<p>This study aimed to contribute to the current debate around equity in health care resource allocation by measuring the current allocation of resources, relative to need in the Northern Cape. It also discussed the level of inequities in health financing/expenditure and staffing at the primary health care level between different districts of the Northern Cape.</p>

Many parts of South Africa face a shortage of doctors within the public health system. While the PHC system is driven primarily by nursing staff, there is a need for doctors to provide certain services at primary and secondary levels. In 1996, as part of its efforts to address the shortage of doctors, the DoH began recruiting Cuban doctors to work in South Africa. This programme, now underway in eight of the nine provinces, falls under a government-to-government agreement aimed at strengthening the provision of health care in the areas of greatest need: townships and rural areas. The programme has demonstrated tangible success. However, it has also been criticised in some sections of the medical community and the media, where it has been portrayed in a controversial light. All this underlines the importance of an analysis of the programme, but to date, no such evaluation has been carried out.<br /> <br /> This research assesses the Cuban Health Programme in Gauteng province. On the basis of this thorough assessment, the government can take steps to improve the national programme, using Gauteng as a case study. This study was conducted in July 2004, employing qualitative methods to develop an in-depth understanding of recruitment and induction processes in Cuba and South Africa, the scope of practice of Cuban doctors, professional relationships, adaptation to the health system and broader society, and other factors. The researcher also conducted a review of official documents. Gauteng began with two Cuban doctors at the outset of the programme in 1996. The number peaked at 32, and has since dropped to 15. All of these doctors were interviewed in the course of the research, along with five managers and five peers. The study revealed that all the interviewees, except one manager, firmly believe that the programme has achieved its objectives, and should continue. Peers and managers commended the high quality, comprehensive and caring approach of the Cuban doctors, and say they are satisfying a real need. The Cuban doctors, however, believe that because they are providing mostly curative services, they are under-utilised. Flowing from the research are a series of recommendations. These include a proposal that the government recommit to the programme and ensure its continuity, and review the current role of the Cuban doctors, taking into consideration their willingness to provide training and expertise in preventive interventions.

The research explored the new health care service vehicle of South African with special reference to health service providers in Western Cape Department of health for the period 1995-2001. A study was made of the District Health System and the shift of emphasis from tertiary and secondary level of health care to the more cost effective Primary Health Care Service rendered at District level.

M.Cur. (Nursing Management) / Transformational leadership involves the creation of a motivating climate that enhances growth, development, commitment, goal achievement and enjoyment which encourages behaviour based on a set of shared values (Price, 2006:124). In this study transformational leadership referred to concepts of motivation, and change management with regard to the implementation of the Cervical Cancer Screening Programme in a PRe setting. During support visits in Ekurhuleni Health District, the researcher observed a lack of transformational leadership among facility managers in Primary Health Care Clinics to transform the Cervical Cancer Screening Program in line with relevant health care legislation. It was apparent that the problems in implementing the Cervical Cancer Screening Programme were related to poor motivation and lack of implementation of change management principles in the PHC clinics. From the problem statement the following research questions emerged: To what extent is the facility manager perceived as a transformational leader to implement the Cervical Cancer Screening Programme in a PHC clinic? Which actions should the facility manager take to implement the Cervical Cancer Screening Programme in PHe? From the findings guidelines for the facility managers were described to enable them to implement a Cervical Cancer Screening Programme in a Primary Health Care clinic within legal requirements...

Dissertation submitted in the partial fulfillment for the requirements of the Degree of Master in Public Management, Durban University of Technology, Durban, South Africa, 2015. / The challenges facing the South African public health systems, especially public clinics seem to be increasing. These Primary Health Centres are having to deliver service under difficult circumstances thereby making the “offering” of the service being perceived as poor. The way in which these centres operate is mainly hampered by infrastucture and resource allocation which is seen as sufficient to render appropriate service to the “black communities”. To the eyes of an outsider, this particular service is seen as ideal, yet the people for whom it is meant, do not fully benefit from it. Prior to 1994, South Africans were faced with poor health facilities; with the democratic elections, they thought the delivery of essential services was going to change for the better. In the White Paper for Transformation of the Health System in South Africa, one of the objectives states that various implementation strategies were to be designed to meet the basic needs of all people, given the limited resources available, but this does not seem to be the case. Research has shown a huge discrepancy in the delivery of service between rural and urban areas. Some of the findings are that one nurse will attend to a huge number of patients without any assistance, either from the doctor or other nurses. The literature review contained in this research indicates that there is still a gap between how the service delivery should be made available to the public and how it is currently administered or managed. This research, which is driven by a passion and love for good public service delivery assesses the perceived quality of service in the public clinics of Sobantu and Scottsville. Interviews were conducted within employees of both the clinics and the patients being served by these two clinics to assess the perceived quality of service received in these clinics / An electronic copy of the Thesis is currently unavailable.

Dissertation submitted in partial compliance with the requirements for the Master's Degree of Technology: Nursing, Technikon Natal, 2002. / The Integrated Management of Childhood Illness (IMCI) is an approach that aims to reduce the mortality and morbidity in children under the age of five years. When this programme was initiated, the conditions targeted were acute respiratory infections, diarrhoea, fevers associated with malaria and measles and malnutrition. As a result of the HIV pandemic in South Africa, the identification of children who are symptomatic of HIV infection was included. This study evaluates the use of the HIV portion of the IMCI algorithm by nurses in selected, public sector, primary health clinics in KwaZulu Natal. IMCI nurses were observed as they used the IMCI approach while consulting with sick children. Data was collected in relation to the accuracy with which the nurses used the algorithm and the extent to which the HIV portion of the algorithm was used to guide their management decisions when consulting with the children. Seventy-two observations were undertaken. In-depth interview were conducted with 13 IMCI nurses to establish factors that influenced the use of the HIV portion of the algorithm. The study showed a poor level of accuracy when using the HIV portion of the algorithm. In addition, as a result of poor accuracy when using the algorithm to assess and classify for symptomatic HIV infection, it appeared that nurses were not using the HIV portion of the algorithm to guide management decisions regarding children who were possibly symptomatic of HIV infection. I A general poor level of knowledge about HIV infection was identified which the researcher felt could be one of the factors influencing the use of the HIV portion of the algorithm. Death anxiety, low level of counselling skills and burnout also seemed to play some role in the use of the HIV portion of the algorithm.Recommendations were made to adapt future training of IMCI nurses and include an HIV training course and a course on growth monitoring of children in this age group. Further recommendations to continually evaluate the practice of nurses were made. Future areas for research were suggested. / M

Thesis (M. Cur.) --University of Limpopo, 2015 / The purpose of this study was to determine the factors that were contributing to selfreferrals of antenatal women at the Dilokong Hospital in the Tubatse Local Municipality. By employing a quantitative, non-experimental research method, 360 women completed and submitted a structured questionnaire. Validity and reliability were insured by pre-testing the data collection instrument on respondents who were not part of the main study. Data was analysed by using the SPSS and Excel computer programs with the assistance of a statistician. The age group between 21 and 30 years 197 (54.7%) was larger than the other age groups. Primigravida women represented less than half 147 (40.3%) of the respondents. These women were also supposed to be referred to the hospital for delivery; however, only 23.3% of the women were referred to the hospital for delivery. The choice of the delivery site was influenced by a lack of women’s knowledge about the referral system and of services offered at the clinics, as well as the unavailability of doctors, midwives, food, equipment, enough space for delivery at the clinics, and the perceptions that nurses and midwives were rude. The government should ensure that the clinics are provided with adequate human resources and other resources that are needed for providing these health services. Pregnant women should be given referral letters and information with regard to where they are supposed to deliver. Key concepts: Antenatal women, self-referral, referral system, and Primary Health Care (PHC).

The research explored the new health care service vehicle of South African with special reference to health service providers in Western Cape Department of health for the period 1995-2001. A study was made of the District Health System and the shift of emphasis from tertiary and secondary level of health care to the more cost effective Primary Health Care Service rendered at District level.

Many parts of South Africa face a shortage of doctors within the public health system. While the PHC system is driven primarily by nursing staff, there is a need for doctors to provide certain services at primary and secondary levels. In 1996, as part of its efforts to address the shortage of doctors, the DoH began recruiting Cuban doctors to work in South Africa. This programme, now underway in eight of the nine provinces, falls under a government-to-government agreement aimed at strengthening the provision of health care in the areas of greatest need: townships and rural areas. The programme has demonstrated tangible success. However, it has also been criticised in some sections of the medical community and the media, where it has been portrayed in a controversial light. All this underlines the importance of an analysis of the programme, but to date, no such evaluation has been carried out.<br /> <br /> This research assesses the Cuban Health Programme in Gauteng province. On the basis of this thorough assessment, the government can take steps to improve the national programme, using Gauteng as a case study. This study was conducted in July 2004, employing qualitative methods to develop an in-depth understanding of recruitment and induction processes in Cuba and South Africa, the scope of practice of Cuban doctors, professional relationships, adaptation to the health system and broader society, and other factors. The researcher also conducted a review of official documents. Gauteng began with two Cuban doctors at the outset of the programme in 1996. The number peaked at 32, and has since dropped to 15. All of these doctors were interviewed in the course of the research, along with five managers and five peers. The study revealed that all the interviewees, except one manager, firmly believe that the programme has achieved its objectives, and should continue. Peers and managers commended the high quality, comprehensive and caring approach of the Cuban doctors, and say they are satisfying a real need. The Cuban doctors, however, believe that because they are providing mostly curative services, they are under-utilised. Flowing from the research are a series of recommendations. These include a proposal that the government recommit to the programme and ensure its continuity, and review the current role of the Cuban doctors, taking into consideration their willingness to provide training and expertise in preventive interventions.

<p>This study aimed to contribute to the current debate around equity in health care resource allocation by measuring the current allocation of resources, relative to need in the Northern Cape. It also discussed the level of inequities in health financing/expenditure and staffing at the primary health care level between different districts of the Northern Cape.</p>