Thesis (DCur)--Stellenbosch, 2000. / ENGLISH ABSTRACT: Guided by the researcher's clinical experience and through recent outreach research projects (Stellenberg, 1996 and 1997) the factors influencing the health status of two communities were identified through health screening. It was further identified that these problems affecting the health status of these communities were magnified through the poor accessibility, availability, and affordability of health services. According to the researcher, despite the efforts of the Government and attempts to remedy the disparities of the past, the introduction of any such policy should be based on scientific evidence. The researcher decided to investigate the factors influencing the health status of the Coloured people of the Western Cape. This population group is the largest in the Western Cape, being 60,8%. Its domination in this province determines the health status of the province. By acquiring knowledge about the factors influencing the health status of the Coloured population, it will be possible for the policy makers in health care to direct their emphasis on health care policies more appropriately. Currently differences in socio-economic and knowledge levels, along with existing inequalities in health service pose major challenges for the policy makers in health care. Therefore, knowledge about the health status, health practices and health beliefs of minority groups will improve the average health status of the general population. It is against this background, that this research study was undertaken. Specific objectives were set for the study. • To determine the health status of economically active Coloured people in an urban area as defined with specific reference to the indicators as identified by the researcher • To determine the prevalence of factors influencing the health status of economically active Coloured people in an urban area as defined. • To determine the relationship between the health status and the factors influencing the health status of economically active Coloured people in an urban area as defined. • To determine an association between factors influencing the health status of economically active Coloured people in an urban area as defined. • To make recommendations to the health policy-makers concerning factors influencing the health status of the economically active Coloured people in an urban area as defined and possibly related ethnic groups. These objectives were met through an in-depth research study of this population group in six identified suburbs. Factors influencing the health status of an individual as described in the literature were explored and described. The recommendations based on the findings confirmed that the health status of the Coloured population is influenced by the following factors: • Socio-economic Level (education, financial income and occupation) • Lifestyle of individuals (High Risk Behavioural Practice such as smoking, use of alcohol and illegal drugs, dietary intake, minimal exercise, stress management and leisure time) • Ethno-cultural Beliefs: health and illness • Religion, health and illness • Environmental factors • Health Services: accessibility and affordability of services Recommendations based on the findings • Emphasis on re-development and health education of all age groups. • The introduction of social grants for those who are unable to support themselves and their families have become essential in order to improve their health status. • The creation of jobs to improve the socio-economic circumstances of the populations. • Current health services at primary health care level and environmental factors influencing the health status of the population require urgent attention. / AFRIKAANSE OPSOMMING: Gelei deur die navorser se persoonlike kliniese onde'rvinding asook onlangse navorsingsprojekte oor uitreikingsaksies ten opsigte van gemeenskapsgesondheid (Stellenberg, 1996 en 1997), is faktore wat In rol in die gesondheidstatus van gemeenskappe speel, geïdentifiseer. Daar is ook bevind dat faktore wat probleme rondom die gesondheidstatus van hierdie gemeenskappe vererger, elemente is soos toeganklikheid, beskikbaarheid en bekostigbaarheid van gesondheidsdienste. Ten spyte van pogings van die regering om die ongelykhede van die verlede uit die weg te ruim behoort die regstelling daarvan volgens die navorser op wetenskaplike bewyse gegrond te word. Die navorser het daarom besluit om die faktore wat gesondheidsorg van die Kleurlinggemeenskap in die Wes-Kaap beïnvloed, te ondersoek. Hierdie bevolkingsgroep is die grootste in die Wes-Kaap, naamlik 60,8%. Die oorheersing van die Kleurling in die provinsie bepaal grootliks die gesondheidstatus van die provinsie. Deur kennis in te win van faktore wat die gesondheidstatus van die Kleurlinggemeenskap beïnvloed, is dit moontlik vir besluitnemers in gesondheidsorg om dit beter te bestuur. Daarom sal kennis oor gesondheidsorg, gesondheidspraktyke en -gelowe van minderheidsgroepe die gesondheidstatus van die totale bevolking verbeter. Dit is teen hierdie agtergrond wat die navorsing onderneem is. Spesifieke doelwitte vir die studie was om die volgende te bepaal: • Die gesondheidstatus van die ekonomies aktiewe Kleurling-gemeenskap in In stedelike gebied soos gedefinieer met spesifieke verwysing na die indikatore soos geïdentifiseer deur die navorser • Die prevalensie van faktore wat 'n invloed op die gesondheidstatus van die ekonomies aktiewe Kleurling-gemeenskap in In stedelike gebied soos gedefinieer • Die verwantskap tussen die gesondheidstatus en die faktore wat In invloed uitoefen op die gesondheidstatus van die ekonomies aktiewe Kleurling-gemeenskap in In stedelike gebied soos gedefinieer • Die moontlike assosiasie te bepaal tussen faktore wat die gesondheidstatus beïnvloed van die ekonomies aktiewe Kleurlinggemeenskap in In stedelike gebied soos gedefinieer. • Aanbevelings aan die gesondheidsowerheidsbeleidmakers oor bevindings wat In invloed uitoefen op die gesondheidstatus van die ekonomies aktiewe Kleurling-gemeenskap in In stedelike gebied soos gedefinieer, en moontlike verwant etniese groepe. Die doel is bereik deur in-diepte navorsingsonderhoud met die Kleurling bevolkingsgroep in ses geïdentifiseerde gebiede. Faktore wat die gesondheidstatus van individue soos in die literatuur beskryf beïnvloed, is ondersoek en beskryf. Die aanbevelings is gebasseer op bevindings gedoen in die ondersoek van die gesondheidstatus van die Kleurling bevolking, en is deur die volgende faktore in die ondersoekgroep beïnvloed: • Die sosio-ekonomiese vlak (opleiding, inkomste en beroep) • Lewenstyl van respondente (hoë risiko faktore soos rook, die gebruik van alkohol, verdowingsmiddeis, daaglikse dieët, oefening, hantering van spanning en vryetydsaktiwiteite). • Etnies-kulturele gelowe: gesondheid en siekte • Geloofsgesondheid en siekte • Omgewingsfaktore • Gesondheidsdienste: toeganklikheid en bekostigbaarheid van dienste Aanbevelings wat op die navorsingsbevindings gebaseer is, is die volgende: • Beklemtoning van die herontwikkeling van gesondheidsvoorligting vir alle ouderdomsgroepe. • Die instel van In toelae vir individue wat nie in staat is om hulself en hulle gesinne te help nie, is noodsaaklik vir die verbetering van hulle gesond heidstatus . • Die skep van meer werk om sosio-ekonomiese omstandighede in die bevolking te verbeter • Huidige gesondheidsdienste op pnmere gesondheidsorgvlak en omgewingsfaktore wat die gesondheidstatus van die gemeenskap beïnvloed, vereis dringend aandag.

No abstract available. / Thesis (M.Sc.U.R.P.)-University of Natal, Durban, 1999.

This ethnography was undertaken in an AIDS hospice with the objective of understanding the functioning of the Centre holistically, including the experiences of the patients and the role of the Centre in the fight against HIV/AIDS. Organisational anthropology in a clinical setting involved gaining entry and rapport with the staff and patients. The methodology included interviewing and observation. The personnel structure and leadership of the Centre were explored, revealing communication, power and management relations that shape the organisational culture. The staff’s attitude towards their jobs and their commitment to assisting those suffering from AIDS revealed the underpinnings of the organisation. The care that patients receive at the Centre was examined along with adoption of the children and the effects of stigmatisation surrounding HIV/AIDS and its impact on patients and their families. The meaning of illness for patients and their sick role as well as the impact of death from HIV/AIDS are exposed. / Anthropology and Archaeology / M.A. (Anthropology)

This study addresses the healthcare needs of employees and their families living in the Kruger National Park (KNP). A quantitative, explorative, descriptive research design was used to interview respondents who comprised of 75 male and female employees with children of various ages. The findings revealed that physical, psychological, environmental, socio-cultural, and behavioural needs of the employees and their families living in the KNP is probably unattainable as healthcare services are poorly distributed throughout the KNP, being mostly concentrated in the main camp of Skukuza. A number of respondents indicated that they required consultations about psychological and socio-cultural stresses in their lives. These services are not available in the KNP. / Health Studies / M.A. (Health Studies)

Adolescent reproductive health services (ARHS) in Gauteng Province are not meeting the reproductive health needs of adolescents. There is also no formalised adolescent/youth policy laid down to assess the quality of care given to adolescents attending these clinics although the policy is currently in the process of being finalised. The purpose of the study therefore was to critically analyse the ARHS in Gauteng Province to determine which adolescents attended the clinics, whether the clinics were accessible and available and whether they provided comprehensive care, gave information and counselling to the adolescent and whether the clinics \\·ere adolescent-friendly. Using the quality care model as the conceptual framework for the study, the following research questions were asked to determine the quality of care in terms of the adolescent's needs at these clinics: Who is the adolescent using ARHS in Gauteng Province') Are the ARHS in Gauteng Province accessible and available to adolescents? Do the ARHS in Gauteng Province provide comprehensive care to adolescents? Are adolescents receiving information and counselling from the ARHS in Gauteng Province? Are the ARHS in Gauteng Province adolescent-friendly? A quantitative cross-sectional exploratory, descriptive research design using a self-administered, researcher­ designed questionnaire was used to collect data from a 203 nonprobability convenient sample, at selected ARHS in Gauteng Province. The analysed data indicated that females in the older age group. ie 18-19 years used the ARHS more than the female adolescents in the younger age group and males. Findings also indicated that the ARHS in Gauteng Province are geographically accessible and available to adolescents. However, there appeared to be a need to extend the days and hours of functioning of the ARHS so as to make them more accessible and available to adolescents. Comprehensive care is not given to adolescents attending ARHS. Adolescent gave contradictory mformation especially with regard to the attitudes of service providers. Recommendations made include management strategies that will attract the adolescent in the younger age group and in particular the male adolescent. This necessitated that service providers at ARHS be equipped with the appropriate information given in an outcome-based format in adolescent care. / Health Studies / D. Litt. et Phil. (Advanced Nursing Science)

This ethnography was undertaken in an AIDS hospice with the objective of understanding the functioning of the Centre holistically, including the experiences of the patients and the role of the Centre in the fight against HIV/AIDS. Organisational anthropology in a clinical setting involved gaining entry and rapport with the staff and patients. The methodology included interviewing and observation. The personnel structure and leadership of the Centre were explored, revealing communication, power and management relations that shape the organisational culture. The staff’s attitude towards their jobs and their commitment to assisting those suffering from AIDS revealed the underpinnings of the organisation. The care that patients receive at the Centre was examined along with adoption of the children and the effects of stigmatisation surrounding HIV/AIDS and its impact on patients and their families. The meaning of illness for patients and their sick role as well as the impact of death from HIV/AIDS are exposed. / Anthropology and Archaeology / M.A. (Anthropology)

Adolescent reproductive health services (ARHS) in Gauteng Province are not meeting the reproductive health needs of adolescents. There is also no formalised adolescent/youth policy laid down to assess the quality of care given to adolescents attending these clinics although the policy is currently in the process of being finalised. The purpose of the study therefore was to critically analyse the ARHS in Gauteng Province to determine which adolescents attended the clinics, whether the clinics were accessible and available and whether they provided comprehensive care, gave information and counselling to the adolescent and whether the clinics \\·ere adolescent-friendly. Using the quality care model as the conceptual framework for the study, the following research questions were asked to determine the quality of care in terms of the adolescent's needs at these clinics: Who is the adolescent using ARHS in Gauteng Province') Are the ARHS in Gauteng Province accessible and available to adolescents? Do the ARHS in Gauteng Province provide comprehensive care to adolescents? Are adolescents receiving information and counselling from the ARHS in Gauteng Province? Are the ARHS in Gauteng Province adolescent-friendly? A quantitative cross-sectional exploratory, descriptive research design using a self-administered, researcher­ designed questionnaire was used to collect data from a 203 nonprobability convenient sample, at selected ARHS in Gauteng Province. The analysed data indicated that females in the older age group. ie 18-19 years used the ARHS more than the female adolescents in the younger age group and males. Findings also indicated that the ARHS in Gauteng Province are geographically accessible and available to adolescents. However, there appeared to be a need to extend the days and hours of functioning of the ARHS so as to make them more accessible and available to adolescents. Comprehensive care is not given to adolescents attending ARHS. Adolescent gave contradictory mformation especially with regard to the attitudes of service providers. Recommendations made include management strategies that will attract the adolescent in the younger age group and in particular the male adolescent. This necessitated that service providers at ARHS be equipped with the appropriate information given in an outcome-based format in adolescent care. / Health Studies / D. Litt. et Phil. (Advanced Nursing Science)

This study addresses the healthcare needs of employees and their families living in the Kruger National Park (KNP). A quantitative, explorative, descriptive research design was used to interview respondents who comprised of 75 male and female employees with children of various ages. The findings revealed that physical, psychological, environmental, socio-cultural, and behavioural needs of the employees and their families living in the KNP is probably unattainable as healthcare services are poorly distributed throughout the KNP, being mostly concentrated in the main camp of Skukuza. A number of respondents indicated that they required consultations about psychological and socio-cultural stresses in their lives. These services are not available in the KNP. / Health Studies / M.A. (Health Studies)

The study comprehensively analysed the impact of primary prevention services for reproductive health in the environment within which the adolescents grow towards life skills ecquisition and positive behavior patterning. The availability, accessibility and the effectiveness of adolescents' accompaniment in Soshanguve Township by certain caregivers were assessed. Unstructured observations, review of documents, questionnaire and semi-structured interviews were used for data collection. The results revealed the least support by parents and churches to accompany the adolescents and the inaccessibility of specialised center to the disadvantaged. The continued lack of knowledge and life-skills perpetuated the onset of reproductive problems. The lack of programmes to equip care providers on how to improve communication during care provision was a major setback. There is a great need for the erection of special care centers for adolescents. / Health Studies / M.A. (Nursing Science)

The study comprehensively analysed the impact of primary prevention services for reproductive health in the environment within which the adolescents grow towards life skills ecquisition and positive behavior patterning. The availability, accessibility and the effectiveness of adolescents' accompaniment in Soshanguve Township by certain caregivers were assessed. Unstructured observations, review of documents, questionnaire and semi-structured interviews were used for data collection. The results revealed the least support by parents and churches to accompany the adolescents and the inaccessibility of specialised center to the disadvantaged. The continued lack of knowledge and life-skills perpetuated the onset of reproductive problems. The lack of programmes to equip care providers on how to improve communication during care provision was a major setback. There is a great need for the erection of special care centers for adolescents. / Health Studies / M.A. (Nursing Science)