Philosophiae Doctor - PhD / The value of accountability as a key feature of strengthening health systems and reducing maternal, newborn and child mortality is increasingly emphasised globally, nationally and locally. Frontline health professionals and managers play a crucial role in promoting maternal, newborn and child health (MNCH) services in an equitable and accountable manner. They are at the interface between higher-level health system management and communities, facing demands from both sides and often expected to perform beyond their available means. Although accountability is a central topic in the governance of MNCH literature, it has mostly been approached at global and national levels, with little understanding of how accountability is integrated into the routine functioning of local health systems.

Introduction An estimated 11.4% of South Africans are infected with HIV. As of 2007, 1.7 million people required antiretroviral therapy (ART) and only 460 000 were reported to be on ART. ART can improve the quality of life and socio-economic status for HIV positive patients. This study aimed at evaluating the role played by the different factors in influencing treatment adherence among HIV patients on ART. Methods The study was conducted on patients receiving out-patient ART in two district hospitals (one urban and the other rural) of Mpumalanga Province, South Africa. The study project was approved by the Research and Ethics Committee of the University of Pretoria as well as by the Mpumalanga Provincial Department of Health. This was an analytical, cross-sectional study. The sample size for the study was 490 (245 per site). Facility-based patient appointment registers for the period June-August 2008 were used as the sampling frame. The respondents were selected through systematic random sampling. An interviewer directed standardised questionnaire was administered to the respondents after securing voluntary informed consent. Data were also extracted from the attendance registers in the two facilities. Adherence was measured using the Patient Medication Treatment Adherence Questionnaire. The Pearson chi-square test of association and binary logistic regression analysis were used for identifying significant predictors of non-adherence variables. Results Four hundred and twenty nine questionnaires of the 488 returned questionnaires were analysed. Sixty one questionnaires were disqualified due to incompleteness of data. The response rate was 99.7% in both study areas and participants reported adherence was 92.54%. The median age of the respondents was 36 (IQR, 13), gender distribution was 21.13% males and 78.87% females. The median duration of treatment (in months) with ART was 15 months (IQR, 18). Treatment adherence was higher in the urban than in the rural hospital. The variables that were significantly associated with non-adherence were ‘urban residence’ (OR 0.39 [0.2-0.8]); ‘lack of social support’ (OR 2.74 [1.3-5.7]); Discussion There were also some qualitative variables that had a bearing on quality of healthcare services that could explain differences between the rural and urban sites. Social support and urban residence demonstrated association with treatment adherence. Copyright / Dissertation (MMed)--University of Pretoria, 2010. / School of Health Systems and Public Health (SHSPH) / Unrestricted

This study investigated the interactive use of computer simulations (CS) and videos on magnetism in Grade 10 at four high schools in the Mpumalanga province. Magnetism is one of the sections of the Physical Sciences CAPS curriculum. Four MST high schools in the Badplaas/Mashishila circuits of the Gert Sibande district in Mpumalanga were used as a case study. Three schools were used as experimental groups while the fourth school was used as control group. The first group was taught using computer simulations. The second group was taught using videos. The third group was taught using both computer simulations and videos, and the fourth group was taught using normal traditional methods. Using the pre-post test non-equivalent control group design, it was found that learners in all the experimental groups, who were taught using either computer simulations or videos or both, achieved significantly higher scores after being subjected to the post-test than learners in the control group, who were taught only by the normal traditional method. Furthermore, learners who were taught using a combination of CS and videos achieved significantly higher scores than learners who were exposed to only CS or only videos. Class observations conducted during the study reported that the use of information communication technology (ICT) tools with learners in the experimental groups proved to be informative, motivational and inspirational. This was evidenced by active learner participation, the learners being able to make predictions after observations and provide scientific explanations of concepts through discussions. The use of ICT tools in the form of CS and videos proved to be an effective instrument which can enhance learning. / Physics / M. Sc. (Physics Education)

The phenomenon of educational inequality on access to physical resources in the Highveld Ridge East Circuit of Mpumalanga was investigated in the study. Since the COVID-19 worldwide pandemic had affected education on a global scale, South Africa included, it became necessary to incorporate this new development into the emerging design that unfolded. The study explored the impact of access to physical resources in three public schools. The aim of the investigation was to ascertain how educational disparities on access to physical resources manifested at the chosen research sites, especially during the COVID-19 pandemic. A qualitative research approach was utilised comprising of a multiple case study design. The study reported how the principal and deputy principals viewed educational inequality on access to physical resources from a management perspective, while educators provided insight on the effect of this phenomenon on the teaching and learning process. Observations, individual interviews involving the principal and deputy principals as participants, and focus group interviews involving the teachers, as well as the scrutiny of relevant official documents provided the empirical data for this investigation. All research participants were purposively selected, as a full staff complement was unavailable at the research sites during the pandemic. The results that emerged from the study indicated that educational inequality was prevalent in these public schools. The dearth of resources, and in some instances basic essential resources, had a marked impact on the management as well as the teachers and students at these schools. A significant point to consider was how ill-equipped the public schools in this area were to deal with education during a global pandemic. The backlog of the inequities on access to physical resources needed to be addressed as a matter of dire urgency if the country had any hope of salvaging the education process even at the most basic level. The recommendations in the conclusion of the study are desperate pleas for help in assisting the country, especially the previously marginalised, to move forward in the worst of times. / Educational Management and Leadership / M. Ed. (Education Management)

>Magister Scientiae - MSc / Subsistence farmers may contribute significantly to food production, food security, and employment in South Africa. However poor storage practices and contamination with mycotoxins, particularly fumonisins and aflatoxins impacts adversely on production, food safety and food security. Mycotoxins are toxic natural food-borne compounds which frequently contaminate agricultural produce worldwide. They are hazardous to humans and animals and result in significant production losses for farmers. This study focused on former Bantustans in Northern South Africa, namely Vhembe District Municipality (Limpopo) and Gert Sibande District Municipality (Mpumalanga). The aim was to assess mycological and mycotoxin contamination of crops grown by subsistence farmers. A semi-structured questionnaire was administered to randomly thirty-nine households. Data on demographics, storage practices and production during period of 2011 and 2012 cropping seasons were collected. One hundred and fifteen (115) crop samples (maize, beans and peanuts) were collected for analysis. Standard mycological methods and validated mycotoxin analysis methods (HPLC and LC- MS/MS) were used. It was found that maize was the staple food in both provinces, with a significant difference (p = 0.0184) in its production between the two districts; Vhembe produced 0.6 tonnes compared to 2.4 tonnes in Gert Sibande. The majority of the farmers for storage used traditional open wooden cribs (15/20) and steel tanks (5/20) while VDM farmers used sealed store houses 5/19 and 15/19 used polystyrene sacks. Aflatoxin occurrence was low with <1% of GSDM samples contaminated compared to 11% of VDM samples. No significant difference (p > 0.05) was observed in the aflatoxin contamination in VDM samples between the year 2011 and 2012. Samples from VDM households had higher Aspergillus fungal infection (maximum incidence 69%) compared to GSDM (27%) over both seasons. The most frequently isolated Fusarium species in VDM samples was F. verticillioides (92%; 93%), and F. subglutinans (97%; 80%) in GSDM samples over seasons 2011 and 2012, respectively. Highest levels of fumonisins (FB1+ FB2) ranged between 1010 μg/kg and 12168 μg/kg with less than 30% extremely contaminated above the regulated limit in 91% of samples from Limpopo over both seasons (2011 and 2012). Fumonisin levels between the two seasons in VDM showed no significant difference (p>0.05). Only three (less than 5%) from 68% GSDM contaminated maize samples were above the FB1 and FB2 limit. In 2011, there were two highly contaminated maize samples (1762 μg/kg and 4598 μg/kg) with the other samples less than 600 μg/kg, whereas in season two (2012) all samples were below 200 μg/kg, except one highly contaminated sample (26115 μg/kg). None of the beans and peanuts from Mpumalanga was contaminated with mycotoxins above the recommended limit, but from Limpopo 1/5 peanuts was found contaminated with aflatoxin G1 (41 μg/kg). Natural occurrence and contamination of both fumonisin and aflatoxin in stored home-grown maize from VDM was significantly (p < 0.0001) higher than GSDM over both seasons. In general, Limpopo farmers’ experience lower harvests and greater mycotoxin contamination of agricultural produce. This may be attributed in part to poor storage practices and environmental and climatic conditions in that agro-ecological zone.