The purpose of the study was to determine the causes, of the increased perinatal mortality, identify and describe other factors contributing to the increased perinatal mortality rate in a rural healthcare facility situated in Sekhukhune district in Limpopo province, and to formulate the recommendations that will reduce the perinatal mortality rate based on the results. A quantitative, descriptive, cross-sectional and retrospective design was conducted. The study population was one hundred and sixty two (162) records of babies who died in the perinatal facility from the 1st January 2015 to the 31st December 2015 with a gestational age of about 28 weeks or more. No sampling was done, but a census was used. The sample comprised of one hundred and sixty two (162) of all the records related to perinatal mortality. Data were collected from patients’ records by using a checklist. Analysis of the data was performed by the IBM Statistical Package for Social Sciences (SPSS) version 14 computer software. Frequency tables and pie graphs were used to present the data. The results indicated that 75.3% (n=122) of the records were associated with health personnel as a factor contributing to perinatal mortality. Furthermore, preterm cases accounted for 45.1% (n=73) and prematurity accounted for 37.0% (n=60) of the cases of perinatal mortality. Therefore, preterm births and prematurity are risk factors that should be managed immediately after birth, and all babies should be managed prior to being transferred to the other healthcare institutions. The recommendations are that the education of patients about early antenatal visit, signs of labour and danger signs during pregnancy and training of healthcare workers on record-keeping have to be done on a continuous basis. Managers should conduct quality improvement programmes, benchmarking and implement maternal and neonatal guidelines in the clinical area throughout pregnancy. / Health Studies / M. P. H. (Health Studies)

Risk management strategy is a broad discipline aimed at identifying, evaluating and handling risks by both physical and financial means. The medical aid industry in South Africa has experienced a disproportionate increase in expenditure relative to the overall economic growth. These cost pressures have placed restraints on their ability to obtain new members, which is vital when subsidizing higher risks with younger healthier members, and has resulted in losses for many schemes. Compounding the problem has been political and regulatory health care reforms as well as technological advances, which have initiated a complete restructure of the industry. This dissertation reviews the risk management strategies implemented by medical insurers in South Africa. An analysis of alternate risk management strategies is taken with the view of recommending a tentative means of making medical aids more efficient in an increasingly difficult market. / Business Management / M. Comm. (Business Management)

The historical evolution of South Africa’s health sector, dating back to the 17th century, is significantly different from that of other African countries. Throughout the four centuries of development there have been numerous advances in health policy, legislative instruments and health system progress. Against this background this dissertation critically analysed the management of records in public health care institutions in South Africa. The study did this by addressing three objectives: assess the legislative, policy and regulatory contextual framework of South Africa’s health care system; assess the effectiveness of records management within public health care institutions; and identify appropriate interventions to address the challenges facing records management in the health care system. The study used purposive sampling to identify respondents with diverse expertise in three main sectors: the public sector, the private sector as well as in academic and research institutions. Using interview research technique the study solicited data that was analysed in order to provide a composite picture in addressing the research objectives. The analysis of data revealed three overarching themes. First, there is substantial legislative and regulatory dissonance in the management of health records in the country. While there are extensive legislative, regulatory and policy instruments that could be used to manage records, many lack coherence with records management issues such as records retention. Second, understanding the complex interplay of different legal and regulatory instruments is a critical first step, but it remains the beginning of the process towards building a sophisticated implementation process. For this process to be successful, study respondents argued that records compliance would have to be the backbone of all other compliance processes. Third, while there were substantial areas of weakness in the management of records in South Africa’s public health sector, there have been a number of pockets of excellence. These include the efforts towards complying to access to information legislation by the Limpopo Department of Health and Social Development as well as the successful introduction of Enterprise Content Management systems in health care institutions by the Western Cape Department of Health / Information Science / D. Litt. et Phil. (Information Science)

MPH / Department of Public Health / See the attached abstract below

PhD (Nursing Science) / Department of Advanced Nursing Science / State patients are admitted to the psychiatric hospital after being declared as such by a court of law in South Africa. After successful rehabilitation of state patients at the psychiatric hospital, they need to be reintegrated into their families. Perceptions of family members of male state patients regarding reintegration including development of a model to support such reintegration, is not largely explored in the scientific body of knowledge. The aim of this study was to develop a model to support reintegration of state patients into their families in Limpopo Province, South Africa. A qualitative approach using descriptive, explorative, and contextual designs was adopted for this study. The study population was family members whose relatives are male state patients admitted and recorded in the admission register of Hayani Hospital, in Limpopo Province. The study was conducted in two phases of which phase one was a situational analysis, and phase two was the development of the model to reintegrate male state patients into their families. This study was conceptualized within the Social Ecological Model (SEM) of human behaviour (Stokols, 2013), the grounded theory for model development outlined in Dickoff et al. (1968), and the approaches outlined in Chinn and Kramer (2008); Walker and Avant (1995). Model evaluation was done by a group of health professionals, some of whom are advanced psychiatric nurses who are doing masters and doctoral studies, and one doctoral graduate who is also an advanced psychiatric nurse. Presentations were made to this group during peer review sessions who in turn gave critical comments regarding the developed model to support reintegration of male state patients until the final model was accepted. Non-probability purposive and convenient sampling were used to sample a hospital and 10 family members of Venda-speaking male state patients. In-depth individual interviews were used as the instrument to collect data which was pretested on one family member who did not form part of the study. Data was analysed using thematic analysis approach. Data was co-coded by an independent doctoral degree graduate to ensure trustworthiness. Conducting home visits by health professionals came up strongly during data analysis. Credibility, dependability, confirmability and transferability to ensure trustworthiness of the study, as well as ethical considerations were adhered to. The findings of the study yielded two themes, being perceptions of participants regarding reintegration of male state patients, and perceptions of participants regarding the support needed from family members to reintegrate male state patients. During phase one, the results indicated that family members accept reintegration and also that they indicated the kind of support needed, that lead to phase two of developing a model to reintegrate male state patients. The study was restricted to only one hospital in the Vhembe District out of the five districts of the Limpopo Province.The researcher acknowledges that this study was contextual and that only family members of male state patients were interviewed, the perceptions of family members of female state patients were not heard. The study concluded that there are perceptions that family members of male state patients have regarding reintegration of these patients into their families. Furthermore, family members of male state patients can describe the kind of support that they need in order to reintegrate male state patients into their families. This should be done using the developed model that should involve family members and the community. The study recommends that psychiatric hospitals should implement the model involving family members of male state patients. Furthermore, a longitudinal study should be conducted for a period of 3-5 years to check the effectiveness of the model. / NRF

South Africa is experiencing shortage of resources in most health services, including tertiary hospitals. This leads to a situation where health care workers, especially professional nurses (PNs) leave to private nursing or go abroad for better work conditions. The aim of this study was to explore and describe experiences of PNs on the shortage of resources at a tertiary hospital in Tshwane District. The study followed a qualitative, explorative, descriptive design based on phenomenological interpretive approach. Purposive sample of 16 participants were recruited. Unstructured interviews with a grand tour question was used to conduct face-to-face individual interviews. Interviews were recorded and transcribed verbatim. TheTesch’s method of analysis was utilised. Target group was PNs aged between 25 and 65 years who have worked for two or more years in selected units. Experiences of PNs on shortage of resources was reported as the major findings of this study. / Health Studies / M.A. (Nursing Science)

PhD (Health Studies) / Department of Public Health / Introduction: Quality healthcare provision is a fundamental need in the life of a person since it helps develop a positive self-image. Healthcare has always been an important issue for society, both economically and culturally. Contrary, dissatisfactions and litigations laid by clients/patients and relatives against the government due to poor service provision become unmanageable. The purpose of the study was the development of strategies to facilitate provision of quality healthcare services in public healthcare facilities in Limpopo province, South Africa. Methods: Qualitative and quantitative methods were adopted for the study. Population for the qualitative study was constituted by professional nurses, and stakeholders (Hospital boards and Clinic health Committees) who were, purposively selected from the randomly sampled hospitals and clinics. Focus Group discussion and questionnaires were conducted to collect data. Analysis. The qualitative data was analysed qualitatively. Population for quantitative study consisted of Clients as stakeholders and professional nurses from randomly sampled hospitals and clinics. The qualitative results were used in the development of questions for questionnaire used in the quantitative approach. For the quantitative approach a self-administered questionnaire was used to collect data from the respondents. Data collection was carried out by means of two instruments for clients and professional nurses. Analysis was done using SPSS 25 version with the assistance of a Professional Statistician. The researcher used the Strength, Weaknesses, Opportunities and Threats analysis to develop strategies for enhancing quality healthcare service provision in the Department of health. The interaction between Strengths, Weaknesses, Opportunities and Threats was analysed and used to develop strategies to facilitate provision of quality health care services in public health care facilities in Limpopo Province. Conclusion Findings of this study is expected to inform nursing education and nursing practice to review curricular on what to emphasize when training the nursing students. The findings will also inform senior management when planning for improvement of health care provision improvement. / NRF

A qualitative research design that is explorative, descriptive and contextual in nature was employed in order to understand and describe the professional nurses' perception of the implementation of a quality circles programme in a public hospital in the Eastern Cape Province and to develop guidelines for the implementation of a quality circles programme in public hospitals. The data-collection techniques were individual semi-structured interviews and field notes. The sample was drawn from a population of 425 Xhosa-speaking professional nurses employed in this institution. The sample comprised eight (8) professional nurses all of whom volunteered for in-depth individual semi-structured interviews. All the respondents answered one question "How do you perceive the implementation of the quality circles programme in your hospital?" During data collection and analysis only one theme emerged, namely the perception of quality circles as a forum for discussing patient care problems and future plans. There were four broad categories in this theme, namely  Staff empowerment  Teambuilding in the nursing discipline  Maintenance of standards by nurses  Challenges to the momentum of a quality circles programme It is recommended that all three tiers of nursing management be involved in the quality circles programme to improve interpersonal, interdepartmental and intradepartmental communication and concomitantly the nursing care. / Health Studies / M.A. (Health Studies)

This explorative, descriptive quantitative survey attempted to determine whether the reduced number of consultations and admissions of sick children less than five years in Emfuleni sub- district clinics is due to the utilisation of the IMCI strategy or other health services. The research population comprised of all the mothers/caretakers of children less than five years who utilised the clinics and those who consulted the private medical doctor. The convenient sample consisted of 169 candidates. Data was collected by means of a questionnaire and analysed using the SAS/Basic computer statistical software package. Findings of the study revealed a need to address the major concern about the waiting time and operational times in all the three clinics. Recommendations were made that staff allocation procedures and policies be reviewed in order to abate long waiting periods at the clinics where children with childhood illnesses are treated. / Health Studies / M.A. (Health Studies)

This explorative, descriptive quantitative survey attempted to determine whether the reduced number of consultations and admissions of sick children less than five years in Emfuleni sub- district clinics is due to the utilisation of the IMCI strategy or other health services. The research population comprised of all the mothers/caretakers of children less than five years who utilised the clinics and those who consulted the private medical doctor. The convenient sample consisted of 169 candidates. Data was collected by means of a questionnaire and analysed using the SAS/Basic computer statistical software package. Findings of the study revealed a need to address the major concern about the waiting time and operational times in all the three clinics. Recommendations were made that staff allocation procedures and policies be reviewed in order to abate long waiting periods at the clinics where children with childhood illnesses are treated. / Health Studies / M.A. (Health Studies)