In South Africa prior to 1994, community-based care and support services were established for whites only. The majority of older African (black) persons received informal support from their adult children and relatives. This has waned over the years due to the social and economic changes that have put into doubt the continued viability of such support. The Older Persons Act of 2006 requires social workers to establish community-based care and support services for older persons. Hence, the study was conducted to understand the factors that influence social workers in establishing CBCSS for older persons in Bloemfontein in the Free State Province. A qualitative research method was undertaken to accomplish the goal of the study. Purposive and snowball sampling techniques were used to identify suitable participants. Face-to-face semi-structured interviews were conducted with fifteen social workers who provide services to older persons. The data was analysed through Tesch’s (cited by Creswell, 2009:186) eight steps of qualitative analysis and data verification was conducted following Guba’s (Kreftling, 1991) model. The major finding is that there is a need for social workers to specialise in older persons programmes (gerontology). For the programmes to be a success, it is recommended that the Department of Social Development (DSD) strive to retain social workers who are knowledgeable and experienced in older persons programmes. / Social Work / M.A. (Social Science)

According to the Ministry of Health (1996:26), the most common chronic/terminal illnesses were cardiovascular disorders, diabetes, cancer, mental disorders, HIV/AIDS, tuberculosis and asthma. Long term treatment and care and the growing incidence of these conditions necessitated the introduction of home-based care (HBC). Consequently, family care givers play a major role in the provision of care to chronically/terminally ill patients and professional health care providers adopt a supervisory role. This study examined the quality of home care services provided in Botswana. The availability and accessibility of home-based care services and resources have a direct bearing on the quality of home-based care delivery system. The researcher used systems theory was used as the conceptual framework for this study. The study aimed to • determine the accessibility and availability of home-based care services in Molepolole East • investigate what the perspectives and experiences of family care givers, patients and professional health care providers of Botswana home-based care are • determine the roles of professionals health care providers, patients, and family care givers and their relationships in the context of home- based care • identify the needs of chronically/terminally ill patents and family care givers • determine the type of support given to family care givers and patients by professional health care providers and make recommendations for the improvement of home-based care • develop a model to prepare family care givers The research design combined quantitative and qualitative research methods. A sample of convenience was used to obtain information from patients' family care givers and professional health care providers. Interviews and questionnaires were used. A proposed care giving preparedness model is presented to meet needs of the family care givers. The study found that family care givers needs are neither known nor catered for by the professional health care provider. The family care givers were not adequately prepared before adopting the care-giving role. It is recommended that • The proposed preparedness care giving training model is considered for training of patients and family care givers before discharge and during HBC. • Increase patients and family care givers decision-making / Health Studies / D.Litt. et Phil. (Health Studies)

Submitted in fulfillment of the requirements for the Doctoral Degree in Nursing, Durban University of Technology, Durban, South Africa, 2016. / This mixed methods study aimed to assess the functioning and processes of the Fast Queue Service Point in order to analyse the quality of care rendered in primary health care (PHC) facilities in the eThekwini district of the KwaZulu­ Natal Province in South Africa. The Fast Queue Service Point provides service in PHC facilities for health care users requiring short consultations. Congestion of PHC facilities is a result of increased access to PHC services with the introduction of free PHC services. This congestion was aggravated by the decentralization of services from hospitals to PHC level such as the introduction on Nurse Initiated Management of Anti-Retroviral Therapy (NIMART). In 2010, the National Core Standards (NCS) for health establishments were formulated further to the PHC Service package, to address issues of quality. An explanatory sequential mixed methods study design was used and data collection was conducted in two phases; the quantitative data collection phase consisting of two subsets of observations namely; the retrospective record review and structured observations of the Fast Queue Service Point process. The Statistical Package for the Social Sciences (SPSS) version 22 was used to analyse data. During the second phase semi-structured interviews were conducted with PHC staff members to describe their experiences of the Fast Queue Service Point and to clarify issues from the quantitative phase. Although Fast Queue Service users received sufficient care, there were important care assessments that had been inadequately performed or omitted. These included discussing side effects of medications and or immunizations and management thereof. Childrens' weights were not interpreted, an important aspect for children under five years of age. There was also lack of supportive supervision coupled with shortage of resources and too many time-consuming written records that were required to compile accurate statistics. Retraining and in-servicing of health personnel and making resources available, would assist in strengthening patient assessment, management and recording thereof. While clinic managers require to offer supportive supervision to health care providers, provision of lower categories of staff would be beneficial in supporting PNs and ENs so that they have time to compile records for statistics purposes, which were found to be taking up the bulk of their time. The framework for continuous quality improvement in implementing a Fast Queue Service in PHC settings was developed based on the findings of the study / D

BACKGROUND: The prevalence of tuberculosis (TB) has been rapidly on the ascendency in the recent years globally due to its co-infection with HIV/AIDS. TB case finding is one of the technical pillars of the Directly Observed Treatment Short course (DOTS) TB strategy and there has been advocacy for early TB case detection to be the new focus of TB control efforts. PURPOSE: The purpose of this non-experimental study was to assess the determinants of TB case finding among pulmonary TB patients registered for treatment in Makana Municipality METHOD: A quantitative, non-experimental, cross sectional descriptive study among PTB patients registered for treatment at the primary health care clinics in Makana Municipality was done. Data collection was by self-administered questionnaires while sampling was by systematic sampling of PTB patients at five systematically selected clinics. RESULTS: Patient–related delay contributed more to total delay, in this study sample, than health system-related delay. Health system delay was found to be significantly associated with poorer finances, passive smoking history, seeking care from multiple health providers, initially visiting a non- NTCP health provider, TB stigma , overcrowding in the household and having difficulty with breathing as an initial symptom (p<0.05). CONCLUSION: There was a significant delay in TB case finding among PTB patients in this local municipality and patient related determinants contributed more than health system related determinants to this delay. There is need for the municipal TB programme to embark on an aggressive health education programme to furnish the populace with accurate information about TB, improve their health seeking behaviour and help address the issue of stigma associated with TB. / Health Studies

The aim of the study was to investigate the knowledge and utilisation of antenatal care (ANC) services by pregnant women at a clinic in Ekurhuleni. A quantitative, descriptive correlational study was carried out on 90 eligible pregnant women. Data were collected with a self-administered questionnaire and analysed with the help of a statistician using the Epi Info version 7 computer program. The results of the study indicate that most women initiated ANC later than the recommendations by the World Health Organization (WHO). Over half of the respondents had overall good knowledge of ANC, but lacked knowledge of medication and screening tests done during pregnancy, some danger signs during pregnancy and of exclusive breastfeeding. Factors that were identified as associated with late initiation of ANC were current employment status, number of children, transport costs to clinic and number of antenatal visits. / Department of Health Studies / M.A. (Public Health)

Women’s procreative capacities and the appreciation of birth experiences have always been recognised in civil society and the early days of psychology. Given that our culture is one that emphasises a woman’s capacity to bear children as one of the greatest social achievements, the social responsibility to procreate and ensure collective survival becomes a potent mandate, especially so for Black African women. To fulfil this social responsibility, traditional African culture dictates a very specific process of pregnancy which involves a series of watershed moments, each of which requires that social support, of whatever form, should be available. This study explored the role that social support from significant others and health professionals play in mediating psychological issues during pregnancy, childbirth and postnatally among Black African women in Madadeni Township in KwaZulu-Natal. The study was rooted in the interpretive, qualitative paradigm and a phenomenological research design was used. Purposive sampling was used to select participants who were aged from 18 to 25 years with a baby older than two weeks but less than six months. Semi structured interviews were conducted in the mother tongue of the participants until the point of saturation where no new information arose from the six participants interviewed. Thematic content analysis was used to extract recurrent themes across participants. The results indicate that social support, especially from parents and partners, plays a defining role in helping women to cope with the stress experienced during pregnancy, childbirth and postnatally. / Psychology / M. A. (Psychology: Research Consultation)

"February 20, 2003" / Includes bibliographical references (leaves 586-603) / xvii, 603 leaves : ill. ; 30 cm. / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Investigates the level of resident participation in decision-making in aged care hostels in South Australia. / Thesis (Ph.D.)--University of Adelaide, Dept. of Psychology, 2003

In recent years, the term "Healthy Communities" has become a catch phrase among planners, health promotion workers, social workers and government agencies, and increasing numbers of professionals have taken a role in the development of healthy communities projects. The literature on the healthy communities concept has increased in size and scope. Yet the concept itself is byno means clearly defined. Nor is there a standard method for developing a successful healthy communities project, or a regional collaboration of healthy communities projects. The question remains, when a planner undertakes a role in the development of a healthy communities project, what are the most important factors to consider? This thesis examines the influence of various project inputs on the ability of a regional healthy communities project to achieve its objectives. The thesis uses a case study of the Tri-City Health Promotion Project, a collaborative healthy communities project undertaken in the cities of Castlegar, Trail and Nelson in the West Kootenay region of British Columbia. In this study, documentary analysis and interviews with Tri-City project staff illuminate the importance of several influences on a regional healthy communities project. Some of these are: the approach used by the participants (task- orprocess-orientation), the resources and constraints specific to each community, the context from which the project grew, the personalities of those involved, the ability of the collaborating communities to work together, and the relationship between the community and regional bodies in the project structure. Conclusions: While every healthy communities project will be affected differently by various inputs, in the case of the Tri-City Health Promotion Project, the relationship between the regional and community bodies in the project structure had the greatest influence on the ability of the community Steering Committees to achieve their goals. Planners working on a regional healthy communities project must carefully examine the design of the project, in order to develop a structure which enhances the working relationship between regional and community bodies. This is particularly crucial in the healthy communities context, where decision-making power often resides at the community level, rather than being centralized in the regional body.

A study entitled `Phenomenological study of ageing amongst the older persons in Zambia' was undertaken with the purpose of gaining an understanding of the ageing phenomenon within the Zambian context and provide frameworks that could be used by policy-makers and health professionals to formulate guidelines or interventions relevant to the lived experiences of older persons and the meaning attached to ageing or being old, and consequently maintain or improve the quality of life of older persons of Zambia. The objectives of the study were to describe (1) the lived experiences of the older persons of Zambia, and (2) the meaning they attached to ageing or being old within the Zambian context. A transcendental phenomenological design within the qualitative naturalistic approach was used to guide the research process and to assist the researcher to reach the purpose and objectives of the study. Focus group and in-depth individual interviews were conducted to generate data from twenty-seven (27) informants. Fifteen (15) informants participated in the focus group interviews and twelve (12) in in-depth individual interviews. In total, 24 in-depth individual interviews were conducted in term of two interviews per informants, and two focus group interviews. Data collection covered a period of three months. Coliazzi (1978) and Giorgi (1985) techniques for qualitative data analysis were used and verbatim excerpts form the transcribed interviews were used to support the themes that emerged from data and to provide a richer picture of the situation. Three frameworks derived from the findings of this study: (1) framework of the lived experiences of older persons of Zambia, (2) framework of the meaning of ageing or being old and (3) framework for understanding ageing within the Zambian context. The researcher believed that these frameworks would make a meaningful contribution toward the understanding and the development of policies and interventions that would assist in enhancing or maintaining the quality of life of older people of Zambia. The main findings of the results of this study indicated three most significant dimensions of the lived experiences of the older persons (health, socio-economic and psychosocial) that need to be taken into account when planning for any programs or interventions aimed at maintaining or improving the quality of life of older persons of Zambia. These interventions and programs should also address the negative feelings or meanings attached to the above experiences. The main findings of the results of this study also showed that the meaning of being old or ageing in Zambia does not depend on the health, socio-economic and psychosocial living experiences of the older person but it depends largely on the inner values of the older persons, such as spiritual, emotional and cultural beliefs. This means that maintaining or improving the quality of life of older persons in Zambia would require comprehensive programs or interventions that should take into account the health, socio-economic, psychosocial, spiritual, emotional and cultural needs of the older people. / Health Studies / D. Litt. et Phil. (Health Studies)

Text in English / In South Africa, retention of newly qualified professional nurses in public health institutions upon completion of their year of compulsory remunerated community service remains a challenge that exacerbates the shortage of professional nurses in these institutions. The literature indicates that many newly qualified professional nurses leave the public health institutions due to lack of professional development support and heavy workloads while they are still finding their feet. A mixed-methods design of concurrent triangulation approach was used to answer the question: How are the newly qualified professional nurses supported in terms of induction and professional development during community service in South Africa? Triangulation was achieved by using both quantitative and qualitative methods. Induction/orientation documents from public health institutions were analysed using a checklist. A survey questionnaire with mixed quantitative closed items (1–43) and qualitative open-ended questions (43–46) was sent to newly qualified professional nurses who had recently completed community service. Focus groups held with operational nurse managers and individual interviews with coordinators of community service for nurses yielded rich qualitative data. Descriptive and inferential statistics were used to describe and synthesise data. The qualitative findings confirmed the quantitative findings. Findings were lack of professional development support in some public health institutions, informal, non-comprehensive support where given, shortage of experienced professional nurses, reluctance by some professional nurses and operational nurse managers to supervise newly qualified nurses, and increased workload due to the shortage of experienced professional nurses in the public health institutions. Inadequate clinical skills, poor discipline and lack of professionalism in the newly qualified professional nurses also played a part. Respondents suggested constructive recommendations for the induction and professional development support of the newly qualified professional nurses, and these were incorporated in the recommended guidelines for the induction and professional development support of newly qualified professional nurses during community service. / Health Studies / D. Litt. et Phil. (Health Studies)