This study investigates the role of public policy and the implementation of public policy with particular reference to public health policy in South Africa from 1910 to 1990. The focus and locus of the public policy phenomenon within the political and administrative processes are also analysed. It is shown that the supposition that public policy is only part of the political process, is incorrect. The public policy phenomenon is subsequently analysed. It is shown that the various levels of public policy impact upon the administrative process and that the policy implementation process is part of the public policy process. In an analysis of the nature and scope of the public policy implementation process, it is argued that public policy implementation, as such, had been an underrated part of the policy process in South Africa up to the 1970's. It is also shown that internal and external variables impact upon the implementation of public policy, namely the generic administrative functions (as internal variables) and certain normative guidelines (as external variables). The external variables that impact upon public policy implementation, namely legislative direction, public accountability, democratic requirements, reasonableness, and efficiency are analyzed. The external variables are used to establish their relevance, or not, to the implementation of public health policy in South Africa from 1910 to 1990. It was found that the external variables figured poorly in the implementation of health policy in the sense that the external variables were brought to bear in an ad-hoc fashion based on crises as it arose, in other words, not on pre-planned actions. / In hierdie studie word ondersoek gedoen na die rol van openbare beleid en die implementering van openbare beleid met spesifieke verwysing na openbare gesondheidsbeleid in Suid-Afrika vanaf 1910 tot 1990. Die fokus en lokus van die openbare beleidverskynsel binne die politieke en administratiewe prosesse word ontleed. Daar word op gewys dat die veronderstelling dat openbare beleid slegs deel van die politieke proses is, verkeerd is. Daar word ook op gewys dat die verskillende vlakke van openbare beleid die administratiewe proses bei'nvloed en dat die openbare beleidimplementeringproses deel van die openbare beleidsproses is. In 'n ondersoek na die aard en omvang van die openbare beleidimplementeringproses word daarop gewys dat openbare beleidimplementering 'n onderskatte deel van die beleidproses in Suid-Afrika tot en met die 1970's was. Daar word op gewys dat interne en eksterne veranderlikes 'n invloed uitoefen op openbare beleidimplementering, te wete, die generiese administratiewe funksies (as interne veranderlikes) en bepaalde normatiewe riglyne (as eksterne veranderlikes). Die eksterne veranderlikes vir openbare beleidimplementering, te wete, wetgewende rigtinggewing, openbare aanspreeklikheid, demokratiese vereistes, regverdigheid, en doeltreffendheid is vervolgens ontleed. Die eksterne veranderlikes word gebruik om hul toepaslikheid, al dan nie, by die implementering van openbare gesondheidsbeleid in Suid-Afrika vanaf 1910 tot 1990 te toets. Daar is bevind dat die eksterne veranderlikes swak, indien ooit, by die implementering van gesondheidsbeleid ter sprake was. Die rede daarvoor is dat die eksterne veranderlikes op 'n ad-hoc wyse ter sprake gebring is omda:t die implementering van openbare gesondheidsbeleid toegepas is op die basis van krisisse soos dit ontstaan het en nie op beplande optredes nie. / D. Litt. et Phil. (Public Administration) / Public Administration and Management

This study investigates the role of public policy and the implementation of public policy with particular reference to public health policy in South Africa from 1910 to 1990. The focus and locus of the public policy phenomenon within the political and administrative processes are also analysed. It is shown that the supposition that public policy is only part of the political process, is incorrect. The public policy phenomenon is subsequently analysed. It is shown that the various levels of public policy impact upon the administrative process and that the policy implementation process is part of the public policy process. In an analysis of the nature and scope of the public policy implementation process, it is argued that public policy implementation, as such, had been an underrated part of the policy process in South Africa up to the 1970's. It is also shown that internal and external variables impact upon the implementation of public policy, namely the generic administrative functions (as internal variables) and certain normative guidelines (as external variables). The external variables that impact upon public policy implementation, namely legislative direction, public accountability, democratic requirements, reasonableness, and efficiency are analyzed. The external variables are used to establish their relevance, or not, to the implementation of public health policy in South Africa from 1910 to 1990. It was found that the external variables figured poorly in the implementation of health policy in the sense that the external variables were brought to bear in an ad-hoc fashion based on crises as it arose, in other words, not on pre-planned actions. / In hierdie studie word ondersoek gedoen na die rol van openbare beleid en die implementering van openbare beleid met spesifieke verwysing na openbare gesondheidsbeleid in Suid-Afrika vanaf 1910 tot 1990. Die fokus en lokus van die openbare beleidverskynsel binne die politieke en administratiewe prosesse word ontleed. Daar word op gewys dat die veronderstelling dat openbare beleid slegs deel van die politieke proses is, verkeerd is. Daar word ook op gewys dat die verskillende vlakke van openbare beleid die administratiewe proses bei'nvloed en dat die openbare beleidimplementeringproses deel van die openbare beleidsproses is. In 'n ondersoek na die aard en omvang van die openbare beleidimplementeringproses word daarop gewys dat openbare beleidimplementering 'n onderskatte deel van die beleidproses in Suid-Afrika tot en met die 1970's was. Daar word op gewys dat interne en eksterne veranderlikes 'n invloed uitoefen op openbare beleidimplementering, te wete, die generiese administratiewe funksies (as interne veranderlikes) en bepaalde normatiewe riglyne (as eksterne veranderlikes). Die eksterne veranderlikes vir openbare beleidimplementering, te wete, wetgewende rigtinggewing, openbare aanspreeklikheid, demokratiese vereistes, regverdigheid, en doeltreffendheid is vervolgens ontleed. Die eksterne veranderlikes word gebruik om hul toepaslikheid, al dan nie, by die implementering van openbare gesondheidsbeleid in Suid-Afrika vanaf 1910 tot 1990 te toets. Daar is bevind dat die eksterne veranderlikes swak, indien ooit, by die implementering van gesondheidsbeleid ter sprake was. Die rede daarvoor is dat die eksterne veranderlikes op 'n ad-hoc wyse ter sprake gebring is omda:t die implementering van openbare gesondheidsbeleid toegepas is op die basis van krisisse soos dit ontstaan het en nie op beplande optredes nie. / D. Litt. et Phil. (Public Administration) / Public Administration and Management

This thesis is intended as a broad examination of the distribution of health resources in South Africa. Issues both macro and micro in nature have been covered to provide a perspective that would be Jacking in a narrower study. Although the title refers to a redistribution of resources, the intention of this thesis is to stress the importance of providing appropriate health measures rather than merely apportioning existing facilities evenly. This realization is insufficient, however, if it is not accompanied by the introduction and utilization of analytical approaches for identifying resource selection priorities. The influences on health status are many. In defining appropriate measures to improve health status it is important to be aware of the limitations of medical-care. Chapter three involves a cross-sectional regression analysis of various countries in order to examine the influences certain variables have on health status. This study suggests the need for an integrated approach to improving the health of a population. Merely focusing on medical care will only have a limited affect. However, this does not mean that medical-care is not important. It must just be provided in an appropriate manner. The rest of the thesis evaluates health-care resource distribution in South Africa. The existing distribution of health-care resources in South Africa is ill-suited to the existing health status of the population. There is a bias toward urban based curative facilities. Furthermore, the location of facilities has been based on racial criteria, whereby some areas have sufficient resources for their needs while others do not. Two methods of identifying how these issues should be dealt with are produced in this thesis. The first deals with a method for adjusting the broad distribution of funds toward those areas where need is greatest. The suggestion put forward by this thesis is that a formula be developed that would be able both to define need on a geographical basis, and to allocate resources based on that need. The formula would be used to allocate government health expenditure. This section is based on a formula that was developed in the United Kingdom. The second deals with a method for defining appropriate medical interventions on the micro level. It is called cost-effectiveness analysis (CEA). CEA is used for micro-economic decision-making where a choice has to be made between at least two alternatives for attaining a particular objective. Furthermore, CEA evaluates projects or programmes that are on-going in nature. It should be noted that CEA can also evaluate non-medical interventions to solve a particular health problem. In order to indicate the type of information that a CEA can provide, an investigation into cervical cancer procedures used on black females was produced. The entire black female population of South Africa was examined. A computer simulation of incidence and mortality rates of the disease was used to evaluate various scenarios. The results indicate that significant gains can be made by introducing cervical cancer screening on a large scale in South Africa. A major priority of this thesis was to stress the importance of using economic criteria to assist in making decisions concerning health-care resource allocations. Very little work of this nature is produced in South Africa. Hopefully this will not always be the case.

Thesis (MA)--Stellenbosch University, 2015. / ENGLISH ABSTRACT: Globalization is changing the face of health concerns worldwide and states are reacting by modifying their foreign policies to keep up with the resultant challenges and opportunities. The purpose of this study is to investigate, using the case studies of South Africa and Norway, the similarities and differences in how emerging and traditional middle powers respectively approach the new foreign policy phenomenon of health diplomacy. The study is interested in the reasons for how and why these similarities and differences manifest themselves in practice. Health diplomacy is a multifaceted concept which envelops negotiation involving health in a number of different concerts and across a wide spectrum of actors. Despite its novelty within the fields of both Global Health Governance and International Relations, the literature offers limited but sufficient frameworks that have utility for its study. The study surveys the literature on middle powers, and its sub-categories of emerging and traditional middle powers. Whilst identification with the middle power category requires the fulfilment of a number of criteria, this further categorization is made on the background of both quantifiable and behavioural characteristics, making their respective members’ inclinations and rationales for engaging in specific foreign policy types typically divergent on a number of issues. The two countries selected for case studies, South Africa and Norway, are generally regarded as exemplars of the two respective middle power categories. In these case studies the health diplomacy of these countries is assessed on the basis on the frameworks developed in the first half of this study, serving as the empirical foundation upon which the subsequent analysis is based. The findings speak volumes both for the two different middle power types and for the respective case study states. A common emphasis on multilateralism is one unsurprising similarity, as middle powers of both types tend to share this general preference in their foreign policy undertakings. However, as South Africa’s health diplomacy is nascent and Norway’s well-developed, divergences are obvious in terms of what strategies the respective countries use in order to gain the international influence that they covet. Furthermore, domestic and regional issues clog the agendas of emerging middle powers, whilst traditional ones enjoy stability in this regard and are able to seek opportunities elsewhere. These characteristics are exemplified in an extreme sense in South Africa, where a genuine health crisis is ravaging the country; conversely, in Norway, domestic issues are relatively minor, and niche diplomacy has bred massive success. At bottom, health diplomacy is a significant nascent area of interest within International Relations broadly, and in niche diplomacy and global health governance specifically, and demands further study. / AFRIKAANSE OPSOMMING: Globalisering verander wêreldwyd die aard van gesondheidsoorwegings en state reageer hierop deur hul buitelandse beleide aan te pas om tred te hou met die gevolglike uitdagings en geleenthede. Die doel van hierdie studie is om die ooreenkomstige en verskille duidelik te stel van hoe ontluikende en tradisionele middelmoondhede (met Suid-Afrika en Noorweë as onderskeidelike voorbeelde) die nuwe buitelandse beleidsfenomeen van gesondheidsdiplomasie benader. Die studie stel belang in die redes waarom en hoe hierdie ooreenkomste en verskille in die praktyk manifesteer. Gesondheidsdiplomasie is ‘n veelkantige konsep wat onderhandelings aangaande gesondheid in verskillende kontekste en oor ‘n wye spektrum akteurs heen omvat. Ondanks die nuutheid van beide Globale Gesondheidsregering en Internasionale Betrekkinge as studievelde, bied die literatuur beperkte maar voldoende raamwerke aan vir die doel van hierdie studie. Die tesis bied ‘n oorsig van die literatuur aangaande middelmoondhede, sowel as die subkategorieë van ontluikende en tradisionele middelmoondhede. Alhoewel lidmaatskap van die middelmoondheid kategorie die bevrediging van ‘n paar kriteria vereis, word hierdie verdere kategorisering gemaak teen die agtergrond van beide kwantifiseerbare en gedragspatrone, en dit maak hul onderskeie lede se oorwegings en beweegredes i.t.v. buitelandse beleidstipes uniek oor ‘n hele paar kwessies heen. Die twee state waarop besluit is as gevallestudies, Suid-Afrika en Noorweë, word algemeen beskou as kernvoorbeelde van die twee onderskeie middelmoondheid kategorieë. In hierdie gevallestudies word die gesondheidsdiplomasie van die twee state oorweeg aan die hand van raamwerke wat in die eerste helfte van die studie ontwikkel word, en dit dien dan as die empiriese ondersteuning vir die analise wat daarop volg. Die bevindings spreek boekdele beide oor die twee verskillende middelmoondheid tipes en vir die onderskeie gevallestudie state. ‘n Gedeelde fokus op multilateralisme is een onverrassende ooreenkoms, aangesien alle middelmoondhede hierdie voorkeur in hul buitelandse beleidsondernemings openbaar. Maar tog, aangesien Suid-Afrika onluikend is en Noorweë goed-ontwikkeld is, is uiteenlopendheid bespeurbaar i.t.v. die strategieë wat die onderskeie state gebruik ten einde die internasionale invloed te kry waarna hulle op soek is. Voorts verlangsaam plaaslike en streekskwessies die agendas van ontluikende middelmoondhede, terwyl tradisionele middelmoondhede in hierdie verband stabiliteit geniet, en dit dan moontlik word vir lg. om elders geleenthede te ondersoek. Sodanige kenmerke is duidelik in Suid-Afrika, waar ‘n ernstige gesondheidskrisis die land verlam; in Noorweë, aan die ander kant, is plaaslike uitdagings nie ernstig nie, en nisdiplomasie word met groot sukses onderneem. Die kernboodskap van die studie is dat gesondheidsdiplomasie ‘n beduidende nuwe ondersoekveld is binne Internasionale Betrekkinge in die algemeen, en dan spesifiek in nisdiplomasie en globale gesondheidsregering, en dit vereis verdere studie.

This research is an endeavour to highlight the state of healthcare in South Africa as seen through the eyes of professional health care workers who are at the cold face of healthcare. Having worked in an environment of inequities and unjust circumstances, healthcare workers expressed their attitudes and beliefs that healthcare are in need of radical change. There appears to be insight from these professionals that the private and public healthcare sectors should forge a relationship, ultimately benefiting South African society. More research needs to be done on a major scale to determine more deeply the attitudes and beliefs of healthcare professionals. Such an endeavour will provide a stimulus for policymakers to harness this energy and direct it in a meaningful way in the transformation of healthcare in South Africa. Chapter 1 focused on several relevant perspectives and definitions on healthcare in South Africa and other countries. In Chapter 2, attention was given to socio-economic rights as per the South African Constitution and the states obligations to fulfil these rights. These rights were examined in the context of landmark Constitutional Court cases, viz. Soobramoney versus the State; TAC versus the State; and Grootboom versus the State. These cases give one the essence of interpreting rights and the constitutional obligation of the state to deliver on them. Healthcare developments in South Africa and other countries together with the RDP and GEAR considerations are outlined in Chapter 3. Research Methodology is outlined in Chapter 4, emphasizing also the limitations of this study. Chapter 5 examines the responses to the questionnaires and analyses its findings. Chapter 6 provides the conclusions and recommendations as well as a critique of healthcare in South Africa. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2004.

This study was aimed at identifying and exploring the perceptions of traditional healers particularly izangoma and izinyanga, on the integration of their practices into the South African National Health System. The main reason behind this research was to establish the position of traditional healers as well as to study their opinions on the issue of integration. The paucity of previous research studies on the 'perceptions of traditional healers on the integration of their practice-s into the national health care system, was the main motivation behind this study. Participants were drawn from the Pietermaritzburg area and selection was based on purposeful sampling. The data of the study was collected by means of semi-structured interviews, which employed open- ended questions. This study was conceptualized within the African world-view and cosmology. The interactive model design by Maxwell (1996) was employed in the design of this study. According to this model the purpose, conceptual context, research questions and methods as well as issues of validity and reliability, are all essential for the coherence of any qualitative study. The ethical considerations of this study were mainly around the issue of informed consent, and this was negotiated and discussed with the participants until they could understand the process of consent. The results of the study reflect the fact that traditional healers are positive about the process of integration. However, the participants were in favol of integration as a process of collaboration and co-operation as opposed to total integration, which was perceived as a process in which one system w0ll-Id dominate and oppress the other. The participants in this study perceive themselves as equal to their western counterparts because oftheir training and ability to treat "spiritual illnesses". Further, they view their role as that of providing alternative healing as well as acting as a medium between people and their ancestors. Education and negotiations were identified as the possible solutions to most problems in the process of integration. The findings of this study further reveal that there is mistrust and suspicion about western healers form traditional healers. As a result of this, improved collaboration between traditional and modem health care systems seems to be the only process, which could benefit all the people of the country. / Thesis (M.A.)-University of Natal, Pietermaritzburg, 2000.

This dissertation explores discourses about culture and illness in the talk of mental health professionals and indigenous healers. It represents an attempt to situate the issue of indigenous healing in South Africa within a particular strand of critical discourse analytic research. In the context of current deliberations on the value, or otherwise, of indigenous healing in a changing health and specifically mental health system, the talk of both mental health practitioners and indigenous healers as they conceptualise “disorder”, and discuss possibilities for collaboration, is chosen as a specific focus for this study. Disputes over what constitutes “disorder” both within mental health, and between mental health and indigenous healing are an important site in which the negotiation of power relations between mental health professionals and indigenous healers is played out. The results of this study suggest that despite the construction of cogent commendations for the inclusion of indigenous healing in mental health, it remains largely marginalised within talk about mental health practice. While this study reproduces to some extent the marginalisation of indigenous healing discourse, it also examines some of the discursive practices and methodological difficulties implicated in its marginalisation. However, in the context of “cultural pride strategies” associated with talk about an African Renaissance, indigenous healing may also function as a site of assertion of African power and resistance in its construction as an essentially African enterprise. At the same time, it may achieve disciplinary effects consonant with cultural pride strategies, in constructing afflictions in terms of neglect of, or disloyalty to cultural tradition. These results are discussed in terms of the methodological difficulties associated with interviewing and discourse analysis of translated texts, which contributes to difficulties with articulating indigenous healing discourse in a way that challenges the dominant psychiatric discourses implicated in its marginalisation within mental health. It concludes with recommendations for future research which addresses indigenous healing discourse in its own terms, and examines its operation as a disciplinary apparatus in South African society.

M.Comm. / Health care in South Africa has been well described in terms of structure. However, to what extent would it be possible to describe the health care sector in South Africa in terms of that used to describe an industry? What conclusions could be drawn at the end of the study if this was or was not possible? Strong emphasis in industry analysis is placed on the nature of the competitive forces and on levels of profitability. Can the South African health care sector also be described in those terms? The following objectives can be identified in this study: To complete a literature review on the structure of health care in South Africa in terms of facilities, geographic location, services offered, manpower, financing, remuneration, population served and legislation. To complete a literature review on models and methods that can be used to analyse industries. To determine to what extent it is possible to apply Porter's model (and others) of industry analysis to the South African health care industry. To identify key success factors for the industry. To draw conclusions from the study and make some recommendations.

Thesis (MPA)--University of Stellenbosch, 2003. / ENGLISH ABSTRACT: The implementation of national policies is a key function of government through its various departments. This is very crucial in the health sector where lives of individuals are involved. The implementation of the national HIV/AIDS policy is very important in dealing with the epidemic. This study combined both quantitative and qualitative methods to analyse the implementation of the South African government’s national HIV/AIDS policy in the Vhembe District of the Limpopo Province. The quantitative phase involved the stratified sampling process, resulting in identifying 2 health workers from each of the 25 health units in the district comprising of 22 community clinics, the infection control unit, the counselling unit at the hospital and 2 from among the doctors. A total of fifty respondents were selected from a workforce of about 500. The staff profile indicates that 76 % of the health workers interviewed were below 40 years of age and 28% of them were chief professional nurses. Of the health workers, 78 % had been in the current position for between 1 and 5 years, 6 % for 6 to 10 years, 6 % for 16 or more years and 10 % for less than one year. All of them had a diploma as a minimum qualification, 8 % had 2 diplomas, 2 % had 3 or more diplomas, 2% had degrees and 2 % had a degree plus diplomas. In terms of HIV/AIDS policy implementation, 100% of all the facilities provided HIV prevention information to clients, 60% of these facilities worked with other organisations in HIV prevention, but only 4% had voluntary counselling and testing (VCT) services. In these health units only 28% had had staff trained regarding HIV/AIDS issues. In addition 96 % of the health units had the male condom stocked at any one time and only 12 % stocked the female condom. In terms of sexually transmitted diseases (STD) control, all clinics were using the syndromic approach in management of STDs and also claimed to have youth-friendly services. On the other hand only 80 % of the facilities had had staff trained in STD management using the syndromic approach. In the area of prevention of mother-to-child transmission of HIV, (PMTCT) none of the clinics had VCT services for pregnant women and only 8% of them had PMTCT counsellors. Because of the lack of VCT services only 4% of the clinics had known HIV positive mothers attending the antenatal care services. On the issue of post-exposure prophylaxis (P.E.P.) all clinics had protocols for this and 88% of them had antiretroviral drugs (ARVs) stocked for post-exposure treatment for health workers. However, only 8% of these clinics had a betadine douche as the only post-exposure intervention for raped women. In the area of treatment care and support for patients none of these clinics offered ARVs, 24 % had protocols for prevention and management of opportunistic infections, 4% were involved in any form of home-based care, 4% had HIV/AIDS dedicated services and 24% collaborated with community non-governmental organisations (NGOs) in HIV/AIDS care. The qualitative phase of the study highlighted what health workers perceived as prominent features of the national HIV/AIDS policy and these included prevention of HIV by use of condoms, faithfulness and pre-test counselling. The respondents also interpreted the social response by government to include provision of home-based care, care of orphans, food provision and safe guarding rights of victims. Other issues that were perceived to be part of the national HIV/AIDS policy were STD management, health education, provision of training to health workers in HIV/AIDS issues, provision of home-based care and occupational health and safety for health workers. The government was also perceived to have a negative attitude towards AIDS NGOs, not providing adequate numbers of the female condom and denying patients antiretroviral drugs (ARVs). The recommendations made on the basis of the study therefore include strengthening the training of health workers in HIV/AIDS care and management, improved provision of VCT services, wider distribution of the female condom, provision of prevention of mother-to-child transmission of HIV (PMTCT) services and the linking of research and care to provide evidence-based practice. Other recommendations are that there should be support programmes for health workers with HIV, addressing gender issues in implementation and provision of ARVs especially where it is already known that they help. / AFRIKAANSE OPSOMMING: Die implementering van nasionale beleid is ‘n sleutelfunksie van die regering, verrig deur sy onderskeie departemente. Dit is veral deurslaggewend in die gesondheidsektor waar die lewens van individue op die spel is en die implementering van die nasionale MIV/VIGS- beleid is baie belangrik in die hantering van die epidemie. In hierdie studie is beide kwalitatiewe en kwantitatiewe metodes gekombineer om implementering van die Suid-Afrikaanse regering se nasionale MIV/VIGS -beleid in die Vhembe-distrik van die Limpopo-provinsie te analiseer. Die kwantitatiewe fase het ‘n gestratifiseerde steekproefproses behels, wat gelei het tot die identifisering van 2 gesondheidswerkers uit elk van die 25 gesondheidseenhede in die distrik, bestaande uit 22 gemeenskapsklinieke, die infeksie-beheereenheid, die beradingseenheid by die hospitaal en die geledere van die dokters. So is ‘n totaal van 50 respondente geselekteer uit ‘n arbeidmag van ongeveer 500. Die personeelprofiel dui aan dat 76% van die gesondheidswerkers wat ondervra is jonger as 40 jaar was en dat 28% van hulle hoof professionele verpleegsters was. Van die gesondheidswerkers was 78% vir 1 tot 5 jaar in hul bestaande posisie , 6% vir 6 tot 10 jaar, 6% vir 16 of meer jare en 10% vir minder as 1 jaar. Almal van hulle het ‘n diploma as ‘n minimum kwalifikasie gehad, 8% het 2 diplomas, 2% het 3 of meer diplomas, 2% het grade en 2% het ‘n graad plus diplomas gehad. In terme van die MIV/VIGS beleidsimplementering het 100% van die fasiliteite MIV- voorkomingsinligting aan kliënte verskaf, 60% van hierdie fasiliteite in samewerking met ander organisasies , terwyl slegs 4% vrywillige berading en toetsdienste verskaf het. Slegs 28% van die gesondheidseenhede het oor personeel beskik met opleiding in MIV/VIGSkwessies. Verder het 96% van die gesondheidseenhede die manlike kondoom in voorraad gehad teenoor slegs 12% eenhede die vroulike kondoom. In terme van die seksueel-oordraagbare siektebeheer, het al die klinieke die sindroom-benadering in die bestuur van seksueel- oordraagbare siektes toegepas en het beweer dat hulle dienste jeugvriendelik is. Daarteenoor het slegs 80% van die fasiliteite beskik oor personeel wat opgelei was in seksueel- oordraagbare siektebestuur met toepassing van die sindroombenadering. Op die terrein van voorkoming van moeder- na- kind- oordraging van HIV het geen van die klinieke oor vrywillige berading en toetsdienste vir swanger vroue beskik nie en slegs 8% van hulle het wel moeder-na-kind– oordragingsberaders gehad. As gevolg van die gebrek aan vrywillige berading en toetsdienste het slegs 4% van die klinieke kennis gedra van HIV- positiewe moeders wat voorgeboortelike sorgdienste bygewoon het. Wat na-blootstellingsvoorbehoeding aanbetref, het alle klinieke protokolle gehad en 88% het antiretrovirale medisyne in voorraad gehad vir nablootstellingsbehandeling van gesondheidswerkers. Slegs 8% van hierdie klinieke het egter ‘n betadine-spoeling(“douche”) as die enigste nablootstelling intervensie vir verkragte vroue gehad. Op die gebied van die behandeling van en ondersteuning aan pasiënte het geen van hierdie klinieke die antiretrovirale medisyne aangebied nie, 24% het protokolle vir die voorkoming en bestuur van geleentheidsinfeksies gehad, 4% was betrokke in enige vorm van tuisgebaseerde sorg, 4% het oor MIV/VIGS -gerigte dienste beskik en 24% het met gemeenskapsvrywilligerorganisasies saamgewerk in die voorsiening van MIV/VIGS-sorg. Die kwalitatiewe fase van die studie fokus op wat gesondheidswerkers beskou as prominente kenmerke van die nasionale MIV/VIGS- beleid en wat insluit die voorkoming van HIV deur die gebruik van kondome, getrouheid en voortoets- berading. Die respondente vertolk die regering se sosiale reaksie as insluitend die verskaffing van tuisgebaseerde sorg, die versorging van weeskinders, voedselvoorsiening en die beveiliging van slagoffers se regte. Ander kwessies wat ook gesien word as deel van die nasionale MIV/VIGS beleid is seksueel- oordraagbare siektebeheer, gesondheidopvoeding, die verskaffing van opleiding aan gesondheidswerkers in MIV/VIGS-probleme, die voorsiening van tuisgebaseerde sorg en beroepsgesondheid en veiligheid vir gesondheids werkers. Die regering se houding teenoor VIGS vrywilligerorganisasies is ook as negatief vertolk deur onvoldoende hoeveelhede van die vroulike kondoom te verskaf en antiretrovirale medisyne te weerhou van pasiënte. Die aanbevelings wat op grond van die studie gemaak is, sluit in die verbeterde opleiding van gesonheidswerkers in MIV/VIGS-sorg en -bestuur, verbeterde verskaffing van vrywillige berading en toetsdienste, wyer verspreiding van die vroulike kondoom, verskaffing van MIV-dienste vir die voorkoming van moeder-na-kind-oordraging en die konnektering van navorsing en sorg om ‘n inligtingsbaseerde praktyk te skep. Ander aanbevelings is dat daar ondersteuningsprogramme vir gesondheidswerkers met MIV behoort te wees wat geslagskwessies aanspreek in die implementering en verskaffing van antiretrovirale medisyne waar dit reeds bekend is dat dit wel help.

Policy is a rule to guide decisions and achieve rational outcomes while advocacy is a strategy to influence architects of decision making or policy makers when they make regulations and laws, distribute resources, and make other decisions that affect peoples' lives. The principal aims of policy advocacy as postulated by Kervatin in 1998 are to create policies, reform policies, and ensure policies are implemented. This study examines the role of civil society in policy advocacy, using the Treatment Action Campaign (TAC) as an example. Therefore, the study uses a content analysis method of data collection and analysis to explicate the various advocacy strategies employed by the Treatment Action Campaign to advocate for access to HIV/AIDs treatment in post-apartheid South Africa. The policy advocacy strategies of the TAC were investigated pertaining to the implementation of health policy on HIV/AIDS in South Africa. There are a variety of advocacy strategies employed by civil society organisations, such as discussing problems directly with policy makers, delivering messages through the media, or strengthening the ability of local organisations to advocate. These strategies are known as advocacy tools for planning successful advocacy initiatives. Most of them are clearly reflected in the case of the TAC organisation, which employed these strategies and others to advocate for HIV/AIDS policy change. / Thesis (M.Soc.Sc.)-University of KwaZulu-Natal, Pietermaritzburg, 2013.