Thesis (MTech (Environmental Health))--Cape Technikon, 2003 / This is a retrospective (descriptive) study ofclinic delivery trends rendered in Cape Town Central District between July 1995 and June 2002. The study describes the history of clinic service delivery in Cape Town Central District, which includes the Primary Health Care model, as well as the District Health system. Clinic delivery trends for the following three periods are determined: I:] Before the implementation ofthe New Health Plan: July 1995 - July 1996; I:] During the implementation of the New Health Plan: July 1997 - June 1998; I:] After the implementation of the New Health Plan: July 1998 - June 2002. The study also determines and compares the nature ofpublic health clinic services delivered during the study period. No official annual health reports were compiled by Cape Town Administration since July 1997. This study therefore serves to determine disease and clinic trends for the periods where no such aonual reports are available. It is important to determine health delivery trends for future strategic plaoning purposes. Changes to the nature and extent ofservices rendered by public health clinics were brought about by the following factors: Cl One approach of Primary Health Care is to refer more patients to public health clinics in order to release pressure from the major tertiary hospitals. If this Primary Health Care (PHC) model is provided appropriately, about 80% ofhealth problems should be solved without referral to another level of care; Cl A number of free public health clinic services have been introduced since the democratization of South Africa in 1994, such as free services to expectant mothers as well as free clinic services to children younger than six years; Cl New clinic services have been added, such as provision ofmedication to stabilized mental health patients; Cl HIV/AIDS has become an international pandemic over the past decade and has shown a 660.8% increase in Cape Town Central District; Cl A limited (19.8%) increase in the population for that area during the study period; Cl Clinic services have been legislated as a nurse driven service since 1997, with an additional emphasis on the curative roles of nurses (traditional roles of nurses at public health clinics were largely preventive and promotive).

Thesis (M.ED (Continuing care and Training)) --University of Limpopo, 2010. / This report describes the research conducted at Phuthanang Home Based Care in Mankweng Township in the Limpopo Province of South Africa. Mankweng constitute a mixture of both formal and informal settlements, both urban and rural settlements and is situated about 32 km to the east of Polokwane which is the provincial capital for Limpopo. The aim of the research was to investigate the challenges faced by Phuthanang Home Based Care (HBC) in providing care and training in Mankweng Township. Having established the challenges faced by Phuthanang Home Based Care the researcher intended to recommend possible solutions to these problems. In an attempt to meet the above mentioned aims; the following research questions were formulated: Main question: • What are the challenges faced by Phuthanang Home Based Care in providing care and training? The following sub questions were asked derived from the main question above: • What are the aims and objectives of Phuthanang Home Based Care? • What are the existing services and training programmes offered by caregivers at Phuthanang Home Based Care? • What are the experiences of caregivers in relation to training for Home Based Care? • What is the level of community participation in Phuthanang Home Based Care activities? Chapter two outlines the theoretical framework based on relevant literature on the subject under study. I also formulated assumptions about the challenges that could be facing home based care programmes; these include issues such as lack of funds, inadequate training and stigmatisation among others. In this chapter key concepts were defined and operationalised to suit this research and to avoid ambiguity in interpretation. Chapter three outlines the research methodology. It clearly explains the research design used, data collection and data analysis. This study was purely qualitative and took the form of a single case study design. This enabled a detailed and intensive study of the case as it exists in its natural setting. Data was collected according to two streams which are fieldwork and document analysis. In fieldwork the researcher used multiple data collection techniques which include open ended interviews with the Project Coordinator, Administrator and Caregivers. The other technique used was observations. A focus group interview with the Coordinator, Administrator and four caregivers was also employed during fieldwork. A data matrix was used in the analysis of data. Chapter four constitutes the presentation and analysis of findings of the study. In this chapter; I describe the setting of the organisation in terms of location, historical background as well as its aims and services rendered. It outlines the challenges encountered by Phuthanang Home Based Care in providing care and training based on the results from document analysis, interviews, observations and focus group interview with the Caregivers’, the Administrator and the Coordinator of Phuthanang Home Based Care. The findings will suggest recommendations that will help bolster the state of care giving, training, and improve the way care is rendered to people living with HIV/AIDS and other terminal illness. Chapter five presents my conclusions by outlining the challenges faced by Phuthanang Home Based Care in providing care and training. This chapter also presents recommendations that might contribute towards finding solutions to the problems faced by Phuthanang Home Based Care. After the recommendations I presented a section on reflections of the research process. In conclusion to this chapter I recommend further research on the challenges faced by home based care organisations which have an element of training in poor communities such as townships, informal settlements and rural areas.

M. Tech. Business Information Systems / The purpose of the study was to develop a framework that could be used to assess e-health readiness for rural South Africa. Data for the study was collected from Moses Kotane Municipality in the North West Province of South Africa. One state hospital and ten clinics were used for data collection. From related literature, six constructs of; core readiness, structural readiness, engagement readiness, societal readiness, performance and effort expectance were used as pillars for e-health readiness assessment. The attributes that were identified in the literature were validated by healthcare administrators at the regional office of the Northwest province.

No abstract available. / Thesis (Ph.D.)-University of Natal, Durban, 1959.

Sex and sexuality issues are still sensitive and controversial subjects despite the growing numbers of sexual and reproductive health (SRH) programmes for adolescents in subSaharan African countries (WHO, 2002; Department ofInternational Development (DFID), 2004). The purpose of this study was to examine and analyze the structure and procedural mechanisms adopted by adolescent sexual and reproductive health (SRH) programmes in two African countries. This study also explored the adolescents' perceived usefulness and relevance of these programmes in addressing their SRH needs. The study was conducted in Ghana (West Africa) and South Africa (Southern Africa) as a cross-national study in these two sub-Saharan African countries. A comparative case study design was adopted involving the use of both quantitative and qualitative approaches to data collection and analysis. Snowballing, critical case, and purposive sampling methods were used. A wide range of personnel from both countries including programme directors, managers, nurse/midwives, peer educators and youth counselors (n=48) were interviewed within the context of adolescent sexual and reproductive health (ASRH) programmes and adolescents (n=247) participated through client exit surveys and focus group discussions. Records review, document analysis and observation of the facilities were employed through a checklist. A Tri-dimensional conceptual framework adapted from Donabedian (1980) and WHO (2001) for: (1) Structure, (2) Process, and (3) Output of ASRH programmes, guided the study and served as the frame for analysis and comparison. Qualitative data were transcribed and analyzed using framework analysis and quantitative data through use of SPSS Version 13.0. Findings of the study revealed that both Ghana and South Africa have established ASRH structures through development of programmes and policies for young people. They also shared common features related to programme focus and philosophy on ASRH matters. Both countries face several challenges associated with sexuality issues, inadequate human and material resources. Religious, socio-cultural, logistical and structural factors were identified as barriers, which hindered access and use of the facilities. These barriers were found to have a profound influence on programme implementation, achievement of objectives and future development. Adolescents in the two countries are confronted with a range of issues affecting their sexual health and general well-being for which they seek services from ASRH programmes. These programmes in both countries were generally perceived as relevant and important by youth utilizing the facilities. The need for changes in the attitude of service providers, structural layout, logistical improvement and staffing composition was expressed. Despite efforts made, there are still programmatic issues needing attention, for which specific recommendations towards improvement were made on the basis of findings from both countries. Findings from this study have implications for nursing practice, management, education, research and relevant stakeholders involved with adolescent health, including policy makers. Recommendations are made that may contribute to the development of an effective model of "Adolescent-Friendly" programmes in the two countries. / Thesis (Ph.D.)-University of KwaZulu-Natal, Durban, 2007.

The Department of Health (DOH) has embarked on a noble initiative to address the disproportionate distribution of resources and spending within the public and private healthcare sectors. Social Health Insurance (SHI) has thus been mooted as the vehicle to obtain a more equitable healthcare dispensation. This thesis explores the state of preparedness of the DOH, for the implementation of SHI. Ten aspects of health have been identified which will assist in determining if sufficient reforms have been implemented to facilitate the successful implementation of SHI. The prospective mechanism of financing of SHI is compared to the highly acclaimed model employed by the Australian Department of Health. Two research methodologies have been utilized viz. the case study approach and semi structured interviews, to provide comprehensive data. This enabled the researcher to adequately answer the research question. The responses from the respondents on the 10 aspects of healthcare have been arranged into themes to facilitate a greater understanding of the issues being highlighted. Established strategic management instruments have been utilized to analyze the data obtained and evaluate the preparedness of the DOH for the implementation of SHI. Following the data analysis, recommendations are proposed that would facilitate the successful implementation of SHI, thereby promoting its viability and sustainability in providing quality healthcare to all who call South Africa home. / Thesis (MBA)--University of KwaZulu-Natal, 2006.

In the context of a country and a continent that is largely rural, education for rural medical practice in Africa is relatively undocumented and poorly conceptualized. The arena of medical education in South Africa has been largely unchanged by the transition to democracy, despite intentions of reform. The literature reveals a lack of empirical evidence as well as theory in education for rural health, particularly in developing countries. This report presents twelve original papers on a range of key issues that represent the author’s contribution to filling this gap in South Africa. It aims to contribute to the development of a discourse in education for rural medical practice in an African context, and culminates in a theoretical paper regarding pedagogy for rural health. A conceptual framework is utilized that is based on the standard chronological steps in the initial career path of medical doctors in South Africa. Beginning with the literature that is focused around the need to recruit and retain health professionals in rural and underserved areas around the world, the report then addresses the policy context for medical education in South Africa, examining the obstacles to true reform of a transformatory nature. The selection of students of rural origin, and the curricular elements necessary to prepare graduates for rural practice are then investigated, including the actual career choices that medical graduates make in South Africa. Out in the workplace, the educational components of the year of compulsory community service are described, including organizational learning and apprenticeship as novice practitioners, placed under severe pressure in rural hospitals in the South African public health service. A community-oriented type of medical practice is described amongst exemplary individuals, indicating the aspiration towards a different kind of educational outcome. Finally the thesis as such is presented in the final paper regarding a theoretical basis for education for rural health, consisting of the combined notions of placed-based and critical pedagogy. It is argued that while the geographic elements of rural practice require a pedagogy that is situated in a particular rural context, the developmental imperatives of South Africa demand a critical analysis of health and the health care system, and the conceptual basis of this position is explained. / Thesis (Ph.D.) - University of KwaZulu-Natal, Durban, 2010.

Diss. (sammanfattning) Stockholm : Karol. inst., 2005. / Härtill 6 uppsatser.

The role of the community pharmacist has changed over the past two decades. The traditional specialist roles of pharmacists, such as compounding and preparation of medications, are now infrequent activities and the profession has moved to a more patient-centred focus. Furthermore, pharmaceutical care has been developed and adopted as a practice philosophy to add value and bring care for patients back into the profession. However, there is still much debate in academic and policy literature concerning the reluctance of community pharmacists to adopt and implement pharmaceutical care in practice environments. Empirical evidence has suggested that the professional identity of pharmacists is both ambiguous and multifaceted. However, the practice of pharmaceutical care has been demonstrated to increase organisational identity of pharmacists, as well as their job satisfaction. In addition, pharmacists in a clinical role have been shown to have higher levels of job satisfaction than their counterparts in nonclinical roles. This study has identified, described and analysed the self-perceived professional identities of community pharmacists within a South African context. Furthermore, it sought to determine their current levels of job satisfaction. The relationships between professional identity, job satisfaction and role were analysed in an attempt to understand the influence of professional identity on job satisfaction and behaviour of pharmacists. This study made use of a mixed method of inquiry, online questionnaire, administered to a large sample, which allowed the researcher to take a broad view of the research foci at a specific moment in time. This study found the existence of six professional identities amongst South African Community Pharmacists; namely the practitioner, the jaded pharmacist, the social carer, the professional, the medicine supplier and the entrepreneur. South African community pharmacists were, generally, satisfied with their jobs, professed to practice pharmaceutical care and adopted it as a practice philosophy. South African Community pharmacists were, in general, committed to their profession. Correlation between a pharmacist’s professional identity and their job title, job satisfaction and their commitment were found to be statistically significant. A pharmacist’s level of job satisfaction was statistically correlated to their practice of pharmaceutical care. No statistically significant relationship was found to exist between a pharmacist’s identity and their work load or tasks performed. Characterising South African community pharmacists’ identities is of great significance in an effort to better understand the forces that drive our profession of pharmacy. In doing so, have found that identity affects many elements of work life such as job satisfaction, professional commitment and the practice of patient care.

A clinic survey was undertaken to investigate the nature of psychiatric problems experienced by the primary health care (PHC) patient population in the Bisho-King William's Town area of the Eastern Cape Region. The study took as its point of departure research findings which attest to the high rate of psychiatric distress amongst this population group in different parts of the world and ohservations regarding the form of presentation in terms of physical complaints. Hypotheses posited relationships between psychiatric problems experienced by patients attending PHC clinics in the study area and four types of variables, namely; somatic complaints, socio-demographic characteristics, patterns of health service utilisation and patient satisfaction with health services. Using a quasi-experimental descriptive approach, a two-stage screening procedure sorted the patient sample into three groups on the basis of the degree of psychiatric symptomatology experienced. The triangulation of the results of between-groups analyses with case materials recorded during psychiatric interviewing provided for an ethnographic account of the cultural experience of distress in the study area. The screening process used standard instruments, the Self-Reporting Questionnaire (SRQ) in the first stage and the Present State Examination (PSE) in the second stage. A pilot study was conducted prior to the fieldwork for the main study. Using the SRQ, thirteen psychiatric paticnts and 31 general PHC patients were sampled for the pilot study and 148 PHC patients were sampled for the main study. Using the PSE, 11 and 57 PSE interviews were conducted in the pilot and main studies respectively. Between-groups analyses used chi-square and F-statistics to investigate possible associations with identified patient correlates (P<0.5). These were socio-demographic, utilisation and satisfaction variables, measured by a separate face-valid self-response instrument compiled for the purposes of this study. Psychiatric symptomatology was found to be statistically significantly related to age, marital status and educational level. Further, patients experiencing more psychiatric symptomatology reported significantly more illnesses requiring treatment, longer consultation periods and a greater number of sick bed days. No statistically significant relationships were found between psychiatric symptomatology and number of children, number of failures at school, amount of treatment utilised, number of consultations, or patient satisfaction with services. Descriptive analyses of symptom and syndrome profiles found certain somatic complaints to be particularly prevalent amongst the patient sample. These include headaches and various tension pains, decreased energy levels and digestive problems. Qualitative analysis of interview data found that many somatic and psychiatric problems experienced constitute culturally defined and meaningful experiences, especially 'umbilini' (or nerves), 'ufufunyana' (a possession state), and accusations of witchcraft. Interpretation of complaints from the local traditional healing perspective, revealed a more complex mode of communication between patients and the health delivery system than may be accounted for in terms of a simple biomedical model. The interpretive analysis in the study showed that some forms of presentation incorporating somatic symptoms, such as 'nerves' may he viewed as help seeking behaviour of the socially unempowered. Implications of the results are discussed in relation to the need for improved identification and management of psychiatric distress at PHC level facilitated by a better developed referral network and closer interaction between biomedical and anthropological perspectives.