Decision-making process in nursing base on scenario. Initial Essay

Decision-making process in nursing base on scenario. Initial presentation of patient and diagnostic fase - Essay Example 2005). When making choices, nurses are obliged to take due care and ensure they discharge their duties in accordance with their professional training and expertise. This experience may have been acquired from work practice or from training (Royal College of Nursing, 2006, p.17). To attain a high degree of joint understanding between the patients, relatives and practitioners, the medical practitioners should establish Ð ° training program to ensure that all the stakeholders are made aware of the prevailing circumstances and the possible consequences of the action taken by the health care practitioners. The healthcare providers must exercise their professional ethics to ensure they act in good faith and in the interests of the patients (Royal College of Nursing, 2006, p.22). The nurses should first assess the problem and then seek for solutions to the emerging issues during the assessment process. The alternative chosen should promise the best outcome and should be as effective as pos sible. The medical practitioner decisions are however influenced by their expertise, the available medical facilities, and the level of acceptance of the consequences of the outcome of the decision taken, as well as willingness of the patient and the relatives to acknowledge those consequences. The nurses have a duty to assess the situation at hand and make decisions concerning the treatment that can be given to the patient. In this case, the patient who is an elderly woman and has a wound on her left limb undergoes many challenges which affect her life in many ways such as inability to move from one place to another (Royal College of Nursing, 2006, p.35). She cannot work for her daily bread since she is unable to move around. She also undergoes a lot of stress because she cannot interact with other people in the society (Jones, 2005). The first thing the nurse has to consider when examining the patient is the family background because this could give them a clue as to what may have caused the wound. Some of the problems are inherited genetically. In case the problem has ever affected one or more of the family members, the medical practitioner can get an avenue for making a conclusion regarding the patient’s condition. Also, patients’ background is likely to point out a situation in the patient’s life which may have contributed to the problem (Lewenson, and Truglio-Londrigan, 2008, p.143). These could include previous surgery wounds which may have resulted in complications for various reasons such as bone fracture during surgery or inflammations sustained during the operation process. The patient has been in this condition for a period of four weeks. Before the practitioners can make a decision regarding the patient’s condition, they should first get information from the patient because this will assist them in making the choice (Royal College of Nursing, 2006, p.26). According to the past records, this patient had similar problem t hree years before its recurrence, and the condition was cured by compression bandaging. The nurses can use this information to interpret the condition which may be affecting the patient. For example the venous ulcers could be treated though compression bandage unlike other types of ulcers such as those caused by depression of diabetes. The health care providers should also carry out physical assessment of the patient. They should examine the skin and the wound

Employee Reward And Resourcing Module_HRM Essay

Employee Reward And Resourcing Module_HRM - Essay Example There are two fundamental reward strategies; pay-related reward policy for the private sector and fixed pay structure for the public sector. These two forms have been critically evaluated. Employee resourcing measures the recruitment, retention and transfer of employees. Its strategic and operational components are Human Resource Planning, Resourcing Plans, Retention Strategy, Flexibility Strategy and Talent Management Strategy. A relation is found between employee reward and resourcing; the higher the reward, the higher the ease of recruitment, retention and transfer of employees. However, the report by CBI cites pay as one of the least related determinants of resourcing. Instead, it identifies the ability of the management staff and communications pertaining to the value of rewards achieved as the main factors influencing resourcing of human capital. As conclusion, some key recommendations are given that would lead to a more efficient working of the public sector and reduce government deficit. Introduction The world believes in the principle of ‘punishment for failures and rewards for achievements’. With the biggest companies going global, a need has been felt to recruit, retain and transfer human resources of the companies, i.e. employees, to various other sites of business in order to expand the scope of business and achieve the maximum corporate dividends. However, research has found that companies are not able to handle this effectively. As a way out of this problem, companies, now, offer higher monetary rewards to their employees as compensation, benefits, bonuses or incentives. But in order to decide standard policies on granting rewards, reward strategies have to be decided. A detailed description on these lines has been provided in the following paragraphs and this subject has been studied, analyzed and criticized in view of the report â€Å"For What it’s Worth?† composed by the CBI. Understanding Organizational Reward Strategy and its Components Mean ing of Reward Strategy â€Å"Reward Strategy is a declaration of intent which defines what the organization wants to do in the longer term to develop and implement reward policies, practices and processes which will further the achievements of its business goals and meet the needs of its stake-holders† (Armstrong, 2009, p.746). It forms a rough framework for reward policies by setting direction and purposes for them. A reward strategy takes into account the needs of the employees and the organization. It develops the values of an organization and sets the basis on which people are to be valued and thus, rewarded. Components of a Reward Strategy There are various components of Reward Strategy and which are interrelated. The important ones have been stated as follows. Non-Financial Rewards: Rewards are not always monetary. Sometimes, they may satisfy a person’s need for influence and reputation. Non-financial rewards may be in the form of recognition, responsibility, ach ievement or growth. For example, an employee may be receiving promotion or awards for attaining a high standard in his field of work. Job-Evaluation: It is a process which involves the identification of particular jobs and the corresponding employees in those jobs and a standard scheme of evaluation is developed and finally, a pay structure is decided upon. (Armstrong and Baron, 2002, p.30) Base Pay: It is the fixed income of the

Creating a conducive classroom Enviroment

Creating a conducive classroom Enviroment When I think of a conducive classroom, the first thing that comes to mind is the climate and atmosphere of the room. Is the room inviting? Is the environment set up in such a way that everyone has access to everything in the room? Does the teacher come off as a warm, caring person? In a conducive classroom, it is the teachers role to create such an environment that children can and will succeed regardless of their educational background, their cultural background or even the language they speak. A teacher needs to establish an effective climate where she still maintains authority and organization, where there is mutual respect and good rapport between each other. As an educator of ELL students, the classroom needs to be a place that will influence the childs achievement and help boost their self-esteem, and have planned organized activities at their levels which can produce success. The ELL student can present many problems for a teacher in the classroom if the teacher is not prepare d to teach this type of population. ELL students often come to school with many disadvantages such as learning a new language, learning new content, cultural differences, socioeconomical issues and the list could go on. In his book, The Natural Approach: Language Acquisition in the Classroom, Stephen Krashen often speaks of the different levels for Language- Acquisition-sometimes referred to as The Natural Approach and how it is a natural process for students to learn the language. In fact, some say it is so natural that it requires very little education and planning on the teachers part, for an ELL student to learn a new language. I took this to mean, if you just put them amongst their peers the learning and language-acquisition will happen. But, as an educator for many years, I can honestly say, I have worked very hard to establish the best policies and practices for a successful conducive classroom. But even after many years of working with the ELL population, I can honestly say I can improve on different strategies that would not only make me a better teacher, but would also benefit my ELL students as well. Problems or issues in the classroom: Building Trust If I had to make any improvements working towards a conducive classroom for my ELL students, I would have to say I could work on establishing more trust from my students, and working on my routines in the classroom. Even though I try to establish a sense of trust with every student, sometimes you will not gain every ones trust in the room but a teacher must continue to try. That is why before the school year even begins, I try to get to know my students during the Meet the Teacher Day offered at our school the week prior to the first day of school. It is during this time I start to build trust. This gives us a chance to get to know one another and during this time, I start to get a feel for my students, their parents, and the family situation. From the minute I shake their hand at meet and greet, I try to make them feel as if we have been together an entire school year already. To help gain trust, I begin by letting them explore their classroom, choose what seat they would like, and I ask them a few questions about their likes and dislikes. I want my students to feel as though I care about them as a teacher and a friend. Even though I try to establish a student/teacher trust, a problem I have found over the years is that not all students feel they can trust a teacher or other adults because of their cultural upbringings. Even though I tell them they can come to me for anything, many are hesitate because they do not want to get a family member in trouble, and believe me, I can see how this affects their school work. So, my solution to the problem is to share personal stories that I think the students can relate to and then ask if anyone has had something similar happen to them. Sometimes it works and they trust in me, other times, they simply keep things inside. Another way I try to establish trust is by showing the student that I care and value their language and culture. I start doing this by pairing up a limited English speaking student with an English proficient student that will help them throughout the day or however long they need each other. Research has shown that when students can continue to learn in their own language the non proficient student will actually learn English faster (Cummins, 1991). That is why, as I am teaching my lessons, I will allow my students to speak to each other in their native tongue which helps the non proficient student understand what is being taught and what is expected of them. There is nothing worse than having new students get lost at the beginning of a school year, and then you will have lost them forever. Even though I try to establish trust in this manner, there are still times I may forget about the non proficient student and when I hear talking during a lesson, I sometimes get upset only to real ize they are translating for me. I feel that every teacher needs to get to know their students on a personal basis; they need to build trust and respect for each other. Teachers need to look beyond the students proficiency levels, their cultural backgrounds, their social-economical status, and remember they are people and we need to embrace our differences and teach them as we would any child. By building a relationship of mutual trust, a teacher can help relieve the anxiety many ELL students feel and therefore provide a conducive classroom that is beneficial to all. Research on Building Trust Maslow, (Maslow, 1968) discusses the basic strategies for safety and security for a new student. One of the very first things he says is that every new student should be assigned a personal buddy, preferably one who speaks the same language. This person would help the new student throughout the day to make sure he/she knows the routines and how to navigate around the school. Additional solutions include that of established routines. Research states if a classroom has routines in place, this can help to lower the ELL students anxiety and it helps them become a part of the classroom (Krashen Terrell 1983). Problems or issues in the classroom: Daily Routines Another issue I may face is trying to set-up the perfect routine. To me, there is nothing more conducive in a classroom that has structure that will promote student success. Structure and routines in a classroom can make all the difference in a successful or a non successful room. In the beginning of the year, I have simple routines that everyone, regardless if they speak English or not, can follow. The routines are so basic and they establish what is expected of each and every student. By having such a routine in place, any new student, ELL or otherwise, can come into the room and know what is expected of them after just 1 or 2 days. A well planned routine helps ease the expectations of many new comers. It does not require them to know English to begin fitting into the classroom. My routines also include how groups are made and organized. I have small groups for every subject area and the students know where they are assigned. Even though I like to think I have the perfect routine established, and my students know how to move from one routine to another, that is not always the case, because at a Title 1 school, I have found that routines are made to be broken, which is something I have to learn to deal with. At a Title 1 school on any given day, I receive numerous intercom interruptions from the office or other teachers asking for so and so to be sent to the Counselors office, or nurses office, or reading/writing lab, or my favorite, they are going home, could you make sure they have their homework. Call me old-school, but, I really like a structured classroom, so whenever I am interrupted it throws everything off. I found that I have to monitor and adjust my schedule on a daily basis, so you can imagine how my students feel when I say, OK we need to change this or that, it takes them a lot longer to adjust. So, I guess one problem I have when establishing a conducive classroom is how to deal with change on a daily basis and how to make the transitions easier for my students as not to disrupt the learning going on. Professional Research on Routines Establishing routines in the classroom is one of the easiest strategies to help ELL students lessen their stress and enjoy their days in schools. In their book, 50 Strategies for Teaching English Language Learners, (Herrell Jordan 2008), go so far as to walking a teacher through the process step by step on how to set up a classroom. Other research also mentions that ELL students need cooperative groupings to interact orally with their peers (ESL learners: a guide for classroom teachers). The guide goes on to say that structured learning groups have many positive outcomes in academic achievement, increase in communication skills, race relations, and social development. I am a firm believer in cooperative learning groups. There have been many times I have seen students teach other and explain things to each other, in only ways they understand. Where I am in producing a conducive learning environment As a veteran teacher of 15 plus years, I believe I already have a classroom that is conducive to the ELL student. To me, it takes many years to establish such a room where the ELL student can produce and become successful. I have implemented many strategies to help ensure the success of each and every one of my students. My classroom is arranged in such a way that students have access to everything they need from bilingual dictionaries, technology, manipulatives, realia, learning centers, and small groupings. I also differentiate instruction, have established routines and structure, I embrace and learn all about my students cultures, I create an environment that makes a child feel comfortable and one that helps to relieve all anxieties a child may feel when entering a strange new place. I instill a love of learning through motivation, hands-on activities, and positive feedback. I understand as an educator that every student has different needs, and the ELL population may have even mo re than your typical American student, but I do whatever I have to, to make sure they have everything they need and to make sure they are in a conducive environment that is task-oriented, engaging, and supportive so that they can and will be successful. References Cummins, J. (1991) Language Development and Academic Learning Cummins, J in Malave, L. and Duquette, G. Language, Culture and Cognition Clevedon: Multilingual Matters Herrell, A. L., Jordan, M. (2008). 50 strategies for teaching English Language Learners, 3rd ed. Upper Saddle River, NJ: Pearson Education, Inc. Krashen, S.D. Terrell, T.D. (1983). The natural approach: Language acquisition in the classroom. Oxford: Pergamon Press Maslow, A. H. (1968). Toward a psychology of being. New York: VanNostrand.

Juvenile Justice :: essays research papers fc

The problem of dealing with juvenile justice has plagued are country for years, since the establishment of the first juvenile court in 1899. Prior to that development, delinquent juveniles had to be processed through the adult justic3e system which gave much harsher penalties. By 1945, separate juvenile courts existed in every single state. Similar to the adult system, all through most of the 20th century, the juvenile justice system was based upon a medical/rehabilitative representation. The new challenges of the juvenile court were to examine, analyze, and recommend treatment for offenders, not to deliver judgment fault or fix responsibility. The court ran under the policy of â€Å"parens patriae† that intended that the state would step in and act as a parent on behalf of a disobedient juvenile. Actions were informal and a juvenile court judge had a vast sum of discretion in the nature of juvenile cases, much like the discretion afforded judges in adult unlawful settings un til the 1970s. In line with the early juvenile court’s attitude of shielding youth, juvenile offenders’ position was often in reformatories or instruction schools that were intended, in speculation, to keep them away from the terrible influences of society and to encourage self-control through accurate structure and very unsympathetic discipline. Opposing to the fundamental theory, all through the first part of the century, the places that housed juveniles were frequently unsafe and unhealthy places where the state warehoused delinquent, deserted, and deserted children for unclear periods. Ordinary tribulations included lack of medical care, therapy programs, and even sometimes food. Some very poor circumstances continue even today. Although putting juveniles into institutions, for many juvenile offenders occurred in the first decades of the 1900s, extensive use of probation for juveniles existed as well. As it does today, probation gave a middle ground nature for judges connecting release and placement in an institution. By 1927, trial programs for juvenile offenders existed in approximately every state. In the 1940s and 1950s, reformers attempted to improve the conditions found in most juvenile institutions. Alternatives to institutions emerged, such as forestry and probation camps. These camps provided a prearranged setting for male juvenile offenders, while emphasizing learning and occupational skills. Though, the efficiency of these options as alternatives to incarceration was dubious since they were not obtainable to the worst offenders. Yet, these changes marked the start of formal, community-based instruction that would turn out to be more extensive in following decades.

National Health Insurance Ghana Health And Social Care Essay

Health in Ghana includes the bar, attention and intervention of diseases and other maladies. As parts of the Ghanese economic system are non to the full industrialised, issues arise that are common to turning healthcare systems, such as waterborne diseases and sanitation jobs. Diseases in Ghana are reasonably similar to those endemic in other Sub-saharan states, with diseases as malaria and HIV/AIDS holding important impact on the population. Like many other states in Africa, Ghana spent much of the 1980s and 1990s paying off debt and ordaining asceticism steps designed to shore up its economic system. The state ‘s wellness sector perceptibly suffered under the economic cutbacks, ensuing in staff deficits and hapless care of wellness installations ( Oppong, 2001: 357-70 ) . In order to control the impairment of wellness services and to hike the quality of wellness attention bringing, Ghana finally implemented a pay-per-service wellness attention theoretical account. This normally referred to as the â€Å" cash-and-carry † system. However, the pay-per-service theoretical account unwittingly ended up know aparting against Ghana ‘s most vulnerable communities, rendering wellness services unaffordable to them. Not surprisingly, a significant diminution in the figure of people accessing wellness attention services in infirmaries became apparent shortly after, with estimations proposing at least a 25 per centum bead in use. The greatest diminutions were recorded among the hapless, aged, adult females, and rural occupants ( Anyiman 1989: 531-47 ; Hutchful 2002: 129-40 ; Konadu-Agyemang, 2000: 475-81 ; Waddington and Enimayew, 1990: 287-312 ) . Ghana ‘s National Health Insurance Scheme ( NHIS ) has been described as ‘pro-poor ‘ because it is scaled to income, leting entree to affordable wellness attention for low-income Ghanaians. There is ongoing argument over the existent rate of registration in the NHIS ; official figures put it at over 60 per centum of Ghana ‘s population, while other surveies cite Numberss that range every bit low as 18 to 34 per centum. Despite efforts to portray the NHIS as pro-poor, there is grounds to suggest that Ghana is fighting to inscribe hapless sections of the population, with the rich at least twice every bit likely to inscribe compared to the hapless. NO. 8 July 2011 The failure of the cash-and-carry system to provide for the wellness attention demands of the state ‘s most vulnerable populations placed wellness attention services and bringing betterments on top of the state ‘s development docket. In 2003, the National Health Insurance Act was approved by parliament, followed by the launch of the National Health Insurance Scheme ( NHIS ) in 2004. The NHIS was designed to offer low-cost wellness attention to the state ‘s hapless, with grownups lending a minimum one-year payment in comparing with the value of their possible wellness attention use. The creative activity of the NHIS has been widely extolled as a imperfect and â€Å" pro-poor † policy. Since its debut in 2004, entree to wellness attention in Ghana has improved significantly, but there are many defects under the plan. This proposal seeks to research the impact of the NHIS in Ghana, stressing both the wellness features and results of adult females who are enrolled with those outside the strategy. It besides seeks to analyze the differences in wellness and use between these two groups of adult females and understand why some adult females join while others do non.Research OBJECTIVESThe chief aim of this survey is to carry on a comprehensive appraisal of the national wellness insurance strategy through the lens of adult females. The survey will further seek to ; Understand how the NHIS work in Ghana. Understand the impact of the NHIS on wellness features. Understand the impact of the strategy ‘s registration on the hapless and pro-poor. Ascertain how the strategy is lending to the wellness demands of adult females in Ghana.RESEARCH QUESTIONSThe chief research inquiry of the survey is to look into how the NHIS is impacting on the wellness of adult females in Ghana. The survey besides aims to look into the followers ; Why are some adult females seeking wellness attention outside the strategy? Why is the registration of the rich to the strategy increasing every bit compared to the hapless or pro-poor? What are the differences in wellness features between adult females who join the strategy and those who do non?RESEARCH TARGETS, MAIN CONCERNS AND CONTENTThis research will aim adult females between the ages of 15 to 49 old ages and their kids. The research will be conducted in two parts of Ghana, that is the Brong Ahafo part and the Upper East part. The Brong Ahafo part was chosen because it has the longest period runing the wellness insurance strategy ; it besides has a good mix of rural and urban colonies which is representative of Ghana. It besides has an first-class mix of formal and informal activities. Last it is the largest part in Ghana and lies in the geographic centre of the state. The Upper East part was chosen for assorted grounds ; one being that it is the most sparsely populated and poorest part in Ghana and rather representative of the northern half of the state. It was besides chosen because of immensely savanna flora and predominately rural hapless, supplying contrast to the Brong Ahafo part and the southern half of the state.NARATIVE DESCRIPTION OF THE POLICYHealth insurance is an agreement that provides the chance to contribute to a fund that can be drawn from when in demand of medical attention. Under Ghana ‘s NHIS, unanticipated wellness attention costs are transferred into fixed premiums, replacing lump-sum out-of-pocket wellness attention payments with a more low-cost and frequent outgo in the signifier of premium payments. In other words, wellness insurance participants portion the fiscal load of wellness attention costs by pooling together their fiscal resources ( Atim, 1999: 881-96 ; Edoh and Brenya, 2002: 41 ; Ekman, 2004: 249-50 ) . In add-on to the premium payments made by enrolled grownups, the NHIS besides draws support from the federal authorities and a 2.5 per centum value added revenue enhancement, applied to all goods and services. The â€Å" pro-poor † perceptual experience of the NHIS is based on three distinct features of the plan. First, the broad benefits bundle creates a degree playing field by easing wellness attention entree for everyone regardless of their fiscal position. Second, the premium sum is measured by incomes, non demand, and are based on the member ‘s ability to pay. On these skiding graduated tables, those who earn more, pay more and those who earn less, wage less, with exact premium payments changing across the state based on the rates set at the territory degree. Harmonizing to the National Health Insurance Authority, the one-year premiums range between Ghanaian Cedis 7.20 to 48.00 ( or about US $ 4.59 to US $ 30.61 ) . Those who work for the authorities are automatically covered by the NHIS through their societal security payments, though they must officially register themselves within their territory. Third, from its oncoming, the NHIS has allowed free wellness coverage for all those considered to be destitute and unable to pay. Under the National Health Insurance Act, an ‘indigent ‘ is considered to be any individual who meets the undermentioned standards: a ) is unemployed and has no seeable beginning of income ; B ) does non hold a fixed topographic point of abode harmonizing to criterions determined by the strategy ; degree Celsiuss ) does non populate with a individual who is employed and who has a fixed topographic point of abode ; and or vitamin D ) does non hold any identifiable consistent support from another individual. The destitute freedom position is intended to protect those missing the fiscal and societal support necessary to get rank in the strategy. However, there have been many unfavorable judgments of the indigent and other freedom positions. Since the execution of the NHIS over seven old ages ago, the state ‘s wellness attention system has increasingly improved. In its original format, the NHIS includes payment freedoms for indigents, those over 70 old ages of age, and members of the formal economic system. Over the old ages, important add-ons have been made to the freedom lists, including coverage of all pregnant adult females since 2008, in acknowledgment of the importance of neonatal attention. Most late, kids under 18 old ages of age whose parents are presently enrolled in the NHIS became eligible for free wellness coverage. In an attempt to farther better young person wellness coverage, Ghana ‘s authorities has promised since 2009 to spread out this to all individuals under the age of 18, and non merely those with parents who are enrolled. This has non yet been rolled out. Reports show that NHIS coverage has been an of import tool in increased use of wellness installations ( Ministry of Health Ghana, 2010: 35 ; Witter and Garshong, 2009: 6 ) . In-patient use increased from 28,906 in 2005 to 846,311 in 2009 ( National Health Insurance Authority, 2010: 31 ) . The figure of out-patient visits increased to 18.7 million in 2010 ( from 2.4 million in 2006 ) and the Ministry of Health studies that the huge bulk of these patients were covered by the NHIS ( Ministry of Health Ghana, 2011: 39 ) While initial figures are assuring, the existent figure of Ghanaians enrolled in the NHIS remains a topic of argument and contention. The National Health Insurance Authority put the state ‘s registration at over 60 per centum in 2009, out-performing marks set for the twelvemonth 2015. But independent surveies and studies have questioned these official figures. For case, a survey in 2011 indicates that the registration rate sits closer to between 18 and 34 per centum if factors such as population additions and non-renewal of ranks are accounted for ( Apoya and Marriott, 2011 ; 58-61 ) . Similarly, informations from the 2008 Ghana Demographic and Health Survey found registration to be between 30 and 40 per centum ( see Dixon, Tenkorang and Luginaah, under reappraisal ) . Even more concerning is the fact that the figure of flush persons take parting in the NHIS is far greater than the figure of hapless Ghanaians enrolled in the strategy. Despite efforts to portray the NHIS as pro-poor, persons with low incomes covered under the strategy are outnumbered by flush 1s and a important part of hapless people still do non hold wellness coverage. Furthermore surveies show that ( though figures vary by part ) the rich are frequently twice every bit likely to inscribe in the strategy as compared to the hapless ( Asante and Aikins, 2008: 3 ; Jehu-Appiah, Aryeetey, Spaan, de Hoop, Agyepong and Baltussen, 2011: 157-63 ; Dixon, Tenkorang and Luginaah, under reappraisal ; Health Systems 20/20, 2009: 12 ; Sarpong et Al, 2010: 195 ; Witter and Garshong, 2009: 6 ) . There is a long list of grounds that hinder the engagement of hapless people in the strategy. First, paying wellness insurance fees on an on-going footing is frequently excessively expensive for hapless people, despite the long-run benefits of inscribing in the strategy. As persons begin to pay into the strategy, the immediate impact of wellness insurance fees can interpret into a lessening in financess for nutrient, communicating, or transit outgos ( Koch and Alaba, 2010: 180-1 ) . With the inexplicit trade-off between basic necessities and wellness insurance, NHIS premiums may be deemed to be an impractical disbursal by persons with low incomes. Although the strategy has made room for freedom positions, there have been jobs in their existent executing. For case, merely one per centum of those populating under Ghana ‘s poorness line were registered for the NHIS in 2008 ( Witter and Garshong, 2009: 5 ) , which seems to propose the uneffective execution of the indigent position freedom. It has been argued that the standard for the destitute freedom are excessively rigorous and should take into history specific local concepts of poorness in order to make those truly in demand of freedoms ( Aikins and Dzikunu, 2006: 12 ) . A treatment on the defects of Ghana ‘s wellness attention system can non be concluded without reference of the impact of mishandled bureaucratism, fraud and escapes. For case, the enrollment system is inefficient and impractical-names and individualities frequently get lost in the system ensuing in people stoping up either without coverage or being forced to pay unneeded fees ( Health Systems 20/20, 2009: 17 ; Apoya and Marriott, 2011: 30-1 ) . Deceitful claims are besides a major concern. In 2010, the National Health Insurance Authority ‘s ain audits found that 13 per centum of claims were undue. Furthermore, perceivers posit that because of the prevalence of improper showing methods, a proper audit is likely to happen that 20 per centum of claims are without virtue.RESEARCH METHODOLOGYFor this survey, single questionnaires will be distributed to a entire sample size of 300 adult females ; 150 from the Brong Ahafo part and 150 from the Upper East part. Institutional questionnaires will besides be distributed to the territory strategy directors from the two parts. Questions which would be asked in the single questionnaire include ; the socio-economic demographic features, NHIS registration or non registration, general wellness attention entree and use, morbidity, mortality and wellness position, maternal and child wellness attention and bar etc. Questionnaires will besides be distributed to forces who run the strategy in the two parts. Questions which would be asked in the institutional questionnaire will include ; the foundation of the strategy, administration and organisational construction, rank and premium benefits, direction and capacity edifice. The statistical tool employed for the rating will be the Propensity Score Matching ( Rosenbaun and Rubin 1983 ) . The grounds for following this tool are as follows ; There is a practical impossibleness of a randomised experiment. The ability to compare the wellness results of treated and untreated groups that are matched by relevant discernible features.RESEARCH ORGANIZATIONPROPENSITY SCORE ModelingTreatment Variable: NHIS rank. Control Variables: Age Education Marital position Religion Distance to wellness attention Ownership of telecasting Ownership of wireless set. Result Variables: Maternal/child wellness results Birth attended Hospital births Prenatal attention Birth complications Infant mortality These variables will so be subjected to analysis of discrepancy through the statistical treaty for societal scientific discipline ( SPSS ) . Focus group treatment will besides be undertaken with the stakeholders of the strategy. Here subjects such as NHIS procedures, benefit bundles, premiums and freedoms, prescriptions, maternal and child attention coverage, fiscal viability of the NHIS, the position jobs, chances and the manner frontward will be on the docket.

Discuss one or more theories of Moral Understanding and evaluate its conclusions Essay

The term morality, according to Shaffer (1993) means â€Å"a set of principles or ideals that help the individual to distinguish right from wrong and to act on this distinction. Morality is important to society, as it would not function effectively unless there is some agreement of what is right and wrong. There are many underlying processes and environmental factors, which limit or promote social, cognitive and moral development in children. In modern society, television could be considered to be one of the major influences on a child’s moral development. There are three approaches to moral development; the cognitive approach, the psychodynamic approach and the social learning theory. The Cognitive-Developmental approach of Piaget and Kohlberg studies how children become more able to reason morally and make moral judgements, whereas the Freud’s psychodynamic approach is more concerned with the development of the conscience and moral feelings such as guilt and anxiety. The social learning theory of Bandura and Mischel investigates the development of moral behaviour and how role models in the family, society and the media, influence it. The theory I am going to discuss is Piaget’s Cognitive-Developmental Approach. His theory of moral development is concerned with how the child’s moral knowledge and understanding change with age. Piaget saw morality as any system of rules, which governs interaction between people. The methods of investigation he used to develop his theories were, he looked at the way children imposed rules in their games. He used games to study the development of children’s moral development as he thought that by studying rules in the context of a game, he could study the child’s spontaneous though directly. He also, assessed changes in the child’s moral judgements by telling hypothetical stories about children who lied, stole or broke something. When using hypothetical stories, Piaget was generally more interested in the reasons why the children give the answers they did and not particularly the answers. Piaget identifies stages of moral development just as he identified stages with cognitive development. His theories of the way children think and their moral reasoning goes through a series of stages, as they are adapting to the world, these are also known as the processes of accommodation and assimilation. He believed that as children’s reasoning about the world changes when they grow older and gain more experience, so does their reasoning about morality. Their ability to think about the world in more complex ways is what causes them to move on from one stage to the next. This is known as cognitive development. Piaget stated that infants don’t understand much about morality until they are about three or four years of age. Their development divides into two main stages after infancy. His stages of moral development are: Pre Moral Stage (up to three or four years) Children don’t understand about rules, and so they don’t make moral judgements Stage of Heteronomous Morality (aged three – six years) Children at this stage think rules are absolute and unchangeable, and the goodness and badness of an action is judged largely on the basis of its consequences rather than by taking intent into account. Stage of Autonomous Morality (from around six or seven) Children at this stage now see rules as more changeable and intentions are taken into account. Children also start to believe that it is possible to break rules and get away with it, whereas earlier they tended to think they will always be found out and possibly punished. Researchers from Europe and America have tested some of Piaget’s theories and have concluded that distinct stages of development do seem to exist however, other research found that children do not see all rules as being equally important as Piaget thought they did. Heteronomous Morality, also known as moral realism, means when the child is subject to another’s laws or rules. Children think that rules must be obeyed no matter what the circumstances. A child at this stage will think that rules are only made by authority figures, such as, parents and teachers. Two other features that are displayed in moral reasoning at this stage are, first they expect bad behaviour to be punished in some way, they believe that the punishment should be expiatory – the wrongdoer must make amends for the crime by paying with some kind of suffering. They have the view that the amount of punishment should match the badness of the behaviour. Secondly, if the bad behaviour goes undetected then the child believes in immanent justice – where any misfortune occurring after the bad behaviour can be seen as a punishment. For example, if a child tells a lie and gets away with it, then later trips and falls, the younger child could consider this as a punishment. In general, they believe punishment should be fair and that wrongdoing will always be punished in some way. Autonomous Morality, which means when the child is subject to one’s own laws and rules. It involves moral relativism whereby the child comes to realise that rules evolve from social relationships. Due to the child ‘decentring’ and their developed ability to think more flexibly about moral issues, they have began to realise it is important to take other people’s opinions into account. At this stage a child will have developed the understanding that sometimes rules of morality can be broken in certain reasonable circumstances. They believe in reciprocal punishment, whereby the punishment should fit the crime. For example, if a child takes another child’s sweets, the first child should be deprived of their sweets or should make it up to the victim in some other way. This is known as the principle of reciprocity. Children will also have learnt at this stage that wrongdoers often avoid punishment, diminishing any belief in immanent justice. They see punishment as a method of making the offender understand the nature of the crime and that punishment is also a deterrent. The move from heteronomous morality to autonomous morality is influenced by two factors. Children around the age of seven begin to move on from the pre operational stage of an illogical and an egocentric way of thinking to more logical and flexible way of thinking, in the operational stage. Their growing awareness that other people have different views allows them to develop more mature moral reasoning. However, moral development lags at least one to two years behind cognitive development because the whole process depends on the cognitive changes occurring first. Kohlberg expanded Piaget’s theory to form a theory that also explained the development of moral reasoning. While Piaget described a two-stage process of moral development, Kohlberg’s theory outlined six stages within three different levels. Kohlberg extended Piaget’s theory, proposing that moral development is a continual process that occurs throughout the lifespan. A study by Colby et al (1983) criticised Piaget’s assumption that children of ten and eleven years old had reached an adult level of moral reasoning. Piaget was always focusing on what an average child was capable of achieving so he neglected the idea of great variations between the individual child’s ways of thinking. In general, Piaget’s cognitive theory has been criticised for the methods of investigation not being as precise as they could have been. Methods he used were seen as complicated, leading critics to think he under estimated younger children’s capabilities of what they could and could not do. This was because later research went on to conclude that children could actually take other motives into consideration, when they understood what motives were involved. Despite criticism, Piaget’s work is still regarded as a revolutionary step forward in the way we understand how children think. It has led to a much more realistic ways of understanding children’s moral development. Many attempts to test Piaget’s theories from researchers around the world have resulted in acceptance that some of his views and methods do appear to exist.