Thesis (MFamMed)--Stellenbosch University, 2015. / Introduction Since 1994 the South African health care system has been undergoing considerable transformation as new health challenges emerges locally and globally. Limpopo and Mopani primary healthcare in particular is not an exception. The information on the reasons for encounter and diagnosis in primary care will create an opportunity to focus on proper planning for the delivery of quality health care that is relevant to the people, socially justifiable and cost effective. The study aimed to determine the range and prevalence of reasons for encounter and diagnoses found among patients attending primary care facilities in Limpopo. Methods Design: A prospective cross-sectional survey Setting: Primary health care centers, clinics and mobile clinics in Mopani district of Limpopo Province, South Africa. Selection of facilities, primary care providers and patients: Patient encounters were obtained from twenty-nine randomnly selected primary care facilities by trained primary care practitioners with data collection sheets. Data collection: The data collection days were spread across all days of the week and across the whole period from July 2009 to March 2010. Analysis: The international classification of primary care (ICPC-2) was used to code and analyse the data. Results A total of 6,666 patient encounters were recorded. Females 4598 (69%), accounted for more than two thirds of all contacts and children aged 0-4 years were the largest age group. Overall the commonest reasons for encounter were cough (13.0%), repeat family planning (8.4%) and headaches (5.7%). The commonest diagnoses were cough/upper respiratory tract infection (16.9%), hypertension (5.7%) and HIV/AIDS (2.6%). The top 20 reasons for encounter (RFE) and diagnoses are presented for all patients, men and women as well as children < 5 years. Conclusion Primary care nurse practitioners, clinical associates and general medical practitioners need to be competent to assess and manage the common RFE and diagnoses in order to deliver comprehensive health care at the primary level. / AFRIKAANSE OPSOMMING: Nie beskikbaar

Health is a basic human right enshrined in the South African Constitution. It is the responsibility of government to ensure that the nation is healthy because good health is a prerequisite for social and economic development as well as an outcome of that process. Special attention on the healthcare needs of rural communities should be given because these communities were the worst affected by the legacy of the apartheid regime. Moses Mabida community is no exception. Since the advent of democracy, work has been done to ensure that adequate primary health care services are delivered to previously disadvantaged communities such as Moses Mabida. To monitor progress on health care service delivery, evaluation of these services is needed. The evaluation of these services will help identify the strengths and weaknesses so as to come up with quality improvement strategies, hence this study. This study takes form of an assessment survey involving a literature review and a survey of members of the Moses Mabida community who depend on the clinic for their health care needs. The literature identified best practice models of primary health care and these were used as an analytic tool to determine to what extent the primary health care services at Moses Mabida comply with national and international standards. It has been shown that the primary health care services at Moses Mabida Clinic largely comply with national and international standards although several recommendations have been presented for consideration.

M.Com. (Economics) / Access to health care is a basic human right in South Africa. Primary health care is viewed by the South African government as the means to improving access to health care in the country. The concept of primary health care is based on the importance of first contact with a primary health worker. The Department of Health introduced free primary health care because it believes that the most significant barrier to access to health care is poverty. When a service is provided for free there is no income generated from user fees and the issue of funding becomes very important. This study performs an analysis of the free primary health care programme in South Africa and how it is financed. An important feature that characterizes South Africa is high inequality which is reflected in the high level ofpreventable diseases as well as high incidents of chronic diseases. The implementation of free primary health care has led to improved access to health care and somewhat improved the health status of the South African population. In order to address the inequalities in the health sector there must be funding targeted towards the needs of the poor. Government's fiscal policy places limits on the expansion of public expenditure, which poses a strain on resources flowing to the health sector. In addition to that there has not been a significant shift of funds from higher levels of care to primary health care. The funding issue will need to be urgently resolved for primary health care to be sustainable...

Thesis presented in partial fulfilment for the degree of Master of Management (in the field of Public Sector Monitoring and Evaluation) to the Faculty of Commerce, Law, and Management, University of the Witwatersrand March 2016 / The South African public health care system is and continues to experience shortage of professional health care workers like other developing countries. These professional health care workers leave the country for better salaries and working environment for private sector and developed countries. The aim of the study is to gather and analyse information on how to integrate traditional health practitioners into the South African primary health care system to address the shortage of the health care workers. This qualitative study used a cross-sectional design to explore the perception, knowledge and recommendation of the national and district Department of Health officials, the western practitioners, the traditional practitioners and the SA citizens in Pretoria, South Africa on how to address this problem. Thirteen individual in-depth interviews and one focus group with the four categories of the research participants were conducted using a semi-structured interview guide. The results indicated that the SA government in partnership with the Interim Traditional Health Practitioners Council have opted for a parallel system to integrate the traditional practitioners into the primary health care level. For the parallel system to be fully implemented there are still issues that need to be achieved by the key stakeholders, one is for the government to build the traditional health care facilities for traditional practitioners, whilst the ITHPC finalise the registration of the traditional practitioners and approval of the Traditional Health Practitioners Regulations of 2015. Lastly, the District Health System has to prepare themselves for a new entrant, which is the traditional health care, into the primary health care to complement the existing system. / MT2017

A research report submitted to the Faculty of Management, University of the Witwatersrand, in partial fulfilment of the requirements for the degree of Master of Management / Rapid Appraisal has gained popularity amongst policy makers, and is used in strategic planning of primary health care services. This study aimed at determining whether Rapid Appraisal is an appropriate planning tool for primary health care services in South Africa. This study compares Rapid Appraisal with a Regional Health Management Information System (ReHMIS), using the Northern Province as a case study, In comparison, Rapid Appraisal took half the time of ReHMIS for data collection, and used less resources in the process, There is significant difference between the two data sets and this is explained by the fact that Rapid Appraisal does not only determine whether the facility is there or not but it also identifies management issues. Rapid Appraisal is an innovative method that engages all the relevant stakeholders in planning their primary health care services, The findings proved that Rapid Appraisal is an appropriate planning tool for primary health care services. / AC2017

M.Cur. / The purpose of this study is to compile a strategy for transformation management in a local authority. Traditionally local authorities rendered preventative and promotive services. The provinces were responsible for rendering of curative services. This service delivery was fragmented due to political policies and diversification. With the new political dispensation in South Africa, the White Paper for the transformation of health services in South Africa (1997), gives direction for the integration of health service delivery to achieve the following mission focussing on equity, acceptability, accessibility, affordability, availability and appropriateness. These policy/legislative changes therefore require a strategy for transformation management of primary health care services. This impacts on the current service delivery system. The type of service delivery has to be reconstructed, to accommodate free primary health care services for all South Africans, additional services like curative services, dental services and termination of pregnancy services. Human resource management will also undergo significant changes as the local authority is expected to take over the existing provincial staff allocated to clinics. This could result in labour unrest if not well managed. There are also financial constraints that will impact on this process of transformation. The scarcity or shortage of medicines, equipment and other supplies necessary for quality service delivery also impact on the transformation process. The changing environment is difficult to handle, especially as it involves human beings who react differently towards change. Some individuals adapt easily in a changing environment, others resist change. Many meetings have been held to discuss the transformation of health services. The outcomes of these meetings have clearly demonstrated that health personnel are experiencing problems which are a direct result of the transformation process. Therefore it is important for management in a local authority in the East Rand, to devise a transformation strategy in order to implement primary health care services effectively and efficiently. The transformation strategy requires careful planning and decision making, that will be beneficiary to all the role players involved. Management in a local authority will have to take a leading role in the transformation management of primary health care services. This situation can be either a "challenge" or a "dilemma".

Submitted in fulfilment of the requirements for D.Tech: Nursing in the Faculty of Health Sciences, Durban University of Technology, 2009. / BACKGROUND In South Africa, Integration of Services Policy was enacted in 1996 with the aim of increasing health service utilization by increasing the accessibility of all services at Primary Health Care (PHC) level. However, the problem with the policy arises in the implementation of integrated PHC (IPHC) as there is no agreed upon understanding of what this phenomenon means in the South African context. Hence, there is a need for shared views on this phenomenon. METHODS A cross-sectional study, using a qualitative approach was employed in this study in order to analyze IPHC in KwaZulu-Natal (KZN). A grounded theory approach was selected as it is a method known for its ability to make the greatest contribution in areas where little research has been done and when new viewpoints are needed to describe the familiar phenomenon that is not clearly understood. Policy makers and co-ordinators of PHC at national, provincial and district levels as well as PHC nurses at functional level participated in the study. The data was collected by means of observations and interviews. The sample size for interviews was comprised of 38 participants. RESULTS It emerged that there were three core categories that were used by the participants as discriminatory dimensions of IPHC in South Africa. These core categories were (a) comprehensive health care, (b) supermarket approach and (c) one stop shop. Based on the findings of the study, it was concluded that the phenomenon, IPHC meant different things in different contexts. / Durban University of Technology, Research Post Grad Development and Support Departments

<p>This thesis investigated the potential role of indigenous healers in life skills education in South African schools. The main focus of this study was to explore how indigenous knowledge of traditional healers can contribute to the development of life skills education in South African schools. The research also sought to strengthen Education Support Services in the South African education system, in order to address barriers to learning. These barriers to learning are linked to health challenges such as substance abuse, violence, malnutrition and HIV/AIDS and many other health-related issues in school-going age learners.</p>

A mini-dissertation submitted in partial compliance with the requirements for a Master's Degree in Technology: Nursing, Technikon Natal, 2002. / Cervical cancer is almost completely preventable, yet it is the second most prevalent cancer amongst women in South Africa. KwaZulu-Natal (KZN) in particular has a high mortality rate of cervical cancer and 1:40 women die from cancer of the cervix. Therefore, in 1997 a cervical screening. policyand-. programme was implemented in the province. The KZN Department of Health and the Sub-Directorate Maternal, Child and. Women's Health needed to know what was happening currently in terms of implementation of the cervical screening programme since it was first implemented three years ago. Therefore, the purpose of the study was to evaluate the implementation of the Provincial Cervical Screening Programme in selected Primary Health Care clinics in lIembe Region, KZN. This study took the form of formative evaluation research. The target population consisted of PHC clinics in KZN that have implemented the cervical screening policy and the programme. The accessible population for this study consisted of the clinics in the lIembe Region. A four-stage selection plan was applied to select the sample from the accessible population. The first stage involved a random selection of two clinics from an urban area and two from a rural area. Within each of the selected clinics, three types of evidence for the evaluation of the implementation of the cervical screening programme were sampled. Therefore, the second stage of the plan was the selection of records. A purposive sample of all records of clients who were diagnosed with abnormal smears was assessed. The third stage involved the selection of all Professional Nurses from each of the selected clinics. Lastly, the fourth stage involved the selection of the day for collecting data on the facilities and resources. The sources of evidence that were used to evaluate the implementation of cervical screening programme by the clinics were non-participant observation, which involved clinic audit, a review of abnormal smear records and self-reports from nurses regarding the cervical screening programme. Results indicated that there was a lack of resources needed for implementing the programme in rural clinics compared to urban clinics. However, all clinics in the study had an adequate supply of the drugs needed for the treatment of abnormal smears. The researcher also found that nurses lacked knowledge regarding the indications for taking smears. On reviewing the records, the researcher noted that most of the results indicated that smears had adequate cells needed for analysis. However, the results indicated that there was a problem with follow-up of clients with abnormal smears. There was lack of necessary resources such as telephones needed to do proper follow-up. Feedback to the clinics from the referral hospital regarding the outcome of the visit was inadequate. The results also indicated thatthe mechanisms of record keeping were poor. Nurses were of the opinion that women should have their first Pap smear at the age of 20 and thereafter at intervals of five years, once they start to be sexually active because of the high rate of sexually transmitted infections and HIV/AIDS in KZN. Therefore, the above results indicate that problems exist at the selected PHC clinics that may result in ineffective implementation of the cervical screening programme. / M

M.Com. (South African & International Taxation) / The tax system in South Africa makes provision for everyday South African citizens to contribute to a greater or lesser extent towards health care funding in South Africa. However, as a result of the high unemployment rate, a large gap exists between tax contributors and non-tax contributors. This raises the question of whether it is fair that the burden to fund the proposed National Health Insurance (NHI) initiative in South Africa is borne by the small percentage of current tax contributors. The purpose of this research was to provide a taxation perspective on the different funding models and financing options available to the South African government for consideration in developing the NHI implementation strategy. The study evaluated the four traditional health care models used worldwide and assessed existing health care systems in selected first and third world countries in order to contribute towards the development of the proposed NHI system in South Africa. The health care models used by France, The United States, The United Kingdom, Brazil and Spain were evaluated in order to achieve an understanding of the funding approaches followed by these countries. It was found that although it is inevitable that South African tax contributors will have to be more heavily taxed in order to fund the NHI, as there are only limited possibilities for distributing the tax burden evenly. The main stumbling block in finding an equitable funding solution is the fact that there is a large disparity in South African income tax contributors.