M.Cur. / A single comprehensive, equitable and integrated National Health System must be created for South Afiica (ANC, 1994:19). This will be achieved by the ANC's commitment too promotion ofhealth through prevention and education. The Primary Health Care approach is the tenet for the restructuring ofthe health system. To be able to create a Health System which is single, comprehensive, equitable and integrated the system should be accessible, effective, acceptable, affordable and just. Community health nursing should be restructured to comply with these conditions. In this study the functions ofthe district nurse as a component ofthe Community Health Nursing Service within the National Health System is described. The aim ofthis study is to render more prominence to the promotive, preventive, curative and rehabilitive aspects ofcommunity health nursing in the home environment. Criteria for the delivery ofa district nursing service as component ofa community health nursing service will also be set and the position ofcurrent district nursing services investigated. An explorative, descriptive study was performed. The functions that the district nurse is supposed to perform will be obtained, by analysing duty sheets, a questionnaire and a literature review, to set guide lines for the delivery ofa district nursing service. Most ofthe district nurse's functions were found to be corresponding, in the duty sheets and questionnaires. But there were also some differences. The final findings are described

The aim of this study has been to examine, in the light of recent events in the field of Health Care in South Africa, the remarks and claims made by the World Health Organization, and the American Psychiatric Association between 1976 and 1978 on Health Care services, as provided for Blacks, by the South African government. In two reports, these organizations instituted the earliest, and arguably most significant claims against South Africa's system of Health Care. This study sketches firstly the political genesis and social context of the WHO, and APA examinations. Secondly, this study evaluates responses made by the South African State to the critical climate inspired by the above mentioned reports, through a close analysis of recent events associated with the politics, and provision of Health Care Facilities - particularly with regard to Black South Africans. This analysis suggests that the governments' earlier tentative policy of privatisation (which was soundly condemned by WHO and the APA) has been even more enthusiastically pursued - in contradiction to it's avowed policies of Commu ity Health Care, and to the continuing detriment of those South African communities who are in most need of adequate Health Care services. The study concludes that the criticisms raised by the WHO and APA had the effect of inspiring positive reforms in South Africa's health services, but in no way thwarted the governments', at first only tentative plans, to increasingly privatise it's psychiatric and other medical institutions.

M.Tech. (Public Health) / Please refer to full text to view abstract

Thesis (MA)--Stellenbosch University, 2000. / ENGLISH ABSTRACT: This study is aimed at exploring mental health services for low-income women in the West Coast I Winelands Region of South Africa. In order to understand the extent to which such services are empowering, the accessibility and theoretical underpinnings of these services are investigated. It was found that although services appear to be available, they are often not very accessible. They also often lack a specific gender focus. In certain instances, services need to increase their accessibility in order to accommodate the restrictive environments of women in this region. As such, it is believed that services require greater integration in their approach to intervention concerning both gender and the origins of mental health problems. Results of this study also highlight areas on which future research could focus. These areas include language of service provision, how organizations understand available theories surrounding service provision, and the service needs of women in this region themselves. / AFRIKAANSE OPSOMMING: Hierdie studie is gemik op die ondersoek van geestesgesondheidsdienste vir vroue van lae-inkomste groepe in die Weskus I wynverbouingstreek van Suid Afrika. Die toeganklikheid en teoretiese onderstuttngs van hierdie dienste word ondersoek in In poging om die graad waarin delke dienste bemagtigend is, te verstaan. Bevindinge toon dat dienste, albeit beskikbaar voorkom, dikwels nie baie toeganklik is nie. Dienste toon ook meestal 'n gebrekkige fokus ten opsigte van 'n spesifieke geslag. In sekere gevalle behoort die toeganklikheid van dienste verbeter te word in 'n poging om die beperkende omstandighede van vroue in hierdie streek tegemoet te kom. As sulks benodig dienste 'n hoër mate van integrasie in hul benadering tot intervensie, beide wat geslag en die oorsprong van geestesgesondheidsprobleme betref. Bevindinge lig ook areas uit waarop toekomstige navorsing kan fokus. Hierdie areas sluit die volgende in: die taal van diensvoorsiening, hoe organisasies beskikbare teorieë ten opsigte van diensvoorsiening verstaan, en die behoefts van die vroue in hierdie streek self ten opsigte van dienste.

Child and adolescent mental health represents a key area of concern and public health relevance. Mental health disorders are one of the most prevalent illnesses affecting young people and contribute significantly to the global burden of disease. Childhood and adolescent mental health problems often persist into adulthood and as such frequently result in lifelong negative consequences. Yet despite the growing concern with regards to the mental health needs of children and adolescents, not much research, both internationally and particularly locally, has focused on the provision of mental health services to children and adolescents. Additionally, little has been published on the changes and trends in diagnostic rates and assessment procedures over time. Only a few international studies have investigated mental health trends in children and adolescents; hence, there is a crucial need for South African data to inform preventative and curative services for children in South Africa. This present study therefore investigated the trends and patterns relating to diagnostic rates and assessment practices in children and adolescents over time at a local South African psychological community service centre in Pietermaritzburg. The study was a retrospective chart review and the sample consisted of 679 case files from children and adolescents between 3-17 years of age, who had been seen at a local psychological service centre between 1987-1989, 1997-1999 and 2007-2009. The case files were systematically analysed with regards to diagnosis and assessment practices. It was hypothesised that the years of continuous social and political conflict in the Pietermaritzburg area, namely 1987-1989, had a direct impact on the psychological development and well-being of children and adolescents from this area, and that this would be reflected in the case files from the corresponding years. The research findings with regard to the assessment practices were comparable to the internationally observed trends relating to choice of tests and procedures. In addition, the findings of the current study also showed similar trends with regard to the increasing diagnostic rates for ADD/ADHD, Mood Disorder, and Autism Spectrum Disorders as were observed internationally. Additionally, the reported decreasing diagnostic rates for Mental Retardation and behaviour disorders were also found in this local study. However, the internationally observed increases in Anxiety Disorder diagnoses contrast with the findings of this study, where the results revealed that the rates for Anxiety Disorder and PTSD were considerably higher in the late 1980s and 1990s. This finding supports the initial hypothesis that the violence and social unrest had an effect on children’s psychological well-being. / Thesis (M.A.)-University of KwaZulu-Natal, Pietermaritzburg, 2012.

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

The existing District Health Information System in South Africa can be described as a facility based Information System, focusing on the clinics and hospitals and not on the community. Consequently, only those who access health services through these facilities are included in the system. Many children do not have access to basic health and social services and consequently, are denied their right to good health. Additionally, they are excluded from the routine Health Information System. Policy and resource decisions made by the District Managers, based on the current health facility information, reinforces the exclusion of these already marginalised children. The premise behind this research is that vulnerability of children can be tackled using two interconnected strategies. The first is through the creation of awareness of the situation of children and the second through mobilising the commitment and action of government and society to address this situation. These strategies can be supported by designing an Information System for action / an Information System that can be used to advocate and influence decisions and policies for the rights of these children / an Information System that includes all children. An interpretive participatory action research approach, using a case study in a rural municipality in South Africa, was adopted for the study of a child-health Community-Based Information System. The context in which the community is placed, as well as the structures which are embedded in it, was examined using Structuration Theory. This theory also influenced the design of the Information System. As the aim of the research is to change the Information System to include vulnerable children, a Critical Social Theoretical and longitudinal perspective was adopted. In particular, concepts from Habermas, such as the creation of a public sphere and the &rsquo / Ideal Speech Situation&rsquo / , informed the methodology chosen and were used to analyse the research undertaken. <br /> <br /> Based on the research conducted in this municipality, four main changes to the Health Information System were made. These were: &bull / determination of the community&rsquo / s own indicators / &bull / changes in data collection forms / &bull / creation of forums for analysis and reflection, and / &bull / changes in the information flows for improved feedback. Other practical contributions of the research are the development of local capacities in data collection and analysis, the development of practical guidelines on the design of a child-health Community-Based Information System, and the development of strategies for enabling participation and communication. In line with the action research approach adopted, and the desire to link theory and practice, the research also contributed on a theoretical level. These contributions include extending the use of Structuration Theory, in conjunction with Habermas&rsquo / Critical Social Theory, to the empirical context of South Africa / addressing the gap of Community-Based Information Systems in Information System design / extending the debate on participation and communication in Information Systems to &rsquo / developing&rsquo / countries, and developing generalisations from a qualitative case study.

M.A. (Psychology) / Please refer to full text to view abstract

The existing District Health Information System in South Africa can be described as a facility based Information System, focusing on the clinics and hospitals and not on the community. Consequently, only those who access health services through these facilities are included in the system. Many children do not have access to basic health and social services and consequently, are denied their right to good health. Additionally, they are excluded from the routine Health Information System. Policy and resource decisions made by the District Managers, based on the current health facility information, reinforces the exclusion of these already marginalised children. The premise behind this research is that vulnerability of children can be tackled using two interconnected strategies. The first is through the creation of awareness of the situation of children and the second through mobilising the commitment and action of government and society to address this situation. These strategies can be supported by designing an Information System for action / an Information System that can be used to advocate and influence decisions and policies for the rights of these children / an Information System that includes all children. An interpretive participatory action research approach, using a case study in a rural municipality in South Africa, was adopted for the study of a child-health Community-Based Information System. The context in which the community is placed, as well as the structures which are embedded in it, was examined using Structuration Theory. This theory also influenced the design of the Information System. As the aim of the research is to change the Information System to include vulnerable children, a Critical Social Theoretical and longitudinal perspective was adopted. In particular, concepts from Habermas, such as the creation of a public sphere and the &rsquo / Ideal Speech Situation&rsquo / , informed the methodology chosen and were used to analyse the research undertaken. <br /> <br /> Based on the research conducted in this municipality, four main changes to the Health Information System were made. These were: &bull / determination of the community&rsquo / s own indicators / &bull / changes in data collection forms / &bull / creation of forums for analysis and reflection, and / &bull / changes in the information flows for improved feedback. Other practical contributions of the research are the development of local capacities in data collection and analysis, the development of practical guidelines on the design of a child-health Community-Based Information System, and the development of strategies for enabling participation and communication. In line with the action research approach adopted, and the desire to link theory and practice, the research also contributed on a theoretical level. These contributions include extending the use of Structuration Theory, in conjunction with Habermas&rsquo / Critical Social Theory, to the empirical context of South Africa / addressing the gap of Community-Based Information Systems in Information System design / extending the debate on participation and communication in Information Systems to &rsquo / developing&rsquo / countries, and developing generalisations from a qualitative case study.

The South African government has initiated the transformation of health services in the country towards primary health care (PHC) in order to provide comprehensive care to individuals and families. The move to PHC involves an increased need for collaboration between health professionals. It is proposed that for effective team-work to take place, an understanding of the roles and functions of team members is imperative in providing quality mental health care. This study explored health professionals’ perceptions of the role and function of clinical psychologists working as part of a health care team in a community context. Three focus groups and three individual interviews were conducted with social workers, nurses and doctors. The data was then processed and analysed using a grounded theory method. The research highlighted the importance of knowledge, and how this affects referrals, perceptions, inter-professional relations and the perceived usefulness of clinical psychology and clinical psychologists. What is of significance is the potential power that the health professionals have as gatekeepers between the general public and clinical psychologists.