Thesis (M.B.A.)-Business Studies Unit, Durban University of Technology, 2006 xv, 200 leaves / Imbalance in the health workforce is a major challenge for health policy-makers, since human resources are the most important of the health systems input (Sanders & Lloyd) Several developed nations are increasingly relying on immigration as a means of coping with domestic shortages of health care professionals (Vujicic et al. 2004). The extent of migration and other losses of professional skills are difficult to quantify. However, the effects of these are multifaceted and have far reaching consequences for both the economy and the maintenance of health services in the country. The effects of this “brain drain” limit service delivery and limit the general population’s access to health services. The purpose of this study is to determine the effectiveness of contracting bursary students to the Department of Health (KwaZulu-Natal) as a specialist skills retention strategy. / M

Thesis (M.B.A.)-Business Studies Unit, Durban University of Technology, 2006 xv, 200 leaves / Imbalance in the health workforce is a major challenge for health policy-makers, since human resources are the most important of the health systems input (Sanders & Lloyd) Several developed nations are increasingly relying on immigration as a means of coping with domestic shortages of health care professionals (Vujicic et al. 2004). The extent of migration and other losses of professional skills are difficult to quantify. However, the effects of these are multifaceted and have far reaching consequences for both the economy and the maintenance of health services in the country. The effects of this “brain drain” limit service delivery and limit the general population’s access to health services. The purpose of this study is to determine the effectiveness of contracting bursary students to the Department of Health (KwaZulu-Natal) as a specialist skills retention strategy.

Thesis (MPhil (Industrial Psychology))--University of Stellenbosch, 2006. / This research was conducted with a group of 24 Health Care workers/trainers working for an NGO, teaching Life Skills and HIV/AIDS in 24 different township schools. These trainers have been trained in an Aligned programme including SAQA Unit Standards on facilitating learning, Life Skills issues as well as HIV/AIDS. The training was based on the fact that they facilitate learning during the Life Orientation lessons, hence the integration of Life Skills and HIV/AIDS into the Life Orientation Curriculum. This programme is not a loose standing programme, but forms part of the LO Curriculum. Not only were they trained, but the result of the training was a formulated product which led to the producing of lesson plans, learning activities and worksheets for Grade R to Grade 10 in their teaching. Through this there is now a training manual for each trainer, consisting of 320 different lessons. This will form the basis of their involvement and training in each respective school, but will also create consistency and uniformity in the actual presentation of the lessons. The learners will have specific work sheets for each lesson. Any time a new trainer has to start with a different group of learners, he/she can refer to the training manual and in doing so, not lose momentum in the process of actualisation of the learning. In training the NGO Health workers, the aim is to develop their teaching strategies, adding confidence to their lesson planning and presentation. With the formalisation of this programme the Life Orientation educator is aided in his/her assessment of the learners in his/her class. This training process and self-development of the trainers aims to become a model to other NGO’s involved in similar endeavours.

Bibliography: pages 273-351 / The context of this research is the occupational wellbeing of employees in the healthcare industry in South Africa. The purpose of this study was to identify occupational wellbeing types that cluster as a result of variables (burnout, work engagement, workaholism and job satisfaction) which can be plotted on the circumplex model of wellbeing, and determining the extent of type differences in as far as it pertains to psychosocial antecedent variables (age, job demands, job resources and work-related sense of coherence), as well as positive and negative outcome variables (comprising organisational commitment and turnover intention). A quantitative survey was conducted on a convenience sample of healthcare workers (N = 461). The population consisted of predominately black African females, aged between 31 and 45 from the nursing profession. Cluster analysis using k-means found statistically significant support for three occupational wellbeing types, namely, Exhausted, Engaged and Burned-Out. Results from MANOVA revealed a difference between all occupational wellbeing types and the psychosocial antecedent variables of job demands, job resources and work-related sense of coherence. The occupational wellbeing types did not however differ, based on the age of the participants. Multinomial logistic regression analysis revealed that age was additionally not a significant predictor of the occupational wellbeing types, whilst Work-SoC predicted the engaged type, and job demands and job resources predicted the engaged and exhausted types in comparison to the burned-out type. Hierarchical moderated regression analysis concluded that each of the occupational wellbeing types played a significant role by moderating the relationship between the psychosocial antecedent variables of job resources and work-related sense of coherence, and the positive and negative outcomes of organisational commitment and turnover intention. Theoretically the study highlighted the importance of addressing the occupational wellbeing concerns and challenges faced by healthcare employees in South Africa face. The empirical value of the study was the identification of the occupational wellbeing types and a potential nomological net. The knowledge derived from the relationship between the variables may be valuable in informing a holistic affective wellbeing model which could direct practices within the healthcare industry in South Africa. / Die konteks van hierdie navorsing is die beroepswelstand van werknemers in die gesondheidsorgbedryf in Suid-Afrika. Die doel van hierdie studie was om tipes beroepsmatige welstand te identifiseer wat saamgevoeg word as gevolg van veranderlikes, naamlik uitbranding, werkbetrokkenheid, werksverslawing en werkstevredenheid wat op die sirkumpleksmodel van welstand geteken kan word, en om die omvang van tipe verskille in so ver aangesien dit betrekking het op psigososiale antesedente veranderlikes, naamlik ouderdom, werksvereistes, werksbronne en werkverwante samehang, sowel as positiewe en negatiewe uitkomsveranderlikes (wat organisatoriese toewyding en omsetintensiteit bevat). 'N Kwantitatiewe opname is gedoen oor 'n gerieflikheidsteekproef van gesondheidswerkers (N = 461). Die bevolking het bestaan uit hoofsaaklik swart vroulike vroue, tussen 31 en 45 jaar oud, uit die verpleegberoep. Cluster-analise met behulp van k-middele het statisties beduidende ondersteuning gevind vir drie tipes beroepswelstand, naamlik uitgeputting, betrokkenheid en uitgebranding. Resultate van MANOVA het 'n verskil aan die lig gebring tussen alle tipes beroepswelstand en die psigososiale antesedente veranderlikes van werksvereistes, werkbronne en werkverwante samehang. Die tipes beroepswelstand verskil egter nie op grond van die ouderdom van die deelnemers nie. Multinomiale logistieke regressie-analise het aan die lig gebring dat ouderdom ook nie 'n beduidende voorspeller was van die tipes beroepswelstand nie, terwyl Work-SoC die betrokke tipe voorspelling en werksvereistes voorspel het, en dat werkbronne die betrokke en uitgeputte tipes voorspel in vergelyking met die uitgebrande tipe. Hiërargiese gemodereerde regressie-analise het tot die gevolgtrekking gekom dat elkeen van die tipes beroepswelstand 'n belangrike rol gespeel het deur die verhouding tussen die psigososiale voorgaande veranderlikes van werkbronne en werkverwante sin vir samehang te modereer, en die positiewe en negatiewe uitkomste van organisatoriese toewyding en omsetintensiteit. Teoreties het die studie die belangrikheid daarvan beklemtoon om die kommer en uitdagings wat gesondheidswerkers in Suid-Afrika in die gesig staar, aan te spreek. Die empiriese waarde van die studie was die identifisering van die tipes beroepswelstand en 'n potensiële nomologiese netwerk. Die kennis wat verkry word uit die verband tussen die veranderlikes, kan waardevol wees om 'n holistiese affektiewe welstandsmodel in te lig wat praktyke binne die gesondheidsbedryf in Suid-Afrika kan rig. / Umongo walolu cwaningo wukuphila kahle kwabasebenzi abasembonini yezokunakekelwa kwempilo eNingizimu Afrika. Inhloso yalolu cwaningo kwakuwukuhlonza izinhlobo zenhlalakahle yomsebenzi ezihlangana ngenxa yokuguquguqukayo (ukutubeka, ukuzibandakanya emsebenzini, ukusebenza ngokweqile nokweneliseka emsebenzini) okungabekwa kumodeli yenhlalakahle ye-circumplex, nokunquma ubukhulu bezinhlobonhlobo zohlobo kuze kube manje njengoba kumayelana nokuhlukahluka kokuphikisana kwengqondo (iminyaka, izidingo zomsebenzi, izinsiza zomsebenzi kanye nokuzwana okuhlobene nomsebenzi), kanye nokuhlukahluka kwemiphumela emihle nemibi (ehlanganisa ukuzibophezela kwenhlangano kanye nenhloso yenzuzo). Ucwaningo oluningi lwenziwe kusampula elula yabasebenzi bezokunakekelwa kwezempilo (N = 461). Isibalo besinabantu besifazane ikakhulukazi abamnyama base-Afrika, abaneminyaka ephakathi kuka-31 no-45 abavela emsebenzini wobunesi. Ukuhlaziywa kweqoqo ngokusebenzisa izindlela ezingama-k kutholwe ukwesekwa okubalulekile kwezibalo zezinhlobo ezintathu zomsebenzi, okungukuthi, Ukhathele, Ukuhlanganyela kanye Nokushiswa. Imiphumela evela kwa-MANOVA iveze umehluko phakathi kwazo zonke izinhlobo zenhlalakahle yomsebenzi kanye nokuhlukahluka kokuphikiswa kwengqondo kwezidingo zomsebenzi, izinsiza zomsebenzi kanye nokuzwana okuhlobene nomsebenzi. Izinhlobo zezenhlalakahle zomsebenzi azizange zehluke, ngokuya ngeminyaka yabahlanganyeli. Ukuhlaziywa kokuhlelwa kabusha kwezinto kwamazwe amaningi kuveze ukuthi iminyaka yobudala ibingeyona imbonakaliso ebalulekile yezinhlobo zenhlalakahle yomsebenzi, ngenkathi i-Work-SoC ibikezela uhlobo lokuzibandakanya, nezimfuno zomsebenzi, nezinsizakusebenza zibikezela izinhlobo ezibandakanyekile nezikhathele uma kuqhathaniswa nohlobo olushile. Ukuhlaziywa kokuhlehliswa kwe-hierarchical kuphethe ukuthi uhlobo ngalunye lwezinhlalakahle zomsebenzi lubambe iqhaza elibalulekile ngokuhlolisisa ubudlelwano phakathi kokuhlukahluka kokuphikiswa kwengqondo kwengqondo kwezinsiza zomsebenzi kanye nokuzwana okuhlobene nomsebenzi, kanye nemiphumela emihle nemibi yokuzibophezela kwenhlangano kanye nenhloso yenzuzo. Ngokwezifundo lolu cwaningo luqhakambisa ukubaluleka kokubhekana nezinkinga nezinselele ezibhekene nabasebenzi bezempilo eNingizimu Afrika ababhekene nazo. Inani lezobuciko lolo cwaningo kwakuwukuhlonzwa kwezinhlobo zenhlalakahle yomsebenzi kanye nenetha elingaba namandla lokuqanjwa. Ulwazi olususelwe ebudlelwaneni obuphakathi kokuguquguqukayo lungaba lusizo ekwaziseni imodeli yenhlalakahle ephelele engaqondisa izindlela ezenziwa embonini yezokunakekelwa kwempilo eNingizimu Afrika. / Industrial and Organisational Psychology / D. Phil. (Psychology)

Integrative Summary In 1997 the Minister of Public Service and Administration of South Africa, Zola Skweyiya, introduced the White Paper on Transforming Public Service Delivery(Department of Public Service and Administration(DPSA,1997: 1). It was premised on what was called Batho Pele (DPSA, 1997: 9), giving effect to Section 197 of the Constitution, Act 108 of 1996 as amended. A linkage to performance management can be found from the assertion made in the White Paper that in future the Batho Pele would form the basis of any assessment of the performance of individual staff and that would contribute to improving the delivery of service (DPSA, 1997:16). Another factor that contributed to the utilisation of a performance management system was the recommendation put forward by the Public Service Commission of South Africa( PSC,2004: 16),that called for public institutions to adopt a clear, comprehensive performance management and evaluation framework for the delivery of public service. That was expected to turn around the ailing public institutions whose record of serving the public with pride and dignity was on the decline. The research aim was to evaluate the effectiveness of the performance management system in creating and resolving role conflict with health professionals employed by the Buffalo City sub-district. The research goal was divided into three objectives, namely: evaluation of the effectiveness of the performance management system as a managerial tool for health managers to manage their subordinates including both professional and support staff, evaluation of the effectiveness of the performance system from the perspective of the health professional as a subordinate and to analyze the functioning and effectiveness of the system in creating and resolving role conflict between professional conduct and organisational requirements. The respondents noted that the implementation of the system was not matched with appointment at managerial level with officials having relevant managerial capacity. Further to that resources at the coal face of service delivery continued to deteriorate and became very scarce and there is no documented proof that has been found of an effort made to check the compatibility of the system to health professionals. The literature identified negative effects that have emanated from the implementation of the performance management system. The study was conducted by interviewing health professionals from the entry level to the management level within the Buffalo City sub-district from three mini hospitals or Health Care Centres. The respondents indicated that there are positives that have been achieved by the implementation of the system, such as the skills gap identification as well as specific targets contained in annual performance contracts. These targets help motivate health professional to focus on that particular direction of activities. Unfortunately it has been clearly documented that the performance management system has also contributed to the development of role conflict in a number of professionals. It has been documented that the system has not been crafted with a health professional in mind and, as such, appears to favour quantity rather than quality of health services as advocated by the codes of practice of different health professionals. There are a number of recommendations that were put forward by the respondents to try to salvage the system and in mitigation of the identified negative factors. For the improvement of the system, the Eastern Cape Provincial Department of Health has to firstly customise the annual contracts to contain only the fundamental information. Secondly need to improve the transparency pertaining to financial pressures facing the Health Department. Thirdly the provision of essential enablers, need to be prioritised. Fourthly there is a need to upgrade the system to incorporate 360 degree feedback. Further research recommendations include a bigger sample incorporating different research methods and to also incorporate searches for measures that can be implemented to improve the system to be more relevant to health professionals. This document is organised and presented in three sections. The first section is the evaluation report with a review of literature, research methodology, findings, discussion and conclusion. The second section is where an indepth literature review is located and the last section details the research methodology.

Text in English with summaries in English, Afrikaans and Zulu / Bibliography: leaves 102-115 / The study investigated the management of medical records in the Primary Health Care services (PHCs) of Diepsloot. The study investigated the regulatory framework, records infrastructure, records security, records management staff skills and the filing system. A qualitative design guided by the interpretive paradigm was used to guide the case study. Interviews, focus groups, and observations generated data from 50 participants. The study revealed that the regulatory instruments used to manage records lack implementation and compliance. There was a lack of security measures, a shortage of records management infrastructure and inconsistency in the filing system. There is a low level of skill in the records management staff. The study recommended the implementation of a regulatory policy that will guide and ensure effective governance of records in PHCs. Records should be secure from misuse by unscrupulous individuals. PHC records need to be managed by experienced professionals. The filing system should be easily accessible. / Die studie het ondersoek ingestel na die bestuur van mediese rekords in die Primêre Gesondheidsorgdienste (PHC's) van Diepsloot. Die studie het ondersoek ingestel na die regulatoriese raamwerk, rekord van infrastruktuur, rekord sekuriteit, vaardighede vir rekordbestuur en die liasseerstelsel. 'n Kwalitatiewe ontwerp gelei deur die interpretatiewe paradigma is gebruik om die gevallestudie te lei. Onderhoude, fokusgroepe en waarnemings het gegewens van 50 deelnemers gegenereer. Die regulatoriese instrumente wat gebruik word om rekords te bestuur, het geen implementering en nakoming nie. Die studie het aan die lig gebring dat daar 'n gebrek aan veiligheidsmaatreëls was, 'n tekort aan infrastruktuur vir rekordbestuur en teenstrydigheid in die liasseringstelsel. Die personeel in rekordbestuur het 'n lae vlak van vaardigheid. Die studie het die implementering van 'n regulatoriese beleid aanbeveel wat die doeltreffende bestuur van rekords in PHC's sal lei en verseker. Rekords moet beskerm word teen misbruik deur gewetenlose individue. PHC-rekords moet deur ervare professionele persone uitgevoer word. Die liasseerstelsel moet maklik toeganklik wees. / Lolu cwaningo luphenywe ngokuphathwa kwamarekhodi ezokwelashwa emnyangweni Wezokunakekelwa kwempilo okuyisisekelo (i-PHCs) eDiepsloot. Ucwaningo luphenywe ngohlaka lokulawula, ingqalasizinda yamarekhodi, ukuphepha kwamarekhodi, amakhono okuphathwa kwamarekhodi nohlelo lokufayila. Umklamo olungaqanjwa uqondiswa yi-paradigm yokutolika wasetshenziselwa ukuqondisa ucwaningo lwesigameko. Izingxoxo, amaqembu okugxila kanye nokubukwa kukhiqize idatha evela kubahlanganyeli abangu 50. Izinsizakusebenza zokulawula ezisetshenziselwa ukuphatha amarekhodi zingenakho ukusebenza nokuhambisana. Ucwaningo luveze ukuthi bekukhona ukuntuleka kwezindlela zokuphepha, ukushoda kwengqalasizinda yokuphathwa kwamarekhodi kanye nokungahambelani ohlelweni lokugcwalisa. Kunezinga eliphansi lekhono kubasebenzi bokuphathwa kwamarekhodi. Ucwaningo lincome ukusetshenziswa kwenqubomgomo yokulawula ezohola futhi iqinisekise ukuphathwa kwamarekhodi kuma-PHCs ngendlela efanele. Amarekhodi kufanele avikeleke ekusetshenzisweni kabi ngabantu abangathembekile. Amarekhodi we-PHC adinga ukuqhutshwa ngochwepheshe abanolwazi. Uhlelo lokufayila kufanele lutholakale kalula. / Information Science / M. Inf.

The study sought to explore professional nurses' perceptions of the roles of home and community-based carers in the Capricorn district of the Limpopo province as well as the problems they experienced and make recommendations to improve the quality of home and community-based care. A qualitative approach with non-probability, purposeful sampling was used in this study. The sample consisted of professional nurses serving as focal points for home-based care in the area of the study. The findings indicated that professional nurses believe that carers have a role in providing care to the community and serve as the extended hands of their services. However, challenges exist, which impact on the quality of service delivery. Recommendations included the strengthening of existing elements, such as improving relationships, communication, and the care of carer's programme, carer training, reporting, and monitoring and carer distribution. / Health Studies / M.A. (Health Studies)

The study sought to explore professional nurses' perceptions of the roles of home and community-based carers in the Capricorn district of the Limpopo province as well as the problems they experienced and make recommendations to improve the quality of home and community-based care. A qualitative approach with non-probability, purposeful sampling was used in this study. The sample consisted of professional nurses serving as focal points for home-based care in the area of the study. The findings indicated that professional nurses believe that carers have a role in providing care to the community and serve as the extended hands of their services. However, challenges exist, which impact on the quality of service delivery. Recommendations included the strengthening of existing elements, such as improving relationships, communication, and the care of carer's programme, carer training, reporting, and monitoring and carer distribution. / Health Studies / M.A. (Health Studies)

This study focuses on the psycho-social challenges faced by HIV/AIDS lay counsellors at a Voluntary Counselling and Testing (VCT) site in Tshwane, South Africa. A qualitative approach was employed by using semi-structured interviews with open-ended questions to obtain information from four lay counsellors, who provide pre- and post-test counselling at a VCT site. The results indicate that the management of clients’ emotions and needs pose enormous challenges to HIV/AIDS lay counsellors who do not receive any formal psycho-social support at VCT sites. The research participants in this study resort to their own coping mechanisms to deal with the challenges – with varying degrees of success. The recommendation is made that a formal support programme should be put in place at VCT sites, which will allow HIV/AIDS lay counsellors to respond to the many demands placed on them. Such a programme can help prevent burnout and a high turnover in lay counsellors. / Social Work / M. A. (Social Behaviour Studies in HIV/AIDS)

Health practitioners collect health data on a daily basis at health facility levels in order to monitor and evaluate the performance of priority national health programmes (District Health Plan 2012:6). Routine data quality for health programmes monitoring need a collective intervention to ensure clear understanding for what data to be collected at primary health care setting. The aim of the study is to explore the understanding of routine health data, determine the use of routine data and feedback mechanism at primary health care clinic setting. Quantitative descriptive research design was used to answer the research question on this research study. Structured data collection questionnaire was used for the study to accomplish the research purpose and reach the study objectives. A total of 400 participants was sampled, and 247 responded. One of the findings was that the understanding of routine health data by Health Practitioners was at 82.6% (% = f/n*100, f= 3242 and n= 3926). / Health Studies