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Dissertations / Theses on the topic 'Health services accessibility – Nigeria'

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Published: 4 June 2021

Last updated: 5 February 2022

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1

Chimezie, Raymond Ogu. "A Case Study of Primary Healthcare Services in Isu, Nigeria." Thesis, Walden University, 2013. http://pqdtopen.proquest.com/#viewpdf?dispub=3558764.

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Access to primary medical care and prevention services in Nigeria is limited, especially in rural areas, despite national and international efforts to improve health service delivery. Using a conceptual framework developed by Penchansky and Thomas, this case study explored the perceptions of community residents and healthcare providers regarding residents' access to primary healthcare services in the rural area of Isu. Using a community-based research approach, semistructured interviews and focus groups were conducted with 27 participants, including government healthcare administrators, nurses and midwives, traditional healers, and residents. Data were analyzed using Colaizzi's 7-step method for qualitative data analysis. Key findings included that (a) healthcare is focused on children and pregnant women; (b) healthcare is largely ineffective because of insufficient funding, misguided leadership, poor system infrastructure, and facility neglect; (c) residents lack knowledge of and confidence in available primary healthcare services; (d) residents regularly use traditional healers even though these healers are not recognized by local government administrators; and (e) residents can be valuable participants in community-based research. The potential for positive social change includes improved communication between local government, residents, and traditional healers, and improved access to healthcare for residents.

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2

Bowerman, Robert Lorne. "Evaluating and improving the accessibility of primary health care services." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1997. http://www.collectionscanada.ca/obj/s4/f2/dsk3/ftp04/nq22192.pdf.

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3

Sansourekidou, Patricia. "Accessibility of Innovative Services in Radiation Oncology." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7738.

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The field of radiation oncology (RO) involves the use of highly advanced techniques to treat cancer and safely spare healthy organs. The discipline has experienced rapid growth in the past 25 years, with technological advancement as the driving force. Available data and an instrument to effectively measure the accessibility of innovation in the field were lacking. The purpose of this study was to investigate the accessibility of innovative services in RO in the United States and assess possible diffusion patterns. Two hundred and forty medical physicists practicing in RO in the United States completed a custom Internet-based survey. The diffusion of innovation theory was used as the theoretical framework for the study. A quantitative cross-sectional analysis was performed to assess how innovation scores may vary depending on individual and organizational factors. ANOVA, Spearman correlation, and multiple linear regression were used to analyze the data. University affiliation, urbanicity, appreciation, and motivation were found to be statistically significant factors affecting accessibility to innovative services. Statistically significant barriers preventing innovation were lack of evidence, increased complexity, staffing constraints, lack of interest from others, lack of interoperability, and lack of reimbursement. Medical physicists are in a leadership position to influence the adoption of innovative services in RO. Encouraging the utilization of innovative and Food and Drug Administration-approved techniques may improve cancer outcomes and consequently have a positive social change effect on public health.

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4

Umar, Abubakar Sadiq. "Use of Maternal Health Services and Pregnancy Outcomes in Nigeria." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/2079.

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Maternal health services (MHS) provide primary, secondary, and tertiary levels of prevention to achieve better pregnancy outcomes. However, use of prenatal and natal services among Nigerian women has been ranked among the lowest in the world and, consequently, the country is among the 10 countries with the highest maternal mortality ratio. Moreover, nationwide community-based studies on the use of maternal health services in Nigeria are limited. To address this gap, this quantitative, cross-sectional study analyzed the 2008 Nigerian Demographic and Health Survey (NDHS) data to identify whether Nigerian women's biological, cultural, and socioeconomic characteristics are associated with their use of MHS and pregnancy outcome as measured by number of antenatal visits, place of delivery, and fetal outcome. The Anderson's health behavior model was used as the theoretical framework for this study. Respondents were women aged 15 - 49 years (N= 31,985), who had given birth between January 2003 and December 2008. Bivariate and multiple logistic regressions were conducted. The results indicated that religion, education, income, and availability of skilled health workers showed consistent significant statistical association with both the number of ante natal care (ANC) visits and place of delivery even after controlling for covariates. Overall, these findings have potential for social change on the choice of public health interventions with collaboration with social services such as education, community, and labor sectors. Further, a systematic involvement of local communities is needed to drive specific culturally-sensitive interventions.

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5

Reynolds, Gillian. "Accessibility and consumer knowledge of services for deaf adolescents." CSUSB ScholarWorks, 2001. https://scholarworks.lib.csusb.edu/etd-project/1977.

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The percentage of deaf and hard of hearing people who need mental health crisis services is similar to the percentage of the general population needing such services. Yet, coordinated mental services for deaf and hard of hearing individuals are virtually nonexistent. People who are deaf and hard of hearing, like everyone else, find themselves, from time to time, in need of mental health services.

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6

Scalli, Leanne Elizabeth. "Accessibility to Health Care Services for Children with Autism Spectrum Disorders." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/5522.

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The study was an investigation into health care accessibility for children with autism spectrum disorder (ASD) following the transition to a private Medicaid system in the state of Florida. Pilot studies of managed Medicaid programs focused on costs and did not address how changes to the system impacted access to health care services. There were limited studies designed to understand how a change in the system, such as a privatization, would affect vulnerable populations such as young children with ASD. Additional concerns existed for children that were historically underserved by the health care system such as African American and Latino children because they typically had more difficulty accessing health care services in general. A modified version of the Consumer Assessment of Health Providers and System (CAHPS) Survey 4.0 was used in this study. The modifications to the survey included reducing the number of survey questions and adding open-ended questions. 86 participants were recruited from local organizations that supported children and families affected by ASD. Findings generated using nonparametric tests such as the Mann-Whitney U test and chi-square revealed delays in accessing therapeutic health care services that were pervasive in both private and public insurance groups. Furthermore, the qualitative analysis indicated that participants did not view their difficulties in accessing therapeutic health care services as related to race or ethnicity. Limitations of the study included the modifications made to the survey instrument. Implications for positive social change include a better understanding of the scope of the issue of therapeutic health care access for those advocating on behalf of children and families affected by autism.

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7

Oluyole, Alexander Bolarinwa. "Community involvement and needs assessment in primary health care in Nigeria." Thesis, Keele University, 1995. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.261479.

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8

Chimezie, Raymond Ogu. "A Case Study of Primary Healthcare Services in Isu, Nigeria." ScholarWorks, 2011. https://scholarworks.waldenu.edu/dissertations/1057.

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Access to primary medical care and prevention services in Nigeria is limited, especially in rural areas, despite national and international efforts to improve health service delivery. Using a conceptual framework developed by Penchansky and Thomas, this case study explored the perceptions of community residents and healthcare providers regarding residents' access to primary healthcare services in the rural area of Isu. Using a community-based research approach, semistructured interviews and focus groups were conducted with 27 participants, including government healthcare administrators, nurses and midwives, traditional healers, and residents. Data were analyzed using Colaizzi's 7-step method for qualitative data analysis. Key findings included that (a) healthcare is focused on children and pregnant women; (b) healthcare is largely ineffective because of insufficient funding, misguided leadership, poor system infrastructure, and facility neglect; (c) residents lack knowledge of and confidence in available primary healthcare services; (d) residents regularly use traditional healers even though these healers are not recognized by local government administrators; and (e) residents can be valuable participants in community-based research. The potential for positive social change includes improved communication between local government, residents, and traditional healers, and improved access to healthcare for residents.

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9

LaRoche, Kathryn J. "The Availability, Accessibility, and Provision of Post-Abortion Support Services in Ontario." Thesis, Université d'Ottawa / University of Ottawa, 2015. http://hdl.handle.net/10393/32786.

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In a study we conducted with Ontarian women about their abortion experiences (OAS), one third of participants expressed a desire for post-abortion support. Yet, there is some anecdotal evidence to suggest that organizations offering these services are using judgmental frameworks. In order to rigorously investigate this, we explored what post-abortion support services are offered across the province of Ontario. This multi-methods study included an analysis of OAS data, creating a directory of post-abortion support services in the province, conducting an analysis of how these services represent themselves online, and carrying out mystery client interactions. We found that the majority of organizations offering post-abortion support services in Ontario are crisis pregnancy centers. The services offered at these organizations are built upon frameworks that are both shaming and stigmatizing of abortion experiences. Efforts to increase the online visibility and overall accessibility of non-judgmental, medically accurate post-abortion support services in Ontario appear warranted.

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10

Rangel, Carlos Felix Garrocho. "The accessibility and utilization of public paediatric services in Toluca, Mexico." Thesis, University of Exeter, 1992. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.304296.

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11

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&amp.

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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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12

Nteta, Thembi Pauline. "Accessibility and utilization of the primary health care services in Tshwane Region." Thesis, University of Limpopo (Medunsa Campus), 2009. http://hdl.handle.net/10386/237.

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Thesis (MPH)--University of Limpopo, 2009.
Background Primary Health Care is a basic mechanism that brings healthcare as close as possible to the people. In South Africa, it is seen as a cost effective means of improving the health of the population. It is provided free of charge by the government. This service should be accessible to the population so as to meet the millennium health goals. Aims The aims and objectives of the study were: • To investigate whether Primary Health Care services were accessible to the communities of Tshwane Region. • To determine the utilization of the health care services in the three Community Health Care centres of Tshwane Region. Methodology Data were collected at the three Community Health Care centres of Tshwane Region using self-administered questionnaires. A document review of the Community Health Care centres records was conducted to investigate the utilization trends of services. Descriptive statistics were used. The analysis was based on the information that was elicited from the questionnaires that the people who utilize the Community Health Care centres of Tshwane Region provided. The extracted data emanating from the records from the three centres were also used. Results The study demonstrated that in terms of distance, the Community Health Care centres of Tshwane Region are accessible as most participants lived within 5km. They traveled 30 minutes or less to the clinic. The taxi and walking was the most common form used to access the clinic. The services were utilized with the Tuberculosis clinic being the most visited. Generally, people were satisfied with the service and their health needs are met. Conclusion The Community Health Care centres of Tshwane Region are accessible and utilized effectively. Key words: Primary Health Care, accessibility, utilization.

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13

Liu, Xiaohui, and 刘晓辉. "Change in access to health care in Guangzhou, 1990-2009." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2010. http://hub.hku.hk/bib/B4517328X.

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14

Christian, Carmen Sue. "Access in the South African public health system: factors that influenced access to health care in the South African public sector during the last decade." University of the Western Cape, 2014. http://hdl.handle.net/11394/4211.

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Magister Commercii - MCom
The aim of this mini-thesis is to investigate the factors linked to access in the South African public health sector - using General Household Survey Data - in order to contribute to a better understanding of the role of access in achieving the National Department of Health’s primary goal of universal coverage. Even though the multi-dimensional interpretation of health system performance has gained acceptance and traction in recent years, much of the research linked to it remains supply-focused. The implicit truth is that demand-side health issues are largely ignored, under-researched and ominously absent from health policies. This is particularly true with regard to the access dimension of health performance, where research and policy focus almost exclusively on availability and affordability perspectives of access while neglecting demand-side aspects of health-seeking behaviour, such as acceptability. The study, therefore, pursues an in-depth exploration of access across its three dimensions - availability, affordability and acceptability - in the South African public health sector and aims to empirically investigate access to public health care from 2002 to 2012. It also identifies the underlying reasons for the observed trends, supplementing and reorienting the current understanding of access to public health care. The empirical findings reveal mixed results: it supports current literature by suggesting that equity has been achieved in terms of making public health care services more affordable, especially for the most vulnerable groups of South African society. However, acceptability and availability issues persist. It is safe to say that the availability of public health care – mainly a supply-side issue – is being addressed in the South African context with Government taking steps to address it. Unfortunately the same attention has not been given to issues of acceptability on the demand-side. Failure to fully understand the demand-side dimension of access and the role health-seeking behaviour plays in public health issues threatens to weaken health policies aimed at improving access. It is imperative that demand-side aspects of health-seeking behaviour and institutional responsiveness to health-demand occupy a more prominent role in South African public health debates, research and policy.

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15

Ichoku, Hyacinth Ementa. "The demand for health care services in Nigeria : a nested logit model." Master's thesis, University of Cape Town, 2000. http://hdl.handle.net/11427/12788.

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Bibliography: leaves 96-99.
The main aim of this study is to understand better the factors that influence the health care demand decisions of Nigerian households. The achievement of this objective involves the estimation of the parameters of the demand for health care services in order to understand the nature of health care choices that Nigerian households make under the present depressed economy. These demand parameter estimates are considered valuable inputs into health care policy. Yet, to date, there is neither sufficient information on the factors that shape households' utilization of health care services nor is there sufficient information on the relative importance of health care alternatives available to them. This is the knowledge gap this study helps to fill. Due to the dearth of data on the subject and the costs of collecting such data for the whole country, this study has been limited to a particular geographical area - Nsukka local government.

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16

Larson, Eric Hugh. "Geographic variation in the risk of poor birth outcome in the non-metropolitan population of the United States, 1985-1987 /." Thesis, Connect to this title online; UW restricted, 1995. http://hdl.handle.net/1773/5634.

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17

Molokwu, Biola. "Determinants of birthweights and causes of childhood deaths in rural South West Nigeria." Thesis, London School of Hygiene and Tropical Medicine (University of London), 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.321686.

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18

Fleming, Robin Jo. "The role of school health services in reducing health and educational disparities : examining usage rates of student health services in the Seattle School District /." Thesis, Connect to this title online; UW restricted, 2008. http://hdl.handle.net/1773/7735.

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19

Park, Ju Moon Aday Lu Ann. "The determinants of physician and pharmacist utilization and equity of access under Korean universal health insurance /." See options below, 1994. http://proquest.umi.com/pqdweb?did=741485541&sid=1&Fmt=2&clientId=68716&RQT=309&VName=PQD.

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20

Kazaure, Nura Ibrahim. "Impact of Free Maternal and Child Health Services on Health Care Utilization in Jigawa State, Nigeria." Thesis, Walden University, 2018. http://pqdtopen.proquest.com/#viewpdf?dispub=10831383.

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In spite of a decrease globally, the maternal mortality rate (MMR) in Nigeria and its Jigawa State has remained persistently high. Few efforts to address the MMR in Nigeria have been undertaken. The purpose of this study was to investigate the impact of Jigawa State’s Free Maternal and Child Health Program (JSFMCHP), education, employment, and parity of pregnant women on health care utilization (the outcome variable), as measured by antenatal care (ANC) visits. Anderson’s behavioral model served as the study’s theoretical framework. The sample size included 400 antenatal records of pregnant women who were randomly selected from the state’s Health Management and Information data collected between 2011 and 2015. Chi-square tests showed a significant association between those who did not participate in the JSFMCHP, education, employment, with ANC. There was no association between parity and the number of ANC visits. The odds ratio suggested that pregnant women who did not participate in the program were 5.53 times as likely to have 4 or more visits compared to those who participated. Furthermore, the recommended number (4 or more) of ANC visits was predicted by tertiary education and employment. This study’s findings indicate the need for a reevaluation of JSFMCHP policy, with a focus on ensuring a minimum recommended number of ANC visits for all program participants. These results can influence positive social change if used by policy makers to strengthen policies that have a beneficial impact on maternal morbidity and mortality in Jigawa State, in particular, and Nigeria, in general.

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21

Liao, Hsin-Chung. "The Association of Spatial Accessibility to Health Care Services with Health Utilization and Health Status Among People with Disabilities." Cleveland State University / OhioLINK, 2010. http://rave.ohiolink.edu/etdc/view?acc_num=csu1295035743.

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22

Buckley, L. C. "Going through changes : a single point of access for health and social care." Thesis, Coventry University, 2013. http://curve.coventry.ac.uk/open/items/7345dede-9192-4dad-827e-9b4ddd4503fa/1.

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Background: Integrated working between health and social care services within England has been encouraged by Government policy in the last decade, and has been argued to provide a seamless, joined up experience for service users (Department of Health 2011). One way of integrating care is through the use of a single point of access to health and social care services. A single point of access to services has been trialled in mental health and learning disability services to improve access, and following on from policy (e.g. Department of Health 2007) and support from literature (Rogers, Entwistle & Pencheon 1998; Lovell & Richards 2000; Raine, Carter, Sensky & Black 2005) a single point of access to health and social care for older adults has been implemented in parts of the UK. This thesis examines the implementation of one such single point of access. Objectives: The aim of the study was to examine the single point of access and whether it had any impact upon integrated working within a county in England, UK. Methods: An ethnographic approach was taken, using a combination of methods including interviews, focus groups and observations. This was complemented by a grounded theory approach to analysis. Findings: The single point of access had an adverse effect upon integration. The poor management of change and lack of communication led to issues within the single point of access such as failure of IT systems and duplication. Staff became frustrated and disengaged from the process, and consequently reported feeling disempowered, retreating back to their professional 'tribes'. Conclusion: Firm conclusions about the efficacy of a single point of access with regard to its effect upon integrated working could not be reached. However, the findings suggest that clear communication, continued change management and recognition of professional culture are decisive factors when attempting to integrate health and social care. Further research into the impact of a single point of access upon integration as well as outcomes for service users is recommended.

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23

Ebosie, Mercy I. "Using Sociodemographic Approach to Examine Health Services and HIV/AIDS Awareness in Nigeria." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/6198.

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The purpose of this study was to examine community health services and HIV/AIDS awareness in rural communities in Abia State Nigeria in respect to the sociodemographic factors of level of community health services, level of education, and community leaders' influence. Two questions guided the research process: To what extent are sociodemographic factors associated with HIV/AIDS awareness, and what is the relationship between level of community health services and extent of HIV/AIDS, as perceived by residents of these communities. A mixed method paradigm was used. A sample of 131 participants, who were HIV/AIDS patients, were purposively drawn from a population of 107,488 individuals from 2 selected rural communities in Aba South, Abia State, Nigeria. The Kolmogorov-Smirnov for normality distribution at p=0.1 for all variables indicated that normality rule was not violated. Descriptive and inferential tests (Spearman's rank order correlation, analysis of variance[ANOVA], chi-square tests of independence, Fisher's exact tests, and independent sample t-tests) were carried out with SPSS V.2 software and the confident level set at 95% (Î±=0.05). Findings revealed no significant association between level of education, level of community health services, and influence of community leaders and extent of HIV/AIDS awareness, as perceived by residents of these communities (p>0.05). Results also indicated significant relationship between the level of community health services and the extent of risk of HIV/AIDS, as perceived by residents of these communities. A well-planned method of information dissemination on HIV/AIDS can also be used to educate rural residents in Nigeria.

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24

Salem, Salem F. "The geography of health in Libya : accessibility to, utilisation of, and satisfaction with public polyclinics in Benghazi." Thesis, Durham University, 1995. http://etheses.dur.ac.uk/1709/.

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25

Whitener, Louise M. "Using Hongvivatana's model to evaluate health care access : a field study of adolescent women's access to reproductive health care services in rural Missouri counties /." free to MU campus, to others for purchase, 2000. http://wwwlib.umi.com/cr/mo/fullcit?p9974703.

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26

Wen, Siying, and 溫思穎. "Health insurance effects on health care access for rural residents in Guangzhou city." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2011. http://hub.hku.hk/bib/B46942749.

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27

Vaughan, David James. "Acceptability of primary care a study of one community in Montana /." Thesis, Montana State University, 2007. http://etd.lib.montana.edu/etd/2007/vaughan/VaughanD0507.pdf.

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28

Khe, Nguyen Duy. "Socioeconomic differences in a rural district in Vietnam : effects on health and use of health services /." Stockholm, 2004. http://diss.kib.ki.se/2004/91-7349-984-6/.

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29

Johansson, Axel. "Patient Empowerment and Accessibilityin e-Health Services : Accessibility Evaluation of a Mobile WebSite for Medical Records Online." Thesis, Uppsala universitet, Avdelningen för visuell information och interaktion, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-262241.

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This thesis evaluates a DEMO version of the mobile web site for medical recordsonline, m.minavardkontakter.se, from a web accessibility point of view. The evaluationis an expert evaluation based on the ISO standard for web accessibility, Web ContentAccessibility Guidelines (WCAG) 2.0 that is complemented with an evaluation basedon fictitious characters, so called personas. The personas were used to representthree groups of people with different kinds of disabilities; perceptual impairment(aniridia), physical impairment (rheumatism) and cognitive impairment (aphasia). Bycombining and comparing these two methods of evaluation, the thesis also evaluatesthe methods themselves. It was seen from both evaluations that the mobile web sitedoes not entirely fulfill the requirements (success criteria) for web accessibility.WCAG 2.0 found more problems in accessibility than did the personas. However, thepersonas found some problems that were overseen by WCAG 2.0, especially whenthe mobile web site was explored using voice synthesis. The results from the twoevaluations were combined in a set of recommendations for improvement, ranked inorder of importance according to the author. The results conclude that WCAG 2.0 isa good tool for evaluating web accessibility but it is recommended to continue to usethe personas in the future development of the mobile web site.

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30

Gharani, Pedram. "Modeling spatial accessibility for in-vitro fertility (IVF) care services in Iowa." Thesis, University of Iowa, 2014. https://ir.uiowa.edu/etd/1459.

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31

Mallow, Peter J. "Access to Health Care Services and the Effect on Health Outcomes in a Region: A Spatial Perspective." University of Cincinnati / OhioLINK, 2013. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1368013861.

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32

Ezeofor, Ifeyinwa Obiageli. "Diagnosis of undernutrition in the first 6 months of life in Enugu city, southeast Nigeria." Thesis, University of Glasgow, 2015. http://theses.gla.ac.uk/7061/.

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The World Health Organisation (WHO) recommends exclusive breastfeeding during the first six months of life for optimal growth. However, the rapid growth of early infancy is limited by undernutrition, and this has been assumed rare. Nonetheless, there has been reported evidence of this problem, particularly in infants with underlying disease. Identifying infants at the risk of undernutrition using growth charts is simple, quick, invaluable, but suggested ineffective. The possible cause is poor health staff understanding, application and interpretation of growth patterns in early infancy, particularly in developing countries. In Nigeria, little is known about patterns of growth, how growth velocity relate to nutritional status, standardised methods for assessing nutrition risk, and prevalence of undernutrition in infants younger than 6 months, particularly hospitalised infants. Therefore, this project based at the University of Nigeria Teaching Hospital (UNTH), Enugu, set out to answer the following research questions: 1) What is the prevalence of undernutrition in infants younger than 6 months, particularly hospitalised infants? 2) What are the implicated feeding patterns and medical conditions of these infants? 3) Can feeding information and growth patterns be used to predict undernutrition in these infants? 4) Is health staff use of growth patterns in identifying undernutrition in early infancy effective? Methods: Data were collected for the project’s three cross-sectional, observational studies. 1) Feeding information from birth to date of assessment was collected from mothers/carers of healthy infants attending the Infant Welfare Clinic (IWC) of the UNTH, Enugu. Their retrospective weight measurements at birth, 6 weeks, 3 months and 6 months were documented from their mother-held Road-to-Health (RTH) growth charts. 2) Feeding and growth information was collected from infants at admission (from birth to 26 weeks of age) to the Hospital Wards of the UNTH. These data were collected using a structured interviewer-administered questionnaire based on the Subjective Global Nutrition Assessment (SGNA); including anthropometric measures of weight, length, head circumference, mid-upper arm circumference, and skinfolds (triceps and subscapular). 3) Paediatric Health Staff were surveyed in two teaching hospitals and four government-controlled primary health facilities using a structured self-completion questionnaire to: - determine how growth charts are used to detect childhood undernutrition - determine the accuracy in plotting and rating/applying/interpreting weight gain patterns shown on the RTH and WHO growth charts for appropriate action - test the understanding of growth trajectories displayed on charts. Results: Infant Welfare Clinic Study: The retrospective weights of 411 healthy infants (0 – 26 weeks old) attending the IWC of the UNTH, Enugu was compiled and used to generate a reference to compare that of their hospitalised peers in the same hospital. There was a steady weight gain increase in the first half and slower gain in the latter half of first six months of life. During this period, the weight Z-scores distribution of the infants compared well to the WHO Child Growth Standards (WHO-CGS). Moreover, 5% of the infants had -2SD (CWG), setting the 5th percentile as slow weight gain threshold, the reference to compare the weight velocity of their hospitalised peers. Therefore, the data compiled from the IWC was transformed successfully into a dataset qualified as a norm for comparing the data collected from the hospitalised infants. However, suboptimal breastfeeding patterns were observed in the majority (391, 95%) of the infants at assessment. Hospital Ward Study: Assessment of growth was done in 210 infants admitted to the paediatric wards from birth to 6 months, of which 143 (80.6%) were younger than 3 months. These younger infants were most commonly admitted for respiratory tract disorders 39 (18.6%), while the older infants were most commonly admitted for sepsis 21 (10.0%). The least of the morbidities were diarrhoea/vomiting 10 (4.8%) and severe undernutrition 8 (3.8%). SGNA-rating showed that the majority (161, 76.7%) of the infants were at low risk for undernutrition. The mean CWG of the hospitalised infants from birth was low, with 23% of the infants recording weight gain since birth below the 5th percentile for slow weight gain. Around one quarter of the hospitalised infants recorded low anthropometric Z-scores of weight, CWG, length, BMI or MUAC. A reference for skinfolds for under-3-month-olds was not available in the WHO-CGS. On applying a reference developed using the infant Paediatric Yorkhill Malnutrition Screening Group’s UK data (iPYMS Reference), over one third of all the infants recorded low sum of skinfolds. Using crude MUAC measurements, two-thirds of the infants were moderately undernourished (<115mm) and over a half severely undernourished (<110mm), significantly (P<0.0001) decreasing with increase in age of admission. The majority (184, 87.6%) of the infants was initially breastfed, however, only 43 (20.5%) of the infants were exclusively breastfed (breastfed without water or other liquids) at any age. Breastfeeding status was related to the reasons for admission and nutritional status: the mean weight change for exclusively breastfed infants was -0.6 Z-score as compared to -1.1 Z-score for partially breastfed infants. Health Staff Study: Of the 222 health staff that responded to the survey in 2 referral hospitals and 4 government-controlled primary health facilities in Enugu city, 78% were hospital-based, 55% nurses, 46% highly experienced. About a third of the respondents often plotted; 87.8% often interpreted growth charts; over a half often identified and treated undernutrition, 88.7% with confidence. However, low accuracy was observed in recognising slow weight gain, particularly with average size; and fast weight gain was also poorly recognised. The respondents were as likely to be as worried about a small infant growing fast as an average weight infant growing slowly. Growth trajectories were better understood and interpreted on the WHO than RTH chart format. Most correct responses came from the medical doctors and moderately experienced respondents. Conclusions: The growth of young Nigerian infants fit the WHO-CGS well and the SGNA-rated nutrition risk is low, but other measures suggest undernutrition in up to one third of the hospitalised infants. Moreover, faulty breastfeeding patterns were prevalent and need to be addressed in future studies involving this population. Furthermore, the ineffectiveness of health staff understanding, application and interpretation of growth trajectories displayed on growth charts as practical tools, suggests the need for training.

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Al-Shahrani, Homoud. "The accessibility and utilization of primary health care services in Riyadh, Kingdom of Saudi Arabia." Thesis, University of East Anglia, 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.410310.

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Kalkbrenner, Amy Elizabeth Daniels Julie Lynn. "Geographic influences on autism diagnosis accessibility of health services and exposure to hazardous air pollutants /." Chapel Hill, N.C. : University of North Carolina at Chapel Hill, 2009. http://dc.lib.unc.edu/u?/etd,2403.

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Thesis (Ph. D.)--University of North Carolina at Chapel Hill, 2009.
Title from electronic title page (viewed Sep. 3, 2009). "... in partial fulfillment of the requirements for the degree of Doctor of Philosophy in the Department of Epidemiology." Discipline: Epidemiology; Department/School: Public Health.

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Queen, Courtney M. Yoder Kevin Allan. "Health status and access disparities among the uninsured working-age population in a safety-net healthcare network in Tarrant County, Texas." [Denton, Tex.] : University of North Texas, 2009. http://digital.library.unt.edu/ark:/67531/metadc12187.

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Maikudi, Abdullahi Ahmed. "Health care delivery in Nigeria in terms of distribution, access and uses with particular reference to Bauchi State." Thesis, University of Nottingham, 1988. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.281135.

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37

Onjukwe, Obinna Emmanuel. "Validity and reliability of the contingent valuation method : a study of willingness to pay for insecticide-treated nets in Nigeria." Thesis, London School of Hygiene and Tropical Medicine (University of London), 2002. http://researchonline.lshtm.ac.uk/682250/.

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Objectives: To contribute to knowledge on the reliability and validity of the contingent valuation method (CVM) and explore the role of context-specific CVM question formats in Southeast Nigeria. Other objectives were to determine the factors that will explain actual willingness to pay (WTP) for insecticide-treated nets (ITNs). Methods: There was an extensive review of theoretical, methodological and empirical literature. A novel WTP question format that mimics price-taking behaviour in south- east Nigeria (called the structured haggling technique (SH)) was developed and compared with the bidding game (BG) and binary with follow-up technique (BWFU). The comparisons were for inter-rater and test-retest reliability, content, construct and criterion validity and the study conducted in three villages in Nigeria. Stated WTP was determined using a questionnaire administered to 810 household heads, while actual WTP was evaluated by offering the ITNs for sale to all respondents after one month of the first survey. Findings: There were considerable gaps in the literature regarding the reliability and validity of the CVM. In the empirical study, BG, BWFU and SH elicited reliable and valid estimates of WTP. The SH was the most content valid, while the BG and SH were the most construct-valid for ITNs and re-treatment respectively. The BG and SH were similarly criterion-valid while the BWFU was the least criterion-valid. All question formats were similar for tests of reliability. There were genuine reasons for divergences between the stated and actual WTP and for test and retest. Low-income status and physical accessibility were the major impediments to ITNs acquisition. Conclusion: The CVM could be used to elicit valid and reliable WTP estimates in the study area, but it was not clearly proven that better content-valid question formats would lead to more valid and reliable estimates of WTP. It is necessary to further determine how the validity and reliability of the SH and other WTP question formats could be improved. Finally, future studies should establish the content validity of question formats in settings where they will be used, and use bigger sample sizes, along with allowing less time between the survey and administering the criterion, for comparing stated and actual WTP.

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Vitale, Michele. "Evaluating access barriers to primary health care servcies for Hispanic residents in toombs County, Georgia." Auburn, Ala., 2007. http://repo.lib.auburn.edu/2007%20Spring%20Theses/VITALE_MICHELE_14.pdf.

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39

Wikström, Daniel, and Ida Sandeberg. "Accessibility, With or Without Colour : A qualitative look on existing accessibility guidelines for colour vision deficiency and its effect on Swedish e-health services." Thesis, Tekniska Högskolan, Jönköping University, JTH, Datateknik och informatik, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-48237.

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Purpose WCAG is a set of guidelines to assist in developing websites accessible for everyone, for example people with colour vision deficiency (CVD). However, there are few guidelines relevant for CVD and with increasing dependant on websites the importance of accessibility on these websites increases as well. The purpose of the research study is therefore to investigate the impact the relevant guidelines for CVD in WCAG 2.1 has on Swedish health care websites and what the consequences are for people who live with CVD. Method An initial literature study was conducted to gain knowledge of previous findings and also evaluate the best approach for the research study. The research study is based on a qualitative approach to gain a deep understanding of the area and to gain insight into the feelings and experiences of the people affected. The methods used to gain the necessary knowledge are an evaluation of 1177.se and e-tjanster.1177.se also observations and interviews around these two websites. Findings The results show that WCAG 2.1 has a positive impact on Swedish health care websites, as well as on users with CVD. From evaluations, interviews and observations it is concluded that 1177.se and e-tjanster.1177.se are easy to perceive for people with CVD. Implications This research study was limited to the mobile version of the websites. However, the results could be different if the research was conducted on the desktop version due to the different structure of the websites and the inclusion of a cursor on desktop. The evaluation could have been affected by the sampling of pages while the interviews and observations should not have been. Limitations The research study was limited to Swedish health care website 1177.se and its subdomain etjanster. 1177.se. Further it was decided to evaluate the mobile version of these websites, although the elements should look similar on desktop and mobile. While not the initial intention, due to over representation of red-green CVD the study was also limited to people with red-green CVD. Also, the experience of browsing the web on a mobile device was considered to reduce the variables for frustrations. Further research For further research, another selection of WCAG guidelines could be considered to evaluate etjanster. 1177.se since the results shows that 1177.se’s and e-tjanster.1177.se's weaknesses seems to be in the structure of the website. A study researching the “blue-yellow colour blindness” compared to websites could contribute with new, relevant knowledge as well.

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Samuel, Stephen Maduabuchi. "Health System Analysis of Diabetes and Diabetic Retinopathy Services in Nigeria – The Case of Akwa Ibom State." Master's thesis, Faculty of Health Sciences, 2018. http://hdl.handle.net/11427/31270.

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This research project, undertaken for a MPH dissertation investigated and analysed the situation of diabetes and diabetic retinopathy services and management systems in four (4) government hospitals in Akwa Ibom State Nigeria using the World Health Organisation (WHO) Tool for the Assessment of Diabetic Retinopathy and Diabetes Management Systems (TADDS). Part A is the research protocol, which explains the background and the key components of this research study. This is a cross sectional descriptive case study involving primary data collection. We conducted the case study using the WHO TADDS to survey health personnel involved in the management of diabetes mellitus (DM) and diabetic retinopathy (DR) in four (4) government hospitals in Akwa Ibom State. Concurrently, semi-structured interviews were conducted with key informants to investigate and analyse the situation of DM and DR services in Akwa Ibom State in Nigeria. Part B is a structured literature review of published articles, online reports, and summaries related to DR. It covers the review of scientific evidence (clinical overview) about the aetiology and prevention of DR and the known risk factors; the review of epidemiological evidence on DM and DR globally and in sub-Saharan Africa (SSA); and the review of the evidence on effectiveness and cost-effectiveness of public health and health system interventions for the prevention and management of DR. Part C is the journal-ready manuscript. In this part, the format of the journal Ophthalmic Epidemiology was used to present the research project and its main findings. Part D contains all the relevant appendices used during the research project.

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Lewis, LaTanya Renee. "Assessing service satisfaction: Experiences of individuals living with HIV/AIDS." CSUSB ScholarWorks, 2008. https://scholarworks.lib.csusb.edu/etd-project/3371.

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The purpose of this study was to explore HIV/AIDS client experiences with supportive services. The consumption of social services for individuals living with HIV/AIDS has assumed increasing importance. This is a crucial population that requires a multifaceted approach to treatment in order to remain active and productive for longer periods of time.

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Elliott, Katherine Pauline. "The Role of Socioeconomic Status and Social Determinants in Predicting Accessibility and Barriers to Mental Health Services in the Canadian General Population." Thesis, Université d'Ottawa / University of Ottawa, 2015. http://hdl.handle.net/10393/33378.

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There is a tremendous discrepancy between the number of people likely meeting criteria for a mental disorder or substance dependence in Canada and the number of people actually receiving mental health or substance dependence treatment. Thus, it is important to examine what facilitates entrance into the mental health care system and what prevents people from receiving the treatment they need. Mixed findings exist as to whether socioeconomic status (SES) and other social determinants of health play a role in receiving treatment in Canada. However, due to several methodological issues with previous studies that have examined this issue, three studies were designed to re-examine and add to the literature in this area by investigating: (1) whether SES (i.e., income and education) and other social determinants as well as psychological distress predict the number of services received by any professional for any mental disorder or substance dependence, as well as predict overall satisfaction with the services received (2) the psychometric validity and reliability of the 3-factor model proposed by Statistics Canada to measure barriers due to accessibility, acceptability and availability, and (3) whether SES, other social determinants and psychological distress predict specific barriers to receiving mental health treatment for an unmet need. All data were obtained from the Canadian Community Health Survey, cycle 1.2, Mental Health and Wellbeing. In Study 1, the SES/social determinants model predicted the number of services received for both medication and psychotherapy. Out-of-pocket spending, was the strongest predictor of the number of consultations from any provider, however it was also inversely related to overall satisfaction with services. Higher levels of distress predicted greater dissatisfaction with services received. Study 2 revealed that the three factor model of accessibility, acceptability and availability was invalid and unreliable as a measure of barriers to mental health services. It is, therefore, recommended that each specific barrier be treated as an independent causal indicator of an index measuring overall accessibility to mental health services. Finally, in Study 3, when examining each barrier independently, both education and income played important roles in recognizing there was a problem, seeking services, and actually accessing the services needed. Other social determinants also played important roles which differed depending on the type of barrier being examined. The results of the three dissertation studies indicate a clear relation between SES, other social determinants and psychological distress, and accessibility and barriers to mental health services in Canada for those suffering any mental disorder or issue related to substance dependence. The findings have significant implications in terms of potential policy implications, recommendations for the design of future national level surveys, and recommendations for future research on this topic.

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Ossai, Peter Ogochukuka. "Awareness, Accessibility And Use Of Malaria Control Interventions Among At-Risk Groups In Lagos Metropolis, Nigeria." Kent State University / OhioLINK, 2014. http://rave.ohiolink.edu/etdc/view?acc_num=kent1416334291.

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44

Xu, Biao. "Access to tuberculosis care in rural China : comparing the impact of alternative control projects /." Stockholm, 2006. http://diss.kib.ki.se/2006/91-7140-510-0/.

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Imam, Nimrah H. "The Limits of Accessibility Under the Affordable Care Act." Scholarship @ Claremont, 2017. http://scholarship.claremont.edu/scripps_theses/916.

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The Patient Protection and Affordable Care Act (ACA) aimed to increase accessibility to medical resources for those previously uninsured. Certainly, the ACA has expanded insurance to millions of Americans, however, the evidence and discourse surrounding health accessibility calls into question why, despite the growth of insured Americans, the increase in health insurance coverage under the ACA has not lead to greater accessibility for low income minorities. I propose that disparities in preventive care, the emergency room, and primary care provider services stand as barriers for low income minorities. Insurance coverage does not necessarily equate to greater accessibility if individuals do not have the means to utilize those resources.

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46

Shreffler, Mary Jean. "Residents' views on access to care in frontier communities with medical assistance facilities /." Thesis, Connect to this title online; UW restricted, 1996. http://hdl.handle.net/1773/7225.

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47

Pessoa, Nivia Tavares. "Perfil das solicitaÃÃes administrativas e judiciais de medicamentos impetradas contra a Secretaria de SaÃde do Estado do CearÃ." Universidade Federal do CearÃ, 2007. http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=3465.

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Conselho Nacional de Desenvolvimento CientÃfico e TecnolÃgico
IntroduÃÃo: A Carta Magna de 1988 estabelece em seu art.196 que âa saÃde Ã um direito de todos e dever do Estadoâ, incluindo, ainda no campo de atuaÃÃo do Sistema Ãnico de SaÃde (SUS), a execuÃÃo de aÃÃes de assistÃncia terapÃutica integral, inclusive farmacÃutica. No Brasil, encontrar o meio de garantir efetivamente esse direito Ã saÃde tem sido um dos grandes desafios que os gestores do SUS tÃm enfrentado. Objetivo: Descrever os processos administrativos e judiciais de solicitaÃÃo de medicamentos a Secretaria de SaÃde do Estado do CearÃ (SESA-CE) e discutir os seus aspectos crÃticos. Metodologia: Estudo descritivo, retrospectivo, realizado no NÃcleo de AssistÃncia FarmacÃutica (NUASF/SESA-CE). Foram coletados dados dos processos datados de 01 de janeiro de 2004 a 31 de junho de 2006. As principais informaÃÃes coletadas foram: tipo, condutor e motivo de instauraÃÃo do processo, doenÃas declaradas, unidade de atendimento e medicamentos solicitados. Resultados e DiscussÃo: No perÃodo foram pesquisados 841 processos entre administrativos e judiciais.Os tipos de processos mais frequentes foram os administrativos (84,9%). Os principais condutores foram a Promotoria da JustiÃa de Defesa da SaÃde PÃblica e o Grupo TÃcnico Social da SESA-CE (79,5%). O principal motivo para instauraÃÃo dos processos foi a falta de condiÃÃes financeiras para adquirir o medicamento (52,6%). As prescriÃÃes eram originÃrias principalmente de unidades pÃblicas (41,4%). As doenÃas mais declaradas foram: DoenÃa de Alzheimer (15,6%), e Diabetes mellitus insulino-dependente (7,5%). Durante o perÃodo estudado foram pleiteados 1.481 medicamentos, divididos em 400 especialidades farmacÃuticas (EF). Os medicamentos mais solicitados foram: rivastigmina (12,7%) e insulina glargina (6,4%). Dos medicamentos solicitados, 60% nÃo tinham financiamento definido, 23,0% eram medicamentos excepcionais e 10% da AtenÃÃo BÃsica. Dos medicamentos sem financiamento, os mais freqÃentes foram: insulina glargina (8,6%), clopidogrel (5,2%) e aripiprazol (5,2%). ConclusÃo: Os processos administrativos e judiciais para fornecimento de medicamentos mostraram grande variabilidade entre os medicamentos solicitados, o que leva a supor que as tendÃncias de utilizaÃÃo se devam Ã introduÃÃo de inovaÃÃes terapÃuticas, a ausÃncia de alguns medicamentos nas listas padronizadas pelo Estado e ao desconhecimento e descumprimento dos protocolos clÃnicos pelos prescritores.

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Onasoga, Olayinka Abolore. "Challenges and barriers to adolescents' post-abortion care services: Implications for reproductive health policy in Nigeria." University of the Western Cape, 2017. http://hdl.handle.net/11394/6503.

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Philosophiae Doctor - PhD
The prevention of abortion related complications and mortality is dependent on the availability, accessibility and usability of emergency post-abortion care (PAC) throughout the health care system. Unfortunately, abortion is not legal in Nigeria and Nigerian women, especially adolescents, are often unable to obtain adequate post-abortion care services due to a variety of reasons. A review of literature shows that adolescent PAC patients receive worse care than older women seeking PAC services. There is widespread recognition of the need to overcome these barriers and make it easier for women to obtain the PAC services they need. Therefore, overall aim of this research study was to provide empirical information on the barriers and challenges to adolescents' PAC and develop a policy document to inform reproductive health services for Nigerian hospitals. To develop this policy document, the study specifically sought to assess knowledge of reproductive-health and related post-abortion care services among health care providers; describe the adolescents' perception of post-abortion care received; determine the service providers' perspectives on adolescents' post-abortion care challenges and barriers; analyze the challenges and barriers faced by adolescents in obtaining post-abortion care services; explore ways in which the knowledge about challenges and barriers to adolescents' post-abortion care can be used to inform policy; develop policy document and make recommendations in key areas to improved PAC services in Nigeria as part of working towards improving reproductive health services.

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Burns-Johnson, Toshiba L. "Are Government Websites Achieving Universal Accessibility?: An Analysis of State Department of Health and Human Services’ Websites." Thesis, School of Information and Library Science, 2007. http://hdl.handle.net/1901/417.

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Research reports that the search for health information is the fourth most popular activity being done on the web (Pew Internet & American Life Project, 2004). However, for disabled persons, barriers experienced when interfacing with the Internet may cause healthcare websites to be inaccessible to them. This study explores the level of accessibility of healthcare websites and the relationship between accessibility and usability by determining how compliant state department of health and human services websites are with accessibility and usability guidelines. A content analysis of each state’s department of health and human services website was conducted. Results revealed that state department of health and human services websites are not very compliant with accessibility guidelines, are somewhat compliant with usability guidelines, and overall are not very accessible. The findings also indicate that there is a significant moderate relationship between accessibility and usability which suggests that the two concepts are interconnected.

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Nwufoh-Oladimeji, Victoria I. "Non-formal education in Oyo State of Nigeria with special reference to the evaluation of family planning education in a community-based distribution project." Thesis, Cardiff University, 1992. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.338972.

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