Filling the language gap: the feasibility of communication resources used in the provision of healthcare for HIV/AIDS and tuberculosis in the Eastern Cape, South Africa
- Authors: Von Witt, Nathalia Jane
- Date: 2025-04-02
- Subjects: Communication in community health services South Africa Eastern Cape , Language and languages South Africa Eastern Cape , Multilingualism , Medical care South Africa , Communication in public health , Health literacy
- Language: English
- Type: Academic theses , Doctoral theses , text
- Identifier: http://hdl.handle.net/10962/478504 , vital:78192 , DOI 10.21504/10962/478504
- Description: South Africa has the largest number of Human Immunodeficiency Virus (HIV)-positive people in the world, the third-highest rate of Tuberculosis (TB) infections, and the second-highest rate of Multi-Drug Resistant TB (MDR-TB) globally, with up to 60% of HIV-positive healthcare users (HCUs) infected with TB as a co-infection. Both HIV/AIDS and TB require strict medicines adherence for disease management or treatment respectively; however, this is often not attained, and as such these statistics also represent lives affected by or lives lost to these diseases. Moreover, in South Africa, up to 80% of healthcare consultations are conducted through a second language. Despite language policies suggesting the contrary, African languages are neglected in healthcare provision in South Africa. This perpetuates inequalities within the South African healthcare system by limiting HCUs understanding of and agency in their own healthcare and maintaining a barrier to more effective treatment. Such language barriers may also result in HCUs defaulting on treatment. Added to this, the fear and mistrust arising from language power dynamics contributes to high rates of avoidance behaviour. This research therefore aimed to (a) explore how healthcare professionals (HCPs) and HCUs communicate when they are not fluent in the same language in care for HIV/AIDS and TB patients; (b) develop practical and feasible strategies that would enable HCPs to address language barriers in their consultations for HIV and TB and (c) to empirically evaluate these strategies in a pilot feasibility trial in the Eastern Cape. The first aim (a) concerning the problem of language barriers in healthcare consultations was addressed through identifying communication barriers experienced by HCPs in South Africa, exploring the strategies used to navigate or alleviate these barriers, creating and implementing communication resources, and analysing the effects of these resources on HCPs’ communication. A selective narrative review was conducted (Chapter 2) to identify the main communication problems experienced by HCPs and HCUs, as well as the main communication strategies and resources used by HCPs to reduce these communication problems. This was further explored by conducting two needs analyses with HCPs (n=31) in South Africa, and specifically in the Eastern Cape, which revealed differing perspectives on health communication and confirmed HCPs’ need for communication resources. For the second aim (b), existing communication resources were reviewed and selected or further developed following a Participatory Action Research approach, and then (c) empirically evaluated in a pilot feasibility trial with six healthcare sites in the Eastern Cape. Both the needs analyses and the pilot feasibility trial were adapted to employ an online or blended approach due to COVID-19-related limitations. The feasibility and acceptability of both the study protocol and the proposed communication resources were evaluated. Three major findings emerged from this research. First, this research echoed existing literature confirming that HCPs do not have the support they need at a structural level. Second, while it was found that there is no one-size-fits-all solution for resources and training to improve HCP-HCU communication, it was noted that the most appropriate resources are those that are flexible, and those that support HCPs’ language learning. HCPs who were already sensitive to communication barriers and were already taking steps to improve their second language (L2) proficiency also took initiative to use the resources in ways other than those suggested in order to best support the communication needs of them and the HCUs they consulted. Third, and linked to the second finding, it was found that communication resources that covered conditions including, but not limited to, HIV and TB were more appropriate. HCPs who used the resources showed a small, although not statistically significant, increase in communication satisfaction, satisfaction with resource support, and trust after using the resources for one month. Although implementation problems were encountered in some settings of the intervention, it was found that this intervention has the potential to be further evaluated in a larger, multi-site randomised controlled trial (RCT). These findings inform recommendations which are made to improve the feasibility of such a study in order to conduct an RCT; to further develop the resources in order to enhance communication between HCPs and HCUs both in HIV and TB consultations and in other fields of healthcare; and to implement a similar intervention at the university level and as Continuing Medical Education. The insights gained into HCPs’ support for language support resources, which resources were used, and particularly how they were used, are significant for taking actionable steps in supporting HCPs’ provision of more equitable healthcare in multilingual South Africa. , Thesis (PhD) -- Faculty of Humanities, Languages and Literatures, 2025
- Full Text:
- Date Issued: 2025-04-02
- Authors: Von Witt, Nathalia Jane
- Date: 2025-04-02
- Subjects: Communication in community health services South Africa Eastern Cape , Language and languages South Africa Eastern Cape , Multilingualism , Medical care South Africa , Communication in public health , Health literacy
- Language: English
- Type: Academic theses , Doctoral theses , text
- Identifier: http://hdl.handle.net/10962/478504 , vital:78192 , DOI 10.21504/10962/478504
- Description: South Africa has the largest number of Human Immunodeficiency Virus (HIV)-positive people in the world, the third-highest rate of Tuberculosis (TB) infections, and the second-highest rate of Multi-Drug Resistant TB (MDR-TB) globally, with up to 60% of HIV-positive healthcare users (HCUs) infected with TB as a co-infection. Both HIV/AIDS and TB require strict medicines adherence for disease management or treatment respectively; however, this is often not attained, and as such these statistics also represent lives affected by or lives lost to these diseases. Moreover, in South Africa, up to 80% of healthcare consultations are conducted through a second language. Despite language policies suggesting the contrary, African languages are neglected in healthcare provision in South Africa. This perpetuates inequalities within the South African healthcare system by limiting HCUs understanding of and agency in their own healthcare and maintaining a barrier to more effective treatment. Such language barriers may also result in HCUs defaulting on treatment. Added to this, the fear and mistrust arising from language power dynamics contributes to high rates of avoidance behaviour. This research therefore aimed to (a) explore how healthcare professionals (HCPs) and HCUs communicate when they are not fluent in the same language in care for HIV/AIDS and TB patients; (b) develop practical and feasible strategies that would enable HCPs to address language barriers in their consultations for HIV and TB and (c) to empirically evaluate these strategies in a pilot feasibility trial in the Eastern Cape. The first aim (a) concerning the problem of language barriers in healthcare consultations was addressed through identifying communication barriers experienced by HCPs in South Africa, exploring the strategies used to navigate or alleviate these barriers, creating and implementing communication resources, and analysing the effects of these resources on HCPs’ communication. A selective narrative review was conducted (Chapter 2) to identify the main communication problems experienced by HCPs and HCUs, as well as the main communication strategies and resources used by HCPs to reduce these communication problems. This was further explored by conducting two needs analyses with HCPs (n=31) in South Africa, and specifically in the Eastern Cape, which revealed differing perspectives on health communication and confirmed HCPs’ need for communication resources. For the second aim (b), existing communication resources were reviewed and selected or further developed following a Participatory Action Research approach, and then (c) empirically evaluated in a pilot feasibility trial with six healthcare sites in the Eastern Cape. Both the needs analyses and the pilot feasibility trial were adapted to employ an online or blended approach due to COVID-19-related limitations. The feasibility and acceptability of both the study protocol and the proposed communication resources were evaluated. Three major findings emerged from this research. First, this research echoed existing literature confirming that HCPs do not have the support they need at a structural level. Second, while it was found that there is no one-size-fits-all solution for resources and training to improve HCP-HCU communication, it was noted that the most appropriate resources are those that are flexible, and those that support HCPs’ language learning. HCPs who were already sensitive to communication barriers and were already taking steps to improve their second language (L2) proficiency also took initiative to use the resources in ways other than those suggested in order to best support the communication needs of them and the HCUs they consulted. Third, and linked to the second finding, it was found that communication resources that covered conditions including, but not limited to, HIV and TB were more appropriate. HCPs who used the resources showed a small, although not statistically significant, increase in communication satisfaction, satisfaction with resource support, and trust after using the resources for one month. Although implementation problems were encountered in some settings of the intervention, it was found that this intervention has the potential to be further evaluated in a larger, multi-site randomised controlled trial (RCT). These findings inform recommendations which are made to improve the feasibility of such a study in order to conduct an RCT; to further develop the resources in order to enhance communication between HCPs and HCUs both in HIV and TB consultations and in other fields of healthcare; and to implement a similar intervention at the university level and as Continuing Medical Education. The insights gained into HCPs’ support for language support resources, which resources were used, and particularly how they were used, are significant for taking actionable steps in supporting HCPs’ provision of more equitable healthcare in multilingual South Africa. , Thesis (PhD) -- Faculty of Humanities, Languages and Literatures, 2025
- Full Text:
- Date Issued: 2025-04-02
Listening otherwise in the face of gender-based violence in South Africa: a critical exploration of the listening deficiencies in public narratives and a listening-based framework for healing and social change
- Authors: Bombi, Thandi
- Date: 2025-04-02
- Subjects: Gender-based violence , Rhetoric Social aspects , Interviewing in journalism , Facilitation , Social change
- Language: English
- Type: Academic theses , Doctoral theses , text
- Identifier: http://hdl.handle.net/10962/478515 , vital:78193 , DOI 10.21504/10962/478515
- Description: South Africa has one of the highest rates of gender-based violence (GBV) in the world. This includes femicide, rape and intimate partner violence. Scholars and activists in the space of GBV have challenged society to alter the way we have been taught to engage with rape and gender-based violence. Despite many interventions, gender-based violence remains an intractable social problem. This study uses Lipari’s (2014) concept of “listening otherwise” to respond to the challenge. By interrogating how South Africa’s violent history and patriarchal society has been normalised, the study attempts to see beyond the narrow ideas prescribed by the country’s history and violent cultures. This study uses the grounded theory approach (Glaser & Strauss 1967) to investigate the relationship between listening and gender-based violence in South Africa. The concept of “listening otherwise” is explored alongside the concepts “voice”, “speak out” and “break the silence” that are the most visible and codified strategies in the fight against gender-based violence. Following the exploration, the study then develops a theoretical and methodological framework for “listening otherwise” in the spaces, fields, and engagements that deal with gender-based violence in South Africa. The two central questions of the study ask; how do we reshape the collective emotional response to patriarchal structural violence? And furthermore, how do we listen otherwise when faced with experiences of gender-based violence in South Africa? The data used to construct the framework includes in-depth interviews, studies of actual cases, academic literature, news interviews and newspaper articles. There are a multitude of ways in which people are talking about gender-based violence, exposing perpetrators and “breaking the silence”. There is, in fact, no silence around rape, gender-based violence and femicide. The silence exists around engagements about gender, misogyny and patriarchy when discussing the causes of gendered violence in the country. This research found that the public’s listening practices around gender-based violence are shaped by patriarchal cultures and rape myths which are endemic in media discourses, legal discourses and in general social talk. Building a caring society, in which people play and use restorative justice practices, may alter the communal listening practices and have an impact on the public response to gender-based violence. The framework for listening otherwise, that emerged as a result of the research, is a contribution to listening scholarship and the activism against gender-based violence. The framework considered various aspects of listening and the field of gender-based violence and arrived at six conceptual considerations and six actions for listening otherwise. , Thesis (PhD) -- Faculty of Humanities, Journalism and Media Studies, 2025
- Full Text:
- Date Issued: 2025-04-02
- Authors: Bombi, Thandi
- Date: 2025-04-02
- Subjects: Gender-based violence , Rhetoric Social aspects , Interviewing in journalism , Facilitation , Social change
- Language: English
- Type: Academic theses , Doctoral theses , text
- Identifier: http://hdl.handle.net/10962/478515 , vital:78193 , DOI 10.21504/10962/478515
- Description: South Africa has one of the highest rates of gender-based violence (GBV) in the world. This includes femicide, rape and intimate partner violence. Scholars and activists in the space of GBV have challenged society to alter the way we have been taught to engage with rape and gender-based violence. Despite many interventions, gender-based violence remains an intractable social problem. This study uses Lipari’s (2014) concept of “listening otherwise” to respond to the challenge. By interrogating how South Africa’s violent history and patriarchal society has been normalised, the study attempts to see beyond the narrow ideas prescribed by the country’s history and violent cultures. This study uses the grounded theory approach (Glaser & Strauss 1967) to investigate the relationship between listening and gender-based violence in South Africa. The concept of “listening otherwise” is explored alongside the concepts “voice”, “speak out” and “break the silence” that are the most visible and codified strategies in the fight against gender-based violence. Following the exploration, the study then develops a theoretical and methodological framework for “listening otherwise” in the spaces, fields, and engagements that deal with gender-based violence in South Africa. The two central questions of the study ask; how do we reshape the collective emotional response to patriarchal structural violence? And furthermore, how do we listen otherwise when faced with experiences of gender-based violence in South Africa? The data used to construct the framework includes in-depth interviews, studies of actual cases, academic literature, news interviews and newspaper articles. There are a multitude of ways in which people are talking about gender-based violence, exposing perpetrators and “breaking the silence”. There is, in fact, no silence around rape, gender-based violence and femicide. The silence exists around engagements about gender, misogyny and patriarchy when discussing the causes of gendered violence in the country. This research found that the public’s listening practices around gender-based violence are shaped by patriarchal cultures and rape myths which are endemic in media discourses, legal discourses and in general social talk. Building a caring society, in which people play and use restorative justice practices, may alter the communal listening practices and have an impact on the public response to gender-based violence. The framework for listening otherwise, that emerged as a result of the research, is a contribution to listening scholarship and the activism against gender-based violence. The framework considered various aspects of listening and the field of gender-based violence and arrived at six conceptual considerations and six actions for listening otherwise. , Thesis (PhD) -- Faculty of Humanities, Journalism and Media Studies, 2025
- Full Text:
- Date Issued: 2025-04-02
Liposomal formulations of metallophthalocyanines-nanoparticle conjugates for hypoxic photodynamic therapy and photoelectrocatalysis
- Authors: Nwahara, Nnamdi Ugochinyere
- Date: 2023-10-13
- Subjects: Liposomes , Photochemotherapy , Phthalocyanines , Photoelectrochemistry , Cancer Treatment
- Language: English
- Type: Academic theses , Doctoral theses , text
- Identifier: http://hdl.handle.net/10962/432159 , vital:72847 , DOI 10.21504/10962/432159
- Description: This thesis investigates new strategies to enhance the efficacy of photodynamic therapy (PDT) under hypoxic conditions using in-vitro cancer cell models. Phthalocyanines are chosen as viable photosensitizer complexes owing to the favourable absorption properties. To this end, this thesis reports on the synthesis and photophysicochemical properties of various zinc and silicon phthalocyanines (Pcs). To afford better photophysicochemical properties, the reported Pcs were conjugated to different nanoparticles (NPs) through chemisorption as well as amide bond formation to yield Pc-NP conjugates. All the studied Pcs showed relatively high triplet and singlet oxygen quantum yields corresponding to their low fluorescence quantum yields. The various mechanisms for hypoxic response include (i) Type I PDT, (ii) PDT coupled with oxygen-independent therapy and (iii) in-situ oxygen generation using catalase-mimicking nanoparticles which serve to supplement in-vitro oxygen concentrations using MPcs or MPc-NPs conjugates. The mechanisms were assessed using electrochemical, computational techniques and catalase mimicking experiments. The as-synthesised Pcs or Pc-NPs were subjected to liposomal loading before PDT studies which led to enhanced biocompatibility and aqueous dispersity. The in-vitro dark cytotoxicity tests and photodynamic therapy activities of the fabricated Pc-liposomes and Pc-NPs-liposomes on either Henrietta Lacks (HeLa) or Michigan Cancer Foundation-7 (MCF-7) breast cancer cells are presented herein. This work further showed that folic acid (FA) functionalization of liposomes could be exploited for active drug delivery and herein led to an almost 3-fold increase in drug uptake vs non-FA functionalised liposomes in accordance with folate receptor (FR) expression levels between HeLa and MCF-7 cells. The in-vitro dark cytotoxicity and photodynamic therapy of selected Pc complexes and conjugates were accessed using MCF-7 and HeLa cell lines. The various mechanisms; (i) Type I PDT, (ii) PDT coupled with oxygen -independent therapy and (iii) in-situ oxygen generation using catalase-mimicking nanoparticles were shown to adequately compensate for the otherwise attenuation of PDT activity under hypoxia. , Thesis (PhD) -- Faculty of Science, Chemistry, 2023
- Full Text:
- Date Issued: 2023-10-13
- Authors: Nwahara, Nnamdi Ugochinyere
- Date: 2023-10-13
- Subjects: Liposomes , Photochemotherapy , Phthalocyanines , Photoelectrochemistry , Cancer Treatment
- Language: English
- Type: Academic theses , Doctoral theses , text
- Identifier: http://hdl.handle.net/10962/432159 , vital:72847 , DOI 10.21504/10962/432159
- Description: This thesis investigates new strategies to enhance the efficacy of photodynamic therapy (PDT) under hypoxic conditions using in-vitro cancer cell models. Phthalocyanines are chosen as viable photosensitizer complexes owing to the favourable absorption properties. To this end, this thesis reports on the synthesis and photophysicochemical properties of various zinc and silicon phthalocyanines (Pcs). To afford better photophysicochemical properties, the reported Pcs were conjugated to different nanoparticles (NPs) through chemisorption as well as amide bond formation to yield Pc-NP conjugates. All the studied Pcs showed relatively high triplet and singlet oxygen quantum yields corresponding to their low fluorescence quantum yields. The various mechanisms for hypoxic response include (i) Type I PDT, (ii) PDT coupled with oxygen-independent therapy and (iii) in-situ oxygen generation using catalase-mimicking nanoparticles which serve to supplement in-vitro oxygen concentrations using MPcs or MPc-NPs conjugates. The mechanisms were assessed using electrochemical, computational techniques and catalase mimicking experiments. The as-synthesised Pcs or Pc-NPs were subjected to liposomal loading before PDT studies which led to enhanced biocompatibility and aqueous dispersity. The in-vitro dark cytotoxicity tests and photodynamic therapy activities of the fabricated Pc-liposomes and Pc-NPs-liposomes on either Henrietta Lacks (HeLa) or Michigan Cancer Foundation-7 (MCF-7) breast cancer cells are presented herein. This work further showed that folic acid (FA) functionalization of liposomes could be exploited for active drug delivery and herein led to an almost 3-fold increase in drug uptake vs non-FA functionalised liposomes in accordance with folate receptor (FR) expression levels between HeLa and MCF-7 cells. The in-vitro dark cytotoxicity and photodynamic therapy of selected Pc complexes and conjugates were accessed using MCF-7 and HeLa cell lines. The various mechanisms; (i) Type I PDT, (ii) PDT coupled with oxygen -independent therapy and (iii) in-situ oxygen generation using catalase-mimicking nanoparticles were shown to adequately compensate for the otherwise attenuation of PDT activity under hypoxia. , Thesis (PhD) -- Faculty of Science, Chemistry, 2023
- Full Text:
- Date Issued: 2023-10-13
Accountability in the global health regime : a critical examination of the institutional policy and practice of the global fund to fight HIV/AIDS, tuberculosis and malaria partnership programme in Ghana
- Authors: Onokwai, John Chukwuemeka
- Date: 2021-04
- Subjects: World health , Global Fund to Fight AIDS, Tuberculosis, and Malaria -- Administration , Public-private sector cooperation -- Political aspects , Public-private sector cooperation -- Social aspects , Public-private sector cooperation -- Administration , Medical policy -- Ghana , Public health laws, International , Ghana -- Social conditions
- Language: English
- Type: thesis , text , Doctoral , PhD
- Identifier: http://hdl.handle.net/10962/177099 , vital:42790 , 10.21504/10962/177099
- Description: The overarching objective of this thesis is to undertake a critical examination of the institutional accountability policy and practice of the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) in the context of its partnership programme in Ghana. The Global Fund is a global public-private partnership (GPPP) in health engaged in public health policy processes worldwide. As a GPPP, the policy mandate that underpins its global response to fight the aforementioned diseases requires it to enter into partnerships with recipient countries to finance their national health policy responses and strategies to tackle these diseases. Situating accountability within the context of the shift from an international health to a global health regime, the study argues that the emergence of GPPPs in health and the formal policy mandate and decision-making powers they exercise have had knock-on consequences for understanding accountability in the global health regime. This is because while the understanding of accountability for public health policy processes in the international health regime revolved solely around state-based and state-led accountability processes, it is no longer so in current global health regime. Since these GPPPs are not states, they derive their understanding of accountability from the nature and character of their individual policy and practice arrangements. However, despite contestation around the Global Fund’s accountability in global health literature, this literature has little to say on the question of how the Global Fund itself (as a partnership organisation) understands accountability in policy and how this understanding informs its practice in specific settings of global health. Thus, this study contributes to literature on GPPPs’ accountability in global health by specifically exploring how the Global Fund understands accountability in policy and how this understanding informs its accountability in practice, in particular in relationship to its implications for country ownership of health policy in Ghana. Drawing on fieldwork undertaken in Ghana, and guided by a critical political economy approach, this study will demonstrate how: 1) the Global Fund’s institutional policy and practice arrangements undermine accountability to the government and to those affected by their activities; 2) the Global Fund’s practice of country ownership is reflective of conditional ownership despite the fact that the Global Fund claims to promote country ownership as a core principle of its accountability practice in aid recipient countries; and 3) the accountability policy and practice instruments of the Global Fund are not politically neutral, but are rather a function of relations of power. To improve the ability of Ghana (and other recipient countries) to own their developmental policies, a reordering of global economic relations is needed, with a renewed emphasis and focus on economic justice and human rights. Such a reordering will improve the material capabilities (control of and access to global centres of production, finance and technology) of aid recipient countries. This will empower Ghana (and other recipient countries) to play a more dominant, rather than a subsidiary role in how the global health landscape is organised and financed and in policy processes undertaken by global health policy institutions like the Global Fund. In this way, Ghana (and other developing countries) will be able to limit and mitigate the dominance and influence of powerful donors who shape the institutional policy and practice arrangements of global health policy institutions like the Global Fund. , Thesis (PhD) -- Faculty of Humanities, Department of Political and International Studies, 2021
- Full Text:
- Date Issued: 2021-04
- Authors: Onokwai, John Chukwuemeka
- Date: 2021-04
- Subjects: World health , Global Fund to Fight AIDS, Tuberculosis, and Malaria -- Administration , Public-private sector cooperation -- Political aspects , Public-private sector cooperation -- Social aspects , Public-private sector cooperation -- Administration , Medical policy -- Ghana , Public health laws, International , Ghana -- Social conditions
- Language: English
- Type: thesis , text , Doctoral , PhD
- Identifier: http://hdl.handle.net/10962/177099 , vital:42790 , 10.21504/10962/177099
- Description: The overarching objective of this thesis is to undertake a critical examination of the institutional accountability policy and practice of the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) in the context of its partnership programme in Ghana. The Global Fund is a global public-private partnership (GPPP) in health engaged in public health policy processes worldwide. As a GPPP, the policy mandate that underpins its global response to fight the aforementioned diseases requires it to enter into partnerships with recipient countries to finance their national health policy responses and strategies to tackle these diseases. Situating accountability within the context of the shift from an international health to a global health regime, the study argues that the emergence of GPPPs in health and the formal policy mandate and decision-making powers they exercise have had knock-on consequences for understanding accountability in the global health regime. This is because while the understanding of accountability for public health policy processes in the international health regime revolved solely around state-based and state-led accountability processes, it is no longer so in current global health regime. Since these GPPPs are not states, they derive their understanding of accountability from the nature and character of their individual policy and practice arrangements. However, despite contestation around the Global Fund’s accountability in global health literature, this literature has little to say on the question of how the Global Fund itself (as a partnership organisation) understands accountability in policy and how this understanding informs its practice in specific settings of global health. Thus, this study contributes to literature on GPPPs’ accountability in global health by specifically exploring how the Global Fund understands accountability in policy and how this understanding informs its accountability in practice, in particular in relationship to its implications for country ownership of health policy in Ghana. Drawing on fieldwork undertaken in Ghana, and guided by a critical political economy approach, this study will demonstrate how: 1) the Global Fund’s institutional policy and practice arrangements undermine accountability to the government and to those affected by their activities; 2) the Global Fund’s practice of country ownership is reflective of conditional ownership despite the fact that the Global Fund claims to promote country ownership as a core principle of its accountability practice in aid recipient countries; and 3) the accountability policy and practice instruments of the Global Fund are not politically neutral, but are rather a function of relations of power. To improve the ability of Ghana (and other recipient countries) to own their developmental policies, a reordering of global economic relations is needed, with a renewed emphasis and focus on economic justice and human rights. Such a reordering will improve the material capabilities (control of and access to global centres of production, finance and technology) of aid recipient countries. This will empower Ghana (and other recipient countries) to play a more dominant, rather than a subsidiary role in how the global health landscape is organised and financed and in policy processes undertaken by global health policy institutions like the Global Fund. In this way, Ghana (and other developing countries) will be able to limit and mitigate the dominance and influence of powerful donors who shape the institutional policy and practice arrangements of global health policy institutions like the Global Fund. , Thesis (PhD) -- Faculty of Humanities, Department of Political and International Studies, 2021
- Full Text:
- Date Issued: 2021-04
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