The purpose of this longitudinal study was to evaluate the enrolled nurse/registered nurse (EN/RN) programme to determine the extent to which the graduates of the programme had acquired knowledge and skills to provide primary health care services to communities using the Stufflebeam CIPP model as a framework. The study determined the extent to which the graduates perceived that their knowledge and skills in provision of primary health care services have been strengthened and the extent to which their supervisors perceived the improvement of the graduates' knowledge and skills in provision of primary health care services in clinical and primary health care settings. The programme used two models for upgrading: one year full-time residential and two year distance education. The study used methodological triangulation for data collection. Data collection tools comprised of self-administered questionnaires to the EN/RN upgrade graduates, structured group interviews to their supervisors from the hospitals and district health teams and the review of the students' examination records from Institute of Health Sciences/University of Botswana (IHS/UB). Data were collected and analyzed from the one year full-time residential graduates who completed the programme from 1995-2000 and from the two year part-time distance education graduates who completed the programme 1996-2000. The findings from the academic records indicated that out of the 1116 enrolled nurses that were admitted into the EN/RN upgrade programme between 1994-2000 nine (0.8%) withdrew from the programme due to ill health or personal reasons before writing the final examinations. This is indicative of a high retention rate in the programme. In the one year full-time residential programme, out of the 695 enrolled nurses were admitted in the programme from 1995-2000 period five (0.7%) withdrew from the programme before writing the final examinations, 690 students sat for the final examination and 640 (92.8%) passed. In the two year part-time distance education programme, out of the 421 enrolled nurses were admitted in the programme from 1996-2000 period four (0.9%) withdrew from the programme before writing the final examinations, 417 students sat for the final examinations and 402 (96.4%) passed. Out of the 1107 students from both the one year full-time residential and the two year part-time distance education programme that sat for the final IHS/UB examinations, 1042 (94.1%) passed. The academic records revealed that the programme was efficient and effective because 1042 (94.1%) out of 1107 students completed the programme in one year and two years as planned because the programme was not repetitive and there were replacement costs. This high pass rate (94.1%) is an indication that the graduates did acquire knowledge and skills for provision of primary health care services. Data analysis from the self-administered questionnaires of the graduates also revealed that the graduates perceived that their knowledge and skills for provision of primary health care services have been strengthened because of the acquisition of the new knowledge in primary health care. This complemented the high academic performance of the graduates that the graduates knowledge and skills to deliver primary health care had been strengthened. Data analysis from the structured group interviews of the supervisors of the graduates further revealed that the supervisors perceived that the knowledge of the graduates in providing primary health care services in the hospitals and the district health teams had improved. The supervisors indicated that the graduates were now providing primary health care services with less supervision in the hospitals and the health districts. / Health Studies / D.Litt et Phil. (Health Studies)

The purpose of this longitudinal study was to evaluate the enrolled nurse/registered nurse (EN/RN) programme to determine the extent to which the graduates of the programme had acquired knowledge and skills to provide primary health care services to communities using the Stufflebeam CIPP model as a framework. The study determined the extent to which the graduates perceived that their knowledge and skills in provision of primary health care services have been strengthened and the extent to which their supervisors perceived the improvement of the graduates' knowledge and skills in provision of primary health care services in clinical and primary health care settings. The programme used two models for upgrading: one year full-time residential and two year distance education. The study used methodological triangulation for data collection. Data collection tools comprised of self-administered questionnaires to the EN/RN upgrade graduates, structured group interviews to their supervisors from the hospitals and district health teams and the review of the students' examination records from Institute of Health Sciences/University of Botswana (IHS/UB). Data were collected and analyzed from the one year full-time residential graduates who completed the programme from 1995-2000 and from the two year part-time distance education graduates who completed the programme 1996-2000. The findings from the academic records indicated that out of the 1116 enrolled nurses that were admitted into the EN/RN upgrade programme between 1994-2000 nine (0.8%) withdrew from the programme due to ill health or personal reasons before writing the final examinations. This is indicative of a high retention rate in the programme. In the one year full-time residential programme, out of the 695 enrolled nurses were admitted in the programme from 1995-2000 period five (0.7%) withdrew from the programme before writing the final examinations, 690 students sat for the final examination and 640 (92.8%) passed. In the two year part-time distance education programme, out of the 421 enrolled nurses were admitted in the programme from 1996-2000 period four (0.9%) withdrew from the programme before writing the final examinations, 417 students sat for the final examinations and 402 (96.4%) passed. Out of the 1107 students from both the one year full-time residential and the two year part-time distance education programme that sat for the final IHS/UB examinations, 1042 (94.1%) passed. The academic records revealed that the programme was efficient and effective because 1042 (94.1%) out of 1107 students completed the programme in one year and two years as planned because the programme was not repetitive and there were replacement costs. This high pass rate (94.1%) is an indication that the graduates did acquire knowledge and skills for provision of primary health care services. Data analysis from the self-administered questionnaires of the graduates also revealed that the graduates perceived that their knowledge and skills for provision of primary health care services have been strengthened because of the acquisition of the new knowledge in primary health care. This complemented the high academic performance of the graduates that the graduates knowledge and skills to deliver primary health care had been strengthened. Data analysis from the structured group interviews of the supervisors of the graduates further revealed that the supervisors perceived that the knowledge of the graduates in providing primary health care services in the hospitals and the district health teams had improved. The supervisors indicated that the graduates were now providing primary health care services with less supervision in the hospitals and the health districts. / Health Studies / D.Litt et Phil. (Health Studies)

The provision of psychological services is vital considering the complex nature of psychosocial issues facing people today. Nevertheless, the provision and utilization of psychological services has not been given due recognition in most African countries, including Botswana. Botswana is one of the countries faced by the challenges of the HIV/AIDS pandemic and other mental health problems, as well as poverty and unemployment. To date statistics on the magnitude of the HIV/AIDS epidemic in Botswana, published annually by the National AIDS Coordinating Agency (NACA) reflect an increased rate of mental illness and psychosocial problems. Considering the complex nature of issues that impact negatively on people in Botswana, there is a need for awareness and the provision of psychological services in the primary health care system. There is little research on the place of psychology and psychological services in Botswana. The availability of such information is crucial for the planning of effective community-based psychological services. The present study employed a quantitative research method to explore and describe awareness and attitudes towards psychological services and referral practices in relation to psychological problems, of health care providers in Botswana. The participants in the study were chosen, based on a non-probability, purposive sampling method. The sample consisted of ninety-six persons and constituted medical doctors, nurses, psychiatrists, psychiatric nurses and clinical social workers from governmental and non-governmental institutions from Gaborone and Francistown in Botswana. Data were analyzed by means of descriptive statistics in order to identify the mean, ranges and standard deviations. Frequency counts and percentages of the participants’ responses were computed. The results of the study revealed an awareness of available psychological services, positive attitudes towards psychology and psychological services and a reasonable percentage of referrals to psychological services. The results also revealed that available psychological services were limited and not easily accessible to patients. There was also an indication of a shortage of trained professionals to offer psychological services in health care centres, which resulted in psychological problems being referred to social workers.

Health Studies / D. Litt. et Phil. (Advanced Nursing Science)

According to the Ministry of Health (1996:26), the most common chronic/terminal illnesses were cardiovascular disorders, diabetes, cancer, mental disorders, HIV/AIDS, tuberculosis and asthma. Long term treatment and care and the growing incidence of these conditions necessitated the introduction of home-based care (HBC). Consequently, family care givers play a major role in the provision of care to chronically/terminally ill patients and professional health care providers adopt a supervisory role. This study examined the quality of home care services provided in Botswana. The availability and accessibility of home-based care services and resources have a direct bearing on the quality of home-based care delivery system. The researcher used systems theory was used as the conceptual framework for this study. The study aimed to • determine the accessibility and availability of home-based care services in Molepolole East • investigate what the perspectives and experiences of family care givers, patients and professional health care providers of Botswana home-based care are • determine the roles of professionals health care providers, patients, and family care givers and their relationships in the context of home- based care • identify the needs of chronically/terminally ill patents and family care givers • determine the type of support given to family care givers and patients by professional health care providers and make recommendations for the improvement of home-based care • develop a model to prepare family care givers The research design combined quantitative and qualitative research methods. A sample of convenience was used to obtain information from patients' family care givers and professional health care providers. Interviews and questionnaires were used. A proposed care giving preparedness model is presented to meet needs of the family care givers. The study found that family care givers needs are neither known nor catered for by the professional health care provider. The family care givers were not adequately prepared before adopting the care-giving role. It is recommended that • The proposed preparedness care giving training model is considered for training of patients and family care givers before discharge and during HBC. • Increase patients and family care givers decision-making / Health Studies / D.Litt. et Phil. (Health Studies)

Health Studies / D. Litt. et Phil. (Advanced Nursing Science)

According to the Ministry of Health (1996:26), the most common chronic/terminal illnesses were cardiovascular disorders, diabetes, cancer, mental disorders, HIV/AIDS, tuberculosis and asthma. Long term treatment and care and the growing incidence of these conditions necessitated the introduction of home-based care (HBC). Consequently, family care givers play a major role in the provision of care to chronically/terminally ill patients and professional health care providers adopt a supervisory role. This study examined the quality of home care services provided in Botswana. The availability and accessibility of home-based care services and resources have a direct bearing on the quality of home-based care delivery system. The researcher used systems theory was used as the conceptual framework for this study. The study aimed to • determine the accessibility and availability of home-based care services in Molepolole East • investigate what the perspectives and experiences of family care givers, patients and professional health care providers of Botswana home-based care are • determine the roles of professionals health care providers, patients, and family care givers and their relationships in the context of home- based care • identify the needs of chronically/terminally ill patents and family care givers • determine the type of support given to family care givers and patients by professional health care providers and make recommendations for the improvement of home-based care • develop a model to prepare family care givers The research design combined quantitative and qualitative research methods. A sample of convenience was used to obtain information from patients' family care givers and professional health care providers. Interviews and questionnaires were used. A proposed care giving preparedness model is presented to meet needs of the family care givers. The study found that family care givers needs are neither known nor catered for by the professional health care provider. The family care givers were not adequately prepared before adopting the care-giving role. It is recommended that • The proposed preparedness care giving training model is considered for training of patients and family care givers before discharge and during HBC. • Increase patients and family care givers decision-making / Health Studies / D.Litt. et Phil. (Health Studies)