Background: Stroke is a major cause of disability in the world and its long term effects require good adherence to treatment protocols of physiotherapy. This will ensure optimal rehabilitation and reduce the burden of care in the society and the health service. Superficial analysis of existing data from the Physiotherapy Department of Mthatha General Hospital (MGH) revealed that there was poor attendance of outpatient physiotherapy by patients discharged from MGH with stroke and this had negative effects on outcomes and health care costs. Aim: To identify factors that influence poor attendance for outpatient physiotherapy by patients discharged from MGH with a stroke. Methods: Following approval from the Research Ethics Committee to conduct the study, an observational descriptive study design was used. The study population was 139 patients with stroke who attended for physiotherapy in MGH from January 2007 to December 2007. From a sample size of 103 randomly selected patients, 85 patients participated in the study with a response rate of 82%. Data collection was done using structured interviews and SPSS was used for data analysis. Results: The majority (86%) of patients did not attend physiotherapy until discharge from physiotherapy department. The major factors that influenced poor attendance were movement of patients to other areas (36%) and long distance from MGH (29%). Conclusion: The majority of stroke patients who attended for rehabilitation in MGH Physiotherapy Department lived in rural areas which were distant from Mthatha and could not attend physiotherapy at MGH as required by the physiotherapists. Recommendation: Development of a Provincial Rehabilitation Policy to address the unavailability of physiotherapy services at clinics and health care centers and ensure creation and filling of vacant physiotherapy positions at these levels of care.

Women constitute the largest proportion of the rural adult South African population. The rural areas host women with the lowest levels of education and skills training in the country. The lack of basic education and skills has resulted in many of them being marginalised, rejected and discriminated against, unemployed and living in poverty. These social problems have serious negative effects on them and their families, which is why the educational provision of Adult and Community Education and Training in South Africa is a significant tool for their socio-economic advancement. This educational provision is aimed at empowering adults in general, and rural women in particular, with the necessary livelihood skills to lead productive lives and consequently the study sought to investigate the socio-economic lives of rural women through skills training for poverty reduction in the Mthatha area of South Africa. A qualitative research approach and an exploratory design were employed for the study. A sample of 35 participants, comprising 20 female learners, 4 educators, and 7 former learners were in addition to 4 learners selected for a focus group discussion. Other instruments with which data were collected constituted in-depth individual interviews and documentary analysis. The theories underpinning the study are Maslow‘s theory of motivation, empowerment theory and critical pedagogy. Among others, the findings revealed the absence of adequate resources with which to empower rural women and consequently the study recommends that Adult and Community Education and Training providers include programmes that can up-skill rural women based at community learning centres in an effort to enhance their economic development. Community learning centres must be fully resourced in terms of facilities and appropriate learning tools to render Adult and Community Education and Training a beneficial educational intervention for these rurally based women. / Educational Studies / Ph. D. (Socio-Education)