Mental health care in South Africa has long been governed by inequalities (Foster & Swartz, 1997). During apartheid, those who did not speak English and Afrikaans could not access mental health services in the same way as those who did (Foster & Swartz, 1997). One main reason for this is the majority of mental health practitioners could not, and were not required to speak languages other than English and Afrikaans (Swartz, 1991). The South African mental health literature suggests that language and communication must be prioritised if there is to be an improvement in mental health care services for those individuals who do not speak English and Afrikaans (Bantjes, 1999; Drennan & Swartz, 1999; Swartz & Drennan, 2000; Swartz & MacGregor, 2002). Drawing on Prasad's (2002) interpretation of Gadamer's critical hermeneutic theory and utilising thematic networks analysis (Attride-Stirling, 2001), this study investigated the process of translated clinical assessment interviews within a psychiatric hospital in the Eastern Cape Province within South Africa. Results of the study revealed that contextual factors, issues concerning linguistic and cultural heritage, clinicians' role expectations regarding translators' role performance, as well as relational dynamics regarding individual levels of control and influence within the translation triad, all impacted on the effectiveness of communication, translation and service provision. These fmdings are supported by literature on the theory and practice of translation that identifies these issues as prominent (Robinson, 2003). Specific recommendations regarding the formalisation of translation practices within the hospital setting, as well as the familiari~ation of clinical practitioners and psychiatric nurses with the intricacies of translation processes are offered.

Indigenous Knowledge (IK) is in danger of being obliterated due to a number of factors, such as the lack of interest from younger generations, low life expectancy where people die before transferring it to the next generation and it not being documented. This is due to the fact that IK, by its very nature, is generally known to have been passed on from generation to generation through oral tradition. This qualitative study utilised the organisational knowledge conversion theory to investigate the acquisition, transfer and preservation of IK by traditional healers in the Limpopo Province of South Africa with the view to develop a framework to provide understanding on how IK is acquired, transferred and preserved by traditional healers. The study adopted hermeneutic phenomenology research method and utilised snowball sampling technique to determine the population of this study which consisted of indigenous healers from the Limpopo Province. Data were collected through interviews with traditional healers, observations, as well as document analysis. Data were analysed and interpreted thematically according to the objectives of the study. The study revealed that knowledge of traditional healing is mainly acquired through observations, imitations, following orders and performing tasks practically. In addition to that, collaboration was highlighted as one of the driving forces behind effective transfer and acquisition of knowledge among healers. The major finding to this study was that ancestors are believed to be the ones preserving this knowledge of traditional healing and they pass it down to the chosen ones through dreams, visions and so on. The study concludes that traditional healers also preserved their knowledge orally and commonly shared and acquire knowledge during interactions with other healers. Furthermore, traditional healing is marginalised and not properly regulated in South Africa. It is recommended that key stakeholders should play an active role in ensuring that traditional healing is incorporated into the country’s healthcare system. This way traditional healing can help reduce a heavy burden on public health sector in terms of treating patients. A further study on integrating traditional healing into mainstream healthcare system in South Africa is recommended. / Information Science / D. Litt. et Phil. (Information Science)

The purpose of this study was to determine the nurse educators’ experiences in implementing the evidence-based practice (EBP) in teaching and learning, and to describe the importance and benefits of EBP teaching and learning to the nursing profession, especially for nurse educators and student nurses. A qualitative research design and methods were followed in conducting the study. A non-probability purposive sampling technique was used to access the sample of twelve nurse educators from two nursing campuses under KwaZulu-Natal College of Nursing within Umgungundlovu Health District. Data were collected using semi-structured interviews, the interview guide, and the digital voice recorder. Data were analysed manually, following a content thematic data analysis approach. Two themes emerged as follows:  Challenges experienced by nurse educators with the implementation of EBP in teaching and learning.  Benefits/value of EBP in teaching and learning. Findings revealed that, although most of the nurse educators are supportive and displayed a positive attitude towards implementing EBP in teaching and learning, the level of knowledge and skills was questionable. This was coupled with a lack of motivation and commitment towards research. Therefore, recommendations for nursing education, nursing practice, and future research were suggested, for successful implementation of EBP in teaching and learning. / Health Studies / M.A. (Health Studies)

Since the 1950s modernization theory predicted within the Third World a trajectory for social evolution and development mirroring perceived social and developmental evolution in Western societies since the 17th Century. Despite this theory being much discredited in both Western societies and the developing world; this theory still forms the basis for much analysis and policy formulation within post-1990 South Africa. This thesis looks at various aspects of urban black South Africans' existence and concludes that African tradition has found a place within an urban existence due to it's flexibility in dealing with peoples' daily challenges. An urban existence can thus no-longer be thought of as supplanting tradition in favour of western influences, but rather as bringing about a mixture of western and traditional influences - with positive and negative theoretical and practical developmental consequences / Development Studies / M.A.

The traditional health care system as it prevails in South Africa is part of African culture and intricately linked with the African world view. It embraces traditional norms and values that have survived to this day. In this sense it is more than a constituent part of medical pluralism which has become a global phenomenon. The role of the traditional healer is far more extensive than that of the modern medical doctor. He advises on all aspects of life, including physical, psychological, spiritual, moral and legal matters. He shares the client's world view. He understands the significance of ancestral spirits, the belief in supernatural forces and the reality of witches. It is in this context that modern scientific medicine has not been able to replace traditional medicine, and arguably never will. Traditional medicine is faced with enormous challenges at present. Firstly, the traditional social order is fast disappearing, making way for the state and the individual whose rights as contained in the Bill of Rights of the 1996 Constitution of the Republic of South Africa may seriously clash with traditional norms. Secondly, especially in an urban environment, the healer may encounter stiff competition from more progressive colleagues and modern physicians. Thirdly, scientific medicine basically regards traditional activities as unscientific, unregulated, often harmful and sometimes fatal. Fourthly, anti-witchcraft legislation hinders the traditional practitioner to deal with witches in the culturally appropriate manner. Traditional medicine will not go away. It is therefore necessary to find ways and means to see it practised in a safe and competent manner. As healers agitate for official recognition, it will be regarded as their corresponding duty to professionalise the traditional sector, create a traditional medical council and establish a register of bona fide healers who possess stipulated qualifications and are subject to rules of conduct and discipline. The modern and traditional sectors are essentially complementary and should be accommodated within a legal framework of official health care that protects healers and healed alike. The legal implications of this strategy are discussed in a global as well as regional African context. / Jurisprudence / LL.D.

The majority of black South Africans utilize the services of indigenous healers and the new National Health Plan for South Africa makes provision for cooperation between the healers and formal health practitioners. The purpose of this study was to determine the role played by indigenous African healers in the prevention of diseases and the promotion of health, and to design a model which will provide guidelines for cooperation between indigenous healers and formal health workers. This study was ethno-medical, contextual, exploratory and qualitative. It was designed to look into the health care of a specific cultural group to explore in depth the experiences of indigenous healers in providing health care within their cultural context. Data was collected by individual free-type interviews from indigenous African healers, users of formal health services and by observation. It was found that there is dual utilization of both formal and indigenous health service systems by clients. A specific culbrral terminology relating to health was found to be used. Such terminology could result in communication gaps and breakdowns if not known to or used by formal health workers. The findings show that cultural beliefs are still strongly adhered to. These were found to influence the life-styles and health maintenance behaviour of a cultural group. The fmdings show that divination fonns the core of health assessment and health-problem diagnosis. It was found that no health problem could be attended to without first going through a divination session. The findings also show involvement of indigenous healers in primary health care workers at first contact levels of prevention in the field of paediatric preventive care. Diarrhoea and vomiting in children was found to be the preventable disease in which healers specialize. Infertility and impotence were found to be conditions taken to healers for treatment. Other sexually transmitted diseases as well as culture-bound syndromes treated by indigenous healers were found in this study. The use of rituals and rites of passage and the involvement of ancestors were found to form part ofholistic health care. The fmdings show the willingness of healers to collaborate with formal health workers. A model is designed to guide the process of collaboration. / Health Studies / D. Lit. et Phil. (Advanced Nursing Sciences)

This research study was initiated by the desire to identify the constraining and enabling factors experienced by environmental health officers (EH Os) and their management in the implementation of environmental health education and promotion programmes in the environmental health sector. The research contextualises the issues of health promotion, the role of education in health promotion, and community-based environmental health service provision with specific reference to the role of the EHO in relation to these issues. The foremost value ofthis study lies in the fact that it profiles the need for change in the delivery of community-based environmental health education and promotion programmes and identifies distinctive policy changes and skills development needs in the field of environmental health promotion which are central to improved and sustainable community-based environmental health education and promotion. / Educational Studies / M. Ed. (Environmental Education)

In contemporary multicultural societies, health is emerging as a fundamental right alongside education and welfare: a frame of reference endorsed by the Government of National Unity in South Africa. Health workers are confronting issues far beyond the more traditional modes of health education. The initial thrust of this research was to investigate the most relevant social, health and education knowledge bases and issues relative to health education in cross cultural encounters in order to formulate universal guidelines applicable to the national situation. Differences inherent in allopathic and traditional health systems are explored in historical time, in conjunction with concepts of social change, communality in diversity and the co-existence of multiple realities. An understanding of common denominators across all human and group experience emerges and, with it, insight into problems that occur when universalistic conceptions of human behaviour are linked to communicocentric hegemony. The parameters within which cross cultural health education are viewed are extended through an analytical, empirical evaluation of the andragogic consequences of a broader conceptualisation of culture and the patterned relationships existing between elements within society. The ontic fact that similar variables may have widely different meanings and be differently construed by people whose life experiences differ is affirmed. Culture shock becomes a potential personal reality for all engaged in cross cultural encounters. Radical reflection on human nature and the eidos of man constitutes the foundation upon which the aims and various theories of health education are systematically and progressively evaluated. Evidence surfaces that the original intent of the research was rooted in the Western medical tendency towards standardisation, specialisation and the creation of scientifically validated routines for professional practice and that gaps exist between the theory and practice of health education and the everyday experiences of people. On the basis of scientifically based insights, guidelines have been formulated to narrow the divide between the factual, linearly based procedural aspects of health education and the human experience of learning. The guidelines embody the notion that the health educator's role in cross cultural encounters is one of facilitating meaningful, appropriate and informed choices on the part of adult learners. / Educational Studies / D.Ed. (Philosophy of Education)

Text in English / Health Communication Campaigns are one of the strategies used in facing the challenges of the spread and effects of the HIV/AIDS epidemic, which is not only a health issue but also has sociocultural implications and consequences. Although there are some models and research tools available to guide the planning, designing, implementing, monitoring and evaluation of health communication campaigns, the premise of the study was on two assumptions. First, most available models that guide the planning and execution of HIV/AIDS communication campaigns do not sufficiently highlight sociocultural variables; and second, since most available models do not sufficiently emphasise sociocultural variables, the design of the instruments for the assessment of the campaigns are not sufficiently geared towards identifying and assessing sociocultural variables of the campaigns. In light of these assumptions, the study was undertaken for three reasons. Firstly, to construct a sociocultural health communication campaign conceptual model that incorporates and highlights sociocultural variables to guide the planning and implementation of health communication campaigns; particularly HIV/AIDS communication campaigns. Secondly to develop an assessment instrument for assessing the presence or absence of sociocultural variables in the planning and implementation of health communication campaigns. Thirdly to test the theoretical sociocultural assessment instrument developed in the study in an HIV/AIDS communication campaign of the Ekurhuleni Metropolitan Municipality’s HIV/AIDS Unit. The results indicated that the instrument is a functional sociocultural assessment tool that can be used to determine three main aspects. Firstly, whether or not and at what level there is/or was active involvement and participation of the target audience in the communication campaigns process. Secondly, whether or not and at what level in the planning and execution of a campaign, the sociocultural context was taken into consideration and the relevant elements of such context incorporated in the campaign process. Thirdly, whether or not and at what level relevant theories/models underpinned the whole process of the health communication campaigns in the planning, designing, implementation, monitoring and evaluation stages. The sociocultural assessment instrument, therefore, is not meant for assessing the effectiveness of health communication campaigns per se. It is rather meant for use to ascertain the presence or absence of those three aspects on the assumption that if they are taking care of in the planning and implementation of such campaigns, the probability is that the campaigns would be more socioculturally appropriate. The implications of this study are that for health communication campaigns to be socioculturally appropriate, they display continuous community interactivity and participative (ensuring mutual relationship between campaign planners and target audience) in their planning, implementation and evaluation/assessment; making the whole campaign process strategic and integrative – their management should be strategic, implementation creative and monitoring and evaluation continuous. / Communication Science / D. Litt. et Phil. (Communication)

There are many inequities that exist in health-care that stem from culture related communication misunderstandings. In most cases where doctors and patients from different cultural and linguistic background interact, doctors use medical language which is different from everyday language used by patients. Patients enter this communication context with anxiety because they depend on the physicians to give them accurate information concerning their health, but they do not always understand all the terms used by physicians to inform them about their conditions. In some cases interpreters are used but their expertise is often inadequate and the interpreting of the patient’s statements to the health staff is also prone to distortion by interpreter / doctor because of the lack of proper understanding of the messages / languages. This may result in a deterioration of the patient’s health condition and unavoidable complications.