Tesi: "World Health Organisation"

1

Lakin, Alison Elizabeth. "The World Health Organisation and the right to health". Thesis, King's College London (University of London), 2001. https://kclpure.kcl.ac.uk/portal/en/theses/the-world-health-organisation-and-the-right-to-health(7fc2d0e1-bc65-48c2-b2e5-50aff5593a54).html.

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2

Rock, Daniel. "A revision of the World Health Organisation psychiatric disability assessment schedule". Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 1999. https://ro.ecu.edu.au/theses/1225.

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The burden schizophrenia places on the individual, on the family and on society in general is determined more by the associated disability rather than the manifest symptoms. Therefore, measurement of disability provides a baseline for evaluating change and directing treatment. This research has two main aims. The primary purpose of this study was to develop and validate a contemporary revision of the World Health Organisation-Psychiatric Disability Assessment Schedule (1988). Data used was based on data from the WHO Collaborative Study on Determinants of Outcome of Severe Mental Disorders (Sartorius et al., 1986). The second aim of this study was to develop a methodology for the construction of a psychometrically rigorous instrument. This involved the use of standard, modified and original data checking and analysis techniques and input from content-experts. Results from this process indicated that the criteria and selection of experts is based upon the considered judgement of the researcher that the sum of the advantages of the expert validation process outweigh the disadvantages. This study has two discrete outcomes: The revised DAS can be used to assess disability in schizophrenia, and a "gold standard" methodology which can be applied during instrument development.

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Mukoma, Wanjiru. "Towards a health promoting University: an exploratory study of the University of Cape Town". Master's thesis, Faculty of Humanities, 1999. https://hdl.handle.net/11427/31850.

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Drawing on developments in the public health field, this exploratory study applies the ideas of Health Promotion (HP) to the University of Cape Town (UCT). It defines UCT as a setting within which HP can and should take place. Following the World Health Organisation (WHO), health is seen as encompassing physical, mental, social, and other environmental factors (WHO, 1978). Sociological perspectives that acknowledge the relationship between social action/behaviour and the social context, hence the relationship between students' wellbeing and the UCT environment are employed. Data and information for this study were collected through focus group discussions, in-depth interviews, participant observation, and a sample of information gathered by first year sociology students. The fear of failure, housing problems, limited social integration, and availability of cigarettes and junk food on campus were found to be some of the factors that influence and constrain students' weIIbeing. It was also found wellbeing is not an explicit consideration in the university plans and policies, even though implicitly these are meant to enhance wellbeing. Strategies to promote health in UCT need to be guided by a commitment to wellbeing in the university's policies. This thesis recommends that the university be required to pass a 'wellbeing test'.

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4

Hutton, Guy Peter Coats. "Can the costs of the World Health Organisation antenatal care programme be predicted in developing countries?" Thesis, London School of Hygiene and Tropical Medicine (University of London), 2001. http://researchonline.lshtm.ac.uk/4646512/.

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The aims of this thesis are to identify and test alternative methods for analysing and predicting health care costs, to construct a framework for guiding analysts in making better cost predictions, and to identify future areas of research in this area. The thesis uses costs collected from a multi-country trial measuring the cost-effectiveness of an evidence-based programme of antenatal care. Detailed costing studies of maternity services (antenatal care, childbirth and postpartum care) were done in two trial countries (Cuba and Thailand), and also a nontrial country, South Africa. Costs are broken down and reviewed by cost components: prices, resource use, and health service use. The review initially considers the application of economic theory to public health care institutions, to identify factors likely to cause cost variation between setting. Then the review seeks empirical evidence proving or disproving the existence of these factors from the health care literature, as well as a review of the methods for analysing health care costs. The empirical analysis first compares health service use, unit costs and cost per pregnancy between settings (between: women with different case-mix, health facilities, trial arms and 'study countries) and examines the causes of variation, before testing alternative cost prediction methods. Variations in unit cost are found to be due to several factors, including different levels of resource productivity, occupancy levels, staffing patterns, prices and exchange rates (between country), input mix and health facility size. Also, uncertainty and measurement error are considered likely to cause some variation in unit costs. Variations in health service use are due to case-mix, clinical practice, and accessibility differences. Again, not all variation is explained. Finally, a range of different cost predictions methods are tested, and their results compared with observed costs in each country. The most accurate cost prediction method is to build costs based on expected changes in resource use, health service use and morbidity rates (called the incremental cost impact approach). The direct and adjusted cross-country transfer methods (transfering costs between countries), although accurate on occasions, are less reliable. Cost predictions using predictors from a regression analysis are highly unreliable for cross-country predictions. Methodological issues and policy implications in relation to cost prediction and generalisability are discussed, including the choice of cost-prediction approach, the valuation methods (opportunity cost and currency conversion methods for cross-country predictions), the measures used for comparing the performance of cost prediction methods, and the limitations· of cost analyses to understand costs. It was concluded that caution is needed in predicting costs both within study countries due to cost variability, and in lower-resourced settings where u,nit costs and health service use are lower. Further cost analyses and testing of cost prediction methods are needed in other areas of health care to compare with the results from this thesis, and build a fuller picture of cost behaviour as well as strengths and weaknesses of alternative cost prediction methods.

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5

Chepkurui, Viola. "Characterisation of national immunisation programmes in countries experiencing public health emergencies within the WHO African region". Master's thesis, Faculty of Health Sciences, 2021. http://hdl.handle.net/11427/33613.

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Background: The World Health Organisation (WHO) Africa region experiences multiple public health emergencies (PHEs) annually. PHEs have been documented to affect the provision of health services including immunisation. To our knowledge, there is a scarcity of studies characterising PHEs and the performance of national immunisation programmes (NIPs) in countries within the WHO Africa region that have experienced PHEs. This study assessed PHEs (armed conflicts, disasters, and disease outbreaks) and the performance of NIPs in the context of PHEs using global and regional immunisation targets. Methods Countries in the WHO Africa region that were reported to benefit from the African Public Health Emergency Fund (APHEF) were used as case studies. Data on PHEs and immunisation indicators recorded between 2010 and 2019 in the study countries were extracted from different electronic PHE databases (the Emergency Events database, the Uppsala Conflict Data Program, the WHO Emergency Preparedness and Response, and the Program for Monitoring Emerging Diseases Mail) and the WHO/UNICEF immunisation database, respectively. The PHEs and immunisation indicators were stratified by country and summarised using descriptive statistics. The Mann-Whitney U test was carried out to determine the association between the frequency of PHEs and the performance of NIPs in the selected countries from 2010 to 2019. Statistical significance was defined at p-value < 0.05. Results Thirteen countries were included in this study. A total of 175 disease outbreaks, 288 armed conflicts, and 318 disasters were reported to have occurred within the 13 countries from 2010 to 2019. The Democratic Republic of Congo had the highest total PHE count (n=208), while Liberia had the lowest (n=20). Only three of the 13 countries had a median coverage value for the third dose of the combined Diphtheria, Tetanus, and Pertussis vaccine (DTP3) that had attained the target for ≥90% immunisation coverage. Higher counts of armed conflict and total PHEs were statistically significantly (p=0.03) associated with not attaining MNT elimination. Conclusion PHEs are prevalent in the WHO Africa region, irrespective of the level of a country's immunisation maturity. In absence of effective interventions, PHEs have the potential to derail the progress of NIPs in the WHO Africa region. As we enter the Immunisation Agenda 2030 era, this study advocates for the prioritisation of interventions to mitigate the impacts of PHEs on the NIPs.

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6

Muzaka, Valbona. "In Sickness and in Wealth: Dealing with Intellectual Property Rights and Public Health at the World Trade Organisation". Thesis, University of Sheffield, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.489668.

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Despite being about wealth and about who owns and controls the new capital - knowledge the study of intellectual property rights has generally attracted little attention from students of contemporary global political economy. This study seeks to bring such study squarely within the field, by opening a window into the complex interactions and contests over intellectual property rules that continue to engage multiple players in various fora simultaneously. The outcomes of these contests are as yet unclear, but they certainly have the potential to alter the future shape mid direction of global economy, for better or for worse. We do not engage in speculations about such outcomes, but seek to point to the growing importance of the politics of intellectual property and trade rules. More specifically, this is a study on the 'how' and 'why' of the emergence of the current global intellectual property regime and the manner in which the interplay between global intellectual property and trade rules has played out in the area of global public health. We seek to offer a political economy approach to understanding and explaining the multifaceted contests between state and non-state actors that have been attempting to resolve the many tensions inherent in the intersection of these three issue-areas in ways which best satisfy their interests. However, this is but one area where actors and interests are clashing over intellectual property rules; our hope is that other studies will follow which will continue to shed light into these contests and help us better to understand how global (intellectual property) governance structures are made and remade over time.

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7

Hsu, Patricia. "Development of a New Zealand version of the World Health Organisation of Quality of Life Survey (WHOQOL) instrument". AUT University, 2009. http://hdl.handle.net/10292/978.

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Research on health related Quality of Life (QoL) is valuable in developing health policy, assessing medical treatment outcomes and social sciences. Different QoL measurement instruments reflect different facets, and some QoL assessment tools are culturally insensitive. This study examines the existing WHOQOL-BREF (World Health Organisation Quality of Life) 26-item instrument for its suitability for use in New Zealand studies. It focuses on seeking facets of QoL of particular importance to New Zealand culture upon which New Zealand national items may be constructed and included when using the WHOQOL-BREF in studies in New Zealand. In order to achieve this goal, the project involved four sub-studies: verifying the existing WHOQOL response scale descriptors; conducting focus groups to elicit new areas or facets of QoL peculiar and particular to New Zealanders; examining the stability of the WHOQOL-BREF importance scale test-retest reliability; and conducting a national survey to assess what facets of QoL are most important to New Zealanders upon which national items may be developed and the national importance survey. The verification of response scale showed good correspondence with the standard English WHOQOL version. A total of 46 candidate importance items were generated from 12 focus groups’ discussions. Test/retest reliability revealed that the existing WHOQOL-Importance questionnaire items were more stable over a three week period, better than several of the new candidate importance items. Two thousand questionnaires asking what is important to New Zealand were sent out to the NZ general population and 585 returned. Results revealed that what is important varies across age, gender and health states. Twenty-four national items were developed from the national importance data. The study confirmed that what is considered as important facets of QoL varies within New Zealand and that there are facets that are important to New Zealanders not in the existing WHOQOL-BREF.

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8

Tempest, Stephanie Elaine. "Using the International Classification of Functioning, Disability and Health (ICF) to enhance healthcare communication : an action research project with an acute stroke service". Thesis, Brunel University, 2014. http://bura.brunel.ac.uk/handle/2438/10558.

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Background: Effective communication is key to team working in healthcare. It can be negatively impacted upon by existing cultures, logistical challenges, role confusion, and a lack of collaborative approaches to practice. Clinical guidelines recommend using the International Classification of Functioning, Disability and Health (ICF) to aid communication within stroke teams. Yet no empirical evidence exists on the process or outcomes of such implementation. Aims: This project aimed to explore ways the ICF could be used with an acute stroke service and identify key learning from the implementation process. Methods: Using an action research framework, iterative cycles were used within exploratory, innovatory and reflective phases. Content analysis was used to map patient notes’ entries to ICF categories. Thematic analysis was undertaken, using a model of immersion and crystallisation, on data generated via interview and focus group, e-mail communications, minutes from meetings, field notes and a reflective diary. Descriptive statistics were used to analyse quantitative questionnaire data. Data from all sources were combined to determine key findings. Findings: Participants chose to develop an ICF-based team transfer of care report with an ICF glossary to aid completion. Five overall themes were determined; the need to: (1) adopt the ICF in ways that met local service needs; and (2) adapt the ICF language and format. Once implemented, the ICF: (3) fostered communication within and beyond the stroke team; (4) promoted holistic thinking; and (5) helped to clarify team roles. Conclusions: These are the first empirical findings within stroke services that demonstrate how to make the ICF a clinical reality. Participants needed to adapt and own the ICF to adopt it. When implemented, it enabled specific team communication challenges to be overcome. The use of action research to implement the ICF has facilitated sustained change and improvements to communication, thus benefiting patient care.

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Li, Phoebe Hung. "Revisiting public health emergency in international law : a precautionary approach". Thesis, University of Edinburgh, 2012. http://hdl.handle.net/1842/6393.

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This work develops a means to encourage states to take advantage of the flexibilities of compulsory licensing in the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) which promotes access to medicines in a public health emergency. In pursuing this solution, the precautionary approach (PA) and the structure of risk analysis have been adopted as a means to build a workable reading of TRIPS and to help states embody the flexibilities of intellectual property (IP). This work argues for a PA reading of TRIPS and that states have the precautionary entitlements to determine an appropriate level of health protection from the perspective of “State responsibility” in international law. A philosophical review is conducted followed by the examination of existing international legal instruments including the WTO Agreement on the Application of Sanitary and Phytosanitary Measures, the WHO International Health Regulations, the Codex Alimentarius, and the Cartagena Protocol on Biosafety. The PA has been found to have a pervasive influence on risk regulation in international law, yet the application is fraught with fragmentations in different legal regimes. In order to reach a harmonious interpretation and application of the PA in the WTO, the legal status of PAs of different WTO instruments have been analysed. Further, a comparative study on PAs in terms of legal status in the exemptions of the WTO and TRIPS obligations has been proposed. The political and moral basis for compulsory licencing in a public health emergency has been bolstered through the interpretation and the creation of legal status of the PA in WTO/TRIPS law.

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Hacking, Damian. "Setting priorities in health research using the World Health Organisation model: Development of a quantitative methodology using Tuberculosis in South Africa as a worked example". Master's thesis, University of Cape Town, 2014. http://hdl.handle.net/11427/22635.

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Kehn-Alafun, Omodele. "A narrative exploration of policy implementation and change management : conflicting assumptions, narratives and rationalities of policy implementation and change management : the influence of the World Health Organisation, Nigerian organisations and a case study of the Nigerian health insurance scheme". Thesis, University of Bradford, 2011. http://hdl.handle.net/10454/5397.

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Purpose: The thesis determined how policy implementation and change management can be improved in Nigeria, with the health insurance scheme as the basis for narrative exploration. It sets out the similarities and differences in assumptions between supra-national organisations such as the World Bank and World Health Organisation on policy implementation and change management and those contained in the Nigerian national health policy; and those of people responsible for implementation in Nigerian organisations at a) the federal or national level and b) at sub-federal service delivery levels of the health insurance scheme. The study provides a framework of the dimensions that should be considered in policy implementation and change management in Nigeria, the nature of structural and infrastructural problems and wider societal context, and the ways in which conceptions of organisations and the variables that impact on organisations' capability to engage in policy implementation and change management differ from those in the West. Design/methodology/approach - A qualitative approach in the form of a case study was used to track the transformation of a policy into practice through examining the assumptions and expectations about policy implementation of the organisations financing the policy's implementation through an examination of relevant documents concerning policy, strategy and guidelines on change management and policy implementation from these global organisations, and the Nigerian national health policy document. The next stages of field visits explored the assumptions, expectations and experiences of a) policy makers, government officials, senior managers and civil servants responsible for implementing policy in federal-level agencies through an interview programme and observations; and b) those of sub-federal or local-level managers responsible for service-level policy implementation of the health insurance scheme through an interview programme. Findings - There are conflicts between the rational linear approaches to change management and policy implementation advocated by supra-nationals, which argue that these processes can be controlled and managed by the rational autonomous individual, and the narratives of those who have personal experience of the quest for 'health for all'. The national health policy document mirrors the ideology of the global organisations that emphasise reform, efficiencies and private enterprise. However, the assumptions of these global organisations have little relevance to a Nigerian societal and organisational context, as experienced by the senior officials and managers interviewed. The very nature of organisations is called into question in a Nigerian context, and the problems of structure and infrastructure and ethnic and religious divisions in society seep into organisations, influencing how organisation is enacted. Understandings of the purpose and function of leadership and the workforce are also brought into question. Additionally, there are religion-based barriers to policy implementation, change management and organisational life which are rarely experienced in the West. Furthermore, in the absence of future re-orientation, the concept of strategy and vision seems redundant, as is the rationale for a health insurance scheme for the majority of the population. The absence of vision and credible information further hinder attempts to make decisions or to define the basis for determining results. Practical implications: The study calls for a revised approach to engaging with Nigerian organisations and an understanding of what specific terms mean in that context. For instance, the definitions and understanding of organisations and capacity are different from those used in the West and, as such, bring into question the relevance and applicability of Western-derived models or approaches to policy implementation and change management. A framework with four dimensions - societal context, external influences, seven organisational variables and infrastructural/structural problems - was devised to capture the particular ambiguities and complexities of Nigerian organisations involved in policy implementation and change management. Originality/value: This study combines concepts in management studies with those in policy studies, with the use of narrative approaches to the understanding of policy implementation and change management in a Nigerian setting. Elements of culture, religion and ethical values are introduced to further the understanding of policy making and implementation in non-Western contexts.

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Pooter, Hélène de. "Le droit international face aux pandémies : vers un système de sécurité sanitaire collective ?" Thesis, Paris 1, 2013. http://www.theses.fr/2013PA010343.

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Face aux pandémies, le droit international s'organise-t-il sous la forme d'un « système de sécurité sanitaire collective» (abandon des mesures unilatérales excessives - garantie offerte par la collectivité par le biais d'une action commune - sauvegarde du droit des États d'adopter les mesures individuelles nécessaires) ? L'étude des instruments adoptés au sein de l'OMS (Règlement sanitaire international et Cadre de préparation en cas de grippe pandémique), des actes unilatéraux de l'ONU (résolutions de l'Assemblée générale, du Conseil de sécurité et du Conseil économique et social), de la coopération entre organisations intergouvernementales et des accords de l'OMC (GATT, Accord SPS et Accord sur les ADPIC) révèle que chaque segment de la question reçoit une réponse positive. Pourtant, on ne peut ignorer le caractère largement imparfait du résultat de la lutte contre les pandémies. S'il existe indéniablement des indices en faveur de la thèse selon laquelle un système de sécurité sanitaire collective serait en formation, le droit international face aux pandémies se caractérise par un agglomérat de fragments aux antipodes d'un édifice juridique cohérent
In the face of pandemics, is international law organized as a "system of collective health security" (foregoing excessive unilateral measures - guaranteed by the community through joint action - upholding State rights to adopt necessary individual measures)? The study of instruments adopted by the WHO (International Health Regulations, Pandemic Influenza Preparedness Framework), of unilateral acts of the UN (resolutions of the General Assembly, the Security Council and the Economic and Social Council), of cooperation between international organizations and of the WTO's Agreements (GATT, SPS Agreement and TRIPS Agreement) reveals that the answer to each segment of the question is positive. However, one cannot ignore the highly imperfect result of the fight against pandemics. If there are undeniable indices which illustrate the existence of a nascent system of collective health security, international law in the face of pandemics is nevertheless thus far characterized by an agglomerate of fragments at odds with a coherent legal edifice

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Maňásková, Martina. "Zrod globálního problému: agenda obezity ve WHO". Master's thesis, Vysoká škola ekonomická v Praze, 2017. http://www.nusl.cz/ntk/nusl-358932.

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The concept of global governance is nowadays commonly used for studying international relations. The goal of this thesis is to analyze the nature of global governance in health sector, to discover how the main participants involved in international relations react to new challenges that arise, specifically how they react to the case of obesity. Global governance occurs on multiple levels; WHO occurs at the global level whereas individual national states occur at the lower level. This thesis answers the questions to topics such as: how the global health governance's politics are made, whether obesity represents a threat and how various participants that are involved in international relations coordinate their steps towards fighting obesity, on which levels they coordinate their agenda and for whom they are working for when fighting obesity.

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Esewe, Roselynd Ejakhianghe. "Developing strategies to enhance implementation of early Kangaroo Mother Care (KMC) guidelines in health care facilities in Edo State, Nigeria". University of the Western Cape, 2018. http://hdl.handle.net/11394/6201.

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Philosophiae Doctor - PhD (Nursing)
The number of healthcare institutions that has embraced Kangaroo Mother Care (KMC) as an effective and efficient method of neonatal care especially in Edo State, Nigeria has not multiplied even after more than a decade of its recommendation by the World Health Organisation (WHO) in 2003. Nigeria ranks seventh among the ten African countries where newborns have the highest risk of dying with over 700 newborn deaths per10, 000 live births. This is worrisome because Edo State is one of the 36 states in Nigeria that contribute about 6,700 neonatal deaths to the 255,500 mortality rate recorded in Nigeria annually. This has led to a concern about the knowledge and attitude of the key drivers in neonatal care of simplified methods aimed at reducing neonatal mortality despite previous training efforts. The development of a strategy to enhance the early implementation of the WHO KMC guidelines in all healthcare facilities across the state was therefore conceptualized. Strategies to increase implementation are considered important to the success of KMC because reducing neonatal mortality rate is contextual. This research aimed to explore and describe the application of the KMC guidelines by the nurses, administrators and parents of preterm infants in the care of premature babies and to develop strategies to enhance its early implementation in healthcare facilities in Edo State, Nigeria.

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Källmark, Amanda. "Maternal health care in natural disasters : A study on the International Federation of the Red Cross’s maternal health care in flooding disaster relief". Thesis, Uppsala universitet, Statsvetenskapliga institutionen, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-439538.

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This thesis aims to describe how the International Federation of Red Cross and Red Crescent Societies (IFRC) tends to maternal health care in floodings and whether it should be deemed sufficient. Floodings in Pakistan (2010), Bangladesh (2017) and Sudan (2013) are used as units of analysis when conducting a content analysis. The theoretical framework consists of critical success factors for disaster response based in the emergency management literature. A big part of the theoretical framework revolves around the importance of expertise and rationality in disaster response planning and implementation. The three floodings received relief efforts from IFRC which are presented in emergency appeal reports. Lists on essential maternal health care interventions in combination with the theoretical framework create analysis questions that are posed to the appeals. Results are presented in a table naming the prevalence of each intervention in each report. The findings show that maternal health care was seen to and deemed sufficient in only one of the three cases: Pakistan. The conclusion is that the discourse on maternal health care in natural disasters should be developed and that further research on the subject needs to be conducted.

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Majok, Daniel Bol. "Access to essential medicines in East Africa: A review of East Africa community and its member states approach to WTO-TRIPS public health flexibilities". University of the Western Cape, 2018. http://hdl.handle.net/11394/6202.

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When the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) was annexed to the Agreement Establishing the World Trade Organisation (WTO) in 1994, it set minimum standards for intellectual property (IP) protection, including protection of patent rights, that must be observed and enforced by all WTO Member States. On the one hand, stringent Intellectual Property protection as seen innovation in the field of science where medical innovation hasled to the creation of live saving vaccines which have reduced prevalence of diseases, ranging from polio to the human Papillomavirus, and invention of antiretroviral medicines which have greatly improved the lives of people living with the Huma Immunodeficiency Virus (HIV). On the other hand, the fulfilment of the obligations under TRIPS has generated a lot of controversy especially as they have been seen as the cause of reduced access to essential medicines in developing countries.
Magister Legum - LLM (Mercantile and Labour Law)

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Kastler, Florian. "Le rôle normatif de l'Organisation mondiale de la santé". Thesis, Sorbonne Paris Cité, 2016. http://www.theses.fr/2016USPCB239.

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Institution spécialisée du système des Nations Unies créée à la sortie de la Seconde guerre mondiale, l'Organisation mondiale de la santé (OMS) s'est vu confiée, par l'article premier de sa Constitution, le but « d'amener tous les peuples au niveau de santé le plus élevé possible ». Pour atteindre cet objectif, les États membres lui ont conféré vingt-deux fonctions dont une normative. Cette dernière lui permet, en théorie, d’adopter à la fois des instruments de santé non contraignants et d'autres contraignants. L'étendue du champ d'application de cette fonction permet à l'OMS d'élaborer des normes au contenu très divers et varié dès lors qu'elle agit dans le cadre de son objectif sanitaire. Parallèlement, en raison de difficultés internes, propres à son organisation régionalisée et à une concurrence externe accrue par la multiplication d'acteurs de santé mondiale, l'OMS est à un tournant de son histoire comme en atteste l'envergure de la réforme qui est toujours en cours depuis 2010. Dans ce contexte, il s'agit de comprendre et d'analyser l'influence du rôle normatif de l'OMS dans les systèmes de santé nationaux. D'abord, une évaluation de son autorité normative, qui apparaît affaiblie, est proposée afin de présenter des évolutions pour la renforcer et ainsi améliorer la protection de la santé mondiale au sein d'un droit international de la santé consolidé. Ensuite, l'étude approfondie de son activité normative est envisagée pour délimiter la conception de la norme de l'OMS par le prisme de son efficacité. L'objectif in fine est de proposer une réflexion sur l'avenir du rôle normatif de l'OMS
The World health organization (WHO), as a specialized agency, was created, after the Second world war with the objective of, according to article 1 of its Constitution, the "attainment by all peoples of the highest possible level of health”. For that purpose, the WHO was granted twenty two functions by the Member States including a normative one. This normative function allows, in theory, the WHO to adopt both binding and non binding health instruments. The extent of the scope of this function offers a wide and diverse content to theses norms with the only limit that it pursues a health purpose. At the same time, the WHO shows internal difficulties, in part, due to its regional structure and overall lack of financing. Further, the increase number and diversity of actors of global health result in potential external competition with the WHO. The reform initiated in 2010 and still ongoing proves that the WHO is a turning point in its history. In this context, this research seeks to understand and analyze the influence of the normative role of the WHO on national health systems. First, we study the normative authority of the WHO which appears weakened. With the objective of increasing health protection based on a reinforced global health law paradigm, our proposals aim at strengthening the normative authority of WHO. Then, our in-depth analysis of the normative activity of the WHO allows to the define the conception of norm by the WHO using effectiveness as our analytical frame. Finally, this research offers an opportunity to reflect on the future of the normative role of the WHO

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Gupta, Shivam. "Spatial modelling of air pollution for open smart cities". Doctoral thesis, Universitat Jaume I, 2018. http://hdl.handle.net/10803/666745.

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A thesis submitted in partial fulfillment of the requirements for the degree of Doctor in Information Management, specialization in Geographic Information Systems
Half of the world’s population already lives in cities, and by 2050 two-thirds of the world’s population are expected to further move into urban areas. This urban growth leads to various environmental, social and economic challenges in cities, hampering the Quality of Life (QoL). Although recent trends in technologies equip us with various tools and techniques that can help in improving quality of life, air pollution remains the ‘biggest environmental health risk’ for decades, impacting individuals’ quality of life and well-being according to World Health Organisation (WHO). Many efforts have been made to measure air quality, but the sparse arrangement of monitoring stations and the lack of data currently make it challenging to develop systems that can capture within-city air pollution variations. To solve this, flexible methods that allow air quality monitoring using easily accessible data sources at the city level are desirable. The present thesis seeks to widen the current knowledge concerning detailed air quality monitoring by developing approaches that can help in tackling existing gaps in the literature. The thesis presents five contributions which address the issues mentioned above. The first contribution is the choice of a statistical method which can help in utilising existing open data and overcoming challenges imposed by the bigness of data for detailed air pollution monitoring. The second contribution concerns the development of optimisation method which helps in identifying optimal locations for robust air pollution modelling in cities. The third contribution of the thesis is also an optimisation method which helps in initiating systematic volunteered geographic information (VGI) campaigns for detailed air pollution monitoring by addressing sparsity and scarcity challenges of air pollution data in cities. The fourth contribution is a study proposing the involvement of housing companies as a stakeholder in the participatory framework for air pollution data collection, which helps in overcoming certain gaps existing in VGI-based approaches. Finally, the fifth contribution is an open-hardware system that aids in collecting vehicular traffic data using WiFi signal strength. The developed hardware can help in overcoming traffic data scarcity in cities, which limits detailed air pollution monitoring. All the contributions are illustrated through case studies in Muenster and Stuttgart. Overall, the thesis demonstrates the applicability of the developed approaches for enabling air pollution monitoring at the city-scale under the broader framework of the open smart city and for urban health research.

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Behr, Janice. "The evaluation of the imp act of interventions by a physiotherapist on intellectually imp aired and physically disabled children and their caregivers in two community groups in peri-urban Cape Town". University of the Western Cape, 2008. http://hdl.handle.net/11394/8367.

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>Magister Scientiae - MSc
Physiotherapy services for disabled children and their families have conventionally been received at a hospital or school for children with special educational needs in the main towns and cities of South Africa. Community-Based Rehabilitation (CBR) programmes were proposed and established as an additional approach to Institutional-Based Rehabilitation to address the need for accessible resources for these families. In this study the author evaluated two CBR programmes for disabled children and their main caregivers in two separate low socioeconomic peri-urban areas of Cape Town. The programme, a weekly group meeting, included physiotherapy interventions to assist the development and functional abilities of the children by means of activities that the caregivers could include in daily home care. They handled their own children following demonstrations and correction of handling skills by the author. The majority of the caregivers were mothers. Their children, less than 13 years old, were severely intellectually impaired. Some with concomitant physical disabilities. The author implemented the interventions of the CBR programme and she required to understand the impact on the particpants in a study using qualiative research methods. In the pilot programme the attendant members were individually interviewed, after her withdrawal, for their opinions of the outcomes. Evaluation documentation.ofjheir children and CBR programme records were related to the caregivers' responses. From the pilot study experiences the author felt that additional methods of data collection would result in a greater understanding of the impacts of the interventions. Expanded methods of research were utilised in the study of the second group. During the interventions at group meetings the author used field notes to record observations. Participant observation allowed the author to analysis the responses of the participants. Focus group interviews assisted in understanding external factors influencing the participants as well as their needs. Individual interviews, after the closure of the CBR programme, allowed the participants to express their views of the interventions. Documentation of the individual evaluation of each child was related to the views expressed by the caregivers. Common meanings and themes were explored in the analysis of the various data collected. Analysis revealed that interventions of education and training for the caregivers improved their knowledge and understanding of the impairments and disability of their children. The children benefited functionally from their families increased skills and knowledge. Through discussion with other families at group meetings, the caregivers had an understanding of other disabilities in children and developmental outcomes possible for their own child. The caregivers were more confident to address the negative perceptions of disability in their communities. It is recommended that physiotherapists implementing any interventions for disabled children should ensure that the caregivers are partners in planning and selection of interventions and that their needs are addressed. Community participation in Community-Based Rehabilitation programmes was required for the participants to become self-reliant and solve their own needs as well as for the programme to be sustainable. This was demonstrated in only one of the programmes.

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20

Kengni, Bernard. "Trade and environment: the environmental impacts of the agricultural sector in South Africa". Thesis, University of the Western Cape, 2012. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_1491_1363781507.

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21

Green, Trevor David. "Food Safety Practice and Food Safety Knowledge in Australia's Retail Food Businesses: Levels, Gaps and Directions for Reform". Thesis, Griffith University, 2009. http://hdl.handle.net/10072/365584.

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Food safety is one of the World Health Organisation’s (WHO) top ten priorities (WHO 2008). The WHO (1999a) estimates that the incidence of diarrhoeal diseases alone is 4000 million cases per year worldwide indicating serious underlying food safety problems. WHO (1999a) also advises that contaminated food contributes to 1.5 billion cases of diarrhoea in children each year, resulting in more than three million premature deaths. These food-borne deaths and illnesses are shared by both developed and developing nations (Centre for Science in the Public Interest 2005). Food poisoning remains a significant public health issue for Australia (Australia New Zealand Food Authority (ANZFA) 1996), with an estimated 4.2 million individual cases of food-borne illness in Australia per year, resulting in a total annual cost to Australia of approximately $2.7 billion per year (Queensland Health 1999; ANZFA 1999b). Unofficial estimates of the number of food-borne illness cases in Queensland in 2002 are between 1.6 million and 1.9 million cases per year. Internationally the WHO has called for more systematic and aggressive steps to be taken to significantly reduce the risk of food-borne diseases (WHO 2008). Nationally the federal government states that the most important reason for introducing food safety reform in Australia is the need to reduce the national incidence of food-borne illness (Roche 2002). The Queensland government has adviseded that it is committed to food safety in the food supply chain from source to consumption (Queensland Health 2000). Australia’s food hygiene regulatory system costs government $18.6 million (net) to enforce and small business $337 million in compliance costs per year, and yet 11,500 consumers contract food-borne disease every day (ANZFA 1999b). Federal, state and territory governments throughout Australia have all acknowledged that this is unacceptable. A reduction in food-borne illness of just 20% would result in an annual saving to the Australian community of over $500 million (ANZFA 1999a), as well as reducing human mortality, morbidity and suffering. To improve the safety of our food, reduce food-borne illness and to assist Australia develop a thriving food industry, the federal, state and territory governments agreed on a series of national food safety reforms (Queensland Health 2000; ANZFA 1999a). But this is not an easy task. The food industry is one of Australia’s major employers with an estimated 131,500 food businesses throughout the country and an annual retail turnover in 1996-1997 of $41 billion (Queensland Health May 1999). In Queensland there are approximately 30,000 registered food businesses (Queensland Health 2004). The majority of these are small food businesses. Owners of small food businesses face considerable challenges to be successful. To improve food safety levels, a number of challenges must be faced and overcome by the both the food industry and government at all levels...
Thesis (Masters)
Master of Philosophy (MPhil)
Griffith School of Environment
Science, Environment, Engineering and Technology
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22

El-Sanady, Magdy Latif. "Performance analysis of Egyptian non-governmental organisations in primary health care". Thesis, Keele University, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.341301.

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Despite recent phenomenal growth of non-governmental organisations (NGOs) in the developing world, especially in the field of primary health care (PHC), their performance currently witnesses many paradoxes. For example, a paradox between their growth in size and diversity, yet increasing concerns about their impact; another paradox is that of the intense questioning of their performance in development and health, and yet the increasing flow of support from most international agencies; and, a third paradox, is that of the increasing pressures for, and acceptance of the need for, performance evaluation, and yet a lack of institutionalisation within NGOs themselves, and the scarcity of models that can guide/help NGOs in that direction. Many explanations have been suggested for these paradoxes, and are likely to include the following: first, an NGO may lack the performance system which enables it to look at its own performance and analyse in a systematic way; second, an NGO, when undertaking a selfevaluation exercise, may confine itself solely to the project level (for accountability reasons) and overlook the other levels of analysis (namely, the organisation, service delivery, and individual levels); and, third, an NGO may not hold an holistic view as to what areas should be analysed, nor may it have the analytical tools readily available which help it to undertake such an analysis. Evidence from different literature supports each of these possible explanations. Accordingly, within this thesis, to help an NGO self-analyse its performance, a performance analysis framework (PAF) has been developed. This framework is structured to analyse the performance of an NGO service provider at three main levels: organisational; project; and, service delivery. Each level addresses an area for analysis, drawing upon a set of criteria for each area, raising a group of relevant questions for each criterion, and casting light on a cluster of possible investigative tools largely, but not exclusively, qualitative in nature. Theunderlying hypothesis of this framework is that the performance of an NGO in health and social development is the outcome of an interaction of many factors within both its external and internal environments. Hence, in the PHC setting, an NGO is confronted with an external environment composed of contextual elements (political, economic, legal, and socio-cultural), as well as a cluster of relationships with different stakeholders (donors, beneficiaries, government bodies, and other NGOs). On the other hand, the internal environment of an NGO is formed of a four-fold set of inter-related elements: its identity, its strategy, its operations, and its resources. Thus, the kinds of interactions taking place in both these environments are key determinants of the overall performance of the NGO. The PAF was then field tested in Egypt through a series of investigations, including focus group interviews as well as instrumental case studies. Four cases were selected from a pool of Egyptian NGOs (ENGOs) with different histories and geographic locations, but all being Community Development Associations (CDAs); participants in umbrella capacity building (CB) programmes sponsored by intermediary NGOs and funded by one bilateral donor; and, having service provision in the area of Maternal and Child Health (MCH). While the PAF was applied at the project level, the four PHC/MCH projects have also served as entry points to the analysis of the four organisations through a participatory self-assessment approach. The PAF, therefore, served as both research tool and conceptual frame of reference against all four cases, relying upon various triangulation techniques, in pursuit of research validation and quality control. The outcome is that of robustly testing the framework: by so doing, important lessons and insights have emerged both about the external and internal environment of ENGOs; and about the levels and kinds of performance CDAs operating in health currently attain, and can attain in the future. The research concludes with recommendations for a proposed capacity-building programme for CDAs guided by the PAF

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23

Baleta, Adele. "Healing the rift : an assessment of a World Health Organisation's media communication programme for health scientists". Thesis, Stellenbosch : University of Stellenbosch, 2006. http://hdl.handle.net/10019.1/17344.

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Abstract (sommario):

Thesis (MPhil)--University of Stellenbosch, 2006.
ENGLISH ABSTRACT: Health scientists agree that the media is a crucial conduit for communicating life-saving, preventative and curative health messages to a wider audience. They also concur that they are the gatekeepers, and the responsibility of communicating their findings and health information to the public rests with them. And yet, their relationship with journalists is often unhealthy and in need of attention. Many health scientists lack knowledge and understanding about who the media are, and what they require to do the job of reporting ethically and professionally. They often lack the skills needed to frame simple, succinct messages timeously, especially on controversial issues such as vaccines and drug safety, immunisation and drug treatment for infectious diseases such as HIV/AIDS. This study argues that health scientists/professionals globally, irrespective of culture, ethnicity, creed, language or media systems, need training on how to communicate with the media in the interests of public health. This is especially so in the modern world with its complex, high-speed communication. The objective of the study was to assess the impact of a WHO media communication training programme for health scientists worldwide. More specifically, the study sought to shed light on whether the training shifted their perceptions and attitudes to the media. And, if so, in what way? It also aimed to find out if the trainees learned any skills on how to deal with reporters. The research methodology was qualitative. A review of the literature, to establish current thinking in the field, was followed by interviews with health professionals. The interviewees are from China, South Africa and Ghana and received the same basic training either in South Africa, China or Sri Lanka. Some were trained in 2005, others in 2004 and others before that. Most had been trained together with participants from other countries. Two focus groups were conducted in China before and after training. Included, is an account of the aims and objectives of each module of the actual training. The study also made use of WHO documents and news and feature articles from newspapers, radio and the internet. Most participants had never had media communication training but had been interviewed by reporters. While some had positive experiences, others felt bruised by their interactions with journalists. After training, however, they registered a shift in attitude toward feeling more positive and less fearful of the media. They felt more confident and better equipped to engage with journalists. Most participants desired more training to consolidate the skills that they had learned. Some had managed to put the training to good use by developing similar programmes in their own country. Others who were trained more recently were enthusiastic about the prospect of sharing ideas with colleagues. Those who were unlikely to deal with the media directly said they felt they could at last contribute to discussions on the media in the workplace. The WHO training, albeit a first step aimed at bridging the gap between health professionals and journalists, goes a long way in addressing the frustrations and the complexities of dealing with the media. Health professionals want to communicate because they need to reach their target population, the ordinary person in the street. Training and facilitation can empower health professionals to deal constructively with the media in getting health messages to the public. This training programme, which imparts practical skills including how to prepare and manage interviews, could be adapted to meet the needs of scientists from different disciplines.
AFRIKAANSE OPSOMMING: Gesondheidswetenskaplikes is dit eens dat die media ‘n uiters belangrike middel is om lewensreddende, voorkomende en genesende gesondheidsboodskappe aan ‘n groter gehoor oor te dra. Hulle stem ook saam dat hulle die hekwagters is en die verantwoordelikheid het om hul bevindinge en gesondheidsinligting aan die publiek oor te dra. Tog is hul verhouding met joernaliste dikwels ongesond en sorgwekkend. Talle gesondheidswetenskaplikes het geen kennis en begrip van wie die media is en wat hulle nodig het om hul taak – verslaggewing – eties en professioneel te verrig nie. Hulle kort dikwels die vaardighede om eenvoudige, saaklike boodskappe betyds te formuleer, veral as dit kom by omstrede aangeleenthede soos veilige entstowwe en medisyne, immunisering en medisyne vir die behandeling van aansteeklike siektes. Hierdie studie voer aan dat wetenskaplikes/gesondheidsberoepslui wêreldwyd – ongeag kultuur, etnisiteit, geloof, taal of mediastelsels – ‘n behoefte het aan opleiding om beter met die media te kommunikeer ter wille van openbare gesondheid. Dit is veral belangrik vir die ingewikkelde en snelle kommunikasie van die moderne wêreld. Die doel van die studie was om die uitwerking van ‘n wêreldwye opleidingsprogram van die WGO oor kommunikasie met die media te bepaal. Die studie het meer spesifiek probeer lig werp op die vraag of die opleiding hul begrip van en ingesteldheid teenoor die media verander het. En, indien wel, op watter manier? Dit het ook probeer vasstel of deelnemers enige vaardighede aangeleer het oor hoe om met verslaggewers om te gaan. ‘n Kwalitatiewe navorsingsmetodiek is gevolg. Bestaande literatuur is bestudeer om huidige denkrigtings op die gebied te bepaal, waarna onderhoude met gesondheidsberoepslui asook ‘n TV-gesondheidsverslaggewer van Beijing, China, gevoer is. Die ondervraagdes kom van China, Suid-Afrika en Ghana en het dieselfde basiese opleiding in Suid-Afrika, China of Sri Lanka ondergaan. Sommige is in 2005 opgelei, party in 2004 en ander vroeër. Die meeste is saam met deelnemers van ander lande opgelei. Twee fokusgroepe is voor en ná opleiding in China bestudeer. ‘n Verslag oor die oogmerke en doelwitte van elke module van die werklike opleiding is ingesluit. Die studie het ook gebruik gemaak van WGO-dokumente, nuus- en artikels uit nuusblaaie, die radio en die internet. Die meeste deelnemers het nooit opleiding in mediakommunikasie gehad nie, hoewel verslaggewers al onderhoude met hulle gevoer het. Terwyl dit vir sommige ‘n aangename ondervinding was, het ander nie goeie herinneringe aan hul interaksie met joernaliste nie. Ná opleiding het hulle egter getuig van ‘n positiewer gesindheid teenoor en minder vrees vir die media. Die meerderheid van die deelnemers wou graag verdere opleiding hê om hul pas verworwe vaardighede uit te bou. Party kon selfs soortgelyke programme in hul eie lande ontwikkel. Van die meer onlangse deelnemers was geesdriftig oor die vooruitsig om gedagtes met kollegas te wissel. Diegene wat waarskynlik nie veel met die media te doen sou hê nie, het gesê hulle kon nou minstens by die werk aan gesprekke oor die media deelneem. Hoewel dit maar die eerste tree is om die gaping tussen gesondheidsberoepslui en joernaliste te oorbrug, slaag die WGO se opleiding in ‘n groot mate daarin om die frustrasies en verwikkeldhede van omgang met die media te oorkom. Mense in die gesondheidsberoepe wil graag kommunikeer omdat hulle hul teikenbevolking – die gewone mense – moet bereik. Opleiding en tussentrede kan hulle toerus om konstruktief met die media om te gaan ten einde gesondheidsboodskappe aan die publiek oor te dra. Hierdie opleidingsprogram kan aangepas word om in die behoeftes van wetenskaplikes in verskeie vakgebiede te voorsien.

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24

Assani, Adjagbe. "La lutte contre le paludisme en Côte d'Ivoire : directives internationales et pratiques médicales (1948-1996)". Thesis, Paris 1, 2017. http://www.theses.fr/2017PA01H030/document.

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Abstract (sommario):

Les politiques de lutte contre les maladies plus généralement et celles relatives au paludisme singulièrement, mises en œuvre depuis 1948, ont connu des fortunes diverses dans leur application à l'échelle locale. L'exemple de la Côte d'Ivoire que cette recherche a mis en lumière en est la parfaite illustration. Ainsi, de la politique «d'éradication du paludisme» qui couvre la période 1955-1970, à laquelle succède celle du contrôle du paludisme depuis cette date, les directives de lutte, qui accompagnent les grands programmes de santé de l'institution internationale, ont été diversement appliquées, du moins en ce qui concerne le paludisme. Les raisons de ce décalage entre les indications normatives et les pratiques thérapeutiques sont à la fois exogènes et endogènes. Cette étude illustre ainsi les contradictions entre les politiques de santé décidées en amont, et leur application, en aval. Elle permet de saisir aussi, le rôle central de l'OMS dans la gouvernance de la santé mondiale. Mais, elle n'occulte pas pour autant les énormes difficultés encore pendantes des systèmes de santé des pays en voie de développement comme la Côte d'Ivoire, malgré tous les efforts entrepris par l'OMS pour y remédier
The policies to fight diseases in general and malaria in particular since 1948 have met different forms in their implementation on a local scale. The example of the Côte d'Ivoire that this study has brought into light perfectly illustrates that point. From an "eradication of malaria" policy that ranges from 1955 to 1970 to a control of malaria since then, the fighting directives, which go along with the main health programs of international institution, have been variously implemented, at least as far as malaria is concerned. The reasons that account for this discrepancy between normative indications and therapeutical practices are both exogenous and endogenous. This study thus illustrates the contradictions between health policies decided upstream and their implementation downstream. It also helps to understand the major role of the World Health Organisation in its govemance in world health. But it does not ignore the huge and still remaining difficulties of health systems of developing countries such as the Côte d'Ivoire in spite of all the efforts undertaken by the WHO to deal with them

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25

King, Mark Johann. "Case studies of the transfer of road safety knowledge and expertise from western countries to Thailand and Vietnam, using an ecological road safety space model : elephants in traffic and rice cooker helmets". Thesis, Queensland University of Technology, 2005. https://eprints.qut.edu.au/16191/1/Mark_King_Thesis.pdf.

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Abstract (sommario):

International organisations such as the World Health Organisation highlight the road crash problem in less motorised (or developing, or low income) countries like those in Southeast Asia and recommend the adoption of Western road safety measures. However, there are many differences between highly motorised and less motorised countries which raise questions about how successfully Western road safety knowledge and expertise can be transferred.----- A review of the statistical information on road crashes shows a great deal of uncertainty about both the scale and likely trajectory of road fatalities globally, in less motorised countries and in Asia. It is generally agreed, however, that Asia accounts for around half of all road fatalities, and analysis of the limited available data shows both that Southeast Asia is not an atypical region of Asia in road safety terms, and that Thailand and Vietnam are not atypical of Southeast Asian countries.----- A literature review of recommended practice approaches to road safety transfer in Asia shows that there are many economic, institutional, social and cultural factors which potentially influence the success of transfer. The review also shows that there is no coherent, comprehensive approach which either conceptualises these factors and their relationship to transfer outcomes, or uses an analysis of these factors to plan or modify transfer. To address this gap, this thesis develops a 'road safety space' model as a tool for conceptualisation and analysis, based on a biological metaphor which views the transfer of road safety measures from one context to another as analogous to the transfer of a species into a new ecological space. The road safety space model explicitly considers economic, institutional, social and cultural factors (from specific to broad) which influence the particular road safety issue which a particular road safety transfer effort seeks to address. A central contention of this thesis is that the road safety space model is both a feasible and useful tool to improve the process of road safety transfer to less motorised countries. Road safety space analysis is seen to have a role in a broader process of selection of road safety measures for transfer, along with knowledge of how the measures are considered to operate.----- The research reported in this thesis is comprised of three studies. Study 1 reviewed evaluations of road safety transfer to Thailand and Vietnam. Studies 2 and 3 were case studies of road safety transfer to Thailand and Vietnam respectively.----- Study 1 was an analysis of existing evaluations of road safety transfer to Thailand and Vietnam. The aims were to analyse the evaluations for their consideration of contextual factors, as described in the road safety space model, and to discuss whether the road safety space model assisted in understanding the reasons for success or failure of transfer. However, very few such evaluations exist, and those that were found generally lacked information on whether contextual factors were considered. This indicated the need for a more detailed, in-depth qualitative investigation of particular cases of road safety transfer, in order to investigate the feasibility and utility of the road safety space model.----- Two case studies (Study 2 and Study 3) were conducted to test whether the road safety space approach was both feasible and useful as a means of improving road safety transfer efforts. Study 2 was a case study of the development and implementation in Thailand of a road safety education program for school children, which involved the transfer of Western research and techniques. The transfer agents (i.e. those who effected the road safety transfer) were Australian consultants working for the Australian Road Research Board (ARRB). The transfer was funded by the World Bank and managed by the Thai Ministry of Education (MOE). Study 3 was a case study of the development and implementation of a motorcycle helmet wearing program in Vietnam, which involved the transfer of Western knowledge, techniques and technology. The transfer agents were staff of Asia Injury (AI), a non-government organisation (NGO), and the program was funded initially by a charitable fund, with the intention of becoming self-funding through operation of a helmet factory.----- The case studies employed background research into existing information on economic, institutional, social and cultural factors relevant to the road safety issues (road use behaviour of school children in Thailand and motorcycle helmet purchase and wearing in Vietnam), and collected data through interviews with key informants, analysis of secondary sources and observations. This information was used to derive the road safety space for each road safety issue, to identify the road safety space recognised and addressed by the transfer agents (ARRB and AI), and to determine which factors they missed, or were aware of but took no action on. The focus of this analysis was on the processes used in transfer, not on the road safety outcomes of transfer, although these provided information on the processes as well. Available evaluation information was used to draw links between the omissions and the success of the transfer processes. It was noted that information on how the transferred measures operate should come from a road safety space analysis in the originating country, although this raised questions about selection of country and time (when the measure was first introduced, or in its maturity).----- The feasibility and utility of the road safety space model were discussed. It was clear that the model provided information on the cases which was missed by the transfer agents. The questions examined next were whether this information could have been obtained from an exercise conducted before the transfer had commenced, whether the required effort and cost justified the potential benefits, and whether the information on the road safety space could have been useful for the transfer agents. Comparisons between the road safety spaces for the two cases showed some areas of commonality, e.g. perceptions of police corruption, but also many differences. It was considered likely that some broad factors could be generic, and the possibility was mooted that less motorised countries share issues with police enforcement. This requires further research, however, and at this stage it is better to treat each road safety space as a unique combination of contextual factors influencing the road safety issue of interest.----- It is concluded that the road safety space model is feasible if used in such a way as to minimise the research involved, and useful, although the degree of utility needs to be further explored in a prospective study. The limitation introduced by restricting informants to those who could speak English are discussed. An approach using road safety space analysis is recommended, emphasising analysis of the country to which the road safety measure is being transferred, supplemented by analysis of the originating country road safety space. Gaps in knowledge are identified for further research and development, in particular the theoretical and practical understanding of road use behaviours and their modification in less motorised countries in Southeast Asia. Elaboration of the model is also recommended, to take into account the influence of the type of measure transferred, the role of the transfer agent, the area of road safety (education, engineering or enforcement), and the time dimension (the time which might be needed for a transfer to show its effects).----- The findings of this research are likely to be applicable to road safety transfer in other less motorised regions of the world, however prospective testing is needed. They may also be relevant to issues of transfer for areas other than road safety, in particular public health and traffic engineering, where similar economic, institutional, social and cultural issues come together.

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26

King, Mark Johann. "Case studies of the transfer of road safety knowledge and expertise from western countries to Thailand and Vietnam, using an ecological road safety space model : elephants in traffic and rice cooker helmets". Queensland University of Technology, 2005. http://eprints.qut.edu.au/16191/.

Testo completo

Abstract (sommario):

International organisations such as the World Health Organisation highlight the road crash problem in less motorised (or developing, or low income) countries like those in Southeast Asia and recommend the adoption of Western road safety measures. However, there are many differences between highly motorised and less motorised countries which raise questions about how successfully Western road safety knowledge and expertise can be transferred.----- A review of the statistical information on road crashes shows a great deal of uncertainty about both the scale and likely trajectory of road fatalities globally, in less motorised countries and in Asia. It is generally agreed, however, that Asia accounts for around half of all road fatalities, and analysis of the limited available data shows both that Southeast Asia is not an atypical region of Asia in road safety terms, and that Thailand and Vietnam are not atypical of Southeast Asian countries.----- A literature review of recommended practice approaches to road safety transfer in Asia shows that there are many economic, institutional, social and cultural factors which potentially influence the success of transfer. The review also shows that there is no coherent, comprehensive approach which either conceptualises these factors and their relationship to transfer outcomes, or uses an analysis of these factors to plan or modify transfer. To address this gap, this thesis develops a 'road safety space' model as a tool for conceptualisation and analysis, based on a biological metaphor which views the transfer of road safety measures from one context to another as analogous to the transfer of a species into a new ecological space. The road safety space model explicitly considers economic, institutional, social and cultural factors (from specific to broad) which influence the particular road safety issue which a particular road safety transfer effort seeks to address. A central contention of this thesis is that the road safety space model is both a feasible and useful tool to improve the process of road safety transfer to less motorised countries. Road safety space analysis is seen to have a role in a broader process of selection of road safety measures for transfer, along with knowledge of how the measures are considered to operate.----- The research reported in this thesis is comprised of three studies. Study 1 reviewed evaluations of road safety transfer to Thailand and Vietnam. Studies 2 and 3 were case studies of road safety transfer to Thailand and Vietnam respectively.----- Study 1 was an analysis of existing evaluations of road safety transfer to Thailand and Vietnam. The aims were to analyse the evaluations for their consideration of contextual factors, as described in the road safety space model, and to discuss whether the road safety space model assisted in understanding the reasons for success or failure of transfer. However, very few such evaluations exist, and those that were found generally lacked information on whether contextual factors were considered. This indicated the need for a more detailed, in-depth qualitative investigation of particular cases of road safety transfer, in order to investigate the feasibility and utility of the road safety space model.----- Two case studies (Study 2 and Study 3) were conducted to test whether the road safety space approach was both feasible and useful as a means of improving road safety transfer efforts. Study 2 was a case study of the development and implementation in Thailand of a road safety education program for school children, which involved the transfer of Western research and techniques. The transfer agents (i.e. those who effected the road safety transfer) were Australian consultants working for the Australian Road Research Board (ARRB). The transfer was funded by the World Bank and managed by the Thai Ministry of Education (MOE). Study 3 was a case study of the development and implementation of a motorcycle helmet wearing program in Vietnam, which involved the transfer of Western knowledge, techniques and technology. The transfer agents were staff of Asia Injury (AI), a non-government organisation (NGO), and the program was funded initially by a charitable fund, with the intention of becoming self-funding through operation of a helmet factory.----- The case studies employed background research into existing information on economic, institutional, social and cultural factors relevant to the road safety issues (road use behaviour of school children in Thailand and motorcycle helmet purchase and wearing in Vietnam), and collected data through interviews with key informants, analysis of secondary sources and observations. This information was used to derive the road safety space for each road safety issue, to identify the road safety space recognised and addressed by the transfer agents (ARRB and AI), and to determine which factors they missed, or were aware of but took no action on. The focus of this analysis was on the processes used in transfer, not on the road safety outcomes of transfer, although these provided information on the processes as well. Available evaluation information was used to draw links between the omissions and the success of the transfer processes. It was noted that information on how the transferred measures operate should come from a road safety space analysis in the originating country, although this raised questions about selection of country and time (when the measure was first introduced, or in its maturity).----- The feasibility and utility of the road safety space model were discussed. It was clear that the model provided information on the cases which was missed by the transfer agents. The questions examined next were whether this information could have been obtained from an exercise conducted before the transfer had commenced, whether the required effort and cost justified the potential benefits, and whether the information on the road safety space could have been useful for the transfer agents. Comparisons between the road safety spaces for the two cases showed some areas of commonality, e.g. perceptions of police corruption, but also many differences. It was considered likely that some broad factors could be generic, and the possibility was mooted that less motorised countries share issues with police enforcement. This requires further research, however, and at this stage it is better to treat each road safety space as a unique combination of contextual factors influencing the road safety issue of interest.----- It is concluded that the road safety space model is feasible if used in such a way as to minimise the research involved, and useful, although the degree of utility needs to be further explored in a prospective study. The limitation introduced by restricting informants to those who could speak English are discussed. An approach using road safety space analysis is recommended, emphasising analysis of the country to which the road safety measure is being transferred, supplemented by analysis of the originating country road safety space. Gaps in knowledge are identified for further research and development, in particular the theoretical and practical understanding of road use behaviours and their modification in less motorised countries in Southeast Asia. Elaboration of the model is also recommended, to take into account the influence of the type of measure transferred, the role of the transfer agent, the area of road safety (education, engineering or enforcement), and the time dimension (the time which might be needed for a transfer to show its effects).----- The findings of this research are likely to be applicable to road safety transfer in other less motorised regions of the world, however prospective testing is needed. They may also be relevant to issues of transfer for areas other than road safety, in particular public health and traffic engineering, where similar economic, institutional, social and cultural issues come together.

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Davey, Peter J. "Municipal Public Health Planning and Implementation in Local Government in Queensland". Thesis, Griffith University, 2007. http://hdl.handle.net/10072/365756.

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Abstract (sommario):

The furious pace of global urbanisation has serious impacts on the long-term sustainability and health of the local communities in which we live. The debate about relationships between population size, environmental management and human well-being must now encompass the fundamental concept of sustainability (Rees, 1992; WCED, 1990; McMichael, 2002; Hancock, 1996). Increasingly, the local municipal level is the most influential setting in which to change our relationship with the environment (Chu, 1994; Chu et al., 2000). In the 1980s, the World Health Organisation (WHO) met this global challenge by advocating healthy public policy and laying foundations for its global Healthy Cities Movement. Significant support developed in the early nineties for participatory health planning action in local government: over 2000 cities world-wide developed municipal public health plans (MPH Plans). The Healthy Cities Movement through regional networks of cities and towns encouraged government partnerships with non-government agencies and industry, to anticipate and mitigate urbanisation’s negative impacts. In Queensland eighteen local governments have developed and implemented MPH Plans using a seven-step process (Chapman and Davey, 1997; WHO (1997b) to improve local planning for health and address the social determinants of health through agency collaboration. There is however limited understanding and evidence of the success factors for the effective implementation of MPH Plans. Studies of the evaluation of Municipal Public Health Planning (MPHP) approaches have focused predominately on the evaluation of the process of planning, without conducting comprehensive evaluation of its implementation. The organisational barriers that contribute to ineffective health-planning implementation have not been well researched and documented. Here lies the gap in the research: MPHP requires thorough qualitative assessment, not only of the planning process, but also the implementation impacts. This research explores the achievements, barriers and success factors associated with MPHP implementation in local government organisations by developing a process and impact evaluation framework and applying it to two MPHP projects in Queensland: one, local planning in an expanding tourist city of over 400,000 people; the second, a regional approach involving two provincial cities with a combined population of 100,000 residents. The research examines the degree of collaboration resulting from health planning and assesses if the aims of the MPH Plans have been met. MPHP is both a health promotion tool and a strategic business planning process applied in local communities: this research seeks to understand more about organisational strategic management issues that act as barriers to planning or impact on the success of planning outcomes. This study design uses qualitative methods with a triangulation approach to analyse and understand the complexities of MPH Plan implementation. Grounded theory provides a methodology for interpreting meanings and discovering themes from the comprehensive process and impact evaluation consisting of preliminary cases studies, key informant interviews, using specific process and impact indicator questions and an analysis of MPHP models compared to other CPHP models and legislative frameworks. The impacts of the intervention are discussed and relate to the implementation effects of MPHP on individuals and organisations including council, government and non-government agencies and on the community. Achievements and barriers associated with MPHP are identified and discussed. Three main factors emerged. Firstly, MPHP had significantly increased the degree of intersectoral collaboration between the agency project partners, with particular success in clarifying the role of agencies in the management and delivery of public health services. The principles of successful partnerships need to be further articulated in local government settings to successfully implement MPHP. Secondly, positive political and organisational support was found to be a critical factor in the success of the planning implementation. Thirdly, and most importantly, the aims of the MPHP had not been substantially met due to a lack of financial and human resources. The study concluded that, although MPHP has strengths and weaknesses compared to other CPHP models, its features most suit local government. Success factors recommended for effective MPHP include formalising collaboration and partnerships and improved agency organisational governance in planning; building individual and organisational capacity to strengthen strategic planning; integrating the many layers of regulatory planning in local government and other agencies; sustaining planning structures and processes through regulation and commitment to investment in implementation stages of MPHP. The study’s major recommendation is that, for MPHP local government should facilitate a three-dimensional platform approach: healthy governance – long-term vision, recognising the many layers of planning, supported by state legislation and local industry and with awareness of legislative planning frameworks; a platform mechanism – sustaining agency networking, hosting the stakeholder forum, supporting the advisory committee, enhancing communication; and strategy implementation – in the context of an improved understanding of organisational behaviour, local government and agencies must action priority strategies, formalising agency partners responsibility, articulating desired outcomes, monitoring progress and evaluation. This recommended Platform Approach to MPHP provides an effective model for managing and implementing future MPH Plans, allocating resources three ways: to build people’s capacity to engage in planning mechanisms, to build organisational capacity to manage planning outcomes and to build more effective Healthy Cities planning approaches. The MPHP evaluation framework developed in this thesis could be used to evaluate other MPHP projects in local governments both in Australia and internationally.
Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
Centre for Environment and Population Health
Faculty of Environmental Sciences
Full Text

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Rosant, Celeste. "Knowledge of and attitudes towards kangaroo mother care in the Eastern Subdistrict, Cape Town". Thesis, University of the Western Cape, 2009. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_7613_1277072386.

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Kangaroo mother care (KMC) was first initiated in Colombia due to shortages of incubators and the incidence of severe hospital infections of new-born infants during hospital stay (Feldman, 2004). Currently it is identified by UNICEF as a universally available and biologically sound method of care for all new-borns, particularly for low birth weight infants (Department of Reproductive Health and Research, 2003) in both developed and developing countries. The Western Cape Provincial Government implemented a policy on KMC as part of their strategy to decrease the morbidity and mortality of premature infants in 2003 (Kangaroo Mother Care Provincial task team, 2003). Essential components of KMC are: skin-to-skin contact for 24 hours per day (or as great a part of the day as possible), exclusive breastfeeding and support to the motherinfant dyad. Successful implementation of KMC requires relevant education of nurses, education of mothers on KMC by nursing staff, monitoring of the implementation of KMC by nurses, planning for a staff mix with varying levels of skill and experience with KMC, the identification of institution specific barriers to the implementation of KMC, and the implementation of institution specific strategies to overcome these barriers (Wallin,et al., 2005
Bergman &
Jurisco, 1994
Cattaneo, et al., 1998). This study aims to determine the knowledge of and attitude towards kangaroo mother care, of nursing staff and kangaroo mothers in the Eastern sub-district of Cape Town.

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Murphy, Anthony Michael. "World Health Organisation's Expanded Programme on Immunization (EPI) : an in-depth study of Hillingdon and West Berkshire Health Authorities, England". Thesis, University of Oxford, 1989. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.305831.

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30

Kickham, Noreen Teresa Mary. "Inter-sectoral collaboration and the World Health Organisation's health for all initiative : a study of five projects in Eastleigh, Hampshire". Thesis, University of Southampton, 1994. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.239528.

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31

Bont, Antoinette de Benschop Ruth. "De organisatie van een virus over de wereldgezondheidsorganisatie, wetenschap en transnationale gezondheidspolitiek /". [Maastricht : Maastricht : Universiteit Maastricht] ; University Library, Maastricht University [Host], 2000. http://arno.unimaas.nl/show.cgi?fid=5972.

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32

El, messnaoui Hamid. "La réadaptation à base communautaire - gouvernance et évaluation". Thesis, Lyon 2, 2011. http://www.theses.fr/2011LYO20103.

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Abstract (sommario):

La notion de Réadaptation à Base Communautaire (RBC), promue par l'OMS, a pour objectif de favoriser l'intégration des personnes en situation de handicap. Cette stratégie est née du constat de la nécessité de conjuguer les efforts des différents acteurs (les personnes handicapées et leurs familles, la communauté, les services sociaux, les services de santé, d'éducation et de formation) pour assurer la réussite et la pérennité des actions. Développé dans les pays en voie de développement, le concept de Réadaptation à Base Communautaire s'applique également aux pays industrialisés, où il est souvent appelé "désinstitutionalisation". La diversité des contextes, tant géographique, économique, politique que culturelle, nécessite une adaptation des modes de gouvernance et des actions. Cette adaptation résulte d'une évaluation poussée, qu'il s'agisse de l'évaluation ex ante, ou des évaluations en cours de programme ou de l’évaluation ex post.Cette thèse présente des outils d'évaluation et des modes de gouvernance adaptés aux programmes RBC. Elle présente également une étude sur la pertinence et les limites de ce concept.Alors est-ce que la RBC est une stratégie pertinente et efficiente, facilement adaptable à tous les contextes ? Quelles en sont les limites ? La présente recherche tentera d'apporter des réponses à ces questions à travers l'étude de trois contextes différents : la France, le Maroc, et le Cameroun
The notion of Community Based Rehabilitation (CBR), promoted by the World Health Organisation (WHO), has as its main objective the integration of individuals living with a disability. This strategy arose from an acknowledgment of the necessity of pooling the efforts of people involved (people with disabilities and their families, the community, social services, health services, educational and training services) to ensure the success and sustainability of the actions undertaken.Developed in emerging countries, the concept of Community Based Rehabilitation also applies to industrialized countries, where it is often called "de-institutionalisation". The diversity of contexts, including geographical, economical, political as well as cultural, requires the adaptation of governance models and actions. This adaptation is carried out following a thorough evaluation and the evaluation may be ex ante, ongoing or ex post. This thesis presents evaluation tools and governance models adapted to the CBR. It also presents a study on the relevance and limits of this concept.So, is the CBR a relevant and efficient strategy, easily adaptable to every context? What are its limits?The present research will attempt to provide answers to these questions through the study of three different geographical contexts: France, Morocco and Cameroon

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Sacco, Solomon Frank. "A comparative study of the implementation in Zimbabwe and South Africa of the international law rules that allow compulsory licensing and parallel importation for HIV/AIDS drugs". Diss., University of Pretoria, 2004. http://hdl.handle.net/2263/1100.

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"Zimbabwe and South Africa are facing an HIV/AIDS epidemic of such proportions that the populations of these countries will markedly decline in the next ten years despite the existence of effective drugs to treat the symptoms of AIDS and dramatically lower the communicability of the virus. These drugs are under patent protection by companies in the developed world and the patents raise the prices above the level of affordability for HIV infected persons in South Africa and Zimbabwe. Zimbabwe has declared a national emergency on HIV/AIDS, apparently in conformance with TRIPS and has issued compulsory licenses to a local company that has started to manufacture and sell cheap anti-retroviral drugs. South Africa has not declared a national emergency and has not invoked the TRIPS flexibilities or utilized flexibilities inherent in its own legislation. However, while thousands of people die every week in the two countries, neither government has yet provided an effective HIV/AIDS policy. Extensive litigation and public pressure in South Africa has led the government to announce a policy of supplying free HIV drugs in public hospitals while the Zimbabwean government has announced the provision of the same drugs, also in public hospitals, apparently utilising the state of emergency. The TRIPS agreement under which the two governments undertook to protect international patents allows compulsory licensing under certain circumstances (not limited to a national emergency) and the Doha Declaration on TRIPS and Public Health, and subsequent agreements by the Ministerial Council of the WTO allow the manufacture and, in limited circumstances, the parallel importation of generic drugs. These provisions provide a theoretical mechanism for poor countries to ensure their citizens' rights of access to health (care). The research is aimed at identifying the extent of the effectiveness of the legal norms created by Articles 20 and 31 of TRIPS, the Doha Declaration and subsequent Council of Ministers' decisions, which together ostensibly provide a framework to allow provision of generic drugs. It is further aimed at investigating how the state of emergency in Zimbabwe has been utilised to provide cheap generic drugs to Zimbabweans and whether this would be an option for South Africa. A comparison of the legal provisions governing the provision of drugs in the two countries will also be undertaken to examine the extent to which international and national constitutional and legal provisions may be utilised to give effect to the right to health." -- Introduction.
Thesis (LLM (Human Rights and Democratisation in Africa)) -- University of Pretoria, 2004.
Prepared under the supervision of Dr. Enid Hill at the American University in Cairo.
http://www.chr.up.ac.za/academic_pro/llm1/dissertations.html
Centre for Human Rights
LLM

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34

Thomas, Gaëtan. "La routine vaccinale. Enquête sur un programme français de rationalisation par les nombres, 1949-1999". Thesis, Paris Sciences et Lettres (ComUE), 2018. http://www.theses.fr/2018PSLEH049/document.

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Cette thèse examine l’apport du travail statistique à la normalisation de la vaccination en France, des années 1950 au milieu des années 1990, une période au cours de laquelle la vaccination a fait l’objet de peu de controverses. Au moyen d’opérations statistiques de rationalisation, de régulation et de justification, l’épidémiologie (entendue comme un ensemble de pratiques plutôt qu’une discipline universitaire autonome) a largement contribué à maintenir cet état de fait – un processus que je qualifie de routinisation. L’enquête est construite sur des archives issues de diverses institutions, nationales et internationales, ainsi que sur une série d’entretiens avec les principaux acteurs du domaine. Elle éclaire le rôle d’un groupe d’épidémiologistes associés au Centre international de l’enfance (1949-1999), qui mit en œuvre un programme de rationalisation et de simplification de la vaccination. Dans cette période coloniale et postcoloniale, l’Afrique subsaharienne était un de leurs terrains de prédilection : ils y réalisèrent de nombreux essais, simultanément à leurs activités métropolitaines. L’implication de l’OMS dans le domaine de la vaccination a conforté la dimension internationale de cette routinisation : les épidémiologistes français se sont appropriés des opérations statistiques popularisées par Genève. À la fin de la période considérée, la controverse de la vaccination contre l’hépatite B a perturbé cette routinisation et mis en évidence un écart croissant entre les logiques de l’épidémiologie et l’expérience des individus vaccinés. Cette recherche éclaire d’une lumière nouvelle la façon dont l’intervention de santé publique la plus courante a été normalisée et gouvernée par des nombres
This dissertation studies the entanglement between statistical production and the normalization of immunization practices in France from the 1950s to the mid-1990s, a period during which immunization remained largely uncontroversial. By rationalizing, regulating, and justifying immunization, epidemiology (understood as a collection of practices, rather than a discrete academic discipline) has contributed greatly to this normalization – a process I term “routinization.” This research project is based on archival findings, both in France and internationally, as well as a series of interviews with significant actors in the field. It is primarily focused on a group of epidemiologists affiliated with the Centre international de l’enfance (French International Children’s Center, 1949-1999), whose mission was to rationalize and simplify immunization for children. Throughout the institution’s history, which overlaps with the late colonial period and the process of de-colonization, there is a significant engagement with Francophone Africa: numerous trials were carried out simultaneously in Sub-Saharan Africa and the Paris region. The transnational nature of this activity is also due, in part, to the involvement of the World Health Organization in matters of immunization – French epidemiologists appropriated calculations popularized on a global scale. At the end of the period in question, the Hepatitis B vaccine controversy disrupted the routinization process and shed light on the rising gap between the discourse and practice of epidemiology and the experience of vaccinated individuals. This study offers new insights into the role of numbers in the maintenance and governance of the most common public health intervention

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Abeysinghe, Sudeepa Margaret. "Uncertain science : H1N1 and the World Health Organisation". Phd thesis, 2012. http://hdl.handle.net/1885/149807.

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On the 11th June 2009, the World Health Organisation (WHO) declared the spread of influenza A/H1N1 virus to constitute a pandemic event. This declaration, the first in 40 years, resulted in the implementation of pandemic preparedness plans and reinforced expectations of an imminent global catastrophe. However, H1N1 failed to produce high morbidity and mortality, leading to criticism of the WHO's actions. Through the analysis of WHO documents, this thesis examines the Organisation's representation and management of the H1Nl pandemic. The thesis also examines texts produced by the Council of Europe, a key critic of the WHO, to demonstrate the contestation of the WHO's narrative and the fluidity of scientific fact-making surrounding the phenomena. Through the perspective of the sociology of scientific knowledge, and drawing upon the sociology of risk and the sociology of institutions, the research explores the way in which the WHO's representation of H1N1 was rendered vulnerable to contestation, and examines the social context in which the WHO was acting. The thesis argues that the WHO's construction of H1N1 was susceptible to contestation due to its instability as a scientific fact. The WHO's construction was fragile in a number of fundamental aspects, including: representations of the nature of the virus; the categorisation of H1N1 as a 'pandemic'; the construction of a robust risk discourse, and; the management of HINI through the means of mass vaccination. These unstable narratives were a product of the social context surrounding HINI, which included: the presence of a high level of scientific uncertainty surrounding the virus; the previously black-boxed and ill-defined nature of key concepts surrounding the event, such as 'severity' and 'pandemic'; the institutional structure of the WHO, and; the contemporary structuring of global public health. Overall, the thesis demonstrates that while pandemic events are a matter of public concern, they are not matters of (incontestable or objective scientific) fact. Furthermore, it illustrates the context of scientific uncertainty in which decision making institutions must act in the management of contemporary global risks. This analysis thereby demonstrates the need for a critical sociology of infectious disease, and contributes to an understanding of the construction and management of contemporary global risks.

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Hahn, Lisa Anne. "Health risk factors associated with morbidity and mortality in a national sample of people with psychosis". Thesis, 2017. http://hdl.handle.net/2440/119561.

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Cardiovascular disease (CVD) is the leading cause of death in people with psychosis. For over a decade, extensive research has shown that people who have a psychotic illness are more likely to live an unhealthy lifestyle and engage in health risk behaviours compared with the general population. The current thesis extends this prior research, using the World Health Organisation (WHO) as a framework to identify risk factors that are responsible for morbidity and mortality among the psychosis population. Out of the eleven health risk factors outlined by WHO, the first three manuscripts focus on two of these risk factors while the remaining manuscripts draw eight risk factors together to provide an overall picture of the health profile in people with psychosis. This research was based on the 2010 Australian national psychosis survey using a large representative sample of adults aged 18-64 years with psychotic disorders (n =1825). The first aim of the thesis was to identify factors associated with individual WHO risk factors in people with psychosis. Paper 1 explored factors associated with dietary inadequacy defined by the consumption of less than four daily servings of fruit and vegetables. Quantitative findings derived from this paper indicated that almost three quarters of participants failed to conform to dietary guidelines, and substance use was the major contributing factor for this dietary non-compliance. Paper 2 extended these findings by providing a comparison of nutrient intake in individuals with psychosis and the general population based on a smaller subset of this population. The former group consumed more fat, vitamins and minerals compared with the normal population. Most people with psychosis did not meet the recommended dietary intake for various nutrients. Paper 3 undertook an investigation into arterial stiffness and peripheral resistance and found that male gender, higher age and a family history of hypertension was positively associated with both of these blood pressure components. In this paper, unmodifiable risk factors were more related with increasing pulse pressure and mean arterial pressure, compared with modifiable risk factors relating to poor health behaviours. The second aim of this thesis was to investigate the absolute number of the WHO-defined risk factors, present in people with psychosis. A risk factor count represents a novel approach to obtaining an overall picture of risks that are associated with disability and death. Paper 4 looked at the total number of these CV risks present in people with psychosis, with a particular focus on young people aged 18-24 years. This paper showed that young men and women had an average of 2-3 risk factors out of 8 WHO-defined risk factors. Paper 5 expanded these findings by examining the total number of CV risks in people with psychosis aged 18-64 years. Relative to the younger participants, older people with psychosis had more risk factors, and risk appeared to increase with increasing age. Taken together, these findings presented within the following chapters, heighten our understanding of the physical health profile and excess mortality in people with psychosis, using risk factors well-validated by the WHO, that make a substantial contribution to morbidity and mortality.
Thesis (Ph.D.) (Research by Publication) -- University of Adelaide, Adelaide Medical School, 2017.

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Gupta, Shivam. "Spatial modelling of air pollution for open smart cities". Doctoral thesis, 2018. http://hdl.handle.net/10362/56707.

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A thesis submitted in partial fulfillment of the requirements for the degree of Doctor in Information Management, specialization in Geographic Information Systems
Half of the world’s population already lives in cities, and by 2050 two-thirds of the world’s population are expected to further move into urban areas. This urban growth leads to various environmental, social and economic challenges in cities, hampering the Quality of Life (QoL). Although recent trends in technologies equip us with various tools and techniques that can help in improving quality of life, air pollution remains the ‘biggest environmental health risk’ for decades, impacting individuals’ quality of life and well-being according to World Health Organisation (WHO). Many efforts have been made to measure air quality, but the sparse arrangement of monitoring stations and the lack of data currently make it challenging to develop systems that can capture within-city air pollution variations. To solve this, flexible methods that allow air quality monitoring using easily accessible data sources at the city level are desirable. The present thesis seeks to widen the current knowledge concerning detailed air quality monitoring by developing approaches that can help in tackling existing gaps in the literature. The thesis presents five contributions which address the issues mentioned above. The first contribution is the choice of a statistical method which can help in utilising existing open data and overcoming challenges imposed by the bigness of data for detailed air pollution monitoring. The second contribution concerns the development of optimisation method which helps in identifying optimal locations for robust air pollution modelling in cities. The third contribution of the thesis is also an optimisation method which helps in initiating systematic volunteered geographic information (VGI) campaigns for detailed air pollution monitoring by addressing sparsity and scarcity challenges of air pollution data in cities. The fourth contribution is a study proposing the involvement of housing companies as a stakeholder in the participatory framework for air pollution data collection, which helps in overcoming certain gaps existing in VGI-based approaches. Finally, the fifth contribution is an open-hardware system that aids in collecting vehicular traffic data using WiFi signal strength. The developed hardware can help in overcoming traffic data scarcity in cities, which limits detailed air pollution monitoring. All the contributions are illustrated through case studies in Muenster and Stuttgart. Overall, the thesis demonstrates the applicability of the developed approaches for enabling air pollution monitoring at the city-scale under the broader framework of the open smart city and for urban health research.

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Sarvan, Imraan. "Orofacial sepsis and HIV at maxillo-facial surgery units in the Western Cape: a prospesctive study". Thesis, 2009. http://hdl.handle.net/11394/3428.

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Abstract (sommario):

Magister Chirurgiae Dentium (MChD)
The World Health Organisation estimated that in 2002 more than 13,772 000 deaths in developing countries were caused by infections. This accounted for more than 45% of all deaths, making up 7 of the top 10 causes of death (World Health Organisation, 2004). Sub-Saharan Africa is the epicentre of the devastating HIV pandemic. The country leading with the highest HIV rate in the world is South Africa, with approximately 5.5 million people infected(UNAIDS, 2008; South Africa Country Progress Report, 2008).The development from HIV to AIDS progressively weakens the immune system, making the individual more susceptible to numerous infections, e.g.various forms of orofacial sepsis (Mindel, and Tenant-Flowers, 2001). HIVpositive individuals are eighteen times more likely to become infected with community-acquired methicillin-resistant Staphylococcus aureus than the general population. (Crum-Cianflone et al., 2006). The management of sepsis is of great concern with regard to human morbidity and mortality, as well as its financial implications, especially in cases of antibiotic resistance (Kimleck et al., 1976; Panlilo et al., 1992; Kirkland et al., 1999). Currently, there is no published peer-reviewed literature assessing the impact of HIV on orofacial sepsis. This study aimed to assess the impact of HIV on orofacial sepsis, investigating the clinical and microbiological profiles of the population. These results were used as a guide in the adaptation of current treatment protocols.The study population consisted of patients with orofacial sepsis (requiring incision and drainage or admission) who were referred to the Maxillo-Facial and Oral Surgery Units at either Groote Schuur or Tygerberg Hospitals. These patients were examined, diagnosed and treated as per standard protocol. The empiric antibiotic treatment was tailored according to microscopy and sensitivity results when it became available. The exclusion criteria of the study were refusal of HIV testing or unwillingness of patients to participate in the study.The ratio of HIV positive patients treated was much higher than the population prevalence (2.4:1.1). Odontogenic infections (71.11%), followed by septic jaw fractures (15.56%) were the most common causes of sepsis. The most common causative teeth were the mandibular posterior teeth (43.75%)(excluding the mandibular 3rd molars). The most common fascial spaces involved in the HIV positive group were the submandibular spaces (36%),followed by the submasseteric and canine spaces (27% each). In the HIV negative group, the buccal (41%) and submandibular spaces (33%) were the most common fascial spaces infected.The HIV negative group had the most multi-fascial space involvement, with 35% having more than one fascial space involved. In comparison, the HIV positive group had only 18% involvement of more than one fascial space. This was also reflected by the HIV negative group, which included five cases of Ludwig’s Angina as compared to one case in the HIV positive group. The Gram Stain showed a predominance of Gram positive cocci for both the HIV positive and negative groups. Gram positive bacilli were significantly more prevalent in the HIV negative group (p = 0.0409). Pre-treatment antibiotics were associated with sterile abscesses in 20% of the cases. No growth on culture occurred only in the HIV negative group (statistically significant with p = 0.00488).A statistically significant increased length of admission was found for the cases with penicillin-resistant bacteria (Wicoxin Rank Sum Test p =0.0072). Penicillin resistance was found in 17.78% (8 cases) with ten strains of five types of bacteria (S. aureus, K. pneumonia, Enterobacter, E. coli,Alpha-haemolytic Streptococcus). Eight percent (5) of these cases were also resistant to co-amoxiclav®.In the HIV positive group the following trends (p>0.005) were found:• The average platelet counts of this group was 112.34 x108/L (lower than the HIV negative group);• The length of admission for the HIV positive group was slightly longer by 0.25 days even though this group had fewer fascial spaces infected;• A larger number of bacteria with penicillin-resistance was more prevalent in the HIV positive group (six resistant bacteria in four cases compared to four resistant bacteria in four cases).Greater numbers of orofacial infections were seen in HIV positive subjects relative to their population prevalence rates. Added to this, was the higher rate of antibiotic resistance and longer hospital admissions.These findings may warrant further investigation of the relationship between HIV positive and negative groups with regard to orofacial sepsis.

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ŠŮSOVÁ, Zuzana. "Zdravotní politika státu a její mediální obraz". Master's thesis, 2009. http://www.nusl.cz/ntk/nusl-52210.

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Abstract (sommario):

Health policy comprises a sum of political activities affecting quality of life and health of people and social groups. The health policy exceeds activities of health-service institutions and covers intended manners of the public, private, public and voluntary organisations and individuals who impact the health. Among them e.g. WHO, one of the biggest and most important specialised institutions of UN. The health policy concentrates on personal, environmental and socioeconomic impact on health and on complicated and complex providing of health care. The long-range strategy of health improvement of the population of the Czech Republic ``Health for Everyone in the 21st Century{\crqq} is a rational and well structured model of complex societal care of health and its development; created by teams of prominent world experts in health policy and economics. In the Czech Republic the Health 21 programme has been applied as the National Action Plan on Health and Environment. Community programmes focused mainly on mapping of the situation in the Czech Republic and consequent continuing prevention. The single programmes are Healthy Town, Healthy School, Healthy Company and Healthy Hospital. Media represent both more and more important form of social, political and cultural life of present societies and condition of economic successfulness of many branches and their role of informant, vehicle of information and public opinion maker can be absolutely key element of propagation and explaining of health policy aspects.

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Batsirai, Murapa. "Factors associated with world health organisation (WHO) clinical staging and related characteristics in HIV positive patients: an application of multistate, missing data and modelling techniques". Thesis, 2019. https://hdl.handle.net/10539/28094.

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Background Human Immunodeﬁciency Virus (HIV) remains a signiﬁcant problem in sub-Saharan Africa which has the highest number (25.6 million) of people living with HIV (PLHIV). South Africa is amongst the top rank of sub-Saharan Africa countries with the highest HIV prevalence. Many studies have been done to have an in-depth understanding of HIVandAIDSdiseaseresultinginvariousinterventionsbeingimplementedtoimprove the lives of people infected by the disease. These studies are usually done using longitudinaldesignswhichhavetheadvantageofenablingresearcherstoobservepatient changes (outcomes) over time; however, they are prone to missingness due to unobserved data as patients may miss scheduled visits. This study aims to determine transition probabilities between WHO stages I, II, III and IV over time and compare Rubin’s and Bayesian methods in determine factors associated with WHO stage ailments and symptomatic conditions amongst HIV infected patients on patient level data from the Adult Wellness study. Methods The researcher conducted a secondary data analysis of the Adult Wellness study which was conducted from 2002 to 2010, to be able to quantify changes in ailments and symptomatic conditions over time, the researcher ﬁtted the general multi-state Markov model which assumes that patients may develop more severe ailments and symptomaticconditions. ThestatesweredeﬁnedbasedonWHOstages,thatis,stage I, II ,III and IV. The researcher also ﬁtted three random effects ordered logistic regression models to determine factors associated with these WHO stage outcomes. The researcher employed the maximum likelihood estimation (MLE) on the ﬁrst model ﬁttedonrawdataandsecondmodelaftermultipleimputation(MI)toaccountformissing data. The last model adopted Bayesian estimation (BE) to the raw data. Finally, the researcherperformedasensitivityanalysisusingsimulateddataandﬁttedallthethree models described earlier. Results A total of 2,609 patients accounted for 12,102 observations were analysed. Majority of the patients were females (77.4%) antiretroviral therapy ART naïve (61.5%) having attained Grade 0-12 (77.9%). The Markov multi-state model showed that patients in WHO stage II were 1.33 times more likely to move to WHO stage III than WHO stage I whilst patients in WHO stage III were 2.26 times (0.16118/0.07124) more likely to move to WHO stage II than progressing to WHO stage IV. The probability of remaining in WHO stage I was 59% after eight year follow up period. Relative to patients with no ailments and symptomatic conditions, patients with one HIV ailments or symptomatic condition has an INCREASED RISK of progressing to advanced WHO stages, (model with raw data OR 2.07, 95%CI: 1.23-3.30). There were some unexpected results were patients on ART and cotrimoxazole (CTX) drugs showed to have increased odds of becoming worse than their counterparts. This was evident in all the three models: raw data MLE model OR 1.5828 (95% CI 1.1948,2.0969) and OR 2.0670 (1.5619,2.7355); MI MLE model OR 1.2252 (95% CI 1.0884,1.3793) and OR 1.5438 (95% CI 1.3186,1.8074); and raw data BE model OR 1.6096 (95% CI 1.2055,2.0952) and OR 2.0758 (1.5507,2.7270) for ART and CTX respectively. Both MLE and BE for the raw data gave similar estimates; however, these estimates were different from the MI MLE model which were more precise (smaller standard errors). Conclusions The results showed that patients had an increased chance of remaining in the same state than either advancing in WHO stages of ailments and symptomatic conditions or recovering. If the level of missing data is reasonable, it is recommended to apply the MI techniques. Multiple imputations and Bayesian missing data methods should be used together and determine which one produce better results per each situation. Finally simulated results showed that multiple imputation and Bayesian models become different as the percentage of missing data increases
MT 2019

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41

Ndlovu, Lonias. "Access to medicines under the World Trade Organisation TRIPS Agreement: a comparative study of select SADC countries". Thesis, 2014. http://hdl.handle.net/10500/14185.

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Despite the adoption of the Doha Declaration on the TRIPS Agreement and Public Health in 2001, which unequivocally affirmed WTO members’ rights to use compulsory licences and other TRIPS flexibilities to access medicines, thirteen years on, developing countries and least developed countries are still grappling with access to medicines issues and a high disease burden. Despite some well researched and eloquent arguments to the contrary, it is a trite fact that patents remain an impediment to access to medicines by encouraging monopoly prices. The WTO TRIPS Agreement gives members room to legislate in a manner that is sympathetic to access to affordable medicines by providing for exceptions to patentability and the use of patents without the authorisation of the patent holder (TRIPS flexibilities). This study focuses on access to medicines under the TRIPS Agreement from a SADC comparative perspective by interrogating the extent of the domestication of TRIPS provisions promoting access to medicines in the SADC region with specific reference to Botswana, South Africa and Zimbabwe. After establishing that all SADC members, including Seychelles which is yet to be a WTO member have intellectual property (IP) laws in their statute books, this study confirms that while most of the IP provisions may be used to override patents, they are currently not being used by SADC members due to non-IP reasons such as lack of knowledge and political will. The study also engages in comparative discussions of topical occurrences in the context of access to medicines litigation in India, Thailand and Kenya and extracts useful thematic lessons for the SADC region. The study’s overall approach is to extract useful lessons for regional access to medicines from the good experiences of SADC members and other developing country jurisdictions in the context of a south-south bias. The study draws conclusions and recommendations which if implemented will in all likelihood lead to improved access to medicines for SADC citizens, while at the same time respecting the sanctity of patent rights. The study recommends the adoption of a rights-based approach, which will ultimately elevate patient rights over patent rights and urges the region to consider using its LDCs status to issue compulsory licences in the context of TRIPS Article 31 bis while exploring the possibility of local pharmaceutical manufacturing to produce generics, inspired by the experiences of Zimbabwe and current goings on in Mozambique and the use of pooled procurement for the region. The study embraces the rewards theory of patents which should be used to spur innovation and research into diseases of the poor in the SADC region. Civil society activity in the region is also identified as a potential vehicle to drive the move towards access to affordable medicines for all in the SADC region.
Mercantile Law
LL.D.

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42

Zaman, Fazluz. "Assessing employee work health and safety in the Bangladesh ready-made garment industry". Thesis, 2017. http://hdl.handle.net/1959.13/1351714.

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Professional Doctorate - Doctor of Business Administration (DBA)
Workplace Health and Safety (WHS) is an integral part of employment industries. Employers are responsible for providing a safe and working environment for their staff, where hazards are clearly outlined and procedures are put in place to minimise the risk of harm or death. In recent decades, the Bangladesh Ready Made Garment Industry (RMG) has seen some tragic accidents in their factories leading to hundreds of fatalities. These accidents have drawn global attention to the industry. The RMG industry is highly competitive on a global scale and it is crucial to the Bangladesh economy. However, as is obvious from the magnitude of the accidents that have unfolded in the industry, there is a lot to be said for the current WHS standards. In my research, I have attempted to assess the current 'Work Health and Safety' issues and employees’ safety preferences irrespective to the gender to suggest a reasonably practicable way to deal with them. These issues can be found in any public or private ventures. This issue is further linked to the individual or organisation that is conducting the business. Private entrepreneurs own the majority of garments factories. Their top-level business performance has contributed to the image of country to the outside world, especially in clothing export. The operators need to ensure control over safe manufacturing operations, proper management of plant and substances, monitor and record health and safety issues, offer adequate facilities (i.e. washrooms, shower place, toilets, lockers, dining areas, first aid), arrange training, ensure participation in the consultation and arrange extra supervision if required. At the same time, both temporary and full time employees need assurance and commitment from management for the planned and continuous improvement in health and safety approaches. All workers should be entitled to have protection from any workplace risks, actively use the personal protective equipment (PPE), be proactive and become actively involved in reporting hazards, and have more engagement and participation in workplace training and communication to improve health and safety. While WHS risks can never be eliminated, hazards can be controlled and precautions can be put in place to reduce the risks associated with working in RMG factories. In my proposed framework, I have asked many questions related to the current health and safety program in terms of planning, implementing and reviewing to assess the common practice. I have also attempted to explore the current capacity building context from the employee awareness, workplace culture and training needs analysis. This conceptual framework from the above two perspectives provides a positive contribution to WHS improvement in the garments sector. The sample comprised 315 RMG employees and supervisors from Bangladesh. Respondents were interviewed using a questionnaire with closed-ended questions. Descriptive research was adopted in one part to determine the gender-based responses under each category. Simple random sampling is used as the sampling technique. At the same time, SPSS ANOVA test, Pearson Correlation test were used to select the significant correlation within each heading. Owing to force completion, data was free from missing value. At the same time, for the treatment for outliers, we tried to ensure that the relationships were not attributable to one or a few outliers, the scatter plots and box plot were used to examine presence of any outliers and to check for normality. For the examination for normality, normal Q-Q Plots have been used. Preliminary analysis revealed that data was normally distributed. All the constructs form a normal distribution, mostly negatively skewed and cases fall more or less in a straight line. Cronbach's Alpha was used to test reliability of the statistics. All those analyses were used to identify hazards as a source of damage, harm or adverse health effects on something or someone under certain conditions at work. The entire work environment runs on meeting the foreign buyers’ fashion cycle times. It is almost impossible to check the WHS in the floor area, where hundreds, if not thousands of workers are in action. During this research, I found employees to be careful in their workplace. Female employees were far more attentive than males due to their family dependency issues. Both male and female employees brought up the importance of training. However, employers were in a dilemma on training design and training cost arrangements with their foreign buyers. International pressure coming from the International Labour Organisation (ILO), accord and diverse lobbyist groups on meeting compliance at one side, and the continuous push from the buyers to rein in costs misaligned the drive to improve training safety and raising safety costs. Thus, the study’s findings showed that WHS issues and non-compliance are widespread and extra attention is necessary to control risks and prevent further tragedies like those of Rana Plaza and Tazreen Fashions. Furthermore, such issues cannot be disregarded in Bangladesh, owing to the massive dependency of the country on garment export earnings.

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Yordanov, Yassen. "Un modèle systémique d’analyse de changement dans les organisations : le cas de l’analyse de l’implantation du projet PATH de l’OMS Europe en France". Thèse, 2012. http://hdl.handle.net/1866/9128.

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L’objectif de la thèse est d’approfondir la compréhension des enjeux liés au processus d’introduction du changement dans les organisations. Ce sujet semble important vu les enjeux majeurs auxquels sont actuellement confrontées les organisations pour implanter des changements jugés nécessaires. Notre recherche aborde l’analyse du changement dans les organisations selon une approche systémique. Cette approche a été développée dans le cadre de la thèse et propose de voir l’implantation du changement jugé nécessaire dans les organisations, non comme des initiatives isolées et déconnectées de l’environnement, mais plutôt comme des processus émergents ou programmés permettant autant le changement de l’organisation que le changement et l’évolution de l’environnement dans une perspective de co-évolution des organisations et de leur environnement. Au niveau des organisations, cette approche systémique amène à se pencher sur la question des possibilités réelles des organisations de produire les changements jugés nécessaires. Elle cherche à comprendre pourquoi, malgré les possibilités réelles des organisations de créer des conditions favorables à l’acceptation et à l’implantation du changement et de l’innovation, les organisations ne s’engagent pas à créer de telles conditions et par conséquent ont des difficultés à produire le changement. Dans le cadre de la recherche, nous avons étudié le changement des pratiques professionnelles et managériales dans le contexte hospitalier français suite à l’introduction d’une innovation d’amélioration de la performance hospitalière, et notamment le projet PATH de l’OMS Europe. Il s’agissait pour nous d’analyser la dynamique de l’implantation de PATH dans la production des effets et le degré d’implantation de PATH, tout en faisant ressortir les facteurs contextuels qui permettent d’expliquer les variations dans le degré d’implantation et les effets. Les résultats de notre recherche soutiennent la proposition qu’il est probablement possible de prédire le niveau d’atteinte des objectifs poursuivis par un changement à partir de la connaissance des capacités collectives de l’organisation pour produire le changement et la façon dont elles ont été mobilisées pour atteindre les objectifs poursuivis. Ils envoient un signal fort aux établissements de santé qui voudraient réussir l’implantation des pratiques novatrices d’amélioration de la performance hospitalière qu’ils doivent s’occuper du contexte dans lequel les efforts de l’implantation sont pratiqués et que ces efforts ne sauraient être entrepris tant que des conditions favorables à l’acceptation et à la réalisation du changement ne sont pas mises en place. Les conditions favorables se matérialiseraient dans les établissements par la mise en place de structures favorisant le travail en groupe multi professionnels, de formations relatives à l’implantation de l’innovation, de coordination de l’action collective, d’implication des utilisateurs finals de l’innovation dans tous le processus d’implantation et de soutien du leadership médical et administratif.
The objective of the thesis is to look further into the comprehension of the issues related to the process of introduction of the change into the organizations. This subject seems important in view of the major challenges currently facing the organizations to implement changes considered to be necessary. Our research approaches the analysis of the change in the organizations according to a systemic approach. This approach was developed within the framework of the thesis and proposes to see the introduction of the change considered to be necessary in the organizations, not like isolated and disconnected initiatives from the environment, but rather like emergent or programmed processes allowing the change of the organization as much that the change and the evolution of the environment in a context of co-evolution of the both entities. To the level of the organizations, this systemic approach for analysing the change in the organizations brings to consider the question of the real possibilities of the organizations to produce changes deemed necessary. She seeks to understand why, despite the real possibilities of the organizations to create favourable conditions for the acceptance and to the implementation of the change and of the innovation, the organizations are not committed to create such conditions and consequently have difficulties in produce the change. Within the framework of research, we studied the change of the professional and managerial practices in the French hospital context following the introduction of a hospital performance improvement innovation: the WHO Europe’s project PATH. Our objectives were to analyse the dynamics of the implementation of PATH in the production of effects and the degree of implementation of PATH, and to identify the contextual factors that allow explaining the variations in the degree of implementation and the effects. The results of our research support the proposal which it is probably possible to predict the level of achievement of objectives pursued by the change from the knowledge of the collective capacities of the organization to produce the change and the way in which they were mobilized to achieve the objectives pursued. They send a signal to the hospitals which would like to introduce innovative hospital performance improvement practices that they must deal with the context in which the implementation efforts are practiced and that these efforts could not be undertaken as long as favourable conditions for the acceptance and for the implementation of the change are not put in place. These favourable conditions are materialized in hospitals by structures supporting multidisciplinary group work, by training related to the implementation of the innovation, by a coordination of the collective action, by the end-users of the innovation implication in all the implementation processes and by the medical and management leadership support.
Thèse de doctorat effectuée en cotutelle au Département d’administration de la santé Faculté de médecine, Université de Montréal et à l’École doctorale Biologie-Santé Faculté de médecine, Université de Nantes, France

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Hradilová, Tereza. "Kvalita života osob se sluchovým postižením". Doctoral thesis, 2017. http://www.nusl.cz/ntk/nusl-368378.

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The thesis titled The quality of life among hearing impaired people focuses on the current issue regarding the assessment of the quality of life in adult hearing impaired people in the Czech Republic. The conceptual basis of the submitted work is the current professional paradigm, with the emphasis on well-being in the lives of individuals with specific needs. The text deals with the multidimensional character of the concepts of the quality of life and the quality of life relating to health. It illuminates the subjective and the objective part of this broad and current concept. One theoretical chapter focuses on the area of hearing impairment in adult people in connection with the aspects which are bound to the quality of life in this part of the population. Mentioned are the personality traits of a hearing impaired person and the current social dilemma, which is connected to hearing loss, and is projected in the overall assesment of the quality of life of the people with this sensory handicap. One of the sub- chapters of this part of the text focuses on the key factors which influence the personal experience of life quality in the case of hearing loss. The research part of the work deals with method, continuation and assesment of the executed quantitative and qualitative research investigation. In...

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Ndou, Pfarelo Agreement. "Challenges faced by health professionals regarding the implementation of HIV/AIDS guidelines at PHC facilities of Vhembe District, South Africa". Diss., 2019. http://hdl.handle.net/11602/1462.

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MPH
Department of Public Health
HIV/AIDS is an overwhelming global pandemic that affects the country’s health-care system. In order to reduce HIV/AIDS morbidity and mortality, the World Health Organization has called on countries to provide earlier access to antiretroviral therapy. In order to comply with the World Health Organization’s call, South Africa has developed the National Consolidated Guidelines, which were aimed at increasing access to ART as well as reducing new infections through viral suppression. Although the new guidelines have been implemented, they have not been fully implemented, especially in rural-based Primary Health Care facilities. The researcher observed that women who were pregnant were not tested every three months, as prescribed by the HIV/AIDS guidelines. The aim of this study was to investigate Challenges faced by health professionals regarding the implementation of HIV/AIDS guidelines at PHC facilities of Vhembe District, South Africa. This study adopted a qualitative, explorative, descriptive and contextual approach targeting nurses working at rural-based primary health care facilities at Vhembe District. Face-to face in-depth, Semistructured interviews were conducted, audiotaped and transcribed verbatim. The study used non-probability quota sampling method to identify participants until data saturation was reached with 12 participants. The results revealed that nurses faced some challenges when implementing HIV/AIDS guidelines, including shortages of resources, poor technical support, poor infrastructure, work overload, patients starting ART while there are not ready, shortage of ART, late booking of antenatal care, and mothers’ denial of HIV positive status, HIV positive babies, and poor RPC after birth. Ethical considerations were observed throughout the study. The data collected was analyzed using interpretative phenomenological analysis and all measures to ensure trustworthiness of the study findings were ensured. Some recommendations were made based on the findings of the study
NRF

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Skhosana, Thabang Johannes. "A pentecostal response to the challenges of HIV/AIDS in Tumahole". Diss., 2000. http://hdl.handle.net/10500/16052.

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This dissertation is a challenge to the Pentecostal churches, particularly, the Apostolic Faith Mission Church in Tumahole, to take an action in meeting the challenges posed by HIV/AIDS. This disease, HIV/AIDS, is the latest enemy to human life that the nations are faced with. In the newspapers like Sowetan, there is an article almost daily about HIV and AIDS. In this dissertation, I have tried to show shocking figures of how this disease is spreading in Africa. The seriousness of the disease, unlike other diseases, is its in curability. The secular organisations are far ahead of the churches in as far as the relevant programmes on combating HIV/AIDS are concerned. Despite these massive programmes, the disease is spreading like the wild fire. Deducing from this background, it is no longer the question of whether the Pentecostal churches have any role to play, but what specific role should the church play in this challenge. In this challenging times, many people look at the church as one of the most important institute that would play a positive role in bringing hope to the hopeless.
Christian Spirituality, Church History and Missiology
M. Th. (Missiology (Urban Ministry))

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Hashim, Che Gon. "Identifying predictors of postoperative persistent pain in women with breast cancer: assessments of investigative tools". Master's thesis, 2018. http://hdl.handle.net/1885/162744.

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Persistent pain after surgery in breast cancer has a significant impact on the patient’s survival. The value of escalating research on breast cancer in Malaysia cannot be underestimated. However, it is not known how many of these women experience persistent pain after surgery. This study surveyed previously unknown figures on prevalence, and explored the predictive factors of persistent pain women with breast cancer in Malaysia. There were three objectives. First, to assess the reliability of the already established investigative tools, namely, the Brief Pain Inventory, Distress Thermometer, and Resilience scale RS-14; second, to survey the prevalence of persistent pain; and thirdly to identify predictors of persistent pain in women after breast surgery, using the above measures. A test and retest design with no intervention and a recall period of 3 to 7 days was employed for assessment of the investigative tools. A cross-sectional study, with a prospective, correlational design, a retrospective review of medical records was used to identify predictors of persistent pain. These investigations were conducted in two phases –Section A and Section B – using separate data sets, with different inclusion and exclusion criteria. Participants were recruited from the University of Malaya Medical Centre, Malaysia. Descriptive statistics, a stepwise regression model for reliability testing, Cronbach alpha, and factor analysis were used. This study divided pain into categories 0 = no pain, 1–4 = mild pain, 5–6 = moderate pain, and 7–10 = severe pain. Section A: The tools were found reliable. Section B: A total of 123 participants were recruited; 119 participants remained because 4 of them did not meet the inclusion criteria. A total of 43% of the participants had persistent pain (n = 51). Pain interfered with their work, mood, and sleep. Based on a “Yes” answer for pain today (n = 51), data were analysed to determine predictors. The results revealed three predictors: distress, B = –.911, resilience, B = –.444, and pain interference, B = .309. The model was statistically significant, F (3, 41, 44) = 13.827, R2 = 0.267, .381, .467), and adjusted R2 = .250, .351, .467, p = 0.001. Significant P value ≤ .005. Pain prevalence was 43% in this Malaysian population. This study provided empirical evidence which is an important new knowledge to health care systems, health care providers, policy makers, and future research. The impact of persistent pain on work, mood, and sleep are justifiable medical concerns. The results obtained and identified predictors are catalysts for providing extra support for breast cancer women after surgery. Ideally, all women with breast cancer should have very good life satisfaction.

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Tesi sul tema "World Health Organisation"

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