La pratique infirmière en soins palliatifs en fin de vie à domicile fait l’objet de critiques lorsqu’elle est circonscrite à des paramètres biomédicaux, comme la gestion des douleurs et des symptômes de fin de vie. Cet accent maintiendrait parfois la pratique infirmière en porte-à-faux avec les volontés réelles des personnes soignées, ce qui limiterait leur possibilité de vivre pleinement leur vie dans la période du mourir. Partant de l’idée que la discipline et la pratique infirmière visent la santé des personnes, quelle que soit la période de leur vie, le but de cette thèse est de concevoir des mécanismes actionnables pour une pratique infirmière pour la santé en soins palliatifs en fin de vie à domicile, afin que les personnes soignées vivent la vie qu’elles valorisent dans la période du mourir. Une démarche itérative comportant un volet théorique et un volet empirique est présentée, en cohérence avec les principes de l’épistémologie du constructivisme projectif et une conception systémique de la pratique infirmière. Le volet théorique de la thèse prend appui sur l’approche par les capabilités d’Amartya Sen. Les capabilités des individus représentent l’ensemble des libertés qu’ils possèdent réellement pour vivre la vie qu’ils ont raison de valoriser. À partir d’idées de Sen, nous proposons une modélisation de l’agir complexe de la pratique infirmière comme processus de conversion de ressources vers des capabilités pour la santé. Le volet empirique de la thèse est fondé sur cette proposition théorique. La question de recherche suivante est posée : Comment la pratique infirmière pour la santé en soins palliatifs en fin de vie à domicile peut être conçue comme un processus de conversion vers des capabilités pour la santé? La recherche empirique suit les paramètres d’un devis qualitatif descriptif interprétatif combinant une approche narrative et une méthode d’analyse par questionnement analytique. Une première partie des résultats empiriques présente trois récits coconstruits auprès d’infirmières œuvrant en soins palliatifs en fin de vie à domicile et un quatrième récit assemble les réflexions de l’étudiant-chercheur issues de sa pratique clinique et de recherche. La deuxième partie des résultats empiriques présente quatre mécanismes de la pratique infirmière pouvant participer à la création de capabilités pour que les personnes soignées vivent la vie qu’elles valorisent dans la période du mourir : 1) naviguer entre la vie valorisée par l’Autre et des normes, 2) concevoir l’Autre à la fois capable et vulnérable; 3) engager la réflexivité sur soi, et 4) agir par la présence créative. Ces résultats suggèrent une conception de la pratique infirmière en soins palliatifs en fin de vie à domicile comprise sous l’angle d’une praxis qui appelle à la réflexivité, la réciprocité et la créativité des infirmières pour s’engager dans la relation au mourant. Pour la discipline infirmière, l’approche par les capabilités permet de comprendre comment la pratique infirmière peut s’engager concrètement vers la vie valorisée par les personnes soignées, jusqu’à leur mort. / Home-based palliative care nursing has been critiqued for its focus on biomedical parameters, such as pain or end-of-life symptom management, which tend to maintain nursing practice at odds with patient aspirations, thus limiting their ability to live life to the fullest until death. Based on the premise that the aim of nursing discipline and practice is health throughout all stages of life, the purpose of this thesis is to theorize actionable mechanisms of health-oriented nursing practice in home-based palliative care so that dying people can live the life they value until death. An iterative methodology combining theoretical and empirical work was conducted, in coherence with a pragmatic constructivist epistemology and a systemic model of nursing practice. The theoretical component of this thesis is based on Amartya Sen's capability approach. Capabilities are defined by Sen as the set of effective freedoms people possess to live the life they have reason to value. Based on Sen's ideas, we propose that nursing practice can be conceptualized as the conversion process of resources into health capabilities. The empirical component of this thesis proceeds from the above proposition with the following research question: How can health-oriented nursing practice in home-based palliative care be conceptualized as a conversion process towards health capabilities? A descriptive-interpretive qualitative design, combining narrative inquiry and analytical questioning produced two sets of empirical results. The first presents three stories co-constructed with nurses practicing home-based palliative care; whilst a fourth story recounts the author’s emerging reflections in relation to his own clinical and research practice. The second set of empirical findings presents four nursing practice mechanisms that tend to create capabilities of dying people as they live the life they value until death: 1) navigating between a life valued and norms, 2) seeing a dying person as both capable and vulnerable; 3) reflexively engaging with one’s practice, and 4) being creatively present. These findings suggest that home-based palliative care nursing can be understood as a praxis that engages reflexivity, reciprocity, and creativity in relation to the dying person. For the discipline of nursing, a capability lens reveals how nursing practice can engage with the lives valued by dying people, until their death.

Child rights, especially the right to health for children, is a concept of human development. The aim of this qualitative study is to explore the obstacles to gender equality in the right to healthcare for children under five years in East Champaran, Bihar, North India. Ten key informant interviews and nine focus group discussions with mothers, fathers, grandmothers and grandfathers were conducted to research the barriers of guardians to accessing healthcare for their children, including their root beliefs and choices, which causes health inequalities. It was found that a strong patriarchal tradition predominates in these communities in North India, which favour sons and disadvantages daughters in healthcare provision. Despite the existing child rights and human rights policies that have been legislated, in India traditional practices that discriminate against female children remain dominant in the society, and limit development in East Champaran, Bihar, North India. / Development Studies / M.A. (Development Studies)

The study aimed to investigate Human Security and Development: A Case of Diepsloot, extension 12 in Johannesburg. There are in total 30 participants who took part in the research, they were all living in this informal settlement. A case study design was used in conjunction with a qualitative research approach. Thirty (30) participants were identified using purposive sampling. Semi-structured interviews were conducted through an interview guide on their human security and development. The interviews were also recorded. A thematic analysis was used to extract the essence from the data as it emphasises identifying, analysing and interpreting patterns of meaning within qualitative data and presenting the findings according to themes supported by quotes. The research findings demonstrate that the residents of Diepsloot, extension 12, were not provided with human security and opportunities to promote development. The South African government claims to provide service delivery to its citizens in support of the objective of the government’s National Development Plan (NDP) to eradicate poverty by 2030. Yet, the study proved that inhabitants of the Diepsloot settlement were in dire need of support and job opportunities to upgrade their living conditions. The study recommends that: Human security and development should be the government’s priority, focussing on the implementation of development policies, especially in informal settlements / Lesifundvolucwaningo sihlose kuphenya Kuvikeleka Kweluntfu Nentfutfuko: Sehlakalolucwaningo saseDiepsloot Extension 12 eJozi. Linani selilonkhe lalabangenela lolucwaningo bebangu-30; bonkhe bebahlala eDiepsloot Extension 12, lokuyindzawo lehlala bantfu lekangahleleki eJozi. Lesifundvolucwaningo lesehlakalo sisetjentiswe ngekuhlanganisa nendlela yelizingasimo. Kwakhetfwa labatawungenela lolucwaningo labangu-30 ngekusebentisa kukhetsa emasamphula ngenhloso. Kwasetjentiswa inkhombandlela yekwenta i-inthaviyu kute kubanjwe ema-inthaviyu lasakuhleleka nalabo labangenele lolucwaningo. Lama-inthaviyu bekagcile ekuvikelekeni kweluntfu nentfutfuko, futsi arekhodwa. Kwasetjentiswa luhlatiyo ngekwengcikitsi kutfola bunjalo kuleyo datha. Kwakugcilwe ekuboneni, ekuhlatiyeni nasekuhumusheni emaphethini enshokutsi kuleyo datha yelizingasimo, kanye nekwetfula loko lokutfoliwe ngekulandzela tingcikitsi letesekelwa ticashunwa. Lokutfolwe ngulolucwaningo kuveta kutsi bahlali baseDiepsloot Extension 12 bebanganikwa kuvikeleka kweluntfu kanye nematfuba langagcugcutela intfutfuko yabo. Hulumende waseNingizimu Afrika utitjela kutsi yena unika takhamuti tawo tinsita ekwesekeleni inhloso yeLisu lakhe Lavelonkhe Lentfutfuko (i-NDP) kute kucedvwe buphuya nga-2030. Nanome kunjalo, lesifundvolucwaningo siveta kutsi bahlali basendzweni lengakahleli yaseDiepsloot badzinga kakhulu kwesekelwa kanye nematfuba emisebenti kute bente ncono timo tabo tekuphila.Lesifundvolucwaningo sincoma kutsi kuvikeleka kweluntfu kanye nentfutfuko kufanele kutsi kube tintfo hulumende latibeka embili kutsi utawucala ngato atente; kanye nekutsi kugcilwe ekufezekiseni tinchubomgomo tentfutfuko, ikakhulu etindzaweni letihlala bantfu letingakahleleki / Esi sifundo sajolisa ukuphanda Ukhuseleko Nophuhliso Loluntu: Imeko yase D Diepsloot Extension 12 eRhawutini (Human Security and Development: A Case of Diepsloot Extension 12 in Johannesburg). Bangama-30 abantu abathatha inxaxheba kolu phando; bonke abehlala eDiepsloot Extension 12, indawo yokuhlala engekho sesikweni Rhawutini. Kwasetyenziswa uyilo lophando lwesifundo esingumzekelo kunye nendlela yophando ngokuphonononga izimvo (ukuzathuza). Kwachongwa ngononophelo isampulu yabathathi nxaxheba abangama-30. Kwasetyenziswa isikhokelo sodliwano ndlebe ekuqhubeni iindliwano ndlebe ezingaqingqwanga nabathathi nxaxheba. Iindliwano ndlebe zagxininisa kukhuseleko nophuhliso loluntu kwaye zashicilelwa njengengxelo. Kwasetyenziswa uhlalutyo lwemixholo ukuze kuhluzwe ingxam/undoqo womcimbi kwidatha. Kwakugxininiswe ekuchongeni, ekuhlalutyeni nasekutolikeni iipatheni zeentsingiselo kwidatha yozathuzo, nasekunikezeleni okufunyanisiweyo gokwemixholo exhaswa kokucatshuliweyo. Okufunyaniswe kuphando kwadiza ukuba abemi baseDiepsloot extension 12 abanamathuba okhuseleko anokukhuthaza uphuhliso lwabo. URhulumente woMzantsi Afrika uthi unikezela ngeenkonzo zoluntu kubemi bakhe ngeenjongo zokuxhasa iCebo Lophuhliso Likazwelonke (iNational Development Plan - NDP) ukuze uthi ufika owama-2030 kube kupheliswe tu ubuhlwempu. Noxa kunjalo, olu phando lububungqina bokuba abemi baseDiepsloot badinga ngamandla inkxaso namathuba emisebenzi ukuze baphucule iimeko zabo zentlalo. Esi sifundo siphakamisa ukuba ukhuseleko nophuhliso loluntu ibe yimiba esentloko kulungiselelo karhulumente; kwaye kufuneka kugxininiswe ekusetyenzisweni kweenkqubo zophuhliso, ngakumbi kwiindawo zokuhlala ezingekho sesikweni. / Development Studies / M.A. (Development studies)

It is widely acknowledged that poverty has declined globally over the last few years. In fact, this idea has become so ingrained in our society that it is almost taken for granted and assumed as an incontestable fact. The question that remains unanswered is where all the poor are now. Are they living a prosperous life or are they tinkering on the edge of poverty? This research study focuses on the precarious non-poor, who are the people surviving just above Upper Bound Poverty Line used by Statistics within South Africa. Although they are not ‘officially poor’ they are still a group that is often overlooked or ignored within the global development community since they are not poor enough to warrant intervention yet not secure enough to demand action. As the research study will show through using a mixed-method approach, they are far from being prosperous and in fact, still struggling to survive. The quantitative findings are based on a statistical analysis of the General Household Survey (2011) that overlaps with the latest Income and Expenditure Survey (2011). It gives valuable background to the problem that was also used during the qualitative phase of the research study to inform the sample choice and interview guide. The quantitative analysis shows that the precarious non-poor is not a unique problem, and as a group, they are found across South Africa. The qualitative findings are based on in-depth interviews conducted in Cape Town, Western Cape and Newcastle, KwaZulu Natal. Framed by the capability approach, set out by Amartya Sen, and a focus on basic capabilities such as employment, education and housing, the results show that the precarious non-poor lack access and choice in terms of capabilities and the opportunity to realise them into functionings. The precarious non-poor in this study are mostly employed within insecure, uncertain or underpaying jobs, underpinned by a social support program, living in neighbourhoods where they feel unsafe while trying to secure a better future for themselves and especially their children. In fact, they are probably no better off than their poor counterparts with prosperity remaining out of reach. / Sociology / Ph. D. (Sociology)