With the global economy in a crisis, debt levels are at an all-time high. The United States of America’s national debt exceeds $14 trillion and the South African outstanding gross consumer credit book is at R1,39 trillion. This pattern of debt levels is seen worldwide, with various adverse effects on the debtors and the economy in general. Although debt is an important mechanism in the growth of an economy, the amount of debt must be managed. Unsecured debt is a higher risk loan offered to debtors who cannot support the debt through any form of security. Default on this type of debt leaves the creditor with only a few options to recover the debt. It is thus important to understand the reasons for these defaults in order to manage the debtor and the risk associated with these loans. This study investigates the default rate and demographics of unsecured debt defaulters. A large study population is analysed to determine the total default rate and demographics of the defaulting debtors. The aim is to get a better understanding of the risk involved in unsecured debt in order to manage the credit vetting process more efficiently. Factors including loan size, number of loans, geographic distribution, gender and the age of debtors are studied to determine the profile of a typical debt defaulter. This is then compared to the non-defaulting population. The research findings confirm that there are statistically significant correlations between loan size, number of loans, geographic distribution, gender and age and the number of defaults in the population. The practical significance is, however, weak. It further proves that the profile of a defaulting debtors’ book is the same as the initial debtors’ book. A further challenge will be to incorporate affordability and other relevant data to understand the defaulting population and the reasons for default better. / MBA, North-West University, Potchefstroom Campus, 2014

With the global economy in a crisis, debt levels are at an all-time high. The United States of America’s national debt exceeds $14 trillion and the South African outstanding gross consumer credit book is at R1,39 trillion. This pattern of debt levels is seen worldwide, with various adverse effects on the debtors and the economy in general. Although debt is an important mechanism in the growth of an economy, the amount of debt must be managed. Unsecured debt is a higher risk loan offered to debtors who cannot support the debt through any form of security. Default on this type of debt leaves the creditor with only a few options to recover the debt. It is thus important to understand the reasons for these defaults in order to manage the debtor and the risk associated with these loans. This study investigates the default rate and demographics of unsecured debt defaulters. A large study population is analysed to determine the total default rate and demographics of the defaulting debtors. The aim is to get a better understanding of the risk involved in unsecured debt in order to manage the credit vetting process more efficiently. Factors including loan size, number of loans, geographic distribution, gender and the age of debtors are studied to determine the profile of a typical debt defaulter. This is then compared to the non-defaulting population. The research findings confirm that there are statistically significant correlations between loan size, number of loans, geographic distribution, gender and age and the number of defaults in the population. The practical significance is, however, weak. It further proves that the profile of a defaulting debtors’ book is the same as the initial debtors’ book. A further challenge will be to incorporate affordability and other relevant data to understand the defaulting population and the reasons for default better. / MBA, North-West University, Potchefstroom Campus, 2014

Magister Public Health - MPH / Background: Tuberculosis (TB) poses a major public health challenge in South Africa and in the Northern Cape Province. The province has the third highest in TB incidence rate in the country. Poor adherence to TB treatment impacts negatively on treatment outcomes. Siyanda district in the Northern Cape Province has the second highest number of TB defaulters in the province despite the fact that 79.9% of these patients are on Community Based Direct Observation of Treatment (CBDOT). Aim: To explore the reasons for defaulting of TB patients from TB treatment in the CBDOT Programme in the Siyanda district, Northern Cape Province Study design: This was a qualitative exploratory study. Study population and sampling: Two TB nurses with varying years of experience in the TB Control Programme serving as key informants were selected from the participating facilities in the study area. Ten TB defaulters who were on the CBDOT programme were selected from the Electronic TB Register. Two focus group discussions (FGDs) comprising of purposively selected DOT Supporters (five in one group and six in the other) from different NGOs in the community were selected for maximum variation. Data collection: Key informant interviews were conducted with the TB nurses. Records of all defaulters in the study population were reviewed including clinic progress notes and patient TB treatment cards. In-depth interviews were conducted with the TB patients. FGDs were conducted with DOT supporters. Analysis: Analysis commenced simultaneously with collection of data. This enabled the researcher to continuously review and reflect on the data collected. Thematic content analysis was done.Categories emerged through the inductive process of the data analysis. Notes that were kept during data collection, reflections, audiotapes and transcripts were used to support the thick description of the findings. Results: The participants generally appreciated the programme and mostly had a good relationship with the DOT supporters. However, the quality of care exacerbated by inadequate health services such as lack of adherence counselling training of health professionals, low levels of education amongst TB defaulters, were found to be major contributory factors to TB defaulting. The patients interrupted treatment several times before defaulting, were not counselled during the interruption phase and understood TB messages differently. TB defaulters in the Siyanda District face socio economic challenges which include alcohol abuse, a major historic ill in the district and the grape farming community in the region. The impact of the disability grant on TB treatment adherence remains anecdotal and requires further research as TB defaulters did not admit to defaulting so that they could continue benefiting from the disability grant although these statements were refuted by the DOT supporters and key informants. The attitude of employers and fear of losing employment were also contributing factors. Conclusion and recommendations: It has become evident that TB in the Siyanda District is a public health issue. The predominantly rural, impoverished and transient community that moves to the farms to seek employment requires a CBDOT programme that will address pertinent challenges in the district to achieve a positive reduction in the TB defaulter rate. It will require collaboration with stakeholders including farmers, to address the challenges posed by the disease. Improved staff allocation, staff capacity development and community education are also recommended to improve quality of care.

MPH / Department of Public Health / Background: The provision of antiretroviral treatment for people living with HIV/AIDS has encountered many challenges associated with poor adherence in South African and other countries in Africa as a whole including globally. Taking ARVs Properly has shown to reduce viral load to a level where the virus becomes undetectable and these results in an increase of CD4 count cells. These decreases chances of oppotunistic infections but it requires a proper adherence and compliance to treatment which seems to be difficult to most patients on ART. Purpose: The study investigated factors contributing to clients defaulting antiretroviral treatment. Methodology: A qualitative explorative cross-sectional study design was conducted at Matoks in Capricon District, in the months of May, June and July 2017. A purposive sampling method was used to select 19 respondents whom where willing to voluntrily participate in the study from a population of People Living With HIV/AIDS (PLWHV). An indepth face to face interview was used to collect data, guided by a central question and probing. It was then analyzed by the use of eight steps of Tesch. Results: The findings revealed that women were more defaulters than men. Shortages of antiretroviral treatment and most clients were unable to collect ART on time due to lack of transport to the clinic and the long distance from their perspective homes to the clinic. Socio economic conditions and indegenious health beliefs were some of factors identified. Recommendations: extensive health education and promotion should be intensified to reach all community members of Matoks and PLWHA in terms of HIV/AIDS care and consistent taking of treatment that clients who live far away from the clinic will be able to collect the ARV treatment nearer to their place of residents. / NRF

PhD (Psychology) / Department of Psychology / Background: South Africa has world’s highest prevalence of HIV-positive people with approximately 7.06 million HIV-positive people with 110 000 HIV- related deaths reported by Statistics South Africa in 2017. South Africa has expanded access to anti-retroviral therapy services, from urban centers to resource-constrained rural communities. The rate of loss, however, to follow-up for patients on anti-retroviral treatment continues to increase. Aim of the Study: The aim of this study was to determine patient and nurse perspectives on loss to follow up among HIV-positive patients in Sekhukhune District of Limpopo Province, South Africa. The findings of the study guided the development of a proposed strategy to decrease loss to follow up among HIV-positive patients. Method: A qualitative research design was used with non-probability purposive sampling and with probability systematic sampling. The sample of patients comprised 30 HIV-positive people classified as lost to follow-up from clinics with high prevalence rates of lost to follow-up patients. Eight nurses, four from clinics with high rates and four from clinics with low lost to follow-up rates comprised the sample of nurses. Semi-structured interviews were conducted using the study research questions as a guide. Eight interviews were conducted with nurse clinic managers and 30 with the patients. Content analysis was used to analyze the data. Results: The key themes that emerged from the study included patients’ and nurses` perspectives on factors contributing to loss to follow up among HIV- positive patients; and Patients’ and nurses’ perspectives on strategies that would address barriers to loss to follow up among HIV- positive patients. Sub-themes on patients’ and nurses’ perspectives on factors contributing to loss to follow up among HIV- positive patients included: Lack of understanding of anti-retroviral treatment; fearful to disclose HIV status; lack of confidentiality; negative side effects; use of traditional medicine; self-transfer from one clinic to another. Patients’ and nurses’ elicited the strategies that would assist patients to remain in care and to take antiretroviral treatment consistently. The strategies included: providing patients with health education; working as a team; implementing social support group programme; providing nurses with in-service education on ethics and ethos. Informed by various intervention models in HIV care: Information Motivational Behavioural model; Health Belief Model; Social Action Theory and Social Cognitive Theory; I proposed a strategy that may reduce the rate of non-adherence and loss to follow up among patients with HIV in Limpopo Province. / HWSETA