MPM / Oliver Tambo Institute of Governance and Policy Studies

Thesis (MPH.) -- University of Limpopo, 2017 / Background: Since the introduction of optometry services in 1994 in Limpopo hospitals there is a need to improve the eye care services. Hospital records revealed that most of the spectacles worn by health professionals were not issued by the hospital optometry department. Those who were issued with spectacles when they were newly employed had not renewed from the hospital’s optometry department after the recommended two years. The aim of this study was to determine perceptions and attitudes of public healthcare workers towards optometry services in Zebediela. Limpopo Province, South Africa Methods: A quantitative descriptive cross-sectional study design was used. Participants were public healthcare professionals in Zebediela hospital and clinics in Zebediela sub-local municipality. Following the ethical approval and informed consent, a self-administered questionnaire with closed-ended questions was used to collect information on the perceptions, attitudes and socio-demographic factors. Data were analysed using IBM SPSS statistic 23 software. Results: The majority of participants had negative perceptions (78.7%) and 76.4% had positive attitudes towards the optometry department. There was significant association between perception according to profession of participants (P=0.025). There was significant association between attitude according to profession (P=0.001), as well as years in institutional employment (P=0.035). There was no significant association between either perceptions or attitudes and age group, gender as well as employment experience Conclusion: The health professionals held negative perceptions but favourable attitudes towards the optometry staff and the optometry service but needed more information for themselves and the general patient. The health professionals were not impressed by the type of spectacles issued and optometry service delivery aspects. Awareness campaigns by optometrists, need to be increased to the public and also inter professional relationships need to be strengthened to reduce negative perceptions through peer cross professional education in the health system.

MPM / Oliver Tambo Institute of Governance and Policy Studies

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).

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.

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)

PhD (Health Studies) / Department of Public Health / Introduction: Quality healthcare provision is a fundamental need in the life of a person since it helps develop a positive self-image. Healthcare has always been an important issue for society, both economically and culturally. Contrary, dissatisfactions and litigations laid by clients/patients and relatives against the government due to poor service provision become unmanageable. The purpose of the study was the development of strategies to facilitate provision of quality healthcare services in public healthcare facilities in Limpopo province, South Africa. Methods: Qualitative and quantitative methods were adopted for the study. Population for the qualitative study was constituted by professional nurses, and stakeholders (Hospital boards and Clinic health Committees) who were, purposively selected from the randomly sampled hospitals and clinics. Focus Group discussion and questionnaires were conducted to collect data. Analysis. The qualitative data was analysed qualitatively. Population for quantitative study consisted of Clients as stakeholders and professional nurses from randomly sampled hospitals and clinics. The qualitative results were used in the development of questions for questionnaire used in the quantitative approach. For the quantitative approach a self-administered questionnaire was used to collect data from the respondents. Data collection was carried out by means of two instruments for clients and professional nurses. Analysis was done using SPSS 25 version with the assistance of a Professional Statistician. The researcher used the Strength, Weaknesses, Opportunities and Threats analysis to develop strategies for enhancing quality healthcare service provision in the Department of health. The interaction between Strengths, Weaknesses, Opportunities and Threats was analysed and used to develop strategies to facilitate provision of quality health care services in public health care facilities in Limpopo Province. Conclusion Findings of this study is expected to inform nursing education and nursing practice to review curricular on what to emphasize when training the nursing students. The findings will also inform senior management when planning for improvement of health care provision improvement. / NRF

In the last decade, the deployment of Electronic Health Records has increased tremendously in many developed countries. This increasing trend intensifies the need for developing countries like South Africa to implement electronic health record systems in state owned hospitals to facilitate e-referral processes to improve health care delivery. The aim of this research was to investigate the current process of patient record keeping, management, and the referral process of patients within the same hospital and to other hospitals and based on the findings compile an Electronic Health Record (EHR) framework to facilitate e- referral processes. This research study was based on a qualitative case study approach. A multiple data collection technique was used which included group interviews, questionnaires, document analysis and informal discussions with the hospital workers. Data were analysed by categorization and thematic approach. The findings obtained from state hospitals indicated that there is no EHR system which accommodates patient health record systems to facilitate e-referral processes. These findings led to a compilation of the Limpopo Electronic Health Record System (LEHRS) to aid e-referral processes in state hospitals. The increasing need for accurate, reliable, available and accessible EHR will be addressed by the implementation of LEHRS as information will be stored in a central database in a useable format and will be easily accessed. / Computing / M. Tech. (Information Technology)