Travel Report from the first field trip within the SIDA supported project "Mini-grids supplied by renewable energy - improving technical and social feasibility : Including visits to Ihushi Development Center, Tweyambe Secondary School and Mavuno Project in Tanzania. Conducted in April 2011

This report describes the outcome of the first visit to Tanzania, within the project "Mini-grids supplied by renewable energy - improving technical and social feasibility". The trip included visits to three different organizations; Ihushi Development Center (IDC) near Mwanza, TIDESO near Bukoba, and Mavuno Project in Karagwe. At IDC, a brief evaluation of the current power system was done and measuring equipment for long term measurements were installed. At all three locations investigations regarding the current and future electricity demand were conducted and connections to people relevant to the study were established. The report is including as well some technical specifications as some observations regarding organization and management of the technical systems. The trip was including only short visits and therefore only brief introductions to the different organizations, based on observations done by the author. The report is hence describing the author’s understanding of the technical system and social structures after only short visits to each of the organizations, and may differ from observations done at another point in time, over a different time period, or by some other person.This report describes the outcome of the first visit to Tanzania, within the project "Mini-grids supplied by renewable energy - improving technical and social feasibility". The trip included visits to three different organizations; Ihushi Development Center (IDC) near Mwanza, TIDESO near Bukoba, and Mavuno Project in Karagwe. At IDC, a brief evaluation of the current power system was done and measuring equipment for long term measurements were installed. At all three locations investigations regarding the current and future electricity demand were conducted and connections to people relevant to the study were established. The report is including as well some technical specifications as some observations regarding organization and management of the technical systems. The trip was including only short visits and therefore only brief introductions to the different organizations, based on observations done by the author. The report is hence describing the author’s understanding of the technical system and social structures after only short visits to each of the organizations, and may differ from observations done at another point in time, over a different time period, or by some other person.

Health and quality of care from older peoples' and formal caregivers' perspective

Aim: The overall aim of this thesis was to gain a deeper understanding of older people's view of health and care while dependent on community care. Furthermore to describe and compare formal caregivers' perceptions of quality of care, working conditions, competence, general health, and factors associated with quality of care from the caregivers' perspective. Method: Qualitative interviews were conducted with 19 older people in community care who were asked to describe what health and ill health((I), good and bad care meant for them (II). Data were analyzed using content analysis (I) and a phenomenological analysis (II). The formal caregivers; 70 nursing assistants (NAs) 163 enrolled nurses (ENs) and 198 registered nurses (RNs), answered a questionnaire consisting of five instruments: quality of care from the patient's perspective modified to formal caregivers, creative climate questionnaire, stress of conscience, health index, sense of coherence and items on education and competence (III). Statistical analyses were performed containing descriptive statistics, and comparisons between the occupational groups were made using Kruskal-Wallis ANOVA, Mann-Whitney U-test and Pearson's Chi-square test (III). Pearson's  product moment correlation analysis and multiple regression analysis were performed studying the associations between organizational climate, stress of conscience, competence, general health and sense of coherence with quality of care (IV). Results: The older people's health and well-being were related to their own ability to adapt to and compensate for their disabilities and was described as negative and positive poles of autonomy vs. dependence, togetherness vs. being an onlooker, security vs. insecurity and tranquility vs. disturbance (I).  The meaning of good care (II) was that the formal caregivers respected the older people as unique individuals, having the opportunity to live their lives as usual and receiving a safe and secure care. Good care could be experienced when the formal caregivers had adequate knowledge and competence in caring for older people, adequate time and continuity in the care organization (II). Formal caregivers reported higher perceived quality of care in the dimensions medical-technical competence and physical-technical conditions than in identity-oriented approach and socio-cultural atmosphere (III). In the organizational climate three of the dimensions were close to the value of a creative climate and in seven near a stagnant climate. The formal caregivers reported low rate of stress of conscience. The RNs reported to a higher degree than the NAs/ENs a need to gain more knowledge, but the NAs and the ENs more often received training during working hours. The RNs reported lower emotional well-being than the NAs/ENs (III). The formal caregivers' occupation, organizational climate and stress of conscience were associated with perceived quality of care (IV). Implications: The formal caregivers should have an awareness of the importance of kindness and respect, supporting the older people to retain control over their lives. The nursing managers should employ highly competent and adequate numbers of skilled formal caregivers, organize formal caregivers having round the clock continuity. Improvements of organizational climate and stress of conscience are of importance for good quality of care.