The health care system in South Africa is currently under strain and it does not cater for everyone's needs. This has left a gap in society whereby you will find that the poor citizens of the country are not being catered for in terms of getting access to adequate healthcare. With this existing gap, there are Non-Governmental Organizations (NGOs) in some of the poor communities in the country. These NGOs have volunteer caregivers who go around the community and taking care of the sick people. Research has often ignored these volunteer caregivers, this current research study investigated the experiences of these volunteer caregivers. The goals of the research study were to investigate the experiences of the caregiver, the motivations of the caregivers and the challenges that they encounter and how they cope with the challenges that arise while performing their caregiving duties. The study was based on the phenomenological paradigm. This paradigm believes that the subjective experience of the individual is an essential source of information. In-depth interviews were conducted with the four participants who took part in the study. An interview guide was utilised to help guide the interview process. Interpretive Phenomenological Analysis (IPA) was used in analysing the data. IPA is a way of analysing data, which investigates how a person, in a given setting understands an experience. The findings showed that the caregivers had both negative and positive experiences. They experienced the care recipients as being appreciative of them. However, they experienced the family members of the care recipients as being uncaring; financial constraints were also a negative experience. Several challenges were stated by the participants, including a lack of government support, alcohol abuse by the care recipients and challenging working conditions. The participants were motivated to volunteer as caregivers by a number of things. Altruistic motivation was the first, which included the love for the community and the poverty in the community. Reciprocity was another motivating factor, as well as religious duty and career advancement. In this research study there was one coping strategy that came out; the participants stated that they seek advice and consult with someone or go for supervision within the organization when they are faced with a difficult situation. The findings in the research study were similar to those found in previous research. One notably different finding was that in previous research, the caregivers have been found to abuse alcohol in order to cope with stress. However, in this research study, the care recipients are the ones who are abusing alcohol. The research recommends that the government assists the informal caregivers, either financially or with infrastructure.

Due to the increasing availability of ART (antiretroviral therapy),HIV is starting to be seen as a chronic disease. This has several effects on families, one of which is the need to disclose their HIV status to children who were born with the illness. Potential barriers and available support structures with regards to paediatric HIV disclosure need to be considered before specific guidelines can be given to caretakers and health care providers. This study aimed to explore and describe the patterns of paediatric HIV disclosure or non-disclosure using a sample of caretakers or parents of children/adolescents who were born with HIV. The Disclosure Decision Making Model (DDMM) was used as a framework to understand the decision-making process that leads to either disclosure or non-disclosure. Qualitative data was gathered by means of in-depth, semi-structured interviews, conducted in English. Ten participants were recruited from a community health care centre that offers HIV counselling and testing in the Nelson Mandela Bay Health District. Data gathered was transcribed and analysed using thematic analysis. Lincoln and Guba’s model was used to determine the trustworthiness of the data. The two themes that emerged from the study were (1) caretakers wish to disclose HIV status to the child but identified barriers to doing this and, (2) caretakers identified factors that helped them to disclose the child’s status. This study provides a more in-depth understanding of the factors that influence disclosure in a resource-limited setting in the Eastern Cape.

The topic of the research is derived from the researcher‟s own interest as a social worker and observations of reality within youth-headed families. Over the past few years the number of published studies on child and youth-headed households has grown out of the realisation that this multi-faceted phenomenon is growing in numbers and complexity. Most of these studies and reports concentrate on the issue of scale and the severity of the crisis of child and youth-headed households (UNICEF, 2002; Maqoko & Dryer, 2007 & Kuhanen, Shemeikka, Notkola & Nghixulifwa, 2008). These studies reveal the complex nature of the phenomenon of child and youth-headed families and the challenges that face young people within these families which impact on their growth and development. In most of the studies, the phenomenon of child and youth-headed households has been reported to have an impact on societal framework as a result of its complexity (UNICEF, 2002, 2008; van Dijk, 2008; Kuhanen et al., 2008; Evans, 2010). Over the past years there has been a steady increase in studies that has focussed on coping and resilience of children and young people. Many of these studies have identified resilience-related factors through quantitative ecological approaches to research. To date, there seems to be very few qualitative studies that have been undertaken to delineate the construct of resilience in child and youth-headed families within the South African context from the perspectives of children and young people growing up in these families (Beeka, 2008; Nkomo, 2008; Leatham, 2005). McCubbin (1999, in Smith 2006:48) argues that qualitative research is well suited to understanding processes and strategies in the study of resilience. This study therefore corresponds to McCubbin‟ calling by employing a qualitative research to the study of resilience in youth-headed families. The first goal of this study was to gain a deeper understanding of the experiences and needs of youth-headed families in Port Elizabeth, South Africa, as well as to enhance understanding of the protective factors and processes within youth-headed families and their environment that enable them to cope with their circumstances. The secondary goal of this study was to formulate practice guidelines for supporting members of youth-headed families that could be used by social workers and other service providers rendering services to these families in order to enhance their coping and resilience. The following objectives were formulated to guide the research process: - To explore and describe the experiences and needs of youth-headed families; - To explore the perceptions of community members regarding the needs of youth-headed families, as well as their perceptions regarding how these needs are addressed at community level; - To identify and describe the protective factors and/or processes within individual members of youth-headed families, their families and community context that promote the coping and resilience of youth-headed families; - To explore the views of service providers rendering services to youth-headed families regarding the nature of interventions and programmes rendered to these families; - To review the literature on existing family support programmes in order to identify good practice examples to inform the formulation of practice guidelines for supporting members of youth-headed families.

D.Ed. / The purpose of this inquiry was to explore perceptions and practices of family well-being in the context of child-headed families, and to propose a comprehensive framework that would be beneficial for supportive, educational interventions in the families. This inquiry was conducted among orphans living in two child-headed families. Family life of the orphans was the major focus of this study. All the resources from within a family, the activities, interactions and the way a family organizes and plans determines the well-being of individuals in the family. The specific characteristic of this inquiry is that it captures phenomena around human group way of life (families) and human conduct (lived experiences, interactions and behaviours). It is for this reason that the qualitative ethnographic design was employed and a Grounded Theory Approach of analysis was used to inductively derive a comprehensive framework for the facilitation of well-being in the child-headed families who participated in this study. Data generation was done through in-depth interviews, small group discussions, visual and imagery observation, and theoretical sampling. Interviews were conducted with orphans 12 years and older and for orphans under the age of 12 years observations were employed for ethical compliance. The grounded theory analysis included initial coding, focused coding, axial coding, identifying main categories and memo writing to develop the framework.

Thesis (MPH.) -- University of Limpopo, 2016 / Background: Disabled children with different conditions such as cerebral palsy, traumatic brain injuries, developmental delays, severe orthopaedic impairment, hydro and micro-cephalous are brought to Elim Hospital for rehabilitation therapy. Most of these disabled children stay with caregivers who are responsible for their care including rehabilitation therapy at home to avoid complications. The aim of the study was to establish factors that contribute to development of complications in disabled children. Methods: The quantitative descriptive study design was used and convenience sampling method was used to select 52 caregivers out of the population of 60. Questionnaires and observation checklist were used for data collection at the rehabilitation therapy clinic during their rehabilitation therapy visit. Data were analysed using SPSS version 22. Results: The results show that there is no association between diagnosis and the development of complications. There was an association between availability of resources which is one of the caregiver factors and the development of complications. Conclusion: The study concludes that, availability of resources to provide the rehabilitation therapy on the disabled children is the contributing caregiver factors on the development of complications in disabled children at Elim Hospital.

MPH / Department of Public Health

Department of Nutrition / MSCPNT

Thesis (PhD)--University of Stellenbosch, 2005. / ENGLISH ABSTRACT: The South African primary health care (PHC)system is in a period of transition. This, and the growing HIV epidemic, place tremendous strain on PHCworkers in public health services. Staff morale is low and this results in turnover and poor quality of care. Therefore, staff need to be supported, so that they are better equipped to provide quality care for patients. This dissertation describes a process of action research that aimed to explore possibilities for staff-support interventions to health teams in the public PHCsector. Data were collected through in-depth interviews, group interviews, focus group discussions and consultation sessions, with health staff and middle managers. Data were analysed using a grounded theory approach, with the assistance of the Atlas.ti 4.1 software package.The interpretation of data was informed by psychoanalytic and open systems theories. Four cycles of action research were conducted. The first action stage involved a qualitative assessment of the nature of stressors in the PHC system. The second action stage describes the experiences of two staff teams from a health prevention clinic and a day hospital (curative service) as they prepared to merge and integrate aspects of service delivery. In the third action stage the research team explored the feasibility of a short programme aimed at building capacity amongst middle and facility level managers to act as containers for staff stresses. However, due to external factors the programme was not completed. The final action stage describes interviews with selected participants to reflect on the effects of the current action research process on them and their work. The current research suggests that a psychodynamic approach may be a useful component of action research in health settings. This approach makes room for interpretation of unconscious processes in the stress experiences of health workers, and has the potential to move health staff and management to alternative modes of functioning and coping. / AFRIKAANSE OPSOMMING: Primêre gesondheidsdienste in Suid Afrika is tans in 'n proses van transisie. Die toenemende druk wat die VIGS-epidemie op gesondheidsdienste plaas, maak dit eweneens moeilik vir gesondheidswerkersom aan te pas by 'n gedurig-veranderende stelsel. Dit bring mee dat moraal laag is, baie werkers die publieke sektor verlaat en gehalte van dienslewering verswak. Hierdie situasie noodsaak dat programme ontwikkel moet word om gesondheidswerkerste ondersteun in hul werk, sodat hulle beter toegerus is om kwaliteit sorg aan pasiënte te verleen. Hierdie proefskrif beskryf aksienavorsing wat gedoen is met die doelom ondersteuningsprogramme vir gesondheidswerkers en hulpwerkers in openbare primêre gesondheidsdienste te ontwikkel. Individuele en in-groepsverband in-diepte onderhoude, asook fokusgroepbesprekings en konsultasies met gesondheidswerkers en middelvlak-bestuurders is gevoer om data in te samel. Data-ontleding was gedoen volgens die gegronde teorie aanslag en die Atlas.ti 4.1 sagteware pakket Is vir hierdie doel gebruik. Teorieë van psigoanalise en oop stelsels is deurgans geraadpleeg met die interpretasie van bevindinge. Die navorsingsproses bestaan uit vier siklusse van aksienavorsing. In die eerste navorsingsiklus is ~ie aard van stress in the publieke primêre gesondheidstelsel ondersoek. Die tweede siklus behels 'n beskrywing van die ervaringe van twee personeelgroepe soos hulle gereed gemaak het om aspekte van hulonderskeie dienslewering te integreer met die oprigting van 'n gemeenskaplike gesondheidsentrum. Die derde siklus beskryf die implementering van 'n kort program wat gerig is daarop om middel-vlak en diens-bestuurdersvaardighede aan te leer om personeel beter te ondersteun. Eksterne invloede het meegebring dat hierdie opleidingsprogram nie ten volle uitgevoer kon word nie. In die finale siklus is onderhoude met geselekteerde deelnemers gevoer om te bepaal hoe deelname aan die aksienavorsingsproses hulle in hul persoonlike hoedanigheid asook In die uitvoering van hul pligte beïnvloed het. Die huidige navorsing stel voor dat die psigodinamiese benadering 'n gepaste komponent van aksienavorsing in publieke gesondheidsomgewingskan wees, omdat hierdie benadering Insig kan verleen tot die onbewuste prosesse wat gesondheidswerkersse belewenis van stres beïnvloed, en verder ook die potensiaal het om gesondheidswerkers en bestuurders tot alternatiewe funksionering en hantering van stres te motiveer.

Thesis (MScPhysio (Physiotherapy))--University of Stellenbosch, 2007. / Stroke is a difficult condition to manage because of the complex nature of its effects. Caregivers are therefore, crucial in providing ongoing care for the stroke patient at home. Caregivers experience considerable strain during caregiving, as their needs are often overlooked because therapeutic management tends to focus mainly on the stroke patient. In third world countries like South Africa, there are currently no research studies found describing an optimum support intervention which addresses the caregivers' needs and reduces their strain levels. Objective To determine the effectiveness of a caregiver support intervention programme (CSIP) that was developed to address the expressed needs identified by the primary caregiver of the stroke patient in the Bishop Lavis community. Method A prospective and descriptive qualitative study design was used to evaluate the effectiveness of the CSIP. A total of 29 caregivers participated in three CSIPs, which were implemented over five sessions each. The Barthel Index was used to measure the functional level of each stroke patient. The needs of stroke caregivers were determined by 15 semi-structured interviews, until data saturation was reached. The Caregiver Strain Index was completed before and after implementation of the CSIP, in order to measure whether the intervention programme had been effective in reducing the caregivers' level of strain. Written or verbal feedback forms was also completed by the caregivers after each of the five intervention sessions. Results were analysed using repeated measures ANOVA and descriptive qualitative analysis. Results The qualitative results of this study suggest that the CSIP was effective in addressing mainly the physical needs, as well as the emotional, educational and socio-economic needs of the primary caregivers. The CSIP was also effective in reducing caregiver strain in 61.5% of the sample (N=13). However, an additional finding of this study was the personal and logistical barriers identified which limited the caregivers' attendance of the sessions. Conclusion The CSIP was effective in addressing the physical, emotional, socio-economic and educational needs of the primary caregiver. In addition, the results also verified that the CSIP was effective in reducing caregiver strain in the majority of the caregivers, despite a small sample size. The barriers identified which affected the caregivers' attendance, need to be taken into consideration when planning future intervention programmes for caregivers in poor socioeconomic communities. Due to the low attendance rate by the caregivers, a larger sample size is recommended to accommodate for the high drop-out rates in such a population.

M.Ed. (Educational Psychology) / The changing structures of family and the increase in number of orphans are progressively becoming noticeable both nationally and internationally. A growing number of South African children are left without parents who can provide them with basic needs and emotional care and support. The influence of the HIV/AIDS pandemic has had a detrimental effect on the lives of children and adolescents who have lost one or both parents because of it. Orphans living in child-headed households within underprivileged communities are amongst the most vulnerable children and there is a need to stimulate broad-based discussion, and heighten awareness of and sensitivity to their plight, special needs and rights. This study aims to explore and describe the lived psycho-educational experiences of Grade 7 child-headed orphans in a primary school in Soweto and the support programmes available. It also aims to stimulate interest amongst other role players within government, agencies and communities to assist in addressing the situation of these learners through effective intervention strategies. The researcher has made use of a qualitative, phenomenological case study research design. Data was gathered through individual interviews, focus group interviews and the written life essays/stories, analysed according to Tesch’s method of open coding. The findings of this research revealed that the Grade 7 child-headed orphans’ psychological experiences included anger, sadness, lack of trust and need for love, while their educational experiences included performance in class and transition to high school. They also indicated how they experienced support by School Based Support Team (SBST), teachers, peers, community and Non-governmental Organisations (NGOs). The results of the study led to the formulation of recommendations which are intended to heighten awareness via the Department of Education (DoE) and stimulate interest amongst role players, such as school counsellors, educational psychologists and social workers, who are assisting these vulnerable children.