA), lamb vigour (LV) and sucking assistance (SA). These scoring systems were then validated in a separate flock by simultaneously recording scores and the latency to perform certain landmark behaviours. The results obtained indicated that the scoring systems developed were a practical, reliable and sensitive indicator of lamb fitness traits. To determine whether neonatal lamb vigour traits were heritable, scores from the scoring systems previously developed and validated were recorded in an experimental flock of pure-bred Texel sheep for the purpose of estimating genetics parameters for each trait. Results indicated that heritabilities for all traits range from low-moderate, BA 0.43 (s.e. 0.063), LV 0.15 (s.e. 0.059), SA (0.27 (s.e. 0.045), suggesting there is sufficient variation present within this Texel sub-population to allow for selection for improved neonatal fitness traits. Thus far, we have determined that neonatal traits are heritable and can be measured using proxy scoring systems. The next step was to establish whether the proxy scores developed were feasible, in a commercial setting, for the mass data collection needed for estimation of genetic parameters and to determine the relationship between neonatal traits and later production traits, with the aim of integrating this data into breeding programmes. A total of 11,092 lambs with complete neonatal records, from 290 flocks belonging to the Industrial Partner, the Suffolk Sheep Society (UK), were analysed to report the genetic variance present within the UK population of registered pure-bred Suffolk sheep. The results from this analysis show that heritabilities were moderate for BA, 0.26 (s.e. 0.03), LV, 0.40 (s.e. 0.04) and SA, 0.32 (s.e. 0.03) with genetic correlations between neonatal traits all moderate to high and positive. This demonstrates that neonatal fitness traits can have heritabilities comparable to those of production traits. The analysis also shows that neonatal survival traits of birth assistance and sucking assistance are moderately heritable, when treated as a lamb trait rather than a sire or ewe trait, indicating the selection should target the lambs in order to successfully, and efficiently, improve survival. A possible alternative method for improving dystocia and lamb vigour would be to introgress genes for improved lambing ease and lamb vigour from the New Zealand strain of Suffolk sheep into the British Suffolk strains. However, there has been no published record of how much ‘NZ genetics’ would improve (or compare to) British Suffolk’s under standard UK management practises. Therefore, the objectives of this study were to examine possible differences in neonatal behavioural traits (birth assistance, lamb vigour and sucking assistance) between NZ and UK Suffolks when used as terminal sires on commercial cross-bred ewes. Thus, neonatal scores from cross-bred lambs sired by rams from one of the three main Suffolk strains currently used in the UK were compared. The analysis indicated there was no significant effect of sire strain on any of the neonatal traits, and that individual sire variation was greater than the variation between the strains. In conclusion, the work contained within this thesis shows that neonatal lamb behaviour traits can be measured accurately and easily using well-realised and biologically relevant scoring systems. Furthermore, these scoring systems are a feasible and practical method of measuring neonatal lamb vigour which may be used to evaluate management systems and to improve selection criteria for neonatal traits.
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Rostila, Mikael. "Healthy bridges : studies of social capital, welfare, and health /." Stockholm : Department of Sociology, Stockholm University, 2008. http://urn.kb.se/resolve?urn=urn:nbn:se:su:diva-7486.
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Park, Jong Il. "A study of strategies for vitalizing mission for the elderly through church districts welfare works for domiciliary old-aged people." Theological Research Exchange Network (TREN), 2003. http://www.tren.com.
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Zinyakatira, Nesbert. "Completeness of death registration in Cape Town and its health districts, 1996-2004." Master's thesis, University of Cape Town, 2007. http://hdl.handle.net/11427/17272.
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It is important for health planners to have timeous and accurate data on deaths. The Department of Home Affairs is responsible for the registration of deaths and the City of Cape Town has a well-established system of collating the death statistics based on vital registration, but the completeness of the death registration has not been assessed previously. The completeness was assessed for the City of Cape Town by comparing their statistics with an estimate based on data obtained from adult deaths reported in the 2001 census. A second approach assessed the trend in completeness between 1996 and 2004 by identifying three rates of mortality considered to be stable over time (non-lung and non-oesophageal cancers, the 10-14 age group and the 60+ age group) and inspecting to observe whether there was any trend apparent over time. Since deaths in most cases are under reported, and the under reporting usually differs in completeness between children and adults, child deaths from the ASSA model projection assuming that they are more complete were compared with the child deaths from the vital registration between 1996 and 2004 to check for completeness of the child vital registration data in Cape Town and its eight health districts The results show high levels of completeness in the adult deaths for Cape Town as a whole in 2001, around 95 per cent, but varying levels in the health districts. The completeness of reporting of male deaths in Cape Town declines with age, whilst completeness for females is fairly level with respect to age, with similar trends being observed in the health districts. Completeness of child (0 -4) death registration averaged around 60 per cent, about 35 per cent lower than the completeness of adult deaths in Cape Town. Cape Town as a whole and most of its health districts revealed two levels of completeness in the registration of deaths, 1996-1999 and 2001-2004 with 2000 sometimes consistent with the first and sometimes with the second period or different from either period in some of the health districts. In conclusion, the completeness estimates obtained are more rigorous from 2001 onwards suggesting that they can be reliably used to monitor trends in the levels of mortality in the city of Cape Town.
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Njoumemi, Zakariaou. "Enabling and regulating private sector provision of malaria services in three districts of Western Cameroon." Doctoral thesis, University of Cape Town, 2007. http://hdl.handle.net/11427/7442.
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Includes bibliographical references (leaves 369-414).This study aims to examine the existing enabling and regulatory interventions in Cameroon, and to explore their impact on the performance of private providers of malaria services. It makes recommendations to decision-makers on the best strategies for influencing the performance of private providers of public health services in low income countries. The study’s framework involves the Ministry of Health as a principal who authorises the private sector as an agent to provide malaria services to populations, in exchange for mutually agreed rewards and in the context of specified rules. Data were collected using both qualitative and quantitative research methods. This study found that the private sector provides a substantial portion of malaria services in Cameroon. There is evidence that enabling and regulatory interventions can enhance the private sector's quantity and quality of inputs which are used for expanding coverage, improving quality of care and affordability of malaria services. These interventions can approximate the objectives of multiple stakeholders including the Ministry of Health, Medical Council, managers, clinical staff and patients, thereby addressing the principal- agent problems in the health sector. Areas of private sector activity that are particularly difficult, but critical to influence are those of overcharging, unnecessary self-referral and issues of informal providers. Enabling interventions neither compete with nor negate traditional regulations in the health sector but seek to complement regulatory mechanisms by adding value from the perspective of influencing private sector providers’ behaviour. Government needs to invest in its ability - improving capacities and governance, providing resources and logistics - to oversee the ongoing development, implementation, monitoring and revision of enabling and regulatory interventions for the private health sector. The performance of private providers appears to be more positively influenced by enabling interventions than by regulatory mechanisms. In the absence of enabling interventions it may be inappropriate to try to influence the performance of private providers through regulatory mechanisms alone. While the resources needed for enforcement of regulations are limited, enabling and regulatory interventions can be integrated in such a way that it is in the interests of the private sector to comply with regulation of health service delivery. This can reduce the level of resources needed for effective enforcement of regulation amongst private providers. This study concludes that the integration of enabling and regulatory interventions appear to be a strategic policy option for influencing the performance of private providers of malaria services in low income countries.
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Södergren, Carin. "How stimuli by toys affect pigs growth, health and welfare." Thesis, Högskolan på Gotland, Institutionen för kultur, energi och miljö, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:hgo:diva-731.
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Pigs do naturally have a high motivation to explore their environment. In a poor environment pigs still display this motivation and when there is no stimulation in the pen, pigs direct their behavior at pen-mates and pen components. Lack of stimulation can lead to decreased welfare and increased stress. This study investigates if extra stimuli by toys would affect pigs growth, health and welfare. Growing pigs (219) were followed during 7 weeks and divided into twenty two pens, eleven with toys and eleven without toys. I found partly support for the prediction that toys would help in a short time perspective but there was no support for the prediction that in a longer run the toys (used in this experiment) would increase pigs welfare. One explanation to this might be the straw that all the pens had (by law in Sweden), which seemed to be the most importuned component for satisfying pigs behavioral needs.
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Cook, Kay Elizabeth. "Working for welfare, low-income single-mothers' experiences and health." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2000. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape4/PQDD_0005/MQ59791.pdf.
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Corbett, L. E. "Recipient health in response to welfare reform, Ontario 1994-1999." Thesis, University of Cambridge, 2009. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.597992.
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Increasing attention is being paid to the common ground uniting income inequalities and health status by gauging how societal structures influence population health. Yet within this nascent literature, more work must be done to study the association between welfare policy and recipient health. To redress this lacuna, the introduction of the welfare reform initiative ‘Ontario Works’ in 1995 offered an apposite before-and-after scenario to gauge how neoliberal ideology affected welfare policy in Ontario. In turn, welfare benefit declines permitted an assessment of the effect that welfare state retrenchment had on recipient health. To achieve this end, Ontarians responding to the National Population Health Survey in 1994-1995 and 1998-1999 were assessed on self-reported health measures to determine whether diminishing welfare benefits predicted health declines. From the results it emerges that long-term welfare recipients reported significant health declines over the study interval, declines that proved particularly noteworthy given that the health status of welfare recipients was initially superior to that of the provincial sample. These findings may lend further credence to the assertion of welfare state apologists that state intervention ameliorates the health effects of wider neoliberal directives.
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Chubarova, Tatiana Vladimirovna. "Occupational welfare in Russia with special reference to health care." Thesis, London School of Economics and Political Science (University of London), 2001. http://etheses.lse.ac.uk/1663/.
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Relying on new empirical data, derived from a survey, and supplemented by an extensive study of available secondary material, this thesis represents the first attempt systematically to explore key issues regarding occupational welfare in Russia, with special reference to health care. The thesis is divided into three parts: a discussion of the problematic; an investigation of the evolution of policy; and an examination of primary and secondary empirical data. The fundamental theoretical problems of occupational welfare are approached in the light of research in the West, in the Soviet Union and in post-Soviet Russia with emphasis both on divergences and commonalities. It is argued that any endeavour to separate Soviet and Western experiences is artificial and ultimately unproductive. Rather, the analytical penetration of ideological barriers renders possible an examination of their fruitful interaction. On the basis of existing knowledge two perspectives of occupational welfare -- social policy and organisation -- are introduced. An attempt to formulate a general definition of the notion of occupational welfare is also made. The evolution of occupational welfare and in particular its health care component are examined in their context, from the Tsarist era, during the Soviet Union and through to post-Soviet times, with a concrete aim of elucidating any continuities in policy pathways. Contemporary issues are associated with the initial outcomes of health reforms in the 1990s that are indispensable for projecting the future prospects of occupational welfare. The empirical component of the thesis reports the results of fieldwork carried out in Moscow between 1995 and 1997. The brief was to explore the contemporary status of occupational welfare in Russia in the context of changing social policy aims and methods evolving in the course of the transformation. The attitudes of senior managers of industrial enterprises providing in-kind health services for their employees were investigated, as were employers' actual health responsibilities in the light of the introduction of compulsory health insurance legislation. It is argued that occupational welfare has a distinct sphere of operation and offers potential, not only for the survival of the service area but also for its further development in the evolving socio-political environment. The thesis is a first step towards a deeper analysis of occupational welfare in Russia: an audit of outstanding issues, although not exhaustive, completes the account as an aid to further discussion and research.
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Högberg, Björn. "Ageing, health inequalities and welfare state regimes – a multilevel analysis." Thesis, Umeå universitet, Sociologiska institutionen, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-100401.
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The paper studies class inequalities in health over the ageing process in a comparative perspective. It investigates if health inequalities among the elderly vary between European welfare state regimes, and if this variation is age-dependent. Previous comparative research on health inequalities have largely failed to take age and ageing into account, and have not investigated whether cross-country variation in health inequalities might differ for different age categories. Since the elderly belong to the demographic category most dependent on welfare policies, an ageing perspective is warranted. The study combines fives data rounds (2002 to 2010) from the European Social Survey. Multilevel techniques are used, and the analysis is stratified by age, comparing the 50-64 year olds with those aged 65-80 years. Health is measured by self-assessed general health and disability status. Two results stand out. First, class differences in health are strongly reduced or vanish completely for the 65-80 year olds in the Social democratic welfare states, while they remain stable or are in some cases even intensified in almost all other welfare states. Second, the cross-country variation in health inequalities is much larger for the oldest (aged 65-80 years) than is the case for the 50-64 year olds. It is concluded that welfare policies seem to influence the magnitude of health inequalities, and that the importance of welfare state context is greater for the elderly, who are more fragile and more reliant on welfare policies such as public pensions and elderly care.
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Kim, Ki-tae. "The relationship between income inequality, welfare regimes and aggregate health." Thesis, University of Birmingham, 2016. http://etheses.bham.ac.uk//id/eprint/7031/.
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The Scandinavian welfare regime is expected to have better aggregate health than other welfare regimes due mainly to its narrow income inequality. This theoretical expectation is in part related to the Wilkinson Hypothesis that, in industrialised nations, a society’s narrow income inequality enhances its aggregate health. This thesis tests both of the above propositions. This is achieved by means of four methods not previously applied to this field, namely a ‘review of reviews’, a decomposition systematic review, a new case selection method, and a use of the OECD regional dataset for the cross-national comparative health study. These new methodological approaches lead to four main findings. First, the Scandinavian welfare regime shows worse-than-expected aggregate health outcomes. This thesis terms this counterintuitive finding as ‘the second Scandinavian puzzle’. Second, the East Asian welfare regime shows unexpectedly good aggregate health, which is proposed as ‘the East Asian puzzle’. Third, regarding the Wilkinson Hypothesis, it is income, rather than income inequality, which is a statistically significant determinant of aggregate health. Fourth, the effects on health of income inequality or welfare regimes reverse over a certain threshold of age, which is termed here ‘the age threshold effect’.
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Kyomuhangi, Rosette. "Benefit incidence analysis of antiretroviral drugs in Uganda : a case study of Kampala and Masaka districts." Master's thesis, University of Cape Town, 2005. http://hdl.handle.net/11427/9436.
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Includes bibliographical references (leaves 118-127).In the face of rising morbidity and mortality due to HIV / AIDS epidemic in Sub-Saharan Africa, there has been an increasing pressure to provide life sustaining antiretroviral (ARV) drugs to countries in most urgent need of them. Antiretroviral Therapy (ART) has been identified by policy-makers in Uganda as a potential programme aimed at mitigating the pervasive effect of HIV / AIDS on the social and economic life of the country. Since 2000, the country has shifted its focus from primarily HIV prevention to paying equal attention to care and treatment including ART. Provision of the ART programmes have been made possible through concerted efforts of international and national organizations such as the Global Fund to fight AIDS, Tuberculosis and Malaria (GFATM), the World Bank, Multi-country AIDS Programme (MAP), Great Lakes Initiative on AIDS (GLIA), the USA President's Emergency Plan for AIDS Relief (PEPFAR), UN agencies, Bi-lateral and Government of Uganda inputs (UAC 2004). New and increased funding notwithstanding, the Ugandan population has continued to grow exponentially at a rate of 3.5% and even though the economy has been growing at a rate of 6 % per annum, there is a widening disparity in incomes attributed largely to high levels of unemployment in the country (Ministry of Finance 2002). These income disparities have also greatly contributed to health inequities in Uganda, thus affecting the equitable allocation of the limited health resources including ART. The main aim of the study was to establish the socioeconomic status of those individuals who benefit most from the provision of free ARV drugs and to explore factors that influence the distribution of such benefits. The study was carried out in Kampala district (Uganda's capital city) and Masaka district. The study employed both qualitative and quantitative methods. Facility-exit interviews with patients accessing free ARVs formed the quantitative method, while Focus Group discussions with community representatives and in-depth interviews with key informants formed the qualitative part of the study. Quantitative data was obtained by use of a questionnaire, which was structured to obtain information on socioeconomic characteristics, including asset possession as a measure of wealth. A principal component analysis was run for both the Uganda Demographic Health Survey (UDHS) and facility-exit asset data to determine utilization of ARV by wealth quintiles. A benefit incidence costing model was also employed to determine monetary benefit of free ARVs in Uganda.
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Jamieson, Jen. "Adolescents, education and farm animal welfare." Thesis, Royal Veterinary College (University of London), 2013. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.572485.
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Leake, Michelle. "Do school districts have the tools they need to hire effective teachers? Deriving predictors of teacher effectiveness from information available to school district hiring personnel." Thesis, The University of Texas at Dallas, 2013. http://pqdtopen.proquest.com/#viewpdf?dispub=3592201.
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The purpose of this study is to determine the extent to which teachers' academic and professional characteristics predict their classroom effectiveness, as measured by value-added indicators of their students' growth. Teachers' college transcripts, service records, and district records of classroom assignments are used to examine undergraduate content and pedagogy courses, graduate work, and professional experience; the district's own value-added indices are utilized as the measure of teacher effectiveness. The study examines a subset of 318 teachers who were continuously employed over a four-year period at one of 19 "hard-to-staff" secondary schools in one of the nation's largest school districts. The study finds that local experience and college coursework in the teacher's assigned content modestly predict the teacher's classroom effectiveness, which has implications for hiring practices in public schools.
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Abel, Karin M. "Welfare State Context and Individual Health: The Role of Decommodification in Shaping Self-Perceived Health." DigitalCommons@USU, 2015. https://digitalcommons.usu.edu/etd/4311.
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My research brings together two areas of sociological inquiry. The first area involves the study of the welfare state and the second the determinants of health status. Drawing on Esping-Andersen's work concerning a particular aspect of the welfare state, decommodification, two questions are of interest. First, are individuals in countries with more decommodifying welfare states less likely to report poor self-perceived health than individuals in countries with less decommodifying welfare states? Second, does decommodification affect the health of various population groups in different ways? Gender and income groups are of interest here. Theoretically, I argue that the welfare state impacts the stratification order, that social inequality is tied to social cohesion, and that social cohesion is linked to health. I draw on sources of both country- and individual- level data, including the comparative welfare Entitlements dataset, the World Values Survey, and the European Values Study, to test hypotheses concerning the link between decommodification and self-perceived health. In general, I hypothesize that higher levels of decommodification will contribute to a decreased likelihood that individuals report poor self-perceived health. Given the miltilevel structure of my research questions and hypotheses, I use multilevel binary logistic regression to assess relationships of interest. My findings indicate that, for all groups, decommodification does not have a statistically significant relationship with self-perceived health. In other words, higher levels of welfare support do not decrease the likelihood that individuals report poor health. To elaborate, for all groups, those who are trusting, as compared to those who are not, are less likely to report poor health. Overall, the data do not support my hypotheses, revealing potential flaws in my theory linking the welfare state and health status. My research, then, has both theoretical and empirical implications.
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Van, Dijk Lisa. "Farmer innovation for improvement of animal health and welfare : a comparison of different policy interventions to enhance practice-led innovation for animal health and welfare improvement." Thesis, University of Bristol, 2018. http://hdl.handle.net/1983/38617a97-74da-411d-96c6-873bbd51c971.
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Encouraging farmers to adopt more animal-health and welfare-friendly husbandry practices remains a critical challenge for animal-welfare improvement. This thesis, operating at the critical intersection of the applied animal welfare and social sciences disciplines, examines, evaluates and demonstrates the potential of practice-led innovation processes in the context of applied animal welfare science and animal welfare practice change to improve animal health and welfare. A series of recent policy interventions case studies, with a strong practice-led approach to enhance farmer innovation for animal health and welfare improvement, were investigated, documented and analysed: a new collaborative learning approach for farmer-led Participatory Policy Making aimed at reducing antibiotic use in dairy cattle (initiated by two dairy producer groups, the Waitrose Dairy Farmers and Coombe Farm) and a practice-led innovation approach used in the laying hen sector (promoted by the EU-H2020-funded Hennovation project). In the empirical sections of this thesis, these interventions were ́tested ́ and compared with a more conventional top-down regulatory/compliance approach to practice change, in this instance, existing and new initiatives to engage farmers in on-farm welfare-assessment approaches to promote welfare-improvement through farm assurance promoted by the AssureWel project. The research findings demonstrated that practice-led approaches provide, clear tangible benefits for farmers and lead to stronger relationships with other farmers, suppliers and support actors and networks. And provided evidence that practice-led innovation could offer an alternative approach and an effective mechanism for generating animal welfare practice change and innovation (or a certain kind of innovation) at the ‘on-the-ground’ level of farming practice. The examination of the three interventions shows that opportunities and advantages exist for the enhanced integration of more participatory approaches to farmer innovation in future strategy and policy initiatives, alongside more conventional advisory pathways and other welfare-improvement strategies. Recommendations are offered to enhance and support practice-led approaches to farmer innovation for animal health and welfare improvement.
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Hennessy, Rachel A. "Deinstitutionalisation of the welfare state: the case of mental health care." Thesis, Virginia Polytechnic Institute and State University, 1986. http://hdl.handle.net/10919/94465.
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Creutzinger, Katherine C. "The Effect of the Social Environment on Transition Dairy Cow Behavior and Health." The Ohio State University, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=osu159972509295374.
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Kilgus, M., Andres Pumariega, Pat Wade, Michele R. Moser, and V. Holtzwarth. "CALOCUS: Correlation to Child Welfare Outcomes." Digital Commons @ East Tennessee State University, 2003. https://dc.etsu.edu/etsu-works/4970.
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Mlcek, Susan Huhana Elaine. "Paucity management models in community welfare service delivery." View thesis, 2008. http://handle.uws.edu.au:8081/1959.7/33647.
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Thesis (Ph.D.)--University of Western Sydney, 2008.A thesis presented to the University of Western Sydney, College of Arts, Social Justice and Social Change Research Centre, in fulfilment of the requirements for the degree of Doctor of Philosophy. Includes bibliographies.
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Thomson, Sarah. "Voluntary health insurance and health system performance in the European Union." Thesis, London School of Economics and Political Science (University of London), 2011. http://etheses.lse.ac.uk/226/.
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This thesis examines the usefulness of voluntary health insurance (VHI) as a lever for improving health system performance. It posits that VHI may further health policy goals if it addresses gaps in statutory coverage, if it does not make those who rely on statutory coverage worse off, and if those who need VHI have access to it. The thesis presents four studies that analyse markets for VHI in the European Union; developments in public policy towards VHI, including the implications of the EUlevel regulatory framework for VHI; the impact of VHI on health system performance; the effects of allowing people to choose between statutory and voluntary health insurance; and VHI’s influence on consumer mobility where insurers compete to offer statutory benefits. The thesis finds that while VHI is critical to financial protection in some countries, it does not always address key gaps in statutory coverage or reach those who need it, and the depth of its coverage has declined over time, even in heavily regulated markets. VHI has a regressive effect on equity in health financing, lowers equity in the use of health services and does not seem to have a positive effect on efficiency, partly because insurers in many countries lack appropriate incentives. What is more, a failure to align incentives across VHI and statutory health insurance can undermine the efficiency of public spending on health. Many of VHI’s negative effects can be attributed to poor policy design. Policy makers can try and ensure VHI contributes to rather than undermines health system performance through the following mechanisms: better understanding of VHI’s interaction with the health system; stronger policy design, focusing on aligning incentives in pursuit of health policy goals and ensuring efficiency in the use of public resources; willingness and capacity to regulate the market to secure financial and consumer protection; and regular monitoring and evaluation.
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Nkosi, Moremi Eric. "Factors that influence household health care utilization patterns in two districts of Zambia : a rural - urban comparative evaluation." Master's thesis, University of Cape Town, 2005. http://hdl.handle.net/11427/9345.
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Includes bibliographical references (leaves 111-116).This research project was undertaken with the primary objective of determining whether there are differential household health care utilization patterns between rural and urban areas in Zambia and what factors, if any, are responsible for such spatial variations. The factors considered in this study include: the gender of the household head, age of individual household members, religious affiliation of the household, the marital status of the household head, the size of the household, the educational status of the household head, the household head's employment status, and the socio-economic status of the household. The data was collected using a household health survey with questionnaires administered to the household head. A total of 660 households (3,150 persons) were sampled, 320 households (1,696 persons) in Chipata District and 340 households (1,454 persons) in Ndola District. The data included information on socio-economic and demographic factors that have been regularly considered in the theoretical literature and empirical evidence as impacting upon household and individual decision-making when it comes to utilization of both formal and informal care. A multinomial logistic regression model was used to analyse the data quantitatively in Stata® Version 8.0 software. Close to a quarter ofthe overall sample admitted to suffering an illness or injury in the 4-week period preceding the interview. Self-care at the household level was the most frequently reported type of care chosen for minor and moderate illnesses or injuries (35.80 percent). Bivariate analysis and the multinomial logistic regression results indicate that the variables considered not only produce differential effects on household health care utilization patterns in both districts but also that the effects are different depending on location of the household. The results from our sample analyses show that household religious affiliation (Christianity) is negatively associated with formal health care utilization in the urban area while the age of the individual increases the household's utilization of formal and informal care, and the gender of the household head (female), hislher marital status, educational attainment, and employment status all have a positive impact on formal health care use in the rural area.
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Tatar, Mehtap. "Health for all by the year 2000 and primary health care : the Turkish case." Thesis, University of Nottingham, 1992. http://eprints.nottingham.ac.uk/13688/.
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This study aims at analyzing Turkish health policy from a Primary Health Care perspective as pronounced in Alma-Ata, 1978. The Alma-Ata Declaration has long been regarded as a watershed in the health field and 134 countries, including Turkey, have endorsed the Declaration showing their support for the views expressed in the Document. However, although the international community gave its full support, in practice, different interpretations and implementation of the principles have emerged. Turkey, one of the countries where health has rarely occupied the agenda, has been undergoing radical reforms since the mid 1980s with the ultimate aim of achieving Health for all by the Year 2000 through Primary Health Care. There is full commitment at the national policy-making level to endorse policies coherent with the principles of Alma-Ata. However, not all policies adopted seem to be consonant with what was declared in Alma-Ata requiring a detailed analysis of the policies suggested and implemented. In the light of this, the aims of the study are: (1) to analyze Turkish health policy since the 1960s from a Primary Health Care perspective with the aim of exploring the Turkish response to Alma-Ata; (2) to explore the perceptions of Turkish health policy-makers about Primary Health Care and related issues; (3) to discuss the prospects for Primary Health Care in Turkey. Basic principles of the Primary Health Care approach as declared in Alma-Ata have been taken as a guideline in analyzing Turkish health policy and the perceptions of the Turkish health policy-makers. These principles and their implementation, or the way they are perceived, have guided the research in answering the question ''what are the prospects for Primary Health Care in Turkey?" The nature of the research, based on document analysis and semi-structured interviews, has necessitated a qualitative stance. It was concluded that the Turkish version of Primary Health Care differs from the Declaration in a number of ways. A number of possible reasons for this have been offered. The perceptions of the policy-makers on certain issues that are closely related with the Approach, inter alia, has been found as one of the most possible explanations behind the current situation and a need to alter the ascendant approach towards health issues in general has been emphasized.
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Huo, Huade. "The Effect of Electronic Health Records Adoption on Patient-specific Health Education Prescription, Time Utilization, and Returned Appointments| A Propensity Score Weighted Analysis." Thesis, Georgetown University, 2015. http://pqdtopen.proquest.com/#viewpdf?dispub=1586131.
Full textAbstract:
In this analysis, we use National Ambulatory Medical Care Survey data to investigate whether the adoption of the ambulatory electronic health records (EHR) system is associated with changes in patient-specific health education prescription rates, patient-physician interaction time, and returned appointment rates. We estimate the treatment effect of EHR adoption with multinomial propensity score weighting adjusted regressions. We find evidence to suggest that full EHR adoption positively affects patient-specific health education prescription rates. We find no robust evidence to show a significant effect of the EHR system on time utilization or returned appointment rates. We discuss possible reasons for our findings. We recommend linking patient education with quality improvement efforts and improving the usability of EHR systems.
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Washek, Jessica. "Apples and Oranges: Comparing the Nutritional Quality of Elementary School Lunches Across U.S. Public School Districts." Thesis, Boston College, 2020. http://hdl.handle.net/2345/bc-ir:108812.
Full textAbstract:
Thesis advisor: Natasha SarkisianThe food served in schools can be a critical source of nourishment for children, particularly those who come from households which lack access to fresh, affordable food. Within the context of an obesity pandemic perpetuated by junk food, this research looks at the nutritional content of food served in elementary school cafeterias. Focusing on calorie content as a measure of nutritional quality, I analyze whether school districts across the country are actually offering meals which meet nutrition recommendations for children and whether there are differences across school districts according to measures of socioeconomic disadvantage. The findings of this research have implications for school nutrition policy
Thesis (BA) — Boston College, 2020
Submitted to: Boston College. College of Arts and Sciences
Discipline: Departmental Honors
Discipline: Sociology
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Appleton, Victoria Catherine Jane. "Working in partnership to develop and implement an oral health promotion programme." Thesis, University of Central Lancashire, 2016. http://clok.uclan.ac.uk/20473/.
Full textAbstract:
Dental decay is a worldwide Public Health problem. In the last decade Oral Health professionals in the UK have focused on developing national and regional Oral Health programmes to reduce dental caries rates in young children. Smile4Life is an example of a regional programme, which has been implemented in North West England. Recent research suggests health programmes should have a conscious theoretical base and incorporate multi-sectorial approaches. A literature review was undertaken to identify the differences between the theoretical underpinnings used in Oral Health interventions compared to General Health interventions. This showed that Oral Health interventions have been predominately underpinned by educational approaches and used fewer approaches that consider organisational and environmental factors. However, the literature review did not identify barriers and facilitators to the use of theoretical underpinnings in real-life settings. To understand the barriers and facilitators to developing and implementing interventions in real-life settings, and how barriers and facilitators relate to the theoretical underpinnings identified in the literature review, semi-structured interviews were conducted with nine policymakers who were responsible for developing and ten implementers who were responsible for delivering Smile4Life. The analysis was undertaken using an inductive thematic analysis. The interview findings consist of an overall meta-theme and three themes. The meta-theme refers to ‘intra-group relationships and inter-group boundaries’. Intra-group relationships refer to the relations within the policymaker group or implementer group. The inter-group boundaries refer to divisions between the two groups that meant people within each group perceived themselves to be distinct from people in the other group. The first theme intra-group inclusion and inter-group exclusion outlines that within each group, individuals interacted with one another and had a shared sense of unity and group beliefs. However, there were boundaries between the two groups due to a lack of interactions and feelings of exclusion between the groups. The second theme, different knowledge, experiences, and beliefs identified that each group shared similar knowledge and experiences, but between the groups this knowledge was not shared. The third theme standardised or flexible implementation identified that due to the differences in knowledge, experiences, and beliefs between the groups, these differences prevented the formation of a shared vision of how to implement Smile4Life. The groups divisions led to the implementers making changes to the intended implementation strategy of Smile4Life. This research suggests that the implementers (middle managers) are important in the development and implementation of Oral Health programmes and potentially other interventions. Currently, theoretical underpinnings do not explicitly consider middle managers in the development and implementation of interventions. A set of Implementer Engagement Guidelines, underpinned by the Social Identity Theory, are presented that consider the engagement of middle managers in the development and implementation of interventions, to enable policymakers to develop future General and Oral Health programmes.
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Diesel, Gillian. "Rehoming dynamics and health of dogs at a UK dog welfare charity." Thesis, Royal Veterinary College (University of London), 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.504800.
Full textAbstract:
Each year in the UK, in addition to the stray dogs passed onto animal welfare organisations and dog kennels from the dog warden service, many others are handed over by members of the public for rehoming. Dogs Trust rehomed over 12,000 dogs during 2006. The stresses of staying in kennels and the change in environment can have a negative impact on the health of these dogs and this compromises their welfare and affects the success of rehoming. There have been very few studies examining the processes influencing success of rehoming in the UK. The current studies were conducted to describe indirect effects such as the previous owners, the dogs and their home environments, the health of the dogs in kennels and the effect factors directly affecting the success of rehoming these dogs. A descriptive study showed the most common reasons for dogs to be relinquished were behavioural problems and the owner feeling that the dog needs more attention than they can give it. Additionally, it was shown that behavioural issues were more common amongst those dogs relinquished for the second time whilst owner-related factors were more common for those dogs relinquished for the first time. Another descriptive study focussing on the, health of the dogs whilst in kennels showed that many dogs were ill when they arrived at the kennels making it difficult to prevent the introduction of diseases. It was also found that if the dogs were ill soon after adoption they were more likely to be rehomed unsuccessfully and returned to kennels. Risk factors that increased the likelihood of a dog being rehomed unsuccessfully were identified using a prospective cohort study. The results suggest that behavioural problems are an important factor especially if the dog had shown aggressipn towards people. However, there were also indications that by the owners obtaining advice, this risk couid be significantly reduced. Attending training classes significantly decreased the chance that the adoption would be unsuccessful. The data a1so suggested that families with younger adults and young children, and owners who found that the effort and work involved in looking after their dog to be more than they expected were more likely to return the dog. This study highlighted the importance of behavioural problems and therefore the agreement between members of staff at the rehoming kennels during the behavioural assessment of dogs was assessed using an additional study. These studies were able to highlight particular factors which could be changed or where new policies could be implemented in order to prevent some relinquishments or improve the reterition of dogs post-adoption.
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Diggins, Marie. "What works : researching success in parental mental health and child welfare work." Thesis, Anglia Ruskin University, 2013. http://arro.anglia.ac.uk/346870/.
Full textAbstract:
This study investigates success in parental mental health and child welfare work. Research has established the potential direct and indirect impacts of mental illness on parenting, the parent–child relationship, and the child, and the extent to which this poses a public health challenge. Problems with how adult and children’s services understand and deliver support to parents with mental health problems and their children have also been identified. In contrast, there has been little research about how parents with mental health difficulties and their children can be supported successfully. ‘What works’, or what constitutes success in parental mental health and child welfare work is missing from the literature. This study aims to begin to address this gap by providing an original contribution to conceptualising and evaluating success in parental mental health and child welfare work. This is an exploratory study, and as such covers a diverse population, i.e. different family members, different cultural and ethnic backgrounds, parents with different diagnoses, and statutory and voluntary sector agencies. The main issue here is to cover diversity; in terms of exploring different opinions of success – both in outcomes and processes – rather than to ensure applicability of the findings to all families in which there are parents experiencing mental illness. An interpretative approach was chosen for the study (within that data) to explore these issues. This was obtained by undertaking a multiple embedded case study methodology (Yin, 2003) with 12 families and their key workers from community mental health, children’s social care and the voluntary sector. Data collection was undertaken in three stages: individual interviews with parents, children and the professionals who support them; a review of the agency case files kept about the same families; and three focus groups. Participants were asked to identify successful situations that had occurred in each case study family during the 18 months prior to interview and give details about why these situations worked out well. The focus groups were convened to discuss the emerging findings from the first two phases of data collection. An examination of emerging themes, and the interplay between themes, gives insight into the shared ideas about what works and the shared methods and practices that are associated with successful outcomes. On the basis of these similarities, the findings offer a contribution to knowledge and practice about a mode of working which seems to make it possible to succeed in helping families previously considered beyond help. What is more, the practitioners also benefit from the helping relationship in this context.