The Association for Play Therapy (2009) promotes play therapists’ awareness of personal cultural identity, obtaining continuous cultural knowledge, and displaying culturally appropriate practices. Play therapy research includes studies on working with specific culturally diverse populations. Founding play therapists, such as Virginia Axline, have made suggestions for toys that should be included in the therapist’s playroom. This exploratory survey inquired about play therapists’ perceptions of culturally sensitive play therapy, materials used, and perceived barriers to implementing culturally sensitive play therapy. Members of the Association of Play Therapy with at least master’s degree (n=385) reported on their ability to incorporate culturally sensitive materials into their playroom, most commonly arts and crafts materials. Participants noted less often the use of culturally sensitive board games and culturally sensitive dress up clothes, making them the least commonly used. Play therapists reported encountering barriers to implementing culturally sensitive materials, such as costs, availability, and space. Having space, specifically a designed play therapy room, was significantly related to the use or availability of culturally sensitive items, such as dramatic play materials, dollhouse and/or materials, and sand tray materials. Additionally, an individual’s status as a registered play therapist was related to the use of a dollhouse and/or materials. Some play therapists were able to overcome barriers through education, personally purchasing materials, and networking. Overall, the play therapist’s ethnicity, education and licensure type did not relate to their use of culturally sensitive play therapy materials. Play therapists could benefit from training on how to locate, incorporate, and use costs effective culturally sensitive materials. It was clear that play therapists valued continuing education and kept current on play therapy recommendations, indicating that those forums would be the most beneficial avenue to offer information on culturally sensitive material.

M. Tech. (Food Service Management, Dept. of Hospitality and tourism, Faculty of Human Sciences)|, Vaal University of Technology, / INTRODUCTION: Caring for children is a challenge that requires a number of resources including knowledge, a reasonable workload, time and social support of the caregiver. Maternal education is an important asset in providing good care giving practices: child feeding practices and the use of preventative health services depend on knowledge more than on household resources. Poverty has been linked with poor childcare and child malnutrition; South African children especially those who are living in informal settlements, are vulnerable to poverty. Appropriate practices by caregivers have enabled them to raise well~ nourished children in a community where there is poverty. This implies that caregiver's attitudes, beliefs and practices in relation to childcare, and proper utilisation of limited resources can make a major difference in their children's health, growth and development. In order to plan appropriate interventions in the Eatonside informal settlement, an improvement in the knowledge of, attitude toward and practice of childcare and care giv1ing is required. OBJECTIVES: To examine the knowledge, attitudes and practices (KAP) of caregivers regarding childcare and care giving behaviours with children aged 0- 60 months and to assess existing types of care arrangements in the study area. STUDY DESIGN: An exploratory study was conducted among 145 randomly selected caregivers of children aged 0-60 months, living in the informal settlement of Eatonside. Knowledge and practices were determined by focus group discussions (FGD); an attitude scale questionnaire was used to determine attitude; and a hygiene and feeding observation checklist was used to determine the hygiene and feeding practices.

Abstract Background: Studies into risk factors and causes of childhood mortality present the opportunity to identify intervention programs appropriate in different populations in our attempt to reach the WHO Millennium Development Goals. Objectives: To determine whether there is an association between parental labour migration and child mortality in the Agincourt Health and Demographic Surveillance Site (HDSS) in 2002. Methods: Secondary data extracted from the longitudinal database from the Agincourt Health and Demographic Surveillance System were used to study the association between father’s migration and child mortality in 2002 using logistic regression and survival analysis. The analysis included 10050 children born between 01 January 1998 and 31 December 2002. Results: The child mortality in 2002 was 12.9 deaths per 1000 person years. There was a statistically significant difference in death rate in infants (50.9 deaths per 1000 person years), and in children aged 1-4 years (9.6 deaths per 1000 person years). There was no association observed between migration and child mortality (OR: 0.97, 95% CI 0.59-1.60). The factors associated with mortality were the age of the child, the number of siblings that a child had, the refugee status of the mother, age of the mother at birth, breast feeding and whether the mother was deceased or not. The chances of dying were lower in older children compared to younger ones (OR: 0.58, 95% CI 0.50-0.68). Children who had one or more siblings were less likely to die (OR: 0.62, 95% CI 0.51-0.93) compared to those with none. Child mortality risk was higher in children born to refugees than to local residents (OR: 1.56, 95% CI 1.05-2.33). Those children who were not breast fed had increased chances of dying than those breast fed (OR: 5.33, 95% CI 2.60-10.95). The death of a mother increased the risk of the child dying (OR: 9.35, 95% CI 5.02-17.40). About 84.3% of migrants were sending remittances to members of the households remaining behind but there was no significant difference in child mortality among remitters and nonremitters. The leading causes of death among households with migrant father and those with a non-migrant father were infectious diseases (mainly HIV/AIDS related illness) with 47% and 50% respectively. Conclusion: The results from this study suggest that on average children of migrants in a rural area in South Africa do not experience increased mortality compared to children of non-migrants. The findings from this study where no association between fathers’ migration and child mortality was observed were rather inconclusive. So far, this area of research has not been adequately addressed and much remains to be learned about the lives of children left behind by fathers migrating to seek employment elsewhere. For future studies it would be advisable to study in great depth the long term effects of migration on child mortality particularly in Africa.

A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in partial fulfilment of the requirements for the degree of Master of Science in Occupational Therapy. Johannesburg, 2017. / Introduction Appropriate motor coordination is a prerequisite for most occupational tasks (Summers, et al., 2008) (Case-Smith & O'Brian, 2010). Young children develop motor coordination over a period of years (Case-Smith & O'Brian, 2010) (Gallahue, et al., 2012). This can be observed in the development of gross motor skills such as jumping, hopping, skipping etc. (Case-Smith & O'Brian, 2010). Delays in the development of motor coordination can thus have an effect on a child’s development in all other aspects of their life (Gallahue, et al., 2012). Problem There is a need in South Africa for a cost-effective standardised tool to evaluate motor coordination in children in a valid and reliable way. Currently standardised tools must be imported from the United States of America (USA) or the United Kingdom (UK) and may not be suitable for South African children. An evaluation tool for motor coordination does exist in South Africa, but its current scoring depends in part on the experience and skill set of the professional to judge the quality of movement during a movement task and its psychometric properties have not been explored. Aim This study aimed to identify salient behavioural characteristics that separate children with typical motor coordination development and mild to severe motor coordination dysfunction from each other on the items of the Clinical Observations of Gross Motor Items (COGMI) (SAISI, 2004), in order to provide recommendations to improve the reliability and standardization of the scoring of this tool in the 5 year 0 months – 5 years 11 months age group. Method A quantitative, comparative, descriptive, cross-sectional study design was used, with a total of 23 children in this age group. The participants were divided into a typical motor coordination (green) group and a mild to severe motor coordination dysfunction (red) group. They were videoed while performing 15 of the 18 items of the COGMI. These video recordings were analysed using movement analysis to determine specific behaviours which identify function and dysfunction in this age group. Results From the observations which could be seen when using the COGMI, clusters could be identified. As the COGMI focuses on coordination of movement rather than postures, the starting and finishing position were discarded and further analysis was only done on the movement component of items. The observations made during the movement portion of items on the COGMI were divided into observations made of the upper limbs, the lower limbs, head, neck and core. Comparisons were made between the two groups and looked at the salient behavioural characteristics that determine function and dysfunction in the age group of five year old children. Conclusion Throughout this study it was very clear that this specific age group presents with a lot of variability due to the fact that they are still developing in their gross motor skills and are not yet proficient in fundamental skills. Using these characteristics a checklist of behaviours was developed, which can be used in combination with the COGMI scoring sheet. / MT2017

A Research Project Submitted in partial fulfilment of the requirements for the Master of Science Degree in Epidemiology and Biostatistics / Background: There is evidence suggesting a considerably high prevalence of malnutrition in Zimbabwe. However, there is little evidence available to suggest the factors that may be associated with malnutrition in the local context. Objectives: This study investigates the distribution of malnutrition and the factors associated with each of three types of malnutrition (stunting, wasting and underweight) among Zimbabwean children aged 0-59 months for the period 2010/2011 Methods: The study makes use of the Zimbabwean Demographic and Health Survey (ZDHS) data from the 2010/11 survey. SaTScan software was used to identify clustering of malnutrition outcomes at the time of data collection. Binary Logistic regression for survey data was used to determine factors associated with each type of malnutrition, while unconstrained Generalised Ordered Logistic (GOLOGIT) regression for survey data was used to determine the factors associated with a four-level ordinal malnutrition variable, generated by summing up all the types of malnutrition a child had at the time of data collection. Bayesian hierarchical spatial models were built in INLA to incorporate spatial autocorrelation in the modelling of malnutrition. Results: Factors associated with at least two types of malnutrition in this study were mother’s body mass index (BMI), mother’s breastfeeding status, child’s sex, age group, birth weight category and twin status as well as household’s wealth index. There was a consistent observation that female children were at a less risk for malnutrition than males and also that higher birth weight was protective of malnutrition. There was no clustering of malnutrition outcomes. The spatial random components that were added to the Bayesian hierarchical models did not improve any of the models. Conclusion: The findings from this study are consistent with findings from other researches and identify the factors associated with each of the common types of malnutrition. In addition the study reveals that there was no particular spatial distribution of malnutrition outcomes at the time of data collection. The study suggests further investigation of the effects of dietary diversity and mothers’ decision making power on malnutrition. Zimbabwean policy makers can make use of the findings from this study to provide evidence on which to base nutritional programmes in the country.

The following dissertation explores the experience and representations of child abandonment in urban Johannesburg, South Africa. I examine this complex social behaviour through a number of perspectives specifically: how it is portrayed in the media; how it is represented and managed by child protection officers; the lived experience of the abandoning mother and the abandoned child; and finally how it is understood in the context of Western biomedical principles and those of indigenous African ancestral beliefs. I suggest that child abandonment has been individualised and medicalised in South Africa. Individualised, in that it has been termed a problem that falls entirely within the domain of poor women, and frequently that these women are young teenagers. Medicalised in that a social behaviour that is not new, is increasingly being defined in medical terms through the portrayal and labelling of the abandoning mother as emotionally unstable and criminally insane. I argue that this has been done in an attempt to motivate for stricter surveillance and control over women’s sexual reproductive health and to divert attention from the state’s role in addressing this growing social challenge.

A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in partial fulfilment of the requirements for the degree of Master of Science in Occupational Therapy. 2012 / This study investigated the effects of a five-day “block” of intensive NDT on the gross motor function and occupational performance of 34 children with CP from an under resourced rural area of South Africa, functioning at GMFCS Levels I-V. The repeated measures research design used two preintervention (baseline of change) and two post-intervention (immediate and sustained change) assessments. The GMFM–66 and PEDI–Modified Functional Skills Scale (MFSS) were used to assess change in motor skills and occupational performance in self-care, mobility and social function over a 21 week period. The intervention included individual NDT therapy, caregiver training and provision of adapted equipment. Participants showed significant positive improvement in scores postintervention compared with the pre-intervention period, in: GMFM-66 total score (p=0.050); PEDI-MFSS: self-care skills (p=0.001), mobility (p=0.002) and social (p=0.000). The greatest gains were made in the self-care domain. In this sample, positive change was effected by a five-day intensive NDT programme.

A dissertation submitted to the Faculty of Health Sciences, School of Therapeutic Sciences, University of the Witwatersrand, Johannesburg, in fulfillment of the requirements for the degree of Master of Science in Occupational Therapy. Johannesburg 2017 / Early skin-to-skin contact is a biological need of newborn infants (Bergman & Bergman, 2013). Preliminary research informs us that this contact directly and indirectly influences the mother-infant relationship. This relationship in turn forms the basis of the infant’s social-emotional development (Phillips, 2013). This study investigated South African mother-infant dyads with and without early skin-to-skin contact and the influence on bonding and touch. Contact over the first 24 hours and bonding were measured within one week postpartum. Tactile interactions in daily routine, touch during face-to-face interaction as well as a repeat of the bonding assessment were completed at six to eight weeks postpartum. No correlation was found between skin-to-skin contact and bonding within one week postpartum. A positive correlation was identified between skin-to-skin contact and bonding as well as an increase in touch in daily living at six to eight weeks postpartum. This was substantiated by an increase in touch during face-to-face interaction. Further more stringent research is however required to confirm these findings. / MT2017

A research report submitted to the Faculty of Health Science, in partial fulfillment of the requirement for the award of a Master’s Degree in Nursing Sciences by the Witwatersrand University of Johannesburg, South Africa. / This study, entitled “Knowledge of and challenges of health workers managing maternity patients at PHC facilities of Yobe State, Nigeria,” had the following objectives:  To describe the socio-demographic characteristics of the health workers in the Primary health care (PHC) facilities in the state.  To determine the level of knowledge of the health workers regarding the management of maternity patients in Primary health care facilities in Yobe State.  To determine the challenges experienced by the health workers in the Primary health care facilities in the state. The study was primarily aimed at exploring the health workers level of knowledge, skills and competencies in the management of maternity patients and their contributions towards the control and reduction of maternal mortality in the state. METHODS: A cross sectional survey study in PHC clinics of six selected local government areas of the state, namely Gujba, Geidam, Fune, Fika, Nguru and Jakusko local government areas. A total of 221 health workers (n=221) were interviewed using structured questionnaires, whilst 46 facility managers (n=46) were given self-administered questionnaires while on duty, and data were collected concurrently from clinic records. The data were cleaned, entered in to Epi info statistical software, imported and analysed using STATA. Descriptive and inferential statistics were used to interpret the outcomes of the analysis. RESULTS: More than half of the respondents were female (65.61%) with an average age of 33 years (SD± 8.1). Categories of the health workers who participated in the study were SCHEW, JCHEW, SSCE, TBAS, EHA/EHO and others who were not trained in any form as health workers, but were found running the affairs of maternity patients. More than 80% of the clinics did not have functional ambulances and there was gross inadequacy of basic services in most of the clinics; only 14 out of 46 clinics had portable water supply and electricity. There was a large seasonal turnout of patients in the clinics but poor patronage by maternity clients. The health workers in the maternity unit were found to be deficient in the knowledge, skills and competencies to manage maternity patients. Protocols were not followed (68.78%), some significant information about ante-natal care was not given to v clients and maternity clients were not adequately informed of some of the danger signs of pregnancy. There was a poor standard of institutional deliveries and the majority of the Health Workers had no training on EOC or conducting a clean and safe delivery. CONCLUSION: Examining the background of the current health workers in the primary health care facilities, the attainment of MDG 5 by 2015 will not be a reality, unless urgent measures are put in place, including large recruitment and motivation midwives, and deployment of these midwives to the rural health clinics. There is a need for the existing health workers to be supported by government and enrolled in short course training in Colleges of Midwifery to acquire the much needed skills and competencies for the care of maternity patients.

Mgr. Radka Dohnalová CHILDREN'S RIGHTS IN THE LIGHT OF LEGAL OBLIGATIONS IMPOSED ON THE CZECH REPUBLIC 2012 SUMMARY The main purpose of my thesis is to analyse the level of implementation of legal obligations imposed on the Czech Republic by international child law. For this purpose, the study maps out the ambit of the international child law relevant to the Czech Republic; it deals especially with binding documents, but it does not ignore non-binding legal instruments, as far as their influence on child rights is certain. The wide range of subject matter is examined with regard to particular analysis of the two most important treaties - the UN Convention on the Rights of the Child and the European Convention for the Protection of Human Rights and Fundamental Freedoms. Clarification of the obligations and an evaluation of their impact is mainly undertaken through an analysis of the outcomes of the control mechanisms. The introduction is followed by two chapters dealing with the theoretical background for the ensuing research. Chapter Two briefly examines the basic theoretical origins of children's rights, since this question is seldom discussed in Czech legal literature. This chapter also analyses crucial concepts such as the definition of the child, the best interest principle and participation rights....