Graduation Speech -- Graduation Speech, Commencement Address

Christopher Columbus, reflecting on his voyage which led him to the discovery of America, said, Following the light of the sun, we left the Old World. I am sure that after foursome years of high school, we have all formed our own opinion of Christopher Columbus - especially if you had Mrs. Powers - but whether you view him as a genocidal rogue or the first American Hero, I find his quote fitting for where we stand today. As we set sail, leaving behind the Old World of Coleman High School, on that point are many things that I am sure none of us get out miss. We will enter a world with stunned Scholarly Papers or Culminating Exhibitions a world where we can use our cell phones freely and urinate without the permission of our teacher. In the real world, Sareth wont throw away your lunch before youve interpreted your first bite. Of course, if youve made it this far - if you are graduating here tonight - there are surely things you will miss about this Old World as well. Maybe youll mi ss coming to school early and being surprised by free hot chocolate, or that third period teacher who would invariably let you turn in your assignments late. It might be that coach that never let you quit and always pushed you to your limits, or that gorgeous girl (or guy) that you got to sit contiguous to freshman year. It could be walking with your best friend to class everyday, or that giant excuse of a bear that sits in front of the cafeteria. Whatever it whitethorn be, we will all leave this place with something that we will miss and cherish forever, even if we dont fully realize what that is today. We will also leave behind a number of beloved teachers, counselors, and other staff persons - many of whom have had huge impacts on getting us here tonight. We will surely miss the... ...ves whose advice do we take - Martin Luther King Jr.s or Homer J. Simpsons? Do we put our brooms in the closet of futility and go inside and watch TV, or do we take them out and sweep like no swe eper has ever swept before? No matter where our passage takes us, we must navigate it to the best of our abilities, or we will fail. In conclusion, I will leave you with one last thought from the founder and President of Habitat for Humanity, Millard Fuller, who put it best when he said Its non your blue blood, your pedigree or your college degree. Its what you do with your life that counts. I would like to thank you all and congratulate you for surviving four years of my speeches and suffering the pangs of my vox on the announcements nearly everyday this year - but you have heard my voice for the last time so clap loud. Lets graduate. Thank you and God Bless.

The Relationship of Torvald and Nora Essay -- A Dolls House Henrik Ibs

The Relationship of Torvald and Nora At the beginning of the play, Nora and Helmer seem to have a happymarriage, although it is quite a childish relationship as Helmer oftenuses petty language and names such as songbird or squirrel totalk to Nora. However, by the end of the play Nora seems to havechanged. The way Nora speaks changes from being a immature girl to beinglike a woman. Finally, she leaves Torvald.At the start of the play Nora speaks in a actually childish manner. Younotice this when she says things such as scads and the great bluesky. This shows that she is mentally naive. She says these things asa child would say them. For example, the lines that she speaks have alot of exclamation points and as Nora says some things she jumps upand down or claps her hands, this shows the childish way she acts.Torvald speaks to her in very over-romantic language and it seems asthough maybe it isnt real and their love is just commence of a game. Itis so romantic it seems as though h e is trying to convince himselfthat he loves her. He says things such as squirrel, lark orsongbird. Songbirds are kept in cages so this may have something todo with Noras situation as Torvald controls the way she thinks and soshe is caged in his world.Torvald also acts very maternal(p)ly towards Nora and patronises her.Helmer uses the word little a lot when he speaks to Nora. He callsher his little Nora or little creature which shows that theirrelationship seems to be more paternal than marital. Helmer treatsNora like a daughter. This is really noticeable when he does thingslike kissing her on the forehead or putting his arm around her. Helmerand Nora play a game and Nora manipulates Hel... ...lived byperforming tricks for you, Torvald. She also says that Torvald hadher as his doll-wife and that Torvald played with her as thechildren played with their dolls.When she announces that she is going to leave him Torvald reacts atfirst by trying to keep her from leaving I shall not allo w it Iforbid it and since this doesnt work Helmer tries to use religionas an argument so that she doesnt leave. Also, he suggests thatsociety will look on her badly, and then he pleads with her not toleave and says that hell change for her. However, Nora had her setview even though Helmer act to use strength, religion and his sweetcharm to keep her at home. In the end Nora leaves. She slams the door as she goes which shows asymbolic cut between her source life and the life that she is about tolead. She has finally left her Dolls house.

Financial Analysis of Robert Mondavi :: GCSE Business Marketing Coursework

Financial Analysis of Robert MondaviRobert MondaviSeeing that I have already made millions upon millions in my moderately successful modeling career, I have decided to turn my attention to investing my money in stock, in particular, Robert Mondavi.1998 was a hard year for Mondavi, an unforeseen shortage of their most best-selling(predicate) wine (Woodbridge Chardonnay- 55% of their revenues) and stiff competition from several new trade brands forced net income down almost $8,000, and cut their earnings per share by 78%. For 1999, Mondavi was forced to take several actions to achieve their objectives. This included re stunt man concentre on the two largest-volume brands, appointing their Chief Financial Officer to Chief Operating Officer, doubling media expenditures to $7.3 million, taking a $6 million charge to write-off tautological parentage and streamline their workforce, creating Brand Teams to improve accountability and planning, and adopt FIFO manner of inventory accou nting to improve predictability earnings and improve the measurement of inventory value.Mondavi has apparently shown great results from the restructuring, the concent dimensionn on the two largest-volume brands have accounted for 20% of the maturation of all U.S. varietal wines. They surveyed record gains in their first quarter report of 2000. The bottom line of the annual report for 1999 shows a 14% increase in net income.But is the company safe to invest in? stalls growth throughout 1995-97 showed net income bolt to $38,125, up 310%. But 1997 showed the risks involved with investing in a company that so heavily relies on earthy resources (grapes). Shortages in supplies dropped net income by almost $8,000 earnings per share dropped .53 from 2.43 to 1.90. After analyzing the monetary statement, I was able to determine several interesting aspects a .52 debt ratio shows appeal to lenders a current ratio of 6.31 is very impressive. Seeing that inventory is so unstable and subje ct to many natural extraordinary events, the more eventful acid test shows Mondavi has a comfortable, but less impressive ratio of 1.54.I have found that the financial statement for Robert Mondavi is not to my liking. The strange fonts and subdues alterFinancial Analysis of Robert Mondavi GCSE Business Marketing CourseworkFinancial Analysis of Robert MondaviRobert MondaviSeeing that I have already made millions upon millions in my moderately successful modeling career, I have decided to turn my attention to investing my money in stock, in particular, Robert Mondavi.1998 was a hard year for Mondavi, an unforeseen shortage of their most popular wine (Woodbridge Chardonnay- 55% of their revenues) and stiff competition from several new imported brands forced net income down almost $8,000, and cut their earnings per share by 78%. For 1999, Mondavi was forced to take several actions to achieve their objectives. This included redoubling focus on the two largest-volume brands, appoi nting their Chief Financial Officer to Chief Operating Officer, doubling media expenditures to $7.3 million, taking a $6 million charge to write-off excess inventory and streamline their workforce, creating Brand Teams to improve accountability and planning, and adopt FIFO method of inventory accounting to improve predictability earnings and improve the measurement of inventory value.Mondavi has apparently shown great results from the restructuring, the concentration on the two largest-volume brands have accounted for 20% of the growth of all U.S. varietal wines. They reported record gains in their first quarter report of 2000. The bottom line of the annual report for 1999 shows a 14% increase in net income.But is the company safe to invest in? Stable growth throughout 1995-97 showed net income bolt to $38,125, up 310%. But 1997 showed the risks involved with investing in a company that so heavily relies on natural resources (grapes). Shortages in supplies dropped net income by al most $8,000 earnings per share dropped .53 from 2.43 to 1.90. After analyzing the financial statement, I was able to determine several interesting aspects a .52 debt ratio shows appeal to lenders a current ratio of 6.31 is very impressive. Seeing that inventory is so unstable and subject to many natural extraordinary events, the more important acid test shows Mondavi has a comfortable, but less impressive ratio of 1.54.I have found that the financial statement for Robert Mondavi is not to my liking. The strange fonts and subdues colors

Feminism in M. Butterfly Essay -- David Henry Hwang

Feminism in M. Butterfly In the 1989 drama M. Butterfly, the masterwork of contemporary American playwright David Henry Hwang, the bailiwick of sexual politics underlies all other themes, and creates a tension between the genders that pervades throughout the text moreover, Hwang subverts traditional thematic aspects of sexual politics by challenge the most fundamental unit of sex by considering the very nature of gender and what defines a male or a female. These elements unite and develop a penetrating examination of feminism, and an inspection of the role of females in two Western and Eastern societies as they relate to males, and an expos of the inequalities of gender which are present, perhaps fundamental, in both cultures. The tug-of-war for control, both sexual and intellectual, between male and female pillow slips, especially Rene Gallimard and Song Liling, is ubiquitous throughout the text, and culminates in the final scene where Rene commits seppuku, or Japanese ritua l suicide. In M. Butterfly, Hwang views feminism from a variety of unusual lenses by looking at both genders, and serving to draw attention to the traits and qualities of both using dialogue, character study, and clever dramatic techniques. Any discussion of feminism in M. Butterfly must be chronological, and show the development of the characters over time this allows the reader and sense of hearing to mark the character study of the selves over duration of the drama. In the opening act the reader is introduced to a very feminine Song Liling, the character who premier assumes the function of the female. Hwang acquaints the reader with Song dancing, and in female garb, in the stage directions of the first act yet the audience can guess as earlier as two page... ...ruitless and impossible way to establish a productive, working relationship between men and women. From the three gossipers to Gallimard and Marc, from Gallimard and Renee to Gallimard and Song, Hwang inspects femi nism using a crude and unusual viewpoint throughout the play, which he asserts in various ways. Hwang states that only as equals can male and female coexist in harmony telling underlying sexism in both the cultures of East and West, Hwang shows there is much room for improvement, and that education of gender would be a valuable thing. M. Butterfly is a soaked and creative drama driven by strong and creative ideas, but none are as clear or as forceful as the inequalities between men (the errant need to control) and women (submitting to these controls) and their sources (male insecurities, fear of vulnerability), which he discloses, and ultimately, condemns.

The Language of Slavery in Jane Eyre Essays -- Jane Eyre Bronte Papers

While Brontes novel is a story of hotshot womans rise from dependant, patriarchal oppression to financial stability and emotional liberation, the narration of that story is often turns to the figurative representation of bondage. Bronte applies the metaphor of thralldom to the domestic trials facing British women at the time. Time and again her narrative language turns to this device in order to draw parallels between slaveholding and former(a) vehicles of oppression, namely gender and class. Just as the majority of issues in the novel are two-sided, the implications of these parallels are two-sided as well. Carl Plasa, Lecturer in English at the University of Wales College of Cardiff, clearly explains the dichotomy in his essay Silent Revolt The deployment of a metaphorics of slavery as a way of representing forms of domestic oppression is, from one perspective, both rhetorically powerful and a politically radical maneuver. Yet from another perspective--that precisely of those wh o are or have been enslaved, experienced the metaphor, as it were--such a strategy can only be viewed as deeply problematic. (67-8)If Bronte had turned to these metaphors solely as a way of representing forms of domestic oppression the effect would have been positive. Her references to slavery would have come across as rhetorically powerful and politically radical. Unfortunately, Bronte goes too far. She creates a narrator, Jane, who exploits images of slavery, using them to obtain personal gain and dismissing them when convenient. It is taken for granted(predicate) that Bronte makes use of the experiences of the British colonies throughout the text of Jane Eyre. In an effort to make her readers more comfortable Bronte chooses not to address the issue of British dom... ...hough her troping of the language of slavery is problematic, she creates through her novel, as Meyers says in her essay, a fascinating example of the associations-- and dissociations-- between a resistance to th e political orientation of male domination and a resistance to the ideology of colonial domination (162). Works Cited Bronte, Charlotte. Jane Eyre. 1848. Ed. Beth Newman. Boston Bedford/St. Martins, 1996. Burns, Sir Alan. History of the British West Indies. London Allen & Unwin, 1965. Meyer, Susan. From Colonialism and the Figurative Strategy of Jane Eyre. Post-Colonial Theory and English Literature A Reader. Ed. quill Childs. Edinburgh Edinburgh UP, 1999. 149-163. Plasa, Carl. Silent Revolt Slavery and the Politics of Metaphor in Jane Eyre. The Discourse of Slavery. Ed. Carl Plasa and Betty J. Ring. London Routledge, 1994. 64-93.

The Language of Slavery in Jane Eyre Essays -- Jane Eyre Bronte Papers

While Brontes fiction is a story of one womans rise from dependant, patriarchal oppression to financial constancy and emotional liberation, the narration of that story is often turns to the figurative representation of slavery. Bronte applies the metaphor of slavery to the domestic trials facing British women at the time. Time and again her recital language turns to this device in order to draw parallels between slavery and other vehicles of oppression, namely gender and class. Just as the majority of issues in the novel are two-sided, the implications of these parallels are two-sided as well. Carl Plasa, Lecturer in English at the University of Wales College of Cardiff, clearly explains the dichotomy in his essay Silent Revolt The deployment of a metaphorics of slavery as a way of representing forms of domestic oppression is, from one perspective, both rhetorically powerful and a politically radical maneuver. Yet from other perspective--that precisely of those who are or have be en enslaved, experienced the metaphor, as it were--such a strategy can only be viewed as deeply problematic. (67-8)If Bronte had turned to these metaphors altogether as a way of representing forms of domestic oppression the effect would have been positive. Her references to slavery would have come across as rhetorically powerful and politically radical. Unfortunately, Bronte goes too far. She creates a narrator, Jane, who exploits images of slavery, using them to obtain personal gain and dismissing them when convenient. It is obvious that Bronte offs use of the experiences of the British colonies throughout the text of Jane Eyre. In an effort to make her readers more comfortable Bronte chooses not to address the issue of British dom... ...hough her troping of the language of slavery is problematic, she creates through her novel, as Meyers says in her essay, a fascinating example of the associations-- and dissociations-- between a resistance to the ideology of male domination and a resistance to the ideology of colonial domination (162). Works Cited Bronte, Charlotte. Jane Eyre. 1848. Ed. Beth Newman. Boston Bedford/St. Martins, 1996. Burns, Sir Alan. History of the British air jacket Indies. London Allen & Unwin, 1965. Meyer, Susan. From Colonialism and the Figurative Strategy of Jane Eyre. Post-Colonial Theory and English Literature A Reader. Ed. Peter Childs. Edinburgh Edinburgh UP, 1999. 149-163. Plasa, Carl. Silent Revolt Slavery and the Politics of Metaphor in Jane Eyre. The communication of Slavery. Ed. Carl Plasa and Betty J. Ring. London Routledge, 1994. 64-93.

Communicative Games In Teaching Speaking Education Essay

English instruction has drawn much public attending as English has become one of the most effectual international linguistic communications. In such inclination of society for developing hearing and talking accomplishments instead than reading and composing accomplishments, surveies on how to better scholars linguistic communication drudgery accomplishments overhear been carried out, but there argon still many facets left undiscovered.In some non-English speech production states like Viet Nam, many high school disciples frequently find it hard to talk English and experience world-weary and nervous in talking lessons. The grounds are because they spend much clip on the topics that they will impact their consequences of university entryway test than the others, because English trials in high schools and in entryway tests are in composing and reading signifiers but non in talking signifier, and because the figure of periods of topics of inherent scientific discipline is more than topics of societal scientific discipline or frailty versa. Therefore assorted methods have been apply to accomplish the effectiveness in learnedness English speech production, and one of them is utilizing communicative games. It is said that communicative games is one of the most effectual methods to better study English speech production in high schools due to their positive effects.In add-on, the survey into using communicative games in learning English speech production in high schools is helpful to my procedure of learning pattern in high schools. For the above grounds, the research subject Application of communicative games in learning speech production in English 10 is hoped to lend to the effectivity in learning English speech production.2. Purposes and aimsThe survey is to show the effectivity in application of communicative games in learning speech production in English 10. The research has some chthonianmentioned purposes To happen out jobs that pupils represent in speech production categories.To analyze the effectivity of communicative games in speech production categories.To propose some pedagogical deductions to accomplish the effectivity in learning speech production.3. Scope of the surveyThe research is examined in 10th run pupils of three categories at Quoc Hoc high school. For the clip bound and the length bound, the survey trades with 4 units which are unit 12, 13, 14 and 15 in English 10.4. search inquiries What are the troubles that pupils encounter in speech production categories? How effectual are communicative games in speech production categories?5. Methods of the surveyThe survey is a qualitative and quantitative research. The collected informations by making a study on 10th grade pupils of three categories at Quoc Hoc high school will be quantitatively analyzed. A qualitative analysis on informations collected on pupils will be carried out to demo the effectivity of application of communicative games in learning English s peech production.6. Design of the surveyThe thesis is organized into five chief separate as followsChapter 1 Introduction presents the grounds for taking the subject, the purposes and aims of the survey, the range of the survey and the organisation of the survey.Chapter 2 Literature Review and Theoretical Background includes two parts. The world-class portion reviews old related surveies. The 2nd 1 is to show an overview of English 10 text edition, state of affairs of learning and larning English speech production in high schools, scholars communicative competency, communicative activities and communicative games.Chapter 3 Methods and Procedures shows the research design and research methods, the description of the process of informations aggregation and information analysis, the description of participants and instruments in the research.Chapter 4 Findingss and Discussion is to show the findings of the probe and analysis and to discourse the consequences of the study.Chapter 5 De cision and Implications summarizes the survey, shows deductions and restrictions of the survey and suggests for farther research.Table OF CONTENTSChapter 1 Introduction1.1 Rationale1.2 Purposes and Aims1.3 Scope of the Study1.4 Research Questions1.5 Organization of the StudyChapter 2 Literature Review and Theoretical Background2.1 Previous research plants2.2 Theoretical Background2.2.1 Overview of English 10 Textbook2.2.2 Communicative Language education2.2.3 Communicative Competence2.2.4 Communicative Activities2.2.5 Communicative Games2.2.5.1 Definition of Communicative Games2.2.5.2 Functions of Communicative Games in Teaching EnglishChapter 3 Methods and Procedures3.1 Research Design and Methodology3.. Study ProceduresChapter 4 Findingss and Discussion4.1 Troubles of Students in Speaking Classs4.2 Effectiveness of Communicative Games in Speaking Classs4.3 Discussion4.4 DrumheadChapter 5 Decision and Deductions5.1 Decision5.2 Deductions5.2.1 Design Principles of Communicative Gam es5.2.2 Principles of Application of Communicative Games in Teaching Talking5.2.3 Some Suggested Communicative Games in Teaching Talking5.2.3.1 Some Communicative Games for Unit 125.2.3.2 Some Communicative Games for Unit 135.2.3.3 Some Communicative Games for Unit 145.2.3.4 Some Communicative Games for Unit 155.3 Restriction5.4 Suggestions for Further ResearchEXPECTED OUTCOMESThe consequences of this survey are expected as followsFirst, games are activities that make people experience relaxed and aroused and utilizing communicative games in learning English speech production draws attending of non lone instructors but besides scholars.Second, instructors crowd out cognize more about the effectivity of communicative games in learning speech production, and cognize how to take or plan communicative games suited for scholars and learning points.Third, learning English speech production is more exciting and effectual because communicative games motivate scholars and assist them compre hend learning points in a natural manner.Plan OF THE PROJECTOccupationDetailss of occupationTime1Choosing a subject and planing the program of the undertaking Determination job countries that require probe Choosing a suited subject Consulting applicable surveies and paperss Planing the program of the undertakingBy 24th December2Roll uping informations and analysing the information Design questionnaires Making study on 10th grade pupils by utilizing questionnaires Analyzing the informationBy the terminal of February3Writing the thesis Writing the first acme of exchange Completing the thesis and composing the concluding bill of exchangeBy the terminal of Marchi? I thirstily underscore my committedness to carry throughing this research paper as scheduled under the direction of my supervisor.i? The first bill of exchange needs more work nevertheless, I agree to assist the pupil on status that the pupil can transport out the undertakings as planned.SUPERVISOR STUDENTVo Tha Thanh Diap Nguyan Thian Ma?

Adults Essay

Childhood is a first moment of experience that people encounters later on the birth. I saw many people especially my friends who said they want to go back to their puerility. Childhood can be the best moment of vitality because you dont have to worry about many things. However, in my opinion, childhood is not the best moment of a persons life. First, childhood is not the best moment of a persons life because it is limited. Since childhood refer that we are still kids, adults prohibit us for many things.For example, in amusement park, I saw a staff restricted whatsoever people who are below in age 7 to ride some rides which is kind a unfair to me. Another reason why childhood is not the best moment of the persons life is because you are physically weaker than adults. It is obvious that children are much weaker than adults body because their bodies are not yet developed than adults. We need stronger and developed bodies enable to protect ourselves and do works fast. Lastly, childhoo d is not the best moment of the persons life because they are not big.I saw many children appealing to their parents to let them spend one night in their friends house. Most of the parents refuse them to go there because they consider their childs security. However, adults are reposition to sleep in anywhere. In conclusion, childhood is not the best moment of the persons life because many children are restricted and not free for many things and their bodies are not fully developed. If people ask me when could be the best moment of my life, I would choose adulthood because you can enjoy youth.

.Northwest Airlines Essay

1).Northwest Airlines applied mathematical models to determine which customers in its database were currently prudent for most of its profitability and which customers were not currently profitable but had similar characteristics to the most profitable customers. Northwest Airlines utilized _____ to identify these customers. 2) Minute maiden over sees enquiry as the fundamental first step in any business decision, and it created proprietary methods for conducting research. At what level of the hierarchy of business decision makers does Minute Maid operate 3) Which of the following questions is considered first when discussing a management dilemma 4) The goal of ethics in research is to _____. 5) _____ occurs when the participants are told only part of the truth or when the truth is fully compromised. 6) The process of stating the basic dilemma and then developing other questions by progressively breaking down the original question into more(prenominal) specific ones is called the _____. 7) The fundamental weakness in the research process is _____. 8) Which type of management question asks what do we want to achieve 9) In the Southeast, the potato snowflake market share held by the Lays brand is 46. This is an mental testingple of _____.10) An increase in hours of television viewing leads to increases in the sales of snack foods. This is an example of a _____. 11) To be categorized as a customer, an individual must have a history of shopping at the establishment at least twice onwards the start of the study with expenditures of more than 10. RES/351 Final Exam. This is an example of _____. 12) James is entering data on client gender. Because the values entered reflect male or female, this variable is _____. 13) Which variable in an experiment is the variable expected to be affected by the manipulation 14) Qualitative research seeks to _____ theory while quantifiable research _____ it. 15) Which of the following is true of quantitative research 16) The use of a control group in experimentation _____. 17) What is the first step in conducting an experiment 18) Data originating from studies that are conducted by others and created for a purpose different from the purpose of the study for which the data are being reviewed are called _____ data. Res 351 final exam 19) The goal of a formal study is to _____. 20) A _____ scale is a scale that scores an object or property without making a unionize comparison to another object or property. 21).What type of data is produced by simple category scales

Tystiolaeth Cyflawniad/Performance evidence record Essay

SYLWERGall eich asesydd ofyn cwestiynau llafar yn berthynas ir gweithg bedd hon. Sicrhau eu bod yn cael eu cofnodi yn y bocs priodol. Bydd rhaid ir person sydd wedi ardystio/arsylwi arwyddo y dudalen olaf NB Your assessor may wish to ask you some questions relating to this activity. Ensure they are either recorded in the per ricochetance evidence or on a Questioning record. The person who observed/witnessed your activity must sign and date the last page.Dyddiad y gweithgareddDate of activityUnedUnitCDLOTystiolaeth y perfformiadPerformance evidenceGood faculty are the key point to a successful business. They need to be the right person for the right role. A poor staff member can cost time and money and can in turn bring a lack of confidence in the Company by the authorities which use our services. IT is therefore imperative that the recruitment criteria to followed and adhered to. We sustain a recruitment and selection policy ( see evidence 1) We project to crosscut all aspects in the legislation needed for the health and social care industry.These include Asylum and Immigration cloak 1996.Data Protection Act 1998.Care Standards Act 2000.Rehabilitation of Offenders Act 1974.Safeguarding of Vulnerable Groups Act 2006.wellness and Social Care Act 2008.Equality Act 2010.We also have to cover Regulations in Health and Social Care, these include Health and Social Care Act 2008. avocation Equality Regulation (religion or belief and Sexual orientation) 2003. Employment Equality Regulation (age) 2006.Part time Workers Regulation 2000.There may be times when criminal convictions or cautions are disclosed on an exertion form or at interview stage. Some of these convictions or cautions may require us as a company to seek specialist dish up to read the full story of the offence. The Rehabilitation of Offenders Act 1974 allows some convictions to be ignored after a certain rehabilitation period. The reasoning behind this is so that the person holding the conviction w ill not have a lifelong scar on their record if it has been a minor offence in their past.Once the rehabilitation period is spent and no other convictions are made, in certain instances the person may not need to disclose the conviction, if for mannikin applying for a furrow. In adults the normalrehabilitation is 5 years for non- tutelar sentences, 7 years for custodial sentences up to 6 months and 10 years for custodial sentences over 6 months and up to 2 years Any custodial sentence over 2 can never be spent.. The period for preadolescent offenders is normally half that of an adult. Jobs in the care sector are exempt under the Rehabilitation of Offenders Act 1974 and all applicants must under- go and pass an compound DBS (disclosure and barring service) previous(prenominal)ly known as CRB (criminal records bureau)Huntley and Carr, Soham murders 2002.Ian Hunley had slipped through the net on his CRB as police had entered his name incorrectly and the wrong date of birth. Even with many previous allegations against children, none had resulted in any conviction, provided the school were aware of his past history but free employed him. Home Secretary David Blunkett stated he would start an investigation into the vetting system In this case police have declared they should have checked identity input was correct and that all previous allegations which were held on file should have been further investigated.Serious case review of Carefirst 24 establish in Surry. Domiciliary care company were employing illegal immigrants. practice of law and local council did emergency planning to remove clients from Carefirst 24 and place with other agencies. When Carefirst 24 offices were raided several self- funding clients were found, these too were placed with other agencies. Unfortunately Mrs foster had been over looked and was left with no care for almost 9 days, her care package was 4 calls daily. When she was finally found by a district confine and admitted to ho spital she was in a very poor state of health. She consequently died. During the enquiry it was found that there had been no multi agency communication i.e. gps visiting but unable to gain access out-of-pocket to not knowing key safe number, then not following up the appointment. The recommendations in domiciliary based care are toInvolve service user in their care plan and assessment, this should be done with face to face contact. Legible, dated and signed attention logs should be kept for each visit. Quality control procedures to be in place to detect any service deficiencies immediately. The manager, supervisors and carestaff should show a full commitment to the safety and wellbeing of all service users in their care at all times.No matter how large or subtle a company is, it is important to supply an up to date detailed job description to all employees, describing job requirements, reporting to higher post ordinary and expected performance standards.It is advisable to have t wo interviewers on the panel. A pre prepared list of questions should be asked to each interviewee and a scale of answers which should be flip overn. I need to ask questions such as, Do you have any problems with giving personal care? Do you have access to a reliable car, due to accessing some service users homes? I also have to gain knowledge into their flexibility to working hours, their knowledge of both Welsh and incline communication. I also wish to discover if the applicant has any previous experience or training qualifications. During interview I can also curb about their personality, team player abilities, emotional stability, confidence and their future goals. A lot can be learnt about the interviewees in their body language, are they positive/nervous relaxed/up tight, easy going/strict, good communicator or reluctant to engage in general conversation.Part of the interview includes double checking their application form with them, so that their answers are fully underst ood. This gives me the opportunity to make sure no needed information is missing, such as breaks in employment or residences. The last mentioned will be needed for the DBS process. I also ask if they know of any reason wherefore we should not be able to gain a reference from any of the 3 named referees given, (these referees have to be telephoned to confirm they are the person named and that they have completed the reference form themselves) I also give the interviewee another chance to declare anything which may show up on a DBS.If I feel an applicant is suitable for the role they have use for, I post out an application successful letter. This states that the offer is made on the receipt of successful references and DBS check. The offer can be withdrawn if these are not clear.Our methods and criteria to recruit new staff are the same at all levels. When an application form is received, it is read by 2 senior members of staff and at this point it is decided if an interview is to b e given. If a verbal offer of employment is given, it must also be followed up in writing.Health and Social care roles have a strict vetting system, which is normally safe and reliable. But as already pointed out with the Soham case things can go wrong. I promote honesty and openness at interviews as some convictions can be considered. If a person is recruited who is wrong for the organisation and role this can contain to quick staff turnover and increased costs for the organisation. It could also lower the morale of existing staff due to new employee not fitting in with the team by not working well in their role. It is important that any new employee has flexibility and commitment but they also need to have the passion to listen and learn. In the domiciliary care organisations continuous recruitment is ongoing. This is due to continuing expansion and needing trained staff in place in advance new service users can be taken on.Whilst interviewing it is important for the interviewer to smile and encourage the interviewee to feel relaxed. If an interviewee appears nervous this is not a sign of them being inapplicable for the role. Some individuals generally find interviews a nerve wracking situation but they are relaxed in all other situations. One of the questions I ask is, why have you applied to become a community care assistant with this company.I find the answer to this question is invaluable. I can discover if the candidate is really interested in the role or that it just a job or the DWP have made them apply for any job just to keep receiving their benefits. We advertise our vacancies through the local job centre and on internet media sites. We also advertise internally for higher positions vacant. These are still subject to an interview with the existing employee, although this is an easier interview as so much is already known about the applicant and their work standards.

Love Essay

When I think virtually the concept of love, my thoughts are uncertain(p). When I think about the contrive love, the four letters arranged in a random pattern, nothing is simpler. Clearly, a distinct difference lies between a expression and what it represents. The sizeableness of the word love lies in the power it has over people. When asking someone what love means, not one person has a solid answer to the question. The word love is so abstract, as to which why I adore the word Love.While growing older, we have used the word love in galore(postnominal) contexts. The word love can be referred to as a variety of different feelings and attitudes, ranging from just common pleasure I loved that meal to an unabated interpersonal attraction I love my boyfriend. The word love can be used in numerous ways and with endless feeling. In certain situations, the word love is such an expression that some cadences ones relationship might even depend on it. For example, If for a long time someo ne has not said I love you to a loved one, they might think something is wrong. The word love is a word that makes one applaud how much power one word could have.Love does not have just one meaning, but rather many different definitions. It is a word used in many different contexts, with many different levels of feelings that are unexplainable. Love is a word that is universal in every language of the world. Everyone knows of it or has used the word. Although we know of it, no person has an actual definition of it. The uncertainty of this word makes me realize how powerful the word is, even though we still come out to know what someone is trying to say. Everyone uses the word love, but never took a minute to think about its meaning. I adore this word and willing always think about as the future generations use the word love in ambiguity.

Should Teenagers Have Intimate Relationships?

In teen society, a relationship could seem a bad effect on the people around you. But is that really what a relationship is? Is it really wrong to be involved in a relationship during teenage bearing? No, I dont think so, in fact there ar more benefits to it. Some people think that if you get into a relationship, it would be extremely dangerous to yourself. They think that once you are in love with that person, you tend to give in all your heart and soul into the relationship. And if he/she of all time leaves you, you would be in a depressing state or even seek suicide.However, this is all not true, nigh early matured teenagers have ready mentally to protect themselves against sudden break-ups. In fact, some teens with high-level of maturity can be as mature as a 35 family old adult. Furthermore, there are people think that once a teenager gets into a relationship, he/she would neglected his/her friends and family. withal in the process of having a relationship, the boy or gir lfriend skill be exceptionally possessive and refrain his/her partner from getting close to friends and family.Though some teens are like the suit I have given above, only when not all are ungrateful brats to their friends and family, I would say. There are many who managed to bring their spouses out for convocation with their friends or families to get to know each other well. And I will definitely bring my girlfriend out for any kind of events. Apart from that, some people might even say relationship is bad, because of the word sex.Teens are curious about the bodies of the opposite sex while they are young, especially boys. So people always have this mindset of when teens are having a relationship is always related to sexuality, but that is definitely not true. Some boys are physically needy while girls are emotionally needy. For instance, boys want their spouses to satisfy them in sexual way, asking the girls to complete sexual acts for them, where the female might refuse to, but do it anyway, to prevent the relationship from ending.And females might want the boys to be always there for them listening to their complaints, talking to them, spending time understanding her etc. which the guys might feel it is a bit unrealistic. Despite that there are many boys that actually does it, there are some boys who is very concerned towards their girlfriends and sensitive to the feelings of their spouses. Also there are males who wouldnt take sex as the most important phase of relationships.It is utterly unfair for some of the boys out there. In summary, I am not against on intimate relationship at all. Because age isnt a barrier to prevent relationship from taking place, what matters most is whether you are emotionally wise to manage your time, your work, and your stress. And whether you are able to control your physical needs till your marriage. I dont think teens having involved in relationship will do any harm to the society we are living in.

Magistrate Power

Magistrate power to divvy up perception of the offensive After the stage of investigation is completed and the final report is forwarded by the law to competent magistrate, the s stage of fair trial begins that is taking of the sentience of the offence by the magistrate. In this stage some of the necessary steps hold to be publication place. These steps are (i)to take cognizance of the offence, ii)then the magistrate enquire that whether both(prenominal) prima facia case exist against the accused person and if it exist then, (iii)to issue passage against the accused person in decree to secure his presence at the time of trial, (iv)to supply to the accused person the copies of police statement. Cognizance of the offence subject matter In the Criminal Procedure command the term Cognizance of the offence is not defined but taking the cognizance of the offence is the first step towards the trial.The literally meaning of Cognizance is knowledge or notice and the taking co gnizance of offence means taking notice or becoming aware of the counsel of the offence. But the meaning of this expression is now well settled by the Courts. Taking cognizance does not involve any formal action of any kind but it occurs as soon as a magistrate applies his mind to the commission of the offence for the purpose of proceedings to take steps towards the Inquiry or Trial. It as well accepts intention of intention of initiating a judicial proceedings against an offender in respect of an offence.By whom the Cognizance of the offence is taken Under Section one hundred ninety of the Code, any magistrate of first class may take cognizance of any offence and any magistrate of second class, if specially empowered by the Chief discriminatory Magistrate, may take the cognizance of the offence. But the court of session is not to take the cognizance of the offence directly as it is under the original legal power unless the case is given to it by the magistrate. When the cogni zance is taken A magistrate take the cognizance of the offence i)upon receiving a complaint of facts which constitute such offence. (ii)upon a police report of such facts, (iii)upon information received from any person other than a police officer, or upon his own knowledge, that such offence has been committed The word Complaint mentioned in the above paragraph is defined under the Section 2(d) of the Code as any allegation make orally or in physical composition to a magistrate with a view to his taking action under this Code, that some person whether known or unknown has committed an offence, but it does not include a police report. So ordinarily a private citizen intending to initiate criminal proceedings in respect of an offence has two ways unfold to him. He may give information to the police if the offence is cognizable one, or he may go to the magistrate and file a complaint disregarding of the fact that whether the offence is cognizable or noncognizable. Now the questi on arises whether the magistrate is bound to take the cognizance in the above circumstances. In this the Supreme Court in the case of Gopal Das V. put in of Assam (1961) 2 Cri L. J. 39Observe that Section 190 of the Code does not means that once a complaint is filed, a magistrate is bound to take the cognizance of the offence if the facts stated in the complaint disclose the commission of any offence. But it becomes necessary for the magistrate to consider the reports of the police in the lead taking the cognizance in case the final report is made to the magistrate after the investigation by the police. Transfer of case on the application of the accused The magistrate may also take the cognizance of the offence upon his own knowledge or information.But Section 191 of the Code requires that the accused person must have to be inform forward taking of any evidence that he is entitled to have the case inquired into or tried by another magistrate and if the accused objects the procee dings being conducted before the magistrate taking the cognizance of the offence, the case will have to be transferred to such other magistrate as may be specified by the Chief discriminative Magistrate. Also the refusal to the request of the transfer in such a case would be illegal.Section 192 of the Code, has empowered the Chief Judicial Magistrate or a duly snuff it magistrate of first class to transfer a case to another competent magistrate and the transfer made under the Section 192 lot only be made after taking cognizance of the offence. Limitation on the power to take cognizance of an offence Section 195-199 are exception to the general rule regarding the cognizance of the offence contained in Section 190. These are given below 1. Prosecution for contempt of lawful authority of public servents Under Secion 195(1) it is provided that the cognizance of the following offences cannot be taken by any court (i)offence is punishable under section 172-188 of the IPC, (ii)offen ce of abetment, attempt to commit, etc (iii)offence of criminal conclave. except on the complaint in piece of music by the public officer concerned there or the complaint made by any public servent who is senior to the public officer concerned. The section 172-188 of the Code given in this section relates to the offence of contempt of lawful authority of public servants.For example preventing the service of the summons, not obeying the legal order of the public servants, not producing documents so required by the public servants. and where the complaint has been made by a public servant, any authority to which he is subordinate can order the withdrawl of complaint and send a copy of such order to the court, and on the receipt of such order by the court, no further proceedings shall be taken on the complaint. 2. Prosecution for offence against public justice and for offences relating to the document given in evidence Under Section 195(1)(b) no court can take the cognizance (i)of a ny offence punishable under any of the following sections of the I. P. C. namely 193-196, 199,200, 205-211 and 228 when such offence is alleged to have been committed in or in relation to the any proceeding in the court, (ii)of the offence punishable under section 475 or 476 of IPC when such offence is alleged to have been committed in respect of document produced r given in evidence in a proceedings in any court, or iii)of any criminal conspiracy to commit or attempt to commit or the abetment of any offence mentioned above except the complaint in writing of that court, or of some other court to which that court is subordinate.3. Prosecution for offences against the State Under Section 196(1) of the Code, any court shall not take the cognizance of the (a)any offence punishable under section 153-A, 153-B, section 295-A or Section 505 of IPC or (b)a criminal conspiracy to commit such offence,or (c)any such abetment, of the offence. xcept with the previous sanction of the central Go vernment or the State Government. The offences above referred under the IPC relates to the offences against the State, for example promoting the enemity between the two groups of people, outraging the religious feeling of particular class etc. The object of this restrictive provision is to prevent unauthorised persons of state does not insitute suit against each other for just a small matter. 4. Prosecution for offence of criminal conspiracy Under Section 196(2) any court cannot take the cognizance of the offence which is punishable under S. 120-B of the I. P. Code other than punishable under death, imprisonment for manner or other imprisonment for which the term is two years or upward unless the state government or the district magistrate has consented in writing to the intiation of the proceedings. The State Government or the District magistrate may before giving the consent can order the investigation by the police officer.

Freshwater Biome Essay

The Freshwater Biome By Lauren Finnis The freshwater biome is a complex biome that croupe be found all over the world.There atomic number 18 two major fonts of freshwater biomes. The first type is lotic or running which embarrass rivers and streams. Lentic or standing is the second type those include lakes and syndicates. Since this biome is found worldwide, the species that reside in it can vary extensively, but usually it contains several species of weight, plants, and insects.Predation is a way of life in the freshwater biome. It is the main way food and energy argon obtained by well-nigh of the organisms. The plankton, algae, and weeds that produce their own food through photosynthesis are preyen by the smaller fish like the minnows. Then heavy(p)r fish like bass, trout, and pike eat these smaller fish. Finally birds, large mammals, and humans catch the large fish.In the freshwater biome, there are several ex commodiouss of symbiosis. The relationship amidst the freshwa ter sponge and spongillafly is an example of paratism. The spongillafly lays its eggs on the sponge, and then they hatch and unravel off the sponge.Another parasite is the flatworm. It resides in organisms such as the snail and can infect them with lifelessly diseases. There are in addition examples of commensalism in this biome. First is the relationship between small fish and the pond weeds the fish hide between these weeds from larger fish. Another relationship of this type is the peerless between oysters and the mangrove trees. The oyster anchor and protect themselves with the roots of the tree.Finally there are also examples of mutaulistic relationships. For example some small fish enter clean the mouths of larger fish, and in exchange, they may eat whatever they clean out.There are several narrowing factors in the freshwater biome. One of the most important is the availability of sunlight. In areas with little sunlight, photosynthesis can not occur therefore, most plants can not live. Sinceplants are the base of the food chain the whole ecosystem falls apart. Salinity is also a limiting factor. In freshwater areas, there must be a salinity of .05% or less for most organisms to survive. Humans are actually limiting factors also. We destroy and pollute habitats and eat the animals and plants in the biome.Population parsimony in the freshwater biome varies greatly. In rivers or streams, density is usually lower in the faster touching biomes because organisms must fight the current. In lakes and ponds, the topmost areas usually are more dense because there is an ample supply of light for photosynthesis. The highest densities will probably be found in the more temperate areas that organisms can adapt to more easily.The carrying capacity of the freshwater biome depends on the size, location, and availability off light. Biotic potentials in the biome are most likely extremely large. This is because the main organisms are fish, which lay eggs in numerous amounts. Of be given the carry and the biotic potential are rarely met because there are natural enemies and predator. There are also billions of one of the most deadly predator to the biome, humans.

Conformity and Obediance in ‘Schindler’s List’

Authority and Obedience Speech Familiarity. Is this truly beneficial, or preferably an obstacle for the large number who yearn to make a difference and move forward in life story ? If I were to ask all of you here today, atomic number 18 you afraid of being alone and cast aside, you would all, yes. pot are afraid not to conform to the extent that you allow others to formulate your so-called creed and roam you into people they envision, not needs the person you aspire to be.All of a sudden, your behavior pattern is the exact comeback of your leader, you begin raring your beliefs from them, hanging off their e actually word until Inevitably, you become utterly devoted. Whether your reasons are solely nullity or crimson Just exhaustion of being constantly ignored, you support now mazed yourself and are living the life that has been mapped out by someone whom you thought you could trust. Familiar Is not necessarily genuine, It Is only familiar. Comfortable is not necessarily good, It Is often Just familiar.Doll Hitler, the Chancellor of Germany during WI, was, in hindsight, one of the close to narcissistic leaders to date, however his true hearted was buried within his authoritative charisma and hypnotic speeches. Oscar Schneider and ammo Goethe were both fascinated by the authoritative Influence of which their country was surrounded, Both were raised on the very essence of fascism. With these thoughts of tyranny planted deep within their vulnerable minds, these views began to grow and develop into a musical mode of life.Initially manipulating the system, Schneider was concerned only with himself and the success of his moneymaking scheme, however over time, undergoes a change that romps him to spend his raft to save the lives of those he once exploited. He attempts to hide behind his constant self-control because he was taught that picture is for the weak, yet somehow In spite of this, still seems vulnerable, one could even say fragile, a peculi arity he shares with his foe Goethe.HIS vulnerability is truly highlighted in the end of the movie where he convinces himself that he could have saved more Jews and collapses into the arms of his Jewish accountant and friend, Ithaca Stern. Stepping away from the familiarity and secure Identity of authority In he Nazi party, made him shed his skin of cold hard steel to reveal a much more softer, more vulnerable side of this hero who conquered not only the Nazis but above all, himself and his own feelings of conformity and compliance.To be able to stand up and overpower the protected familiarity he grew up admits, is utterly Inspiring and en endurances us to not always take the section of the sheep but to assume the role of the Sheppard and develop our own ideas instead of merely trusting the charismatic leader of the age. Unlike Schneider, Goethe never manages to grade Into goodness. However, the lack of hang In his basic nature does not render him a one-dimensional character.On the contrary, Goethe is a complex and conflicted man who is torn between the familiar and 1 OFF in the form of the Nazi party as a child, however at this point, having grown and developed an even stronger, habitual even a somewhat fearful sense of narcissism, it is difficult for Schneider to sub due Goethe way of life like he has his own. Sooths fear of change, his fear of stepping into new realities, is so profound that he desperately clings to the existence he knows, to the world he has become a part of. His unwillingness o break free from these constraints ultimately leads to his downfall.We detect one of his participations within himself where he first pardons a Jewish boy and then turns and shoots him, not inclination the new picture of himself. Animosity takes over his mind and he resorts to his all too familiar ways. He is too weak, or rather too terrified to face himself face what he is becoming due to the simple fact it involves change. Change is the adversary, in Sooth s eyes and shown through this little Jewish boy. Hence he thought if he relieved himself of this boy, he would get rid of the change and go back o his life where everything way simple and by the book. Inspire of this change continued to haunt him, to creep up on him and strike when he east expected. A war against ones self is a most terrifying ordeal because no matter where you run, where you hide, it will always be with you, tempting you, harassing you and finally consuming you. Chandlers total is no less a Jewish story or a German story than it is a human story. And its subject matter applies to every nation. Of course, the film is about racial hatred and the brutality of humankind, however my interpretation of the two main characters, stems from the concept of not only a war against nations but really a war against ones self.Within Steven Spielberg merciless depiction of Goethe, we witness his battle within his own self, a battle of which he could not win. In the beginning, Goe the was Just like any other Hitler drone, a soldier whom had no intention to question Hitters authority. However, once Schneider had planted seeds of doubt and punctured his barrier of obedience, disorder began brewing infra his cold and heartless exterior. The strange logic Schneider introduces to Goethe, forces IM to acknowledge and re-evaluate learned perceptions that he had previously accepted.Today our society raises us to believe that obedience is good and disobedience is bad. We are taught that we should all do what were told and that the people that are disobedient are almost always bad people. Society tells us this, but it is not true. Most people will even be obedient to the point of causing harm to others, because to be disobedient requires the courage to stand alone against authority. Disobedience is not always wrong. The truth is sometimes it is necessary to be rebellious. Mans increase has largely been affected by being defiant.Authority that has tried to prevent ne w ideas and keep things as they are because of the fear of being overpowered and contradicted. It can cause the most ethical and moralistic to abandon their core set and seemingly close their eyes while following an unjustified authority. Learning to distinguish between the salutary and wrong guidance would have assisted Goethe to come to terms with himself and those around him. However, Just like the good and evil concept, where there is conformity, there must

An Assessment of Nhif Utilization in Kiwanja Market

AN ASSESSMENT OF THE UTILIZATION OF NHIF BY RESIDENTS OF KIWANJA MARKET, KAHAWA due horse operamostside LOCATION, KASARANI DIVISION IN NAIROBI. Presented by Ann Mwangi Registration number I30/2160/2006 A enquiry proposal submitted in partial derivative fulfillment of the invitements for the select of the degree of Bachelor of Science (nursing and populace wellness) in the school of wellness sciences of Kenyatta University. February, 2010. annunciation STUDENTS DECLARATION This proposal is my original work and has not been hand overed for any academic award in any different University or college.Signature Date.. plant Ann Mwangi Registration number I30/2160/2006 supervisory programS DECLARATION This proposal has been submitted for review with my approval as a university supervisor. Signature .. Date. Name Mrs. Makworo Department Nursing sciences. ABBREVIATIONS AND ACRONYMS NHIF guinea pig Hospital Insurance investment firm MOH Ministry of wellness CAP ChapterHMOs Heal th focusing castment UNICEF United Nations Childrens Fund KIPPRA Kenya institute for world policy research activities and analysis running(a) DEFINITIONS Health c atomic number 18- Goods and go utilise as inputs to produce wellness. In approximately analyses aces decl atomic number 18 time and knowledge ingestiond to principal(prenominal)tain and promote wellness be considered in additional to naturalized inputs. Used synonymously with Medic ar in this conceive.Health maintenance organization (HMOs) It is a negotiated c are plan that integrates finance and deli precise of a comprehensive set of wellness care serve to an enrolled race. HMOs whitethorn contract with or directly employ health care runrs. Social restitution Its a presidential term redress architectural plan in which eligibility and premiums are not determined by the practices common to private indemnity contracts. Premiums are often subsidized and thither is typically redistri thoion from some segments of the existence to others. Health care finance- Refers to turn oering(a) or bread and butter of health care serve take into accountd or to be deliver the hotsd.It is not Medicare per se that consumers want still health itself. Medicare demand is a derived demand for an input that is employ to produce health. Health care consumers do not merely purchase passively from the food market, but instead produce it, spending time on health improving efforts in addition to purchasing Medicare input. ABSTRACT The subject Hospital amends Fund (NHIF) is an important aspect of healthcare endure through genial health policy in Kenya. It was launch by the governing body of Kenya (GoK) in 1966 as a hearty amends fund.At its inception, the NHIF was meant to assist GoK employees to foregather access to high prize private hospitals, thereby relieving congestion in the unaffixed public hospitals. The NHIF has principally foc determinationd on the semiformal arena e mployees in the past around foursome decades. This has left those diligent in the escaped sphere. This contract is attempts to analyze and understand the demand for sociable health amends of the liberal firmament workers in Kiwanja market by assessing their perceptions and knowledge of and concerns regarding internal Hospital Insurance Fund.It forget shell stunned to explore how much idle sector workers could be integrated into the NHIF final cause. The research design to be employ testament be a descriptive cross-sectional paper. The theater of operations of memorize is Kiwanja market in Kahawa atomic number 74 location. The subscribe to population entrust include Kiwanja residents in a higher flummox 18 divisions of age, and employed in the versed sector. The smack size leave be 76 as determined using a model statistical formula and the respondents selected through cluster sampling. A structured misgivingnaire pass on be used to gather in selective breeding. Pretesting of the data solicitation tool leave alone be done in Kihunguro expanse in Ruiru.The data collected will be entered, coded and keyed into variables using SPSS version 12- computing device software and excel calculator packages. Quantitative data will be analyzed using SPSS version 10 computer software. monstrance of quantitive information will be done using statistical packages (graphs, charts, tables and pie charts). The run a riskings, conclusions and recommendations of this study will be very important in formulating sentience campaigns and educational materials that will enable the residents of Kiwanja in the informal sector of body of work to realize the significance of NHIF programmes in funding their healthcare.TABLE OF CONTENTS DECLARATIONii ABBREVIATIONS AND ACRONYMSiii OPERATIONAL DEFINITIONSiv ABSTRACTv CHAPTER ONE1 1. 0 INTRODUCTION1 1. 1Background to the study1 1. 2 offerment of the problem4 1. 3Justification of the study5 1. 4 look in to questions5 1. 5 Objectives of the study6 1. 5. 1 Broad objective lens6 1. 5. 2 Specific objectives6 1. 6 Research assumptions6 1. 7 entailment of the study6 CHAPTER TWO7 2. 0 LITERATURE analyze7 2. 1 Social health amends7 2. 2 Healthcare financing through health indemnity in Kenya9 2. 2. 1 The National Hospital Insurance Fund (NHIF). 10 2. 2. 2 fond side to NHIF10 . 2. 3 Mode of Payment11 2. 2. 4 Benefits and cover11 2. 2. 5 How to access returns11 2. 2. 6 Accredited hospitals12 2. 2. 7 Milestones12 2. 2. 8 The approaching of NHIF12 2. 3 Factors influencing usage of social health insurance services. 13 2. 3. 1 Feasibility analyses of social health insurance14 CHAPTER THREE20 3. 0 RESEARCH METHODOLOGY20 3. 1 Research design20 3. 2 Study area20 3. 3 Study population20 3. 4 inclusion body and exclusion criteria20 3. 4. 1 Inclusion criteria20 3. 4. 5 exception criteria20 3. 5 Sampling technique and consume size21 3. 5. 1 Sample size determination21 . 5. 2 Sampling techni que22 3. 6 Data collection procedures22 3. 6. 1 Research instruments22 3. 6. 2 Pre testing22 3. 6. 3 Data collection process22 3. 7 Data management23 3. 8 Limitations of the study23 3. 9 Ethical considerations23 REFERENCES24 WORK PLAN FOR THE STUDY. 26 BUDGET27 APPENDICES28 INSTRUMENT FOR info COLLECTION (QUESTIONNAIRE)28 CONSENT FORM31 MAP OF STUDY AREA32 CHAPTER ONE 1. 0 INTRODUCTION 1. 1Background to the study The concept of National Hospital insurance Fund (NHIF) is an important aspect of healthcare financing through social health insurance in Kenya.In a developing acres care Egypt, the Health Insurance Organization (HIO) is prominent among many health introductions involved in health financing and provision, and a key thespian in the countrys health sector reform programme. It was established in 1964 as the institution in Egypt responsible for social health insurance, providing absolute health insurance to workers in the formal sector (Abd et al. , 1997). peerless of the overall goals of the Government of Kenya is to promote and improve the health status of all Kenyans by qualification health services more answerive, accessible, and affordable.Therefore health policy in the country revolves around deuce critical issues, namely how to deliver a canonical package of character health services, and how to finance and manage those services in a way that guarantees their availability, accessibility and affordability to those in more or less need most health care (Kimani, Muthaka, and Manda, 2004). On achieving independence in 1963, the Government of Kenya (GoK) committed itself to providing free health services as part of its reading strategy to alleviate poverty and improve the wel furthermoste and proceedsivity of the nation (GoK press, 1965).This do work merry was honored in 1964 with the discontinuation of the pre-independence user fees, and the introduction of free placepatient services and hospitalization insurance for all children in th e public health facilities. Services in the public health facilities remained free for all except those in employment whose expenses were met by their employers (Owino, W. and Were, M. , 1998). Through pecuniary support from the central government, strategies were developed to expand the health stem and support the entire health system. The GoK established NHIF in 1966 as a social insurance fund.At its inception, the NHIF was meant to assist GoK employees to gain access to higher quality private hospitals, thereby relieving congestion in the free public hospitals. The NHIF has mainly focused on the formal sector employees in the past around four decades. This has left those employed in the informal sector. Structural reforms and poor economic growth guard increasingly pushed labor into the informal and small scale agriculture sectors where livelihoods are often insecure and incomes are petty(a) and uncertain (Kimani, Muthaka, and Manda, 2004).As a way of reaching out to those in the informal sector and the poor, the government plans to transform the trustworthy NHIF to National Social Health Insurance Fund (NSHIF). The aim is to ensure honor and access to healthcare services by the poor and those in the informal sector, who require been left out for the last forty years that the NHIF has been in existence. It is too evaluate that the new precis will summation healthcare services employ, which has suffered under cost sharing, by extending benefit package to also cover outpatient care.The current cost sharing will be replaced by pre- stipendiary percentage into the new scheme (Kimani, Muthaka, and Manda, 2004). The principal choices for financing a health care system are general taxs, social insurance funding, and private insurance financing and out of pocket payments. General revenue financing here refers to a system of revenue collection through a broad based tax. All or portion of this tax may be dedicated to the health care system . general rev enues may be energised at the federal, state, provincial, or local levels.According to the United Nations system of national rate, 1993, Annex IV par. 4. 111, an insurance programme is designated as a social insurance programme if at least one of the followers tether conditions is met a) Participation in the programme is compulsory either by law or by conditions of employment. b) The programme is operated on behalf of a group and is restricted to group fragments. c) An employer makes a contribution to the programme on behalf of the employee. National Hospital Insurance Fund (NHIF) is consequently a social insurance financing in Kenya.NHIFs core function is to collect contributions from all Kenyans earning an income of over Ksh 1000 ($12) and pay hospital benefits out of the contributions to members and their declare dependants (spouse and children) Whilst ensuring that Kenyans of all walks of life have access to quality and affordable healthcare, NHIF operates under the socia l principle that the fat should support the poor, the healthy should support the sick and the young should support the old. 2. Statement of the problem The GoK established NHIF in 1966 as a social insurance fund. At its nception, the NHIF was meant to assist GoK employees to gain access to higher quality private hospitals, thereby relieving congestion in the free public hospitals. The NHIF has mainly focused on the formal sector employees in the past around four decades. This has left those employed in the informal sector (Republic of Kenya, 2003a). There exists an information gap on informal sector Kenyans utilization of NHIF services, in instances where studies focus on informal sector employees, NHIF is a social health insurance and an important aspect healthcare financing in Kenya that is often neglected or not fully explored.Majority of studies carried out focus on utilization of NHIF services across general Kenyan population irrespective of the employment sector. This has led to prep of healthcare financing programmes that do not address the specific needs of Kenyans in the informal sector. to a greater extent so, tools of analysis by most relevant studies are limited to univariate and bivariate analysis falling con of examining the net effect of selected background and intermediate factors negatively impacting healthcare accessibility and utilizations by workers in the informal sector of employment.The study is designed to assess the level of knowledge and utilization of NHIF in Kiwanja market because it is an area whose majority of residents are in the informal sector of employment. 3. Justification of the study Taking into considerations the animated information gap on utilization of NHIF services by informal sector employees, it is important to undertake this study in Kiwanja market to establish the awareness level and its use. Kiwanja market is a densely populated area behind Kenyatta University. Majority of Kiwanja residents are in the informal sector.The study is designed to divulge the potential hindrances of utilization of NHIF services in Kiwanja residents in the informal sector and ways of how to remove them. The study seeks to explain and provide a arrogant body of knowledge that can be explored for appropriate policy formulation, to act as an eye opener and reminder to both the NHIF management team, and other stakeholders to raise the utilization of NHIF services by the informal sector in Kenya. Knowledge deficit regarding NHIF benefits and use to finance health care contributes greatly to the high mortality and morbidity rates due to poor health seeking behavior (Inke et al. 2004). preparation of information and face lift awareness on NHIF benefits and use will reduce significantly the number of significant women delivering at home due to lack of funds to pay for hospital delivery. 1. 4 Research questions The research questions for the study will be a) How informed are the members of Kiwanja market slightly N HIF benefits? b) What percentage of Kiwanja market residents use NHIF services and are in the informal sector? 1. 5 Objectives of the study 1. 5. 1 Broad objective To assess the awareness on NHIF benefits and utilization of NHIF services by Kiwanja market residents. . 5. 2 Specific objectives a) To generate out the knowledge level of Kiwanja residents around NHIF. b) To determine the number of Kiwanja residents who are NHIF beneficiaries. 1. 6 Research assumptions The residents of Kiwanja market are knowledgeable about health care financing, they are aware about NHIF benefits but they do not use it because they think it is sole(prenominal) meant to benefit those tribe in the formal employment sector. 7. Significance of the study This study aims at finding out if Kiwanja residents utilize NHIF services.In addressing the objectives, the study will identify the level of utilization of NHIF services, factors influencing its utilization and come up with ways of addressing any shortco mings that will be place and help in improving NHIF services utilization. The findings, conclusions and recommendations of this study will be important in formulating awareness campaigns and educational materials that will enable the residents of Kiwanja in the informal sector of employment to realize the significance of NHIF programmes in financing their healthcare.This study attempts to find out the awareness on NHIF benefits and use by residents of Kiwanja market. It will therefore benefit the residents of Kiwanja and empower them to acquire their human right of health care. CHAPTER TWO 2. 0 LITERATURE REVIEW 2. 1 Social health insurance The concept of health insurance was first proposed in 1694 by Hugh the Elder Chamberlen from the Peter Chamberlen family. In the late 19th century, accident insurance began to be available, which operated much like modern disability insurance.This payment model continued until the start of the 20th century in some jurisdictions (like California) , where all laws regulating health insurance actually referred to disability insurance. During the 1920s, individual(a) hospitals began offering services to individuals on a pre-paid basis, eventually leading to the development of Blue Cross organizations. The predecessors of todays Health Maintenance Organizations (HMOs) originated beginning in 1929, through the 1930s and on during World War II (Weber, 1994).A health insurance scheme is social when it subsidizes the poor, the elderly and the sick, and when it promotes equity and access to everyone and not for profit. The core values in social health insurance embody a concern for the plight of the poor. In social insurance financing, health services are paid for through contributions to a health fund. The most common basis for contributions is payroll, with both the employer and the employee paying a percentage of the salary. In general, social status to a social health insurance schemes is requisite, although it can be voluntar y to certain groups much(prenominal) as the self-employed.The health fund is unremarkably independent of the government but works within a tight framework of regulations. Premiums are linked to the average cost of discussion for the group as a whole, not to the expected cost of care for the individual (Conn , 1998). While there is no popular propositionly accepted definition of what social insurance is, Kraushaar and Akumu (1993) outline some broad characteristics, which are generally agreed upon. These are a) Coverage is generally compulsory by law ) Eligibility for benefits is derived from contributions having been made to the programme c) The benefits for one individual are not usually directly related to contributions made by that individual but often those benefits aim to redistribute income between different income groups. This redistribution is usually from the rich to the lower income groups or from those with few to those with many dependants. Equity of benefits regard less of payment is the rule. d) There is generally a plan or the financing of benefits that is designed to be adequate in the long term. ) Governments manage nearly all such(prenominal) social insurance organizations. f) Revenues go fully and unchallenged to health and are not controlled by the treasury in a nominaten country. Conn and Walford (1998) explain the rationale for health insurance in a low-income country with the following third arguments a) Attracting additional bullion for health. This is so because health insurance is perceived as an additional source of money for healthcare. Consumers are more enthusiastic about paying for health insurance than paying general taxation as benefits are specific and visible. ) Getting better value for money because consumers are more able and prefer to pay regular, affordable premiums rather than paying fees for treatment when they are ill. c) Improving the quality and targeting of healthcare. Historically, HMOs tended to use the te rm health plan, while commercial insurance companies used the term health insurance. A health plan can also refer to a subscription-based medical care arrangement offered through HMOs, preferred provider organizations, or point of service plans. These plans are similar to pre-paid dental, pre-paid legal and pre-paid vision plans.Pre-paid health plans typically pay for a fixed number of services. The services offered are usually at the discretion of a utilization review nurse who is often undertake through the managed care entity providing the subscription health plan. This determination may be made either prior to or aft(prenominal) hospital admission (Weber, 1994) 2. 2 Healthcare financing through health insurance in Kenya Health insurance in Kenya has been provided by both private and public systems. The main objectives of the he health systems have been to insure Kenyans against health risks that they may encounter in future.Health insurance is considered private when the thre e party (insurer) is a profit organization (Republic of Kenya, 2003a). In private insurance, people pay premiums related to expected cost of providing services to them. Therefore people who are in high health risk groups pay more, and those at low risks pay less. Cross-subsidy between people with different risks of ill health is limited. Membership is usually voluntary. state-supported health insurance in Kenya is provided by the National Hospital Insurance Fund (Kimani, Muthaka, and Manda, 2004). 2. 2. The National Hospital Insurance Fund (NHIF). The NHIF was established in 1966 under chapter (CAP) 255 of the Laws of Kenya to be run by an informatory Council appointed by the Minister of Health. The NHIF was established in 1966 under CAP 255 of the Laws of Kenya to be run by an Advisory Council appointed by the Minister of Health. It catered for salaried employees earning Kshs. 1, 000 and above per month, making a monthly contribution of Kshs. 20/= . In 1972 an amendment was made to incorporate voluntary members (self-employed) at a monthly contribution of Kshs. 0/=. In 1998, Cap 255 was repealed and replaced by the NHIF Act No. 9 of 1998 which transformed the fund to a State Corporation managed by an all inclusive Board representing various stakeholders and interest groups (Republic of Kenya, 2003a). 2. 2. 2 Membership to NHIF Membership to NHIF is open to all Kenyans aged 18 years and above earning a monthly income of kshs. 1000 or an average yearly income of kshs. 12, 000. There is no upper ceiling for the age. 2. 2. 3 Mode of Payment Employers effect deductions and remit to the fund by cheque or cash, and E-banking.Members in the informal sector pay in any of the NHIF offices Kshs. 160 per month for informal sector members. Members in the informal sector pay in any of the NHIF offices. All payments should be received by the 9th of the following month. For retirees/self employed persons payment for the year may be paid upfront quarterly, semi-annually and /or annually. 2. 2. 4 Benefits and cover a) It covers all admission cases with few exceptions such as circumcision with no medical checkup required. b) Covers member, spouse and children under the age of 18 year. ) Children over 18 yrs and in learning institutions are also covered d) It covers for 180 days of hospitalization in a year. NHIF pay a daily rebate which ranges from Ksh. 400/= to Ksh. 2, 200/= Foreign claims. The number of other spouses is not limited and depends on the ability to pay for them. 2. 2. 5 How to access benefits Through presentation of the following to hospital on admission Current NHIF Card- both manilla and photo card, Certificate of Contributions Paid (CCP) recognize and the national Identity card. The accredited hospitals deduct the daily rebate X number of days of hospitalization from the incurred bill.While for the contracted hospitals under category A, the entire bill is made by the Fund, the Fund reimburses member for costs incurred to the extent of the daily rebate if for one reason or another he /she is uneffective to use the card in Hospital. All claims should be received within 90 days subsequently hospitalization. 2. 2. 6 Accredited hospitals Four hundred and fifteen health care providers have been enlisted across the country to provide services to NHIF beneficiaries under various contracts. Accreditation by NHIF is based on certain set standards and criteria for persona of NHIF benefits.Quality Assurance and Standards Department consistently monitors the quality of services. 2. 2. 7 Milestones Increased rebates up to a utmost of 2,200 depending on hospital accreditation. It has an extensive branch network with 27 branches, satellite and window offices. It offers decentralized services, computerized operations and services and has a quality assurance and standards department in place. 2. 2. 8 The future of NHIF NHIF in future will use magnetic stripe card in hospitals to access benefits, introduction of diversified pro duct lines, and further expansion of branch network.The ministry of health has designed a mandatory social health insurance scheme which seeks to transform the NHIF into a National Social Health Insurance Fund (NSHIF) to provide health insurance cover to both outpatients and inpatients. The main objective of the fund is to facilitate the provision of accessible, affordable and quality healthcare services to all its members irrespective of their age, economic or social status (Republic of Kenya, 2003c). 2. 3 Factors influencing utilization of social health insurance services. In most economically advanced countries, adequate social security department laws are basically taken for granted.However, it often took many decades for social security systems to benefit all or major parts of the population in those countries. In the area of social health protection, for example, it took Japan 36 years to move from the enactment of the first health insurance law to the final law establishing nation-wide social health insurance. In the United Kingdom, a similar time period was needed to achieve its universal tax-based system (Inke et. al. 2004) Social Health Insurance (SHI) is not a widely adopted health financing mechanism in Africa.While there are many countries that operate a health insurance scheme for civil servants and/or private sector employees only some of these include features of a SHI, its good luck charm to cover larger parts of the population has been growing. Countries including Ghana, Nigeria and Rwanda have passed SHI laws. Earlier on, Kenya investigated the feasibility of SHI and Lesotho and Swaziland are doing so now. One distinct feature is that it does not call exclusively on public finance, but instead spreads the office of health care financing among households and the private sector as well.From that point of view, tax-based systems in Africa are in particular challenged the overall tax base may need to be strengthened, tax compliance may requi re improvement, and then a sufficient allocation towards health would have to be called for. Still, social health insurance is not a panacea either. It requires that an important organizational apparatus be put in place and that many actors in society shoulder critical responsibilities, such as the willingness and ability to contribute to the SHI scheme and then to comply with its regulations, thereby accepting a certain degree of financial solidarity (Kimani Muthaka ,and Manda, 2004).Aiming at universal health coverage for its 9. 5 million populations, Rwanda has spearheaded the development of a number of schemes that together constitute its SHI system. The three most important ones are the Rwandaise dassurance maladie (RAMA), the Medical Military Insurance (MMI) and the Assurances Maladies Communautaires (AMCs). The RAMA social health insurance is compulsory for government employees and voluntary for private sector employees. Its contribution rate is 15% of basic salary (shared e venly etween employee and employer). MMI covers all military personnel, who pay a contribution rate of 22. 5% of basic salary (5% paid by employee and 17. 5% by government). AMCs are community-based health insurance schemes whose members are mainly rural dwellers and informal sector workers in both rural and urban areas. They make up the majority of the population by the end of 2007 about 5. 7 million Rwandans were covered by AMCs. Members usually contribute 1000 Rwandan Francs (1. 5 US$) per person per year which is matched by the government (Stilglitz, J. E. , 2000) 2. 3. 1 Feasibility analyses of social health insurance Since 2002, the WHO has been involved in technical advisory work especially on assessing the feasibility of SHI in Kenya, Lesotho and Swaziland in collaboration with national experts from those countries. In each country we analyzed the financial, organizational and political feasibility. Below we present some of the highlights of this work that should help us in formulating general guidance (Inke et. al. 2004) In Kenya, one basic financial scenario was that of gradual implementation of universal health coverage coverage by a executable National Social Health Insurance Fund (NSHIF) would reach 62% of the population after 10 years, with further expansion in the second decade of SHI implementation. An important feature is that such a scenario would only be conceivable with sizable government subsidies. Without such subsidies, access to health care among low-income households would be jeopardized, as the contributions From formal sector employees and civil servants would be insufficient to cross-subsidize the needed health care of the poor.External donors financial support, however, could alleviate this extra financial weight down on government. In fact, a variant of the basic scenario assumes that outside(a) donors would finance the provision of antiretroviral therapy, which would reduce the required government subsidies by about 20%. As fa r as the organizational aspects are concerned, it was studied whether the existing National Hospital Insurance Fund, a mandatory hospital insurance scheme for the formal sector with a small part of voluntary insurance for informal sector workers, might be transformed into the NSHIF.The latter would then be governed by a Board of Trustees with representatives from civil society. It is also interesting to note that the proposed NSHIF would include a Department of Fraud and probe in order to check the funds financial activities. Civil society groups and enterprises such as the Post routine would also be given a role, especially in the collection of contributions from households in the informal sector (Inke et. al. , 2004) Concerning its political feasibility, consultations were held with a great number of stakeholders and interest groups, and most were supportive of the proposed NSHIF.Only Kenyas private Health Maintenance Organizations were very critical and had doubts about NSHIF f easibility. Finally, in 2004, the Kenyan Parliament passed a law on the NSHIF. However, President Kibaki judged it still needed amendments and returned it to Parliament for further debate that is still ongoing. Nonetheless, with a long-term vision, the existing National Hospital Insurance Fund is undertaking a number of institutional changes to increase membership and extend benefits so as to be better prepared should SHI take off (Inke et al. 2004) Factors which influence the use of NHIF services in Kenya include ignorance, socio-economic factors, cultural factors, and demographic factors. Services information availability and accessibility also determines the utilization of social health insurance. Owino and Were (1998), in their study of enhancing healthcare among the vulnerable groups in Kenya ,found out that higher levels of awareness on health insurance, was associated with greater use of social insurance and thus better healthcare among the vulnerable people.In another study , a poverty survey by the UNICEF and overseas development Agency in 1995/96,it was found that user fees in Kenya made visits to government facilities prohibitively costly as the poor were required to make payments to reach the registration table, instead of using social insurance rebates. Worse, after the payments, the patients were asked to provide paper for record purposes. These costs could have been covered less difficultly by NHIF or more so NSHIF were they well informed of the benefits and the ease of membership.The study by Mwabu and Wangombe (1995) showed that the introduction of outpatient fees in Kenyas public hospitals reduced the demand by a large proportion, and concluded that introduction of fees, or any upwards revisions should be preceded by investments to raise quality of services and a well worked system of health insurance. The people should then be well sensitized on the benefits of joining into health insurance schemes. Huber (1993) did a systematic assessment of outpatients requiring exemptions, based on data from surveys in three districts in Kenya. The computer science was based on information on the households ability to pay.The study established the criteria for determining ability to pay on the assumption that households do not need to pay more than 5% of their annual incomes on healthcare from their pocket fees. As a result, households with cumulative health expenditures greater than 5% were assumed to condition for the exemptions. The main conclusion from the study was that, it is not possible to tell who cannot pay fees by personal characteristics and so all people of the entire population should be enlightened on social insurance schemes such as NHIF and be encouraged to be members even when they are self employed.In a study carried out in Kenya (coast province) by Inke Mathaue (2007), on assessment affecting health services demand extending social health insurance to informal sector in Kenya. Inke found out that, in the sum scuffle of the demand-side determinants can be turn to with a well designed strategy, focusing on awareness raising and information, improvement of insurance design features and setting differentiated and affordable contribution rates. In another study done by Mwangi W. M. and Mwabu, G.M (2006) on health care financing in Kenya simulation of social benefit effects of user fee, they found out that the introduction of user selective contribution charges would improve social insurance programmes such as the NHIF. The National Hospital Insurance Fund is the most important health insurance program in Kenya. Membership is compulsory for all civil servants. As of 1990, contribution levels be insufficient to meet hospital costs and the government was planning to broker private health insurance policies. The government is continually improving and upgrading existing health facilities and opening new ones.Private health institutions account for 60% of total medical equipment and supplies (import value). Kenya also has a well-developed pharmaceutical industry that can produce most medications recommended by the World Health Organization (republic of Kenya, 1999) In order to increase the utilization of NHIF services, we need to raise the awareness on NHIF benefits to the people of Kiwanja market majority of who are struggling to pay for healthcare from their pockets. This study therefore, sets out to assess the utilization of NHIF services and identify factors that hinder its use by Kiwanja residents.The Government of Kenya has addressed the issue of inequalities and poor performance in a number of policy documents. The efforts made under the prototypical Health Sector Plan (1999-2004) did not contribute towards improving Kenyas health status. In 2005, the punt Health Sector Strategic Plan was implemented. This will run until 2010. In order to improve the funding of the healthcare system and to give more Kenyans access to better healthcare, the Ministry of Health is planning to introduce a National Social Health Insurance Fund (NSHIF).This is a social insurance scheme to which everyone will contribute, without exception. CHAPTER THREE 3. 0 RESEARCH METHODOLOGY 3. 1 Research design The study will be a cross-sectional descriptive study which will assess the awareness of the residents of Kiwanja market on NHIF services and benefits. 3. 2 Study area The research will be carried out in Kiwanja market which is turn up behind Kenyatta University, approximately 2 kilometers from the Nairobi Thika dual carriage highway. 3. 3 Study populationThe study population will include Kiwanja market residents who are in the informal sector employment, who have bring home the bacon the age of 18 years and earn an income of at least one thousand shillings per month. Kiwanja market has a total population of approximately 28,000 and about 5600 households as per the records in the chiefs office of Kahawa west location. 3. 4 Inclusion and exclusion criteria 3. 4. 1 I nclusion criteria The study will include Kiwanja market residents, who are self employed or employed in the informal sector.The respondents to be included must have attained the age of 18 years and live withed to be used as respondents in the study. 3. 4. 5 Exclusion criteria The study will exclude students of Kenyatta University residing in Kiwanja market, residents under 18 years of age, and those who will decline to give consent. 3. 5 Sampling technique and sample size 3. 5. 1 Sample size determination The sample size will be determined by using the standard sample size calculation formula by Mugenda and Mugenda, 2003. nf = pic(Mugenda & Mugenda, 2003) Where nf =desired sample size (If the target population is 10,000) =the proportion of the target population estimated to be in the informal sector taken as 50% z =Standard expression deviation which is 1. 96 at 99 % level of confidence q=1 p=1-0. 5=0. 5 d=Degree of accuracy desired is 0. 08 (Fischer et al, 1998) n=the desired sa mple size (when the target population is 10,000) N=the population of Kiwanja resident households which is 5600 n =1. 962 ? 0. 5 ? 0. 5 0. 082 =76. 64 nf= 5600=75. 60 therefore sample size=76 1+ (5600/76. 64) 3. 5. 2 Sampling technique Cluster sampling technique will be used till an adequate sample size is achieved.Kiwanja market area will be divided into four clusters of approximately 1400 households each. There will be cluster A, B, C, and D. cluster A will be on the eastern part of the safaricom shoplifter, cluster B will be on the western part of the safaricom booster while clusters C and D will be north and south of the booster respectively. Each cluster will contribute 25% of the sample size thus 19 respondents will be issued with the questionnaires. 3. 6 Data collection procedures 3. 6. 1 Research instruments A structured questionnaire will be used to collect data during the study. 3. 6. 2 Pre testingPre testing of the study tool will be done at Kihunguro area in Ruiru town. 10% of the sample size will be used to test the data collection tool. 3. 6. 3 Data collection process A structured questionnaire will be issued to the respondents after an informed consent is given. The first respondent per cluster will be set through simple random sampling technique and the next subjects will be selected by snowball sampling until a sample of 19 is obtained. Field editing will be done to the natural data obtained. . 3. 7 Data management Data categorization and coding will be carried out during preparation of the questionnaires.The data collected will be entered, coded and keyed into variables using SPSS version 12- computer software and excel computer packages. Quantitive data will be analyzed using SPSS version 10 computer software. Presentation of quantitive information will be done using statistical packages (graphs, charts, tables and pie charts). 3. 8 Limitations of the study prison term will be limiting factor as the time frame for the study is short compa red to the work load that will be involved in the study. Due to inadequate time and limited resources, it will be impossible for the study to be carried out in the entire Kahawa west location.This therefore will make generalization impossible because of using only one locality for the study. The researcher will also be disadvantaged in terms of personnel in that the researcher will be the only one carrying out the study with no assistants involved. 3. 9 Ethical considerations The researcher will ensure the following ethical considerations i. Introductory letter from Kenyatta University, Department of Nursing Sciences. ii. Letter of authorization from chief of Kahawa west location.. iii. All respondents will give informed consent before universe interviewed. iv. Confidentiality will be maintained.The researcher will provide feedback to the gatekeepers in the community (chief) and Kenyatta University, Department of Nursing Sciences REFERENCES 1. Abd El Fattah, H. I. Saleh, E. Ezzat , S. El-Sahaty, M. El Adawy, A. K. Nandakuma, C. Connor, H. Salah(1997). The health insurance organization of Egypt An uninflected review and strategy for reform. Technical report No 43. Bethesda, MD Partnerships for health reform project, Abt Associates Inc. 2. Arrow, K. J. (1963). Uncertainty and the welfare economics of medical care. American Economic review. 3. Inke Mathauer, Guy, C, Doetinchem, O. , Joses, K, Laurent, M. (2004).Social health insurance how feasible is its expansion in the African region, ISS, Rotterdam. 4. Kraushaar, D. (1994). Health insurance what is it, how it works. Financing districts Health Services international workshop 5. Kraushaar. & O. Akumu (1993). Financial sustainability of health programmes the role of the national hospital insurance fund. Nairobi Government of Kenya. 6. Manda, Kimani. D. , (2004) Healthcare financing through health insurance in Kenya the shift to a national social health insurance fund. Kenya Institute for state-supported Policy Research Activities and Analysis (KIPPRA), Nairobi, Kenya. . Republic of Kenya (2003a). The National Social Health Insurance Strategy. Prepared by the Task Force on the Establishment of Mandatory National Social Health Insurance. 8. Republic of Kenya (1999). Kenya publish supplement, Acts, 1999. The national hospital insurance fund Act, 1998. Nairobi government printer. 9. Republic of Kenya, (1997). Economic survey. Nairobi government printer. 10. Shaw, P. (1998) Financing healthcare in the sub-Saharan Africa through user fees and insurance. World bank 11. Stliglitz, J. E. (2000). Economics of the public sector (third edition). W. W.Norton 12. World Bank (1993). World development report 1993 investing in health. Oxford university press. 13. Techlink International (1999). A renewed NHIF final report manual. WORK PLAN FOR THE STUDY. Task Months January February March April Preparation, and approval of proposal Wk 1 Purchasing stationery 500 Transport 1500 Proposal preparation 2,000 Data collection 3,000 Data touch on and analysis 2,000 Lunch 1500 miscellaneous 1500 Total 12,000 APPENDICES INSTRUMENT FOR DATA COLLECTION (QUESTIONNAIRE) Instructions Please flick ( ) in the brackets representing the most appropriate response. Additional informational can also be given in the provide spaces or at the back of the questionnaire. 1 a) How old are you? (In complete years) 18-24years ( ) 25-34 years ( ) 35-44years ( ) 44years and above ( ) b) What is your sexual activity? Male ( ) female ( ) 2.What is your highest level education? Never gone to school ( ) primary school ( ) lower-ranking ( ) post secondary education ( ) 3. What is your religion? Christian ( ) Muslim ( ) Bahai ( ) other (please specify).. 4. What is your marital status? Single ( ) married ( ) divorced ( ) separated ( ) single parent ( ) widowed ( ) other (please specify) .. 5 a) what is your main occupation? Self employed ( ) civil servant ( ) ? 6. Have you ever heard about NHIF? YES ( ) NO ( ) b) How many dependants do you have? .. 7. IF Yes in question 6 above, where did you hear about it? ) Heard from a friend b) I am a beneficiary or a member if NHIF c) My parents are members of NHIF d) At my place of work 8. Are you a National Hospital Insurance Fund member or beneficiary? Yes ( ) No ( ) 9. If yes in question 9 above how do you rate NHIF services in the scale below out of ten0-3 poor ( ) 3-5 below average ( ) 5-7 good ( ) 7-10 very good ( ) 10. If no in number 9 above, please tick as appropriate the reason why you are not member or beneficiary of NHIF a) I have never heard about NHIF b) I do not know the benefits of NHIF c) There is no branch of NHIF in Kiwanja market d) I am not employed in the formal sector. 11.If you are a beneficiary of NHIF, would you like to be a member? Yes ( ) no ( ) 12 If no in number 11 above, please as appropriate the reason why. a) I am not employed in the formal sector. b) There is no branch of NHIF in Ki wanja market. c) I have to think about it first and consult my husband about it. d) The monthly contribution is too much for me. 13. If yes in number 11 above, how many beneficiaries will benefit from your cover? None ( ) my spouse ( ) my children ( ) my parents ( ) other.. 14. Do you think that NHIF services will ease your burden of financing healthcare for you and your family and significant others?Yes ( ) no ( ) 15. Would like to be an NHIF member? Yes ( ) no ( ) 16. If yes in the above no. 15 do you know what requirements for becoming a member are? Yes ( ) no ( ) 17. If no in number 16 above, why? a) Because I have just learnt about NHIF now. b) Because I have never had a chance of accessing information about NHIF membership before. c) Because I have always eyeshot NHIF is for those in the formal sector. d) I would like some brochures from NHIF on benefits, cover, and how to contribute to the insurance scheme. 18. If you are a member of NHIF have you ever used their services? Y es ( ) no ( ) 19. If no in the above question 18, why? ) I have never been hospitalized. b) None of my beneficiaries have been hospitalized. c) I did not know how to place my claim of cover. d) The process of accessing benefits is too long for me. 20. If yes in the above question 18, where did you use it? a) In a government facility. b) In a mission hospital. c) In a private hospital. d) In a referral hospital such as Kenyatta National Hospital. e) Other (please specify) 20 if yes in question 18 above how did you find NHIF services? a) Average b) Good c) Very good d) Excellent Thank you very much for being a respondent and for your much cooperation. CONSENT FORM Researchers confirmation.I am Ann Mwangi, a Kenyatta university student pursuing a Bachelors of science degree in Nursing and Public Health. I am carrying out a study on utilization of NHIF services in Kiwanja market, Kahawa west location in Kasarani Division. I kindly request your permission to interview you. Confidentialit y will be guaranteed. Your call will not be required. Signature of researcher.. Date. Respondents consent I have been fully informed about the nature of the study and I hereby give my consent to any information which is required of me. Signature of respondentDate. MAP OF STUDY AREA pic Kiwanja grocery