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1
Salins, Swarthick E. "Primary health care delivery in rural India : examining the efficacy of a policy for recruiting junior doctors in Karnataka." Thesis, St Andrews, 2008. http://hdl.handle.net/10023/630.
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Tangimana, Michelle M. "National Survey of Degreed Mental Health Workers Providing Services to American Indian Populations: Identification of Preferred Theoretical Orientations and Treatment Modalities." DigitalCommons@USU, 1990. https://digitalcommons.usu.edu/etd/6016.
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Previous surveys of mental health professionals regarding theoretical orientation and the use of various treatment modalities provided valuable information concerning the nature of mental health delivery but primarily focused on professionals providing services to dominant-culture clientele. The present study focused on those degreed workers whose primary clientele were American Indian. Questionnaires were returned by 140 mental health workers who are American Psychological Association (APA) members of American Indian descent, members of the Society of Indian Psychologists (SIP), employees of the Indian Health Service (IHS), and graduate psychology students. Questionnaire responses were analyzed in terms of orientation and treatment modality for various subgroups of respondents. In addition, demographic data (e.g., age, sex, emphasis of graduate study, intervention level, work setting, and service delivery to primary age groups) were compared for Indian and non-Indian respondents. The results provide a unique assessment of current trends in therapeutic approaches used in mental health service delivery with American Indians.
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Jeffery, Roger. "Health and the State in India." Thesis, University of Edinburgh, 1985. http://hdl.handle.net/1842/24023.
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Mathur, Brijesh. "Urban services in the national cities of India : organization, financing, planning and delivery." Thesis, University of Sheffield, 1991. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.302220.
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Button, Catherine. "WTO review of national health regulations." Thesis, University of Oxford, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.273098.
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Atueyi, Kene Chukwu. "Implementing management information systems in the National Health Service." Thesis, Sheffield Hallam University, 1991. http://shura.shu.ac.uk/4990/.
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As a discipline Management Information System (MIS) is relatively new. Its short history has been characterised with epistemological dialectism. The current conflict and debate about MIS inquiry is broadly between the advocates of the social systems and technical systems perspectives. Few authors have made positive contributions toward clarifying the meaning and nature of MIS, and the appropriate design framework for MIS development. This thesis adds to their effort by using a MIS designed and implemented through action research at the North Western Regional Health Authority. There are seven Chapters in this thesis. Chapters One and Two examine the nature of the problem addressed by this research; the project history, ontological assumptions and research strategy. Chapter Three examines the debate, nature and conflicting views about MIS. It defines the theoretical problem addressed by this thesis and proposes a new concept of MIS. The theoretical problems are dealt with in Chapter Four. In Chapter Five the application of the theoretical concepts developed in Chapter Four is demonstrated in the design of MIS. Chapter Six relates some of the findings of this thesis to the work of other authors. It also examines the problem of human inquiry and the suitability of action research for MIS research. The main findings of this research summarised in Chapter Seven provide a new perspective of MIS as a purposeful system; the taxonomy of purposeful systems; primary context and secondary context of MIS; context analysis and context evaluation of MIS.
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Hopkins, Jan. "From National Lottery to national screening : improving cervical screening coverage and quality in South Lancashire." Thesis, Lancaster University, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.301823.
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Sexton, Jonathan. "The maximisation of strategic health care objectives through the commissioning of health services." Thesis, University of Kent, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.365209.
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Domapielle, Maximillian K. "Extending health services to rural residents in Jirapa District : analyses of national health insurance enrolment and access to health care services." Thesis, University of Bradford, 2015. http://hdl.handle.net/10454/14803.
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This thesis sheds light on differences in health insurance enrolment determinants and uptake barriers between urban and rural areas in the Jirapa district of Ghana. The National Health Insurance Scheme in Ghana has made significant progress in terms of enrolment, which has had a commensurate increase in utilization of health care services. However, there are challenges that pose a threat to the scheme’s transition to universal coverage; enrolment in the scheme has not progressed according to plan, and there are many barriers known to impede uptake of health care. Interestingly, these barriers vary in relation to locality, and rural residents appear to carry a disproportionate portion of the burden. A mixed method approach was employed to collect and analyse the data. On the basis of the primary qualitative and quantitative results, the thesis argues that the costs of enrolling and accessing health care is disproportionately higher for rural residents than it is their urban counterparts. It also highlights that the distribution of service benefits both in terms of the NHIS and health care in the Jirapa district favours urban residents. Lastly, the thesis found that whereas rural residents prefer health care provision to be social in nature, urban residents were more interested in the technical quality aspects of care. These findings suggest that rural residents are not benefitting from, or may not be accessing health services to the extent as their urban counterparts. Affordability, long distance to health facilities, availability and acceptability barriers were found to influence the resultant pro-urban distribution of the overall health care benefit.
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Wainwright, Sunila Claire. "Gender and family formation in Uttar Pradesh, India." Thesis, University of Edinburgh, 2007. http://hdl.handle.net/1842/1512.
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While modernising influences affect many facets of the lives of millions of Indian families, there remain deep-rooted socio-cultural practices and traditions that survive and become engendered in new institutional mechanisms. Labour market policy is but one example where age-old ethnic affiliations distort governmental efforts and find new ways of expressing themselves. Efforts over the past decade to slow the rate of population growth, by encouraging adoption of modern family planning methods have failed to tackle son preference and have caused the sex ratios at birth to be worse than at any other time in the nation's history. This is particularly so in urban India, even among the more educated populace, and it is worsening. This thesis sets out to assess the way in which such gender considerations affect family formation decisions, primarily concerning the quantity and quality of children, with an appreciation of the dynamic nature of the problem. First we assess how fertility preferences and past child outcomes affect the demand for family planning and how behaviours associated with the greater autonomy of women impact upon this process. The empirical work makes use of data from the latest round of the National Family Health Survey (NFHS) for India, 1999, for the state of Uttar Pradesh, in a simultaneous equation framework, in an effort to take account of the joint determination of many of the variables inherent in modelling such dynamic processes with cross-sectional data. We find that although women's autonomy has been held up as a means of achieving lower fertility, the two do not necessarily go hand in hand, unless coupled with the wider participation of women. Unless the primary social and economic motivations for preferring sons are tackled and dismantled through legislation and through changes to social attitudes, superficial policies to promote the well-being of women will have little real impact and may lead to worsening female child outcomes. One of the policies heralded to achieve the deeper goal of gender equality has been the promotion of education of female children, who as a group lag well behind their male counterparts on both literacy and numeracy rates. We thus turn our attention to investigating the way in which household time allocation decisions are made, focusing on the parental choice of each child's main activity; to go to school, to work in the home, or in the formal labour market, in an effort to understand how the household's opportunities and resource constraints, along with social norms impact such decisions. While some state governments are offering cash incentives to families to keep their female children in school and unmarried, significant labour market discrimination against women continues and constrains the value of this government investment. Making use of the same NFHS data for Uttar Pradesh, we estimate each child's trinomial time allocation with competing speci cations and then compare the results. The standard multinomial logit model is estimated initially but imposes some fairly tight assumptions on behaviour and the resultant data, that are unlikely to hold in the present application. A Mixed Logit model is then estimated that is able to bring greater flexibility and descriptive richness than is possible with the standard Logit model. Estimation results are compared and con firm the ability of the Mixed Logit to capture more fully the unobserved heterogeneity inherent in the data and to allow for correlation in the errors across children of the same family that is not permitted within the standard logit setup.
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Rawabdeh, Ali Ahmad Awad. "An integrated national health insurance system for Jordan : costs, consequences and viability." Thesis, Keele University, 1997. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.337091.
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Arguably, in common with many other nation states, Jordan could be said to have drifted into different ways of paying for health services without always foreseeing the long run consequences of taking the strategic direction necessary. In part, of course, as in many developing countries, the financing of Jordan's health care services has been influenced by its colonial past. This partly explains why, historically, Jordan has attempted not only to provide wholly free services, but to provide privileged access to medical services, not only to the military personnel but also to public servants in general. With world economic instability and recent economic difficulties, notwithstanding the opportunities created by Jordan signing the peace treaty with Israel, and the unclear but likely stark future conditions facing the Jordanian economy, it is highly improbable that Jordan will continue to be in a position to sustain, from central government monies, a health system which currently consumes about7percent of the GDP. Financing strategies will, therefore, have to address the heightened expectations for rising health expenditures. Options under active consideration at this time include: introducing or extending the present system of user charges; community financing (participation ); (increased) use of the private sector; public or private health insurance; and, improving efficiency in the use of hospital and community resources. These are all financing options open to the Jordanian government to adopt, whether singly or in combination, to generate more resources for the health system and to make better use of existing resources. Examining the range of different modalities of health services' financing reveals, not surprisingly, that there are advantages and disadvantages in each financing scheme. Nevertheless, depending on Jordan 's circumstances, some of the approaches may be more appreciated than others: that is from a political, cultural, socio-economic, or strictly fiscal point of view. This thesis focuses upon one particular health financing approach, "National Health Insurance (NU)", and is aimed to lead the government of Jordan to rigorously explore the concept, consider the options, and develop an implementation strategy benefiting, where appropriate, from other countries' experiences with systems of NHI. Specifically, the thesis first provides an overview (or situation analysis) of the healthiness of the Jordanian economy, its key demographic and epidemiological characteristics, and salient features of the Jordanian health sector. This is followed by a largely theoretical discussion of the principles of insurance, and its potential relevance to the unpredictability and uncertainty of health and disease. Methodological problems inherent in public or private health insurance schemes are highlighted, and then considered in a comparative context, drawing on lessons and experience around the globe. The thesis considers as its basic premise that a system of national health insurance is both desirable and feasible for Jordan as it faces the next millennium. To test that premise, the study is conducted by means of a series of investigations emphasising both secondary and primary sources of data, and a range of quantitative and qualitative research methods including: content and document analysis; experimental and survey methods; interviews; and questionnaires. The conclusions drawn from the evidence supports the contention that the introduction of NM is potentially both desirable and feasible in Jordan but subject to meeting very strict conditionalities, not least government ownership of the scheme, and the willingness to address the present choice and diversity in health service provision through health sector reform. These matters are as much political as technical matters. On the more technical front, nonetheless, the design of an appropriate NHI is shown to raise critical issues regarding: coverage; benefits; organisation and management; costing and financing; and, provider payment mechanisms. Various technical options are discussed in the thesis, and were consulted upon with key decision makers in Jordan. Further directions of research and development are also identified, which likely have applicability beyond the specifics of Jordan itself.
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Mowbray, Derek. "Decision making in the Management Advisory Service to the National Health Service." Thesis, University of Bath, 1991. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.306735.
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Khetrapal, S. "Public-private partnerships in the health sector : the case of a national health insurance scheme in India." Thesis, London School of Hygiene and Tropical Medicine (University of London), 2016. http://researchonline.lshtm.ac.uk/3141184/.
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Public-Private Partnerships (PPPs) in the health sector are essential in light of the challenges the public sector is facing in healthcare finance, provision and management. Recognizing the need to provide insurance coverage to those below the poverty line (BPL), Rashtriya Swasthya Bima Yojana (RSBY) was introduced in 2008 by the Ministry of Labour and Employment in India. RSBY is a social health insurance scheme for the informal sector, where health care delivery and management involves a multitude of stakeholders from both public and private sectors who are governed by contractual agreements. A family of up to five pays INR 30/- (£0.30) annually for enrolment for a coverage of INR 30,000/- (£302). The balance of the premium is subsidized and shared by the Central (75%) and the State (25%) governments. This research aims to evaluate the availability, provision and management of health services under RSBY Public-Private Partnership contracts and factors that might influence them in order to inform policy makers on how to improve scheme implementation for the BPL beneficiary. The study was conducted in the districts of Patiala and Yamunanagar, in the States of Punjab and Haryana respectively. The study has both qualitative and quantitative components using primary and secondary data. The results of the study can be broadly categorized under the main pillars of scheme design and implementation. These include political, regulatory and institutional capacity; stakeholder contracting; enrolment of beneficiaries; empanelment of health facilities; and finally provision and utilization of services. RSBY has clearly attempted to address the existing gaps in the provision of health services by offering a balanced Public-Private Partnership model that provides some degree of financial protection to the end user. Despite the weaknesses identified, it is a robust and evolving model that needs to be continuously developed, on the basis of lessons learnt from implementation of the scheme.
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Holloway, Jacqueline Anne. "Performance evaluation in the National Health Service : a systems approach." Thesis, Open University, 1990. http://oro.open.ac.uk/57302/.
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This research explores the contribution which systems theories, methodologies and models can make in the design and application of effective performance-evaluation processes. Approaches to performance assessment of organisations are reviewed, and the history and structure of the NHS, its objectives, and dimensions for evaluation are described. Drawing on questionnaire and interview data from health service and civil service staff, and secondary data, current performance evaluation and planning processes in the NHS are described and some problems identified. To test the hypothesis that attention to systemic factors could improve performance evaluation, eight topics are analysed by the application of systems methodologies or models. Four of the topic and methodology or model combinations have received detailed analysis: 1. Making and implementing strategic plans; the Open University's Hard Systems Methodology. 2. Controlling NHS performance through structure and process, e. g. the use of annual reviews, performance indicators; double-loop learning and cybernetic control model. 3. Improving the quality of NHS care; Stafford Beer's Viable System Model. 4. Assessing performance through the outcomes of care; Peter Checkland's Soft Systems Methodology. The areas studied in less detail are: 5. Planning for uncertainty and complexity; 6. Issues related to the politics of health; 7. Reducing the length of waiting lists and times; 8. Planning for health (health promotion and the prevention of ill health).
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Cunningham, Vivian Main. "Social determinants of utilization of skilled birth attendants in two states of India." Diss., Online access via UMI:, 2006.
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Narayan, Thelma. "A study of policy process and implementation of the National Tuberculosis Programme in India." Thesis, London School of Hygiene and Tropical Medicine (University of London), 1998. http://researchonline.lshtm.ac.uk/682263/.
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TB, a major public health problem in India since the 1900s, has a current prevalence of 14 million and an estimated annual mortality of 500,000 persons. Nation-wide government sponsored anti-TB public health measures introduced in 1948, developed into the National TB Programme in 1962. Despite gains, implementation gaps between programme goals and performance, over 35 years, have been of a magnitude sufficient to cause concern. This study aimed to understand explanatory factors underlying the implementation gap. A policy analysis approach was adopted, focusing on the policy process and specifically on implementation, at national, state, district and local levels. It undertook a historical review with a two-tiered framework covering the period 1947-97. In the first tier the historical narrative is woven around a framework of context, content, process and actors. The nature of the problem and policy relevant technical dimensions of intervention measures are discussed, as are effects of pharmaceutical policies and financial resource flows on TB policy. The second tier applies a framework of implementation factors to national policy development and implementation at state and district level. Interviews were conducted with TB patients, elected representatives, front-line health workers, doctors, district and state staff, national programme managers, researchers and representatives from international agencies. Documents were reviewed. Thus the study incorporated an integrative bottom-up cum top-down approach. Findings highlight that interests of patients, medical and allied professionals, pharmaceutical and diagnostic industries and the state are interdependent, but often conflictual. Unequal societal relations affect not only the development and transmission of TB, but also the implementation of control programmes, particularly for the impoverished, among whom high levels of indebtedness due to the disease and difficulties accessing private services were noted. Techno-managerial approaches to TB control often mask societal and policy process factors accounting for the implementation gap. The importance of leadership, institutional development, capacity at the patient provider interface and accountability and need for sustained policies were noted, within an affirmative framework embodying social justice and safeguarding the interests of the majority of patients.
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Thomas, Karen Anne. "The National Health Service contract for pharmaceutical services 1995 to 1998." Thesis, University of Portsmouth, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.368471.
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Jain, Sumeet. "From negotiation to accommodation : cultural relevance in the Asha Gram Mental Health Program, Barwani district, India." Thesis, McGill University, 2002. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=78184.
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This thesis analyzes the degree of cultural relevance in the Asha Gram Mental Health Program in Barwani, India. The focus is on the role of community mental health workers as bridges between a professional culture of psychiatry and the local cultural understandings of mental health. Processes of cultural interaction are analyzed on a continuum from negotiation, defined as interaction without fundamental cultural change, to accommodation, defined as interaction with cultural change. Accommodation at the level of the vision of mental health disorders was limited while there was an active negotiation that resulted in some transformation of the social vision. Negotiation with communities at the level of relationships underpinned this transformation and contributed to a social accommodation with local forms of relationships. Although, professional and class power were important obstacles to achieving cultural relevance, the Program also demonstrates the necessity to subvert this power in order to create social change.
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McNulty, Terence H. "Organization, cultures and the management of change in the National Health Service : case studies in one District Health Authority." Thesis, Nottingham Trent University, 1990. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.245382.
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This thesis is concerned with the issues of managerial effectiveness, organizational change and cultures in the National Health Service. Using the micropolitical and cultural perspectives it is concerned to offer an approach which builds on existing organization, management and change theory in order to further an understanding of these issues in relation to National Health Service organizations as well as other contexts. The focus of attention is on the relationship between structure and culture at both the official and unofficial levels of the organization. The three case studies of organizations undergoing organizational change have allowed the opportunity to understand the complexity of the relationship between the official and unofficial arrangements in the organization and the impact of this on managerial effectiveness and organizational change. The main finding of the thesis is that within organizations, structure and culture are inextricably bound and their consonance at both official and unofficial levels of the organization is a necessary condition for managerial effectiveness. The types of organizational culture developed during the investigation indicate how the plurality of interests, beliefs and cultures within an organization make it difficult to achieve this condition. Concerning National Health Service organizations, the researcher argues that the recommendations contained within the Griffiths Report (1983) have offered a model of management which is based on cultural assumptions which are different to those which have traditionally underpinned the managerial process in the NHS. Following this, the researcher demonstrates via the cases, that the introduction of these recommendations has served to offer greater scope for a diversity of managerial style and philosophy at Unit level. They have also served to raise conflict between cultures, in particular the medical and managerial, to the point that the conditions needed for achieving managerial effectiveness do not exist.
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Surender, Rebecca Miriam. "Managed competition and the National Health Service : an evaluation of General Practice fundholding." Thesis, University of Oxford, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.285536.
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Allen, Pauline Wanda Louise. "Legal and economic aspects of contracts in the National Health Service internal market." Thesis, London School of Hygiene and Tropical Medicine (University of London), 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.312841.
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Stanley, Michael J. "The effect of change on the National Health Service general managers' information needs." Thesis, Sheffield Hallam University, 2001. http://shura.shu.ac.uk/20820/.
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The research enquiry using a sample of 20 NHS organisations with similar revenue and population characteristic profiles sets out to identify the information needs of the NHS General Managers and in doing so highlight the information that they need to meet their organisations' key success factors. The research identifies through the enquiry process the General Managers' information needs and describes the categories of those needs, the pressures and influences of the General Managers' working environment on those needs and the links to the influences that have been reflected in their information needs. In particular the external influence of the Department of Health and the business environment has not only changed the General Managers' information needs but affected the balance of power between the stakeholders, which in turn has affected those information needs. These organisational and environmental changes, health policies, stakeholder demands, and changes in the balance of power between the stakeholders has resulted in a change in the way in which the General Managers work with information, which has in turn increased the need for more accurate, timely and complex information. The research analyses the General Managers' understanding of their roles in the General Manager/patient/doctor relationship and analyses the potential areas of conflict arising when the patients' interests clash with the market-led (business) interests of the healthcare organisations and the diverse needs of the Provider, Purchaser and Regional Executive General Managers. These problems together with the effects of organisational resistance, organisational culture clash and system requirements and its effect on the information needs of the General Managers were examined for associated links with the difficulties that the General Managers experience in defining their information requirements. The research provides an understanding of the links between a market-led healthcare environment, the General Managers' information needs, and their attitude towards information as well as an understanding as to whether the patient, a key stakeholder, has benefited in the healthcare empowerment stakes as a result of the re-delineation of the General Managers' information needs and the impact upon their decision making. The information needs identified as a result of the research have shown them to have become business orientated with financial targets as a key measure and clinical performance (outcomes) increasingly being seen as the other key factor as an indication of success for the organisation. The hypothesis (Null Hypothesis) of the research asserts that it is not possible to link a market-led healthcare environment, the General Managers' information needs, their attitudes and behaviour towards information, and patient empowerment in such a way as to develop a model of information needs that is common across the Purchaser, Provider and the NHS Executive organisations. However, the research has developed as a first step, a series of outline models of information needs that will lead to a more complex and common model of information needs across the General Managers' organisational groups that will allow, when assessed against key success factors, a judgmental view of the ability of both the General Managers and their organisations to deliver their aims and objectives.
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Gremu, Chikumbutso David. "Building an E-health system for health awareness campaigns in poor areas." Thesis, Rhodes University, 2015. http://hdl.handle.net/10962/d1017930.
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Appropriate e-services as well as revenue generation capabilities are key to the deployment and the sustainability for ICT installations in poor areas, particularly common in developing country. The area of e-Health is a promising area for e-services that are both important to the population in those areas and potentially of direct interest to National Health Organizations, which already spend money for Health campaigns there. This thesis focuses on the design, implementation, and full functional testing of HealthAware, an application that allows health organization to set up targeted awareness campaigns for poor areas. Requirements for such application are very specific, starting from the fact that the preparation of the campaign and its execution/consumption happen in two different environments from a technological and social point of view. Part of the research work done for this thesis was to make the above requirements explicit and then use them in the design. This phase of the research was facilitated by the fact that the thesis' work was executed within the context of the Siyakhula Living Lab (SLL; www.siyakhulaLL.org), which has accumulated multi-year experience of ICT deployment in such areas. As a result of the found requirements, HealthAware comprises two components, which are web-based, Java applications that run in a peer-to-peer fashion. The first component, the Dashboard, is used to create, manage, and publish information for conducting awareness campaigns or surveys. The second component, HealthMessenger, facilitates users' access to the campaigns or surveys that were created using the Dashboard. The HealthMessenger was designed to be hosted on TeleWeaver while the Dashboard is hosted independently of TeleWeaver and simply communicates with the HealthMessenger through webservices. TeleWeaver is an application integration platform developed within the SLL to host software applications for poor areas. Using a core service of TeleWeaver, the profile service, where all the users' defining elements are contained, campaigns and surveys can be easily and effectively targeted, for example to match specific demographics or geographic locations. Revenue generation is attained via the logging of the interactions of the target users in the communities with the applications in TeleWeaver, from which billing data is generated according to the specific contractual agreements with the National Health Organization. From a general point of view, HealthAware contributes to the concrete realizations of a bidirectional access channel between Health Organizations and users in poor communities, which not only allows the communication of appropriate content in both directions, but get 'monetized' and in so doing becomes a revenue generator.
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Han, Ik-Hee. "Health care policy, equity and the welfare state : the case of national health insurance programme in the Republic of Korea." Thesis, University of Bristol, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.302096.
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Singh, A. J. "An evaluation of the district blindness control societies and the cost-effectiveness of cataract surgery delivery options in India." Thesis, University of Liverpool, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.366438.
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Cotter, Siobhan Maire. "The clinical role of the hospital pharmacist in the United Kingdom National Health Service." Thesis, London School of Hygiene and Tropical Medicine (University of London), 1995. http://researchonline.lshtm.ac.uk/682295/.
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This thesis examines the roles adopted by clinical pharmacists in the United Kingdom (UK), the evidence for the effectiveness of the interventions arising from these roles, and the challenges to and opportunities for future developments in clinical pharmacy. The research was undertaken in four phases: problem definition; national survey of services currently provided; in-depth interviews on roles; and a review of literature on effectiveness. A literature search provided background information on the evolution of pharmacy and of clinical pharmacy, particularly in the UK. These developments in have been set in the context of changes in health care provision and in the roles of the other health care professions and occupational groups. Preliminary interviews, meetings and group work were carried out to facilitate clarification of the research questions and to assist in the choice of methods. Two nationwide postal questionnaire surveys were conducted. One inquired about the provision of clinical pharmacy services to the primary care sector and the other about service provision within secondary care facilities in the National Health Service (NHS). The response rates were 91% and 90% respectively. The results show some diversity in the provision of clinical pharmacy services and provide possible explanations for this variation. Subsequently, semi-structured interviews were conducted with pharmacists, pharmacy technicians, doctors, nurses and managers at eight sites selected to represent different characteristics of hospitals. These qualitative data were analyzed by constant comparison. The results provide a picture of the clinical roles that hospital pharmacists are, and should be, providing. In addition, they indicate the potential barriers to, and opportunities for, future role development. An assessment of the evaluative literature on clinical pharmacy services was undertaken. Most literature is descriptive and much of the evaluative literature has shortcomings. The results present the evidence for the effectiveness of clinical pharmacy services in improving patient care and financial outcomes in the UK NHS. Finally, quantitative information gathered in the questionnaire survey, qualitative information from the interviews and the literature evidence were combined to create models of the future role of the hospital clinical pharmacist in the UK.
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Lu, Jyh-Cherng 1959. "The national survey of hospital pharmaceutical services in the Republic of China." Thesis, The University of Arizona, 1990. http://hdl.handle.net/10150/277927.
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A study of hospital pharmacy practice in the Republic of China was conducted in the Summer of 1987. The status of selected innovative pharmaceutical services and the attitudes of pharmacy directors toward developing and implementing those services were assessed. The innovative services were unit dose drug distribution, pharmacy-prepared i.v. admixtures, pharmacy computerization, drug information and clinical pharmacy services. A questionnaire was used to obtain data and information from a random sample of hospitals in Taiwan, R.O.C.. Most of selected services were performed in about 25% of the surveyed hospitals. The i.v. admixture program was performed by the lowest percent of general hospitals as compared to the other services in this study. Pharmacy directors indicated that their attitudes toward selected innovative pharmaceutical services in terms of seven possible effects or outcomes were positive, but the scores relating to the other professionals and operating expenses were neutral or negative.
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Goodall, Andrew K. "Comparing management development in the National Health Services of Britain and France." Thesis, Cardiff University, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.342311.
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Al-umaran, Saleh. "Culture dimensions of information systems security in Saudi Arabia national health services." Thesis, De Montfort University, 2015. http://hdl.handle.net/2086/11393.
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The study of organisations’ information security cultures has attracted scholars as well as healthcare services industry to research the topic and find appropriate tools and approaches to develop a positive culture. The vast majority of studies in Saudi national health services are on the use of technology to protect and secure health services information. On the other hand, there is a lack of research on the role and impact of an organisation’s cultural dimensions on information security. This research investigated and analysed the role and impact of cultural dimensions on information security in Saudi Arabia health service. Hypotheses were tested and two surveys were carried out in order to collect data and information from three major hospitals in Saudi Arabia (SA). The first survey identified the main cultural-dimension problems in SA health services and developed an initial information security culture framework model. The second survey evaluated and tested the developed framework model to test its usefulness, reliability and applicability. The model is based on human behaviour theory, where the individual’s attitude is the key element of the individual’s intention to behave as well as of his or her actual behaviour. The research identified a set of cultural and sub-cultural dimensions in SA health information security and services.
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Witter, Sophie. "Making delivery care free : evidence from Ghana and Senegal on implementation, costs and effectiveness of national delivery exemption policies." Thesis, Available from the University of Aberdeen Library and Historic Collections Digital Resources, 2009. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?application=DIGITOOL-3&owner=resourcediscovery&custom_att_2=simple_viewer&pid=25753.
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Poppi, M. K. "A cross-national study of childhood autism." Thesis, City, University of London, 2016. http://openaccess.city.ac.uk/16174/.
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Autism is considered to be a chronic developmental disability that affects communication, relationships, emotional development and imagination (NAS, 2010). Prevalence rates for autism spectrum disorder (ASD) suggest that the rates have increased over time and recent research shows that 1 in 68 children are diagnosed with the disorder (Baio, 2014). These children’s difficulties in the areas of communication, social skills and restricted/repetitive behaviours and interests lead to the need of therapeutic support (APA, 2013) and often it falls to parents to find an appropriate treatment for their child (Marcus et al, 2005). Among recommended services to these children are speech and language therapy, occupational therapy (Johnson and Myer, 2007) and psychotherapy (Alvarez et al, 1999). There are a number of intervention approaches for children with autism that have been developed, however none have been universally accepted as being the most effective (Farrell et al, 2005). As a result, parents often find it difficult to know which is the most appropriate approach for their child. This study aims to explore the development of children with autism over time in the areas of social skill and communication, regardless of the kind of treatment (speech and language therapy, psychoanalytic/psychodynamic psychotherapy and occupational therapy) they are receiving and to investigate the association between therapy context and the patterns of developmental change. This thesis is designed as a cross-national study in order to examine the aspects of the disorder that differ in the UK and Greece along with the differences (if any) in the developmental patterns across countries. The significance of doing a cross-national study is to explore autism from a wider international perspective and to identify any differences and similarities across the two countries. Twenty children with autism who had completed one of two differing types of treatment in the UK (psychotherapy, n=10 and speech and language therapy, n=10) were recruited to be monitored post-therapy twice over a two-year period. Twenty children with autism who had received one of two types of treatment in Greece (occupational therapy, n=10 and speech and language therapy, n=10) were also recruited to be monitored post-therapy twice over a two-year period. The research found that all children changed significantly over time on all aspects of measurement. Furthermore, no significant differences were found in the children from the two different countries at the start of the study and they developed in a very similar way as well. The results suggested though that based on the ADOS-Social (p=0.008) and ADOS-Imagination (p=0.008) children in the UK improve faster in the areas of social skill, imagination and the CDI-no of words understood and produced (p=0.015) showed an increase in their ability to understand and say words compared to the children in Greece. However, the CDI-no of words understood (p=0.027) showed that the children in Greece improved faster in the area of comprehension. The children who received SLT are also mainly developing in a very similar way across the two countries. Most measures showed change over time, except for the SCQ (p=0.081), ADOS-Ster (p=0.050) and CDI-U (p=0.141|). Also, only the ADOS-Social (p=0.021) and the Social Communication Questionnaire (p=0.021) showed a significant interaction effect. Thus, the SLT group from the UK seems to improve faster in the area of social skills compared to the SLT group from Greece. Additionally, in regards to the effect of the therapy context on the developmental pattern of children with autism, there were no differences across intervention contexts at the beginning and there were mainly non-significant interactions in the rate of change across the differing types of intervention. The findings suggested that all measures showed change over time. Only the SCQ (p=0.041) and the ADOS-imagination (p=0.033) showed a significant interaction effect before adjusting for age. Therefore, the SLT group in the UK seems to improve faster in the social communication area and the Psychotherapy group in the UK improved faster in the area of imagination. Conclusively, the SLT groups showed more change on language and communication measures, whilst the psychotherapy and occupational therapy groups saw changes in other areas of autistic symptomatology not achieved in the SLT groups, such as imagination and stereotypical behaviour. In summary, the current study helps parents gain better insight in different therapy choices and raises awareness of other types of therapy that are available in terms of intervention. The findings of this study can help professionals who work with children with autism further their understanding of the disorder and how it manifests through time in order to provide appropriate services based on each child’s needs. Additionally, the cross-national approach was intended to give some suggestions about the manifestation of autism across countries and about the way childhood autism is treated in each country. In regards to the more specific changes that the analysis revealed, they seem to fit well with the intervention targets of each type of therapy. Thus, the analysis suggested that certain characteristics tend to be associated with specific treatment types, which leads us to believe that sometimes the most effective course of treatment is a combination of therapies depending on the individual needs of each family. Finally, the results of this study offer original findings with respect to the outcomes of psychodynamic/psychoanalytic psychotherapy for children with autism since there is a lack of rigorous research in this field.
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Saroha, Ekta. "Caste as a determinant of utilization of maternal and neonatal healthcare services in Maitha, Uttar Pradesh, India." Thesis, Birmingham, Ala. : University of Alabama at Birmingham, 2007. https://www.mhsl.uab.edu/dt/2008r/saroha.pdf.
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Forbes, Thomas McCrone. "Strategic management and National Health Service hospital trusts : empirical evidence for the West of Scotland." Thesis, University of Glasgow, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.247706.
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Lewis, Richard. "Improving London's primary care : centre-local relations in the implementation of national policy objectives." Thesis, London School of Hygiene and Tropical Medicine (University of London), 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.248237.
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Subramanian, Shobana. "Reconfiguring home, world and cosmos health initiatives in women's self-help groups in Kanyakumari, India /." Columbus, Ohio : Ohio State University, 2006. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=osu1150483913.
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Read, Susan Margaret. "Management changes in the National Health Service : nursing and organisational theory in relation to the development of a new unit of health care." Thesis, University of Sheffield, 1989. http://etheses.whiterose.ac.uk/2978/.
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This thesis gives an account of research into management changes in the English NHS following the implementation of the Griffiths' Report (1983). The research had three aims: 1. To describe and consider the effects of new management philosophies plans and practices by conducting a case study of one particular unit of health care. 2. To study theories of nursing and health care organisation. 3. To assess the relationship, if any, between experience and theory, suggesting ways to bring theory and practice closer together. The academic perspective is multidisciplinary, drawing on literature from nursing, organisational 'theory and behaviour, health service management, social science, philosophy, history, economics and policy studies. The thesis commences with a discussion of research methodology, arguing the appropriateness of an interpretive stance. An account of the development of the NHS and nursing's place within it is followed by a detailed case study of one unit, which lasted nine months and involved more than a hundred interviews. Particular characteristics of the case study are:- Data analysis utilising grounded theory methodology Inclusion of members of the organisational context A system for participants to validate data pertaining to themselves. The style is naturalistic, qualitative and processual. Presentation of the results recognises the existence of multiple interpretations of organisational reality; a metaphor likens the development of the Unit to the weaving of a tapestry, where the backing is the structure of the unit, and the pattern the perceptions, values and aspirations of its staff, patients and context members. Emerging themes in the thesis are:- the complexity of the NHS professional philosophies and their relationship to management organising as a process growth of a distinctive unit culture. A deliberate choice is made to expose the conflicts and difficulties of naturalistic inquiry, by reflecting on research method throughout the thesis, which is written in the first person.
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Veena, Sargoor. "Cognitive performance during childhood and early adolescence in India : relationships to birth size, maternal nutrition during pregnancy and postnatal growth." Thesis, University of Southampton, 2015. https://eprints.soton.ac.uk/385138/.
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Maguire, Stuart. "The development of a methodology for the introduction of information systems within the National Health Service." Thesis, Lancaster University, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.287250.
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This thesis represents over five years of research focusing on the development and implementation of information systems within the National Health SefV1ce. It aims to contribute towards a better understanding of the information systems development process from inception through to system evaluation and review. Five long-term interventions have been undertaken in a range of National Health Service sites, examining different aspects of information provision. The length of the interventions ranged from nine months to almost two years. The five sites were all at different stages of system development. The research has been carried out using a combination of participant observation and action research. This has meant working with National Health Service staff on a series of system projects. The aim of the research is to try and help National Health Service (NHS) organisations deal more successfully with their information provision. The research question asks, "how can NHS organisations think about, and hence go about their information provision in such a way that successful information systems are introduced'!". Information systems development has generally been regarded as a technical discipline. This has led to a narrow view being taken of a number of areas that may affect the success or otherwise of system projects. Historically, the system development process has been concentrated in the hands of a small number of experts even though the implementation of systems can have far-reaching consequences for the organIsation. The output of the research is a set of issues that should be addressed when introducing information systems within the NHS. These have been translated into the OASES materials which form the appendices. OASES is not a prescriptive methodology but a set of principles and guidelines to try and improve the way that information systems are developed within the NHS. It IS hoped that the outcome of the research will be a situation in which effective information systems are developed that take account of the behavioural, cultural, and organisational issues that are important within complex organisations.
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Desombre, Terence Robert. "The role and preparation of Executive Nurse Directors in the new National Health Service (post 1990)." Thesis, University of Reading, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.388394.
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Powell, Alison. "Examining the implementation of acute pain services in the UK National Health Service." Thesis, University of St Andrews, 2006. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.667194.
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Davies, Ian. "Emerging management education issues for the human services." Thesis, University of Bristol, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.343294.
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Wungchun, Kittipadakul Nonglak Pancharuniti. "Client satisfaction towards oral health services under universal health coverage project in Singburi province, Thailand /." Abstract, 2004. http://mulinet3.li.mahidol.ac.th/thesis/2547/cd363/4637905.pdf.
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Wood, Aileen J. "Towards a national library and information services policy in public sector healthcare in the United Kingdom." Thesis, University of Brighton, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.275086.
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Thompson, Carl Anthony. "Quality : a multi-method exploration of the social construction of a contested concept in the National Health Service." Thesis, University of York, 1998. http://etheses.whiterose.ac.uk/13991/.
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Kumar, Naresh. "The provision of infrastructure services in Rohtak and Bhiwani districts, Haryana, India, 1981-98 : a geographical analysis." Thesis, Durham University, 1999. http://etheses.dur.ac.uk/4396/.
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Abstract: Provision of three basic infrastructure services (namely education, health and transport) in Rohtak and Bhiwani Districts (India) is examined using three types of data: 1. 507 households spreading in 8 villages, 2. Informal discussion with villagers and services providers in both districts, and 3. Secondary data for 921 villages and 14 towns and cities. These data were analysed using both statistical and GIS techniques. The analysis reveals that quantitatively there has been considerable expansion of education and health services over a period of fifteen years (1981 to 1996), and the average distance people have to travel to access these services has also declined significantly. But little evidence was found of any logical criterion being followed for the location of new services and the upgrading of existing services. Consequently, there was no improvement in the efficiency level (measured in terms of demand and geographical distance) of existing infrastructure services (both public and private); moreover, the efficiency level of private services was significantly lower than that of public services. It was further observed that the poor and women had relatively poor access to education, health and transport; and income, caste, gender, education level and village location had significant impact on access to and utilisation of basic services. In the study area, public services were functioning sub-optimally and service users were not satisfied with the quality of services; a significant proportion of clients had to rely on private services. Although public services may not be available in all the villages, the main focus should now be on improving the quality of existing services. Therefore, a solid transport network is needed in rural areas so that the availability of frequent and reliable transport services facilitate villagers' access to quality services even if located at distant places. Thus far, the role of the public in service provision has been minimal, which may be one of the reasons for poor quality of public services. Therefore, the active involvement of clients (service users) is essential in the operation, maintenance and monitoring of basic services in order to improve their quality and efficient functioning, and to effectively cater for people's needs in general and deprived sections of the society in particular.
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Bentley, Melissa. "A National Assessment of Ideal Cardiovascular Health among Emergency Medical Service Professionals." The Ohio State University, 2016. http://rave.ohiolink.edu/etdc/view?acc_num=osu1480456097279235.
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Friedrich, Allison. "School-Based Mental Health Services: A National Survey of School Psychologists’ Practices and Perceptions." Scholar Commons, 2010. http://scholarcommons.usf.edu/etd/3549.
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This study explored the current role of school psychologists in the provision of school-based mental health services, including factors that relate to their provision of such services, by surveying a national sample of practicing school psychologists. Despite an extensive knowledge base regarding which professional services school psychologists provide in general, few studies have focused exclusively on specific modalities of mental health services. Previous lines of research also have not fully identified why school psychologists do not spend as much of their professional time in the provision of mental health services as they would desire. Therefore, a central purpose of this study was to determine the extent to which specific factors are perceived as facilitating or prohibiting practitioners from providing psychotherapeutic interventions, including content/knowledge areas and training experiences that are tied to high perceptions of competence to provide mental health services in the schools.
Mail out survey methodology was utilized to allow for data collection from a large, national sample of school psychologists in a timely and cost efficient manner. In total, surveys were completed and returned by 226 out of a possible 600 respondents, representing a 37.7% response rate. School psychologists reported receiving referrals for a variety of student issues (although primarily externalizing student behaviors, academic problems, and interpersonal problems) and providing a wide array of mental health services (e.g., consultation, social-emotional-behavioral assessment, individual counseling). Factors identified as posing significant to moderate potential barriers included caseload constraints, role strain, school-level factors (e.g., inconsistent treatment), and systems-level factors (e.g., insufficient funds for services from district administration). The highest rated facilitators to school-based mental health service provision involved personal characteristics (e.g., personal desire to provide mental health services), having adequate training and confidence, and school-related factors (e.g., availability consult with other mental health professionals). Important training preparation included a variety of didactic content areas (e.g., social-emotional behavioral assessment, consultation with teachers and parents) and many of the applied graduate training activities and professional development activities included in the current survey. Implications for future research and practice are presented, specifically related to the training and professional development needs of school psychologists.
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Matthews, Jean Isabel. "Power, management and complexity in the NHS : a Foucauldian perspective." Thesis, University of South Wales, 2009. https://pure.southwales.ac.uk/en/studentthesis/power-management-and-complexity-in-the-nhs(bb92809f-944d-4bfd-8502-7ffd0791a35a).html.
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This thesis is a critical and post-structural exploration of the discourse of managerialism in the NHS secondary care sector in Wales. Its central intent is to destabilise the dominant thinking about NHS management practice and to evoke intellectual debate about alternative discourses of management that ontologically perceive the organisation as a complex adaptive human system. The emergent theoretical framework conjoins the discipline of Complexity with post-structural conjecture, posing a novel conceptualisation of a fractal self where relations of power are seen as essential for harmonising diverse influences and legitimising a local discourse that informs and regulates practice. Using Foucault’s insights on power and knowledge the thesis critiques the strategic nature of NHS discourse, exposing the discursive dominance of managerialism and its inherent relations of power and debates what this predicates for a local negotiation and a flexible, safe and innovative environment. The methodological approach employs a reflexive and micro-level interpretative strategy to emphasise the singularity of agents and to explore the way in which the discursive constitution of the self influences agent practice. My profound experience of the secondary care system requires I situate my self reflexively within the context where I explore and liberate my own voice in conjunction with my participants. The research adopts a biographical narrative method of data collection and uses Foucauldian discourse analysis as a framework for exploring the underlying discourse in agent stories. The findings demonstrate the polyphonic nature of the secondary care context and reveal the demonstrate the polyphonic nature of the secondary care context and reveal the diverse ways in which agents legitimise, negotiate or resist the conflicting truth claims of various discourse in order to strategically sustain an image of health care historically constituted in their self. The results portray a web of discourses that endorse conformity or complicity through oppressive mechanisms of disciplinary control and surveillance, perpetuating authoritative and dualist structures, dissipating relations of trust and removing intellectual thinking from the front-line. The conclusion asserts that this significantly jeopardises the ability of agents to legitimise local ‘discourse’, severely limiting their capacity for adaptive practice and the generation of new order.
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De, Voe Jennifer. "New national approaches to community health : a comparative analysis of historical case studies from Australia and the United States." Thesis, University of Oxford, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.367771.
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Algaman, Abrahim Hamad. "TQM implementation in a health care setting : a case study of a Saudi Arabia National Guard primary care setting." Thesis, Manchester Metropolitan University, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.311074.
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