Text in English / The aim of this study was to gain understanding of community service nurses’ experiences of health care services at Tshwane district public hospital. This qualitative study followed an Interpretative Phenomenological Analysis (IPA) approach to explore the community services nurses’ experiences of health care services at Tshwane district public hospital. Data were collected from 11 purposively selected community service nurses using a semi-structured interview format. Data was analysed using Interpretative Phenomenological Analysis framework for data analysis. Four super-ordinates emerged from data analysis: (1) Resources, (2) Work environmental relations, (3) Supervision and support and, (4) Impact of community service experiences. The study revealed that the health care services rendered at the hospital studied are substandard. Community service nurses reported several challenges experienced during their placement in the hospital under study. Lack of human and material resources, supervision and support contributed to hindrance of smooth acquisition of their clinical skills and experience. These challenges resulted in the psychological and emotional drain of the participants. There is a need for development of guidelines to ensure constant and adequate support to all the community service nurses placed at Ratanang Hospital. / Health Studies / M.A. (Nursing Science)

South African health systems are struggling to cope with the HIV/AIDS pandemic. Home based care has become an invaluable resource that relieves overburdened and under-resourced hospitals. Home based carers provide basic nursing care and support to patients and their families, in the patient's home. Little is know about what motivates home based carers. Minimal research has been undertaken to investigate the expectations and experiences of these noble voluntary helpers. This study was conducted with a sample of home based carers at Community Outreach Centre, St Mary's, Mariannhill. Being field focused it used a qualitative research approach and participatory action research methodology. Focus group discussions were conducted with home based carers to explore their needs, motivations and expectations of Community Outreach Centre. The study enlightens us about issues related to home based care that directly affect them. Despite the painful realities of their lives, they appeared positive about serving as volunteer home based carers. / Social work / M.A. Social Science (Social Work)

The study was about the process evaluation of the development of the YOUNG WORKERS CAMPAIGN (YWC) Programme to document and analyses the involvement and participation of stakeholders in the development process. The purpose of the study was on the assessment of stakeholder participation and involvement in the development of the YWC to maximise the effectiveness, acceptability and sustainability of the intended programme. Informant interviews, focus group interviews and document analysis were the primary means of collecting data for this research study. The main findings are as follows: Few of the stakeholders were involved in the conceptualisation phase of the YWC Programme and their roles in the development process were not clearly described. Stakeholder analysis was not done and their involvement in decision-making was limited. In order to address the problem of participation, YWC stakeholders should pass through a process of stakeholder analysis, that is, they should be assessed in terms of contribution and value-adding to the development process. / Sociology / M.A. (Social Behaviour Studies HIV/AIDS)

Curative primary health care nurses are the first level of contact with health personnel the patient has when entering the district-driven health system of South Africa. It is imperative that these nurses are competent, or patients may suffer. Several factors exist as barriers to competent curative care. Donabedian's structure-process-outcome framework has been used in the study of these factors. Literature were selected from international and national studies of nursing to discover barriers and enablers in general nursing care but also specifically in curative primary health care. The curative primary health care nurses in the Southern Cape/Karoo region were used as a sample for the study. Data gained from questionnaires were organised to present the findings: Barriers to a curative PHC service seem to be multifactorial, with scarce resources causing great stress for the workforce. This have a negative impact on relationships between employer and employee, CPHCNs and their patients, the type of managing that take place, and the quality of the examination and treatment of patients. Slow changes frustrates workers, causing more stress and poor attitudes, feelings of not being valued, and not being motivated (internally and externally). Enablers examined showed that although the workforce may be discontented and overworked, they still try to deliver their best, with few medical mistakes. Patients still have a lot of respect for their healthcare deliverers, but this trend may not continue for much longer. Patients are already returning more often to clinics, causing even more stress for staff. / Health Studies / M.A. (Health Studies)

In this study the researcher attempted to determine the current role expectations of a clinic manager in a primary health care setting, to identify factors determining and influencing the role of a clinic manager, to determine what effect the current role expectations had on the management of primary health care services rendered at the clinic, to establish the developmental needs of clinic managers to enable them to adhere to their role expectations, and to identify and recommend measures to support clinic managers in the execution of their managerial role by addressing the identified deficiencies. The researcher selected a quantitative, exploratory, descriptive and contextual design. Clinic managers of fixed clinics in the Free State province were randomly selected to participate in the study and a questionnaire was utilised as data-collection instrument. The study found that the clinic manager's role is comprehensive and varies from telephonic booking patients to assessment of the quality of primary health care programmes. A number of non-managerial functions were identified, such as consultation of patients, management of medicine, dispensing of medicine and ordering of stock. It was also found that the respondents were not involved in a number of management functions such as financial and human resource management, and adherence to the implementation of standards. Factors that negatively influenced the clinic managers' management role included: * Lack of time due to the large number of patients they had to consult due to the shortage of staff. * Shortage of staff. * The execution of non-managerial tasks. Although it was found that the current role of the clinic manager was confusing as it entailed much more than just clinic management, it is foreseen that the role of the clinic manager could in future be clarified if the recommendations are implemented. / Health Studies / D. Litt. et Phil. (Health Studies)

Women face a greater risk of HIV infection worldwide than men. This study explored socio-economic, cultural and environmental factors influencing young women’s vulnerability to HIV. A quantitative explorative study was conducted among young women in Sunnyside, Pretoria. A sample of 158 young women in the age group 18 to 24 years from all language groups was randomly selected to participate in this study. The findings showed that poverty, peer pressure and multiple sexual partners were the main factors that influenced young women in Sunnyside’s vulnerability to HIV. Behavioural change and social change were recommended as long-term processes, which need to be taken into consideration. Findings from the Sexual Relationship Power Scales show that young women between 18 and 21 years experience physical abuse, emotional abuse, sexual abuse and forced sex in their relationships. The study concluded with specific recommendations for the successful implementation of policy makers and planners to protect women. / Health Studies / M.A. (Social Behaviour Studies in HIV/AIDS)

Late booking is associated with high perinatal and maternal morbidity and mortality. The World Health Organization (WHO, 2016) recommends that pregnant women should book for ANC full first before 12 weeks of gestation. The aim of the study was to explore and describe factors contributing to late antenatal care booking at public health facilities of Mopani District. A qualitative approach was used. In-depth interviews were conducted with twenty one pregnant women who booked after twelve weeks of gestation and agreed to participate in the study. The study was conducted at four selected public health care facilities rendering maternal health services in Mopani district. Data was collected through in-depth interview with the aid of an interview guide. The analysis of data was done manually using a coding system to develop themes. The results revealed that there are personal and provider factors contributing to late antenatal care booking in Mopani district. Personal factors contributing to late antenatal care booking were unplanned and unaccepted pregnancy, lack of support, late recognition of pregnancy, cultural and religious beliefs, ignorance of the importance of antenatal care and fear. System or provider factors contributing to late booking were long waiting time, midwives’ attitude and lack of resources. / Health Studies / M.A. (Public Health)

PURPOSE: The purpose of the study was to explore the perception of the R48 trained professional nurses with regard to implementation of the EPI in Tshwane District Gauteng Province. METHODOLOGY: A qualitative research design was followed. Data were collected through in-depth qualitative interviews from a purposive sample of eight (8) R48 trained professional nurses. Eight steps of Tech’s inductive, descriptive open coding technique was followed. FINDINGS: The study established that EPI programme is important in R48 training. The implementation of integrated approach was viewed as beneficial leading to the reduction of diseases. The successful implementation would be more beneficial if it is consistently coupled with support from programme managers and regular in-service on up-dates of new vaccines and technologies are introduced within the programme / Health Studies / M.A. (Nursing Science)

Text in English / With the Acquired Immune Deficiency Syndrome (AIDS), first recognised in 1981 as a new disease that subsequently took on pandemic proportions, home-based caregivers became instrumental to ensure that, notwithstanding the encumbered health care systems, people living with HIV and AIDS (PLWHA) receive care, support and treatment within their households to live prolonged dignified lives. Despite their pivotal role in the field of HIV and AIDS care, there seems to be a dearth of literature, and research locally and internationally, from the ambit of Social Work on the topic of how HBCGs manage and cope with the work-related challenges they experience when caring for PLWHA and their need for Social Work support. Through this exploratory, descriptive, contextual and phenomenological qualitative study, I scrutinised the HBCGs’ experiences and associated challenges and the coping strategies they employ to address these challenges as well as their views on how social workers could support them in overcoming these challenges in the specific case on home-based care to PLWHA. Twenty-five HBCGs were identified and recruited through purposive and snowball sampling techniques from twelve home-based care organisations in South African provinces, namely, North West, Limpopo and Gauteng. Data was collected through individual face-to-face semi-structured interviews using an interview-guide. Data analysis was conducted through Tesch’s eight steps (in Creswell 2014:189) while Guba’s model (in Shenton, 2004) was adopted for data verification. Cast against Loretta Williams’ (2014) middle range theory of caregiving dynamics (Williams 2014), the coping theory of Lazarus and Folkman (1984) and the strength-based perspective (Saleebey, 2013) adopted as theoretical frameworks for this study, the following findings were revealed. The HBCGs were motivated by, among other factors, their mere desire to care for PLWHA; their personal experiences of caring for an ill relative; and future career aspirations to become involved in this care work. HBCGs were found to face various work-related challenges in connection with reactions from community members, the patients and their relatives; their unsafe working conditions; as well as from their colleagues, other role players and their own organisations. It was found that for most of the HBCGs their care work saddened, pained and discouraged them. In the midst of feeling sorry for their patients, they feared getting infected themselves, in addition to their work-related challenges that caused them to experience feelings of failure. The strategies adopted to cope with their work-related challenges included getting support from employers, receiving counselling and becoming involved in support groups. Finally, several suggestions were directed to the management structures of HBC organisations, the HBCGs themselves and social workers on how they could address the work-related challenges. Based on the research findings, some recommendations are forwarded concerning guidelines for Social Work support directed at work practice, policies and programmes; associated education and training endeavours; and continuous professional development initiatives, as well as avenues for further research. / Social Work / D. Phil. (Social Work)

The purpose of this study was to develop a framework for provision of essential medicines for the district health services. A qualitative descriptive, exploratory and contextual action research design was followed. The data collection was conducted through site visits and semi structured interviews targeting the responsible pharmacists who were purposively selected on the basis of their expert knowledge and experiences from the eight of the nine provinces of the Republic of South Africa which is a developing country with limited resources for provision of healthcare services. The study found that there was no standardised framework for provision of essential medicines for the District Health Services. Based on the site visits and action research findings a proposed framework covering the selection, procurement, warehousing, distribution and management support components for provision of essential medicines for district health services was developed and subjected to national pharmaceutical experts and district health services managers review and critique which is finally presented, after taking into consideration the experts inputs as a proposed framework emanating from the study. The proposed framework will contribute towards improving the provisioning and availability of essential medicines within the district health services. / Health Studies / D.Litt. et Phil. (Health Studies)