Submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Durban University of Technology, Durban, South Africa, 2018. / Background: The World Spine Care (WSC) is a non-governmental organization that provides evidence-based spinal care to underserved communities around the world. The WSC opened a clinic in the Mahalapye District Hospital (MDH) in 2011 (Haldeman et al., 2015:2304). The WSC aims for long term presence in Botswana. They will require ‘buy in’ from the local community including the health care professionals of the region. Little is known about how WSC has been received by other health care professionals in the settings where they are present. Hence, this study aimed to determine the knowledge, attitudes and perceptions of health care professionals working at the MDH about the WSC. Method: A qualitative exploratory descriptive study was conducted using semi-structured interviews. Twenty health care professionals were interviewed at the Mahalapye District Hospital to ascertain their levels of knowledge, attitudes and perceptions. The interviews were semi- structured and conducted in English and later transcribed verbatim. The transcripts were then analyzed using the thematic analysis described by Graneheim and Lundman (2003:105). Thereafter codes, categories and themes were formed. Results: A variety of health care professionals from different departments were interviewed. Three overarching themes emerged from the data: knowledge of WSC and the management of spinal related disorders at the MDH, the perceived role of WSC, challenges to integration and possible solutions. The HCPs had varying levels of knowledge of the WSC depending on the amount of interaction they had with WSC. Some HCPs who had greater inter-professional interaction with WSC displayed more positive attitudes towards WSC. Many of the HCPs had a positive perception of the WSC though they were not confident in their knowledge of the WSC scope of practice which has limited referral by HCPs WSC. This is mainly due to an unclear referral pathway within the hospital and limited knowledge of WSC’s scope of practice. Increased awareness and an improved system of referral was a strong recommendation made. Many mentioned an unclear referral pathway for their patients. Those who had interacted with WSC generally had pleasant personal interactions with the WSC. Several of the HCPs had themselves been patients of the WSC. Most HCPs felt that WSC was beneficial to patients and made suggestions for WSC to expand to other centres across Botswana. Conclusion: Overall there was a positive perception of WSC however more effort to increase knowledge of what WSC offers and how it can be integrated into the hospital is necessary. Future studies should assess the perceptions of patients as well as knowledge and attitudes of HCPs towards WSC at other sites. / M

The provision of psychological services is vital considering the complex nature of psychosocial issues facing people today. Nevertheless, the provision and utilization of psychological services has not been given due recognition in most African countries, including Botswana. Botswana is one of the countries faced by the challenges of the HIV/AIDS pandemic and other mental health problems, as well as poverty and unemployment. To date statistics on the magnitude of the HIV/AIDS epidemic in Botswana, published annually by the National AIDS Coordinating Agency (NACA) reflect an increased rate of mental illness and psychosocial problems. Considering the complex nature of issues that impact negatively on people in Botswana, there is a need for awareness and the provision of psychological services in the primary health care system. There is little research on the place of psychology and psychological services in Botswana. The availability of such information is crucial for the planning of effective community-based psychological services. The present study employed a quantitative research method to explore and describe awareness and attitudes towards psychological services and referral practices in relation to psychological problems, of health care providers in Botswana. The participants in the study were chosen, based on a non-probability, purposive sampling method. The sample consisted of ninety-six persons and constituted medical doctors, nurses, psychiatrists, psychiatric nurses and clinical social workers from governmental and non-governmental institutions from Gaborone and Francistown in Botswana. Data were analyzed by means of descriptive statistics in order to identify the mean, ranges and standard deviations. Frequency counts and percentages of the participants’ responses were computed. The results of the study revealed an awareness of available psychological services, positive attitudes towards psychology and psychological services and a reasonable percentage of referrals to psychological services. The results also revealed that available psychological services were limited and not easily accessible to patients. There was also an indication of a shortage of trained professionals to offer psychological services in health care centres, which resulted in psychological problems being referred to social workers.