The nursing student who has undergone the four year diploma or degree training as a nurse also has to undergo compulsory community service as a requirement before she/he can be registered as a qualified professional nurse. While it has been compulsory for other health professionals such as doctors, dieticians or dentists to place students in compulsory community service, it has only been compulsory for nursing students since 2008. This means that the practice is relatively new in nursing and it is not clear how the newly qualified professional nurse experiences compulsory community service (CCS). The overall goal of this study is to determine the experiences of professional nurses placed at the state hospitals in Nelson Mandela Bay regarding compulsory community service clinical placement exposure and to use these descriptions to develop guidelines. The study followed a qualitative, exploratory, descriptive, contextual design. Literature was reviewed in order to identify research that was done previously regarding compulsory community service amongst health care professionals. The research population included professional nurses who underwent compulsory community service in the three state hospitals in the Nelson Mandela Bay. Purposive sampling was utilised to identify the participants. Semi-structured interviews were conducted to collect information and field notes were kept. The interviews were transcribed and Tech’s (1990) in Creswell, 2009:186) eight steps of data analysis were followed to create meaning from the data collected. An independent coder assisted with the coding process to ensure the trustworthiness of the findings. The researcher ensured the validity of the study by conforming to Lincoln and Guba’s model of trustworthiness which consists of the following four constructs, namely credibility, transferability, dependability and conformability (Lincoln & Guba, 1999, as cited in Schurink, Fouche & de Vos, 2011:419- 421). Three themes and sub themes were identified. Literature control was done to compare the findings with existing research results. The researcher ensured that the study was conducted in an ethical manner by adhering to ethical principles such as beneficence, justice and fidelity. All the participants in the study felt that the clinical placement exposure was a worthwhile experience. The participants expressed a feeling of gratitude that they were afforded this opportunity of practicing under the guidance of experienced professional nurses. To them it was an opportunity to master whatever they were taught as student nurses so that by the time they practice as independent practitioners they would be confident and knowledgeable. The CCS nurses indicated that orientation and mentorship were not always of good quality and professional nurses were not always available as in some units professional nurses were not readily accessible. The CCS nurses were left alone and isolated with no one to consult. If proper orientation and mentorship had been in place the CCS nurses would have enjoyed the community service year more and they felt that they would have benefited more. Had there been a mentoring system in place it could have gone a long way to ascertain that the participants gained confidence and were able to perform tasks independently and confidently. The participants overwhelmingly indicated that unit management should have been included in their CCS year placement. During the CCS year the CCS nurses were not exposed to unit management. This was seen by CCS nurses as a missed opportunity. Had they been afforded the opportunity to practice unit management under the supervision of unit nursing managers, professional growth and development in unit management could have been facilitated. That they were not afforded that opportunity deprived them of a valuable skill as well as personal and professional growth. In conclusion guidelines for placement of CCS nurses in the Nelson Mandela State hospitals have been formulated for implementation. Recommendations were made to enhance nursing practice, nursing education and nursing research.

Primary health care has been the cornerstone of South Africa's health policies since its transition to democracy in 1994. In order to optimise the effectiveness of primary health care, the South African government introduced community health committees hich were intended to facilitate primary health care at the grassroots level through community participation. As statutory bodies outlined in the National Health Act, 61 of 2003, and in provincial legislation, Community Health Committees were to be the liaison between communities and government and assist government in improving health services in communities. Since being re-established in 2010, Community Health Committees in the Nelson Mandela Bay Health District, Eastern Cape Province, South Africa have sought to fulfil this role and have remained sustainable. This research was aimed at investigating the strategies and approaches which sustain Community Health Committees in Nelson Mandela Bay Health District. It focused on eliciting information regarding the factors that sustain Community Health Committees, factors that threaten their sustainability and factors that motivate continued membership in Community Health Committees. Qualitative research methods of key informant interviews, observations and focus groups were used and analysed to identify these factors. The findings indicated that Community Health Committees struggle to remain sustainable because of various threats to their functioning. The major threat identified was the disengagement of the Department of Health in the operations of the Community Health Committees. The Department of Health was not visible; rather it was passive and unresponsive to the reports submitted by Community Health Committees on behalf of their communities and provided no re-imbursement for administration costs. Despite threats to sustainability, these Community Health Committees had commitment, passion and drive to assist with the health improvement of their communities in partnership with health facilities in their communities. Good interpersonal relationships in the Community Health Committees, good professional relationships with the health facility staff and the liaising role played by health facility management are some of the factors that contributed to sustainability. Recommendations were made at the end of the study that may assist the Nelson Mandela Bay Health District and the Department of Health to create a working environment that will be conducive to the sustainability of Community health Committees.

This study identifies the Integrated School Health Programme’s implementation constraints in (Ekurhuleni Metropolitan Municipality, Southern Region), and describes how these constraints have affected the implementation of school health services. This predominantly qualitative study employed the structured interview-based research design and focus group discussion approaches, with the target population consisting of school health nurses and educators working with them in Ekurhuleni Metropolitan Municipality, Southern Region. The criterion-referenced sampling strategy was opted for, because of the researcher’s knowledge of the research environment. The focus group discussions, structured interviews and participant observations complement the study’s data collection methods. The principal findings depicted the Integrated School Health Programme was not as effective as expected in its implementation. The main constraints were identified as lack of resources and knowledge; and poor teamwork of the Department of Health, the Department of Basic Education, and parents. Emanating from these findings, the study recommends innovative collaboration mechanisms between the two government departments, and that relevant and sufficient resources should be allocated for effectively implementing the Integrated School Health Programme. / Health Studies / M. P. H.

The purpose of this study was to explore the lived experiences of the newly qualified professional nurses in midwifery section doing community service. A qualitative descriptive, interpretative phenomenological research was conducted to determine the experiences. The sample included newly qualified professional nurses doing community service. Data collection was conducted by means of unstructured interviews from ten (n=10) informants. Each interview was approximately 45 minutes. Ethical issues were considered. Hussel and Heidergadian’s data analysis steps were followed. Four (4) themes and eleven (11) sub-themes emerged from the data collected. The findings revealed that the newly qualified professional nurses were in a state of reality shock, demonstrated by challenges such as shortage of human and material resources; overcrowding; lack of support; and the placement of Midwifery Nursing Science in the curriculum has impacted negatively on midwives’ registration as professional nurses. Based on the current practical nursing education environment and further research, this study concludes by presenting its recommendations and limitations. / Health Studies / M. A. (Health Studies)

MPM / Oliver Tambo Institute of Governance and Policy Studies

MPH / Department of Public Health / Workplaces are important settings for health promotion and disease prevention. Participation in sport and recreation can lead to improved health of individuals and increased productivity levels at work places. Despite the health benefits of sports and recreation and the approval of the workplace sports and recreation policy in the Limpopo Department of Health, many employees still do not participate, even when invited for games. The aim of the study was to determine the perceived factors influencing participation of non-medical staff members in workplace sports and recreation at Elim Hospital using the constructs of the Health Belief Model. A quantitative descriptive cross-sectional study was conducted. The population were all non-medical staff members of Elim Hospital. A total sample of 222 non-medical staff members of Elim Hospital were used for the study. Participants were divided into three categories, depending on the type of their work. A researcher-administered structured questionnaire based on the construct of the Health Belief Model was used to collect data. The Statistical Package for Social Sciences (SPSS) version 23 and Microsoft Excel was used to analyse the data. A descriptive statistical method was used to analyse frequencies and Chi-square test was used to determine the level of significance of correlations between the different variables. A probability level of 0.05 or less was used to indicate statistical significance. The study revealed that the rate / level of participation in workplace sports and recreation among non-medical staff members at Elim Hospital was low (30%). Participants perceived themselves mainly as less susceptible and not susceptible to NCDs. The major barriers to participation that were identified include lack of awareness of the sports and recreation policy as well as busy work schedule. There was a significant relationship between participation and age of respondents, as well as between participation and occupation category. Educational programme geared towards increasing awareness of employees on the policy as well as on benefits of sports and recreation can significantly improve participation in workplace sports and recreation.

Thesis (M. A. (Clinical Psychology)) -- University of Limpopo, 2020 / The integration of mental health care (MHC) into primary health care (PHC) has been identified as a practical intervention to: increase accessibility to mental health care; reduce stigma and discrimination against people living with mental illnesses; improve the management of chronic mental illness; and, to reduce the burden of comorbidity of mental illnesses with other chronic illnesses. In the South African context, integrating MHC into PHC also seeks to respond to numerous legislative reforms, with the aim of providing comprehensive health care, particularly to previously disadvantaged populations. The aim of the present study was to explore the perceptions of facility managers in the Tshwane District (Gauteng Province) towards the integration of mental health into PHC. Fifteen participants from the Tshwane district facilities participated in the study. The participants were selected through a non-probability purposive sampling method. Data was collected through in-depth interviews using a semi-structured questionnaire, and analysed using the thematic coding approach. Significant findings suggested that the major hindrances to the realisation of the policy objectives may be due to: the lack of rehabilitation and psychotherapeutic services; insufficient skill and knowledge of mental health on the part of staff; insufficient or unsuitable practice space in the facilities; and, poor cooperation between South African Police Services, Emergency Medical Services and Primary Health Care. Inter-facility communication, district implementation support and policy knowledge has notably increased over the years and were deemed to be amongst the biggest enablers.

This dissertation reports on an evaluation of the home visiting programme of the SACLA Rehabilitation Worker project against the background of the socio-economic context of the community and the history of the project. The evaluation had two aims. Firstly, it aimed to highlight the programme's strengths and weaknesses so that the work could become both more efficient and more effective. Secondly, it aimed to establish whether the SACLA rehabilitation project is an effective model of a community based rehabilitation project on which other local projects could be based. Quantitative data was collected by interviewing the caregivers of disabled children who were involved in the project. In-depth interviews with the rehabilitation workers provided qualitative data which was used to confirm the validity of some of the quantitative data. The foremost findings were that the mothers were very positive about the support received from the RWs. The majority of the caregivers remembered the activities that they had been taught by the RWs and performed them well. Poor communication with the caregivers and a lack of skills on the part of the RWs gave rise to a number of problems. A number of changes highlighted by the evaluation were suggested. In conclusion, the project was found to be an effective model of local community based rehabilitation on which other projects could be based.

This cross-sectional study looks at the health profiles of street children both in institutions and on the street between May and November 1989. The former group had a clinical examination, with blood and urine investigations done where possible; the latter group were only interviewed. 159 street children were interviewed of whom 47 were interviewed on the street. 73 children had clinical examinations; 64 of these had blood and urine investigations. The age range was 8 years to 19.8 years. 18.2% were females and 28.3% were black. 59,6% of those interviewed on the street had not been in an institution or shelter for street children. 27, 2% of the total group had been on the street for more 3 years. 3 7, 1 % perceived colds and chest complaints as their main physical health problem. This was confirmed by the fact that 69,2% had a history of respiratory problems. 44,7% said that they would go to a hospital if they injured themselves or were ill; however, 36,5% said they would not use or get any medication for problems such as a headache or a bad cold. 37·, 7% of children used a hospital while they were on street but 59, 7% had not used any facility while on the street. Most street children (72,8%) washed themselves at least occasionally and 61% washed their clothes. 47,2% had suffered trauma significant enough to seek hospital attention. 56% had skin problems (including lice and scabies) while on the street. 15,7% complained of visual problems and 10,7% complained of reduced hearing. Dental problems appeared to be of major concern with 37,7% complaining of either toothache or dental caries (23,3% had obvious caries on examination). 73,4% admitted to solvent abuse, 49,9% had never taken alcohol and 12,7% had never smoked. 43% had tried dagga, 10,8% white pipe (mixture of dagga and "Mandrax" which is smoked) and only 7,6% "Mandrax" alone. 10, 9% of boys and 10, 0% of girls indicated that they had been sexually exploited. Of the 67 examined 32,8% were below 90% of expected height for age, 44,8% were below 80% of expected weight for age and 8,6% had a circumference of head below 95% of standard. There is a 9,4% Hepatitis Bs ag carrier rate. No HIV (human immunodeficiency virus) antibodies were detected in 64 sera tested. On the basis of these results, the following are recommended: 1) Improving accessibility of health care resources. 2) Improving the availability of health care resources. 3)· Initiating contacts with street children by employing field health workers. 4) Drawing up a health care policy for street children institutions and field care workers. 5) Limit venereal disease management to single dose treatment where possible. 6) Further studies need to be undertaken in the following areas: - solvent abuse - utilisation of health care resources utilisation institutions of street children shelters and Further breakdown of habits, physical problems and results of examinations are presented.

Post-graduate students specializing in Community Health, are attached to different health authorities during their training. During these attachments they are exposed to the day-to-day management of health services and experience at first hand, the difficulties as well as the successes that are encountered in tending to the health needs of communities. It is also expected that post-graduate students do research projects during their attachments, usually on topics on which the health services managers need information. The topic discussed in this report was an assignment given to the author at the start of his attachment to the department of Hospital (Health) Services of the Cape Provincial Administration. The period of attachment was from February to May 1987. The whole question of the regionalization of health services is a complex one, and it is necessary that any proposals for a system of regionalization benefit from the inputs of many experts in different fields. However, as has been the experience in the United States of America, such inputs are no guarantee -that a successful system of regionalization will result. (1) In the local front, the Department of Works, at the request of the Director of Hospital Services, began an investigation into the existing system of regionalization of hospital services in 1985. This attempt was aborted, possibly because of the magnitude of the task, among other things. (2). What follows hereafter should therefore be seen as merely a framework for the development of a system of regionalization rather than as a blueprint for such a system. Perhaps a few remarks about the age-old problem of line-staff conflict would not be amiss at this stage. During the development of this framework, it became apparent that line officials might be expecting a quick proposal of regions and/ or sub-regions for the delivery of health services based on a purely management approach. As a staff official, the author naturally had different expectations. The report is an attempt to marry the two sets of expectations and it is left to the reader to judge to what extent, if at all, the author has succeeded in this attempt. Much of the data used in the study are new, and computation was done largely by hand. The generation of the data, was therefore time-consuming and much of the first phase of the study was devoted to the generation of the data and collection of data that were available from other sources. The study has proved to be a fascinating one and it is hoped that permission will be obtained to pursue the study in more detail. This report should therefore be seen as a preliminary report which addresses the question of regionalization of health services in the Cape Province in 'macro' terms. And finally, the author hopes that some of the information in this report may prove of value to those responsible for the delivery of health services to the people of the Cape Province.