Assessing variation in personal health service delivery and workplace smoking ban enforcement by local health departments

Thesis (Ph.D.)--University of Washington, 2016-08

Mothers’ perception of recovery and satisfaction with patent medicine dealers’ treatment of childhood febrile conditions in rural communities

Background Infant mortality in rural areas of Nigeria can be minimized if childhood febrile conditions are treated by trained health personnel, deployed to primary healthcare centres (PHCs) rather than the observed preference of mothers for patent medicine dealers (PMDs). However, health service utilization/patronage is driven by consumer satisfaction and perception of services/product value. The objective of this study was to determine ‘mothers’ perception of recovery’ and ‘mothers’ satisfaction’ after PMD treatment of childhood febrile conditions, as likely drivers of mothers’ health-seeking behaviour, which must be targeted to reverse the trend. Methods Ugwuogo-Nike, in Enugu, Nigeria, has many PMDs/PHCs, and was selected based on high prevalence of childhood febrile conditions. In total, 385 consenting mothers (aged 15–45 years) were consecutively recruited at PMD shops, after purchasing drugs for childhood febrile conditions, in a cross-sectional observational study using a pre-tested instrument; 33 of them (aged 21–47 years) participated in focus group discussions (FGDs). Qualitative data were thematically analysed while a quantitative study was analysed with Z score and Chi square statistics, at p < 0.05. Results Most participants in FGDs perceived that their child had delayed recovery, but were satisfied with PMDs’ treatment of childhood febrile conditions, for reasons that included politeness, caring attitude, drug availability, easy accessibility, flexibility in pricing, shorter waiting time, their God-fearing nature, and disposition as good listeners. Mothers’ satisfaction with PMDs’ treatment is significantly (p < 0.05) associated with mothers’ perception of recovery of their child (χ2 = 192.94, df = 4; p < 0.0001; Cramer’s V = 0.7079). However, predicting mothers’ satisfaction with PMDs’ treatment from a knowledge of mothers’ perception of recovery shows a high accord (lambda[A from B] = 0.8727), unlike when predicting mothers’ perception of recovery based on knowledge of mothers’ satisfaction with PMDs’ treatment (lambda[A from B] = 0.4727). Conclusions Mothers’ satisfaction could be the key ‘driver’ of mothers’ health-seeking behaviour and is less likely to be influenced by mothers’ perception of recovery of their child. Therefore, mothers’ negative perception of their child’s recovery may not induce proportionate decline in mothers’ health-seeking behaviour (patronage of PMDs), which might be influenced mainly by mothers’ satisfaction with the positive attributes of PMDs’ personality/practice and sets an important agenda for PHC reforms.

Promotion and diffusion of tha career Bachelor and Licenciature of Mathematics Teaching in rural areas of Costa Rica project: effects and results

This article describes the purpose and activities of the project Promoting Mathematics Education in Rural Areas of Costa Rica. The activity has focused on two objectives. First, supporting and monitoring students who have expressed interest in studying a mathematics teacher. To achieve this, it has been working with students who have an ideal profile for the career, mainly from rural areas. The second objective is to conduct training workshops for high school in-service teachers, to strengthen and improve their knowledge in the area of mathematics. Among the results of the project, it can be highlighted a significant increase in the enrollment of students in the career of Mathematics Education in 2010 and 2011, and the training processes in the field of Real Functions of Real Variable and Geometry at different regional areas mostly rural as Aguirre, Sarapiquí, Coto, Buenos Aires, Limón, Cañas, Pérez Zeledón, Nicoya, Los Santos, Turrialba, Puriscal, Desamparados, San Carlos, Puntarenas, Limón, Liberia, Santa Cruz y Upala.

Diseño de un modelo de situación problema, con la unidad facilitadora solidaria llamada Belisol, para fortalecer el pensamiento numérico y variacional, en los estudiantes de la Institución Educativa Rural Benigno Mena González

Al analizar los resultados deficientes de las Pruebas Saber, del PTA ( Programa Todos a Aprender del MEN), y la participación en las Olimpiadas del Conocimiento, de los estudiantes de la Institución Educativa Rural Benigno Mena González del municipio de San Jerónimo, se consideró implementar un proyecto pedagógico, como plan de mejoramiento para la enseñanza y aprendizaje de las matemáticas, que sirviera como una iniciativa para fortalecer los pensamientos numérico y variacional en los estudiantes de secundaria de la Institución; se buscaba, con la implementación de esta propuesta, desarrollar habilidades en dominio, comprensión y solución de situaciones problemas cotidianas dentro del contexto escolar y desde la innovación de nuevas prácticas metodológicas en los procesos educativos. Desde esta perspectiva, nace el interrogante: ¿Cómo modelar una situación problema, teniendo como motivo la unidad facilitadora solidaria denominada Belisol, para fortalecer el pensamiento numérico y variacional, en los estudiantes de la Institución Educativa Rural Benigno Mena González del municipio de San Jerónimo?, para dar tránsito a una propuesta de investigación innovadora. Ahora bien, para intervenir y reflexionar sobre este interrogante, se propuso el método de Investigación Acción Participación (IAP), el cual se aplica a estudios que se interesan sobre realidades humanas y problemáticas cotidianas o sociales, que además, sean reales, de la acción, y de constante participación de los sujetos, entidades o comunidades involucradas; aquí cabe la posibilidad de un aprendizaje cooperativo, colectivo, y por supuesto, colaborativo donde se ha planteado como motivo de la situación problema planteada la unidad financiera llamada Belisol con el fin de exteriorizar los fundamentos de una acción formativa, orientada a la incursión en el ámbito de la educación matemática económica financiera, a través del ejercicio del ahorro escolar y el trueque, promoviendo de esta manera el espíritu solidario en la comunidad Benigniana.