>Magister Scientiae - MSc / The Northern Cape province has not been able to achieve the 90% immunization target recommended for South Africa’s expanded programme on immunisation (EPI). The situation has been attributed to the lack of access to EPI in the rural community. The Northern Cape’s poor infrastructure renders the provision of equitable preventive care service to rural communities a complex and costly task. The province is predominantly a rural setting consisting of farmland, with low population densities, and many residents have poor access to public transport to receive primary health care services from surrounding fixed or satellite clinics. Consequently, mothers often do not adhere to the immunization schedules, and lack awareness of the risks associated with the failure to have their infants vaccinated against communicable diseases. EPI services delivered via mobile clinics serve the primary health care needs for rural communities, but their sustainability remains a challenge. Additional barriers are found in literature which highlighted the shortage of health professionals, unreliable funding, limited transportation within rural areas and deficiencies in maintenance and suitability of mobile clinic vehicles.

Philosophiae Doctor - PhD / This study deals with the social interpretation of childhood diarrhea among the Xhosa speaking people of the Western Cape in South Africa. It highlights how in the Western Cape political consciousness and moralist discourses strongly influence relationships between different health care systems and the production of continuing conflicts around problems of health care delivery. It is argued that if meaningful relationships could be found between socially based health-seeking strategies and biomedical classifications of enteric and other diseases of women and children, they could facilitate the provision of more equitable, effective and widely acceptable health care. Furthermore, it compares the etiological explanations of childhood illness signs and symptoms of mothers and health practitioners of two kinds, i.e., professional nurses trained in biomedicine and indigenous African health practitioners (IHPs). The comparison focuses particularly on the interpretation of stool quality and associated symptoms. For stool quality the study refers to the color and texture of children's feces that mothers and health practitioners identify and associate with distinctive conditions of affliction. The study found these descriptive categories do not exhaust the variety of interpretations known to Nguni people in the area. There is variation, even ambiguity, in the interpretation of commonly understood illness categories and with respect to diarrheal illnesses, knowledge remains contested between mothers and professional nurses. Moreover, the availability of a wide range of therapeutic options m Khayelitsha diversifies the mother's causal explanations. It was found this diversity in causality and management of illnesses is manifested in the quality of children's stools, "green" feces in particular. Here too, different hues are not separable from the media in which they appear. Their interpretations draw on senses of value, ideas, social histories, different forms of power, systematic knowledge, and a great variety of other forms of significance that are embedded in the concrete domains of everyday life. In addition to the notion of isuntu,(that is humaneness) the study more importantly reveals that among Nguni of the Western Cape a tripartite relationship of umoya,(vital force) inyongo,(gallbladder) and ithongo (ancetral dream) is the dynamic philosophical component that describes Nguni experiences of health and illness. vi https://etd.

The scourge of HIV and AIDS can no longer be underestimated. Its devastating effects have been translated into immeasurable monetary and human costs. Women and children, particularly among the rural communities, have borne most of the brunt accruing from the devastating socio-economic consequences of the disease. PURPOSE This study is intended to highlight the plight of rural communities who are constantly besieged by the demand and supply disequilibrium in the provision of primary health care and preventive interventions. OBJECTIVES To describe, compare and analyse HIV / AIDS health care services provided by fixed and mobile clinics in the Madibeng Sub-District of the North West Province. POPULATION The sampled participants were selected from a universal population among pregnant women. SAMPLING A sample of 100 pregnant women from the fixed and mobile clinics participated in answering the questionnaires during their antenatal care visits. RESEARCH SETTING The Madibeng Sub-District in the North West Province been selected as a suitable research site, as it met most of the selection criteria developed by the researcher's judgement sampling. RESEARCH DESIGN The data recorded on the questionnaires by the participants was used to compare and analyse the pregnant women's feelings about HIV / AIDS services of fixed and mobile clinics. Group discussions were also held prior self completion of questionnaires. Questionnaires were administered by the researcher and the two health promoters. FINDINGS It was found that participants in both mobile and fixed clinic have attended HIV / AIDS health care services. Fixed clinic and mobile clinic are respectively viewed as offering better health care services to pregnant women. CONCLUSIONS The research results from this study indicate that HIV / AIDS services provided at both the fixed clinic and mobile service points, including antenatal or prenatal care, are almost similar. RECOMMENDATIONS It is recommended for improving HIV / AIDS health care services that health care providers at Jericho mobile clinic and Jericho fixed clinic intervene by slowing the progression of HIV infection because it has a negative impact on the lives of women. The Jericho clinic and mobile clinic staff should be encouraged to adopt the perspective that HIV / AIDS is not a death sentence, but a preventable disease, not withstanding its deadly consequences on families and communities. The staff at these clinics is also to be motivated to adopt co-operative health care and psycho-social strategies, in which team work and the involvement and participation of all relevant stakeholders is viewed as an integral part of the struggle against HIV / AIDS and its devastating spread. / Health Studies / M.A. (Health Studies)

The scourge of HIV and AIDS can no longer be underestimated. Its devastating effects have been translated into immeasurable monetary and human costs. Women and children, particularly among the rural communities, have borne most of the brunt accruing from the devastating socio-economic consequences of the disease. PURPOSE This study is intended to highlight the plight of rural communities who are constantly besieged by the demand and supply disequilibrium in the provision of primary health care and preventive interventions. OBJECTIVES To describe, compare and analyse HIV / AIDS health care services provided by fixed and mobile clinics in the Madibeng Sub-District of the North West Province. POPULATION The sampled participants were selected from a universal population among pregnant women. SAMPLING A sample of 100 pregnant women from the fixed and mobile clinics participated in answering the questionnaires during their antenatal care visits. RESEARCH SETTING The Madibeng Sub-District in the North West Province been selected as a suitable research site, as it met most of the selection criteria developed by the researcher's judgement sampling. RESEARCH DESIGN The data recorded on the questionnaires by the participants was used to compare and analyse the pregnant women's feelings about HIV / AIDS services of fixed and mobile clinics. Group discussions were also held prior self completion of questionnaires. Questionnaires were administered by the researcher and the two health promoters. FINDINGS It was found that participants in both mobile and fixed clinic have attended HIV / AIDS health care services. Fixed clinic and mobile clinic are respectively viewed as offering better health care services to pregnant women. CONCLUSIONS The research results from this study indicate that HIV / AIDS services provided at both the fixed clinic and mobile service points, including antenatal or prenatal care, are almost similar. RECOMMENDATIONS It is recommended for improving HIV / AIDS health care services that health care providers at Jericho mobile clinic and Jericho fixed clinic intervene by slowing the progression of HIV infection because it has a negative impact on the lives of women. The Jericho clinic and mobile clinic staff should be encouraged to adopt the perspective that HIV / AIDS is not a death sentence, but a preventable disease, not withstanding its deadly consequences on families and communities. The staff at these clinics is also to be motivated to adopt co-operative health care and psycho-social strategies, in which team work and the involvement and participation of all relevant stakeholders is viewed as an integral part of the struggle against HIV / AIDS and its devastating spread. / Health Studies / M.A. (Health Studies)

OBJECTIVE/ METHOD The study examined implementation challenges faced by primary health care workers within the Ekurhuleni Metropolitan Municipality in Gauteng South Africa. Data collection was based on semi-structured interviews carried out on a purposive sample (n=19) of frontline clinicians working within the district as primary health care practitioners. RESULTS Participants confirmed that work within the primary health care service disproportionately focussed on curative and rehabilitative functions of their roles with little prioritisation of preventive and promotive interventions. Primary identified reasons included, institutional culture that prioritised short-term curative approaches. Clinicians also cited a range of other organisational barriers, such as – poor strategic planning, and a lack of understanding of health promotion and illness prevention. CONCLUSIONS Although the challenges that exist in implementing primary health care are clearly understood, clinicians perceive the solutions for these as being within the control of policy makers and those with power within the organisation. / Health Studies / M.A. (Public Health)

OBJECTIVE/ METHOD The study examined implementation challenges faced by primary health care workers within the Ekurhuleni Metropolitan Municipality in Gauteng South Africa. Data collection was based on semi-structured interviews carried out on a purposive sample (n=19) of frontline clinicians working within the district as primary health care practitioners. RESULTS Participants confirmed that work within the primary health care service disproportionately focussed on curative and rehabilitative functions of their roles with little prioritisation of preventive and promotive interventions. Primary identified reasons included, institutional culture that prioritised short-term curative approaches. Clinicians also cited a range of other organisational barriers, such as – poor strategic planning, and a lack of understanding of health promotion and illness prevention. CONCLUSIONS Although the challenges that exist in implementing primary health care are clearly understood, clinicians perceive the solutions for these as being within the control of policy makers and those with power within the organisation. / Health Studies / M.A. (Public Health)