The aim of this study was to identify the health needs and problems of black employees within the Germiston City Health Department in order to indicate a possible relationship between such needs and problems and a high rate of absenteeism. Although the findings could relate to all employees, this study was limited to black employees only. Data was collected by means of observation, perusal of health records and personal interviews with personnel as well as with the selected sample. The results of the study highlighted the specific health needs and problems of employees as well as factors which could influence their health status and which could contribute to the problem of absenteeism. The main factors identified included interalia poor working conditions and unsatisfactory methods of solving employees problems. Relevant recommendations were made ;· to address the problem of absenteeism in the Germiston City Health Department / Health Studies / M.A. (Nursing Science)

With the advent of the new National Health Act, health care in South Africa is at a critical point as this will be the first time in history that a National Health Insurance is being implemented in this country. Globally National Health Insurance has been around for more than a hundred years, however some countries with long established national health schemes are currently grappling with funding issues surrounding their health systems. South Africa should take note of these issues as it embarks on this journey. The objective of this study was to perform a literature review on how South Africa’s National Health Insurance can be funded taking cognisance of the history of the country and experiences of other countries. It is imperative for each country to achieve optimal health care funding to ensure the success and long-term sustainability of National Health Insurance. The analysis of the problems experienced by other countries revealed that balancing the three main funding options namely, allocated from the national revenue fund, user charges and or donations or grants from international organisations, is critical as the funds needed in a system to achieve coverage at an affordable cost is dependent on the current state of health care in a country. Considering South Africa’s history and current inequality in society and health care it is clear that the majority of funding for the National Health Insurance should be supplied by the national revenue fund. The required funds can either be raised by increasing existing taxes or introducing a new tax specifically aimed at financing the National Health Insurance. The use of user charges is important however, although not purely for a revenue collection point, but from a cost control point of view as well. Some studies have revealed that the lack of user charges results in a misuse of the system. / Financial Accounting / M. Phil. (Accounting Science)

The purpose of the study was to determine professional nurses’ knowledge of culture- competent care at selected medical and oncology wards and outpatient departments in Mopani District, Limpopo Province. A quantitative descriptive design was used and data collected from one hundred and five professional nurses by means of a structured questionnaire. The study found that cultural knowledge needs to be nurtured through continuing education and mentoring and that culture-competent care should be included in the curriculum. Furthermore, cultural knowledge is not effective if there is no correlation of theory and practice and early clinical placement of student nurses during their basic training / Health Studies / M. A. (Health Studies)

Submitted in fulfillment of the requirements for the Doctoral Degree in Nursing, Durban University of Technology, Durban, South Africa, 2016. / This mixed methods study aimed to assess the functioning and processes of the Fast Queue Service Point in order to analyse the quality of care rendered in primary health care (PHC) facilities in the eThekwini district of the KwaZulu­ Natal Province in South Africa. The Fast Queue Service Point provides service in PHC facilities for health care users requiring short consultations. Congestion of PHC facilities is a result of increased access to PHC services with the introduction of free PHC services. This congestion was aggravated by the decentralization of services from hospitals to PHC level such as the introduction on Nurse Initiated Management of Anti-Retroviral Therapy (NIMART). In 2010, the National Core Standards (NCS) for health establishments were formulated further to the PHC Service package, to address issues of quality. An explanatory sequential mixed methods study design was used and data collection was conducted in two phases; the quantitative data collection phase consisting of two subsets of observations namely; the retrospective record review and structured observations of the Fast Queue Service Point process. The Statistical Package for the Social Sciences (SPSS) version 22 was used to analyse data. During the second phase semi-structured interviews were conducted with PHC staff members to describe their experiences of the Fast Queue Service Point and to clarify issues from the quantitative phase. Although Fast Queue Service users received sufficient care, there were important care assessments that had been inadequately performed or omitted. These included discussing side effects of medications and or immunizations and management thereof. Childrens' weights were not interpreted, an important aspect for children under five years of age. There was also lack of supportive supervision coupled with shortage of resources and too many time-consuming written records that were required to compile accurate statistics. Retraining and in-servicing of health personnel and making resources available, would assist in strengthening patient assessment, management and recording thereof. While clinic managers require to offer supportive supervision to health care providers, provision of lower categories of staff would be beneficial in supporting PNs and ENs so that they have time to compile records for statistics purposes, which were found to be taking up the bulk of their time. The framework for continuous quality improvement in implementing a Fast Queue Service in PHC settings was developed based on the findings of the study / D

Thesis (MComm)--Stellenbosch University, 2002. / ENGLISH ABSTRACT: Historically health care in South Africa has been an area of great inequity. Health care was inequitable, inadequate and racially based. In order to redress the gap in the delivery of health care services, created by the previous dispensation of separate development, the National Department of Health has adopted a Primary Health Care (PHC) approach as the guiding principle for the reconstruction of the health system in South Africa. One of the pillars of this approach is the empowerment of communities to participate, thus moving from facility based- to community based health care. The aim of the National Health System (NRS) is to promote health and health knowledge, to provide an equitable, accessible, and appropriate health service, and to empower people to take greater responsibility for their own health. It is constructed around the belief that health for all cannot be achieved simply by improving the formal health system, but that a holistic and multi-sectoral approach is required. This thesis explores the community health worker (CRW) as a possible cost-effective and efficient supplementary service, to the current formal health system, to bridge the gap in the formal health system through the provision of PHC services in a rural setting. This was done through the economic evaluation of a CHW programme operating in the Winelands are of the Western Cape. The aim of this study was to evaluate and analyse the nature, performance, and costs of the programme and place it in context by comparison to other similar programmes. This comparison focused on physical characteristics, goals, and cost structures. It also aims to measure the direct and indirect impact of this type of intervention on the agribusiness sector as well as the local health authorities. The evaluation proceeded from the premise that the CHW programme, if implemented correctly with proper and appropriate training, and adequate post training support, will be a cost-effective and efficient model for the provision ofPHC services in this rural/farming area. The economic evaluation of this CHW programme required it to be viewed from two perspectives. The first component viewed the implementation of the programme from the perspective of the agribusiness sector. This aspect of the study included both a qualitative as well as a quantitative VIew of the costs, benefits (perceived or otherwise), and perceptions of the CHW intervention. The second component assessed the CHW programme within the context of a resource constrained public sector health budget. Since the implementation of this programme implies certain expenditures on the part of the local health authorities, these cost had to be identified and quantified to gauge the effectiveness of that expenditure. / AFRIKAANSE OPSOMMING: Geskikte en doeltreffende gesondheidsdienste in Suid-Afrika se onlangse geskiedenis was nog gereserveer vir 'n uitgesoekte groep mense. Die gesondheidstelsel was ontoereikend, onvoldoende en gebaseer op ras. Daar het 'n gaping ontstaan tussen die dienste wat gelewer is en die werklike behoeftes van die mense wat dit moes gebruik. Ten einde hierdie gaping aan te spreek het die Nasionale Departement van Gesondheid besluit om 'n Primêre Gesondheidsorg (PRe) benadering te volg wat klem plaas op die bemagtiging van plaaslike gemeenskappe deur deelname. Dit was 'n duidelike skuifvanaffasiliteit- na gemeenskap gebaseerde gesondheidsdienste. Die oorkoepelende doel van hierdie verskuiwing in fokus was om voorheen benadeelde gemeenskappe voldoende toegang te gee tot gesondheidsdienste en ook om hierdie dienste aan te pas by die behoeftes van sodanige gemeenskappe. Hierdie tesis ondersoek die Wynland distriksraad se Gemeenskap Gesondheidswerker Program as 'n moontlike koste-effektiewe stelsel vir die lewering van toepaslike primêre gesondheidsdienste in landelike areas. Die doel van die studie was die sistematiese ontleding van die werking en omvang van, en die kostes verbonde aan die implementering en onderhoud van hierdie program. Die studie poog om die impak van hierdie program op die formele landbou sektor asook die plaaslike gesondheidsowerhede te identifiseer en, waar moontlik en prakties wenslik, te kwantifiseer. Die ondersoek sluit in die stelselmatige ontleding van kostes en voordele vir die formele landbou sektor sowel as die plaaslike gesondheidsowerhede. Die kostes asook die kliniese uitkomste geassosieer met die implementasie van die Gesondheidswerker program sal dan in konteks geplaas word deur dit te vergelyk met ander soortgelyke programme wat in die verlede aangepak is. Die vergelyking sal fokus op die fisiese eienskappe, koste struktuur, bronne van ondersteuning en die primêre doel van die intervensie.

This study takes the concept of ubuntu, which means humanness and applies it to healthcare issues in general, and women's health, in particular. Ubuntu is based on the reality of interdependence and relatedness. It is a philosophy or way of life that finds its roots and meaning in humanity. The values espoused in ubuntu emphasize caring, sharing, reciprocity, co-operation, compassion and empathy in recognition that for human beings to develop, flourish and reach their full potential, they need to conduct their relationships in a manner that promotes the well-being of others. The values championed in ubuntu are what inform and shape African cultural, social, political and ethical thought and action. / Thesis (Ph.D.)-University of KwaZulu-Natal, Pietermaritzburg, 2007.

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 South African health care environment is a two-tier health care delivery system consisting of the public sector and the private sector. The focus of this study is on the private health care sector. Private health care is funded by medical schemes through employer and employee contributions. The private sector is also the most profitable sector for multinational pharmaceutical organisations to market and sell their products within the South African health care environment. The major cost saving initiative by employers and medical schemes in the private health care sector has also been the introduction of managed health care initiatives. The goal of managed health care is to establish a system which delivers value by giving people access to quality and cost-effective healthcare. The new reality of managed health care initiatives are changing the boundaries of the South African pharmaceutical industry. The managed health care wake is overturning the business processes which made the pharmaceutical industry so successful and are rendering obsolete the industry's conventional models of corporate strategy and management systems. In the context of these turbulent changes, pharmaceutical companies are being forced simultaneously to develop new strategic approaches for the future, design new business processes which will link them more firmly to their new customers, and implement the cultural changes neccessary to accomplish the transformation from yesterday's successful pharmaceutical company to tomorrow's customer-led, integrated health care supplier. The way forward lies in three organising concepts. The first is cutomer alignment. The effort of transformation must start with an understanding of how the customer defines the value of the services and/or products offered by the organisation. Everything that follows involves aligning internal processes with external contingencies. The second is sequencing. It is vital to understand not just what needs to happen first in the transformation process, but also what the subsequent steps is and in what order the steps need to be undertaken. The third organising concept is learning. The sequence of interventions that lead to organisational transformation must occur in such a way as to maximize the ability of the organisation to learn: from customers and the marketplace, and from itself. / Business Management / D.B.L.

The purpose of this quantitative, descriptive study was to identify shortcomings in the implementation of the Batho Pele Principles in a public hospital. Findings were obtained from a range of patients who had been admitted to specific units for three or more days, and more evidence was gathered from articles in mass media. Data was collected through a structured questionnaire from one hundred respondents (n=100) and analysed by means of descriptive statistics. The research findings revealed that none of the Batho Pele Principles were implemented effectively and that patients in general were not satisfied with treatment in public hospitals. Shortcomings are attributed to insufficient management skills and knowledge on different levels of the health care system, as well as a lack of awareness among patients of their rights and responsibilities in health care. / Health Studies / M.A. (Public Health)

The study aimed to explore and described the assessment of patient’s satisfaction with the quality of health care services rendered by the Crossroads Community Health Centre (CHCC). The target population comprised of adult male and female patients who have attended the clinic more than once. One hundred and twenty patients participated in the study. The convenience sampling method was used to select the respondents. A questionnaire was used to collect data. Validity and reliability were ensured. The Chronbach’s alpha reliability test was used to measure the internal consistency of the likert scale questionnaire items and was less than 0.4 for sections B-F, and 0.675 for section E. Descriptive and inferential data analysis was conducted using the Statistical Package for the Social Sciences 16.0 for Windows, release 16.0.1 with the assistance of a statistician. The findings indicated a positive perception of the quality of health care services rendered by the Crossroads CHCC. It was concluded that despite a positive perception of the health care services, there was a percentage of the respondents that rated the quality of the service as poor in relation to environmental cleanliness, staff attitudes, long waiting times, medications shortage, the complaints system reporting and health care service drainage to other CHCC where patient’s resided. The issue of quality improvement in these aspects was noted to be crucial and recommendations were made to improve the quality of the health care service at Crossroads CHCC. / Healh Studies / M.A. (Health Studies)