Thesis (MPA (Public Management and Planning))--University of Stellenbosch, 2010. / ENGLISH ABSTRACT: The accessibility of anti-retroviral drugs to patients and families affected by HIV and AIDS, and the affordability of these drugs, have been challenges to the Du Noon community in the Cape Peninsula. The aim of the study was to assess the effectiveness of primary health care services in addressing HIV/AIDS in the light of these challenges. The focus was on patients registered on the ARV programme and who were receiving treatment at Du Noon Clinic. Interviews were conducted with 15 groups of 10 patients each using a patient questionnaire. During these interviews qualitative and quantitative data were gathered and secondary data was used for quantitative analysis. The results that the data analysis yielded are in keeping with the hypothesis that the HIV/AIDS programme is effective in meeting the needs of the HIV/AIDS patients of Du Noon. After content analysis of qualitative data, two themes related to patient satisfaction emerged: positive and negative feelings that were categorised as satisfied and not satisfied with the service. Most often noted was the feeling of satisfaction with the services rendered at the clinic and that the staff were helpful. The staff rendering the service were also satisfied with the kind of service offered to the patients, but were dissatisfied with the allocation of resources. An increase in enrolment figures of patients was noted in the statistical analysis for the period 2004-2008 with 1,018 patients registered. The statistics illustrate the linear tendency in the enrolment of patients, which indicated the accessibility and affordability of the service. / AFRIKAANSE OPSOMMING: Geredelike toegang tot en die bekostigbaarheid van anti-retrivorale middels (ARM’s) vir pasiënte en families wat deur MIV en VIGS aangetas is, is ‘n uitdaging vir die Du Noon-gemeenskap in die Kaapse Skiereiland. Die doel van die studie was om die doeltreffendheid van primêre gesondheidsorgdienste te bepaal wanneer MIV/VIGS aangespreek word. Die fokus is op geregistreerde pasiënte wat die ARM-program volg en behandeling by die Du Noon Kliniek ontvang. Met behulp van ‘n pasiëntevraelys was onderhoude met 15 groepe van 10 pasiënte elk gevoer. Tydens hierdie onderhoude is kwalitatiewe data versamel en vir kwantitatiewe analise was sekondêre data aangewend. Die resultate wat uit die data analise verkry was, strook met die hipotese dat die MIV/VIGS-program doeltreffend is om die behoeftes van die pasiënte en die gemeenskap van Du Noon aan te spreek. Nadat ‘n inhoudsanalise van die kwalitatiewe data onderneem was, het twee temas rakende positiewe en negatiewe gevoelens – gekategoriseer as tevrede en nie tevrede nie – ten opsigte van die gelewerde diens na vore getree. Veral die gevoel van tevredenheid teenoor die diens gelewer by die kliniek en die personeel as behulpsaam, is opgemerk. Die personeel wat die diens lewer, was ook tevrede met die diens wat aan die pasiënte gelewer word, maar was ontevrede oor die toekenning van hulpbronne. By die statistiese analise is ‘n toename in die inskrywingsgetalle deur pasiënte waargeneem. Toename in inskrywingsgetalle deur pasiënte is gemerk in statistiese analise van 2004 - 2008, met 1,018 pasiënte geregistreer. Die statistiek het die lineêre tendens toegelig ten aansien van die inskrywing van pasiënte wat die toeganklikheid en bekostigbaarheid van die diens uitbeeld.

Thesis (MBA)--Stellenbosch University, 2013. / The South African Northern Cape Department of Health has many challenges to overcome in order to provide the province with quality public health care. One of these challenges is the recruitment and retention of foreign doctors in order to maintain and improve on the population’s access to physicians. Due to the lack of locally trained physicians willing to work and settle in the Northern Cape Province, the Department of Health in the province have been employing foreign-trained physicians to fill the gap in providing adequate medical care to its population. This study examined how well foreign doctors have integrated into the Northern Cape public health care system. It further identified, described and explored the factors that might influence the integration of these foreign physicians. This was done in order to make recommendations to improve the existing retention strategies of the Northern Cape Department of Health. This research utilised the mixed-method of research by obtaining secondary qualitative as well as primary quantitative data. The qualitative data were obtained through a literature review. Questionnaires informed by the literature review were utilised in order to obtain the primary quantitative data. The data obtained were subjected to a statistical analysis.The results indicated that the needs of the foreign doctors were generally met and the factors pertaining to work, community and family aspects of integration did not have an overtly negative or positive influence on integration. The results pertaining to rurality were not as prominent as expected. The main factors identified related to relational (professional as well as personal) factors. The researcher concluded that relational factors contributed the most as they had an influence on all the categories of possible factors that might influence integration. This finding stressed that the social phenomena that influence integration should not be overlooked. The implementation of interventions to improve integration and retention should be accompanied by a detailed examination of the factors that affect the recruitment, integration and retention of the workforce in a country/region. This research could be an important step towards achieving this goal for the Northern Cape Department of Health.

Recent South African research has confirmed that there is reason to be concerned about the mental health status and well-being of our youth. School-going youth are engaging in a wide array of risk behaviours that seriously threaten their well-being and hamper their chances of experiencing success in the future. The aim of this research was to explore factors relating to risk, resilience and health promoting schools in order to enhance the well-being of youth in South Africa.

This research investigated the availability and nature of the rehabilitation service at primary health care level rendered by rehabilitation staff in the Metropole district health services. The aim of the study was to determine the extent to which selected elements of the rehabilitation components of the primary health care service package are currently being implemented. In doing so, the study aimed to identify obstacles within the district management as perceived by rehabilitation therapists that hinder the implementation of the rehabilitation programme, so as to make recommendations for future planning.

The purpose of this study was to explore and describe staff experiences in managing data and/or information when utilising the District Health Information System (DHIS) as a support mechanism for data quality improvement, including the strengths and weaknesses of current data management processes. It was also aimed to identify key barriers and to make recommendations on how data management can be strengthened. Key informants included in this study were those based at the district office (health programme managers and information officers) and at the primary health care (PHC) facilities (facility managers, clinical nurse practitioners and data capturers). An exploratory, descriptive and generic qualitative study was conducted. Consent was requested from each participant. Data were collected through semi-structured interviews. The study findings highlighted strengths, weaknesses and key barriers as experienced by the staff. Strengths, such as having data capturers and DHIS software at most if not all facilities, were highlighted. The weaknesses and key barriers highlighted were staff shortages of both clinical and health management information staff (HMIS), shortage of resources such as computers and Internet access, poor feedback, training needs and data quality issues. Most of the weaknesses and key barriers called for further and proper implementation of the District Health Management Information Systems (DHMIS) policy, the standard operating procedures (SOP), the eHealth strategy and training of the staff, due to the reported gaps between the policy and the reality and/or practice at the facility / Health Studies / M. A. (Public Health with specialisation in Medical Informatics)

The purpose of this study was to describe and evaluate the strategies used to reduce maternal mortality of the Fezile Dabi District in the Free State Province, South Africa. A quantitative descriptive study was conducted at three hospitals to describe and evaluate the strategies. Data collection was done by using the Maternal and Neonatal Programme Effort Index (MNPI) self-administered questionnaire. The study population comprised of 71 (midwives (52), doctors (13), management-operational managers (6). The overall response rate for the three hospitals was (43.5%). The study indicated that programme efforts for maternal health are similar across the three hospitals, however, there are particular areas in each hospital that need more attention. The ratings of all the strategies generally showed weak to partial effort. The findings revealed general poor performance under the following strategies: postpartum care, training arrangements, information, education, communication and hospital protocols. Based on the study results, the quality of maternal health care need to be improved / Health Studies / M. A. (Public Health)

The purpose of this study is to explore and describe the nature and extent of school health nurses’ roles and responsibilities in the prevention of drug abuse by learners in schools. The study was conducted at two high schools in Eldorado Park Extension 4 (Region G), in Johannesburg West. A mixed-methods (triangulated) research approach was opted for, in terms of which structured focus group interviews, self-administered questionnaires, and participant observations optimised and complemented the data collection process. The non-probability simple random sampling technique was utilised to select 35 research participants consisting of 9 (nine) educators, 1 (one) school health nurse and 25 community healthcare workers. The 1 (one) school health nurse and the 25 community-based healthcare workers were involved in the study by means of structured self-administered questionnaires, while the nine (9) educators (who were not part of the 26) only participated in the study’s two focus group interview sessions. Among others, the study’s findings indicate that the distribution of professionally trained and registered school health nurses is not yet proportionally commensurate to addressing the problem of drug and substance abuse in schools. There has been a need to augment the shortage of school health nurses with community-based school health workers. / Health Studies / M.A. (Nursing Science)

Recent South African research has confirmed that there is reason to be concerned about the mental health status and well-being of our youth. School-going youth are engaging in a wide array of risk behaviours that seriously threaten their well-being and hamper their chances of experiencing success in the future. The aim of this research was to explore factors relating to risk, resilience and health promoting schools in order to enhance the well-being of youth in South Africa.

This research investigated the availability and nature of the rehabilitation service at primary health care level rendered by rehabilitation staff in the Metropole district health services. The aim of the study was to determine the extent to which selected elements of the rehabilitation components of the primary health care service package are currently being implemented. In doing so, the study aimed to identify obstacles within the district management as perceived by rehabilitation therapists that hinder the implementation of the rehabilitation programme, so as to make recommendations for future planning.

Thesis (MFamMed)--Stellenbosch University, 2012. / INTRODUCTION: Access to health care, like childhood survival, often depends on where one lives. The infant mortality rate in rural South Africa (SA) is 52.6 per 1000 births, compared to 32.6 per 1000 births in urban areas. Furthermore, three of the four districts in SA with the highest HIV prevalence are rural. These being two commonly used health indicators, it is clear that rural populations have significantly poorer health outcomes than their urban counterparts. About half the world’s population live outside major urban centres, where health services and specialist medical services are concentrated. Rural SA are home to 43.6% of the population, but are served by only 12% of doctors and 19% of nurses. Of the 1200 medical students graduating in the country annually, only about 35 work in rural areas in the long term. There are 30 generalists and 30 specialists/100 000 people in urban areas, compared to an average of 13 generalists and two specialists/100 000 people in rural areas. The question arises whether the poorer access to particularly specialist services is a contributing factor towards poorer outcomes. Specialist outreach to rural communities is one way of improving access to care. In the Eden and Central-Karoo districts of the Western Cape of SA there are one level 2 (regional) hospital and ten level 1 (district) hospitals. All clinical disciplines reach out, with varying frequencies. On average, the four main district hospitals receive 17 specialist outreach visits per month; while the smaller district hospitals receive three specialist visits per month (Appendix 1). A typical outreach visit includes a problem ward round, outpatient session, theatre list for some surgical disciplines and formal/informal educational sessions. In principle, stakeholders agree that specialist outreach and support (O&S) to rural populations is necessary, as it improves access to specialized health care services. In practise however, there are factors that influence whether or not O&S reaches its goals. This in turn affects the sustainability of O&S projects. Understanding these factors would aid recommendations for a suitable model for O&S.