Despite recent phenomenal growth of non-governmental organisations (NGOs) in the developing world, especially in the field of primary health care (PHC), their performance currently witnesses many paradoxes. For example, a paradox between their growth in size and diversity, yet increasing concerns about their impact; another paradox is that of the intense questioning of their performance in development and health, and yet the increasing flow of support from most international agencies; and, a third paradox, is that of the increasing pressures for, and acceptance of the need for, performance evaluation, and yet a lack of institutionalisation within NGOs themselves, and the scarcity of models that can guide/help NGOs in that direction. Many explanations have been suggested for these paradoxes, and are likely to include the following: first, an NGO may lack the performance system which enables it to look at its own performance and analyse in a systematic way; second, an NGO, when undertaking a selfevaluation exercise, may confine itself solely to the project level (for accountability reasons) and overlook the other levels of analysis (namely, the organisation, service delivery, and individual levels); and, third, an NGO may not hold an holistic view as to what areas should be analysed, nor may it have the analytical tools readily available which help it to undertake such an analysis. Evidence from different literature supports each of these possible explanations. Accordingly, within this thesis, to help an NGO self-analyse its performance, a performance analysis framework (PAF) has been developed. This framework is structured to analyse the performance of an NGO service provider at three main levels: organisational; project; and, service delivery. Each level addresses an area for analysis, drawing upon a set of criteria for each area, raising a group of relevant questions for each criterion, and casting light on a cluster of possible investigative tools largely, but not exclusively, qualitative in nature. Theunderlying hypothesis of this framework is that the performance of an NGO in health and social development is the outcome of an interaction of many factors within both its external and internal environments. Hence, in the PHC setting, an NGO is confronted with an external environment composed of contextual elements (political, economic, legal, and socio-cultural), as well as a cluster of relationships with different stakeholders (donors, beneficiaries, government bodies, and other NGOs). On the other hand, the internal environment of an NGO is formed of a four-fold set of inter-related elements: its identity, its strategy, its operations, and its resources. Thus, the kinds of interactions taking place in both these environments are key determinants of the overall performance of the NGO. The PAF was then field tested in Egypt through a series of investigations, including focus group interviews as well as instrumental case studies. Four cases were selected from a pool of Egyptian NGOs (ENGOs) with different histories and geographic locations, but all being Community Development Associations (CDAs); participants in umbrella capacity building (CB) programmes sponsored by intermediary NGOs and funded by one bilateral donor; and, having service provision in the area of Maternal and Child Health (MCH). While the PAF was applied at the project level, the four PHC/MCH projects have also served as entry points to the analysis of the four organisations through a participatory self-assessment approach. The PAF, therefore, served as both research tool and conceptual frame of reference against all four cases, relying upon various triangulation techniques, in pursuit of research validation and quality control. The outcome is that of robustly testing the framework: by so doing, important lessons and insights have emerged both about the external and internal environment of ENGOs; and about the levels and kinds of performance CDAs operating in health currently attain, and can attain in the future. The research concludes with recommendations for a proposed capacity-building programme for CDAs guided by the PAF

Student Number : 9001367H - MPh research report - School of Public Health and Oral Health Sciences - Faculty of Health Sciences / Introduction: Compulsory Community Service (CS) for health professionals has been introduced in South Africa since 1997. Some of the aims for its introduction were to: 1) address the maldistribution of health service providers, 2) prevent qualified health professionals from emigrating and 3) improve clinical skills and knowledge of newly qualified medical graduates. The Oral Hygiene (OH) and Dental Therapy (DT) professions have as yet not been included in the performance of CS. However the Department of Health (DOH) is planning to introduce CS for these groups of health professionals in the near future. The role of the oral hygienist and dental therapist in South Africa (SA) cannot be over emphasized. Given the high caries levels, low oral hygiene education levels, large unmet oral health needs and the preventative approach of the DOH at all levels, the oral hygienist and dental therapist can provide invaluable human and technical resources that are currently required to address these concerns. Aims: To assess the attitudes of OH and DT students registered during 2004 at the five dental schools in South Africa regarding the introduction of CS. Objectives: 1) To obtain the demographic data of the OH and DT students, 2) to determine whether their current training programme prepares these students for CS, 3) to identify the provinces in which the OH and DT students would prefer to be placed for CS and 5) to identify the different types of professional activities that the OH and DT students would like to perform whilst completing CS. Methods: A self administered questionnaire was jointly developed between the Kwa- Zulu Natal Department of Health and the Division of Public Oral Health at the University of Witwatersrand, Johannesburg. The questionnaire was sent to all OH and DT students who were registered at each of the five dental schools in SA during 2004. Results: There were a total of 163 students (68%) who responded to the questionnaire. Of the respondents, 109 (70%) were OH students and 54 (64%) were DT students. There were 132 (81%) females and 31 (19%) males. The average age of the student’s was 21 years (17-37; mode 19; median 20 and SD 3.2). There were 59 (36%) Whites, 53 (33%) Black, 31(19%) Asian and 18 (11%) Coloured students. The majority of OH students (63%) were against the introduction of CS. There was a significant number (p<0.05) of White students who were registered for the OH degree that did not want to perform CS. A significant number of respondents (p<0.05) felt that they were adequately trained to perform all the necessary duties that may be required of them during their CS. Most of the respondents chose Kwa-Zulu Natal (26%), Western Cape (26%) and Gauteng (22%) provinces respectively as their first choice province for carrying out their CS. The majority of students (p<0.05) chose their resident province as their first choice province in which they would prefer to perform their CS. Students indicated a preference to perform oral health promotional activities (56%), health educational activities (21%) and clinical work (18%) in their CS programme. Conclusion: The majority of DT students supported the concept of CS. This was in contrast to the OH students where less than half of them supported its introduction. Overall, most of the students chose the more urban provinces (Kwa-Zulu Natal, Western Cape and Gauteng) to complete their CS.

none

No description available.

A case study of seven religious institutions in the Greater Boston Area, this paper attempts to analyze the similarities and differences between religious-based and state-based social service programs beginning by examining the motivations of religious leaders and the influence various conceptions of poverty have on religious poverty programs and outreach. The paper begins with an overview of the current literature on the effects of government welfare programs and policies on the populations they target. It then continues with common categorizations of poverty used by scholars to understand government programs and concludes by using these categories as a starting point for understanding the points of view of local religious leaders towards the people they serve.

No description available.

Magister Curationis - MCur / Community service has been an inevitable part of most health professionals’ lives since it began in 1998. In 2004 the Health Minister in South Africa announced that community service will be extended to include nurses once the Nursing Bill of 2005 was passed by Parliament. Community service for nurses is one year of service after graduation and before the graduate is registered as a professional nurse with the South African Nursing Council. The period of transition from student to newly qualified nurse is known to be stressful. “Reality shock” is a common experience for newly qualified nurses who find themselves in work situations for which they feel inadequately prepared. The aim of the study was to explore the professional nurses’ experience of the community service year at a secondary hospital in the Western Cape. The two objectives were to explore the professional nurses’ experience of their transition from student to community service practitioner and to explore the support and challenges experienced by professional nurses during their community service year at a secondary hospital in the Western Cape. A qualitative research approach and an exploratory and descriptive research design were used to gain insight into the professional nurses’ experiences of their community service year. The population included all professional nurses employed in community service during 2012-2013 and who were working at the selected research site, a secondary academic hospital in the Western Cape. Participants, sampled through purposive sampling, participated in semi-structured interviews during September 2014-January 2015. The inductive process described by Thomas (2003) was used to analyse the data. The results of this study revealed that the community service year was experienced as difficult as it required the community service practitioners to apply new knowledge and take on a higher level of responsibility in practice. The undergraduate nursing programme was perceived as not preparing them for the responsibility as community service practitioner.However, transition from student to community service practitioner was experienced as positive as they developed positive relationships with staff that supported them through the process while they developed professionally.

This mixed- assembly space is designed as a permanent mission trip training and housing facility. Predominately the space will be used by middle school and high school youth. By creating a modern experience, teens are given a better opportunity to engage in a space they can relate to. It becomes a space where young people feel encouraged to share their feelings, beliefs and desires as they journey into a closer, more intimate relationship with a higher being. The space is intended to serve a transient population. A large portion of the first floor is devoted to communal gathering which provides a space dedicated to praise and worship as well as an adjacent space for dining. The space also features lounge areas, a welcome center, restrooms and locker rooms, and spaces for lodging. This project is an exploration of story-telling and how it can both impact and encourage a space. The idea behind the project is to help teenagers focus on something they cannot see or touch. Design strategies including connections, interactions, processions and transitions become very influential to the space.

Magister Scientiae (Occupational Therapy) - MSc(OT) / Professional socialisation is a key dimension within the professional development of an occupational therapy practitioner. Professional socialisation in the first year of practice involves a process of change within the individual with regards to knowledge, skills and reasoning. The process further involves the novice’s developmental induction into the culture of the profession and into the practice context. Novice practitioners who are not appropriately supported in their professional socialisation process may become demoralised as practitioners. It is necessary to explore professional socialisation from the perspectives of novice occupational therapy practitioners themselves, in order to generate an understanding of how professional socialisation can be supported in the first year of practice. This is of vital importance otherwise the profession may run the risk of attrition. Therefore, the aim of this study was to explore and describe novice occupational therapists’ perceptions and experiences regarding professional socialisation during the first year of practice. A qualitative research approach and exploratory descriptive research design was utilised in the public health system in South Africa. Purposive sampling was utilised to select nine participants for the study. Data collection methods included two semi-structured interviews and a dyad interview discussion which were audio-recorded, transcribed verbatim and analysed through thematic data analysis. The strategies of member checking, peer review, reflexivity, and an audit trail ensured trustworthiness of the study. Ethics clearance was obtained from the UWC Research Committee. Three themes originated from the findings of this study. The first theme, stepping into the unknown, illustrates a dissonance between the participants’ expectations for practice and the actual realities of practice that they encountered. The second theme, uncovering the occupational therapy culture, highlights power dynamics and inconsistencies within the profession as perceived by the participants. The third theme, becoming a professional, highlights how the participants responded to the challenge of transitioning from student to professional and started to internalise their professional identity. Recommendations to support the professional socialisation of novice therapists in the South African context are made in respect of occupational therapy education, continued professional development, support for novice therapists, transformation in the profession and future research.

Community service organisations play a crucial role in the delivery of many social services while functioning from a strong values base often associated with a particular religion. They attempt to respond to the needs of multiple stakeholders. This creates a complex and sometimes ambiguous set of accountability relationships. Government contributes significantly to the funding of most community service organisations, and often this is reflected in close working relationships between public servants in funding departments and managers of community service organisations. The nature of this relationship was changed as a consequence of a wave of public sector reforms beginning in the 1980s. These reforms aimed to increase the efficiency, effectiveness and accountability of government departments. Strategies adopted included funder-purchaser-provider models of service delivery, leading to the contracting out of some services previously provided by government and the adoption of more contract-like agreements with existing external service providers. This led to the development of additional mechanisms for measuring and monitoring performance. These were directed both internally towards public sector staff and externally to funded programs. The community services sector’s concern about the impact of reform on their functioning and survival provided the impetus for undertaking this qualitative study of the management of accountability in community service organisations in South Australia. Data were collected in 2000-2001 through interviews with community service organisation and public service staff, and through analysis of organisational documents related to accountability. Staff from twelve community service organisations, and state and federal public servants participated. While the analysis shows the costs to community service organisations and the damage to their relationship with government resulting from reform, it also identifies improvements to the management of accountability in some organisations. Governments at both state and federal levels have since adopted the language of partnership and collaboration. This occurred partly in recognition of the negative impacts of an over-zealous emphasis on distanced purchaser-provider relationships and partly from an increasing recognition of the failure of existing systems to resolve complex social issues. Follow-up data were collected in 2004 that identified changes in the relationships between the community service organisations and funding departments, and in the community service organisations’ management of their own accountability. Analysis of these data found a significance increase in formal relationships between community service organisations but limited change in the relationship with government. Through an analysis of the impact of public sector change on community service organisations in South Australia, this thesis contributes to the understanding of inter-sectoral relationships and the management of accountability in community service organisations.