The purpose of this study was to identify the need for a training programme and to develop the training programme to meet the needs of traditional birth attendants in the management of pregnancy, labour and puerperium. The study was conducted in the Flagstaff district which is one of the districts of the north eastern region (region E) of the Eastern Cape. The target group consisted of all the traditional birth attendants who availed themselves at the residential clinics of Flagstaff district and the number is not known as not all traditional birth attendants who presented themselves are recognized by their communities as traditional birth attendants. The study was a quantitative descriptive design and the data was collected by means of structured interviews using a questionnaire that was designed by the researcher. According to the findings the traditional birth attendants are functioning without being formally trained before. They lack knowledge and skill in the management of pregnancy, labour and puerperium. Some of their practices are reason for concern, for example cephalic versions and not using protective devices. There is a need for the development of the training programme in the Flagstaff district. This programme was developed from the information obtained from the data-analysis and is given as annexure F / Health Sciences / M.A. (Advanced Nursing Sciences)

Text in Afrikaans / Summaries in Afrikaans and English / Die doel van die sensus was om 'n perspektief te verkry oar die bestuur van plaaslike owerhede in die Vrystaat se primere gesondheidsafdelings deur verpleegkundiges. Faktore rakende die omvang van die verpleegkundige in beheer se bestuursfunksies, die werksverhoudinge tussen hulle en hul hoofde, hul optimale benutting ten opsigte van bestuur en sekere aspekte van hul bestuursopleiding is ge"ldentifiseer as belangrike komponente. Ontleding van data het getoon dat verpleegkundiges en hoofde van mekaar verskil ten opsigte van hul sienings rakende die bestuursfunksies van die verpleegkundige in beheer. Werksverhoudinge tussen die verpleegkundiges en hul direkte toesighouer is nie altyd bevredigend nie. Die swak benutting van hul bestuursvaardighede blyk vir die verpleegkundiges in beheer onaanvaarbaar te wees. Sekere aspekte van die bestuursopleiding van verpleegkundiges behoort aandag te geniet. Plaaslike owerhede behoort aan verpleegkundiges geleenthede vir voortgesette bestuursopleiding te bied. Aanbevelings om die optimale benutting van verpleegkundiges in beheer van primere gesondheidsafdelings van plaaslike owerhede te bevorder, is geformuleer. / The purpose of this census was to obtain a perspective on the management of primary health services of local authorities by nurses in the Free State. Factors regarding the extent of management in primary health care services by nurses, working relationships between them and their superiors, their optimal utilisation with regard to management and certain aspects of their managerial training, were identified as important components. Analysis of data indicated that nurses and their superiors differ from one another regarding their views on managerial functions of the nurses in charge. Working relationships between nurses in charge and their superiors were not always satisfactory. Nurses found the poor utilization of their management skills unacceptable. Certain aspects of the managerial training of nurses should receive attention. Local authorities should provide opportunities for ongoing managerial training for nurses. Recommendations to utilise nurses in charge of primary health care services optimally, were formulated. / Health Studies / M.A.

This study reflects a critical analysis of the procedures followed in child rape cases in Mpumalanga Province and in the process to enhance investigative capabilities with sound detective development. Empirical research was conducted with a literature review, docket analysis and interviews as methods to obtain information where the following important aspects were addressed: an overview of the field of forensic investigation, the shortcomings with regard to child rape investigations and correct procedures for conducting child rape investigations formulated. The study found that generally rape cases were not properly investigated, correct procedures were not followed (biological/physical evidence was not readily identified nor correctly handled) and applicable directives pertaining to child rape investigations not complied with. Investigators had a narrow understanding of the concept forensic investigation. In child rape investigations it would be of more evidential value and reliable to collect physical evidence such as blood, semen, vaginal fluids and saliva as the child’s testimony at court might not be reliable, particularly when subjected to cross examination. Rape is both a contact crime as well as a psychologically motivated crime and both aspects of the trauma needs attention during the investigation process. Crimes against women and children are also a national concern, thus making child rape a priority crime for the South African Police Service. For any successful prosecution it is necessary that policy and correct procedures are not compromised but rather strictly adhered to. The Locard Principle in relation to physical evidence such as body fluids at the crime scene needs to be focussed on during the investigation process. The research suggests that the current standing operating procedures be amended to include the critical aspects of child rape investigation such as processing of the crime scene, the search for biological evidence as well as the packaging and preservation of biological evidence. / Police Practice / M. Tech. (Forensic Investigation)

Injuries, illnesses and deaths happening in schools are a growing menace in Gauteng province, South Africa. This qualitative research study sought to evaluate the administrative efficacy of first aid (FA) provisioning in Gauteng schools in the wake of rampant injuries, deaths and disfigurement among learners and teachers, as documented in the local print and electronic media. An emergent research design underpinned by a phenomenological theoretical perspective unravelled the administrative efficacy of the provisioning of FA in two pre-schools, two primary schools and two high schools in Gauteng province. Observations in one school, semi-structured face-to-face interviews with one pre-school manager, three FA appointed persons, one deputy headmaster and a subject head of department, as well as focus group discussions with learners and teachers in two schools, were the data-gathering tools. A thematic analysis approach was the method adopted to analyse data. Research findings indicate very low levels of FA literacy and competency among learners, teachers, pre-school managers and principals in the sampled schools. I recommend and advocate a national conversation aimed at instituting a massive drive to make it mandatory for all learners and teachers to be trained in FA. / Educational Leadership and Management / D. Ed. (Education Management)

Postnatal care provides the opportunity for protecting the health of women and their babies by optimising human immunodeficiency virus (HIV) treatment and management. This study intended to explore the implementation of postnatal care to HIV positive women by explicating nurses’ views regarding their practices with the aim of improving the programme. The study was conducted at three clinics in Mangaung. An evaluative case study design was used to provide a detailed account on implementation of postnatal care to HIV positive clients. The purposive non-probability sampling was used. Semi-structured methods using focus group interviews were used to collect data. Data were reviewed through thematic analysis. The study found that nurses understood guidelines, used them to direct their practice and challenges were highlighted. It was concluded that the system limitations needed to be addressed, skills of health care providers improved and linkages with community based services strengthened to improve effectiveness of care. / Health Studies / M.PH.

This is a study on the prevalence of refractive errors and patients requiring refractive services at 15 eye clinics in the Amathole, Chris Hani, Joe Gqabi and OR Tambo District Municipalities of the Eastern Cape. This is an area characterised by extreme poverty where the cost of an eye examination and prescription spectacles remains financially unobtainable for most. Optometry services are provided mainly by private optometrists who service the small proportion of the population that can afford them. Adults and children remain house bound or are labelled as dull and unproductive simply because they don’t have access to an eye examination and a pair of spectacles. Purpose The purpose of the study is to identify patients with refractive errors and those requiring refractive services at the 15 eye clinics in the Eastern Cape. Another purpose is to describe the refractive services that are available to patients attending health facilities, where the eye clinics are conducted. Lastly, the purpose is to explore the possibility of nurses providing refractive services independently or under the supervision of optometrists to supplement the lack to refracting and dispensing services. Study Method A quantitative and qualitative non-experimental descriptive design was used. Research involved the analysis of Vision Care’s eye clinic records collected from 15 eye clinics from January 2010-June 2010. Semi-structured interviews were conducted with 30 nurses working at the 15 health facilities where the eye clinics were conducted using purposive sampling. The quantitative data was analysed using excel spreadsheets and graphs and qualitative data was analysed using coding and categorizing methods. Conclusion According to Vision Care’s data of the patients assessed, 19.2 percent had a refractive error and 54 percent of the patients required refractive services. It is estimated that 71.41 percent of the patients had a refractive error according to the optometrist. Although there were some organisations active in the eradication of cataracts, there was little healthcare available in the form of refraction services. xiv Patients needed to travel an average of 63.8kms to access refraction services against the backdrop of poor roads, poverty and unemployment. 28 out of 30 nurses either ‘strongly agreed’ or ‘agreed’ that nurses could be trained to perform refractions and dispense spectacles. 29 out of 30 nurses thought that this would have a positive impact on eye care. Further research is necessary to assess the feasibility of implementing a nurse operated refractive program and whether it should be within their scope of practice to refract and dispense spectacles.

This qualitative study explored traditional healers’ perceptions on collaborating with bio medical professionals. Purposive sampling was used to select study participants, and individual in-depth interviews were used to collect data. Thematic data analysis was conducted. The main findings of the study were that healers are very popular and highly respected amongst African communities. Traditional healers experienced mistrust and disrespect by biomedical health professionals who demonstrated ignorance on traditional medicine. Lack of motivation, incentives and financial support to conduct collaboration activities was another key finding including lack of clear policies and management structures for collaboration. Due to concern for their patients, healers resorted to practising covert collaboration such as not using official referral slips. Positively, healers experienced transformation in terms of knowledge gained from the training on basic HIV-TB epidemiology. There was clear evidence of high ethical practices amongst healers where they put their patients’ welfare ahead of their business interests / Health Studies / M.A. (Public Health)

MPH / Department of Public Health

PhD (Advanced Nursing Science) / Department of Advanced Nursing Science / iii Abstract The Mental Health Act is the law which sets out when you can be admitted, detained, and treated in hospital against your wishes. It is also known as being “sectioned”. For this to happen, certain people must agree that you have a mental disorder that requires a stay in hospital. In South Africa, the Mental Health Act of 1973 was noted to have many gaps. Due to all the shortcomings, in 2004 the Mental Health Care Act No. 17 of 2002 came into being in order to protect human rights of the mental health care users. This study sought to determine the knowledge and explore the experiences of medical doctors regarding the implementation of Mental Health Care Act No. 17 of 2002. Secondly, based on the findings, to develop a programme to facilitate the implementation of the Mental Health Care Act No. 17 of 2002 by medical doctors in Vhembe District. The population of this study consisted of all medical doctors working in Vhembe District Hospitals with mental health units and at a specialized mental health hospital as well as all documents completed by medical doctors during admission, care and discharge of mental health care users were purposively sampled. The study was conducted in two phases. In phase 1, where quantitative and qualitative designs were followed to do situational analysis. In phase 2, the programme was developed using results from phase 1, the theoretical framework and approaches outlined by Dickoff, James and Wiedenbach (1968); Chinn and Krammer (1999); Walker and Avant (1995). Individual in-depth interviews and questionnaires checklist were used to collect data which was analysed through opened coding method and SPSS. The findings of this study indicate that medical doctors have knowledge and skills deficit regarding implementation of the Mental Health Care Act No. 17 of 2002 during the admission, care, and discharge of mental health care users. Based on these, a programme to facilitate the implementation of the Mental Health Care Act No. 17 of 2002 by medical doctors during admission, care and discharge of mental health care users was developed. The study concludes that this is a significant contributor in supporting the vision of the National Department of Health to ensure improved mental health for all in South Africa. The study recommends a longitudinal study, tracking the impact of a developed programme, the knowledge of medical doctors regarding the implementation of Mental Health Care Act No. 17 of 2002, and its contribution to the improvement of mental health for all should be conducted over a period of 5 (five) to 10 (ten) years

MCur / Department of Advanced Nursing Sciences / See the attached abstract below