This prospective descriptive study describes the referral patterns to the Red Cross War Memorial Children's Hospital. The study was conducted from 1st July to 31st December 1987 and entailed the collection of all referral letters presented (9288) to the hospital and the analysis of a sample of these letters (4702). The results indicated: * The patients are similar in terms of age and sex to those attending the Outpatients Department except that relatively fewer referred patients are Black. * The private sector, i.e. general practitioners, is the largest referral agency followed by Day Hospitals. * Most patients were ref erred to the Outpatients Department without an appointment. * Of the specialist clinics, the surgical clinics, i.e. Ophthalmology and Ear, Nose and Throat Clinics, were utilised the most. * The majority of patients (84,90%) were not admitted. * The contact made by the hospital with referral agents was poor (only in 30,30%). * The quality of information in referral letters was generally poor and did not contribute to patient care. Recommendations are made to the hospital and relevant health authorities.

Bibliography: pages 108-115. / The aim of the proposed study is to evaluate demographic factors and treatment characteristics contained in the historical records of those treated as in-patients at the Sonstraal Adolescent unit of Lentegeur Hospital, during the period 1986 to 1990. This demographic study details the following aspects of the adolescent in-patients: size, that is, numbers of those admitted to the unit; composition, including age, sex and area. Treatment characteristics such as reasons for admission, diagnosis of psychopathology, referral agent on admission and discharge and length of stay in the unit are considered. The data for the study have been extracted from the clinical records contained at Sonstraal, namely , the 'Clinical Summary on Discharge' form. This form is completed by the therapist of each adolescent attending the unit. The EpiInfo computer programmes have been utilised to create a database and to select the appropriate procedures and statistics which form the basis for data analysis and interpretation. Data interpretation includes an analysis of the emerging trends and details the implications for policy issues, unit staffing and treatment options. Analysis of the trends and comparisons with literature findings have facilitated the generation of hypotheses which could be tested in future studies. This study therefore provides a working document for future prioritising and planning of in-patient, out-patient and community mental health services to adolescents, their families and communities. This involves recommendations for intervention and community involvement. In addition, the study provides a basis for future research into adolescent mental health care.

Submitted in fulfillment of the requirements for the Degree in Masters of Technology in Homeopathy, Durban University of Technology, Durban, South Africa, 2015. / Introduction In South Africa homoeopathy is relatively unfamiliar, even though it has been in existence with formal qualification from 1989 at the Durban University of Technology, (formerly Durban Institute of Technology and Techikon Natal) as well as the University of Johannesburg formerly Wits Technikon). A large portion of the South African public is unclear with regards to homoeopathic understanding and homoeopathic medicine use. South African studies exploring the perception of homoeopathy have revealed that there is a degree of ignorance or misinterpretation of homeopathy. The objectives of this study were to expand the database of knowledge regarding the patients’ experiences of homoeopathy, by investigating their experiences of homoeopathic care rendered at a PHC facility in the eThekwini district, namely, the Redhill homoeopathic clinic. This study was guided by the following grand tour question: What are the experiences of patients of homoeopathic care rendered at a primary healthcare clinic in the eThekwini District? Aim of the study The aim of this study was to determine the experiences of patients receiving homoeopathic care rendered at a primary healthcare facility in the eThekwini district. Methodology A qualitative, explorative, descriptive and contextual design was employed. Qualitative research in this study was considered the most appropriate method to gain an in-depth understanding of the patients’ experiences of homoeopathic care. Convenience sampling was used to recruit a minimum of 10 potential research participants from patients receiving homoeopathic care at the Redhill homoeopathic clinic, but the sample size was only determined once data saturation was obtained. The study population were patients who were visiting the Redhill homoeopathic clinic for the second time or more and those who had utilized homoeopathic remedies. The data was collected and analysed using Tesch’s eight-step procedure. Results Results from this study showed that the study group had knowledge of homoeopathy and that there is growth in the knowledge of homoeopathy as compared to previous studies. The researcher observed that Indian participants had a better understanding of homoeopathy than African participants. Participants showed great confidence in homoeopathy and most of them revealed a high level of satisfaction with the homoeopathic treatment and were very happy with the service delivery. Results showed that there had been an improvement of the patients’ ailments since the commencement of homoeopathic treatment.

Thesis (MComm)--Stellenbosch University, 2002. / ENGLISH ABSTRACT: Historically health care in South Africa has been an area of great inequity. Health care was inequitable, inadequate and racially based. In order to redress the gap in the delivery of health care services, created by the previous dispensation of separate development, the National Department of Health has adopted a Primary Health Care (PHC) approach as the guiding principle for the reconstruction of the health system in South Africa. One of the pillars of this approach is the empowerment of communities to participate, thus moving from facility based- to community based health care. The aim of the National Health System (NRS) is to promote health and health knowledge, to provide an equitable, accessible, and appropriate health service, and to empower people to take greater responsibility for their own health. It is constructed around the belief that health for all cannot be achieved simply by improving the formal health system, but that a holistic and multi-sectoral approach is required. This thesis explores the community health worker (CRW) as a possible cost-effective and efficient supplementary service, to the current formal health system, to bridge the gap in the formal health system through the provision of PHC services in a rural setting. This was done through the economic evaluation of a CHW programme operating in the Winelands are of the Western Cape. The aim of this study was to evaluate and analyse the nature, performance, and costs of the programme and place it in context by comparison to other similar programmes. This comparison focused on physical characteristics, goals, and cost structures. It also aims to measure the direct and indirect impact of this type of intervention on the agribusiness sector as well as the local health authorities. The evaluation proceeded from the premise that the CHW programme, if implemented correctly with proper and appropriate training, and adequate post training support, will be a cost-effective and efficient model for the provision ofPHC services in this rural/farming area. The economic evaluation of this CHW programme required it to be viewed from two perspectives. The first component viewed the implementation of the programme from the perspective of the agribusiness sector. This aspect of the study included both a qualitative as well as a quantitative VIew of the costs, benefits (perceived or otherwise), and perceptions of the CHW intervention. The second component assessed the CHW programme within the context of a resource constrained public sector health budget. Since the implementation of this programme implies certain expenditures on the part of the local health authorities, these cost had to be identified and quantified to gauge the effectiveness of that expenditure. / AFRIKAANSE OPSOMMING: Geskikte en doeltreffende gesondheidsdienste in Suid-Afrika se onlangse geskiedenis was nog gereserveer vir 'n uitgesoekte groep mense. Die gesondheidstelsel was ontoereikend, onvoldoende en gebaseer op ras. Daar het 'n gaping ontstaan tussen die dienste wat gelewer is en die werklike behoeftes van die mense wat dit moes gebruik. Ten einde hierdie gaping aan te spreek het die Nasionale Departement van Gesondheid besluit om 'n Primêre Gesondheidsorg (PRe) benadering te volg wat klem plaas op die bemagtiging van plaaslike gemeenskappe deur deelname. Dit was 'n duidelike skuifvanaffasiliteit- na gemeenskap gebaseerde gesondheidsdienste. Die oorkoepelende doel van hierdie verskuiwing in fokus was om voorheen benadeelde gemeenskappe voldoende toegang te gee tot gesondheidsdienste en ook om hierdie dienste aan te pas by die behoeftes van sodanige gemeenskappe. Hierdie tesis ondersoek die Wynland distriksraad se Gemeenskap Gesondheidswerker Program as 'n moontlike koste-effektiewe stelsel vir die lewering van toepaslike primêre gesondheidsdienste in landelike areas. Die doel van die studie was die sistematiese ontleding van die werking en omvang van, en die kostes verbonde aan die implementering en onderhoud van hierdie program. Die studie poog om die impak van hierdie program op die formele landbou sektor asook die plaaslike gesondheidsowerhede te identifiseer en, waar moontlik en prakties wenslik, te kwantifiseer. Die ondersoek sluit in die stelselmatige ontleding van kostes en voordele vir die formele landbou sektor sowel as die plaaslike gesondheidsowerhede. Die kostes asook die kliniese uitkomste geassosieer met die implementasie van die Gesondheidswerker program sal dan in konteks geplaas word deur dit te vergelyk met ander soortgelyke programme wat in die verlede aangepak is. Die vergelyking sal fokus op die fisiese eienskappe, koste struktuur, bronne van ondersteuning en die primêre doel van die intervensie.

Submitted in fulfillment of the requirements for the Degree in Masters of Technology in Homeopathy, Durban University of Technology, Durban, South Africa, 2015. / Introduction In South Africa homoeopathy is relatively unfamiliar, even though it has been in existence with formal qualification from 1989 at the Durban University of Technology, (formerly Durban Institute of Technology and Techikon Natal) as well as the University of Johannesburg formerly Wits Technikon). A large portion of the South African public is unclear with regards to homoeopathic understanding and homoeopathic medicine use. South African studies exploring the perception of homoeopathy have revealed that there is a degree of ignorance or misinterpretation of homeopathy. The objectives of this study were to expand the database of knowledge regarding the patients’ experiences of homoeopathy, by investigating their experiences of homoeopathic care rendered at a PHC facility in the eThekwini district, namely, the Redhill homoeopathic clinic. This study was guided by the following grand tour question: What are the experiences of patients of homoeopathic care rendered at a primary healthcare clinic in the eThekwini District? Aim of the study The aim of this study was to determine the experiences of patients receiving homoeopathic care rendered at a primary healthcare facility in the eThekwini district. Methodology A qualitative, explorative, descriptive and contextual design was employed. Qualitative research in this study was considered the most appropriate method to gain an in-depth understanding of the patients’ experiences of homoeopathic care. Convenience sampling was used to recruit a minimum of 10 potential research participants from patients receiving homoeopathic care at the Redhill homoeopathic clinic, but the sample size was only determined once data saturation was obtained. The study population were patients who were visiting the Redhill homoeopathic clinic for the second time or more and those who had utilized homoeopathic remedies. The data was collected and analysed using Tesch’s eight-step procedure. Results Results from this study showed that the study group had knowledge of homoeopathy and that there is growth in the knowledge of homoeopathy as compared to previous studies. The researcher observed that Indian participants had a better understanding of homoeopathy than African participants. Participants showed great confidence in homoeopathy and most of them revealed a high level of satisfaction with the homoeopathic treatment and were very happy with the service delivery. Results showed that there had been an improvement of the patients’ ailments since the commencement of homoeopathic treatment. / M

Background: The recognition of growing health disparities globally and, in particular Sub-Saharan’s continued poor health outcomes, has been responded to with a call to revitalise primary health care (PHC) 30 years after the Alma-Ata Declaration. Despite some limitations, and although not the only solution, community health workers (CHWs) have been shown to be able to reduce factors that can act as barriers to accessing care. However, CHW programmes (often provided by non-governmental organisations in South Africa) have historically been poorly regulated and fragmented. The South African government has proposed to address the health inequities through a series of health system reforms. One of these has been a current attempt to strengthen PHC through the use CHWs in order to reach underserved communities. The capacity of CHWs to provide effective outreach services remains unclear. This work examined the experiences of CHWs in their efforts to improve access to care through community participation and outreach services that work across sectors. Aim: The study aimed to examine the implementation of community health worker-provided services through the comparison of three case studies in order to identify enabling and constraining factors. Methodology: A case study method was used to compare three CHW programmes. Qualitative methods such as key informant interviews, participant observations, focus group discussions and network maps, were used to collect data. A thematic content analysis was used to identify a priori and emergent themes. Results: CHWs operate in communities with multifaceted needs (food, transport, health and social welfare services) requiring a comprehensive approach. The experiences of households in this thesis illustrate the various barriers to accessing services. The success and sustainability of CHW programmes depends on the ongoing commitment of resources, including investment in quality training, supervision, mentoring and organizational support. Furthermore, government institutional contexts with poor cross-sectoral integration, conflicting departmental mandates and poor accountability constrain the efforts of CHWs at local level. Operating within a community with strong social cohesion and social capital provided an enabling environment for CHWs to mobilise the community and facilitate community participation, which is crucial for implementation of cross-sectoral outreach activities. Conclusion: The study indicates that CHWs provide services in communities that live in poverty which results in multiple problems that contribute to ill health. The study goes further to illustrate that in order to strengthen outreach services across relevant sectors, the role of central government is crucial. These findings indicate a need for greater understanding about how to strengthen institutional contexts both in government and in non-governmental organisations.

Thesis (M.Arch. (Professional))--University of the Witwatersrand, Faculty of Engineering and the Built Environment, 2016. / Indigenous medicine has existed in society for centuries. It is one of the few age old practices that has remained an innate part of our sociocultural environment. African indigenous healing is an important component of African culture and is significant in ensuring both well-being and health of the people. The World Health Organization statistics shows that at least 70% -80% of the population have used indigenous medicine in South Africa. Indigenous medicine often carries stigmas and negative perceptions. Countless misconceptions and misunderstandings are experienced by indigenous medicine and indigenous medicinal practitioners that have contributed to their isolation. The intention of this thesis is to explore the coexistence of different medical and health systems through a place of dialogue and education. The study focuses on creating an interface between conventional and local indigenous health systems. Through spaces of collaboration, well-being and knowledge, a connection can be established between the two systems which could essentially promote an interaction and understanding. Through an exploration of the primary theme of “the self and the other” and a secondary theme of holistic well-being. An intricate theoretical framework can be established within the thesis that contributes to both the design development and practicality of the proposal. By further studying literature that pertains to the themes and by interviewing people within both fields will allow for the profound understanding of both forms of medicine. The role of architecture as a social instigator for the de-stigmatization of indigenous medicine and holistic well-being will also be explored, with reference to perception as an awareness tool. The architectural response to the thesis is a collaborative facility at Chris Hani Baragwanath Hospital that will look at cooperation, education and research with indigenous practitioners, doctors and the public. The will create an opportunity to link the two medicinal systems together and encourage interaction and understanding between the two. It will further place importance on indigenous systems and knowledge that could potentially be used to treat patients universally. Indigenous medicine practitioners will also be housed within the facility to offer an alternative to the conventional system. Thus ideally creating a place where there is dialogue, transformation and appreciation for indigenous knowledge systems. / EM2017

A research report submitted to the Faculty of Management, University of Witwatersrand, in 50% fulfilment of the requirements for the degree of Master of Management (in the field of Public and Development Management) September 2016 / The objective of the South African Integrated School Health Programme is to improve health status of learners at schools. Health programmes have been implemented through the integrated school health programme at schools in South Africa since 2012. Targets were set to monitor the implementation of the programme in provinces. The North West Province did not reach its targets for the health programme between 2014 and 2015. A qualitative study was conducted to investigate barriers to implementation of the programme in Ditsobotla sub district. A sample of twenty five participants was selected from a group of teachers, principals and school governing body at ten schools, nurses, education managers, and NGO. In-depth interviews and focus group discussions were conducted. The main findings were that learners were not able to utilize the integrated school health programme service because parents did not give consent. The programme did not have enough dedicated school health programme service providers. Consequently the study recommends that more advocacy sessions should be conducted with the key stakeholders. This study can form a basis for further research seeking to improve the integrated school health programme in the North West Province. / GR2018

Discourse for the partial fulfillment of the requirements for the degree of Master of Science (Development Planning) at the University of the Witwatersrand, Johannesburg, / A definition of development includes improving living conditions and the quality of life. There is an interrelationship between health and social and economic development. "Health Leads to and at the same time is dependant on a progressive improvement in conditions and quality of life". (World Health Organisation). Therefore a dIscussion on health has to take into account the socio-economic and political context. In assessing the health profile of the homeland populations one finds them to be the least healthy. The problem is that the level of health of the rural population is low and the health care situation follows that of a developing society, where poverty-related diseases and infant mortality rates are high and life expectancies are unacceptably low. The rationale of this discourse is to express the need of action by governments, and health Bnd development workers, to protect and promote health. The aim is to examine the primary health care approach in Q sample area and see how it can be used to achieve an acceptable level of health. Background on the state of health will be addressed. The health services under apartheid is discussed in the first section, with attention given to statistical information and health indicators. / AC2017

A research report submitted to the Faculty of Commerce, Law and Management, University of the Witwatersrand, in fulfilment of the requirements for the degree of Doctor of Philosophy Johannesburg, November 2015 / The aim of this study was to give an account of what it means to be a hospital consultant in a national health service that has been undergoing change for almost three decades. Classic grounded theory was used to identify the main concern of hospital consultants sampled for the study and how they resolved this concern on a routine basis. Data were obtained from three sources: interviews, observation and document analyses. Classic grounded theory procedures of constant comparison and theoretical sampling were used and Rolling with the Punches emerged as the pattern of behaviour through which the hospital consultants dealt with their main concern, which was managerialism. Rolling with the Punches involves four modes: Stabilising Temporarily, Resisting, Limiting the Impact and Adjusting to/Living with. The mode of behaviour was contingent on a central and on-going Weighing-up process, in which the hospital consultants used their personal narratives, beliefs and commitment structures to make sense of what was happening and what they could possibly do about it. Hence, the mode of behaviour was contingent, historicised and in flux. The Weighing-up process can set off triggers that can lead to a change of mode that need not be linear. Key words: doctors, managers, grounded theory, weighing up, stabilising temporarily, resisting, subverting, quibbling, limiting the impact, lying low, faking it, living with, adjusting to, going with the flow, complying, waiting it out. / MB2016