The study sought to investigate the factors influencing the contents of antiretroviral therapy (ART) reports in the Amathole Health District of the Eastern Cape Province. A qualitative and quantitative study was conducted to assess the challenges that inhibit this phenomenon. Structurally, the population consists of Amahlati and Nkonkobe sub-districts. Operational managers, information officers, professional nurses, data capturers, and administration clerks were randomly selected from sixteen facilities. Data collection was done on semi-structured interviews, questionnaires; observations were done using the probability sampling method, and the findings were analysed according to the same technique. The study revealed that the District Health Information System (DHIS) is the universal data management and reporting system which all healthcare and ART facilities are using to manage ART. However, regardless of all these universal arrangements such as the use of the DHIS to aid in reporting, the contents of ART reports from various facilities have not been uniform due to various factors. There is a lack of a reliable network to link DHIS computers across facilities. The shift from paper-based to electronic data management has caused the difficulties in the collating and management of ART data since some facilities are manual paper- based while others are automated using the modern DHIS. Lack of daily capturing and validation is a major challenge across the ART facilities. Further, there are Non-Governmental Organisations(NGOs) such as AFRICARE and the IYDSA that have signed a memorandum of understanding (MOU) with the district to provide a budgetary support for staff training in data management of ART reports in the district. While the NGOs keep on assisting the ART facilities with data management, there is a lack of skills transfer. The district could not account on follow-up of ART patients from one facility to another. This is increasing the number of defaulting in ART patients, thus there is no accurate figures on retention of patients in ART Programme. The officials from ART sites tend to use their own transport to carry data from facilities to the district offices and this resulted in late submission of reports. The study thus recommends that, inter alia, data management and trainings should be done to improve data quality in reporting, a reliable computer network be installed, backed-up and maintained for data and report management in the all healthcare facilities. All the ART sites should adopt and use the automated data management system for universality and eliminating the faults of manual paper data management and reporting. This would ensure that the contents of ART reports are uniform and a true reflection of the situation on the ground towards universal access to ART and healthcare in the Amathole Health District, and South Africa at large.

The Republic of South Africa emerged as 'a product of a historical moment' and also as a reaction against imperialism, colonialism, racial discrimination and domination over the majority of black South Africans by the white minority. The democratic dispensation came into being also for the first time in its life in memorial for a long turbulent history followed by the general democratic elections held on 27th April 1994. The 1994 first general election liberated South Africa from the apartheid system and its subsequent primary objective was “… to transform South Africa into a non-racial and democratic society”. The new democratic government now looks politically different from the racist regime because the current government since 1994 has been, and to date still is, a truly and broadly representative of the South African citizens and also a transparent one, whereas the defunct apartheid government was characterized primarily by, among other things, the violation of human rights, denying black South Africans of any rights of basic services, no rights of owning property or land, no freedom of association and speeches and firmly practised discrimination which was detrimental to the majority of the black population groups in this country. According to the then President Nelson Mandela whilst addressing the ANC masses that were commemorating the eighty-third (83rd) anniversary of the African National Congress on the 8th January 1995, democracy entails “… a thorough-going process of transformation, of overcoming the political, social and economic legacy of apartheid colonialism, of racism, sexism and class oppression.” The government is still grappling with the challenge of ensuringa better life for all the citizens of this country (http://www.anc.org.za/show.php?doc=ancdocs/history/jan8-95html:1).

The purpose of the study is to investigate lived experiences of refugees when accessing healthcare services in Pretoria, South Africa. A qualitative phenomenological research approach was followed which assisted in exploring and describing the day-to-day lives of refugees living in Pretoria regarding their health outcomes. Face-to-face interviews were conducted on purposively selected participants, representing refugees from different African countries ranging from age 27 to 58 years. Collected data were transcribed, coded, and relevant themes were extracted and analysed by employing Colaizzi's seven-step analysis framework. Main findings demonstrated that the public healthcare services accessed by refugees, compared to private healthcare services, can be described as mostly dysfunctional. Also, healthcare providers from public healthcare services are often hostile towards refugees of African descent. Failure to speak a local language, unofficial documentation as viewed by a healthcare provider on duty, being a foreigner, and failure to pay undue consultation fees led to refugees being denied access to healthcare or receiving negative treatment in the public healthcare sector. Recommendations for programmes to promote human rights and refugee awareness in healthcare facilities could subsequently contribute to alleviating complications around access to healthcare services, which would denote improved health outcomes for the refugees. / Health Studies / M. P. H. (Health Studies)

MPH / Department of Public Health / South African youth, like many young people the world over, experience obstacles related to accessing age-specific health care services. School-based health centres, therefore, represent a mode of delivery of youth-friendly services tailored to meeting the healthcare needs of young people, such as university students. The aim of the study was to investigate the barriers faced by University of Venda (UNIVEN) students in accessing the institution’s health services.The objectives of the study were to assess the level of awareness of the respondents regarding the UNIVEN campus health services and to determine the availability and acceptability barriers experienced by students in accessing the campus health services.The study is quantitative using a self-administered questionnaire, informed by literature review, to collect data from the respondents. The study population consisted of all the students who were resident on campus. The sample size were five hundred and thirty four (534) respondents drawn from all the residences on the university campus and comprising of students from all the schools and levels. Questionnaires were administered face-to-face to respondents in the respondents’ rooms. The validity and reliability of the study were ensured. Ethical considerations, such as informed consent, right to privacy, and no-harm to participants, were observed and addressed in this study. Data was entered and analysed using Statistical Package for Social Sciences 23. For continuous variables such as age, descriptive variable was calculated. For categorical variables, frequencies and percentages are presented.The results indicated that the average age of the study population was 21.85 years with almost all of the respondents (95%) being aware of the existence of a health clinic on the Univen campus. However, only 63% had gone for consultation at the clinic. Awareness of the clinic’s services appears to be poor, with HIV Counselling & Testing being the most known service, while minor illnesses’ management was the most utilised service (48%). Barriers experienced by the respondents were related to waiting times and opening hours of the clinic, with only 33% and 39% respectively, describing them as ideal.The study provides evidence that although university health services may be provided at no cost students still experience barriers in accessing them. Effective measures are needed to increase students’ awareness of the clinic’s services and to shorten waiting times and improve clinic opening hours.

MPH / Department of Public Health / See the attached abstract below

PhDH / Department of Advanced Nursing Science / Background: The National Committee for the Confidential Enquiries into Maternal Deaths recommend the implementation of “Saving Mothers’ recommendations” as a measure to reduce maternal deaths. However, this objective has not been achieved because the Maternal Mortality Rate in South Africa was standing at 134.33/100 000 live births and Limpopo Province at 165.16/100 000 live births. The national target for reduction of maternal mortality was 20% for all provinces for 2016. Limpopo Province’s reduction was below 12.5% for 2016. Purpose: The purpose of the study was to develop a strategy to enhance the implementation of the Saving Mothers’ recommendations in the maternity units of Limpopo Province. Methods: The convergent parallel design was used in this study. The study was conducted in phases, namely: Phase 1(a) was a qualitative research approach and a non-experimental, descriptive and exploratory design. The population consisted of district managers who were managing the Maternal Health Services and registered midwives who were working in the maternity units of Limpopo Province. Non-probability purposive sampling was used for both the district managers and the registered midwives. Data were collected using a central question for the managers managing Maternal Health services which was “What support are you giving to facilitate the implementation of the recommendations by the Saving Mothers Report?” and the question for the registered midwives was “What challenges are you experiencing when implementing the Saving Mothers’ recommendations.” Tesch’s open-coding technique was used to analyse qualitative data. Trustworthiness was ensured through credibility, confirmability, dependability, transferability and authenticity. Phase 1(b) was a quantitative and a non-experimental descriptive design. The population comprised of 200 patients who were included in the study. Questionnaires were developed and used to collect ABSTRACT vi data. Data was analysed using the Statistical Package for Social Sciences (SPSS, version 24.0) with the assistance of the statistician. Discussion of data were done in an explanatory sequential way where data from Phase 1a was discussed and supported by data from Phase 1b. Findings: The themes that emerged were: Challenges related to implementation of the recommendations of the Saving Mothers Report in maternity units, Description of existing training programmes and in-service education for health care professionals, Knowledge on implementing recommendations for the Saving Mothers Report when providing care in maternity units and Suggestions related to improvement of adherence to recommendations for the Saving Mothers Report in maternity units. Some of the themes were supported by the quantitative results whilst some not supported. Validity and reliability were ensured by giving the questionnaires to experts on the subject, colleagues and promoters to analyse and determine if items adequately represent content in the correct proportion. Ethical considerations were ensured by obtaining ethical approval from the University of Venda Ethics Committee and permission to access the facilities from the Limpopo Province Department of Health. The participants signed informed written consent. Phase 2 entailed strategy development and validation of the developed strategy. Recommendations: The recommendations included that the Department of Health should employ more staff and put operational managers in permanent positions. Sufficient equipment and supplies essential for maternal health care and maternal health infrastructure should be procured and a good plan for the managing thereof implemented. It is also recommended that health care workers should work hand in hand with the community structures and the ‘mosate’. / NRF

MPM / Department of Public Health / The dawn of democracy in 1994 saw huge strides in the adjustment of various statutory instruments that aimed at opening the systems to all South Africans particularly the previously excluded groups. Health care system was one of the ear marked areas by the South African government for post-apartheid transformation. Resultantly, access to health care was declared a right and incorporated into the Constitution of the Republic of South Africa 1996. Numerous legislative and practical steps towards achieving access to health care for all have been made with notable results. However, due the apartheid spatial planning which persuaded separate development left some sections of the community remote and with no infrastructure to support health care delivery. As a result, this has made the realization of the health care for all dreams elusive. Reportedly, the most affected communities were mainly homelands which were largely rural and townships. Despite notable improvements in the delivery of health care services across the Republic, there are still major challenges faced in this sector mainly in the rural areas and townships. Therefore, the study was set to investigate and evaluate the state of health care service delivery in rural Ndengeza Township. The study employed both qualitative and quantitative method following a descriptive design (cross-sectional) and data was collected using a self-administered questionnaire and interview questions. The results revealed that transport, staff-patient relationship, unavailability of medication and medical staff were the major challenges of health care service delivery in rural areas. The respondents alluded that to improve health service delivery in the area, there is need to make available basic medication and trained medical personnel. It is believed, by the participants, that adding the number of staff will go a long way in changing the negative perceptions such as long queues, unavailability of critical services and unprincipled professionals that the public have of the local health care centers / NRF

The purpose of this study was to explore and describe the knowledge of clients regarding renal donation at a specific urban health care facility in the Limpopo province. A quantitative, explorative, descriptive and cross-sectional design was used. Data was collected using a structured pre-tested questionnaire. Out of 317 questionnaires, 300 were valid and considered for the study. Analysis was done using Statistical Package for Social Sciences (SPSS) computer software version 25. Data was presented using tables, graphs and charts. The study revealed that 32% (n=95) were males and 68% (n=205) were females. The results showed that there are a significant correlations between the attitudes, knowledge and actions of clients with regards to renal donation. The study revealed inadequate knowledge on the majority 74,7% (n=224) of the respondents on renal donation. A recommendation was that awareness campaigns on renal donation to be planned on world kidney days. Furthermore, the recommendations of the study will be presented to the Limpopo Department of health to take effective measures to educate people with relevant information on renal donation. A policy regarding awareness programme of renal donation should be developed. / Health Studies / M.A. (Public Health)

Curative primary health care nurses are the first level of contact with health personnel the patient has when entering the district-driven health system of South Africa. It is imperative that these nurses are competent, or patients may suffer. Several factors exist as barriers to competent curative care. Donabedian's structure-process-outcome framework has been used in the study of these factors. Literature were selected from international and national studies of nursing to discover barriers and enablers in general nursing care but also specifically in curative primary health care. The curative primary health care nurses in the Southern Cape/Karoo region were used as a sample for the study. Data gained from questionnaires were organised to present the findings: Barriers to a curative PHC service seem to be multifactorial, with scarce resources causing great stress for the workforce. This have a negative impact on relationships between employer and employee, CPHCNs and their patients, the type of managing that take place, and the quality of the examination and treatment of patients. Slow changes frustrates workers, causing more stress and poor attitudes, feelings of not being valued, and not being motivated (internally and externally). Enablers examined showed that although the workforce may be discontented and overworked, they still try to deliver their best, with few medical mistakes. Patients still have a lot of respect for their healthcare deliverers, but this trend may not continue for much longer. Patients are already returning more often to clinics, causing even more stress for staff. / Health Studies / M.A. (Health Studies)

The study was aimed at furthering the health objectives of the government's Reconstruction and Development Programme (ANC 1994b) in the area of primary health care. . The purpose of the study was to examine the possible reduction of medical scheme claims for cardiovascular disease by means of primary health care, so that medical scheme benefits do not become exhausted so rapidly. The overall outcome of the study showed that if cardiovascular disease could be diagnosed and treated early, the financial benefits could be substantial. This was illustrated by the comparison of primary, secondary and tertiary treatment of cardiovascular disease using case studies over a period of one year. Recommendations centered around nurse-based primary health care for cardiovascular disease and the cost-effective management of the medical scheme. It was concluded that as a result of nurse-based primary health care, costs could be contained so that medical scheme benefits would not become exhausted so rapidly. / Health Studies / M.A. (Nursing Science)