Thesis (MA) -- University of Stellenbosch, 2002. / ENGLISH ABSTRACT: no abstract available / AFRIKAANSE OPSOMMING: Hierdie navorsing ondersoek die behoefte van Sielkunde as professie om meer sosiaal relevante en gepaste dienste vir al die mense van Suid-Afrika te lewer. Dit bespreek die kritiek teen tradisionele sielkunde en die dringende behoefte vir 'n meer kontekstuele benadering om the negatiewe sielkundige verskynsels in the samelewing te begryp en verklaar. Die waarde van Gemeenskapsielkunde om voorkomende, kuratiewe en bevorderende geestesgesondheidsdienste aan gemeenskappe te lewer, word ook ondersoek. Verskeie modelle van gemeenskapsielkunde en die voorgestelde integrasie van geestesgesondheidsdienste by Primere Gesondheid word bespreek. Die plasing van 'n voorligtingsielkunde internskap binne 'n gemeenskapsomgewing, naamlik, die Don en Pat Bilton Kliniek, Jamestown, word beskryf en qeevalueer.

Thesis (MPA)--Stellenbosch University, 2000. / ENGLISH ABSTRACT: Sharp divisions featured between curative and preventative health care in the Public Health Services of South Africa before the democratisation process. There was fragmentation in authority structures and inequalities between urban and rural areas as well as along racial lines. This resulted in a situation where there was duplication and inequality in the distribution of resources amongst the different levels of health care which led to costly inefficient and ineffective health services. The introduction of the White Paper Towards the Transformation of Health System in South Africa in 1997, aims at the restructuring of health services towards a unified health system which is capable of delivering quality health care to all in a caring environment. The District Health System (DHS) is featured as the key to ensuring decentralised, equitable Primary Health Care (PHC) to all the citizens of South Africa. This study looks at the reorganisation of health services in the clinics and the day hospitals which are rendered by the Health Department of The City of Tygerberg and the Community Health Service Organisation (CHSO) of the Provincial Administration of the Western Cape(P AWC) in Khayelitsha with the aim of achieving comprehensive PHC services. Inthe absence of legislation for the integration of health services, initiatives for the achievement of quality comprehensive PHC within the district are envisaged. / AFRIKAANSE OPSOMMING: Openbare Gesondheidsdienste in Suid Afrika was voor die demokratieseringsproses gekenmerk deur 'n skeidig tussen kuratiewe en voorkomende gesondheidsdienste. Daar was fragmentasie van bestuurstrukture, ongelykheid tussen stedelike en landelike gebiede asook ongelykheid op grond van ras. Dit het gelei tot duplisering van, en ongelykheid in, die verspreiding van hulpbronne op die verskillende vlakke van gesondheidssorg. Die Witskrif op die Transformasie van Gesondheidstelsels in Suid-Afrika, 1997, fokus op die herstrukturering van gesondheidsdienste en het 'n verenigde gesondheidstelsel ten doel wat daartoe in staat is om gehalte gesondheidsorg in 'n sorgsame omgewing aan almal te lewer. Die Distriksgesondheidstelsel (DGS) word gekenmerk deur gedesentraliseerde, gelykmatige Primêre Gesondheidsorg (PGS) dienslewering aan al die inwoners van Suid-Afrika. Hierdie studie kyk na die herorganisering van gesondheidsdienste wat deur die gesondheidsdepartement van die Stad Tygerberg en die Gemeenskapsgesondheidsdiens organisasie van die Provinsiale Administrasie van die Wes-Kaap (PAWK) in die klinieke en daghospitale in Khayelitsha gelewer word met die doel om omvattende Primêre Gesondheidsorgdienste te voorsien. Weens die afwesigheid van wetgewing vir die integrasie van gesondheidsdienste word inisiatiwe vir die bereiking van gehalte omvattende Primêre Gesondheidsorg binne die distrik beoog.

Thesis (MPhil)--Stellenbosch University, 2011. / The objectives of this research report on a scenario planning exercise for the SA healthcare sector were to prepare the material that would feed into such a exercise, to document some ideas about how the planning workshops would run, and identify some possible role players in the process. Several items of research regarding the SA healthcare environment are presented, including economic research data and an environmental scan of recent developments in the healthcare arena. In addition, primer material on various futures studies techniques has been prepared. These are deemed to hold the potential to shift the prevalent thinking within the SA healthcare environment. The list of techniques includes scenario planning, systems thinking and causal layered analysis. The set of data presented confirms that there are several critical issues facing the SA healthcare environment. These need to be tackled in a unified way by all players in the industry if the prevailing dynamics that give rise to these issues are to change. Scenario planning is proposed because it creates a forum within which to do so. The effectiveness of futures studies problem solving techniques in addressing these challenges is demonstrated. This is achieved by recognising, for example, that the problems besetting the current industry are, in one sense, structural (from systems thinking) or that perceptions about the issues are seated in mental models which are not necessarily universally-held (from causal layered analysis). Scenario planning is a first step to imagining an alternative future for SA healthcare which is different from the one toward which it is heading by default. As a collaborative planning technique, it also starts to shift the mode of interaction of the various sectors that make up the SA healthcare environment. Instead of the de facto conflict-based adversarial modes of interaction designed to maximise individual interests (e.g. law suits and competitive dynamics), the scenario planning exercise creates a fresh space for co-operation and holistic thinking designed to optimise collective interests. The relationships formed in this safe space often survive well beyond the duration of the scenario planning workshop (as was the case with the Montfleur scenario exercise), thereby adding a new dimension to the systemic operation of the healthcare environment.

Transformation of service delivery in the Westcoast winelands region's hospitals: challenges and prospects

Abstract Keywords: Lay counsellors, training and evaluation. The training of lay counselling is of great significance to the field of Counselling Psychology. Therefore,the Health Professions Council of South Africa (HPCSA) decided to allow for the registration of lay counsellor training courses. However, the criteria for registration need to be formulated. This study evaluated the Wits Crisis course for volunteer counsellors, via illumination of the perceptions of the trainees and a measurement of their self-efficacy and personal relations before and after the training. The study included qualitative and quantitative methodology. Past trained counsellors and trainees were interviewed and then assessed on Self-Efficacy and Personal Relations before and after training. A Wilcoxon Matched-Pairs Signed-Rank significance in self-efficacy or personal relations scores after training. However, the interviews of the participants' perceptions of the course and its impact on them supported the hypotheses. Overall, perceptions were positive. Negative perceptions were highlighted, as this information could add to the knowledge base of the program. / GR 2016

Occupational health is concerned with health in its relation to work and the working environment. This study was undertaken to present an overview of occupational health in South Africa, with national and international perspectives on the discipline, in the light of : (a) the recent commissions of enquiry into aspects of occupational health in South Africa (b) the development of the national and self-governing states (c) new strategies by the authorities in the form of decentralization and deregulation. Information on the health profile of its workers, current legislative and service provisions and on policies for economic development and urbanization is vital for health administrators, occupational health and safety practitioners and policy makers. Data was collected through the use of literature surveys and postal questionnaires to the various interested persons and groups involved with occupational health. The findings reveal that (a) an inadequate occupational health policy exists in that the responsibilities of government(s), employers, workers and health professionals are not defined (b) there is an absence of an organizational and service framework for an occupational health system in South Africa although the morbidity and mortality data are significant (with their concomitant economic and social consequences) (c) there is a lack of financial and human resources for the practice of occupational health in South Africa. Recommendations are made taking into account the developed and developing components of South Africa. / Thesis (M.Med.)-University of Natal, Durban, 1987.

The issue of adolescent health has steadily grown momentum with people realizing the vulnerability ofthis sector ofthe world's population. Within the South African context, the tide had also turned. However, most initiatives aimed at the prevention of problems, one of which was adolescent pregnancy. Extant literature revealed that despite efforts to reduce adolescent pregnancy, adolescent fertility rate in SubSaharan Africa remained on the rise. As such, the need for appropriate maternity services for this group became a concern, as extant literature also revealed the costly long term effects to pregnant and parenting adolescents, as well as society as a whole. Within KwaZulu-Natal pregnant and parenting adolescents use the same maternity services as their adult counterparts. It was not clear if these services were appropriate to the needs of these clients. As such, a Glaser Grounded Theory approach was used to explore the maternity services from the points of view of the various stakeholder groups. Data was collected, using theoretical sampling, by means of semi-structured interviews and focus group interviews. Constructs of adolescent-friendly maternity care were identified from the findings. The components of the constructs included aspects of (1) Structures and Resources, (2) Attitudes to AMCs, and (3) Services. The resources or structures that either need to exist and/or be improved included policies, the quality and quantity of HCps, formalized support for AMCs, a sensitized administration, community involvement and the educational preparation of HCps. The attitudes that service providers were expected to demonstrate in their interaction with AMCs included those of equality, empathy and respect. They were also expected to show understanding towards AMCs and provide them with reassurance and support. The third component identified specific services to be provided to AMCs during the antenatal, labour and delivery, and postnatal period. These constructs can be used by health care planners and providers to strengthen and improve service provision to and utilization by pregnant and parenting adolescents and form the foundation on which a theory of adolescent-friendly maternity care can be based. Recommendations were made with regards to future service and research endeavours. / Thesis (Ph.D.)-University of KwaZulu-Natal, 2005.

Two research methods, a correlational survey and a case study method were used to explore the impact of health focused and economic focused women's organizations on community development and health. Through the study the following questions were answered: (i) Is there a difference in the health and development indicators of the households of Elim Care Group Project members, Akanani members and members of the community who do not belong to any of the organizations? (ii) What contribution have these organizations made to individuals' and/or communities' way of life? (iii) What aspects of these organizations' structure and/or function strengthen or weaken the organization? For the correlational survey, quantitative data were collected from three categories of thirty households each that belonged to Care Group members, Akanani members and community members who did not belong to any organization. The analysis of the data showed that both the health focused and economic focused organizations kept their focus even though their functioning tended to overlap. The health focused group had a greater impact on health indicators e.g. number of diarrhoea episodes, respiratory tract infection episodes, nutritional state, while the economic focused group had greater impact on development indicators e.g. housing, income and education. The improvement in the development indicators did not influence the health indicators directly. The qualitative data collected for the case study provided an indepth information about the case studied. The health focused organization demonstrated stability in its management. This was composed of health personnel under the employment of the Department of Health Managing the Care Group was a paid job for them. The organization was established and supported by the community and therefore expressed the community's concerns. The economic focused organization provided opportunities for the rural people to establish money making enterprises. Some of the problems shown in this study in this regard relate to poor managerial and business skills that resulted in the production of products that were not readily marketable in the locality. This caused a lot of anxiety amongst members as earnings were irregular. The differences in the structure and functioning of the groups were analysed. These influenced the effectiveness and continued viability of the organizations. / Thesis (Ph.D.)-University of Natal, Durban, 1996.

No abstract available. / Thesis (M.Sc.U.R.P.)-University of Natal, Durban, 1999.

HIV and AIDS is one of the biggest challenges facing South African young people today (Govender, 2010). Young people are at risk, partly through their own behaviour and partly through the attitudes, expectations and limitations of the societies in which they grow up (Panos AIDS Briefing, 1996).The are many HIV prevention programmes developed globally and nationally, specifically for young people but the pandemic still escalates rapidly. The fourth decade now calls for multidimensional approaches when communicating HIV prevention for young people. This thesis explores how young people can contribute to this multidimensional approach through their active participation in the various phases of developing HIV projects. The study does this through a sample of eight youth-focused HIV organisations in KwaZulu-Natal and a sample of students from the University of KwaZulu-Natal, to gain more insight into participation of young people in the development of HIV programmes. Bodymapping, a visual and art-based method, was used to explore young people’s understanding of HIV, their perceptions of HIV programmes and the possibilities of their participation in the developing of further HIV projects. The study used a grounded approach and applied principles of participatory action research to collect data in four phases. The first phase used interviews and focus group discussions with eight sample organisations to give insight into the programmes offered to young people and how they engage and make sense of their participation within these programmes. The second phase draws on previous bodymapping workshops that have been conducted with students from UKZN and young people in various communities to explore the application and relevance of bodymapping. In the third phase, data is presented on two bodymapping workshops conducted, to engage with young people about their contribution to the development of HIV programmes. The final phase draws on two focus group discussions, conducted with bodymapping participants, to examine their experiences and interpretation of the bodymapping process. Some of the key findings indicate that a blanket approach to HIV programmes will not always work, as young people’s sexual behaviour needs to be explored within a wider socio-ecological framework that recognises the inter-relational and interconnected system in which they make their sexual choices. The data indicates that youth and organisations strongly support the importance of participation and the inclusion of participants when developing HIV projects. However, discussions about participation indicated that while young people could identify the importance of participation, they still lacked an understanding of how to participate and how they could learn more about their lived experiences through participation. This was evident in the data where there was a distinction in how participation was defined from those in the UKZN group and those from rural KZN. In understanding what constitutes participation, young people are better positioned to aid the process of developing effective HIV related projects that are participant specific. I argue that bodymapping can be used as a process to initiate and aid the participation of young people in the various phases of developing HIV projects. A three level model for applying bodymapping and planning processes has been developed to encourage participation with young people where the first step ensures that young people define what participation means to them. This becomes the foundation for how communication practitioners and academics make sense and theorise participation from a participant informed perspective. Bodymapping was pivotal in this process of engaging young people in self-reflection and introspection which encouraged a process of dialogue towards better understanding and defining participation from a participant perspective. Bodymapping in this way can be identified as a catalyst that encourages dialogue as part of communication for participatory development. / Thesis (Ph.D.)-University of KwaZulu-Natal, Durban, 2013.