South Africa, many plants which are used in traditional medicines are collected from wild populations. The high demand for trade and use of these medicinal plants place an enormous pressure on their natural populations, especially because they are indiscriminately harvested. The most affected of these plant species are those harvested from their underground parts, among which is Gunnera perpensa L. Gunnera perpensa is of considerable ethnobotanical interest in traditional medicine because of its wide usage. The rhizomes are widely used and indiscriminately collected in large quantities from the wild to meet the ever increasing demand in traditional medicine markets. As a result, this valuable medicinal plant species is being endangered. According to the Red List of South African Plants, the conservation status of G. perpensa has been listed as ‘declining’. The ethnobotanical survey conducted as part of this research confirms the plant species as threatened. It is, therefore, important to develop propagation and conservation strategies for this medicinal plant. Clonal propagation of G. perpensa was conducted using varying lengths of the rhizome (1, 2, 3, 4 and 5 cm) segments as propagules. While regeneration was possible with all the rhizome lengths, most of the growth parameters were significantly higher in the 5 cm rhizomes than the other rhizome segments. The appropriate planting depth for the rhizomes was also determined and 4 or 5 cm planting depths were found appropriate. No significant difference was observed in the growth parameters amongst the planting depths; nevertheless, 4 cm depth gave higher growth and yield. The results of this study show that regenerating G. perpensa.

The AIDS epidemic affects the capacity of the South African public service to deliver essential services. In response, the Department of Economic Development, Environment and Tourism in Limpopo implemented its HIV/AIDS workplace policy in 2003. This research evaluated the extent to which resources were allocated towards the implementation of the workplace policy, to effectively respond to the impacts of HIV/AIDS on the workplace. A combined quantitative and qualitative approach was used. Data was collected through face-to-face interviews of 43 officers involved in the implementation of the workplace policy, using a semi-structured questionnaire. The results indicated that the resources allocated for the workplace HIV/AIDS policy, namely budget, human resources and materials, were inadequate, with district offices being worse affected. / Social Work / M.A. (Social Behaviour Studies in HIV/AIDS)

Text in English / The purpose of this study was to explore and describe the experiences of community members regarding their participation in hospital boards in Dr Kenneth Kaunda district, North West Province. A qualitative exploratory-descriptive research was conducted on a purposively selected sample of community members who served in the board for a minimum period of two years. Data were collected by means of individual interviews and analysed by means of thematic data analysis. Three themes that emerged from data analysis were creation of opportunities, benefits and challenges. A mix of positive and negative experiences was expressed by community representatives regarding their participation in hospital boards. Participants described their experiences as enjoyable and empowering while others described it as a learning experience through which they acquired knowledge and new skills. The challenges experienced whilst serving in hospital boards included ineffective communication, poor relations and role conflict as a result of lack of role clarification. The findings from the study may be used to enhance the effectiveness of hospital governing boards through the participation of community members. / Health Studies / M.A. (Public Health)

Thesis (MPhil)--University of Stellenbosch, 2003. / ENGLISH ABSTRACT: On The io" of May 1994 Nelson Mandela was inaugurated as the first democratically elected black president of South Africa. The occasion was regarded, both nationally and internationally, as a triumph for humanity and perfused with a widespread optimism for the future of South Africa. Mandela proclaimed in his inaugural speech that "Never, never and never again shall it be that this beautiful land will experience oppression of one by another .... The sun shall never set on so glorious an achievement." However, now, less than 10 years later the rapidly accelerating and devastating HIV/AIDS epidemic is again 'obscuring the sun'. Those people affected so negatively by the racial, economic and gender injustices of the apartheid past, seem again to be suffering a possible injustice, because of a health and welfare system that is struggling to meet the needs of the HIV affected population. The purpose of this dissertation is to examine the concept of distributive justice in South Africa, within the context of this devastating epidemic. I begin by discussing the Bill of Rights in the South African Constitution. I argue that an acceptable framework for a theory of justice for health care in South Africa, must be worked out against the background of this egalitarian Bill of Rights. I then consider the extent of the HIV epidemic, the effect it is having on the people of South Africa and the consequent implications for health care needs. It is within this context that I examine and compare three theories of distributive justice, namely utilitarianism, John Rawls' theory of "Justice as Fairness" and a libertarian concept of justice, as proposed by Robert Nozick. Utilitarianism is a consequentialist theory that focuses on producing the 'greatest happiness for the greatest number'. I argue that many health policy decisions in South Africa are in fact guided by this principle. However utilitarianism has both strengths and weaknesses which are critically examined. Within the framework of health care policy making, utilitarian justice dictates that rights are derivative and that the welfare of the majority usually takes precedence over the pressing needs of a minority. This issue in particular is discussed. Rawls' theory of "Justice as fairness" is critically discussed next. This theory has been adapted to health care by Norman Daniels, who argues that the Rawlsian principle of "fair equality of opportunity" is a suitable founding principle for health care institutions. Apartheid entrenched a system of 'inequality of opportunity'. Consequently, a theory that focuses on equality of opportunity, has many advantages within the South African context. I examine this theory in detail and provide justification for my assertion that it could be usefully adapted to South African healthcare and the HIV/AIDS epidemic. Finally, I discuss a Libertarian (Nozickian) theory of justice and examine both the strengths and weaknesses of this theory. I attempt to demonstrate why a libertarian system, with it vigorous commitment to moral and economic individualism and belief that one is only entitled to that share of healthcare that can be paid for, would be unjust, if rigorously applied within the post-apartheid South African context. I conclude my dissertation by reiterating my assertion that "Justice as Fair Equality of Opportunity" could be used as a just foundation for a theory of justice for health care in current day, HIV/AIDS affected South Africa. / AFRIKAANSE OPSOMMING: Teorieë van geregtigheid en 'n gesondheidsbeleid vir die VIGS epidemie in Suid Afrika: 'n vergelykende ontleding. Op die 10de Mei 1994 is Nelson Mandela ingehuldig as die eerste demokraties verkose swart president van Suid- Afrika. Die geleentheid is in beide Suid-Afrika en in die buiteland beskou as 'n oorwinning vir humaniteit. Optimisme oor Suid-Afrika se toekoms was oral tasbaar. Mandela het in sy inhuldigingstoespraak verkondig dat dit nooit weer sal gebeur dat hierdie pragtige land sal lyonder die onderdrukking van een oor die ander nie. Hy het gesê dat die son nooit salondergaan op so 'n wonderlike prestasie nie. Nou, minder as tien jaar later, is die verwoestende VIGS epidemie besig om weer die 'son te laat ondergaan'. Dieselffde mense wat alreeds onder apartheid se rasisme en ekonomiese en geslagsongeregtighede gely het, blyk nou weer verontreg te word; hierde keer omdat die gesondheids- en welsynsisteem sukkel om in die behoeftes van die VIGS-geaffekteerde populasie te voorsien. Die doel van hierdie verhandeling is om die konsep van distributiewe geregtigheid in die konteks van die dreigende VIGS epidemie te bespreek. Ek begin met 'n bespreking van die Verklaring van Regte soos vervat in die Suid-Afrikaanse Grondwet. Ek voer aan dat enige aanvaarbare teorie oor geregtigheid in die Suid-Afrikaanse gesondheidsisteem gegrond moet word op hierdie egalitêre Verklaring van Regte. Tweedens kyk ek na die omvang van die VIGS epidemie, die effek wat dit op die HIV-positiewe populasie en hulle familielede het, en die gevolglike implikasies vir gesondheidsbehoeftes. Dit is binne hierdie konteks dat ek drie teorieë van distributiewe geregtigheid ondersoek en vergelyk; naamlik utilitarisme, John Rawls se teorie van "Justice as Fairness", en 'n libertynse konsep van geregtigheid soos voorgestel deur Robert Nozick. Utilitarisme is 'n konsekwensialistise teorie wat beteken dat die regte daad die een is wat in enige situasie die grootste geluk vir die meeste persone sal meebring. Ek voer aan dat baie van die beleidsrigtings wat 'n gesondheidsorg in Suid-Afrika gevolg is, deur hierdie teorie beïnvloed is. Utilitarisme het uiteraard sterk en swak punte en beide kante word krities ondersoek. In 'n gesondheidsorg konteks beteken utilitarisme dat regte altyd afgelei is en dat die welsyn van die meerderheid gewoonlik belangriker is as die van 'n minderheid, selfs wanneer die probleme van die minderheid ernstig en dringend is. Rawls se teorie van geregtigheid word vervolgens krities bespreek. Hierdie teorie is deur Norman Daniels aangepas vir gesondheidsorg. Hy stel voor dat Rawls se beginsel van 'regverdige gelykheid van geleentheid' baie effektief aangepas kan word vir gesondheidsorginstellings. Apartheid het 'n sisteem van ongelyke geleentheids verskans; gevolglik hou 'n teorie wat gelykheid van geleentheid verseker baie voordele vir die Suid- Afrikanse situasie in. Ek bespreek hierdie teorie in detail en poog om my standpunt dat die teorie besonder geskik is vir Suid-Afrikaanse gesondheidsisteem - veral in die konteks van die VIGS epidemie - te regverdig. Laastens bespreek ek die libertynse teorie van geregtigheid soos voorgestel deur Robert Nozick. Ek probeer aantoon waarom hierdie teorie, wat gebaseer is op morele en ekonomiese individualisme en gevolglik aanvoer dat mense geregtig is op gesondheidsorg alleenlik as hulle daarvoor kan betaal, onregverdig is in die Suid-Afrikaanse post-apartheid konteks. Ek sluit hierdie. verhandeling af deur weer te argumenteerdat Rawls se teorie en die beginsel van 'geregtigheid as gelyke geleentheide' uiters geskik is as 'n grondslag vir gesondheidsorg in Suid-Afrika vandag.

Text in English / The purpose of this study was to explore and describe the experiences of community members regarding their participation in hospital boards in Dr Kenneth Kaunda district, North West Province. A qualitative exploratory-descriptive research was conducted on a purposively selected sample of community members who served in the board for a minimum period of two years. Data were collected by means of individual interviews and analysed by means of thematic data analysis. Three themes that emerged from data analysis were creation of opportunities, benefits and challenges. A mix of positive and negative experiences was expressed by community representatives regarding their participation in hospital boards. Participants described their experiences as enjoyable and empowering while others described it as a learning experience through which they acquired knowledge and new skills. The challenges experienced whilst serving in hospital boards included ineffective communication, poor relations and role conflict as a result of lack of role clarification. The findings from the study may be used to enhance the effectiveness of hospital governing boards through the participation of community members. / Health Studies / M.A. (Public Health)

PhD (Advanced Nursing Science) / Department of Advanced Nursing Science / iii Abstract The Mental Health Act is the law which sets out when you can be admitted, detained, and treated in hospital against your wishes. It is also known as being “sectioned”. For this to happen, certain people must agree that you have a mental disorder that requires a stay in hospital. In South Africa, the Mental Health Act of 1973 was noted to have many gaps. Due to all the shortcomings, in 2004 the Mental Health Care Act No. 17 of 2002 came into being in order to protect human rights of the mental health care users. This study sought to determine the knowledge and explore the experiences of medical doctors regarding the implementation of Mental Health Care Act No. 17 of 2002. Secondly, based on the findings, to develop a programme to facilitate the implementation of the Mental Health Care Act No. 17 of 2002 by medical doctors in Vhembe District. The population of this study consisted of all medical doctors working in Vhembe District Hospitals with mental health units and at a specialized mental health hospital as well as all documents completed by medical doctors during admission, care and discharge of mental health care users were purposively sampled. The study was conducted in two phases. In phase 1, where quantitative and qualitative designs were followed to do situational analysis. In phase 2, the programme was developed using results from phase 1, the theoretical framework and approaches outlined by Dickoff, James and Wiedenbach (1968); Chinn and Krammer (1999); Walker and Avant (1995). Individual in-depth interviews and questionnaires checklist were used to collect data which was analysed through opened coding method and SPSS. The findings of this study indicate that medical doctors have knowledge and skills deficit regarding implementation of the Mental Health Care Act No. 17 of 2002 during the admission, care, and discharge of mental health care users. Based on these, a programme to facilitate the implementation of the Mental Health Care Act No. 17 of 2002 by medical doctors during admission, care and discharge of mental health care users was developed. The study concludes that this is a significant contributor in supporting the vision of the National Department of Health to ensure improved mental health for all in South Africa. The study recommends a longitudinal study, tracking the impact of a developed programme, the knowledge of medical doctors regarding the implementation of Mental Health Care Act No. 17 of 2002, and its contribution to the improvement of mental health for all should be conducted over a period of 5 (five) to 10 (ten) years

The AIDS epidemic affects the capacity of the South African public service to deliver essential services. In response, the Department of Economic Development, Environment and Tourism in Limpopo implemented its HIV/AIDS workplace policy in 2003. This research evaluated the extent to which resources were allocated towards the implementation of the workplace policy, to effectively respond to the impacts of HIV/AIDS on the workplace. A combined quantitative and qualitative approach was used. Data was collected through face-to-face interviews of 43 officers involved in the implementation of the workplace policy, using a semi-structured questionnaire. The results indicated that the resources allocated for the workplace HIV/AIDS policy, namely budget, human resources and materials, were inadequate, with district offices being worse affected. / Social Work / M.A. (Social Behaviour Studies in HIV/AIDS)

Despite the availability of numerous models for knowledge translation into practice and policy, research uptake remains low in resource-limited countries. This study was aimed at developing a model to facilitate research uptake in healthcare practice and policy development. The study used a two-phase exploratory sequential approach (QUAL→QUAN). Qualitative data were collected through semi-structured interviews with a total of 21 participants, categorised as researchers (6), frontline workers/practitioners (7), programme/policy managers (4), and directors/senior managers (4) from government, private sector and academic institutions of higher learning (universities and colleges). Quantitative data were collected through an online cross-sectional survey, administered to 212 respondents who conducted research studies in the Mpumalanga Province between 2014 to 2019. The most significant findings seem to be lack of awareness of research findings and champions to lead engagements among research stakeholders on research uptake. In addition, the research has established a failure by researchers to align public health research projects to existing local contexts and available resources. Conversely, there is a growing propensity of using informal research without consideration of data quality issues. It was further observed that establishing and sustaining beneficial collaboration between all research stakeholders is required to promote effective research uptake for practice and policy development. The survey results established a total of 13 components: four individual factors (support, experience, motivation & time factor); four organisational factors (research agenda, funding, resources & partnerships), and five research characteristics factors (gatekeeping, local research committees, accessibility of evidence, quality of evidence & critical appraisal skills). However, the Spearman’s correlation coefficient revealed that of the 13 factors, only six factors had a significant positive correlation with research uptake, namely: support, experience, motivation, time factor, resources, and critical appraisal skills. Consequently, a model for institutionalising research uptake is proposed. The roles of local research committees have been clarified, and a logical framework has been incorporated with pathways and channels of engagements to enable successful implementation of the research uptake model. / Health Studies / Ph. D. (Public Health)

A higher infant mortality rate and shorter life expectancy, coupled with a high prevalence of a variety of diseases commonly associated with malnutrition, are usually a reflection of the social conditions of poverty in a society. By arguing that apartheid formed the basis of inequality and therefore the main underlying cause of an unacceptable burden of the diseases of poverty among black South Africans, this thesis, Poverty, Health and Disease in the Era of High Apartheid: South Africa, 1948-1976, locates these health problems within their social, economic and political context. It further argues that if health and disease are measures of the effectiveness with which human beings, using the available biological and cultural resources, adapt to their environment, then this relationship underpins the convergence of medical and cultural interests. Under the impact of modern technology and society's dependence upon it, profound cultural changes have taken place and issues of health and the etiology of disease are among the areas most affected by these changes. This thesis explains why, in a pluralistic medical setting, where only modern (scientific) medicine was recognised as legitimate medicine by the apartheid government, for the majority of black South Africans the advent of modern medicine was viewed not so much as displacing indigenous (African) medicine but as increasing the medical options available to them. It is therefore contended here that for most black South Africans, indigenous medicine has played a critical role; it has mitigated the impact of apartheid medicine. Since differences that people perceive in these two medical systems are crucial to the medical choices that they make at the onset of illness, this thesis argues that knowing and understanding the reasons for making such choices would not only have practical value for health authorities in their efforts to improve local, regional and national health service delivery, but would also contribute to a general understanding of human therapy-seeking behaviour in this age of the HIV/AIDS pandemic. / History / Thesis (D. Litt. et Phil. (History))

This explorative, descriptive quantitative survey attempted to determine whether the reduced number of consultations and admissions of sick children less than five years in Emfuleni sub- district clinics is due to the utilisation of the IMCI strategy or other health services. The research population comprised of all the mothers/caretakers of children less than five years who utilised the clinics and those who consulted the private medical doctor. The convenient sample consisted of 169 candidates. Data was collected by means of a questionnaire and analysed using the SAS/Basic computer statistical software package. Findings of the study revealed a need to address the major concern about the waiting time and operational times in all the three clinics. Recommendations were made that staff allocation procedures and policies be reviewed in order to abate long waiting periods at the clinics where children with childhood illnesses are treated. / Health Studies / M.A. (Health Studies)