The aim of this study is to discover the relationship between health, media and gender, more specifically HIV and AIDS prevention, women’s magazines and women as readers. This research has been conducted within a Master’s dissertation at the Centre for Communication, Culture, Media & Society (CCMS) at the University of KwaZulu-Natal in 2012 and the primary emphasis is on media reception and the way in which women make sense of women’s magazines messages, particularly of HIV and AIDS messages. Therefore, the study’s focus is on media consumption, influences of women’s magazines and personal interpretation of embedded messages. The aim is to identify the role of women’s magazines as part of mass media within a particular field of communication rather than to identify the magazines’ impact on gender roles. My study will discover the reception of health messages on HIV and AIDS surrounded by controversial messages on femininity and gender stereotypes. The main research questions are: i) How, why and when are recipients using women’s magazines? ii) How are recipients perceiving and interpreting HIV and AIDS messages in women’s magazines, and specifically within the context of contradictory messages on sex, femininity and gender roles? iii) And, if and how are health messages in women’s magazines influencing recipients and their interaction with others? The interpretive qualitative research paradigm is applied and the method of qualitative interviews is used for collecting the data. The uses and gratification theory, social learning/social cognitive theory, the concept of entertainment education (EE), and the women-centred sense-making approach are consulted. As an overall result, the analysis reflects a positive picture and interpretation of women’s magazines by the participants, but it also shows the dual character of women’s magazines. Contradictions and critique on content were expressed, positive and negative features were identified, female stereotypes and at the same time the enjoyment of reading was noted, and with regards to health messages, the overall reception was predominantly positive and various content elements seemed to be relevant for the participants. In conclusion, the decisive factors for health messages on HIV and AIDS in women’s magazines, identified in my study are: motivation as an important stage, according to social learning/social cognitive theory in order 7 to enable behaviour modelling; relatedness, originally identified as a third human need within the self-determination theory, which helps to strengthen intrinsic motivation; the dual character of women’s magazines as an on-going conflict between the pleasure of reading a magazine and the consciousness of reprehensible stereotypes and female roles; the sense of female community and finally the role of readers as female opinion leaders. These results present women’s magazines as a multifaceted medium and might influence future research and programmes for health communication on HIV and AIDS prevention. Key words: Women, health, HIV and AIDS, women’s magazines, print media, reception analysis, HIV and AIDS communication, development communication, media usage, media consumption, health messages, relatedness, duality. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2013.

Submitted in fulfillment of the requirements for the Degree in Master of Health Sciences in Nursing, Durban University of Technology, Durban, South Africa, 2016. / Introduction and Background According to the Declaration of Alma-Ata, maternal and child health care forms an integral component of primary health care. In line with this, the South African national government legislated free maternal and child healthcare services in the public sectors to ensure accessibility and availability of basic health care services to the community of South Africa. However, poor access and utilization of antenatal care services in rural areas continues and contributes to high maternal mortality and morbidity rates and untoward pregnancy outcomes. Aim The aim of this study was to explore the experiences of pregnant women from the KwaMkhizwana rural area regarding antenatal care services in order to identify the factors affecting effective provision of and access to the antenatal care services. Method A qualitative, explorative, descriptive research design, which was guided by Rosenstock’s Health Belief Model, was used to conduct the study. Data were collected by conducting semi-structured interviews with 15 participants who were purposively sampled between February and March 2016 and was analysed using Tesch’s method of data analysis. The sample size was determined by data saturation that was reached after ten interviews were conducted. A total of five additional interviews were conducted to confirm saturation of data. Findings There were five major themes and several sub-themes that emerged from the interviews. The major themes included: 1) availability and accessibility of antenatal care services; 2) established practices by the health post staff to reduce the number of clients; management and administration of the health posts; 3) access to health information by pregnant women; 4) communication between the pregnant women and the health post staff; and 5) socio-cultural taboos and beliefs of the community in the area. Conclusion and Recommendations The information gathered from the participants with regard to their experiences affirms that challenges still exist in this rural community regarding access to health care services, particularly antenatal care services. Recommendations pertaining to policy development, institutional management, practice, and research were made. Some of these recommendations included that several policies that are currently non-existent should be developed in order to promote accessibility of antenatal care service at primary health care level, more primary health care training schools should be established to increase the number of primary health care trained nurses, short courses for training of clinic supervisors should be conducted and that further research studies looking at ANC service accessibility especially in rural areas, focusing on health care workers and management experiences be conducted. / M

Thesis (MEng)-- Stellenbosch University, 2013. / ENGLISH ABSTRACT: South Africa’s health sector has not yet shown enough improvement to reach the Millennium Development Goals related to health. One of the problem areas is the low infant and child vaccination coverage in certain areas of South Africa. The use of mobile phones in health care (mHealth) has the potential to strengthen the primary health care system through improved information management. A mobile health solution for vaccination (MHSV) can be used to improve information management of vaccinations, which in turn can improve vaccination coverage. However, the feasibility of implementing such an MHSV in the South African context is unknown. This study therefore investigates the feasibility of using mobile phones to improve information management for child vaccinations in South Africa. Feasibility is determined by using a feasibility framework together with business model development. The feasibility framework, which is informed by a literature study, surveys and a case study, determines the feasibility of an MHSV in terms of human factors, technical feasibility, information management, policies and ethics, and economics. It is found that an MHSV is feasible in South Africa, although certain areas pose challenges that will have to be considered. Complementing the feasibility framework, business models are developed to suggest possible ways in which an MHSV can be deployed in South Africa. These models build on the results from the feasibility framework and are developed using Osterwalder’s business model canvas. The effect of the National Health Insurance (NHI) on these business models is also examined. In order to validate the feasibility framework and business models, interviews were held with experts in health care and mobile phone solutions. These interviews show that the research is valid and that the feasibility framework and business models can be generalised to the wider field of mHealth solutions. / AFRIKAANSE OPSOMMING: Suid-Afrika se gesondheidsektor het nog nie genoeg verbetering getoon om die gesondheidsverwante Millenium Ontwikkelingsdoelwitte te bereik nie. Een van die probleemareas is die besondere lae inentingsdekking van babas en kinders in sekere gebiede van Suid-Afrika. Die gebruik van selfone vir gesondheidsorg hou die potensiaal in om die primêre gesondheidsorgstelsel te versterk deur inligtingsbestuur te verbeter. ’n Inentingsoplossing wat gebruik maak van selfone, bekend as ‘n “mobile health solution for vaccination” (MHSV), kan inligtingsbestuur van inentings verbeter, wat hoër inentingsdekking tot gevolg kan hê. Die haalbaarheid van die implementering van so ’n MHSV in die konteks van Suid-Afrika is egter onbekend. Hierdie studie ondersoek dus die haalbaarheid daarvan om selfone te gebruik vir beter inligtingsbestuur van kinder-inenting in Suid-Afrika. Haalbaarheid word vasgestel deur ’n haalbaarheidsraamwerk en die ontwikkeling van besigheidsmodelle te gebruik. Die haalbaarheidsraamwerk, wat toegelig word deur ’n literatuurstudie, vraelyste en ’n gevallestudie, bepaal die haalbaarheid van ’n MHSV in terme van menslike faktore, tegniese haalbaarheid, inligtingbestuur, beleid en etiek, en ekonomie. Daar word gevind dat ’n MHSV haalbaar is in Suid-Afrika, alhoewel sekere areas uitdagings inhou. Die haalbaarheidsraamwerk word aangevul deur die ontwikkeling van besigheidsmodelle wat moontlike maniere voorstel waarop ’n MHSV in Suid-Afrika ontplooi kan word. Hierdie modelle word geskoei op die resultate van die haalbaarheidsraamwerk en word ontwikkel met behulp van Osterwalder se besigheidsmodelskema (“business model canvas”). Die effek van die nasionale gesondheidversekering op hierdie modelle word ook ondersoek. Onderhoude met kundiges in die veld van selfoonoplossings vir gesondheidsorg word gebruik om die haalbaarheidsraamwerk en die besigheidsmodelle te valideer. Die onderhoude toon dat die navorsing geldig is en dat die haalbaarheidsraamwerk en besigheidsmodelle veralgemeen kan word na die wyer veld van selfoonoplossings vir gesondheidsorg.

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United Nation's (UN) millennium development goal number three is aimed at eliminating gender inequality and empowering women. Gender-based violence is recognised as a global public health and human rights problem that leads to high rates of morbidity and mortality, including sexually transmitted infections, depression, post-traumatic stress disorder, substance dependence and suicide. In responding to this international public health and human rights concern, the South African government has adopted numerous public health communication strategies to highlight the plight of women and children. One of the campaigns that are conducted in South Africa is the 16 Days of Activism for No Violence Against Women and Children (16 Days of Activism Campaign). This campaign was introduced in 1999 but the literature review reveals that to date, no studies have focused on its evaluation. As such, the purpose of this study is to evaluate the 16 Days of Activism Campaign with special reference to the Soshanguve community in Gauteng province. This study builds on two theories, namely the excellence theory and the diffusion of innovation theory. Mixed research methods (also called triangulation) was used whereby in-depth interviews were conducted with representatives from the Government Communication and Information System and the Department of Women, Children and People with Disability to establish the promotion strategies used in the campaign and the methods used to assess the effectiveness of the campaign. Furthermore, a self-administered questionnaire survey was conducted within the Soshanguve community to evaluate the promotion strategies and assess the impact of the campaign.This study revealed a high level of reliance on the television, radio and newspapers in the communication strategies. Both government departments acknowledged that they do not have a tool to evaluate the effectiveness of the campaign from the receivers‟ perspective. The Soshanguve community felt that in essence the campaign is relevant but not on time. The residents viewed the study as an important part of creating awareness about the campaign and they believed the campaign helped them to know what to do when faced with gender-based violence so that they can assist those who are affected by it.

The prevalence of Brucella canis in South Africa is unknown and suspected to be under-detected. The majority of dogs in South Africa are not tested for Brucella canis, not only because of the level of awareness of Brucella canis in South Africa, but also because of the lack of clinical suspicion. It is not known how the infection entered South Africa. Brucella canis, a zoonotic organism that causes canine brucellosis in dogs, is a significant cause of reproductive failure in dogs worldwide. Canine brucellosis is a chronic infectious zoonotic disease whose main etiological agent, the Brucella canis bacterium, are rough, intracellular proteobacteria in the Brucellaceae family. Clinical signs in bitches are mainly infertility and abortion, while in males, epididymitis and orchitis occur. However, discospondylitis may develop in both sexes. A serological survey was conducted to determine the prevalence of Brucella canis infection in dogs from the Nelson Mandela Bay Metropolitan (NMBM) Port Elizabeth (PE) area. A total of 400 samples were collected, 350 of which were collected in seven different townships and 50 were collected in the three different welfare organisations in the study area. Of the 400 serum samples collected, 39 (9.75%) tested serologically positive by using the Tube Agglutination Test (TAT), the 2-Mercaptoethanol-TAT (2ME-TAT) or the Compliment Fixation Test (CFT). The results of the CFT showed that nine of the 39 positive samples had a maximum antibody titre of 784 IU/ml. The prevalence rate varied tremendously between the samples from the townships and those from the welfare organisations. The prevalence rate of seropositive animals in PE ranged between 5% and 16% in the study area. No positive cases were found in KwaMagxaki and the Animal Welfare Society of PE, but both were surrounded by areas that had positive cases of Brucella canis infection. The female dogs in the study area had a higher sero-prevalence of only 0.0169 (95% CI, 0.0631 to 0.1489) differences in proportion, and were thus not significant (p > 0.05). However, the female spayed dogs had a much higher significant difference of 0.1898 (95% iv CI, 0.1058 to 0.2738) in proportion to the male neutered dogs and were thus statistically significant (p < 0.05). Despite those results, out of all the dogs positive for Brucella canis only two were neutered males and five were spayed females, and the rest were all intact. In conclusion, according to the results, Brucella canis antibodies were detected in sera of dogs mostly from the townships surveyed. Preventive measures against this contagion should be taken into consideration to eliminate Brucella canis infection from the entire dog population. Reservoir dogs and actively infected dogs either should be kept in quarantine or should be euthanized, because not only can they spread the disease and end the reproductive life of any breeding animal, but they are also a risk to human health. Even though this is the first survey conducted in the Eastern Cape, the results are still high dogs in the study area had a higher sero-prevalence of only 0.0169 (95% CI, 0.0631 to 0.1489) differences in proportion, and were thus not significant (p > 0.05). However, the female spayed dogs had a much higher significant difference of 0.1898 (95% iv CI, 0.1058 to 0.2738) in proportion to the male neutered dogs and were thus statistically significant (p < 0.05). Despite those results, out of all the dogs positive for Brucella canis only two were neutered males and five were spayed females, and the rest were all intact. In conclusion, according to the results, Brucella canis antibodies were detected in sera of dogs mostly from the townships surveyed. Preventive measures against this contagion should be taken into consideration to eliminate Brucella canis infection from the entire dog population. Reservoir dogs and actively infected dogs either should be kept in quarantine or should be euthanized, because not only can they spread the disease and end the reproductive life of any breeding animal, but they are also a risk to human health. Even though this is the first survey conducted in the Eastern Cape, the results are still high / College of Agriculture and Environmental Sciences / M. Sc. (Agriculture)

In Ciskei, the development of urban housing and local authority structures has not been able to keep up with this immigration. As a result, a number of communities have sprung up in the tribal Authority areas close to this conurbation of some half a million people. These communities are neither urban nor rural, and comprise people with rural farmworker backgrounds who obtain their main source of income from employment in urban areas. In contradistinction to their true rural cousins, the breadwinners in these communities do not need to become migrants living and working far from home. Rather, they work during the week in an urban location close to home, and return on weekends to their families and children. This volume reports on one such community. The settlement of Tsweletswele is new, situated in a Tribal area, and within thirty kilometres of East London. Its residents who came from farms in the region work in East London. Their level of living is low, their access to state services minimal, and their tenure in the settlement uncertain. This report aims quite simply to establish what strategies these people choose to survive in their settlement. Subsequently, a set of recommendations are made which are aimed at improving the levels of living in the community, the delivery of essential services, and the tenure arrangements in the settlement / Digitised by Rhodes University Library on behalf of the Institute of Social and Economic Research (ISER)

The aim of the study was to explore the perceptions of nurses regarding communication with nurse managers in the workplace. The design of the study was a generic qualitative. The methodology of choice was qualitative, explorative method. The sample was non-probability and the approach or technique used was purposive sampling method. It comprised of thirty nurses, ten of each category. The category was a component of professional nurses, enrolled nurses and enrolled nursing auxiliary nurses. The data collection method used in the study was in-depth interviews using a self-designed interview guide. Face to face interviews was conducted in a quiet room within the hospital ward as a natural setting. Data was collected using a voice recorder for the sake of protecting the missing of information which may be important. The data analysis was with the help of employing transcribing and coding of voice recorded data and observation noted during the collection of data. The data collection method used in the study was in-depth interviews using a self-designed interview guide. Face to face interviews was conducted in a quiet room within the hospital ward as a natural setting. Data was collected using a voice recorder for the sake of protecting the missing of information which may be important. The data analysis was with the help of employing transcribing and coding of voice recorded data and observation noted during the collection of data. The findings showed that there were dynamics in communication from all nurse categories and that also indicated that there was a need to conduct a research so that the root cause may be identified and suggestions to be put in place to curb the challenges. In conclusion it showed that communication is the key problem of all and it is a worldwide problem. / Health Studies / M.A. (Health Studies)

Thesis submitted in fulfilment of the requirements for the degree Master of Technology (MTech) in Information Technology In the Faculty of Informatics and Design, at the Cape Peninsula University of Technology (CPUT), 2013 / Healthcare services are vital to all human beings, as our daily lives depend on them. In South Africa approximately eighty per cent of the population uses the public healthcare services. In the current healthcare systems data corruption exists which threatens data quality in the systems. The aim of this study was to understand the existing information handling processes and factors that affect the accuracy and integrity of healthcare data. A qualitative research methodology, under the interpretive paradigm was used for this investigation. Activity theory is used to formulate an analytical framework, the “healthcare information system data quality activity theory framework”. This was very helpful for understanding the healthcare information handling process as an activity system that consists of actors with individual goals. Though the goals are varied, they are joined together by the common objective. The logic of the framework is that a realisation of goals in the activity system depends on a number of factors. At the beginning, there must be a synchronous inter-linkage between the goals of the actors, the mediating factors such as adequate tools, user skills, enabling policies, and the systematic procedures that are diligently enforced. It is assumed that any situation which prevents this inter-linkage will have a negative impact on the realisation of the sought objective. The framework therefore, was very helpful in informing questions, the data collection and ultimately, the analysis processes. The public healthcare sector is the main source of data; other sources were literature, the Internet and books. The analysis of data was done using content analysis to find what themes emerge and the relationship (s) between them in what is being analysed. The findings reveal a lack of adherence to information handling procedures and processes which lead to corrupt data in the systems. In addition, most users have limited skills, which is a hindrance to them in performing their duties as expected by the healthcare sector. In fact, the healthcare sector is also challenged by systems which are constantly slow or down, due to limited network capacity and human errors. The presence of these challenges suggests non-adherence to data handling procedures, which explains the existing corrupt data in the healthcare systems. Therefore the recommendation is that the public healthcare administration must enhance their training programs. The training must be re-designed to cater for the needs of all users, regardless of their background. It needs to improve user skills and boast their confidence in using electronic systems. Obviously, any changes and improvements need to be sustainable, and the sector is unlikely to succeed without enforcement of new procedures. Therefore, adherence to data handling procedures must be strictly enforced, with policies thoroughly communicated to the users. That way, the sector will not only have systems and related policies, but also ensure their full exploitation for improved service delivery in the public healthcare sector in South Africa.

South Africa has an estimated 920 000 patients on antiretrovirals (ARVs), the largest number of patients in any country. ARV therapy demands adherence levels in excess of 95% to avoid development of drug resistance, but adherence to ARV therapy is estimated to be only between 50% and 70%. Poor medication adherence is acknowledged as a major public health problem, reducing the effectiveness of therapy and promoting resistance to ARVs. More than two thirds of the South African population have marginal reading skills and this significantly influences a patient’s ability to read and understand health-related information. Patient education materials tailored for the South African population could be a useful aid in facilitating communication with patients and perhaps impact positively on their medicine-taking behaviour. This behaviour is influenced by patient knowledge, beliefs, attitudes and expectations and includes self-management, self-efficacy and adherence. Self-efficacy, which refers to patient confidence in the ability to self-manage medicine taking, is a key factor influencing adherence. This study aimed to develop illustrated patient information leaflets (PILs) and medicine labels for all first-line ARV regimens used in the public health sector in South Africa and, using a randomised control study design, to investigate the impact of these illustrated information materials on knowledge, medication-taking behaviours and health outcomes in HIV/AIDS patients taking ARVs. To achieve this aim, the objectives were to assess HIV/AIDS and ARV-related knowledge, as well as self-efficacy and adherence to ARV therapy; to assess the influence of demographic variables on knowledge, adherence and self-efficacy; to assess the influence of the information materials on knowledge, self-efficacy and adherence and to assess the association of knowledge with health outcomes. Medicine labels and PILs, both English and isiXhosa, were developed for ARV regimens 1a, 1b, 1c and 1d. The 8-item Morisky Medication Adherence Scale (MMAS-8) and HIV Treatment Adherence Self Efficacy Scale (HIV-ASES) instruments for measuring respectively adherence and self-efficacy, were modified to optimize clarity, simplicity and cultural acceptability and were translated into isiXhosa using a multi-stage translation-back translation. The questions and the rating scales, for both the MMAS and HIV-ASES, underwent preliminary qualitative evaluation in focus group discussions. Patients were recruited from local Grahamstown clinics. A pilot study to evaluate applicability of the instruments was conducted in 16 isiXhosa AIDS patients on ARVs and the results from this study informed further modifications to the instruments. One hundred and seventeen patients were recruited for the randomised control trial and were randomly allocated to either control group (who received standard care) or experimental group (who received standard care as well as pictogram medicine labels and the illustrated PIL). Interviews were conducted at baseline and at one, three and six months. Data were analysed statistically using the t-test, chi-squared test and ANOVA (Analysis of Variance) at a 5% level of significance. Correlations were determined using Pearson and Spearman rho correlations. Approval was obtained from Rhodes University Ethical Standards Committee, Settlers Hospital Ethics Committee and the Eastern Cape Department of Health. The results of this research showed that illustrated PILs and medicine labels enhanced understanding of HIV/AIDS and ARV information, resulting in a mean overall knowledge score in the experimental group of 96%, which was significantly higher than the 75% measured in the control group. Variable knowledge scores were measured in three areas: baseline knowledge of general HIV/AIDS-related information was good at 87%, whereas knowledge scores relating to ARV-related information (60%) and side-effects (52%) were lower. These scores improved significantly in the experimental group over the 4 interviews during the 6 month trial duration, whereas in the control group, they fluctuated only slightly around the original baseline score. There was no significant influence of gender on knowledge score, whereas health literacy, education level and age tested (at one and three months) had a significant influence on knowledge. Self-efficacy and adherence results were high, indicating that the patients have confidence in their ability to adhere to the ARV therapy and to practice optimal self-care. Age, gender and education, in most cases, significantly influenced self-efficacy, but were found to have no effect on adherence. The CD4 count improved over the trial duration which may have been influenced by a number of factors, including better knowledge of ARVs and improved adherence. No significant parametric correlation was found between knowledge score and change in CD4 count, however, Spearman's rho showed significance (rs=0.498; p=0.022). Both patients and healthcare providers were highly enthusiastic about the illustrated labels and PILs, and indicated their desire for such materials to be routinely available to public sector HIV/AIDS patients. The isiXhosa version of the PIL was preferred by all the patients. These simple, easy-to-read leaflets and illustrated medication labels were shown to increase understanding and knowledge of ARVs and HIV/AIDS in low-literate patients, and their availability in the first-language of the patients was central to making them a highly useful information source.