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A study of the business models adopted by medical aid societies in order to survive in a turbulent operating environment (2005-2013)
No full textThe purpose of this study was to investigate the business models being used by medical aid societies in order to survive in a turbulent economic environment experienced by Zimbabwe between 2005 and 2013. The turbulent economic environment caused operational difficulties for most medical aid societies like failure to meet claims costs, diversification into questionable non core activities and skyrocketing costs of doing business. These challenges threatened the long term survival of societies, therefore the study delved deep to understand what can be done to guarantee long term survival of the societies.
The research followed a positivist or quantitative research philosophy. A deductive approach was used. The study used a survey research strategy and the time horizon was cross-sectional as opposed to longitudinal. The study had a population of about 36 650 people and a sample of 200 people received questionnaires. The respondents were split across medical aid subscribers, employees, shareholders and managers of various medical aid societies. The sample was arrived at using the stratified random and convenience sampling techniques. The study relied on primary sources of data. Collected data was analyzed by the SPSS software.
Medical aid societies are following efficiency based business models which lack robust value chains. They are not providing services that meet customer expectations as shown by 40% of respondents. The current regulatory framework is enough for the operations of medical aid societies as expressed by 73% of respondents. There was no pattern or mutually agreed strategies used for survival by medical aid societies. However, most societies followed the strategy of lessening costs to survive. All forms of innovation are low across all societies.
In conclusion, the study established that the business models being used are not robust and need to be improved especially their value chain components. The challenges faced by medical aid societies could be lessened should this component get addressed otherwise challenges like skyrocketing claims costs will continue making medical aid societies less viable
The effects of irrigation methods, calcium levels and other nutrients on soft rot (pectobacterium carotovora subspecies brasiliensis) infection of potato (solanum tuberosum l.)
No full textTwo main experiments were carried out to study the effects of irrigation methods, calcium
levels and other nutrients on soft rot infection of potato. The first experiment was an outdoor
pot experiment, conducted in 2012 and 2013, during the summer season (August –
December). The objective was to explore the potential for controlling tuber soft rot using
calcium fertilization in combination with other nutrients: potassium, nitrogen, magnesium
and phosphorus. In addition plant growth parameters were measured. The experiment was
laid out as a 9 x 3 factorial design in a Randomised Complete Block Design (RCBD).
Calcium was applied at 0, 8.11 and 16.22 g/ pockect calcium nitrate (15.5 % N, 19.9 % Ca)
while other nutrients were magnesium sulphate (9.1 % Mg) at 1.2 and 2.7 g/ pocket,
ammonium nitrate (34.5 % N) at 4.05 and 6.76 g/ pocket, single superphosphate (19.3 %
P2O5) at 20.27 and 27.03 g/ pocket, potassium sulphate (50 % K2O) at 6.08 and 6.76 g/
pocket, and a nil control.
The fertilizer treatment combinations did not exhibit significant difference in both the number
of tubers harvested per plant and the yield in both 2012 and 2013. However, in 2012 only
calcium nitrate fertilizer resulted in significant differences in the number of tubers per plant,
with the application of 8.11 g/ pocket and 16.22 g/ pocket increasing the number of tubers.
Harvested tubers were also analysed for tissue calcium concentration and they were not
significantly affected by the fertilizer combinations. Red clay loam soils used in this
experiment could have decreased the leaching of calcium nitrate to the subsurface where
tubers were formed. Maceration tests were carried out on harvested tubers by inoculating
with Pectobacteriumcarotovora subspecies brasiliensis. The rotting zone diameter was
measured after 24 and 48 hours. However, there were no significant differences in the rotting
zone diameter in all treatments.
The second experiment was a field study conducted to evaluate the effects of irrigation
methods and plant nutrition on the growth of potato and on the susceptibility of tubers to
potato soft rot, carried out in 2012 and 2013, during the summer season (August – December)
at the University of Zimbabwe, Crop Science field experiment blocks. The experiment was
set up under overhead and drip irrigation using a RCBD, with seven blocks and five calcium
nitrate fertilizer rates of 0, 300, 600, 900 and 1,200 kg / ha. All treatments received an equal
amount of nitrogen.
Tuber calcium analysis indicated that there were no significant differences in the tuber
calcium content in tubers harvested from both drip and overhead irrigation in both years.
Testing for the susceptibility of tubers to soft rot was carried out using maceration tests.
Tubers harvested from drip irrigation in 2012 did not show any significant differences in the
rotting zone diameter at both 24 and 48 hours after maceration. No rotting was observed in
2013. Tubers harvested from the overhead irrigated field did not show any signs of rotting,
both in 2012 and 2013. Calcium fertilization did not influence yield or tuber size distribution,
perhaps because of high inherent calcium already in the plots used and in irrigation water.
This work, therefore failed to show that loss from soft rot could be reduced by tuber calcium
perhaps because the calcium supplied from irrigation water was above the threshold level for
such protection from infection.The Regional Universities Forum for Capacity Building in Agriculture (RUFORUM) and
The Beit Trust (Zimbabwe
The impact of transformation in United States of America (USA) foreign policy approach from the Bush to the Obama adminstration on Middle East peace and security: The case of Iraq (2000 - 2013)
No full textThe idea of security in International Relations has for a long time been identified by the vague pursuance of national interests by states. Traditionally, concepts of security focused on the aspect of military protection of a state’s borders and territory. This view has changed over the years to focus on more on human security. The United States (US) foreign policy since the cold war, through the demise of the Soviet Union in the 90s, up to the advent of US unipolarity, has gone through corresponding changes, to guarantee the protection of US citizens at home and abroad. After the September 11 (9/11) terrorist attacks on the US, the Bush administration adopted a pragmatic realist basis of foreign policy. The assumption of power by the Obama administration however ushered in a more progressive liberal tone to US foreign policy in the Middle East. This change in foreign policy approach was expected by the US population, the Iraqi people and the international community, to bring about a matching change in the state of peace and security in the Middle East. The Region has however remained gripped in violent conflict, despite these changes.
This study focuses on the effects of the transformation from the Bush administration’s neo-conservative unilateral approach to the Obama administration’s multi-lateral approach in US foreign policy in the Middle East Peace. Focus will be on Iraq between the years 2000-2013. Qualitative research methodology, focusing on documentary search will be the main tool of research in this study. This methodology will be used to explore the underlying principles of US foreign policy in the Middle East which have always been understood to be; safeguarding US access to Middle East oil reserves’, supporting Israel as a strategic ally in the region, prevent any state from dominating the region and spreading of democracy and human rights.
This study reflects the view that the prevailing conditions of insecurity in Middle East are despite the diplomatic maneuvers adopted by the Obama administration in US foreign policy. Currently in the Middle East, there is continued sectarian violence in Iraq, the ongoing war in Syria and the continued Israeli-Palestine conflict over the West Bank, is nowhere near a peaceful resolve. This study recommends that any meaningful drive towards peace and security in the Middle East should address the divide on ethnic and sectarian lines as the clashes of these groups are leading to escalating conflict
Loss to follow up in HIV exposed infants in the PMTCT programme in Hurungwe District, Zimbabwe
No full textHigh rates of loss to follow-up (LFU) of HIV exposed infants after birth have been described to be a challenge in the PMTCT programme. In Hurungwe District out of the 148 exposed infants in the exposed infants register 73,6% (109)at Karoi Hospital were lost to follow up as of October 2011. A better understanding of the characteristics of women-infant pairs lost to follow and those still coming for PMTCT reviews is needed so as to come up with factors associated with loss to follow up.
Methods: A 1:1 unmatched Case-Control study was conducted in 3 health centers purposively selected with the top 3 PMTCT coverage’s in Hurungwe District Mashonaland West Province. A case was any infant who was HIV exposed who defaulted regular reviews for 3 months or more and during the course of the study was still lost to follow up. A control was any infant who was HIV exposed who was still coming for their regular review visits for the period (less than 3 months).The sample size was calculated at 95% confidence, 80% power and assuming 50% exposure in control group with odds ratio of 0,30 the sample size was set at 56 cases: 56 controls total sample size at 112. The study instruments were constructed according to the educational diagnosis phase of the PRECEDE-PROCEED Model borrowing constructs from the Theory of Planned Behavior. Focus group discussion guide and an interviewer administered questionnaire were used for data collection.
Results: Mothers who took ARVs during labor were less likely to be lost to follow up (0.0303). This protective association was statistically significant at 95% CI. Infants who were alive and well were significantly more likely to be lost to follow up (9.75). 5.4% (3) infants had deceased. Infants who were receiving extended Nevirapine and Cotrimoxazole were less likely to be lost to follow up with odd’s ratio of 0.0171 and 0.2391 which were statistically significant. Infants with good nutrition (OR0.76) less likely to be lost to follow up however this was not statistically significant. The log odds of mothers that said they were likely to take their child for review and drug resupply were protective (OR: 0.2732) with cases less likely to intended to take their child for such visits, this was statistically significant at 95%CI (0.1215;0.6141).
Conclusion: The District Health Executive for Hurungwe district should formulate interventions to increase the behavioural intention of mother of exposed infants to access care. Mothers should be given health education on the importance of early infant diagnosis and the need to prevent opportunistic infections through the use of extended nevirapine and cotrimoxazole prophylaxis
Factors influencing treatment failure in HIV positive adult patients on first line antiretroviral therapy
No full textBackground: Risk factors for treatment failure in HIV positive adults have not been studied extensively in Zimbabwe.
Aim: To investigate socio-demographic, psychosocial and antiretroviral drug related factors as possible risk factors for treatment failure.
Objective: To compare the accuracy and reliability of CD4 count results in diagnosing treatment failure versus viral load results.
Design: Adescriptive cross-sectional survey.
Setting: Harare Central Hospital adult opportunistic infections clinic.
Participants: One hundred and eighteen (118) HIV positive participants on Is' line antiretroviral therapy (any 1 of stavudine, tenofovir or zidovuume combined with lamivudine and nevirapine or efavirenz) for at least 1 year. Participants were conveniently sampled.
Main Outcome Measures: First line treatment failure as defined according to World Health Organisation (WHO) 2010 guidelines.
Results: Factors associated with higher odds of treatment failure were severe depression [OR 3.7; p-value 0.002; 95% Cl 1.6-8.5] and discontinuing ART [OR 4.4; p-value 0.02; 95% Cl 1.3-14.7], Factors associated with lower odds of treatment failure were age =42 [OR 0.3; p-value 0.007; 95% Cl 0.1-0.7], taking ART on time [OR 0.2; p-value 0.02; 95% Cl 0.05-0.8], time on ART >4 years [OR 0.6; p-value 0.02; 95% Cl 0.3-0.9] and female sex [OR 0.4; p-value 0.02; 95% Cl 0.2-0.8], There was statistically significant difference between CD4 count and viral load results in diagnosing treatment failure [OR 8.7; p-value 0.0005; 95% Cl 3.6-21.2], Conclusion: Severe depression and discontinuing ART predisposed to treatment failure. CD4 counts were not as reliable as viral load measurements in diagnosing treatment failure
A study to determine relationship between partner support and adherence to Zidovudine among HIV positive pregnant women attending PMTCT clinic at Shurugwi hospital
No full textThere are low levels of adherence to zidovudine prophylaxis among HIV
positive pregnant women at Shurugwi District Hospital in Zimbabwe. The most likely
contributing factor to low adherence levels could be related to the level of partner
support. The purpose of this study was to determine the relationship between partner
support and adherence to zidovudine prophylaxis by HIV-positive pregnant women
attending Shurugwi PMTCT clinic. Pender’s Health Promotion Model guided the
study. A descriptive correlational design was used. A sample of eighty (82)
participants who met the inclusion criteria were selected into the study using a
systematic sampling method. Data were collected using interviewer-administered
questionnaires over a period of three (3) weeks. Data were analyzed using descriptive
and inferential statistics. The results showed that Sixty-six (80.4%) participants
demonstrated poor sub-optimal levels (<95%) of adherence to zidovudine prophylaxis
and 62 (75.6%) perceived partner support to be low. The Pearson correlation
coefficient (r=.677; p<.01) showed a strong positive significant relationship. Partner
support had an impact of 45.9% on adherence to zidovudine prophylaxis (R2 0.459).
The findings reflect that as partner support increased, adherence to zidovudine
prophylaxis among HIV-positive pregnant women increased. Midwives should
intensify partner involvement in PMTCT programmes in order to achieve optimal
(>95%) adherence to zidovudine prophylaxis among HIV-positive pregnant women
so as to be able to suppress Mother to Child Transmission of HIV
Proceedings Of The Nectar/Chris/Imherz Workshop Held At Harare Holiday Inn 3rd - 5th Of February 2011
No full textProf Hakim started the workshop by welcoming the guests
and thanked them for being punctual and then handed over
to the Chair of the morning session Prof Chidzonga who
formally welcomed the guests to the workshop making special
mention of the guests from UK, USA and South Africa
before handing over to the Vice Chancellor, Prof Nyagura
to give the Official Opening Speech
A national IPC training strategy in Zimbabwe-rewards and challenges
No full textThis presentation will discuss the strategy that has evolved over the first 3 years of the National IPC Training programme, its outputs and challenge
An audit of clinical assessments of low back pain conditions managed at Parirenyatwa hospital’s rehabilitation department: 2 year retrospective study (2010-11)
No full textand Aim: Musculoskeletal conditions contributed 62% of all the cases that presented to Parirenyatwa Hospital’s Physiotherapy Outpatient Department during the year 2010-11. Low back pain contributed 13% of these musculoskeletal conditions. Although assessment forms are available at Parirenyatwa, Physiotherapists do not use these preferring to a “helicopter” type of assessment which does not cover all areas of low back pain assessment. This lead the author to investigate the adequacy of such assessments.
Methods: A retrospective audit study was carried out on assessment forms used for patients presenting with LBP conditions at Parirenyatwa Hospital’s Physiotherapy Department during 2010-11. A Chartered Society of Physiotherapy (CSP) pro forma was utilized for auditing the records. In addition a focus group discussion (FGD) was carried out with Physiotherapists working at Parirenyatwa. Data were entered into EPI info version 3.5.3 and descriptive statistics used to obtain the frequencies, graphs and tables.
Results: A total of 86 assessment forms of patients presenting with low back pain conditions were audited. The most assessed areas under subjective assessment were social and family history (97.7%), presenting condition (96%), past medical history (89.5%), current medications (79.1%), investigations (60.5%) and the least documented were precautions (2.3%), patient’s perceptions (0%) and expectations (0%). The most assessed areas under objective assessment were palpation (81.4%), observation (66.5%), problems (66.3%), and the least documented was impression of clinical diagnosis (7%), and result of outcome measurement (7%). Results of the FGD were that:- clinical supervision, continuous professional development, staff shortage, clinical judgment, work experience, attitude and competence all contributed to what areas were assessed.
Conclusion and Recommendation: A “helicopter” assessment leads to inadequate assessment as shown by the results for example patient’s perception and expectations were not addressed, therefore it is necessary to audit assessment forms at regular intervals to ensure quality care