South Africa has been brain drained of nurses and doctors and the Eastern Cape as a Province within South Africa is not an exception. Its rural nature has caused many nurses and doctors loose interest of serving in its facilities. This study sought to describe factors that can influence retention especially of nurses in the rural health facilities of the Eastern Cape Province and develop recommendations for nurse managers on how to retain nurses in rural areas. The major inferences drawn from this study is that nurses are dissatisfied with lack of promotional opportunities, lack of professional support, facing drastic responsibilities but with less income, tremendous workloads, emotional demands and unrealistic salary package. The researcher believes that the nurse managers have a crucial role to play in ensuring nurse retention and the recommendations drawn from this study can contribute in improving the work environment. / Health Studies / M.A. (Health Studies)

Educational Studies / M. Ed. (Guidance & Counselling)

This study highlighted the distinction between retributive and restorative justice. Diversion and the Journey as a diversion option for youth in South Africa was discussed. Literature indicated that certain family aspects such as family cohesiveness, communication, discipline, and conflict in the home could lead to youth offending. Interviews, focus groups, and questionnaires were used to determine possible problematic family interactions as well as parents' needs of a parent programme. It was found that parents experience feelings like anger, disappointment, shock, helplessness, frustration, and humiliation regarding the child's crime. It was established that dealing with parents' feelings, communication, discipline, conflict resolution, and problem solving should be included in the parent programme. An evaluation of the programme was done and the following aspects showed improvement: communication, mother's involvement with the child, understanding and support in the family, youth's independence, affection, family relations, problem solving and the amount of time spent with family. / Psychology of Education / M. Ed. (Guidance and Counselling)

Thesis (MTech (Public Management))--Cape Peninsula University of Technology, 2017. / The purpose of this study was to examine the problem of access to health care centres in the Western Cape and to forward recommendations that will improve access to health care facilities in the Western Cape. The first objective of the study was to identify trends in primary health care looking at Nigeria, with the view of learning lessons of experience. Secondly, the study provided an overview of the South African health care system. The study further examined the problems around access to Gugulethu Community Health Clinic. The research objectives were directly linked to the composition of chapters. The study utilised a mixed-method approach of quantitative and qualitative approaches. This method is called multi-method approach. The purpose of combining the two approaches was to understand the research problem from a subjective and objective point of view, as well as to provide an in-depth understanding of a research topic, which led to more reliable research results. Data collection was acquired by utilising a structured questionnaire and personal observations. Two groups of respondents participated in the study inter alia: the patients and the staff of Gugulethu Community Health Clinic.

Evidence suggests that the prevalence of certain non-communicable diseases, such as hypertension, is increasing rapidly, and that patients with these diseases are making significant demands on the health services of the nations in sub-Saharan Africa. However, these countries also face other health-related challenges such as communicable diseases and underdevelopmentrelated diseases. Developing countries like South Africa have limited resources, in terms of man power and financial capital, to address the challenges that they are facing. Non-communicable diseases cannot be ignored and since health care providers cannot meet the challenges, it is worthwhile to empower patients to be involved in the management of their conditions. Patient education is a tool that can be used to enable patients to manage their chronic conditions and thereby reduce the morbidity and mortality rates of these conditions. The aim of this study was to investigate the effect of a patient education intervention on participants’ levels of knowledge about hypertension and its therapy, beliefs about medicines and adherence to anti-hypertensive therapy. The intervention consisted of talks and discussions with all the participants as one group and as individuals. There was also written information given to the participants. Their levels of knowledge about hypertension and its therapy were measured using one-on-one interviews and self-administered questionnaires. Beliefs about medicines were measured using the Beliefs about Medicines Questionnaire (BMQ) whilst adherence levels were measured using pill counts, elf-reports and prescription refill records. The participants’ blood pressure readings and body mass indices were also recorded throughout the study. The parameters before and after the educational intervention were compared using statistical analyses. The participants’ levels of knowledge about hypertension and its therapy significantly increased whilst their beliefs about medicines were positively modified after the educational intervention. There were also increases, though not statistically significant, in the participants’ levels of adherence to anti-hypertensive therapy. Unexpectedly, the blood pressure readings and body mass indices increased significantly. The participants gave positive feedback regarding the educational intervention and indicated a desire for similar programmes to be run continuously. They also suggested that such programmes be implemented for other common chronic conditions such as asthma and diabetes. This study proved that patient education programmes can be implemented to modify patients’ levels of knowledge about their conditions and the therapy, beliefs about medicines and adherence to therapy. However, such programmes need to be conducted over a long period of time since changes involving behaviour take a long time.

Type 2 diabetes mellitus is a chronic disease of pandemic magnitude, increasingly contributing to the disease burden of countries in the developing world, largely because of the effects of unhealthy lifestyles fuelled by unbridled urbanisation. In certain settings, patients with diabetes are more likely to have a healthcare encounter with a pharmacist than with any other healthcare provider. The overall aim of the study was to investigate the potential of South African community pharmacists to positively influence patient adherence and metabolic control in Type 2 diabetes. The designated primary endpoint was glycated haemoglobin, with the intermediate health outcomes of blood lipids, serum creatinine, blood pressure and body mass index serving as secondary endpoints. Community pharmacists and their associated Type 2 diabetes patients were recruited from areas throughout South Africa using the communication media of various nonstatutory pharmacy organisations. Although 156 pharmacists initially indicated interest in participating in the study, only 28 pharmacists and 153 patients were enrolled prior to baseline data collection. Of these, 16 pharmacists and 57 patients participated in the study for the full twelve months. Baseline clinical and psychosocial data were collected, after which pharmacists and their patients were randomised, nine pharmacists and 34 patients to the intervention group and 8 pharmacists and 27 patients to the control group. The sample size calculation revealed that each group required the participation of a minimum of 35 patients. Control pharmacists were requested to offer standard pharmaceutical care, while the intervention pharmacists were provided with a scope of practice diabetes care plan to guide the diabetes care they were to provide. Data were again collected 12-months postbaseline. At baseline, proportionally more intervention patients (82.4%) than control patients (59.3%) were using only oral anti-diabetes agents (i.e. not in combination with insulin), while insulin usage, either alone or in combination with oral agents was conversely greater in the control group (40.7%) than in the intervention group (17.6%) (Chi-squared test, p=0.013). Approximately half of the patients (53.8% control and 47.1% intervention) reported having their HbA1c levels measured in terms of accepted guidelines. There was no significant difference in HbA1c between the groups at the end of the study (Independent t-test, p=0.514). In the control group, the mean HbA1c increased from 7.3±1.2% to 7.6±1.5%, while for the intervention patients the variable remained almost constant (8.2±2.0% at baseline and 8.2±1.8% at post-baseline). Similarly, there were no significant differences between the groups with regard to any of the designated secondary clinical endpoints. Adherence to medication and self-management recommendations was similarly good for both groups. There were no significant differences between the two groups for any of the other psychosocial variables measured. In conclusion, intervention pharmacists were not able to significantly influence glycaemic control or therapeutic adherence compared to the control pharmacists.

This thesis analyses the state of health care in South Africa with particular reference to a clinic and the Provincial Hospital in Port Elizabeth, Eastern Cape. The complexities of health care provision in a diverse sociolinguistic environment where certain languages are emphasized over others, forms the cornerstone of the research. The research focuses on health care in a complex multi-cultural environment. The goal of the research is to present a coherent and robust translation framework for the development of suitable materials to enhance communication across language and cultural barriers in the health care sector. A model (based on research completed in the USA) is presented as a possible alternative in the final chapter of the thesis.

M.Cur. / The entire country is currently in a process of reconstruction that inevitably lead to reconstruction within the health care system. The ANC (African National Congress) formulated a National Health Plan based on primary health care that is a practical expression of providing an effective and equitable health care to all inhabitants of the country. Recognising the need for transformation, a process was initiated by the African National Congress (ANC) to develop an overall National Health Plan based on the Primary Health Care approach (ANC, 1994: 7) . In the light of these present needs, the vision is to develop a strategy to empower our professional nurses that can effectively implement primary health care whilst operating within the limitations of the existing resources (Human Resource Committee for Health, 1994:5). The context of the study is applicable to the Northern Region of the North West Province. There are various courses available to empower professional nurses to primary health care, but for the purpose of the study is the Diploma Course in Clinical Nursing Science, Health Assessment, Treatment and Care described

This thesis provides a historical account of the emergence of the pharmacy education system in South Africa, and an analysis of the influence of competing interest groups over the pharmacy education curriculum. It provides a critical evaluation of structural-consensus and micro-interpretive approaches to medical and pharmacy education, and sets out a macrointerpretive account of pharmacy education in South Africa. Following Margaret Archer (1979) it analyzes three forms of negotiation between competing interest groups in their efforts to change the pharmacy curriculum; these are political manipulation, external transaction and internal initiation. The thesis argues that whilst the private sector interest group (comprising of retail, wholesale and manufacturing pharmacy) dominated the pharmacy education system until 1994, since then a newly emerged government interest group has begun to compete for educational control. The priorities pursued by this interest group have consistently reflected the objectives set out in the ANC National Health Plan of 1994. The thesis maintains that given its frustration over the non-implementation of the ANC’s health policy objectives, the government interest group is likely to resort to direct political manipulation by passing legislation to alter the content of the current pharmacy curriculum. Such changes would seek to ensure that the syllabus more accurately reflects the ANC Plan’s community health and primary health care objectives. The thesis asserts that such an outcome (of direct political manipulation of the curriculum) is not inevitable, and can be avoided through a process of internally initiated change. It presents the findings of an interpretive case study into how the Rhodes University Community Experience Programme (CEP) influenced final year pharmacy students’ perceptions of the role of the pharmacist. The students’ comments were collected by means of focus group interviews, participant observation and documentary analysis. Whilst the CEP did not successfully transform their concept of the pharmacist’s role, it did succeed in influencing students’ understanding of the notions of community pharmacy and primary health care in line with the government interest group’s health objectives. This thesis concludes that internally initiated change within the pharmacy education system, would be preferable to that imposed through external political manipulation, as such change would be more likely to preserve the independent professional interests of pharmacy academics.

Please read the abstract in the section 00front of this document / Thesis (DPhil)--University of Pretoria, 2010. / Medical Oncology / unrestricted