National healthcare departments all over the world are facing the problem of rationing very limited resource to achieve acceptable levels of health care for their citizens. At the centre of healthcare challenges is the problem of an increasing disease burden, increasing pharmaceutical prices, increasing healthcare worker remuneration and the globalisation of healthcare services. Under such restrictive and competitive conditions, healthcare organisations need to find more efficient ways of working. This puts healthcare managers at the forefront of efforts to improve healthcare services and to find new ways to do more with shrinking resources. The need for well-trained managers is at its most critical level, especially in Third World countries like South Africa. This study set out to establish whether training needs existed amongst Medical Managers in public hospitals in the Province of KwaZulu-Natal, South Africa. Should training needs be found to exist, the aim was to establish where those needs may be. The study then identified what Medical Managers perceived as the preferred training methods for delivering the necessary training. The study had a sample size of 30 respondents out of the 54 potential respondents. This represents a response rate of 55.5 percent. The research method that was chosen for the study combined both the quantitative and qualitative methods through a questionnaire that listed 37 tasks. Each Medical Manager had to rate these tasks on their relevance, their own perceived performance of the task, the likelihood of receiving any required training through a formal training method like courses for each task and finally the likelihood of receiving training through on the job training for each task. The quest ionnaire also included an openended question that asked respondents to list up to ten additional training needs which had not been covered by the questionnaire. The study found that all the tasks which were audited were relevant, that the perceived level of overall performance was high and there was an almost equal preference for both formal and informal training method. Based on this study‟s findings, training initiatives targeting this group of managers should ideally combine both formal and informal training methods. A recommendation for further research with a more qualitative approach is being made to better understand the context within which the training needs exist. The minimisation of subjectivity of ratings through the involvement of Medical Manager Supervisors might also reveal a more objective overall outcome to the analysis of the problem. / Thesis (MBA)-University of KwaZulu-Natal, Durban, 2012.

Globally HIV and AIDS are considered to be a major health and developmental challenge facing humanity. The HIV infection of children is not only an area of great concern for families but for the future of humankind. Caring and nurturing of children generally is considered as a challenging responsibility. Caregivers of HIV infected children are faced with the added responsibility of ensuring that these children have access to life saving health care at all times. Caregivers who are responsible for the health and well being of HIV infected children face constant challenges in their care giving role and this has implications for the quality of care of the child. The needs of HIV infected children are complex and vital to their basic needs is the administration of antiretroviral therapy (ART). This study aimed to explore, describe and interpret the experiences of caregivers, caring for HIV infected children and accessing services from a public hospital in Durban. Using the ecosystems theory, this qualitative study explored the experiences of thirty caregivers caring for HIV infected children. The data was collected using semi structured interviews with the caregivers. Four main themes emerged from the data analysis; namely: The caregivers’ intrapersonal experiences, their perspectives on HIV and ART, their access to health and social services and their coping strategies. This study concludes that caregivers of HIV infected children within the public hospital setting, experience numerous psycho-social and economic challenges on a daily basis. Subsequently, these challenges impacted on the quality of care to the HIV infected child. It was evident that respondents dealt with challenges differently, as the older respondents were more equipped emotionally and psychologically than the younger respondents. Generally, all respondents were negatively affected by poor psychological and socio-economic circumstances that prevented them from ensuring the wellbeing of the child. The challenges that they faced on the micro level (economic and psycho-social experiences), the mezzo (stigma, community and family support) and exo levels (health and welfare services) together with the macro level (DOH strategic plans and childcare legislations) determined how they provided for the care of the HIV infected child. Despite these challenges respondents’ resilience and commitment to providing for the health and wellbeing of the HIV infected child was consistent and remained a priority. Multi-level intervention programmes are required to help caregivers cope with their challenges. As such social work practitioners need to take cognizance of the psycho-social, emotional and material support required by caregivers of HIV infected children. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2013.