>Magister Scientiae - MSc / BACKGROUND: The purpose of this study was to determine use, knowledge and attitudes towards traditional, complementary and alternative medicine (TCAM) in Botswana among people who visit public health facilities. PRIMARY AIM: The primary aim of this study was to establish the attitude towards, knowledge of and use of TCAM among patients utilizing two public health care facilities in Botswana. METHODS: The study was descriptive and quantitative in design. Data were collected using structured questionnaires in two public sector hospitals. Data included demographics of participants, current or past TCAM use, perceptions of efficacy and safety of TCAM and knowledge sources on TCAM. RESULTS: The median age of participants was 38.5 years with the youngest participants being 18 years and oldest participant 78 years. Just more than half (55%) of the participants were female.The majority of participants were single (65.6%) and about a quarter (24.4%) of participants were married. Of the study population 16 (7%) participants had no formal education and 40% had a secondary school education. The prevalence of TCAM use in the 90 study participants was found to be 48.9% of which 16.7% were currently using TCAM and 32.2% had used TCAM in the past. However, this practice could not be correlated with any particular demographic variable. TCAM was most often used either to promote overall wellness or to treat a specific health condition. The TCAM modality that was mostly used was African traditional medicine and other herbals. The majority of TCAM users were satisfied with the effects of TCAM of whom 68.4% of participants found the products very helpful. Most of the respondents (79%) reported that they perceived the products to be very safe. However, the participants were split in their willingness to recommend TCAM to another person. In terms of knowledge, most participants would not use TCAM with other medicines. Yet the majority of participants also indicated that they have never discussed TCAM use with their health care professional. Most participants have been exposed to information on TCAM from family or friends (80.6%). CONCLUSION: The prevalence of TCAM use in Botswana is similar to findings in other parts of the world. These products were primarily used for overall wellness and to treat specific diseases, but this practice could not be attributed to any particular demographic profile. The majority of TCAM users were satisfied with the effects of TCAM. Findings support a need for greater integration of allopathic medicine and CAM, as well as improved communication between patients and caregivers regarding TCAM usage.

The current study explored the work-related experiences of psychologists in public health facilities in Botswana. This topic has received minimal research attention, yet the World Health Organization has recognised the importance of treating mental health conditions. There is also recognition that there is a shortage of mental health practitioners, especially psychologists, in low to middle income countries such as Botswana. For this reason, the World Health Organisation has developed an initiative amongst its member states to increase access to mental health services by integrating them into the general health system. This is where psychologists in public health facilities are employed. In order to investigate how psychologists in public health facilities experience this integration, an explorative design was followed which adopted a qualitative methodology for data collection and analysis. Three semi-structured interviews were conducted with clinical psychologists who were recruited through purposive sampling. The data were analysed through thematic analysis. Generally, the participants experienced their work in the public health facilities as a professionally enhancing experience in spite of the various challenges encountered. They described a wide range of supportive and therapeutic functions that served the institutions and society in general. It is hoped that the results of this study can inform policies on mental health and add some valuable insight for further investigation of this topic. / Mini Dissertation (MA)--University of Pretoria, 2019. / Psychology / MA / Unrestricted

Philosophiae Doctor - PhD / The concepts of availability, affordability, accessibility and acceptability otherwise known as the 4As of ATM are key factors that influence access to essential medicines in any given health system. However, the exact scale and extent to which these 4As affect various populations in Nigeria remains unknown. This study investigates the Nigerian healthcare system with special focus on access to quality and affordable essential medicines in three Nigerian States; Abuja, Kaduna and Nassarawa, by drawing upon primary data, using qualitative and quantitative research methods.

Magister Public Health - MPH / Promoting positive and healthy decision-making practices and encouraging the utilization of health care facilities amongst adolescents is an important public health priority given that the period of adolescence is characterized by experimentation and risk taking behaviour. In the Tafelsig area of Mitchell‟s Plain, a poor socio-economic community within the Cape Town metropole, adolescents are exposed to a range of social problems (such as alcohol and substance abuse) that can potentially be harmful to their health. Given this context there was some concern raised by the sub-district health management team that adolescents are not making sufficient use of the local health facilities. The purpose of this study was to gain a greater understanding of the factors that contribute to, or hinder, the utilization by adolescents of the public health facilities in the Tafelsig area and in turn provide the Department of Health with information on adolescents‟ preferences concerning access to and use of the local primary-level health services in Mitchells Plain.An exploratory descriptive study was conducted to explore the topic using qualitative research methods. Permission to conduct the research was obtained from the Higher Degrees Committee of the University of the Western Cape and the School Principal. In-depth interviews were conducted with eight Grade 9 and seven Grade 10 male and female learners from the local secondary school - all of whom were randomly selected from a list of learners who indicated their willingness to participate in the study and who had obtained the written consent from their parents or guardian to do so. Interviews with the learners explored the positive and negative experiences, perceptions and opinions they have of using – or contemplating the use of – the local health facilities. The data from these interviews were analyzed using thematic content analysis.The study demonstrated that even when public health services are available, adolescents are often not in a position themselves to choose for themselves: their parents or guardians invariably make the choice for them. At times they are also reluctant to use public health facilities for fear of being judged by health personnel for being sexually active. The idea of waiting for long periods of time to see a health professional, or being observed at the health facility by other members of their community, are also considered to be disincentives.Many of the learners interviewed expressed a need for more information about sexual and reproductive health issues and matters that affect their health. The findings of this study also suggest that there is an urgent need for youth-friendly health services to be made available in the Mitchells Plain community. It is thus recommended that the Department of Health strategically assess whether an existing public health facility can be re-orientated to cater for the specific health needs of adolescents in Mitchells Plain.

Health Management Information System (HMIS) in developing countries lags seriously behind as compared to the developed countries; and the existing HMIS in many countries is insufficient to support health management functions. The purpose of this study was to describe the implementation of Anti-retroviral Therapy (ART) pharmacy management information system in public health facilities. Quantitative, descriptive research was conducted at 38 public health facilities. The participants of the study were Pharmacists and Druggists those are working at ART Pharmacy. Data collection was done by using structure questionnaire. 76 respondents were recruited to participate in the study. The participants ages ranged from 26-50 years and all had more than 2 years’ work experience. The study indicated that even if there is a system at most health facilities their utilization of information technology (IT) for pharmacy practice were not appreciated. The findings indicated that the need for creating awareness among professionals in giving more skill oriented and also a formal in-service information technology related trainings for the professionals. To achieve better utilization of information technology at health care delivery system particularly pharmacy practice, government and stakeholder should consider capacity building activities through proper training and it should also viewed as a long term socio-cultural and technical development process. / Health Studies / M.A. (Public Health with specialization in Medical Informatics)

Health Management Information System (HMIS) in developing countries lags seriously behind as compared to the developed countries; and the existing HMIS in many countries is insufficient to support health management functions. The purpose of this study was to describe the implementation of Anti-retroviral Therapy (ART) pharmacy management information system in public health facilities. Quantitative, descriptive research was conducted at 38 public health facilities. The participants of the study were Pharmacists and Druggists those are working at ART Pharmacy. Data collection was done by using structure questionnaire. 76 respondents were recruited to participate in the study. The participants ages ranged from 26-50 years and all had more than 2 years’ work experience. The study indicated that even if there is a system at most health facilities their utilization of information technology (IT) for pharmacy practice were not appreciated. The findings indicated that the need for creating awareness among professionals in giving more skill oriented and also a formal in-service information technology related trainings for the professionals. To achieve better utilization of information technology at health care delivery system particularly pharmacy practice, government and stakeholder should consider capacity building activities through proper training and it should also viewed as a long term socio-cultural and technical development process. / Health Studies / M.A. (Public Health with specialization in Medical Informatics)