The tax system in South Africa makes provision for every South African citizen to contribute to a greater or lesser extent to funding the National Health Insurance (NHI), either through VAT or PAYE. However, as a result of the high unemployment rate, a large gap exists between tax and non-tax contributors. The question can now be asked whether it is fair that just a small percentage of taxpayers are responsible for the total funding of the NHI. Furthermore, it could be asked whether the taxpayer is aware of the additional tax burden the NHI will impose on him/her. The purpose of this research was to investigate three countries, namely, Brazil, Spain and Germany, where some form of NHI is in operation, in order to find a possible appropriate funding model for South Africa's NHI and, ultimately, to make conclusions and recommendations based on the outcomes. It was subsequently found that, although the taxpayer should be more heavily taxed in order to fund the NHI, there are a few other possibilities for distributing the tax burden more evenly. However, the impact of the proposed adjustment to increase VAT could have a negative impact on the non-taxpayer and might contribute to greater poverty in South Africa. / MCom (South African and International Taxation), North-West University, Potchefstroom Campus, 2014

The tax system in South Africa makes provision for every South African citizen to contribute to a greater or lesser extent to funding the National Health Insurance (NHI), either through VAT or PAYE. However, as a result of the high unemployment rate, a large gap exists between tax and non-tax contributors. The question can now be asked whether it is fair that just a small percentage of taxpayers are responsible for the total funding of the NHI. Furthermore, it could be asked whether the taxpayer is aware of the additional tax burden the NHI will impose on him/her. The purpose of this research was to investigate three countries, namely, Brazil, Spain and Germany, where some form of NHI is in operation, in order to find a possible appropriate funding model for South Africa's NHI and, ultimately, to make conclusions and recommendations based on the outcomes. It was subsequently found that, although the taxpayer should be more heavily taxed in order to fund the NHI, there are a few other possibilities for distributing the tax burden more evenly. However, the impact of the proposed adjustment to increase VAT could have a negative impact on the non-taxpayer and might contribute to greater poverty in South Africa. / MCom (South African and International Taxation), North-West University, Potchefstroom Campus, 2014

The study comprises an investigation of the quality of the clinical teaching environment of undergraduate students in the accredited Primary health care ( PHC) facilities used by a provincial nursing college in Limpopo. The researcher, who is employed full time in one of the accredited PHC facilities to which undergraduate students are admitted for clinical practice, became aware of the tension between the undergraduate students and professional nurses working in the PHC facility during the performance of clinical practice. Undergraduate students accused the professional nurses of neither supervising them properly during the execution of their clinical practice, nor assessing them on the prescribed practical outcomes. On the other hand, the professional nurses working in the PHC facility complained that undergraduate students were placed at the PHC facilities in large numbers with no clinical accompanist accompanying them. The research objectives were to determine the quality of clinical practice in the PHC clinical learning environment as rated by undergraduate students allocated by a provincial nursing college located working in a PHC facility in a district of Limpopo Province, and to formulate recommendations for the professional nurses in PHC districtmanagement to incorporate supervision for undergraduate students in order to enhance clinical teaching for undergraduate students in Primary health care facilities. The researcher used a quantitative, descriptive, explorative and contextual design. An all-inclusive sampling method was used to select research participants. Participants were undergraduate students of a provincial nursing college in Limpopo. Informed consent was obtained. Ethical approval was obtained from the relevant authorities. Data was collected by using an internationally validated Clinical Learning Environment Supervision and Nurse Teacher Instrument (Saariskoki & Leino-Kilpi, 2008:259-267).. Data analysis was done by using descriptive statistics and revealed that the clinical practice environment was not conducive to enhancing practical skills development in the real practical PHC practice. Evaluation of study, limitations and recommendations for education, research, practice and policy were discussed. / MCur, North-West University, Potchefstroom Campus, 2014

This study focuses on self care among patients with hypertension visiting primary health care clinics in the Naledi sub-district in the North-West Province. Hypertension is one of the chronic diseases that shorten the life expectancy of many people globally and remains the most common and rapid growing cardiovascular disease, affecting 20 million people in sub-Saharan Africa. Hypertension is one of the quadruple burdens of disease associated with risky lifestyle behaviours like unhealthy diets with excessive energy intakes, physical inactivity and tobacco use. Although taking the mentioned common modif iable factors and the fact that hypertension is a manageable condition into consideration, the reality remains that the hypertension. A non-experimental, quantitative research was used to reach the aim of the study namely to identify and describe the self care abilities of patients diagnosed with hypertension, as well as explore and describe their knowledge and perceptions on hypertension. This was done by means of objectives to explore and describe self care abilities, knowledge and perceptions among patients diagnosed with hypertension; if there is an association between self care, knowledge and perception in relation to the level of education, age, income and time period and if there was association between self care and knowledge and perception of patients with hypertension visiting PHC clinics in Naledi sub-district in the North-W est Province. A literature review was first conducted for a clear understanding of self care and hypertension. Thereafter a structured questionnaire, consisting of demographical information, and questions on self care, knowledge and perception among patients with hypertension, was employed. Trained field workers assisted in data collec tion. A number of 142 questionnaires were completed by patients visiting PHC clinics. The demographic data was first analysed with results shown in the frequency table. The exploratory factor analyses were done for data reduction on self care, knowledge and perception among patients with hypertension. Descriptive statistics and Cohen effect sizes for factors on self care, knowledge and perception in relation to the level of education, age, income and other chronic illnesses of patients diagnosed with hypertension, correlational descriptive statistics between self care and knowledge and perception were done. The results revealed that patients with hypertension with low levels of education lack information with regard to hypertension. The higher the income of patients with hypertension, the better their self care abilities compared to those with low income. Patients who are English and Afrikaans speaking have more internal positive power and have better management abilities of hypertension than those who are Setswana speaking. Younger patients have more internal positive power, which declines with age. Those patients who are newly diagnosed with hypertension have more information on management abilities than those who have been diagnosed more than two years. The conclusion regarding the relationship of self care and knowledge and perception of hypertension is that the patients diagnosed with hypertension need knowledge on hypertension in order to adhere to self care abilities. The more knowledge patients have the better they will be able to adhere to self care activities. / Thesis (MCur)--North-West University, Potchefstroom Campus, 2013.

Surgical face masks have been designed to protect health care professionals from the splashes of the patients’ blood or body fluids and also to minimise the transmission of oro- and nasopharyngeal bacteria from the surgical team to the patient’s wounds, thereby decreasing the likelihood of postoperative surgical site infections during a surgical procedure. However, there are several ways in which surgical face masks could potentially contribute to contamination of the wound during a surgical procedure in the operating room. The objectives of this study were to explore and describe the effectiveness of surgical face masks as a protective barrier during a surgical procedure in the operating room in the public hospitals in the North West Province, South Africa and to formulate recommendations regarding surgical face masks worn by health care professionals during a surgical procedure in the operating rooms. A systematic review was conducted, followed by a quantitative, explorative, descriptive and contextual approach. The motivation for a systematic review was to search evidence on surgical face mask efficiency. A search strategy was conducted in February and March 2012 and the total initial search was 9,933 research articles. Screening of articles on effectiveness of surgical face masks during a surgical procedure was done. After six months the search was updated and the final sample of six relevant articles (n=6) was obtained. Studies that met the inclusion criteria were critically appraised based on the scores using standardised critical appraisal tools. The findings of this research project were synthesised and evaluated in order to come to conclusions. Conclusions were integrated and synthesised as the basis of developing a clear overview of the best quality empirical evidence about effectiveness of surgical face masks during a surgical procedure in the operating room. Recommendations were formulated for the nursing practice, education and research focussing on wearing a surgical face mask during a surgical procedure in the operating room. Reviewer’s conclusion: From the limited results it is unclear whether wearing surgical face masks during a surgical procedure in the operating room serve as a protective device for both surgical team and the patient. There is a need for further research. / Thesis (MCur)--North-West University, Potchefstroom Campus, 2013.

Integrated Management of Childhood Illnesses (IMCI) is a strategy that was developed by the World Health Organisation (WHO) and the United Nations Children’s Fund (UNICEF) to reduce the mortality and morbidity rate of children younger than 5 years and to improve the quality of life of these children. The reduction of child mortality and morbidity is one of the Millennium Developmental Goals (MDGs) as sub-Saharan Africa has a high child mortality and morbidity prevalence. The IMCI strategy has three components namely case management, the health system and the household and community component. This strategy was implemented internationally, including South Africa, where it is implemented within Primary Health Care (PHC) facilities. The implementation of the IMCI strategy was introduced to the PHC environment of South Africa and aims to enhance the equity, accessibility, affordability and availability of health care to all South African citizens, with the focus in this study on the child younger than 5 years. The North West province started training the professional nurses and implemented IMCI in 1998. The Dr. Kenneth Kaunda district (one of the districts in North West Province) and with specific focus on the Matlosana sub-district identified challenges in the implementation of the IMCI strategy by professional nurses. Challenges such as a lack of trained staff, the short time frame available for consultation amidst an already overburdened clinic and the physical infrastructure of the PHC facilities are such examples. The main aim of this research was to explore and gain insight and understanding in the challenges professional nurses working in PHC facilities face regarding the implementation of the IMCI strategy. A qualitative research design was used to conduct this study on daily work-life experiences of the professional nurses. Individual, semi-structured interviews were used as the method of data collection. The main question asked was: “What are the challenges faced by professional nurses in PHC facilities regarding the implementation of the IMCI strategy?” Data saturation was reached after 18 professional nurses were interviewed (N=18). Digitally voice recorded interviews were transcribed and content analysis was conducted. The findings of this research suggest that the professional nurses in the PHC facilities indeed experienced challenges regarding IMCI implementation. The main themes that emerged were challenges regarding the organisation and service delivery; challenges specific to the implementation of the IMCI strategy and also challenges external to the clinic that impacted directly on the IMCI strategy implementation. The findings were discussed with literature integration. From the research results and conclusions, the researcher compiled recommendations for nursing education, nursing research, and community health practice. / Thesis (MCur)--North-West University, Potchefstroom Campus, 2013.

The study comprises an investigation of the quality of the clinical teaching environment of undergraduate students in the accredited Primary health care ( PHC) facilities used by a provincial nursing college in Limpopo. The researcher, who is employed full time in one of the accredited PHC facilities to which undergraduate students are admitted for clinical practice, became aware of the tension between the undergraduate students and professional nurses working in the PHC facility during the performance of clinical practice. Undergraduate students accused the professional nurses of neither supervising them properly during the execution of their clinical practice, nor assessing them on the prescribed practical outcomes. On the other hand, the professional nurses working in the PHC facility complained that undergraduate students were placed at the PHC facilities in large numbers with no clinical accompanist accompanying them. The research objectives were to determine the quality of clinical practice in the PHC clinical learning environment as rated by undergraduate students allocated by a provincial nursing college located working in a PHC facility in a district of Limpopo Province, and to formulate recommendations for the professional nurses in PHC districtmanagement to incorporate supervision for undergraduate students in order to enhance clinical teaching for undergraduate students in Primary health care facilities. The researcher used a quantitative, descriptive, explorative and contextual design. An all-inclusive sampling method was used to select research participants. Participants were undergraduate students of a provincial nursing college in Limpopo. Informed consent was obtained. Ethical approval was obtained from the relevant authorities. Data was collected by using an internationally validated Clinical Learning Environment Supervision and Nurse Teacher Instrument (Saariskoki & Leino-Kilpi, 2008:259-267).. Data analysis was done by using descriptive statistics and revealed that the clinical practice environment was not conducive to enhancing practical skills development in the real practical PHC practice. Evaluation of study, limitations and recommendations for education, research, practice and policy were discussed. / MCur, North-West University, Potchefstroom Campus, 2014

This study focuses on self care among patients with hypertension visiting primary health care clinics in the Naledi sub-district in the North-West Province. Hypertension is one of the chronic diseases that shorten the life expectancy of many people globally and remains the most common and rapid growing cardiovascular disease, affecting 20 million people in sub-Saharan Africa. Hypertension is one of the quadruple burdens of disease associated with risky lifestyle behaviours like unhealthy diets with excessive energy intakes, physical inactivity and tobacco use. Although taking the mentioned common modif iable factors and the fact that hypertension is a manageable condition into consideration, the reality remains that the hypertension. A non-experimental, quantitative research was used to reach the aim of the study namely to identify and describe the self care abilities of patients diagnosed with hypertension, as well as explore and describe their knowledge and perceptions on hypertension. This was done by means of objectives to explore and describe self care abilities, knowledge and perceptions among patients diagnosed with hypertension; if there is an association between self care, knowledge and perception in relation to the level of education, age, income and time period and if there was association between self care and knowledge and perception of patients with hypertension visiting PHC clinics in Naledi sub-district in the North-W est Province. A literature review was first conducted for a clear understanding of self care and hypertension. Thereafter a structured questionnaire, consisting of demographical information, and questions on self care, knowledge and perception among patients with hypertension, was employed. Trained field workers assisted in data collec tion. A number of 142 questionnaires were completed by patients visiting PHC clinics. The demographic data was first analysed with results shown in the frequency table. The exploratory factor analyses were done for data reduction on self care, knowledge and perception among patients with hypertension. Descriptive statistics and Cohen effect sizes for factors on self care, knowledge and perception in relation to the level of education, age, income and other chronic illnesses of patients diagnosed with hypertension, correlational descriptive statistics between self care and knowledge and perception were done. The results revealed that patients with hypertension with low levels of education lack information with regard to hypertension. The higher the income of patients with hypertension, the better their self care abilities compared to those with low income. Patients who are English and Afrikaans speaking have more internal positive power and have better management abilities of hypertension than those who are Setswana speaking. Younger patients have more internal positive power, which declines with age. Those patients who are newly diagnosed with hypertension have more information on management abilities than those who have been diagnosed more than two years. The conclusion regarding the relationship of self care and knowledge and perception of hypertension is that the patients diagnosed with hypertension need knowledge on hypertension in order to adhere to self care abilities. The more knowledge patients have the better they will be able to adhere to self care activities. / Thesis (MCur)--North-West University, Potchefstroom Campus, 2013.

Surgical face masks have been designed to protect health care professionals from the splashes of the patients’ blood or body fluids and also to minimise the transmission of oro- and nasopharyngeal bacteria from the surgical team to the patient’s wounds, thereby decreasing the likelihood of postoperative surgical site infections during a surgical procedure. However, there are several ways in which surgical face masks could potentially contribute to contamination of the wound during a surgical procedure in the operating room. The objectives of this study were to explore and describe the effectiveness of surgical face masks as a protective barrier during a surgical procedure in the operating room in the public hospitals in the North West Province, South Africa and to formulate recommendations regarding surgical face masks worn by health care professionals during a surgical procedure in the operating rooms. A systematic review was conducted, followed by a quantitative, explorative, descriptive and contextual approach. The motivation for a systematic review was to search evidence on surgical face mask efficiency. A search strategy was conducted in February and March 2012 and the total initial search was 9,933 research articles. Screening of articles on effectiveness of surgical face masks during a surgical procedure was done. After six months the search was updated and the final sample of six relevant articles (n=6) was obtained. Studies that met the inclusion criteria were critically appraised based on the scores using standardised critical appraisal tools. The findings of this research project were synthesised and evaluated in order to come to conclusions. Conclusions were integrated and synthesised as the basis of developing a clear overview of the best quality empirical evidence about effectiveness of surgical face masks during a surgical procedure in the operating room. Recommendations were formulated for the nursing practice, education and research focussing on wearing a surgical face mask during a surgical procedure in the operating room. Reviewer’s conclusion: From the limited results it is unclear whether wearing surgical face masks during a surgical procedure in the operating room serve as a protective device for both surgical team and the patient. There is a need for further research. / Thesis (MCur)--North-West University, Potchefstroom Campus, 2013.

Integrated Management of Childhood Illnesses (IMCI) is a strategy that was developed by the World Health Organisation (WHO) and the United Nations Children’s Fund (UNICEF) to reduce the mortality and morbidity rate of children younger than 5 years and to improve the quality of life of these children. The reduction of child mortality and morbidity is one of the Millennium Developmental Goals (MDGs) as sub-Saharan Africa has a high child mortality and morbidity prevalence. The IMCI strategy has three components namely case management, the health system and the household and community component. This strategy was implemented internationally, including South Africa, where it is implemented within Primary Health Care (PHC) facilities. The implementation of the IMCI strategy was introduced to the PHC environment of South Africa and aims to enhance the equity, accessibility, affordability and availability of health care to all South African citizens, with the focus in this study on the child younger than 5 years. The North West province started training the professional nurses and implemented IMCI in 1998. The Dr. Kenneth Kaunda district (one of the districts in North West Province) and with specific focus on the Matlosana sub-district identified challenges in the implementation of the IMCI strategy by professional nurses. Challenges such as a lack of trained staff, the short time frame available for consultation amidst an already overburdened clinic and the physical infrastructure of the PHC facilities are such examples. The main aim of this research was to explore and gain insight and understanding in the challenges professional nurses working in PHC facilities face regarding the implementation of the IMCI strategy. A qualitative research design was used to conduct this study on daily work-life experiences of the professional nurses. Individual, semi-structured interviews were used as the method of data collection. The main question asked was: “What are the challenges faced by professional nurses in PHC facilities regarding the implementation of the IMCI strategy?” Data saturation was reached after 18 professional nurses were interviewed (N=18). Digitally voice recorded interviews were transcribed and content analysis was conducted. The findings of this research suggest that the professional nurses in the PHC facilities indeed experienced challenges regarding IMCI implementation. The main themes that emerged were challenges regarding the organisation and service delivery; challenges specific to the implementation of the IMCI strategy and also challenges external to the clinic that impacted directly on the IMCI strategy implementation. The findings were discussed with literature integration. From the research results and conclusions, the researcher compiled recommendations for nursing education, nursing research, and community health practice. / Thesis (MCur)--North-West University, Potchefstroom Campus, 2013.