Structural dynamic investigation of the mutation-induced resistance mechanisms of Mycobacterium tuberculosis DNA-directed RNA polymerase against Rifampicin
- Authors: Monama, Mokgerwa Zacharia
- Date: 2024-10-11
- Subjects: Mycobacterium tuberculosis , Rifampin , Drug resistance , Molecular dynamics Simulation methods
- Language: English
- Type: Academic theses , Doctoral theses , text
- Identifier: http://hdl.handle.net/10962/466849 , vital:76792 , DOI https://doi.org/10.21504/10962/466849
- Description: Emerging resistant strains of Mycobacterium tuberculosis (Mtb), the causative agent of tuberculosis (TB) disease, continue to plague mankind and reduce the efficacies of antitubercular therapies that have been an effective defence against TB for decades. More specifically, mutations located in the β subunit of the multisubunit Mtb RNA replicative machinery, RNA polymerase (RNAP), have been well established as the reason behind resistance to the first-line antitubercular drug rifampicin (RIF), which has resulted in therapeutic failure in several clinical cases. Additionally, elusive details pertaining to the underlying mechanisms associated with RIF resistance due to the presence of Mtb-RNAP-β mutations, have resulted in setbacks in the development of novel and effective drugs that might be able to curb the ongoing threat. Hence, in this investigation, we attempted to resolve the involved Mtb-RNAP structural events at the molecular level to discern potentially important details regarding the nine clinically relevant Mtb-RNAP-β missense mutations under investigation. Hence, for the first time, we conducted an in-silico RIF resistance investigation using the Mtb-RNAP complex. To accomplish the set-out task, we first employed the use of more traditional post-MD analytical approaches such as root mean square deviation, root mean square fluctuation, radius of gyration, center of mass distance analyses, hydrogen bond occupancies, and binding free energy calculations, to conduct a global analysis of the mutated Mtb-RNAP proteins referencing RIF efficacy. Our findings revealed that the mutations may have a perturbation effect resulting in the disruption of essential structural dynamics attributed to the protein’s catalytic functions. This was for instance observed for the βfork loop 2 domain, the β’zinc-binding domain, the β’ trigger loop domain, and the β’jaw domain, which happen to be in line with previously reported experiments detailing changes in RNAP processivity. Complementarily, some of the mutations more specifically perturbed the RIF binding pocket (RIF-BP) which observably led to the reorientation of RIF from the native or active orientation needed to obstruct the processive addition of nucleoside triphosphates to the growing RNA transcript. The mutation-induced repositioning from the active RIF orientation was also reflected through the loss of essential interactions between RIF and the RIF-BP along with the loss of binding affinities captured for a majority of the mutant proteins. In conjunction with traditional analytical approaches, we further employed computational alanine scanning, weighted contact map analyses, and dynamic residue network (DRN) analyses, a novel approach that delineates residue-residue communication pathways through several metrics, to further elucidate how a set of clinically relevant mutations affect Mtb-RNAP function. With that, we were able to observe several key changes in residue importance and interactions that may be instrumental in bringing about RIF resistance and the compensatory conformational changes we observed among the mt systems through global analysis. Furthermore, we identified persistent hubs that may be particularly important in maintaining transcriptional activities in the presence and absence of the investigated mutations and RIF that could serve as potential resistance markers for future therapeutic investigations. We believe these findings will significantly aid future efforts in the discovery of new treatment options with the potential to overcome antitubercular resistance. , Thesis (PhD) -- Faculty of Science, Biochemistry, Microbiology and Bioinformatics, 2024
- Full Text:
- Date Issued: 2024-10-11
- Authors: Monama, Mokgerwa Zacharia
- Date: 2024-10-11
- Subjects: Mycobacterium tuberculosis , Rifampin , Drug resistance , Molecular dynamics Simulation methods
- Language: English
- Type: Academic theses , Doctoral theses , text
- Identifier: http://hdl.handle.net/10962/466849 , vital:76792 , DOI https://doi.org/10.21504/10962/466849
- Description: Emerging resistant strains of Mycobacterium tuberculosis (Mtb), the causative agent of tuberculosis (TB) disease, continue to plague mankind and reduce the efficacies of antitubercular therapies that have been an effective defence against TB for decades. More specifically, mutations located in the β subunit of the multisubunit Mtb RNA replicative machinery, RNA polymerase (RNAP), have been well established as the reason behind resistance to the first-line antitubercular drug rifampicin (RIF), which has resulted in therapeutic failure in several clinical cases. Additionally, elusive details pertaining to the underlying mechanisms associated with RIF resistance due to the presence of Mtb-RNAP-β mutations, have resulted in setbacks in the development of novel and effective drugs that might be able to curb the ongoing threat. Hence, in this investigation, we attempted to resolve the involved Mtb-RNAP structural events at the molecular level to discern potentially important details regarding the nine clinically relevant Mtb-RNAP-β missense mutations under investigation. Hence, for the first time, we conducted an in-silico RIF resistance investigation using the Mtb-RNAP complex. To accomplish the set-out task, we first employed the use of more traditional post-MD analytical approaches such as root mean square deviation, root mean square fluctuation, radius of gyration, center of mass distance analyses, hydrogen bond occupancies, and binding free energy calculations, to conduct a global analysis of the mutated Mtb-RNAP proteins referencing RIF efficacy. Our findings revealed that the mutations may have a perturbation effect resulting in the disruption of essential structural dynamics attributed to the protein’s catalytic functions. This was for instance observed for the βfork loop 2 domain, the β’zinc-binding domain, the β’ trigger loop domain, and the β’jaw domain, which happen to be in line with previously reported experiments detailing changes in RNAP processivity. Complementarily, some of the mutations more specifically perturbed the RIF binding pocket (RIF-BP) which observably led to the reorientation of RIF from the native or active orientation needed to obstruct the processive addition of nucleoside triphosphates to the growing RNA transcript. The mutation-induced repositioning from the active RIF orientation was also reflected through the loss of essential interactions between RIF and the RIF-BP along with the loss of binding affinities captured for a majority of the mutant proteins. In conjunction with traditional analytical approaches, we further employed computational alanine scanning, weighted contact map analyses, and dynamic residue network (DRN) analyses, a novel approach that delineates residue-residue communication pathways through several metrics, to further elucidate how a set of clinically relevant mutations affect Mtb-RNAP function. With that, we were able to observe several key changes in residue importance and interactions that may be instrumental in bringing about RIF resistance and the compensatory conformational changes we observed among the mt systems through global analysis. Furthermore, we identified persistent hubs that may be particularly important in maintaining transcriptional activities in the presence and absence of the investigated mutations and RIF that could serve as potential resistance markers for future therapeutic investigations. We believe these findings will significantly aid future efforts in the discovery of new treatment options with the potential to overcome antitubercular resistance. , Thesis (PhD) -- Faculty of Science, Biochemistry, Microbiology and Bioinformatics, 2024
- Full Text:
- Date Issued: 2024-10-11
Exploring the views of selected, unafflicted women from Walvis bay and Windhoek, Namibia, regarding intimate partner killing and its effect on their well-being.
- Authors: Amadhila,Luise Utuhole
- Date: 2024-04
- Subjects: Intimate partner violence , Gender-based violence , Post-traumatic stress disorder in women
- Language: English
- Type: Doctoral theses , text
- Identifier: http://hdl.handle.net/10948/63653 , vital:73575
- Description: Intimate Partner Killing (IPK), popularly known as passion killing in certain regions, such as in southern parts of Africa, Europe, and America, and also referred to as intimate partner homicide, is a global concern. In Namibia, the rate at which men take the lives of their intimate partners due to failed romantic relationships has sparked apprehension within the communities. This study delves into the perspectives of unafflicted women in Namibia, shedding light on the broader impact of intimate partner killing on female well-being. Using a qualitative approach, the study conducted face-to-face, semi-structured interviews with 14 participants. Grounded theory was applied to analyse the collected data and form categories from it. The data were transcribed and analysed using codes, thematic analysis, and interpretation. The theoretical frameworks intersectionality theory, social feminist theory, structuralist theory and systems theory underpin this study. The findings reveal that intimate partner killing severely affects women’s mental health, leading to vicarious trauma characterised by fear and anxiety. Participants reported difficulty experiencing positive emotions in their romantic relationships due to the pervasive uncertainty of this growing issue. Intimate partner killing leaves women feeling scared, unsafe, and traumatised, often prompting them to exercise extreme caution in their relationships to avoid becoming victims themselves. Symptoms such as feeling unsafe, scared, and traumatised align with post-traumatic stress and generalised anxiety. The study recommends implementing policy interventions and stringent laws in Namibia to prevent or discourage men from resorting to violence against their loved ones. Moreover, establishing assistance centres staffed with social work and mental health professionals is crucial to counselling and supporting women experiencing post-traumatic stress and anxiety resulting from intimate partner violence. , Thesis (PhD) -- Faculty of Health Sciences, School of behavioural Sciences, 2024
- Full Text:
- Date Issued: 2024-04
- Authors: Amadhila,Luise Utuhole
- Date: 2024-04
- Subjects: Intimate partner violence , Gender-based violence , Post-traumatic stress disorder in women
- Language: English
- Type: Doctoral theses , text
- Identifier: http://hdl.handle.net/10948/63653 , vital:73575
- Description: Intimate Partner Killing (IPK), popularly known as passion killing in certain regions, such as in southern parts of Africa, Europe, and America, and also referred to as intimate partner homicide, is a global concern. In Namibia, the rate at which men take the lives of their intimate partners due to failed romantic relationships has sparked apprehension within the communities. This study delves into the perspectives of unafflicted women in Namibia, shedding light on the broader impact of intimate partner killing on female well-being. Using a qualitative approach, the study conducted face-to-face, semi-structured interviews with 14 participants. Grounded theory was applied to analyse the collected data and form categories from it. The data were transcribed and analysed using codes, thematic analysis, and interpretation. The theoretical frameworks intersectionality theory, social feminist theory, structuralist theory and systems theory underpin this study. The findings reveal that intimate partner killing severely affects women’s mental health, leading to vicarious trauma characterised by fear and anxiety. Participants reported difficulty experiencing positive emotions in their romantic relationships due to the pervasive uncertainty of this growing issue. Intimate partner killing leaves women feeling scared, unsafe, and traumatised, often prompting them to exercise extreme caution in their relationships to avoid becoming victims themselves. Symptoms such as feeling unsafe, scared, and traumatised align with post-traumatic stress and generalised anxiety. The study recommends implementing policy interventions and stringent laws in Namibia to prevent or discourage men from resorting to violence against their loved ones. Moreover, establishing assistance centres staffed with social work and mental health professionals is crucial to counselling and supporting women experiencing post-traumatic stress and anxiety resulting from intimate partner violence. , Thesis (PhD) -- Faculty of Health Sciences, School of behavioural Sciences, 2024
- Full Text:
- Date Issued: 2024-04
Guidelines for a job role based approach for Phishing awareness in an academic Institution
- Authors: Mahonga,Sandisiwe
- Date: 2021-12
- Subjects: Identity theft -- South Africa , Computer networks --Security measures
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/55855 , vital:54394
- Description: Phishing attacks have become a perpetual threat to organisations and internet users in general. Phishing websites and emails impersonating well-known entities are launched frequently, with the intent to trick unsuspecting employees to give out sensitive information such as login details to acquire access to corporate networks. Various solutions have been developed to combat Phishing emails from reaching employees and internet users. However, security experts and Phishing attackers are in a race as Phishing attacks are also refined as solutions are developed. Thus, this raises a critical need for security awareness. Reports and Phishing studies have noted that Phishing attacks targeted towards specific job roles have been on the rise. Even though research studies and industry reports provided by organisations dedicated to information security have taken note of this phenomenon, not much guidance, recommendations or guidelines are provided on how Phishing awareness can be provided for the job roles that are most vulnerable to Phishing attacks. Therefore, the problem identified within this research is that there is a need for guidelines for a job role based approach for Phishing awareness. The primary research objective of this study, therefore, is to develop guidelines to aid towards a job role based approach for Phishing awareness. In order to meet the primary research objective, secondary research objectives were defined and met, namely; To determine the current state of Phishing trends facing organisations in relation to the job role of employees; to determine the level of Phishing awareness employees have; to identify security awareness elements from security awareness standards, best practices and frameworks; to integrate the identified security awareness elements from standards, best practices and frameworks including themes identified from the questionnaire results to formulate the proposed guidelines for a Phishing awareness approach that is relevant for the job role of employees in order to the formulate guidelines. 5 Mixed methods were used to achieve this study’s research objectives. The research methods used included a literature review which was used to define and provide an indepth discussion relating to the domain in which this study is contained, namely: Social engineering, Phishing and information security awareness and training. Furthermore, a survey which took the form of a questionnaire, was used ascertain the level of Phishing awareness amongst employees within an academic institution in South Africa. Argumentation was used to argue towards the proposed guidelines. Finally, an elite interview was conducted, in the form of a questionnaire, to evaluate the proposed guidelines. It is envisaged that the guidelines proposed for a job role Phishing awareness approach could assist organisations to equip employees in job roles that are vulnerable Phishing attacks with adequate awareness and training. , Thesis (MIT) -- Faculty of Engineering, the Built Environment and Information Technology, School of Information and Communication Technology, 2021
- Full Text:
- Date Issued: 2021-12
- Authors: Mahonga,Sandisiwe
- Date: 2021-12
- Subjects: Identity theft -- South Africa , Computer networks --Security measures
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/55855 , vital:54394
- Description: Phishing attacks have become a perpetual threat to organisations and internet users in general. Phishing websites and emails impersonating well-known entities are launched frequently, with the intent to trick unsuspecting employees to give out sensitive information such as login details to acquire access to corporate networks. Various solutions have been developed to combat Phishing emails from reaching employees and internet users. However, security experts and Phishing attackers are in a race as Phishing attacks are also refined as solutions are developed. Thus, this raises a critical need for security awareness. Reports and Phishing studies have noted that Phishing attacks targeted towards specific job roles have been on the rise. Even though research studies and industry reports provided by organisations dedicated to information security have taken note of this phenomenon, not much guidance, recommendations or guidelines are provided on how Phishing awareness can be provided for the job roles that are most vulnerable to Phishing attacks. Therefore, the problem identified within this research is that there is a need for guidelines for a job role based approach for Phishing awareness. The primary research objective of this study, therefore, is to develop guidelines to aid towards a job role based approach for Phishing awareness. In order to meet the primary research objective, secondary research objectives were defined and met, namely; To determine the current state of Phishing trends facing organisations in relation to the job role of employees; to determine the level of Phishing awareness employees have; to identify security awareness elements from security awareness standards, best practices and frameworks; to integrate the identified security awareness elements from standards, best practices and frameworks including themes identified from the questionnaire results to formulate the proposed guidelines for a Phishing awareness approach that is relevant for the job role of employees in order to the formulate guidelines. 5 Mixed methods were used to achieve this study’s research objectives. The research methods used included a literature review which was used to define and provide an indepth discussion relating to the domain in which this study is contained, namely: Social engineering, Phishing and information security awareness and training. Furthermore, a survey which took the form of a questionnaire, was used ascertain the level of Phishing awareness amongst employees within an academic institution in South Africa. Argumentation was used to argue towards the proposed guidelines. Finally, an elite interview was conducted, in the form of a questionnaire, to evaluate the proposed guidelines. It is envisaged that the guidelines proposed for a job role Phishing awareness approach could assist organisations to equip employees in job roles that are vulnerable Phishing attacks with adequate awareness and training. , Thesis (MIT) -- Faculty of Engineering, the Built Environment and Information Technology, School of Information and Communication Technology, 2021
- Full Text:
- Date Issued: 2021-12
Ureaplasma species in the placenta and histopathology associated with preterm birth
- Authors: Sprong, Kaitlin Elizabeth
- Date: 2021-12
- Subjects: Port Elizabeth (South Africa) , Eastern Cape (South Africa) , South Africa
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/54128 , vital:46310
- Description: The Eastern Cape province is known for its high perinatal morbidity and mortality rate. Studies from other countries indicate that Ureaplasma spp. have been associated with clinical chorioamnionitis, spontaneous preterm labor and preterm premature rupture of the fetal membranes. The prevalence of Ureaplasma urealyticum, Ureaplasma parvumand Mycoplasma hominisin the placenta and its role in preterm birth is unknown in South Africa. Objectives The objectives of this study were to: (i) analyze placental histology, maternal and neonatal outcomes and clinical presentation of preterm birth, (ii) detect Ureaplasma spp. and M. hominisin the placenta from cases of preterm birth, (iii) determine antibiotic susceptibility profiles of Ureaplasma spp. isolates and investigate mechanisms of antibiotic resistance, (iv) characterize the microbial diversity in the placenta using 16S rRNA next generation sequencing and(v) review pathologies to ascertain whether there is any association between Ureaplasma spp. in the placenta and adverse maternal, obstetric and neonatal outcomes. iiiABSTRACTBackground The Eastern Cape province is known for its high perinatal morbidity and mortality rate. Studies from other countries indicate that Ureaplasmaspp. have been associated with clinical chorioamnionitis, spontaneous preterm labor and preterm premature rupture of the fetal membranes. The prevalenceof Ureaplasmaurealyticum,UreaplasmaparvumandMycoplasmahominisin the placenta andits role in preterm birth is unknown in South Africa. Objectives The objectives of this study were to: (i) analyze placental histology, maternal and neonatal outcomes and clinical presentation of preterm birth, (ii) detect Ureaplasmaspp. and M. hominisin the placenta from cases of preterm birth, (iii) determine antibiotic susceptibility profiles of Ureaplasmaspp. isolates and investigate mechanisms of antibiotic resistance, (iv) characterize the microbial diversity in the placenta using 16S rRNA next generation sequencing and(v) review pathologies to ascertain whether there is any association between Ureaplasmaspp. inthe placenta and adverse maternal, obstetric and neonatal outcomes. MethodsPlacentas were collected from patients presenting with preterm birth (n=100; 28-34 weeks gestational age) and term birth (n=20; >38 weeks) regardless of the APGAR score. Placentas were submitted for histopathology and used for detection of Ureaplasmaspp. by culture (U9 broth, MycoDuo kits;BioRad) and PCR (DNA was extracted from culture and homogenized placental tissue). Antibiotic susceptibility profiles of Ureaplasmaspp isolates were determined by the SIR Antibiogram kit (BioRad) and microbroth dilution method. Molecular mechanisms of resistance were ascertained by PCR amplification of target genes. Placentas were sent to National Health Laboratory Servicesfor routine histopathology. Next generation sequencing was performed on 16S rRNA amplicons from placental DNA for analysis of microbial diversity. , Thesis (PhD) -- Faculty of Science, Journalsim and Media Studies, 2021
- Full Text:
- Date Issued: 2021-12
- Authors: Sprong, Kaitlin Elizabeth
- Date: 2021-12
- Subjects: Port Elizabeth (South Africa) , Eastern Cape (South Africa) , South Africa
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/54128 , vital:46310
- Description: The Eastern Cape province is known for its high perinatal morbidity and mortality rate. Studies from other countries indicate that Ureaplasma spp. have been associated with clinical chorioamnionitis, spontaneous preterm labor and preterm premature rupture of the fetal membranes. The prevalence of Ureaplasma urealyticum, Ureaplasma parvumand Mycoplasma hominisin the placenta and its role in preterm birth is unknown in South Africa. Objectives The objectives of this study were to: (i) analyze placental histology, maternal and neonatal outcomes and clinical presentation of preterm birth, (ii) detect Ureaplasma spp. and M. hominisin the placenta from cases of preterm birth, (iii) determine antibiotic susceptibility profiles of Ureaplasma spp. isolates and investigate mechanisms of antibiotic resistance, (iv) characterize the microbial diversity in the placenta using 16S rRNA next generation sequencing and(v) review pathologies to ascertain whether there is any association between Ureaplasma spp. in the placenta and adverse maternal, obstetric and neonatal outcomes. iiiABSTRACTBackground The Eastern Cape province is known for its high perinatal morbidity and mortality rate. Studies from other countries indicate that Ureaplasmaspp. have been associated with clinical chorioamnionitis, spontaneous preterm labor and preterm premature rupture of the fetal membranes. The prevalenceof Ureaplasmaurealyticum,UreaplasmaparvumandMycoplasmahominisin the placenta andits role in preterm birth is unknown in South Africa. Objectives The objectives of this study were to: (i) analyze placental histology, maternal and neonatal outcomes and clinical presentation of preterm birth, (ii) detect Ureaplasmaspp. and M. hominisin the placenta from cases of preterm birth, (iii) determine antibiotic susceptibility profiles of Ureaplasmaspp. isolates and investigate mechanisms of antibiotic resistance, (iv) characterize the microbial diversity in the placenta using 16S rRNA next generation sequencing and(v) review pathologies to ascertain whether there is any association between Ureaplasmaspp. inthe placenta and adverse maternal, obstetric and neonatal outcomes. MethodsPlacentas were collected from patients presenting with preterm birth (n=100; 28-34 weeks gestational age) and term birth (n=20; >38 weeks) regardless of the APGAR score. Placentas were submitted for histopathology and used for detection of Ureaplasmaspp. by culture (U9 broth, MycoDuo kits;BioRad) and PCR (DNA was extracted from culture and homogenized placental tissue). Antibiotic susceptibility profiles of Ureaplasmaspp isolates were determined by the SIR Antibiogram kit (BioRad) and microbroth dilution method. Molecular mechanisms of resistance were ascertained by PCR amplification of target genes. Placentas were sent to National Health Laboratory Servicesfor routine histopathology. Next generation sequencing was performed on 16S rRNA amplicons from placental DNA for analysis of microbial diversity. , Thesis (PhD) -- Faculty of Science, Journalsim and Media Studies, 2021
- Full Text:
- Date Issued: 2021-12
The implementation of national health strategy (2009-2013) in Vungu District clinics, Midlands Province in Zimbabwe
- Mangwanya, M G https://orcid.org/0000-0002-0362-5546
- Authors: Mangwanya, M G https://orcid.org/0000-0002-0362-5546
- Date: 2019-08
- Subjects: Medical care -- Zimbabwe
- Language: English
- Type: Doctoral theses , text
- Identifier: http://hdl.handle.net/10353/19914 , vital:44454
- Description: The practice of strategy implementation is key to the public sector in Zimbabwe because it helps the government to be up to speed in providing services to the public. This research focused on the National Health Strategy 2009-2013 and its impact on health service delivery in Vungu Rural District Council Clinics. The research was based on qualitative desk study design which made use of existing data and semi structured interviews to understand the effect of the National Health Strategy on health service delivery in Vungu Rural Districts Council Clinics. From the literature reviewed and the data collected, it can be noted that lack of resources has had a huge effect on the execution of the strategy. The findings from the study show that the National Health Strategy was a good initiative. However, it lacked financial resources which posed challenges to the health workers in Vungu Rural District Council Clinics. The health workers were not very familiar with the National Health Strategy and this had a negative impact on its execution because they cannot execute a strategy that they are not familiar with. The study highlighted the importance of resources for the execution of the National Health Strategy. The study therefore sought to find ways the Zimbabwean Health System may formulate the health strategy with the limited resources in order to achieve desired goals. The Health Workers echoed the same sentiments that they needed resources for the implementation of the strategy. It is hoped that the findings would provide guidelines for the formulation and implementation of future health strategies. Recommendations given would ensure that there is utilisation of available resources, which would help in the execution of other health strategies to ensure efficient and effective health care service delivery. The recommendations are also intended to enhance the performance of health workers. Though the study was limited to Vungu Rural District Council Clinics the findings and recommendations would provide guidelines for other rural clinics as they use the National Health Strategy. , Thesis (PhD) -- Faculty of Management and Commerce, 2019
- Full Text:
- Date Issued: 2019-08
- Authors: Mangwanya, M G https://orcid.org/0000-0002-0362-5546
- Date: 2019-08
- Subjects: Medical care -- Zimbabwe
- Language: English
- Type: Doctoral theses , text
- Identifier: http://hdl.handle.net/10353/19914 , vital:44454
- Description: The practice of strategy implementation is key to the public sector in Zimbabwe because it helps the government to be up to speed in providing services to the public. This research focused on the National Health Strategy 2009-2013 and its impact on health service delivery in Vungu Rural District Council Clinics. The research was based on qualitative desk study design which made use of existing data and semi structured interviews to understand the effect of the National Health Strategy on health service delivery in Vungu Rural Districts Council Clinics. From the literature reviewed and the data collected, it can be noted that lack of resources has had a huge effect on the execution of the strategy. The findings from the study show that the National Health Strategy was a good initiative. However, it lacked financial resources which posed challenges to the health workers in Vungu Rural District Council Clinics. The health workers were not very familiar with the National Health Strategy and this had a negative impact on its execution because they cannot execute a strategy that they are not familiar with. The study highlighted the importance of resources for the execution of the National Health Strategy. The study therefore sought to find ways the Zimbabwean Health System may formulate the health strategy with the limited resources in order to achieve desired goals. The Health Workers echoed the same sentiments that they needed resources for the implementation of the strategy. It is hoped that the findings would provide guidelines for the formulation and implementation of future health strategies. Recommendations given would ensure that there is utilisation of available resources, which would help in the execution of other health strategies to ensure efficient and effective health care service delivery. The recommendations are also intended to enhance the performance of health workers. Though the study was limited to Vungu Rural District Council Clinics the findings and recommendations would provide guidelines for other rural clinics as they use the National Health Strategy. , Thesis (PhD) -- Faculty of Management and Commerce, 2019
- Full Text:
- Date Issued: 2019-08
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