Submitted in fulfillment of the requirements for the Degree of Master of Health Sciences: Nursing, Duban University of Technology, Durban, South Africa, 2018. / Introduction: The shortage of skilled health professionals in public health care facilities is the main reason why compulsory community service was started by the South African government. The change in the disease pattern over the past two decades coupled with the mass exodus of health care professionals to overseas countries resulted in severe staff shortages especially in rural areas. Nursing community service practitioners (NCSPs) lack experience in dealing with complex clinical problems especially at primary health care level. They need experienced health professionals to offer clinical support to them. Aim of study: The aim of the study was to establish the degree of clinical support that is offered to NCSPs who are placed for compulsory community service within the Ugu district. Methodology: A qualitative study was conducted using an exploratory­ descriptive design. Purposive sampling was utilized to select eight NCSPs from a regional hospital and a community health centre. Semi-structured interviews were conducted and data was recorded verbatim for accurate analysis. Content analysis of data was employed where data was analyzed into meaningful themes. Results: The study revealed gaps in the clinical support offered to NCSPs. Lack of clinical support was reported more in the hospital than at the community health centre.·organizational problems such as lack of orientation, absence of in-service education and lack of proper rotation to different departments were some of the main concerns that were reported. Conclusion: Nursing community service practitioners need clinical support from experienced health professional to guide and teach them until they develop confidence. / M

Submitted in fulfillment of the requirements for the Master of Health Sciences in Nursing, Durban University of Technology, Durban, South Africa, 2017. / Background Human immunodeficiency virus (HIV) testing, treatment and prevention programmes have been initiated and implemented, but nearly 19 million of the 35 million people globally who are living with HIV do not know they have it. A new and powerful movement called 90-90-90 has been set in motion where the target is that by the year 2020, 90% of all people should know their HIV status, 90% of those testing HIV positive should be commenced on lifelong antiretroviral treatment and 90% of the people receiving treatment should be virally suppressed. It is argued the new innovative HIV self-testing strategy can increase the uptake of HIV testing among key populations and the general public. Aim of the study The aim of the study was to assess health care users’ knowledge, attitudes and perceptions towards HIV self-testing at selected Gateway clinics in eThekwini District, KwaZulu-Natal. Methodology A quantitative, non-experimental descriptive design was used to determine knowledge, attitudes and perceptions of health care users at three selected Gateway clinics in eThekwini Health District. The researcher requested permission and was granted to conduct the study from all the relevant stakeholders. Human rights were protected and ethical considerations were adhered to throughout the research process. The convenience sample was 442 participants with a minimum of 98 and a maximum of 246 participants sampled from each of the three study sites. A survey questionnaire was used to collect data. Version 23 of SPSS was used to analyse data. Graphs and tables were used to represent frequencies. Inferential statistical were used to test whether any of the response options were selected significantly more or less than others Results Results of the study revealed that health care users had a reasonable knowledge of HIV self-testing and there were indications that they would use it if it was made freely available to the public and was properly regulated. Generally, there were indications that health care users had positive attitudes towards HIV self-testing. It was seen as a good idea as it can be performed in the privacy of one’s home and the person would be first to know about the results. Results also revealed that there could be more people who would know their HIV status and people could test more frequently. There were perceptions that there would be no difficulty in performing an HIV self-test. The lack of pre-test counselling, false negative results, possible coercion and sale of unregulated testing kits seemed to be issues of concern that require addressing if HIV self-testing is to be promulgated. / M

M.Cur. (Community Health Nursing) / During employment as a registered nurse and while rendering mobile family planning services on farms in the Eastern Transvaal, it was found that appreciable time was spent on non-nursing tasks. The impression gained, was that the people who visited the clinics were only a part of the total farm community and that possibly a mutual communication gap existed between the formal health sector and the community. The purpose of this study was to establish whether the lay health worker should be formally recognised as a member of the primary health team. The research design was a descriptive, quantitative study in a contextual framework. Data was collected using a literature study and a survey using a questionnaire. The research has confirmed that a gap exists between the formal health sector and the rural community. This gap is bridged by the lay health worker, implying that she should be formally recognised as a member of the primary health team.

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.

Dissertation submitted in fulfillment of the requirements for the Master of Technology: Public Management, Durban University of Technology, 2012. / Access to medical care remains a challenge worldwide. It is particularly severe in developing countries and it is estimated that one million more health care workers are needed in Africa to meet the health related Millennium Development Goals. Though many countries have made significant strides in improving health service delivery by increasing their spending on health care, many health systems remain weak. The situation is no different in South Africa. Community health workers (CHW’s) are thought to be an answer to improving health care delivery. They can be trained to do specialized tasks, such as providing sexually transmitted disease counselling, directly observed therapy and act as birth attendants. Others work on specific programmes performing limited medical evaluations and treatment. With proper training, monitoring, supervision and support, CHW’s have shown to be able to achieve outcomes in terms of health care service delivery. The researcher undertook this study to investigate the perceptions of CHW’s on the training services offered by Masikhulisane (MK). A case study of Inanda, Ntuzuma and KwaMashu (INK) used a mix method approach to determine the perceptions of community health workers on the training services offered by Masikhulisane. The researcher distributed questionnaires to six groups of CHW’s in the INK area at different venues. The findings of the study are useful in making evidence-based improvements in the MK education programme that targets various sectors, including CHW’s. From the findings of this study, it was concluded that CHW’s can make a valuable contribution to improved access and coverage of communities with basic health services. It is recommended that the Masikhulisane training programme should be accredited, the Masikhulisane sectoral approach should be broadened to reach more sectors not reached before and the training content should be revisited to ensure acceptability and appropriateness for targeted sectors.

M.Cur. (Nursing Management) / Information technology is the management of a computer-based information system, particularly software applications and computer hardware, which are used to handle all aspects of information storage, retrieval, transmittal, protection, and processing information securely. The lack of reliable health information is one of the major obstacles to the effective planning of the health services in South Africa. The existing information systems are fragmented and incompatible; most systems are manually driven with minimal computerisation which results in inadequate analysis, interpretation and the use of data at PHC level. The use of computer information technology in the health facilities will improve service delivery; reduce the cost of providing health care; and enhance the management and control of service. Yet, it seems that nurses are insufficiently using computer information technology at the PHC clinics in the eastern part of Ekurhuleni. It has been observed that nurses do not use Computer Information Technology (CIT) to the benefit of the clients. It was unclear what the perceptions of PHC professional nurses about CIT were. The purpose of this study was to explore and describe the perceptions of primary health care nurses with regard to the use of Computer Information Technology (CIT) with the purpose of recommending the actions to be taken by the nurse manager about computer information technology. In this study a quantitative, exploratory and descriptive design was used in order to obtain factual reasoning and information from professional nurses working at five (5) primary health clinics in the eastern part of Ekurhuleni. The total sample of professional nurses was n = 150. The method of data collection was a self-administered and structured survey- questionnaire that took 30 minutes to complete. Descriptive statistics were compiled by using the Statistical Package of the Social Sciences (SPSS) Version 20 software program. Validity and reliability were ensured by the judgments of the researcher and experts about whether the research instrument had covered the comprehensive set of facets that encompassed the concepts (the use of information technology at primary health care clinics). It also included pre-testing of the instrument to establish the consistency with which participants understood, interpreted and responded to all the carefully formulated questions in the survey-questionnaire. Ethical principles and standards for nurse researchers were adhere to. The findings indicated that there were aspects that need to be addressed in respect of the use of information technology in primary health care clinics. Limitations of study and the recommendations for nursing practice, management and research were discussed. This study determined the perceptions of nurses with regard to the use of computer information technology at the PHC clinics that lead to recommendations on the actions to be taken by the nurse managers about the use of computer information technology at PHC clinics.

The study sought to explore professional nurses' perceptions of the roles of home and community-based carers in the Capricorn district of the Limpopo province as well as the problems they experienced and make recommendations to improve the quality of home and community-based care. A qualitative approach with non-probability, purposeful sampling was used in this study. The sample consisted of professional nurses serving as focal points for home-based care in the area of the study. The findings indicated that professional nurses believe that carers have a role in providing care to the community and serve as the extended hands of their services. However, challenges exist, which impact on the quality of service delivery. Recommendations included the strengthening of existing elements, such as improving relationships, communication, and the care of carer's programme, carer training, reporting, and monitoring and carer distribution. / Health Studies / M.A. (Health Studies)

The study sought to explore professional nurses' perceptions of the roles of home and community-based carers in the Capricorn district of the Limpopo province as well as the problems they experienced and make recommendations to improve the quality of home and community-based care. A qualitative approach with non-probability, purposeful sampling was used in this study. The sample consisted of professional nurses serving as focal points for home-based care in the area of the study. The findings indicated that professional nurses believe that carers have a role in providing care to the community and serve as the extended hands of their services. However, challenges exist, which impact on the quality of service delivery. Recommendations included the strengthening of existing elements, such as improving relationships, communication, and the care of carer's programme, carer training, reporting, and monitoring and carer distribution. / Health Studies / M.A. (Health Studies)

Social Work / MA(SS)(MENTAL HEALTH)

Text in English / Even though the prevalence of HIV has declined, South Africa continues to have a large number of people who are infected with HIV. Most communities still have to deal with the effects of HIV and AIDS on orphans and vulnerable children. One way of mitigating the effects of HIV and AIDS is strengthening families and communities to provide stable care to orphans. However, most families do not have the capacity to provide sufficient care to orphans hence the need for external support from the community and civil society organisations, in this instance provided through the loveLife goGogetter programme. The findings proved that the goGogetters relied on the support they received through the relationships and networks established in the community to enable them to provide effective service to orphans. The study demonstrated the importance of community networks in providing for the basic needs of orphans. / Social Work / M.A. (Social Behaviour Studies in HIV/AIDS)