Thesis (Ph. D. (Translation Studies)) -- University of Limpopo, 2014 / The study focuses on communication during consultations between English-speaking foreign medical doctors, patients and nurses as interpreters in the Limpopo province. It aims to identify and describe the communication strategies, politeness strategies, influence of gender on the communication process as well as a review of the policy on language practice in the hospitals with a view to suggesting amendments. Through a field work carried out in 10 public health facilities in Limpopo province, the study adopts an eclectic research method of semi-structured interviews, audio recording, and observation in the collection of data. Thirty-five patients, thirteen nurses and nineteen medical doctors are involved in the study. All the interviews and audio recordings were transcribed and translated wherever needed. Collected data was analysed using the Statistical Package for Social Sciences (SPSS) and Nvivo softwares. Results showed that many foreign doctors were frustrated that they could not communicate directly with patients because they could not speak the indigenous language and the assumption that most patients could communicate in English often turned out to be erroneous. The hospitals are ill equipped to deal with the language problems. The linguistic barrier made it difficult to give equal medical care to all patients and doctors resorted to avoidance strategies in selecting patients. Five consultations types based on the turn-taking were identified. These are clarification, continuation, convergence, knowledge and avoidance strategies. The study also reveals that the doctors use more positive politeness strategies when communicating with the patients and nurses. Gender was found to influence the choice of communication strategies by the foreign doctors. The inadequacies of the National Department of Health Language Practice Policy are highlighted and suggestions are made towards its amendment. KEY CONCEPTS English-speaking foreign medical doctors, communication strategies, politeness strategies, gender, language policy, interpreters.

Submitted in partial fulfilment of the requirements for the degree of Masters in Business Administration (MBA), Business Studies Unit, Durban University of Technology, 2008 / The pharmaceutical industry is in the midst of a fundamental transformation. Time and cost constraints are forcing marketers to search for new ways to maintain and grow brand awareness. The amount of time that doctors allow for representatives to market their products is becoming less and less and as a result products are not getting the exposure they used to. Organisations that find innovative ways to maintain exposure of their products may gain a competitive advantage over those organisations that rely on traditional marketing methods. The prolific increase in the use of the internet may provide pharmaceutical organisations with a complementary channel to market their products. The objective of this study is to determine the levels of internet technology adoption among general practitioners. The Technology Acceptance Model (TAM) is one of the most influential research models in studies of the determinants of information systems/ information technology (IS/IT) acceptance. In TAM, perceived usefulness and perceived ease of use are hypothesised and empirically supported as fundamental determinants of user acceptance of a given IS/IT. Using TAM, this study sets out to determine general practitioners’ intention to use the internet as a source of pharmaceutical information. The literature review provides an extensive evaluation on the development of TAM and its application in different technologies. Based on these findings, the researcher developed this study to investigate internet technology acceptance in the pharmaceutical industry. Use is made of the descriptive survey method and data is retrieved from a sample of 105 general practitioners in Kwazulu-Natal. The observation is made via the benefit of a questionnaire. The process of sampling is that of convenient sampling. The analysis is quantitative and makes use of statistical analysis appropriate for the data. Analysis of the survey results produces useful insights into the factors influencing internet technology adoption by general practitioners. When analysing the independent variables, respondents were not in strong agreement about the perceived usefulness nor the perceived ease of use of internet technology as a source of pharmaceutical information. However, positive results from the relationships between the independent (perceived usefulness and perceived ease of use) and dependent variables (attitude and intention to use) provide valuable data with which organisations may develop internet-based marketing strategies. Based on the survey findings, recommendations using the Beynon-Davies (2004) Internet Adoption Model are suggested.

The Orchidaceae makes up the largest and most diverse family of flowering plants. Orchids are popular, often expensive ornamentals, with a broad range of ethnobotanical applications. There is very limited documented information on South African medicinal orchid species; no formal pharmacopoeia outlining ethnobotanical uses; and ethnobotanical and distribution records are either scarce or inconsistent and plant populations are becoming gradually smaller. There have been significant developments in medicinal orchid research worldwide with medicinal use and corresponding pharmacological and phytochemical properties being extensively investigated. It is evident from the literature that there is no pharmacological research on South African medicinal orchids; hence the need to explore biological activity and chemical composition of South African medicinal orchid species. The ethnobotanical approach used to select the orchid species for pharmacological and phytochemical research elsewhere, yielded valuable biological compounds. Thus, a similar approach was applied to South African medicinal orchids. There are approximately 20 000 species and 796 genera of orchids distributed across the world. In southern Africa, orchids are widely represented with 55 genera and 494 species. Approximately 75% are endemic to this region. As part of the current investigation a review of available ethnobotanical literature on South African medicinal orchids was prepared. The review revealed that an estimated 49 indigenous orchid species from 20 orchid genera are currently being informally traded and used in South African traditional medicine. They are used primarily for medicinal and cultural purposes, especially by the Zulu community in South Africa. Medicinal uses of orchid species include: treatment of inflammatory, intestinal, neurological and reproductive disorders and emetics are used to cause emesis. Non-medicinal uses of orchid species include: love, fertility, protective and lethal charms. Based on their ethnobotanical uses and endemism, South African orchids were considered to be one of the untapped sources of bioactive compounds that needed to be researched. The current investigation addressed the broader aims of medicinal plant research by determining the efficacy, safety and chemical profile of seven indigenous orchid species used in South African traditional medicine and practices. The biological and toxic effects of orchid plant extracts were assessed using established pharmacological bioassays. The phytochemical evaluation of the seven orchid plant extracts provided insight into the classes of chemical compounds present and their possible role in the observed biological activities. The potential of plant extracts from seven orchid species used in South African traditional medicine, as sources of natural bioactive products, are discussed. The current investigation determined the biological activity and chemical profile of seven orchid species commonly traded in KwaZulu-Natal herbal markets: Ansellia africana Lindl., Bulbophyllum scaberulum (Rolfe) Bolus, Cyrtorchis arcuata (Lindl.) Schltr., Eulophia hereroensis Schltr., Eulophia petersii (Rchb.f.) Rchb.f., Polystachya pubescens (Lindl.) Rchb.f. and Tridactyle tridentata (Harv.) Schltr. Well established in vitro micro-dilution bioassays were used to determine the antibacterial, antifungal, anthelmintic activities of crude orchid extracts. A minimum inhibitory and/or lethal effect of organic and aqueous crude orchid extracts was observed against Bacillus subtilis, Escherichia coli, Klebsiella pneumoniae, Staphylococcus aureus, Candida albicans and Caenorhabditis elegans. Tridactyle tridentata aqueous root extract produced the most effective antibacterial activity against S. aureus (0.049 mg/ml). All T. tridentata organic root extracts produced significant inhibitory activities against B. subtilis and S. aureus. Eulophia petersii DCM pseudobulb extracts significantly inhibited all bacterial strains tested (0.39 mg/ml against S. aureus and 0.78 mg/ml against B. subtilis, E. coli, and K. pneumoniae). Eulophia hereroensis 80% EtOH root extract was the only other extract to exhibit significant inhibitory effects against K. pneumoniae (0.65 mg/ml). After 48 h C. albicans was most susceptible to P. pubescens aqueous pseudobulb extract (0.0816 mg/ml). Eulophia petersii DCM pseudobulb extract however, exhibited significant activity against C. albicans (0.65 mg/ml) over 72 h. Cyrtorchis arcuata leaf and root extracts were the most effective anthelmintic extracts with MLCs of 0.041 mg/ml for 80% EtOH leaf and root extracts; 0.049 mg/ml for aqueous leaf extracts and 0.78 mg/ml for aqueous and DCM root extracts. Caenorhabditis elegans was most susceptible to all A. africana and T. tridentata organic root extracts. A similar significant effect was observed for all E. petersii organic pseudobulb extracts, DCM extracts and organic root extracts of B. scaberulum. Only the DCM tuber and root extracts of E. hereroensis exhibited lethal effects on C. elegans. All of the P. pubescens extracts showed poor anthelmintic activity. Similarly, in vitro enzyme based cyclooxygenase (COX) 1 and 2 and acetylcholinesterase (AChE) inhibitory bioassays, revealed significant inhibition of COX-1, COX-2 and AChE enzymes by crude organic and certain aqueous orchid extracts. Out of a total of 53 evaluated extracts, 21 and 13 extracts exhibited significant anti-inflammatory activity in the COX-1 and COX-2 assays respectively. The DCM tuber extract of E. hereroensis was the only extract to significantly inhibit both COX enzymes, 100.02±0.11% and 87.97±8.38% respectively. All B. scaberulum root extracts (DCM, EtOH and water) exhibited COX-2 selective inhibitory activity (100.06±0.01, 93.31±2.33 and 58.09±3.25%). Overall, the DCM root extract of A. africana was found to be the most potent extract (EC50 0.25±0.10 mg/ml). The 80% EtOH root extract of B. scaberulum was the most potent in the COX-2 assay (EC50 0.44±0.32 mg/ml). Generally the root extracts exhibited greater AChE inhibitory activity; where the most active extract was B. scaberulum DCM root extract (EC50 0.02±0.00 mg/ml). All aqueous extracts, except that of A. africana roots and B. scaberulum pseudobulbs, showed poor or no COX-1 and COX-2 inhibition. The antioxidant capacity of crude orchid extracts was determined using: hydrogen atom transfer (HAT) (β-carotene/linoleic acid assay) and single electron transfer (SET) (2,2‟-diphenylpicrylhydrazyl (DPPH) free radical scavenging assay and ferric reducing antioxidant power (FRAP) assay) reaction-based assays. Potent antioxidant effects were observed for certain crude methanolic orchid extracts. Generally, there was a dose-dependent change in radical scavenging activities of crude extracts from which EC50 values were determined. The root extracts of all species, except that of E. petersii, had consistently more effective radical scavenging activity than that of other plant parts within each species. The pseudobulb extract of E. petersii, was the most potent extract (EC50 1.32±0.86 mg/ml). In the β-carotene-linoleic acid assay, based on the oxidation rate ratio (ORR), the leaf extract of T. tridentata and the root extracts of C. arcuata and E. hereroensis exhibited the best antioxidant effects (0.02, 0.023 and -0.15 respectively). Similarly, the average antioxidant activity (%ANT) of these samples was greater than that of BHT (95.88±6.90%) and all other samples. Bulbophyllum scaberulum leaf, pseudobulb and root extracts, E. petersii pseudobulb extract and T. tridentata root extract also exhibited a greater capacity to prevent β-carotene oxidation when compared to BHT. All crude orchid extracts tested demonstrated a general dose-dependent response in the ferric reducing power assay. The reducing power of ascorbic acid (0.08 mM) and BHT (0.05 mM), as measured as absorbance, was 1.12±0.12 and 0.73±0.08 respectively. At 6.25 mg/ml, A. africana root and E. petersii pseudobulb extracts were the most effective in reducing power activity. The short-term bacterial reverse mutation Ames Salmonella/microsome mutagenicity (ASMM) assay, which makes use of mutant histidine-dependent Salmonella typhimurium strains, was used to determine the mutagenicity and toxicity of crude orchid extracts. In the presence of a mutagen S. typhimurium TA98 strain detects frameshift events while the TA100 and TA102 strains detect base-pair substitutions. In the absence of metabolic activation, mutagenic extracts were observed against the TA98 strain only. All A. africana DCM leaf and stem extracts tested, the DCM root extract (0.5, 0.05 mg/ml) and EtOH leaf, stem and root extracts at 5 mg/ml exhibited mutagenic effects. The EtOH root extracts (5, 0.5 mg/ml) of B. scaberulum exhibited mutagenic indices (MI) comparable to that of 4NQO (17.00 and 13.00, respectively). Eulophia petersii PE pseudobulb extract demonstrated mutagenic potential at 5 mg/ml. The ethanolic root extracts of T. tridentata showed mutagenic effects at 5 and 0.5 mg/ml. The mutagenicity index (MI) with metabolic activation (S9) was determined using only the TA98 strain; where no mutagenic effects were observed. In the phytochemical evaluation of crude methanol orchid extracts, the Folin-Ciocalteu assay for total phenolics, butanol-HCl assay for condensed tannins, rhodanine assay for gallotannins and vanillin assay for flavonoids revealed a quantitative chemical profile of the tested samples. The correlation between observed biological effects and chemical compounds present was found to be generally significant. The significant antimicrobial, anthelmintic, anti-inflammatory and antioxidant activity of E. petersii pseudobulb extracts and E. hereroensis tuber and root extracts may be attributed to their high total phenolic content. Alternatively, the significant levels of gallotannin content in E. hereroensis may have contributed to the bioactivity. The flavonoid content of B. scaberulum and T. tridentata may explain the potent activity observed in the anti-inflammatory, antioxidant and acetylcholinesterase inhibitory assays; while the flavonoid content C. arcuata may have contributed to the potent anthelmintic and antioxidant activities. The significantly higher levels of gallotannin content may explain the significant anti-inflammatory and anthelmintic activity of A. africana. A number of biologically active compounds have been isolated from certain Orchidaceae species around the world on the basis of their traditional medicinal uses. The traditional uses of these orchid species were scientifically validated. No pharmacological research has been previously conducted on South African medicinal orchids; therefore the current investigation has produced novel findings on the efficacy and safety of these orchid species and promotes the continued research of medicinal orchids in South Africa. / Thesis (Ph.D.)-University of KwaZulu-Natal, Pietermaritzburg, 2012.

Ingestion of extracts prepared from various medicinal plants to induce or augment labour is common amongst Black South African women during the late stages of pregnancy. This applies particularly to the rural areas where modern health care facilities are often lacking. Many of these plants have not been investigated scientifically and one needs to substantiate claims of quality, safety and efficacy. Furthermore, it is believed that the consumption of these plant extracts can result in foetal meconium staining at delivery. An investigation into the uterotonic properties of three plants viz. Ekebergia capensis Sparrm. Clivia miniata (Lindl.) Regel. and Grewia occidentalis L. were carried out using guinea pig uterine smooth muscle in vitro. Supercritical fluid extraction was performed with water modified supercritical carbon dioxide to extract the uterotonic components. An attempt was also made to couple supercritical fluid extraction directly on-line to the bioassay so that on line screening of crude plant extracts could be performed within short periods of time. The effects of supercritical CO2 decompression on temperature and pH of the muscle bathing solution were considered since these factors affect muscle contractility. The direct effects of excess CO2 on intracellular mechanisms were eliminated by constructing a CO2 reduction interface together with passage of carbogen which aided in the rapid displacement of excess CO2, As samples of these extracts were found to induce muscle contraction, supercritical fluid fractionation (SFF) was performed by sequentially increasing the fluid density. Extracted fractions were obtained by sequentially increasing the pressure at constant temperature and modifier concentration in an attempt to identify the active fractions. Extractions were performed at 200 atm, 300 atm and 400 atm respectively. Subsequent testing of these fractions enabled the detection of active and inactive fractions as well as a fraction that had a spasmolytic effect on uterine muscle. The 400 atm extracts of E. capensis and C. miniata displayed maximum activity while only the 300 atm extract of G. occidentalis induced uterine muscle contraction. Subsequent analysis of the sequentially extracted fractions, by high performance liquid chromatography and micellar electrokinetic capillary chromatography revealed that certain compounds present in the fractions that stimulated muscle contraction, were sensitive to the extraction pressure hence making it possible to determine the compounds that were likely to be active. Column chromatography followed by various spectroscopic techniques were performed in an attempt to isolate and elucidate the structures of the compounds that were present in the plant extracts. The extract of Ekebergia capensis yielded five known compounds (B-sitosterol, oleanonic acid, 3-epioleanolic acid, 2,3,22,23-tetrahydroxy-2,6,1 0, 15,19 ,23-hexamethyl-6, 10, 14, 18- tetracosatetrene and 7-hydroxy-6-methoxy coumarin. The extract of Clivia miniata yieded linoleic acid and 5-hydroxymethyl-2-furancarboxaldehyde while the extract of Grewia occidentalis yielded 3-(4-hydroxy-3-methoxyphenyl)-2-propenal, a novel compound 2,2' ,6,6'-tetramethoxy-4'-al-4-(w-oxo-E-propenyl)-biphenyl and oleanonic acid. The pure compounds were further evaluated pharmacologically to identify the active components and assess the physiological mode of action by the use of various receptor blockers. Oleanonic acid, 3-epioleanolic acid, linoleic acid and 5- hydroxymethyl-2-furancarboxaldehyde and 3-(4-hydroxy-3-methoxyphenyl)-2-propenal were found to induce an agonistic muscle response. All these compounds were observed to mediate their effects through the cholinergic receptors. The results obtained in this study supports the claim of these plants possessing uterotonic properties. / Thesis (Ph.D.)-University of Natal, Durban, 1997.

This study was undertaken to redress the scant knowledge regarding the chemistry and mode of action of pregnancy-related traditional medicines, or isihlambezo (Zulu), which are used by 60 to 80% of women in South Africa. The three selected plants are among the six most frequently cited species from the approximately 90 used by traditional healers. The purpose of the study was to identify components which could cause uterine contractions, those with nutritional value for the foetus and mother, and those with any toxic effects. Plant root extracts were purified via silica gel column chromatography and bioassays were carried out on the fractions, using isolated rat uterine tissue. Purified compounds were identified via spectral techniques, and some were characterised by comparison to authentic standards using HPLC, and others by matching their GC-MS spectra to library standards. Thirty-eight compounds were identified in total, the majority of these being novel to the species concerned. Those isolated from Combretum kraussii were 1 sitosterol, 2 combretastatin, 3 3',4-tri-O-methylellagic acid, 4 combretastatin B-1, 5 combretastatin A-1, 6 3,3'-di-O-ellagic acid lactone, 7a ellagic acid lactone, 7b ellagic acid, 8 and 9 a mixture of combretastatin B-1 and A-1 glucosides, 10 and 11 partly characterised glucosides of ellagic acid. Those isolated from Gunnera perpensa were 12 3',4-tri-methylellagic acid, 13 ellagic acid lactone, 14 1,1'-biphenyl-4,4'-diacetic acid, 15 p-hydroxybenzaldehyde, 16 Z-methyl lespedezate, 17 and 18 partly characterized higher glucosides of Z-methyllespedezate. Those isolated rom Rhoicissus tridentata were 19 (-)-epigallocatechin, 20 (+)-gallocatechin, 21 procyanidin B3, 22 procyanidin B4, 23 (+)-catechin hydrate, 24 (+)-mollisacacidin, 25 (+)-epicatechin, 26 fisetinidol-(4a-8) catechin, 27 (-)-fisetinidol, 28 fisetinidol-(4b-8)catechin, 29 gallic acid, 30 epicatechin-3-0-gallate, 31 partly characterized hydrogel of glucose, 32 sitosterol, 33 sitosterolin, 34 y-sitosterol, 35 oleanolic acid, 36 lupen-3-one, 37 20-epi-y-taraxastananol and 38 triacontanol. The compounds with the greatest in vitro uteroactivity were predominantly proanthocyanidins or phenolic glucosides. It is proposed that effects of phenolic glucosides could be due to the interaction of the sugar moiety as well as the phenolic moiety with the receptor site in muscle tissue. The corresponding phenolic aglycones isolated were only moderately uterotonic, or unreactive by comparison. Non-polar compounds such as sitosterol and sitosterolin showed minimal enhancement of the uterine response at low concentrations, and inhibition at higher concentrations. Aqueous root extracts of the plants were all found to be non-toxic according to cell-viability tests using monkey vero cells and human fibroblasts. Extracts are therefore considered safe for human consumption, although it is recommended that Rhoicissus tridentata be used with caution because it showed the lowest cell viability of the three species, and uterine hyperstimulation has been attributed to this species, as well as CNS depression and respiratory arrest. Ions which could be nutritionally beneficial in pregnancy, calcium, iron, and phospate, were present in low in aqueous extracts. Levels of calcium and potassium ions were considered to be too low to directly stimulate uterine muscle. Proanthocyanidins, combretastatins, ellagic acid derivatives and phytosterols, with health-promoting properties, were also identified. / Thesis (Ph.D.)-University of KwaZulu-Natal, Durban, 2004.

The aim of this study is to isolate and evaluate the anticonvulsant components from the leaves of Leonotis leonorus (L) R.aR. and to see if there is any change in activity with the origin of the plant material and I or the season in which plant material is collected. Therefore, in this study, two sites were chosen for collection of plant material and the collection was made in summer and in winter. Chemical, physical and pharmacological methods were used to isolate, identify and to evaluate compounds isolated from the leaves of Leonotis leonorus for anticonvulsant activity.

For centuries Traditional Health Practitioners (THPs) used their indigenous knowledge (IK) in conserving medicinal plants and environments to maintain sustainability. With the rapid environmental, social, economic and political changes occurring in many areas inhabited by rural people exist the danger that the loss of biodiversity from habitat destruction and unsustainable harvesting practices will result in some species becoming extinct. The main aim of the study was to determine the natural habitat of extinction-prone traditional medicinal plants combining the insight of THPs with an ultimate goal of guiding research for the conservation, propagation and cultivation of traditional medicinal plants. Despite problems, opportunities and challenges expressed and identified by THPs, the analysis of data from interview schedule and personal observations, show that the THPs' practices are shaped by historical processes and local cultural values, social norms and their management strategies that are influenced by a broad range of factors. / Agriculture, Animal Health and Human Ecology / M.A. (Human Ecology)

Pharmacovigilance is “the science and activities relating to the detection, assessment, understanding and prevention of adverse effects or any other drug-related problem”. To date, no comprehensive study has been performed to evaluate the pharmacovigilance system in the public health sector in South Africa. The primary aim of this study was to evaluate the current status of pharmacovigilance systems within the public healthcare sector in South Africa, and the level of functioning of these systems, in order to provide relevant recommendations, where necessary, for improvement, using the Indicator-based Pharmacogivilance Assessment Tool (IPAT). National and provincial entities were deemed compulsory (n=14), while facilities were selected via random, stratified sampling to obtain a representation at each facility level (n=101). The IPAT was amended for relevance at each level of data collection. Indicators are classified as core and supplementary and compliance with core indicators shows the level of functioning National entities obtained an IPAT score of 36 out of a maximum of 72, achieving 50% compliance. Province D and Province G obtained overall IPAT scores of 29 and 12 respectively out of a maximum of 40, achieving an overall 72.5% and 30% compliance respectively Results at provincial and facility levels were not fully representative due to a limited response rate of 22.2% and 65.3% respectively. Regional/tertiary facilities and district facilities displayed increased awareness and implementation of pharmacovigilance activity than the lower levels of Community Health Centres (CHCs) and Primary Health Centres (PHCs). South Africa”s public healthcare system possesses the infrastructure for a well functioning pharmacovigilance system. However there are gaps in level of functioning at a national, provincial and facility level. Addressing these gaps would show a marked improvement in the system and go a long way towards the contribution of medicine safety information not only locally, but to aid other developing nations.

Xhosa psychiatric nurses stand unique at the interface between Western mental health care and indigenous healing in South Africa. They stem from a cultural history that is embedded within traditional health care discourses and yet are trained and work within a Western psychiatric model. In embodying the intersection between these two paradigms, they are faced with the challenge of making sense of such an amalgamation. These nurses' views are thus valuable in reflecting this intersection and illustrating many of the central concerns that surround it. This study explicates the views of these nurses toward traditional healers and their potential role in mental health care in South Africa. In addition, it illuminates some of the cultural dynamics at work amongst these subjects as they struggle to make sense of their unique cultural position. Using a questionnaire-based methodology, the views of Xhosa psychiatric nurses in a psychiatric hospital in the Eastern Cape, toward traditional healers and their role in mental-health care, were examined. The findings reveal that the vast majority of these nurses believe in traditional cosmology, involve themselves in traditional ritual practices and regularly visit traditional healers as patients. In suggesting ways in which indigenous healing and Western mental health care can work together, 75% of the nurses were in favour of a general referral system between the hospital and traditional healers, most (77%) agreed that certain patients would be better off being treated by both the hospital and traditional healers than they would if they were only being treated by the hospital alone, and 85% of the subjects agreed that patients who are already seeing traditional healers should check if psychiatric medication might help them. These findings indicate that these nurses operate across two healing systems which are at this point not conceptually compatible. This results in deep cultural tension for the nurses. In being entangled in the dialectical tension created in this context, the nurses manage the incongruencies in three general ways: a) Most, in one form or another, incorporate beliefs from both systems into an integrative model, b) some assimilate their cultural belief system into the Western mental health paradigm, throwing off their beliefs in traditional healing, and c) others remain ambivalent in the dialectic between traditional and Western health care discourses. Although this may suggest that these nurses reside within a cultural milieu that is somewhat unhealthy, at another level, in managing and containing the incompatibility between the two systems, these nurses ensure a space for on-going and healthy critique of the underlying assumptions involved in this health care malaise.

M.A. (Social Work) / Accountability and competence are two important attributes needed by medical social workers in the changing social, political, economic and organizational situation in South Africa, In order -to be accountable and competent, medical social workers must be in possession of scientific knowledge, skills and the correct attitude regarding assessment, intervention and evaluation. The change in emphasis from long-term to short-term hospitalization and the importance of primary health care, means that within the limitations of the present organization structure, assessment is often the most important and sometimes the only, aspect in the helping process. The knowledge and skills of the medical social workers need to be extended; this study therefore focuses on effective assessment that will equip the medical social worker to render an effective service through linking resources within the patient, hospital and within the community. The aim of this study is the development of a training programme for medical social workers to extend their knowledge and skills in assessment.