The Department of Health, being a public entity, has a responsibility to provide quality health services to the community. The Department has experienced repeated negative feedback from the press with respect to job dissatisfaction and the quality of service. This could be the result of low employee motivation. The researcher was concerned and interested in investigating possible causes of these allegations by the press. The main purpose of this study was to analyse the motivational climate of employees in the Department of Health. The study included a literature study of employee motivation and organisational climate. The purpose of the literature was to determine how the Department of Health measures up to what the literature reveals. A questionnaire was used as an instrument to collect data. The questionnaire was formulated from the literature discussed in the research study. The major findings indicated that the level of motivation in the Department of Health was low. Findings also indicated the majority of employees were not trained in the Batho Pele principle. The researcher argued that if employees were trained in the Batho Pele principle and also practised, the negative press feedback would be minimal. The researcher suggested certain recommendations for those areas where findings indicated shortcomings in an attempt to increase the overall levels of employee motivation within the Department of Health.

The public healthcare sectors within developing nations face a lot of challenges because of constrained resources available to them. The South African public healthcare sector is no different. Although it serves the majority of the South African population, most of the financial resources are directed towards the private sector, which serves very few individuals when compared to the public healthcare sector. Apart from that, other challenges that the National Department of Health has to deal with include the lack of sufficiently trained healthcare employees who can work on the different levels of the public healthcare sector, as well as the burden of diseases such as HIV and Aids, tuberculosis and other chronic diseases. In order to improve service delivery, the National Department of Health is introducing Information and Communications Technology interventions that can increase efficiency and reduce costs, thereby improving the quality of service delivery. This research delivers an m-health application user experience framework to be proposed to the National Department of Health in South Africa, in order to assist in scaling up of m-health applications. The m-health applications that can benefit the South African population if scaled up successfully include those that can be used in remote data collection, treatment and compliance, accessing patients records, remote monitoring, communication and training for healthcare workers and applications that can be used for education and awareness. The study focused on three domains: the Human-Computer Interaction domain, public healthcare domain and Health Informatics domain. The proposed framework was realized by investigating mobile user experience components, mobile health requirements and the South African public healthcare domain components that contribute to the m-health user experience framework. This research was conducted through the interpretivist philosophy. Due to the exploratory nature of the study, an application of qualitative methodology was used. The conceptual theoretical framework was validated through a single case study approach by m-health user experience experts, who reside in South Africa. Data were analysed inductively. An m-health user experience framework was provided at the end of the study. An m-health user experience framework can assist the National Department of Health to look into design issues, address m-health requirements and put the domain needs in place, thus enabling the Department to successfully scale up implementations of m-health applications nationwide.

No description available.

Photocopies of journal articles. * Agrichemical safety practices on farms in the Western Cape. London L. SA Med J 1994 ; 84 : 273-278. * Notification of pesticide poisoning in the Western Cape 1987 - 1991. London L, Ehrlich R, Rafudien S, Krige F, Vurgarellis P. SA Med J 1994 ; 84 : 269-272. * Critical Issues in agrichemical safety in South Africa. London L, Myers JE. Am J Ind Med 1995 ; 27(1) : 1-14. * Repeatability and validity of a field kit for estimation of cholinesterase in whole blood. London L, Thomson ML, Sacks S, Fuller B, Bachmann OM, Myers JE. Occupational and Environmental Medicine 1995; 52 : 57-64. * Biological Monitoring of workers exposed to organophosphate pesticides: Guidelines for field application. London L. Occupational Health Southern Africa July/August 1995 ; 1(4) : 13-17. / Despite playing an important role in crop protection and increasing food production, chemicals used in agriculture may have a range of unanticipated effects on human health. Such effects may range from overt and acute poisonings to gradual-onset chronic morbidity. In South Africa, data on such morbidity are sparse, and subject to much underreporting as one of the included papers illustrates. The dearth of such data has much to do with the marginalised living and working conditions in agriculture and the lack of attention to occupational and environmental health on farms in the country. We have little sense of the extent of hazardous exposures in agriculture, nor of their health impacts on rural populations. Even less so, have methods for the control of poisoning by pesticides been investigated amongst farm workers in South Africa. A public health response to this problem should aim at all levels of prevention (primary, secondary and tertiary), by characterising the extent and distribution of the problems caused by pesticides, identifying risk factors and groups at highest risk for poisoning, as well as testing intervention strategies and technologies. The set of papers presented below attempts to do that by linking a series of investigations into different aspects of agrichemical hazards in South Africa, with a focus on the Western Cape. The first paper examined various aspects of potential exposure to agrichemicals on farms in the Stellenbosch region, taking into account both environmental and occupational routes of exposure. The second paper describes the profile of agrichemical poisoning in the province from 1987 to 1991, identifying high risk groups and characterising the completeness and nature of reported poisonings. The third paper developed from the author's growing realisation of the need to contextualise problems related to agrichemical exposures and effects within the overall legislative and public health framework in South Africa. This paper therefore identifies the key public health issues that need addressing with regard to pesticide safety. Finally, the last two papers address aspects related to workplace interventions for the prevention of agrichemical poisoning. One paper deals with the evaluation of a field kit (for validity and repeatability) for monitoring workers exposed to organophosphate and carbamate insecticides, while the last paper elaborates guidelines for the use of cholinesterase testing in the primary and secondary prevention of organophosphate and carbamate poisoning. In this series, therefore, the papers attempt to address the problem of agrichemical hazards within a public health framework, tracing the problem from potential exposure to acute outcomes, through reviewing the legislative and occupational health environments, through to technologies and policy guidelines related to workplace intervention. In doing so, the papers use the term "agrichemical" to refer to all chemicals used in agriculture for pest and weed control. This supersedes the term "pesticide" which has ambiguous meanings in the technical environment. Readers are therefore advised to understand the term "agrichemical" to include the generic aspects of chemical usage on crops in agriculture. The research on which these papers was based was spawned by the involvement of the author in a larger research project investigating long-term neurobehavioural effects of organophosphate exposure on deciduous fruit farm workers over the period 1991 - 1994. This latter piece of research is not referred to here as it was the basis for another degree at the University of Cape Town.

Submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic at the Durban University of Technology, 2013. / Background: Considering the quadruple burden of disease and chronic shortages of health care professionals in South Africa, the stance of the chiropractic profession on public health (PH) matters has not been established. Therefore, this study aimed to determine the attitudes and perceptions of chiropractors practicing in South Africa on PH, health promotion (HP) and disease prevention (DP). The objectives were to determine demographic profile, lifestyle practices and attitudes and perceptions of practicing chiropractors in South Africa regarding PH agencies, HP and DP. Methods: An IRB approved quantitative survey (electronic and postal) was used to collect data from a total sample of practicing chiropractors in South Africa (meeting inclusion criteria). Follow up email and telephone calls were made to encourage response from participants. After a 17 - week period, returned questionnaires were collected and data analysed. Results: A response rate of 45% was obtained. Of the participants, 51.7% were female, 60.3% practiced in upper – middle income communities and 66.4% perceived themselves as neuro - musculoskeletal specialists. Over 90% of practitioners regularly counselled patients on postural habits, injury prevention and ergonomic risk reduction. Where as 35.1% agreed to counselling patients on STI / HIV prevention, tobacco cessation and related risks (41.4%), alcohol abuse (53.4%) and cancer prevention (56.9%). Regarding evidence – based practice (EBP) and PH agencies, 39.1% could not identify the statistical significance of the p value and 46% were unable to provide examples to journals they used to inform best practice. Similarly, 59% of the participants could not identify PH agencies to refer to for information on smoking cessation / risks or PH agencies to refer patients on HIV (57%), notifiable diseases (59%) and terminal illnesses (45%). Conclusion: The results suggest that chiropractors from this study were proficient on topics of DP, but were reletively less proficient in regards to PH, HP and EBP. It was recommended that further research be done regarding EBP within the profession and that greater emphasis be placed on topics of HP and PH in chiropractic training programmes.

Thesis (MBA)--Stellenbosch University, 2000. / ENGLISH ABSTRACT: Since the first democratic elections in 1994, the emphasis in corporate and public life has been on transforming practices previously advocated by the apartheid government. As the service provider to the public there has been significant emphasis placed on the major sectors such as health and education. In addition to policy documents which focus specifically on health service delivery and the transformation envisaged, policy has also extended to transforming service delivery in all sectors of government. In designing policy for the transformation initiative little if any attention has been paid to the particular needs of the health sector as a whole and the public health sector in KwaZulu-Natal. Research conducted revealed that most employees were unaware of the results required in order to effect transformation within the public health sector of KwaZulu-Natal. To effect change and transformation, an internal marketing strategy and plan had to be designed. This strategy and plan would align the activities of each and every employee to the vision, mission and values of the KwaZulu-Natal Department of Health. The plan seeks to address issues such as performance management, communications, control, and budgeting considerations in order to market transformation to the 52 000 employees of the Department who serve the health needs of 26 percent of the country's population. / AFRIKAANSE OPSOMMING: Sedert die eerste demokratiese verkiesing in 1994 val die klem in beide die korporatiewe en publieke sektore op die transformasie van gebruike/praktyke wat voorheen deur die apartheidsregering onderskryf is. As openbare diensverskaffer is daar aansienlike klem geplaas op sekere hoofsektore soos gesondheid en onderwys. Bo en behalwe beleidsdokumente wat spesifiek fokus op dienslewering en die beoogde veranderings in gesondheid, is beleid ook uitgebrei om verandering in dienslewering in alle regeringsektore in te sluit. In die ontwikkeling van beleid vir die transformasie inisiatief, is weinig of geen aandag geskenk aan die spesifieke behoeftes van die gesondheidsektor in die algemeen en spesifiek die openbare gesondheidsektor in KwaZulu-Natal. Navorsing bevind dat die meeste amptenare onbewus is van welke resultate nodig is om transformasie in die openbare gesondheidsektor in KwaZulu-Natal te verseker. Ten einde verandering en transformasie te laat plaasvind, was dit nodig om 'n interne bemarkingstrategie en-plan te ontwerp. Hierdie strategie en plan sal die aktiwiteite van elke amptenaar fokus op die visie, missie en waardes van die Departement van Gesondheid van KwaZulu-Natal. Die plan poog om aangeleenthede soos prestasie-bestuur, kommunikasie, kontrole en begrotingsimplikasies aan te spreek en sodoende die transformasieproses te bemark aan die 52 000 werknemers van 'n Departement wat die gesondheidsbehoeftes van 26 persent van die land se bevolking bedien.

Thesis (MScMedSc (Biomedical Sciences))--University of Stellenbosch, 2010. / Thesis presented in partial fulfillment of the requirements for the degree Master of Science in Medical Biochemistry at the University of Stellenbosch. / Bibliography / ENGLISH ABSTRACT: Tuberculosis (TB) is an infectious disease which has plagued society for thousands of years. Despite public health programs, anti-TB drugs and a vaccine, the absolute numbers of people infected with TB each year continue to rise as populations grow. The high TB-burden areas are also plagued by other debilitating factors including HIV/AIDS infection, poverty and malnutrition. Nutrition has been implicated in TB susceptibility in a number of studies. While most are observational reports made during times of war, famine or natural disaster, multiple studies provide convincing evidence for poor nutritional status increasing the morbidity and mortality of TB. Numerous approaches are currently utilized in TB research, and there has been convincing evidence to support the role of host genetics in TB susceptibility. Based on previous linkage studies and a search of current literature, three genes were selected for this case-control study. Subsequently, variations located in cathepsin Z (CTSZ), melanocortin 3 receptor (MC3R) and melanocortin 4 receptor (MC4R) were genotyped in the South African Coloured (SAC) population to determine the existence of an association with TB disease. CTSZ is a lysosomal cysteine protease expressed in cells of the immune system. Interaction between this 303 amino acid protein and β2 integrin receptors lymphocyte function-associated antigen-1 (LFA-1) and macrophage antigen-1 (MAC-1) leads to altered lymphocyte proliferation. As a result, a single exonic variant in CTSZ, rs34069356, the same identified in a previous linkage study, showed strong evidence for association with TB susceptibility in cases (n = 410) and controls (n = 301) in the SAC population (p< 0.0001). MC3R and MC4R are two of 5 melanocortin receptors. MC3R has been found to be a key regulator in energy expenditure and host metabolism while activation of MC4R leads to a decrease in food intake. Activation of these two receptors is regulated by leptin, a hormone released by adipose tissue. A variant located upstream of the MC3R gene, rs6127698, also showed evidence of disease association with the less frequent allele, T, being under-represented in cases (n = 540) compared to controls (n = 541) (genotypic frequency, p = 0.0039), suggesting a possible resistance phenotype. Functional analysis of this variant revealed an increase in MC3R expression when stimulated with BCG, with individuals homozygous for the T allele exhibiting an even larger upregulation of MC3R expression than individuals homozygous for the G allele, though this difference was not statistically significant. A single haplotype in MC3R was found to be associated with TB susceptibility (p = 0.0008) and this association remained after permutation testing to correct for multiple testing (p = 0.0061) Three variants were selected for genotyping in MC4R and while none of these showed a statistically significant difference between cases (n = 510) and controls (n = 487), this gene should not be ruled out as both MC3R and MC4R have been found to work closely though not redundantly and double knockout experiments result in exacerbated obesity, suggesting that these proteins have a synergistic effect. The results of this study support both a role of host genetics and nutritional status in TB and strongly motivate further research in both of these fields. / AFRIKAANSE OPSOMMING: Tuberkulose (TB) is ‘n aansteeklike siekte wat reeds vir eeue die gesondheid van die publiek bedreig. Ten spyte van publieke gesondheidsprogramme en verskeie anti-TB medikasie middele, groei die aantal van mense wat hiermee ge-infekteer word steeds jaarliks. Dit is veral in areas waar TB steeds groei, waar ook ander neerdrukkende faktore soos HIV/Vigs, armoede en wanvoeding hoogty vier. Na aanleiding van verskeie verslae tydens oorloë, hongersnood en ander natuulike rampe is dit veral duidelik dat swak nutriënt inname morbiditeit en sterftes wat met TB gepaard gaan verhoog. Talle benaderings word tans gebruik in TB-navorsing, Bewyse is oortuigend om die rol van genetika van die gaheer met vatbaarheid vir TB te verbind. Op grond van vorige studies en die huidige literatuur, het ons drie gene gekies vir hierdie pasiënt-kontrole studie. Variante geleë in cathepsin Z (CTSZ), melanocortin 3 receptor (MC3R) en melanocortin 4 receptor (MC4R) is ge-genotipeer in die Suid-Afrikaanse Kleurling bevolking (SAK) (540 gevalle en 540 kontrole) om sodoende die assosiasie met TB te bepaal. CTSZ is ‘n lisosomale sisteïen protease wat uitgedruk word in immuunselle. Interaksie tussen hierdie 303 aminosuur protein en β2 integrin reseptore nl. LFA-1 en MAK-1 bring veranderde limfosiet proliferasie mee. ‘n Enkele eksoniese variant in CTSZ, rs34069356, dieselfde soos ge-identifiseer in ‘n vorige studie, verskaf sterk bewys vir assosiasie met TB vatbaarheid in gevalle (n = 410) en kontrole (n = 301) in die SAK bevolking. MC3R en MC4R is twee van 5 melanokortien reseptore. Daar is gevind dat MC3R 'n sleutelrol speel in die energie regulering van gasheer metabolisme, terwyl die aktivering van MC4R eindelik lei tot 'n afname in voedsel inname. Aktivering van hierdie twee reseptore word gereguleer deur Leptien, 'n hormoon wat vrygestel word deur adipose weefsel, ‘n Variant, stroomop geleë vanaf MC3R, rs6127698, is ook bewys om met TB ge-assosieer te wees, met die T-alleel meer seldsaam in gevalle (n = 540) as in kontroles (n = 541) wat dui op 'n moontlike weerstandsfenotipe. Funksionele analise van hierdie variant onthul 'n toename in MC3R uitdrukking wanneer gestimuleer met BCG, met individue homosigoties vir die T-alleel wat selfs groter opregulation veroorsaak wanneer vergelyk word met individue homosigoties vir die G allele. Hierdie resultaat was egter nie statisties beduidend nie. 'n Enkele haplotiepe in MC3R is ge-assosieer met TB vatbaarheid en die assosiasie is onveranderd nadat ‘n permutasie korreksie aangebring is (p = .0061). Voorts is drie variante gekies vir genotipering in MC4R en ten spyte daarvan dat nie een daarvan 'n statisties beduidende verskil getoon het tussen pasiënte (n = 510) en kontroles (n = 487) nie, behoort hierdie geen nie uitgesluit word nie, Die rede hiervoor is dat beide MC3R en MC4R verskeie kere gevind is om in samewerking ‘n rol te speel om vetsug te voorkom of te vererger. Die resultate van hierdie studie beaam beide 'n rol van gasheer genetika en voedingstatus in TB en motiveer veral verdere navorsing in beide van hierdie vakgebiede.

Thesis (MPA)--Stellenbosch University, 2000. / ENGLISH ABSTRACT: Sharp divisions featured between curative and preventative health care in the Public Health Services of South Africa before the democratisation process. There was fragmentation in authority structures and inequalities between urban and rural areas as well as along racial lines. This resulted in a situation where there was duplication and inequality in the distribution of resources amongst the different levels of health care which led to costly inefficient and ineffective health services. The introduction of the White Paper Towards the Transformation of Health System in South Africa in 1997, aims at the restructuring of health services towards a unified health system which is capable of delivering quality health care to all in a caring environment. The District Health System (DHS) is featured as the key to ensuring decentralised, equitable Primary Health Care (PHC) to all the citizens of South Africa. This study looks at the reorganisation of health services in the clinics and the day hospitals which are rendered by the Health Department of The City of Tygerberg and the Community Health Service Organisation (CHSO) of the Provincial Administration of the Western Cape(P AWC) in Khayelitsha with the aim of achieving comprehensive PHC services. Inthe absence of legislation for the integration of health services, initiatives for the achievement of quality comprehensive PHC within the district are envisaged. / AFRIKAANSE OPSOMMING: Openbare Gesondheidsdienste in Suid Afrika was voor die demokratieseringsproses gekenmerk deur 'n skeidig tussen kuratiewe en voorkomende gesondheidsdienste. Daar was fragmentasie van bestuurstrukture, ongelykheid tussen stedelike en landelike gebiede asook ongelykheid op grond van ras. Dit het gelei tot duplisering van, en ongelykheid in, die verspreiding van hulpbronne op die verskillende vlakke van gesondheidssorg. Die Witskrif op die Transformasie van Gesondheidstelsels in Suid-Afrika, 1997, fokus op die herstrukturering van gesondheidsdienste en het 'n verenigde gesondheidstelsel ten doel wat daartoe in staat is om gehalte gesondheidsorg in 'n sorgsame omgewing aan almal te lewer. Die Distriksgesondheidstelsel (DGS) word gekenmerk deur gedesentraliseerde, gelykmatige Primêre Gesondheidsorg (PGS) dienslewering aan al die inwoners van Suid-Afrika. Hierdie studie kyk na die herorganisering van gesondheidsdienste wat deur die gesondheidsdepartement van die Stad Tygerberg en die Gemeenskapsgesondheidsdiens organisasie van die Provinsiale Administrasie van die Wes-Kaap (PAWK) in die klinieke en daghospitale in Khayelitsha gelewer word met die doel om omvattende Primêre Gesondheidsorgdienste te voorsien. Weens die afwesigheid van wetgewing vir die integrasie van gesondheidsdienste word inisiatiwe vir die bereiking van gehalte omvattende Primêre Gesondheidsorg binne die distrik beoog.

<p>This study aimed to identify barriers to the availability of essential drugs at health facilities, to identify implementable solutions to those barriers, to develop a monitoring system for tracking implementation of solutions and for tracking drug supply.</p>

Policy is a rule to guide decisions and achieve rational outcomes while advocacy is a strategy to influence architects of decision making or policy makers when they make regulations and laws, distribute resources, and make other decisions that affect peoples' lives. The principal aims of policy advocacy as postulated by Kervatin in 1998 are to create policies, reform policies, and ensure policies are implemented. This study examines the role of civil society in policy advocacy, using the Treatment Action Campaign (TAC) as an example. Therefore, the study uses a content analysis method of data collection and analysis to explicate the various advocacy strategies employed by the Treatment Action Campaign to advocate for access to HIV/AIDs treatment in post-apartheid South Africa. The policy advocacy strategies of the TAC were investigated pertaining to the implementation of health policy on HIV/AIDS in South Africa. There are a variety of advocacy strategies employed by civil society organisations, such as discussing problems directly with policy makers, delivering messages through the media, or strengthening the ability of local organisations to advocate. These strategies are known as advocacy tools for planning successful advocacy initiatives. Most of them are clearly reflected in the case of the TAC organisation, which employed these strategies and others to advocate for HIV/AIDS policy change. / Thesis (M.Soc.Sc.)-University of KwaZulu-Natal, Pietermaritzburg, 2013.