Dissertation submitted in compliance with the requirements for the Masters Degree in Technology: Nursing, Durban University of Technology, 2016. / Introduction Although the South African Government adopted a primary health care approach to health care service provision in order to ensure equitable access to and utilization of health care services to all communities, the country continues to face challenges regarding access and utilisation of health care services especially in the rural communities. Antenatal care which is mostly provided at primary health care level is regarded as the cornerstone for the success of the maternal and child health care programme. Therefore, poor access to and under-utilisation of health care services could potentially influence the success of this programme and pregnancy outcomes. Aim of the study The aim of the study was to determine whether pregnant women from KwaMkhizwana rural community had access to and were utilising antenatal care services. Methodology A qualitative, exploratory, descriptive and contextual study was conducted guided by Thaddeus and Maine’s three delays model. Purposive sampling of the pregnant women and all categories of nurses who were employed in the three health care facilities in the area was done. Data was collected in two phases through in-depth semi-structured interviews with both the pregnant women and the nurses respectively between February and March 2016. The sample size was guided by data saturation. All data were analysed using the Tesch’s method of data analysis. Study findings Six major themes and several sub-themes emerged from the interviews with both Phase 1 and Phase 2 participants. The major themes included: 1) access to health care and emergency services, 2) availability of human and material resources, 3) social and cultural beliefs, 4) past pregnancy experiences, 5) communication and transparency regarding health care service delivery and 6) quality of antenatal care services. Summary of the findings The pregnant women encountered several challenges which led to delays in seeking, reaching and receiving antenatal care. Most of the pregnant women participants related limited access to health care, with under-utilisation of antenatal services. They were unhappy about the antenatal care services they received in the three available health care facilities in the area, which made these facilities to be inaccessible and underutilised. The nurse participants recognised the challenges facing the pregnant women regarding the access and utilisation of antenatal care services, together with the challenges faced by the nurses while working in the three available health care facilities in the area. Recommendations The recommendations that were made included: to consider building a centrally located fixed primary health care clinic that would ensure equal access to health care services, strengthening the implementation of policies regarding the referral system and ambulance services, ensuring sustainable availability of human and material resources, developing strategies to ensure that the antenatal care services are delivered in line with the South African Department of Health policies and guidelines and strengthening community education. A further study on provision of antenatal care services in the area is also recommended. / M

A Research Report submitted to the Faculty of Humanities, University of the Witwatersrand, Johannesburg, in partial fulfilment of the requirements of the Degree of Master of Arts, Applied Ethics for Professionals. Johannesburg, 2017 / Many asylum seekers and refugees in South Africa reportedly find it difficult to access basic health care services. The issue about foreign nationals in relation to health care can be considered from different angles. The concept of access, though, points to gate-keeping. Gate-keeping is the practice that guides decision making about who has access to what and to what extent they might enjoy benefits. In this essay, the question of whether gate-keeping is a morally justifiable practice in South Africa in relation to asylum seekers and refugees’ right to basic health care services is explored. It is concluded that carefully considered and consistently implemented gate-keeping might be a morally justifiable practice that could contribute to ensuring that resources are distributed fairly. It is also argued that the kind of gate-keeping often observed is inconsistent with human rights and Ubuntu precepts. These moral frameworks seem to be the main ones shaping the view of most South Africans as well as our institutional arrangements. Considering the current South African context in which asylum seekers and refugees have difficulty in accessing basic health care services, patriotic bias claims are considered. However, it is concluded that partiality towards compatriots ought not to hold sway when any human being’s basic needs are at stake. / MT2018

M. Tech. Graphic Design / Fetal Alcohol Syndrome is a congenital syndrome cased by excessive consumption of alcohol by the mother during pregnancy, characterized by retardation of mental development and of physical growth. Lack of public information and intervention is one of the reasons why the syndrome persists in townships and rural areas. This study was undertaken in response to the lack of public knowledge within high-risk communities concerning Fetal Alcohol Syndrome. The study hypothesized that embedding persuasive techniques within health communication material would create effective health communication campaigns that would be well received by target audiences.

M. Tech. Business Information Systems / Field-based healthcare is the provisioning of healthcare outside a traditional healthcare facility whose location is fixed. Although healthcare is not location and time dependent, the delivery of the service is often constrained to particular location and time. That is, although data accuracy and timely access to medical information is vital, healthcare service providers are not mobile enough to provide the on-demand healthcare service to patients. With restricted mobility, mistakes, unavailability and inaccuracy of information can have life-threatening consequences. To this point, this mini-dissertation argues that Mobile Information Technology (IT) Innovation could leverage field-based healthcare. Thus Mobile IT is considered essential to reducing medical errors, enhancing patient safety and improving quality of healthcare service delivery. Mobile IT can also be leveraged to meet ICT infrastructural challenges of field-based healthcare. That is, to enhance this service delivery, Mobile IT innovation will include the use of mobile devices such as mobile phones, smart phones, pocket computers, wireless networks and other technologies such as Radio Frequency Identification, smart cards, as well as information systems accessed through these technologies. In recent years, cases of Mobile IT application in healthcare service, particularly in South Africa, suggest the use of Mobile IT for disease management, monitoring as well as evaluation of patient care activities. There is a need for an empirical study to highlight the determinant factors that influence Mobile IT innovation for field-based healthcare. In response to this need, this study captured and unraveled the complexity of Mobile IT innovation for field-based healthcare through a case study conducted at a healthcare service provider.

Over the past decade, chronic illnesses have increased significantly in developing regions around the world, with implications for health service provision. Research shows that morbidity follows a social gradient in many countries around the world. Though various studies highlight the importance of socioeconomic status as a predictor of a person’s morbidity and mortality experience, there is a dearth of data and literature in the South African context. This study aimed to address this gap by examining the association between socioeconomic status and diabetes and hypertension among participants aged 35 years and older. This was achieved by undertaking the analysis of secondary data from the National Income Dynamic Study. The findings of the study reveal that there is a significant relationship between socioeconomic factors and chronic health outcomes of individuals. People with lower levels of education were more likely to have a chronic illness than those with higher levels of education. However, interestingly the lowest rates of prevalence were found in the unemployed category in South Africa. This draws attention to the need for further research on employment and chronic disease prevalence. An important finding of the study was the relatively higher prevalence of chronic conditions in rural areas and among the Black/African population. This data suggests that changes in lifestyle and behavior in the context of globalization and urbanization may be contributing to changes in the health profile of these communities. Policy makers need to acknowledge that chronic diseases are no longer the preserve of the wealthy with diseases such as diabetes and hypertension evident across all sectors of South African society. By addressing the causes of chronic conditions policies and programs can aim to prevent the emergence of future epidemics. In the long-term, sustainable progress will only be achieved with greater attention directed towards the socioeconomic factors underlying the health profile of the country. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2011.

<p>This study aimed to contribute to the current debate around equity in health care resource allocation by measuring the current allocation of resources, relative to need in the Northern Cape. It also discussed the level of inequities in health financing/expenditure and staffing at the primary health care level between different districts of the Northern Cape.</p>

This study explores environmental understanding among the health care practitioners serving a rural community in the Eastern Cape Province in South Africa. During the preliminary phases of the research, the decision was made to adopt a participatory approach to the inquiry as far as was possible. Semi-structured interviews, participant observation and focus group discussions were the techniques chosen to focus the participants' thinking about: the meaning of environment, environmental issues and problems which impact on health, and, environmental education in practice. Comparisons between the recently transformed health education idea proposed by the World Health Organization (WHO), known as "health promotion", and a popular environmental education model are made. It is argued that many of the obstacles to effective health education described by the participants in the study can be overcome by using environmental educationlhealth promotion approaches. The findings show that the health practitioners studied relate to a wide range of environmental issues with varying levels of engagement. They are influenced by changing values, their feelings about indigenous knowledge, and their notions about how people should respond to the environment. An urgent need for more and better communication among the different levels of health practitioners is identified. Finally, it is recommended that health care practitioners be supported with opportunities for professional development which can lead to a confident, seIfreflective approach to health education.

The shortage of skilled professionals in the health sector has been an ongoing problem. This has resulted in poor service delivery and ultimately increased patient deaths. The primary objective of this study was to develop a conceptual model to retain scarce skilled professional workers in the health sector. An exploratory study was conducted which included both professionals and non-professionals in the pathology sector. Recruitment was done from a population of 207 employees. In total 188 employees responded, of which 116 were professionals and a comparator group of 72 being the non-professionals. The study was conducted in three phases. In the first phase, quantitative data collection methods such as the job diagnostic survey, career orientation inventory, organisational commitment questionnaire and intention to quit questionnaire were used to assess the characteristics of the groups of interest. The relationship between the independent and dependent variables were calculated. The results revealed that only a few of the traditional predictors influenced retention in the professional group. The predictors worked much better for the non-professional group. It was concluded that traditional retention strategies are not suitable to retain professionals in the health sector. The second and third phases utilised qualitative methods. The second part of the study related to identifying factors which retain professional staff. Following interviews with 15 professionals, ten themes were identified which relate to the retention of professionals. The third phase of the study consisted of interviews with 3 managers, and this was to determine what the managers can do to influence retention. A retention model for the professionals was then developed. This model not only contributes to the body of knowledge, but is also a useful managerial tool to manage professionals in the health sector / Graduate School of Business Leadership (SBL) / D.B.L. (Business Leadership)

The study aimed at describing patients’ satisfaction with health care services provided in the city of Johannesburg. The research sample consisted of adult male and female patients who visited region E clinics for health services. Questionnaires were used to collect data and descriptive statistics for data analysis. Findings indicated that patients were generally satisfied with health care services provided. Recommendations included ongoing staff training to improve quality of health care and public information and education campaigns to foster community awareness and understanding of health services, develop a sense of ownership thereof, and encourage positive participation. / Health Studies / M.A. (Health studies)

Text in Afrikaans / Verpleegktmdiges het 'n etiese en professionele verantwoordelikheid om elke bej aarde se reg op selfbeskikking te erken, bulle in die uitvoering daarvan te ondersteun en op volgehoue basis te ontwikkel met die oog op die bereiking van die hoogste moontlike vlak van onafhanklikheid in die daaglikse lewe. Die doel van hierdie studie was om die mate te bepaal waarin professionele verpleegkundiges werksaam in geregistreerde, gesubsidieerde tehuise vrr bejaardes in die Pretoria-omgewing hierdie verantwoordelikl1eid uitleef Ontleding van die data, wat deur 'n vraelys ingewin is, dui daarop dat verpleegktmdiges sonder twyfel die bejaarde se reg op selfaktualisering erken. V erpleegkundiges ervaar egter onsekerheid oor die praktiese wyse van selfsorgondersteuning sowel as die wenslik11eid van gesondheidsbevordering by die gelnstitusionaliseerde bejaarde. Ten einde die sinvoll1eid van die gelnstitusionaliseerde bejaarde se bestaan te verseker, sentreer die belangrikste aanbevelings in hierdie studie rondom die voorsiening van opleidingsprogramme aan gerontologiese verpleegktmdiges asook gesondheidsvoorligting aan die bejaarde self / Nurses have an ethical and a professional responsibility to acknowledge the elderly's right to self-determination, to support them in this regard and to ensure ongoing development so that they may attain the highest possible level of independence in their daily life. The purpose of tllis study was to determine to what extent nurses working in registered, subsidized homes for the aged in the Pretoria area live up to tllis responsibility. Analysis of tl1e data, obtained by questimmaire, has clearly shown that nurses acknowledge the right of the elderly to self-actualization, but they feel uncertain about the practical ilnplementation of self-care support and tl1e desirability of promotil1g health amongst the il1stitutionalized aged. In order to ensure that tl1e institutionalized aged person leads a meanil1gfullife, the mail1 recommendations of tllis study centre on providil1g educational progrmes for gerontological nurses as well as health education for the elderly. / Health Studies / M.A. (Nursing)