A Dissertation Submitted to the Faculty of Medicine University of the Witwatersrand, Johannesburg for the Degree of Master of Medicine (Community Health) / The extremely complex fragmentation of health services in the greater South Africa has lead to confusion, duplication and uncoordinated planning. This study assesses the hospital component of the health services in one discrete geographical area where service responsibilities are particularly complex. Each of the hospitals identified within the study area was visited and, after a short conducted tour, detailed information was obtained on a standard questionnaire during interviews with senior hospital personnel. Final detail was obtained by inspection of various functional components in each hospital. Proposals regarding the process of regionalising the hospital services in a future post-apartheid era (when political boundaries, particularly homeland boundaries, have disappeared and the health services can be rationalised under a unified health authority) are made. The major finding is that, while some expansion is needed, the existing facilities can be reorganised into a functional complex at minimal cost and limited disruption of services. / AC 2018

M.A. (Social Work) / The purpose of this study was to ascertain whether the manner in which the management tasks of planning and control are executed in a clinic for the treatment of alcohol dependents. influences the development of financial problems in the conduct of the affairs of such a clinic. The study was motivated by many years experience of a social worker at such clinics. In view of the paucity of research in this field, an exploratory study was undertaken. Research methods included: comparison of selected financial aspects in respect of two financial years, vis 1973/74 and 1983/8'4; a scrutiny of files for confidential information; and an examination of annual reports. The main hypothesis - although this hypothesis was not tested in an experimental manner - was found to be valid. The manner in which the management tasks of planning and control were executed determined the nature of the development of the following financial problems: inaccurate computation of subsidies; fund-raising not related to objectives in terms of the constitution; uncontrolled escalation in expenditure; failure, on the part of committees, to permit an appropriate delegation of powers; inadequate functioning of the social worker; and insufficient liaison with Council. Some of the recommendations made to rectify the situation were as follows : that an in-depth analysis of the subsidisation of clinics for the treatment of alcohol dependents be undertaken; that modern methods of fund-raising be studied and applied; that social workers Iike a personal effort to broaden their knowledge of financial matters, since this will greatly benefit the agencies employing them.

Effective leadership is essential for the achievement of any organisational success. The need for strong leadership and increased diversity is a prominent issue in today’s health service workforce. Effective leadership involves influencing others towards achieving the goals of the organisation. Leadership is the central ingredient necessary for progress as well as for the development and survival of organisations, especially in a changing environment such as is evident in South Africa. This study was undertaken to explore and describe the views of health professionals with respect to factors that promote or influence leadership effectiveness in public hospitals, with specific reference to Uitenhage Provincial Hospital. The research design of this study was a quantitative, explorative, descriptive survey. Interviews were conducted to explore and describe the views and perceptions of healthcare professionals (clinical and nonclinical), and the management of the Uitenhage Provincial Hospital, regarding leadership effectiveness in a public hospital. Firstly, a literature study was conducted on healthcare leadership generally and to identify various leadership approaches and factors that influence leadership effectiveness. More emphasis was put on the current and the most recent approaches to leadership. Secondly, an empirical study was conducted to gain the views and ideas of health professionals regarding leadership effectiveness in the institution. Lastly, the results of the empirical study were evaluated, conclusions were drawn and recommendations were made, based on the information obtained from both the literature study and the empirical study.

A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in partial fulfilment of the requirements for the degree of Master of Public Health. Johannesburg May 2013 / Introduction: The intention of this study is to explore how members of the South African public perceive private and public hospitals in the country. A better understanding of both positive and negative perceptions can guide improvements in public sector services and strengthen public confidence in the health system. Methodology: Eight focus groups, delineated in terms of race and experience with the public/private sectors were run. Thematic content analysis was used in analyses. Results: There was an almost-automatic perception that private hospitals are “better than” public hospitals. However with further exploration, a much more nuanced set of perceptions, acknowledging positive and negative components of each sector, emerged. Discussion: The key concepts arising from this study focussed around issues of trust and the acceptability of health services, which includes discipline, responsiveness, assurance, respect and dignity, choice of health care provider, confidentiality and communication .Currently within the introduction of a National Health Insurance v (NHI) system in South Africa, trust and acceptability of health services are crucial determinants of the extent of the buy-in that the public will demonstrate towards the planned changes.

M.Cur. / The problem of strikes within the public institutions has infiltrated the health sector and has led to nurses participating in the strike action, which affects patient care. The involvement of unions and works' representatives in the health services cannot be wished away as it is a political and constitutional reality in South Africa. The researcher is concerned about the quality of awareness of nurses of the causes of strike action. Confusion amongst nurses about their professional rights and responsibilities contributes to labour unrest. The management of health services is at times not sensitive to the needs of nurses, and nurses are not always recognised for their inherent professional worth. The nursing management is also apparently confused about their roles and responsibilities towards their subordinates in respect of exerting their authority whilst not having the power to make decisions. The researcher, as an observer of the chaos caused by strike action in the health services, decided to investigate the matter through a phenomenological study. The parameters of nursing and beliefs about man, health, illness and nursing are also described. The following questions were generated : Why do nurses participate in strike action? How do professional nurses and nursing service managers experience strike action? What nursing service management strategy can be developed to prevent future strike action by nurses? The objectives of the study are to: Explore and describe the reasons why professional nurses participate in strike action in a public hospital in Gauteng. Explore and describe how strike action is experienced by professional nurses and nursing service managers; and To describe a strategy for nursing service managers to prevent future strike action by nurses within a health delivery system

Submitted in fulfillment of requirements for the Degree of Master of Health Sciences: Nursing, Durban University of Technology, Durban, South Africa, 2016. / Introduction Through centuries the birth of a baby has been considered as a deeply felt spiritual experience. Childbirth is not merely a physiological experience; it also embraces social, emotional, psychological, spiritual and religious aspects. In most Western societies the sacred moment of birth dissipates within the context of a pressured hospital environment. Whilst literature and empirical research has proliferated on midwifery very little has been done to explore how women experience childbirth personally and more importantly how spirituality interfaces within the context of the childbirth experience and midwifery care. There is a growing body of literature on spiritually sensitive care. However, there remained a need to inquire about mother’s personal experience and how spirituality interfaces with the childbirth experience in the hospital context. Problem statement Whilst empirical research in the field of midwifery, has grown, research pertaining to the spiritual aspects related to women’s diverse spiritual needs during childbirth is sparse (Crowther and Hall 2015). Furthermore little attention has been paid to issues relating to how women experienced childbirth in the public sector, and how religion and spirituality influence and impact on childbirth. It is against this background that the current study was conceived. Purpose of the Study The purpose of this study was to explore and describe the experience of childbirth amongst women from diverse spiritual or religious backgrounds viz. Christianity, Islam, African Traditional Religion and Hinduism, at public hospitals in the uMgungundlovu District of KwaZulu-Natal. Methodology A qualitative, explorative, descriptive and contextual study design was used. A total sample of twenty-two postnatal mothers from the following common spiritual backgrounds in South Africa viz. Christianity, Islam, African Traditional Religion and Hinduism were purposively chosen. Data was collected until saturation. Participants were selected from three public hospitals in the uMgungundlovu District of KwaZulu-Natal. Data was collected by means of semi-structured interviews conducted six weeks post-delivery at the six-week health check, but within three months of delivery. Interviews were transcribed manually; the data was analysed through thematic analysis. Findings The main themes drawn from the data reflected that childbirth was a deeply personal and meaningful experience. It was seen as a spiritual experience and spirituality was seen as a vital support system in enabling mothers to cope better with pain and other challenges. Emotional and comfort needs were also identified by mothers as being very important to cope with pain and an easier delivery. The presence of midwives and the need for partner and family support were also seen to be important. More importantly the study found that their spirituality and spiritually based activities and rituals were an important aspect of the overall birth experience. The study found a diverse range of spiritual practices and rituals that were salient across all the spiritual worldviews during childbirth and post-delivery. It also found that mothers often resorted to alternate and traditional therapies to help cope with labour and delivery all of which have salience to midwifery practice that is both respectful and sensitive to the diverse worldviews of mothers. Conclusion Collectively the data reflected that childbirth was a holistic experience that cannot be separated also from partner, family and medical support. Whilst traditionally effective midwifery practice may have been so to focus on primarily physical care, the study found that the physical component is interrelated with the psychological, social and cultural aspects as well. Hence effective and ethical midwifery practice is inseparable from these facets but most importantly inseparable from the spiritual worldviews that most mothers follow and ascribe to. Contemporary education needs to recognize the current move towards spiritual care and provide knowledge and skill to deal with patients from diverse spiritual backgrounds. Finally it needs to recognize as this study has found, that childbirth is a multifaceted experience which is spiritual in nature. Viewed in this way both midwives and the management of public hospitals should then make every effort to create spiritually sensitive care during the childbirth experience. / M

The research problem addressed in this study was to identify what management skills do middle managers require to manage the organisational units effectively. To achieve this objective a theoretical model of management skills required by middle managers to effectively manage a public hospital was developed, using relevant literature in which management skills are identified. The theoretical model consisted of the following categories of management skills whose correct application can promote managerial effectiveness in managing organisational units: General management skills; Technical skills; Human skills; Leadership skills; Financial management skills; Computer skills. Each category of the management skills was broken down into elements that were then analysed using literature identified during the literature study. The model was then used to develop a questionnaire to assess the degree to which managers responsible for running the clinical, nursing and paramedical departments of a public hospital in the Eastern Cape rate the elements in terms of importance. The empirical results obtained indicate that a wide variety of skills are regarded by middle managers as important to performance of their managerial roles. This resulted in the theoretical model being confirmed and the identified management skills being accepted as management skills required by middle managers to effectively manage a public hospital in the Eastern Cape.

M.Cur. (Nursing Administration) / Please refer to full text to view abstract

Knowing about .AIDS and the manner in which it can be contracted in the workplace is essentlal for preventing infection. This thesis attempts to explore whether non-medlcal hospital workers are placed at risk of Infection by virtue of their ignorance of the virus and further seeks to investigate whether "expert" knowledge possessed by professional health workers is disseminated to less-skilled and less-knowledgeable workers. Processes around class and status involved in social closure are investigated to account for the lack of communication concerning AIDS amongst hospital workers. Two research procedures were adopted in this study, namely the intensive interview and participant observation. Findings of the thesis indicate that though all hospital workers are at risk of AIDS infection, unskilled workers remain more vulnerable because they lack knowledge and awareness of the virus. Factors of class, status, educational opportunity and professional elitism striate the hospital workforce and result in exclusionary practices, including the non-dissemination of knowledge about AIDS in the hospital work setting

Thesis (MTech (Public Relations Management ))--Cape Peninsula University of Technology, 2010 / The aim of this study is to examine the relationship of public relations and marketing and how these two functions can fuse their work without encroaching on each others fields. The strategic corporate function of stakeholder management is used as the platform to illustrate this proposed mutually beneficial relationship. The theoretical approach to the study is directed at exploring the three different fields of public relations, marketing and stakeholder management by outlining the general theory of excellence in corporate communication; marketing management theory; and stakeholder management theory. The public relations and marketing role within the Life Healthcare hospitals in the Eastern region are explored through a quantitative study aimed at gaining the incumbents' (in the public relations/marketing positions) view on their outputs within their function mapped against the outputs needed as viewed by the dominant coalition of the various hospitals. The incumbents' contribution to; and the dominant coalition's view of stakeholder management is also explored through the same dual view approach. Differentiating the roles' (public relations and marketing) contribution to stakeholder management (as subset against the theoretical background of what these roles should entail) are the outcomes of this quantitative study in the Life Healthcare group - Eastern region. This will then provide the platform for creating a framework of synthesis where public relations and marketing can collaborate in stakeholder management. Therefore, the outcome of this study, firstly, is a framework for the collaboration of public relations and marketing in stakeholder management within the Life Healthcare Group Eastern region. The framework creates a synthesis of the two corporate functions so that both can effectively contribute to the hospitals' strategic relationship building process in their own right as is necessary in excellent organisations. Secondly, it highlights insights gained (through the quantitative study and exploration of theory) into the public relations and marketing function within the region, and outlines problem areas that should be tackled by the dominant coalition if they are to elevate public relations and marketing to a function which can contribute to the broader organisational strategy.