An institutional analysis of community and home based care and support for HIV/AIDS sufferers in rural households in Malawi
- Authors: Munthali, Spy Mbiriyawaka
- Date: 2009
- Subjects: AIDS (Disease) -- Patients -- Care -- Malawi HIV-positive persons -- Care -- Malawi HIV infections -- Malawi Home-based family services -- Malawi Community health services -- Malawi Community development -- Malawi Economic development -- Malawi
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: vital:985 , http://hdl.handle.net/10962/d1002719
- Description: Standard economic models often emphasize inputs, outputs and an examination of the structures in order to conduct an economic performance evaluation. This study applies the Institutional and Development Framework (IAD) in the broader context of New Institutional Economics (NIE) in order to examine the transaction costs of delivering Community and Home Based Care and Support (CHBC) to HIV/AIDS sufferers. For purposes of unveiling the empirical reality guiding decision making processes in the CHBC service delivery, comparative qualitative research techniques of normative variable and concept formation have been adopted to draw out the relative institutional influences from the HIV/AIDS national response partnerships. The study identifies the conflict between the predominantly standardized and more rigid formal management techniques adopted by key members of the national response and the informal cultural techniques familiar to the rural communities, and a lack of motivational incentives in the CHBC structures as the key factors against CHBC capacities to draw external funding for service delivery. CHBCs are also weakened by incoherent governance structures at the district level for facilitation of funding and information flow exacerbating the community vulnerability. Rationalization of the institutional arrangements and a clarification of roles from district to community levels, a shift of focus to facilitation of informal techniques and an integration of performance enhancing incentives are the critical policy insights envisaged to spur CHBCs to work better.
- Full Text:
- Authors: Munthali, Spy Mbiriyawaka
- Date: 2009
- Subjects: AIDS (Disease) -- Patients -- Care -- Malawi HIV-positive persons -- Care -- Malawi HIV infections -- Malawi Home-based family services -- Malawi Community health services -- Malawi Community development -- Malawi Economic development -- Malawi
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: vital:985 , http://hdl.handle.net/10962/d1002719
- Description: Standard economic models often emphasize inputs, outputs and an examination of the structures in order to conduct an economic performance evaluation. This study applies the Institutional and Development Framework (IAD) in the broader context of New Institutional Economics (NIE) in order to examine the transaction costs of delivering Community and Home Based Care and Support (CHBC) to HIV/AIDS sufferers. For purposes of unveiling the empirical reality guiding decision making processes in the CHBC service delivery, comparative qualitative research techniques of normative variable and concept formation have been adopted to draw out the relative institutional influences from the HIV/AIDS national response partnerships. The study identifies the conflict between the predominantly standardized and more rigid formal management techniques adopted by key members of the national response and the informal cultural techniques familiar to the rural communities, and a lack of motivational incentives in the CHBC structures as the key factors against CHBC capacities to draw external funding for service delivery. CHBCs are also weakened by incoherent governance structures at the district level for facilitation of funding and information flow exacerbating the community vulnerability. Rationalization of the institutional arrangements and a clarification of roles from district to community levels, a shift of focus to facilitation of informal techniques and an integration of performance enhancing incentives are the critical policy insights envisaged to spur CHBCs to work better.
- Full Text:
Peer group supervision as an adjunct to individual supervision: an investigation of models of learning
- Akhurst, Jacqueline Elizabeth
- Authors: Akhurst, Jacqueline Elizabeth
- Date: 2000
- Subjects: Peer-group tutoring of students Psychotherapy -- Study and teaching -- Supervision Psychology -- Supervision of
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: vital:2922 , http://hdl.handle.net/10962/d1002431
- Description: Supervision of practice makes an important contribution to the development of psychotherapeutic skills in the training of psychologists (Bernard and Goodyear, 1998). Much research has, until recently, focussed on dyadic, hierarchical models of supervision, even though other forms of supervision have been developed. Peer group supervision has had little attention in the literature, although it is a common form of supervision utilised by psychologists in practice (Lewis, Greenburg and Hatch, 1988). A review of the literature considers the purposes of supervision; elements of dyadic supervision; various forms of group, peer and peer group supervision; and the leaming process in supervision. The development and implementation of a peer supervision group (pSG) of intern psychologists within the training setting of a University is described in this study. The PSG model was developed from the model proposed by Wilbur, Roberts-Wilbur, Morris, Betz and Hart (1991). Transcripts from nine audio-taped PSG sessions were analysed, and a comparison with four audio-taped dyadic supervision sessions was then undertaken. Grounded Theory methodology was employed in the design of the study and analysis of the data. The form and content of the two models of supervision were examined, with particular attention to the perspective of the trainees' learning experiences. The relative merits of both forms of supervision were assessed, and this analysis clearly demonstrates that peer group supervision has the potential to complement dyadic supervision by contributing differing learning experiences. A model of key influences upon, and effects of, participation in the two forms of supervision has been developed. Suggestions are made of ways in which dyadic supervision may be optimised, and recommendations for further development of the PSG emerge. The results were then considered from a neo-Vygotskian perspective. This enabled the findings to be linked to a comprehensive theory of learning, pointing to the key role of speech in thinking, and the contributions of the various forms of dialogue to deepened understandings. The discussion includes: consideration of techniques which enable trainees to obtain assistance from both more experienced practitioners as well as from their peers; an exploration of aspects of subjectivity and intersubjectivity; and contextual influences which have bearing on the study. This study identifies the need for further consideration of the supervision process in South Africa, and makes recommendations for the training of supervisors. The neo-Vygotskian model offers great promise both as a framework for understanding the leaming process in. supervision, and for developing guidelines for enhancing supervisory practice.
- Full Text:
- Authors: Akhurst, Jacqueline Elizabeth
- Date: 2000
- Subjects: Peer-group tutoring of students Psychotherapy -- Study and teaching -- Supervision Psychology -- Supervision of
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: vital:2922 , http://hdl.handle.net/10962/d1002431
- Description: Supervision of practice makes an important contribution to the development of psychotherapeutic skills in the training of psychologists (Bernard and Goodyear, 1998). Much research has, until recently, focussed on dyadic, hierarchical models of supervision, even though other forms of supervision have been developed. Peer group supervision has had little attention in the literature, although it is a common form of supervision utilised by psychologists in practice (Lewis, Greenburg and Hatch, 1988). A review of the literature considers the purposes of supervision; elements of dyadic supervision; various forms of group, peer and peer group supervision; and the leaming process in supervision. The development and implementation of a peer supervision group (pSG) of intern psychologists within the training setting of a University is described in this study. The PSG model was developed from the model proposed by Wilbur, Roberts-Wilbur, Morris, Betz and Hart (1991). Transcripts from nine audio-taped PSG sessions were analysed, and a comparison with four audio-taped dyadic supervision sessions was then undertaken. Grounded Theory methodology was employed in the design of the study and analysis of the data. The form and content of the two models of supervision were examined, with particular attention to the perspective of the trainees' learning experiences. The relative merits of both forms of supervision were assessed, and this analysis clearly demonstrates that peer group supervision has the potential to complement dyadic supervision by contributing differing learning experiences. A model of key influences upon, and effects of, participation in the two forms of supervision has been developed. Suggestions are made of ways in which dyadic supervision may be optimised, and recommendations for further development of the PSG emerge. The results were then considered from a neo-Vygotskian perspective. This enabled the findings to be linked to a comprehensive theory of learning, pointing to the key role of speech in thinking, and the contributions of the various forms of dialogue to deepened understandings. The discussion includes: consideration of techniques which enable trainees to obtain assistance from both more experienced practitioners as well as from their peers; an exploration of aspects of subjectivity and intersubjectivity; and contextual influences which have bearing on the study. This study identifies the need for further consideration of the supervision process in South Africa, and makes recommendations for the training of supervisors. The neo-Vygotskian model offers great promise both as a framework for understanding the leaming process in. supervision, and for developing guidelines for enhancing supervisory practice.
- Full Text:
The phenomenology of the anorexic body
- Authors: Shapiro, Joel
- Date: 2000
- Subjects: Anorexia nervosa Eating disorders Anorexia nervosa -- Psychological aspects
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: vital:3053 , http://hdl.handle.net/10962/d1002562
- Description: The purpose of the study is to articulate the phenomenology of the anorexic body. In order to describe the complex meaning of the anorexic body, the present research adopts the qualitative and exploratory approach of Seidman's (1991) in-depth phenomenologically based interviewing method. This involves a series of three separate interviews, with three research participants who have had personal experience of anorexia. The method of data analysis used is essentially on editing style of analysis (Miller and Crabtree, 1992) and is based on a hybrid of the grounded theory approach of Glaser and Strauss (1967) and Heidegger's (1927) ontological hermeneutics to form what Addison (1992) calls grounded interpretive research. Anorexic embodiment is conceptualised as precipitating a fundamental disturbance between the interactions of embodied consciousness and the world. The body is no longer taken-for-granted, and becomes an object for scrutiny. As an object, the body is experienced as a thing exterior to the self, and this awareness contributes to the sense of qisorder which permeates anorexic embodiment. Bodily intentionality is frustrated when the sphere of bodily actions and habitual acts become circumscribed. The character of lived temporality and lived spatiality are also effected with the anorexic's focus on the now, ushering in a spatiality of the here. These findings indicate that anorexic embodiment is experienced primarily as a disruption of the 'lived body' rather than that of the biological body. The prevailing discourses of anorexic embodiment are shown to be split between the naturalized discourses that provide a model of the body that is biologically determined and ahistorical, and the denaturalized discourses that provide a model of the body that is culturally constructed and lacks embodied givenness. It is argued that Merleau-Ponty's phenomenology of the body offers a renaturalization of the body that overcomes the nature/culture dichotomy of the naturalized and denaturalized discourses, thereby providing a solid foundation that more directly addresses the phenomenology of the anorexic body. The theoretical and treatment implications of Merleau-Ponty's renaturalization of the anorexic body are highlighted, and suggestions for further research are presented.
- Full Text:
- Authors: Shapiro, Joel
- Date: 2000
- Subjects: Anorexia nervosa Eating disorders Anorexia nervosa -- Psychological aspects
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: vital:3053 , http://hdl.handle.net/10962/d1002562
- Description: The purpose of the study is to articulate the phenomenology of the anorexic body. In order to describe the complex meaning of the anorexic body, the present research adopts the qualitative and exploratory approach of Seidman's (1991) in-depth phenomenologically based interviewing method. This involves a series of three separate interviews, with three research participants who have had personal experience of anorexia. The method of data analysis used is essentially on editing style of analysis (Miller and Crabtree, 1992) and is based on a hybrid of the grounded theory approach of Glaser and Strauss (1967) and Heidegger's (1927) ontological hermeneutics to form what Addison (1992) calls grounded interpretive research. Anorexic embodiment is conceptualised as precipitating a fundamental disturbance between the interactions of embodied consciousness and the world. The body is no longer taken-for-granted, and becomes an object for scrutiny. As an object, the body is experienced as a thing exterior to the self, and this awareness contributes to the sense of qisorder which permeates anorexic embodiment. Bodily intentionality is frustrated when the sphere of bodily actions and habitual acts become circumscribed. The character of lived temporality and lived spatiality are also effected with the anorexic's focus on the now, ushering in a spatiality of the here. These findings indicate that anorexic embodiment is experienced primarily as a disruption of the 'lived body' rather than that of the biological body. The prevailing discourses of anorexic embodiment are shown to be split between the naturalized discourses that provide a model of the body that is biologically determined and ahistorical, and the denaturalized discourses that provide a model of the body that is culturally constructed and lacks embodied givenness. It is argued that Merleau-Ponty's phenomenology of the body offers a renaturalization of the body that overcomes the nature/culture dichotomy of the naturalized and denaturalized discourses, thereby providing a solid foundation that more directly addresses the phenomenology of the anorexic body. The theoretical and treatment implications of Merleau-Ponty's renaturalization of the anorexic body are highlighted, and suggestions for further research are presented.
- Full Text:
Understanding the image in art therapy: a phenomenological-hermeneutic investigation
- Authors: Douglas, Blanche Daw
- Date: 1999
- Subjects: Art therapy Art -- Psychological aspects
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: vital:2966 , http://hdl.handle.net/10962/d1002475
- Description: Part One of the research seeks to establish a context wherein certain assumptions pertaining to the interpretative dimensions of understanding the image in art therapy can be considered and reviewed. Notions about the image, meaning and reality are discussed both in terms of how they relate to current art therapy practice, and how they may be alternatively thought about, both from the perspective of ancient Hellenic Greek thought, and more contemporary thought, particularly that of phenomenological and philosophical-hermeneutics. Part Two of the research investigates the phenomenon of understanding the image in an art therapy situation, with a view to reconsidering certain of the assumptions raised in the first part of the thesis (phrased in the form of research questions). It did this utilizing a qualitative method, by exposing four respondents (patients), and two therapists to an art therapy situation in which images were created out of clay. The respondents (patients) and therapists articulated their understanding of the image production procedure, and the meaning of the images created. The way understanding occurred in the empirical part of the research was explained and illustrated by means of the hermeneutic circle, which was operational on a number of different levels. The results of the research suggest that the meaning of the image in art therapy is a creative synthesis, which emerges from within a dialectics of exchange. This exchange involves a number of meaning-generating contexts, of which the patient’s experience, and the therapist’s knowledge, form only a part. The outcome of this exchange is the derived meaning of the image, which represents a ‘fictional’ world that gives the patient and therapist a way of understanding the patient’s situation. The process of the research, which investigates the way understanding of the image in art therapy occurs, is at the same time, an application of the principles of understanding
- Full Text:
- Authors: Douglas, Blanche Daw
- Date: 1999
- Subjects: Art therapy Art -- Psychological aspects
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: vital:2966 , http://hdl.handle.net/10962/d1002475
- Description: Part One of the research seeks to establish a context wherein certain assumptions pertaining to the interpretative dimensions of understanding the image in art therapy can be considered and reviewed. Notions about the image, meaning and reality are discussed both in terms of how they relate to current art therapy practice, and how they may be alternatively thought about, both from the perspective of ancient Hellenic Greek thought, and more contemporary thought, particularly that of phenomenological and philosophical-hermeneutics. Part Two of the research investigates the phenomenon of understanding the image in an art therapy situation, with a view to reconsidering certain of the assumptions raised in the first part of the thesis (phrased in the form of research questions). It did this utilizing a qualitative method, by exposing four respondents (patients), and two therapists to an art therapy situation in which images were created out of clay. The respondents (patients) and therapists articulated their understanding of the image production procedure, and the meaning of the images created. The way understanding occurred in the empirical part of the research was explained and illustrated by means of the hermeneutic circle, which was operational on a number of different levels. The results of the research suggest that the meaning of the image in art therapy is a creative synthesis, which emerges from within a dialectics of exchange. This exchange involves a number of meaning-generating contexts, of which the patient’s experience, and the therapist’s knowledge, form only a part. The outcome of this exchange is the derived meaning of the image, which represents a ‘fictional’ world that gives the patient and therapist a way of understanding the patient’s situation. The process of the research, which investigates the way understanding of the image in art therapy occurs, is at the same time, an application of the principles of understanding
- Full Text:
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