Text in Afrikaans / Die probleem wat in die studie ondersoek word is: wat die aard van die behoefte aan gemeenskapgesondheidsinligtingdienste (GGID) in Suid-Afrika, met besondere verwysing na Bloemfontein en Mangaung, is. Daar word van 'n verkennende studie gebruik gemaak om die navorsingsdoelstellings te bereik. Die metodes wat gebruik is, is literatuurstudie, gevallestudie en opname. Die tegnieke wat gebruik is, is vraelys, skedule en onderhoud. 'n Oorsig oor gesondheidsorg, met die klem op primere gesondheidsorg as agtergrond vir gesondheidsopvoeding en -inligting, word gegee. Daar word verwys na die rol van verskillende biblioteektipes en die bibliotekaris. Redes vir die ontstaan van gemeenskapgesondheidsinligting, die verspreiding van GGID in die buiteland en die fvksionering daarvan word beskryf. 'n Ondersoek is in Mangaung en Bloemfontein gedoen om die behoefte aan GGID en die aard van gesondheidsinligting te probeer bepaal. 'n Model word saamgestel uit die behoeftebepaling en die literatuurstudie / The subject investigated by this study is: the nature of the need for community health information services (CHIS) in South Africa, with special reference to Bloemfontein and Mangaung. An exploratory study has been used to achieve the research objectives. The methods used are review of the literature, case study and a survey. The techniques used are a questionnaire, schedule and interview. A review of health care, emphasizing primary health care as a backgound to health education and information, is given. The role of different types of libraries and the librarian is discussed. Reasons for the development of community health information, the distribution of CHIS overseas and their functioning are described. An investigation was done in Bloemfontein and Mangaung to gauge the need for CHIS and the nature of health information. A model has been formulated, based on this survey and the literature review / Information Science / M. Bibl. (Inligtingkunde)

The research study focuses on transformation management in a welfare organisation and is aimed at developing a framework for a prospective model for management of a transformation process in a welfare organisation. The research was directed by two components, the nature, and the management of transformation, and was initiated with a literature study on these two concepts. The research study is limited to the Gauteng area, and only child and family welfare organisations which were already active participants of a transformation process were targeted. Data collection process was initiated by means of a structured interview schedule, completed by managers/senior social workers/ Board chairpersons (the target group) . Results of the study indicate that a majority of the twenty targeted organisations had undergone an unstructured transformation process. A structured, well formulated, and planned transformation management process was required as a guideline, with a view to developing a prospective model for the management of a transformation process in a welfare organisation. Results and conclusions drawn from this study can be generalised in the broader spectrum of welfare organisations for the management of a transformation process. Further research is needed to develop the required model. / Social Work / M.Diac. (Social Work)

Since 1994 a number of health reforms took place in furthering democracy. These changes included the decentralisation of Primary Health Care Services. This study is a phenomenological research that chronicles the Primary Health Care decentralisation experiences in the Bophirima District of the North-West Province. Using a descriptive phenomenological orientation, the purpose of this study was to describe the experiences of participants associated with decentralisation in the Bophirima District. Also, to illustrate how the participants perceive these experiences in relation to Primary Health Care services. Furthermore, to provide scientific evidence regarding factors related to the decentralisation of PHC services in the Bophirima District. These and other issues remain of paramount importance given the current state of health care in the South Africa. This study took place in the outskirts of the semi-rural area of Bophirima and Central District in the North-West Province. The investigation followed qualitative research design that was descriptive, exploratory, contextual and phenomenological in nature. The sampling procedure involved non-probability purposive, sampling technique with a sample size of five participants. Data was collected by using an unstructured interview technique. The modified Giorgi method of analysis was used for qualitative data analysis. These are contained in Burns and Grove (2001:596) and Polit and Beck (2004:394) are fully explicated in Chapter Four. Guba model (in Babbie & Mouton, 2001:180) was utilised to ensure the trustworthiness of the study. Ethical requirements were considered throughout and these are reflected in chapter four of the thesis.Three forms of decentralisation: deconcentration, delegation and devolution were identified in the findings. The investigation further indicated that the integration of primary health care services was also underway at the time of decentralisation. This integration triggered different psychological and emotional states amongst research participants. Most importantly, the research revealed that the interest of leadership across three spheres of government played a key role in the decentralisation of PHCs and integration of PHCs, while highlighting the importance of community participation in health service delivery (CP). In conclusion, the decentralisation process was generally perceived as empowering although, nationally, leadership needs to be strengthened to support provinces and districts regarding major policy issues such decentralisation. Key recommendations were made and further research was suggested. / Health Studies / D. Litt. et Phil. (Health Studies)

Text in Afrikaans / Drug dependent adolescents do not display a clear understanding regarding the value of social work intervention during the process of rehabilation, causing them to not utilize the profession of social work effectively during drug rehabilitation. This study aimed to explore and describe the nature and contribution of social work service delivery to drug dependent adolescents from their own perspective. A qualitative research approach, an explorative research design, and a snowball sampling technique were implemented. The sample consisted of drug dependent adolescents from the Western Cape. Semi-structured interviews were executed determining the participant’s perception of the nature and contribution of social work service delivery. Amongst others, the findings indicate that: • social workers are not sufficiently prepared, trained or committed to render effective, professional services to drug dependent adolescents; • social workers need to continuously revisit their knowledge, skill and attitude regarding this specialised field of service rendering. / Social Work / M.A. (Maatskaplike Werk)

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 purpose of this study was to explore and describe staff experiences in managing data and/or information when utilising the District Health Information System (DHIS) as a support mechanism for data quality improvement, including the strengths and weaknesses of current data management processes. It was also aimed to identify key barriers and to make recommendations on how data management can be strengthened. Key informants included in this study were those based at the district office (health programme managers and information officers) and at the primary health care (PHC) facilities (facility managers, clinical nurse practitioners and data capturers). An exploratory, descriptive and generic qualitative study was conducted. Consent was requested from each participant. Data were collected through semi-structured interviews. The study findings highlighted strengths, weaknesses and key barriers as experienced by the staff. Strengths, such as having data capturers and DHIS software at most if not all facilities, were highlighted. The weaknesses and key barriers highlighted were staff shortages of both clinical and health management information staff (HMIS), shortage of resources such as computers and Internet access, poor feedback, training needs and data quality issues. Most of the weaknesses and key barriers called for further and proper implementation of the District Health Management Information Systems (DHMIS) policy, the standard operating procedures (SOP), the eHealth strategy and training of the staff, due to the reported gaps between the policy and the reality and/or practice at the facility / Health Studies / M.A. (Public Health with specialisation in Medical Informatics)

The purpose of the study was to investigate the knowledge of TB patients receiving TB treatment at a clinic in Tshwane regarding the condition and their treatment. A descriptive cross-sectional survey was conducted. Data was collected using a self-designed structured questionnaire administered by the researcher and nurses. The population consisted of diagnosed TB patients. The total sample consisted of 74 respondents. The respondents were described in terms of inter alia their demographics, aspects of their health and TB and aspects related to clinic visits. For the knowledge about TB a competency indicator was set at 70% which means that those that achieved this were regarded as knowledgeable. Those that were found to be not knowledgeable were 41.9% of the sample. The mean score achieved by the group was 61% with a standard deviation of 25. Recommendations were made to amend knowledge deficits of TB patients and for further research / Health Studies / M.A. (Public Health)

Dissertation submitted in fulfillment of the requirements for the Degree in Masters of Technology: Nursing, Durban University of Technology, 2011. / Background South Africa is burdened by consistently high maternal and perinatal mortality rates. In a move to alleviate this burden the South African National Department of Health (DoH) instructed the adoption of the Basic Antenatal Care (BANC) approach in all antenatal care (ANC) facilities. Whereas many facilities have begun the implementation of the BANC approach, in the eThekwini district, not all of the facilities have been successful in doing so. The study was conducted in those eThekwini Municipality Primary Health Care (PHC) facilities that have been successful in order to identify the factors influencing their success in implementing BANC. Methods The facilities that had been successful in implementing BANC were identified, followed by a review of the past records of the patients who had completed their ANC and had given birth. This was done in order to establish whether the facilities that were said to be implementing BANC, were in fact, following BANC guidelines. The factors that influenced successful implementation of BANC were identified based on information obtained from the midwives who were working in the ANC facilities that were successfully implementing BANC. The sample size was comprised of 18 PHC facilities that were successfully implementing BANC from which a total of 59 midwives were used as the study participants. Results Several positive factors that influenced successful implementation of BANC were identified. These factors included; availability and accessibility of BANC services: Policies, Guidelines and Protocol; various means of communication; a comprehensive iii package of services and the integration of services; training and in-service education; human and material resources and the support and supervision offered to the midwives by the PHC supervisors. Other factors included BANC programme supervisors’ understanding of the programme and the levels of experience of midwives involved in implementation of BANC. There were, however, certain challenges and negative factors that were identified and these included: shortage of staff; lack of cooperation from referral hospitals; lack of in-service training; problems in transporting specimens to the laboratory; lack of material resources; lack of management support and the unavailability of BANC guidelines.

Submitted in fulfillment of the requirements for the Degree in Masters of Technology in Nursing, Durban University of Technology, Durban, South Africa, 2015. / Introduction Access to effective health care is at the heart of the discourse on how to achieve the health related Millennium Development Goals. Lesbian and gay persons are affected by a range of social and structural factors in their environment, and as a result have unique health needs that might not be met by existing health care services. Sexual stigma remains a barrier to seeking appropriate health care. Lesbians and gays might delay seeking health care when needed or avoid it all together, because of past discrimination or perceived homophobia within the health care system. Aim of the study The aim of the study was explore and describe the accessibility of primary health care services to lesbians and gays in Umlazi in the province of KwaZulu-Natal. Methodology A qualitative, exploratory, descriptive study was conducted which was contextual in nature. Aday and Andersons’ theoretical framework of access was chosen to guide this study. Semi-structured interviews were conducted with 12 lesbian and gay participants. The findings of this study were analysed using content analysis. Results Four major themes that emerged from the data analysis were discrimination of homosexual men and women by health care providers and community members in PHC facilities; attitudes of homosexual men and women towards health care providers; homophobic behaviour and equality of PHC services. Few participants were satisfied with the primary health care services they received. Intervention by the Department of Health, Department of Education, curriculum planners and Health Professionals Councils is recommended wherein homosexuality education should be addressed during pre-service and in-service education sessions so as to familiarise health care providers with such clients’ health care needs and to decreased homophobic attitudes.

Introduction This research was a descriptive study into the cold chain management of childhood vaccines by nurses in Primary Health Care Clinics in the uMgungundlovu District. It is imperative for health professionals to follow the procedures and policies set out by the immunisation and health manuals by of the World Health Organization. The success of any childhood vaccination programme depends on how well nurses and health professionals are able to adhere to the laws, regulations and procedures. There is also a need for clinics and health institutions to be flexible enough to deal with certain constraints so that the vaccination programmes are not interrupted for extended periods of time but rather run efficiently and benefit the intended population. As a result pandemics are easily avoided and a healthy generation of children will bring about a better society. Methodology The study was carried out in two phases i.e. an observational study and a self-administered questionnaire. In the first phase, the observational study was carried out at 14 different clinics in the uMgungundlovu District. In the second phase, the cold chain management of vaccines by nurses was explored by means of a self-administered questionnaire. Results The key findings of the observational study include that on most occasions policy was not being implemented. Furthermore there were no contingency plans to deal with equipment and electricity issues, no monitoring and evaluation systems, poor recording keeping, poor management of the cold box, access to stock and the actual management of the cold chain for vaccines. The self-administered questionnaire was completed by 276 nurses via a simple random sample from the different clinics. The most salient aspects of the research in this phase of the study revealed that education and experience of the nurses are crucial to the sustainability of the childhood immunisation programme. Not surprisingly, some of the findings were similar to that of the observational study. Issues surrounding equipment and electricity, monitoring and evaluation systems, poor recording keeping, poor access to stock and ordering of stock were prevalent in this phase of the research as well. Conclusion Recommendations have been made for ongoing communication between the Department of Health, the District Office of Health and clinics so that the short and long term problems identified are solved.