MCur / Department of Advanced Nursing Science / Background: Perinatal and neonatal mortality rates remain high in South Africa especially in rural areas and townships where the majority of poor people live. With regard to perinatal and neonatal mortality, South Africa like many other developing countries has failed to achieve MDG 4 and 5 by 2015 regardless of many efforts by the governments. To achieve the SDG which replaced MDGs for child health, it is necessary for the South African public and private health care to reduce substantially perinatal and new born deaths, particularly in rural areas. There are many factors that contribute to a high perinatal mortality rate in public hospitals in rural areas. To understand these factors, a study was conducted with midwives from selected public hospitals in Limpopo, Vhembe district which experiences the highest perinatal mortality rates in South Africa. Purpose and methodology: The purpose of this research study was to assess factors contributing to high perinatal mortality rates in the selected public hospitals in Vhembe district. A quantitative, descriptive, exploratory and cross-sectional design was used to collect data from the sampled hospitals in the Vhembe district. Hospitals were purposively sampled based on the statistics of monthly deliveries. The target population consisted of all registered midwives who had been working in the maternity units for at least two years. Cochrane's formula was used to determine the sample from the target population for each hospital. A random sample of 110 respondents was selected upon which a questionnaire was administered to each by the researcher. Responses from the close-ended and open-ended questions was grouped and analysed quantitatively by means of Statistical Package for Social Sciences 23.0 (SPSS). Results and findings: Results were presented in frequency tables and graphs revealed that most of the midwives lacked knowledge and skills in a number of key areas needed for them to operate efficiently in the maternity wards. There was also high staff turnover which led to a few midwives being overworked. The utilisation of guidelines and protocols in maternity was left to individual midwives as the hospitals did not evaluate the use of it. Conclusions: Lack of key skills in assisting women in labour, and poor use of guidelines and understaffing were the main contributing factors to high perinatal mortality rates in the selected public hospitals of Vhembe district. Midwife attitudes were not a contributory factor. / NRF

The purpose of the study was to explore and describe leadership at Matlala District Hospital in Limpopo, a province of South Africa. The study was critical for a better understanding of leadership styles adopted in different situations (hospital, district or province) at Matlala District Hospital in the Sekhukhune district. The main objectives of the study were described in chapter 1 on leadership styles (transformational and transactional), to determine how best to investigate leadership styles at Matlala District Hospital, to determine what the current leadership style at Matlala District Hospital is and to propose the most appropriate leadership style for Matlala District Hospital. A mixed-methods approach was used with an exploratory and descriptive design. In terms of the qualitative methodology, purposive sampling was used as the managers were selected on their knowledge of the issues under investigation. Firstly, an interview schedule was developed and used to collect data at Matlala District Hospital. The sample size was 82. Interviews were conducted with 12 members of the executive committee who were regarded as senior managers of the hospital. Secondly, the researcher distributed the questionnaires to participants of the hospital that met the inclusion criteria. Seventy participants completed questionnaires, which were collected upon completion. A 100% response rate was reached. Thematic analysis was used to assess the qualitative data. With regard to quantitative data analysis, descriptive, frequency tables and charts and inferential statistics were used. According to the results, those managers who felt that resources had be provided felt strongly that leadership at the hospital should be improved. Accordingly, guidelines for improving leadership at Matlala District Hospital have to be developed to ensure that mitigating factors are in place for the improvement of the situation at the hospital. / Public Administration and Management / M. P. A. (Public Administration)

Text in English / The aim of this study was to gain understanding of community service nurses’ experiences of health care services at Tshwane district public hospital. This qualitative study followed an Interpretative Phenomenological Analysis (IPA) approach to explore the community services nurses’ experiences of health care services at Tshwane district public hospital. Data were collected from 11 purposively selected community service nurses using a semi-structured interview format. Data was analysed using Interpretative Phenomenological Analysis framework for data analysis. Four super-ordinates emerged from data analysis: (1) Resources, (2) Work environmental relations, (3) Supervision and support and, (4) Impact of community service experiences. The study revealed that the health care services rendered at the hospital studied are substandard. Community service nurses reported several challenges experienced during their placement in the hospital under study. Lack of human and material resources, supervision and support contributed to hindrance of smooth acquisition of their clinical skills and experience. These challenges resulted in the psychological and emotional drain of the participants. There is a need for development of guidelines to ensure constant and adequate support to all the community service nurses placed at Ratanang Hospital. / Health Studies / M.A. (Nursing Science)

Text in English / The aim of this study was to gain understanding of community service nurses’ experiences of health care services at Tshwane district public hospital. This qualitative study followed an Interpretative Phenomenological Analysis (IPA) approach to explore the community services nurses’ experiences of health care services at Tshwane district public hospital. Data were collected from 11 purposively selected community service nurses using a semi-structured interview format. Data was analysed using Interpretative Phenomenological Analysis framework for data analysis. Four super-ordinates emerged from data analysis: (1) Resources, (2) Work environmental relations, (3) Supervision and support and, (4) Impact of community service experiences. The study revealed that the health care services rendered at the hospital studied are substandard. Community service nurses reported several challenges experienced during their placement in the hospital under study. Lack of human and material resources, supervision and support contributed to hindrance of smooth acquisition of their clinical skills and experience. These challenges resulted in the psychological and emotional drain of the participants. There is a need for development of guidelines to ensure constant and adequate support to all the community service nurses placed at Ratanang Hospital. / Health Studies / M.A. (Nursing Science)

Background and purpose. The purpose of the study was to determine the costs incurred on the average length of stay (ALOS) on patients with Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) related illnesses admitted in hospital and whether there are any other significant costs involved. Method. A quantitative approach was used to collect data; analysed; interpretation and report writing. Purposive sampling and data collection was done using data collection sheet. This was a retrospective cost analysis data from in-patients records (record review) of ages from 15 years to 49 years both gender. Data analysis and presentation of information was presented by the use of tables; different types of graphs and the interpretation thereof. Results. The study found that males (63%) with HIV Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) related illnesses had longer average length of stay in a hospital compared to females. However, females illustrated higher in-patient costs but majority of patients had costs of between R0–R17 500. Patients with longer hospital stay (>3 days of hospitalisation) had higher in-patient costs. Conclusion. The findings also showed that in-patient care costs were directly proportional to length of stay with higher costs for HIV and AIDS patient management care. Our findings are consistent with other studies regarding higher economic implications of care for HIV infected persons being almost as twice as people who are HIV negative due to longer periods of hospitalisation. / Health Studies / M.A. (Public Health)

Text in English with abstracts in English, Northern Sotho, Tshivenda and Xitsonga / The purpose of this study was to determine the self-reported competence of newly qualified professional nurses on the critical midwifery skills. The study was conducted in the four public hospitals designated for community service in Gauteng Province. A quantitative descriptive design was used with a structured self-report questionnaire as data collection instrument. Non-probability convenience sampling was used for the study. The sample size was eighty-four newly qualified professional nurses. The Stata 15 software was used for statistical analyses. The researcher used descriptive statistics to describe and synthesize the collected data. The findings revealed that most newly qualified professional nurses had no knowledge in identifying different types of decelerations, management of late and variable decelerations, but had knowledge in most of the skills related to management of third stage of labour. / Maikemišetšo a dinyakišišo tše e be e le go hwetša bokgoni bja go ipega ka nnoši bja baoki bao ba ithutetšego profešene ya booki ka go bokgoni bjo bohlokwa bja pelegišo. Dinyakišišo di dirilwe dipetleleng tše nne tša bohle tšeo di kgethetšwego tirelo ya setšhaba ka Profenseng ya Gauteng. Khwanthitheitif diskriptif disaene ‘Quantitative descriptive design’ e dirišitšwe gammogo le lenaneopotšišo leo le beakantšwego la go ipega ka nnoši ‘structured self-report questionnaire’ bjalo ka sedirišwa sa go kgoboketša bohlatsi. “Non-probability convenience sampling” e dirišitšwe mo go kgetheng banyakišišwa. Bogolo bja sešupo e be e le baoki ba masomeseswai-nne ba baswa bao ba ithutetšego profešene ya booki. “Stata 15 software” e dirišitšwe tshekatshekong ya dipalopalo. Monyakišiši o dirišitše dipalopalo tša tlhalošo ‘descriptive statistics’ go hlaloša le go kopanya ‘data’ yeo e kgobokeditšwego. Ditšweletšo di utollotše gore bontši ba baoki ba baswa bao ba ithutetšego profešene ya booki ga ba na le tsebo ya go hlatha mehuta yeo e fapanego ya diphokotšo, taolo ya diphokotšo tša morago le tša go fetoga, efela ba na le tsebo ka go bokgoni bjo bontši bjoo bo amanago le taolo ya kgato ya boraro ya lešoko. / Ndivho ya ngudo iyi yo vha u wanulusa nḓivho ya vhukoni ha iwe muṋe ya vhaongi vhaswa vha kha ḓi bvaho u phasa vhuongi uri vha na zwikili zwa ndeme zwa vhuongi vhubebisi u swika ngafhi. Ngudo iyi yo itwa kha zwibadela zwiṋa zwa muvhuso zwo ṋewaho u isa tshumelo zwitshavhani kha vunḓu ḽa Gauteng. Kha u kuvhanganya mafhungo muṱoḓisi o shumisa ngona ya u ṱalutshedza ya khwanthithethivi ho ṱanganyiswa na mbudziso dzo dzudzanyiwaho dzi bviselaho khagala kha iwe muṋe (structured self-report questionnaire). Vhunanguludzi ho shumiswaho kha ngudo iyi ho vha “Non-probability convenience”. Tshivhalo tsha vhashelamulenzhe vho nanguludzwaho tsho vha vhaongi vhaswa vha kha ḓibvaho u phasa vha fumalo ina. “The Stata 15 software” ndi tshishumiswa tsho shumiswaho kha u sengulusa mafhungo o kuvhanganywaho. Muṱoḓisisi o shumisa zwisiṱatisitika zwa u ṱalutshedza kha u ṱalutshedza na u dzudzanya mafhungo o kuvhanganyiwaho. Ngudo iyi yo bvisela khagala uri vhunzhi ha vhaongi vhaswa vha kha ḓi bvaho u phasa a vha na nḓivho ya u vhona tshaka dzo fhambanaho dza kurwele kwa mbilu ya ṅwana na u langa u lenga ha u rwa ha mbilu ya ṅwana zwo katela na u sa dzudzanyea fhethu huthihi ha kurwele kwa mbilu ya ṅwana, honeha vha na nḓivho ya zwikili zwi yelanaho na vhulanguli ha tshipiḓa tsha vhuraru tsha u beba. / Xikongomelo xa ndzavisiso lowu i ku kuma vuswikoti lebyi munhu a byi twisisaka hi vaongori lava ha ku thwaselaka tidyondzo ta vuongori eka swikili swa nkoka hi vusungukati. Ndzavisiso lowu wu endliwile eka swibedlhele swa mune swa mani na mani leswi yisaka vukorhokeri evanhwini eka Phurovhinsi ya Gauteng, laha ku tirhisiweke maendlelo ya tinhlayo lama hambanaka na swivutiso ku hlengeleta timhaka. Ku tirhisiwile xiphemu xo karhi xa vanhu ku kuma vuxokoxoko hi mayelano na vona hinkwavo. Xiphemu lexi tirhisiweke i xa nhlayo ya vaongori vo ringana makumenhungu-mune wa vaongori lawa ha ku thwaselaka tidyondzo ta vuongori. Ku tirhisiwile “stata software” ku hlela tinhlayo leti tirhisiweke. Mulavisisi u tirhisile tinhlayo, tinhlayonhlamuselo ku hlamusela no katsakanya mahungu lama a ma hlengeleteke. Leswi kumiweke swi paluxa leswaku vunyingi bya vaongori lava ha ku thwaselaka tidyondzo ta vuongori va hava vutivi byo hambanisa mabelo ya mbilu, ku hlawula ku hlwela no hambana ka mabelo ya mbilu, kambe va na vutivi eka swikili mayelana no lawula xiyimo xa vunharhu xo lumiwa. / Health Studies / M.A. (Nursing)