3. Electronic Theses and Dissertations (ETDs) - All submissions
Permanent URI for this communityhttps://wiredspace.wits.ac.za/handle/10539/45
Browse
2 results
Search Results
Item Determinants of health workers' prescription patterns for patients at primary health care facilities in Zambia(2010-04-16T12:31:38Z) Ndhlovu, MickyIntroduction The study aimed at determining health workers’ prescription patterns using selected WHO/INRUD core drug-use indicators and investigated determinants of appropriate antibiotic prescribing in public Zambian primary health care facilities. Methods The study was a secondary data analysis of a cross sectional survey of health facility data collected in four districts of Zambia. This study extracted patients’ diagnoses and treatments and linked them to the health worker demographics and health facility characteristics in order to determine prescription patterns and factors influencing appropriate antibiotic prescribing. Results A total of 2206 prescriptions were analysed. An average of 2.5 drugs per encounter was prescribed. Injections were prescribed in 4% of the encounters. While over 95% of drugs were from the essential drug list fewer drugs were prescribed by their generic names. Only 1.5% of encounters did not result in a prescription. Antimalarial drugs and antipyretics were prescribed in at least 70% of encounters while antibiotics were prescribed in close to 40% of encounters. Of all encounters in which a systemic antibiotic was prescribed, just above a quarter were of appropriate indication and dosage. Determinants of appropriate antibiotic prescribing included patient’s age, presence of clinical wall charts and treatment guidelines; and the health worker cadre. Under-5s were more likely to receive antibiotics when indicated, though at wrong dosages. Health workers with access to guidelines were more likely to prescribe antibiotics only when indicated. Health worker cadre iv without pre-service clinical training were more likely to prescribe antibiotics when not indicated and at wrong dosages. Discussion This study showed that health workers’ performance for most of the WHO drug-use core indicators was similar to findings in other developing countries. The study also revealed overuse of antibiotics for diseases that do not require antibiotics as treatment. Increasing access to guidelines and other clinical job aids, continuous medical education for all health workers and targeted training of health worker cadres without prior medical training will contribute to better prescribing of antibiotics.Item Salience strategy: connectivity, aesthetics and the learning mind(2009-05-29T10:23:41Z) Burnett, Richard Leslie GeorgeThis dissertation adds to the many arguments already made for the value of art (cultural artifact) in teaching and learning. The special approach developed here concludes with the articulation of Salience Strategy. The argument firstly questions the value of seeing intelligence as a problem-solving faculty. It continues by examining consciousness, memory and the imagination as both the ground and substance of intellection. It argues that, amongst other things, interconnectedness, reiterative pathways and networks are central to the operation of consciousness and therefore, are central to its epiphenomenal attributes like intelligence. As education should strive for greater intellectual functioning so it should, therefore, strive to harness the paradigms of interconnectedness, reiterative pathways and networks. The art object, (device, gesture, statement), it is proposed, is valuable when deployed as hubs in networks of ideas allowing learners to form patterns of unexpected and creative linkages enhancing both memory, curiosity and a capacity for imaginative and associative thinking. Learning becomes movement through a landscape of complex objects and outgrowths. Two salience itineraries are explored in this dissertation. The first in relation to concepts overheard during learner conversations over the duration of a school week, and a second, exploiting my own work as an artist, selected work by the British artist Richard Long, and some of the issues raised in the theoretical discussion of consciousness and networks.