Dissertation submitted in compliance with the requirements for the Masters Degree in Technology: Nursing, Durban University of Technology, 2016. / Introduction Although the South African Government adopted a primary health care approach to health care service provision in order to ensure equitable access to and utilization of health care services to all communities, the country continues to face challenges regarding access and utilisation of health care services especially in the rural communities. Antenatal care which is mostly provided at primary health care level is regarded as the cornerstone for the success of the maternal and child health care programme. Therefore, poor access to and under-utilisation of health care services could potentially influence the success of this programme and pregnancy outcomes. Aim of the study The aim of the study was to determine whether pregnant women from KwaMkhizwana rural community had access to and were utilising antenatal care services. Methodology A qualitative, exploratory, descriptive and contextual study was conducted guided by Thaddeus and Maine’s three delays model. Purposive sampling of the pregnant women and all categories of nurses who were employed in the three health care facilities in the area was done. Data was collected in two phases through in-depth semi-structured interviews with both the pregnant women and the nurses respectively between February and March 2016. The sample size was guided by data saturation. All data were analysed using the Tesch’s method of data analysis. Study findings Six major themes and several sub-themes emerged from the interviews with both Phase 1 and Phase 2 participants. The major themes included: 1) access to health care and emergency services, 2) availability of human and material resources, 3) social and cultural beliefs, 4) past pregnancy experiences, 5) communication and transparency regarding health care service delivery and 6) quality of antenatal care services. Summary of the findings The pregnant women encountered several challenges which led to delays in seeking, reaching and receiving antenatal care. Most of the pregnant women participants related limited access to health care, with under-utilisation of antenatal services. They were unhappy about the antenatal care services they received in the three available health care facilities in the area, which made these facilities to be inaccessible and underutilised. The nurse participants recognised the challenges facing the pregnant women regarding the access and utilisation of antenatal care services, together with the challenges faced by the nurses while working in the three available health care facilities in the area. Recommendations The recommendations that were made included: to consider building a centrally located fixed primary health care clinic that would ensure equal access to health care services, strengthening the implementation of policies regarding the referral system and ambulance services, ensuring sustainable availability of human and material resources, developing strategies to ensure that the antenatal care services are delivered in line with the South African Department of Health policies and guidelines and strengthening community education. A further study on provision of antenatal care services in the area is also recommended. / M

M. Tech. Professional practice in Information Technology / Students with disabilities in South African higher institutions are facing debilitating quandaries, including physical, emotional and physiological degradation. As a result, empowering students with disabilities in South Africa to realize their self-esteem, as well as to enhance their skills and employability, represents an interesting and challenging task to South African government, industry, interest groups and individuals worldwide. The purpose of this research was to determine the impact of Assistive Technology on disabilities students studying at South African Higher Institutions, from a student's perspective.

Transport forms an essential element of people's lives. It is transport which determines how people access important resources and it influences the mobility of people. Transport availability improves access to resources and hence fights isolation, which derives from lack of access to resources. This case study examines the influence of transport on access to state grants and health services. The study was based on sample of 170 recipients of state grants and was carried out in September 2000. A quantitative survey through face-to-face interviews of pensioners and other recipients of state grants at two remote rural points was carried out. The results of the study showed that poor road and path infrastructure impacts negatively on old people's access to pension payout points and health services. As a result of poor road infrastructure, people have limited access to alternative means of transport and hence have to pay too much for transport to reach services essential to their livelihoods. In addition to the transport cost these elderly have to pay, they also have an extra burden of having to care for the orphans and unemployed adults staying with them. This puts an enormous pressure on their limited resources and hence deepens the cycle of poverty. The majority of people interviewed were positive about the quality of health service they are receiving and the attitude of health workers. There was no correlation between the quality of services received and the demand for using them. Amongst other things, it has been suggested that locating basic services particularly welfare services and health services nearer rural communities will improve the quality of life and minimize the cost of reaching such services. Furthermore infra structural intervention will impact positively on rural communities by providing them with a wider choice of transport and promoting intermediate means of transport. This will have a positive impact on rural communities by increasing the accessibility of services and improving mobility. / Thesis (M.A.)-University of Natal, Pietermaritzburg, 2001.

More than three decades after the outbreak of the AIDS pandemic, sub-Saharan Africa is home to the largest epidemic in the world. Over 70% of infected people live in this region and are aged 15–49 years. Given that it is at this age that young adults are more likely to start families, their death as a result of AIDS gives rise to the crisis of AIDS-orphaned children. Several studies show that the number of AIDS orphans is on the rise and can reach up to 18 million throughout the continent. Generally, patients expect to be admitted in formal health care facilities for adequate treatment but the absence of cure and an increasing number of infected make it difficult for them to be treated as in-patients. In order to fill the gap, the elderly care for AIDS patients and take on the parenting role of AIDS orphans. However, there is not much information on the implications of caregiving on the well-being of the elderly. This dissertation aims at shedding light on this issue – using data from an informal settlement in the province of KwaZulu-Natal – in order to highlight the risks to the health of elderly caregivers. The elderly are the primary caregivers to thousands of AIDS patients and AIDS-orphaned children across sub-Saharan Africa. Their caregiving activities are strenuous and repetitive on a daily basis. Through qualitative data collected from 14 elderly caregivers, this project found that their well-being was compromised by several caregiving activities and the expectations placed upon them were unbearable. The vulnerability of caregivers was emphasized by the high number of dependents that resulted in lowered standard of living. There was also the risk of contracting HIV during caregiving since the elderly were not able to afford protective equipment. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2012.

It was recommended by the American Psychological Association and the American Bar Association in October 1999, that the time had come for psychologists to do more than act as expert witnesses, and that their influence should be felt " ... at the first level of intervention" (Foxhall, 2000, p. 1). The first level of intervention is considered, in this study, to be the decision-making process. This research examines the decision-making processes used by four of the disciplines integral to the child abuse multi-disciplinary team. Social workers, child protection officers of the South African Police Services, psychologists and prosecutors currently involved in the child abuse arena in South Africa were given case vignettes to anchor their decision-making on simulated examples. On the basis of these in-depth interviews, using a Grounded Theory methodology, three specific questions are addressed, namely: how decisions are made and substantiated; how they differ across disciplines; and how they compare to recommended protocol. Results indicate interesting differences across these four disciplines. The differences between the decision-making processes in the disciplines seem to be rooted in their philosophical tenets, which give rise to specific aims in addressing child abuse. Differences between the decision-making processes and recommended protocol were also noted in cases where guidelines are available. In addition differences in expected outcomes of the vignettes, use ofassumptions and a level of mistrust between professionals was shown. If this research can help to sensitise professionals to begin to understand their own decision-making processes and those of their fellow decision-makers, then perhaps key role players and policy makers may be one step closer to responding to the challenge of child sexual abuse in South Africa. / Thesis (M.A.)-University of Natal, Pietermaritzburg, 2002.

This study investigated how rural children with disabilities and their families in the Qwaqwa Region of the Free State province experience disability. The aim was to examine the various social, cultural, economic, and political factors that impact the lives of the children and their families. It also explored what support systems are available for the children and the families in this rural context. Seventeen children with disabilities and their families were selected through a process of purposive sampling from three areas in the region: Mabolela, Makgalaneng, and Bolata. Nine of the children are currently in primary schools, and eight do not have access to formal schooling. This was a qualitative study. The research method was the semi-structured interview. The main caregiver in each of the families was interviewed. Interviews were conducted in Sesotho and audio-taped. These were transcribed, and then translated into English. The findings in the study reveal that despite the fact that various legislation and policy documents in South Africa make special reference to the protection of the rights of rural children with disabilities, the rights of the children and families in this study continue to be violated. The study revealed the urgent need to address barriers to learning and development that these children are experiencing which are largely located in the system. Some of these are: poverty and underdevelopment; negative attitudes; lack of education and rehabilitation services, lack of access to information; inadequate social and psychological support; lack of community based and accessible support services; lack of access to information about disability; poor access to resources such as health care, and social welfare; lack of coordination between professional services and departments in the province. The study has implications for planning services to address the needs of children with disabilities and their families in this rural context. / Thesis (M.Ed.) - University of Natal, 1999.

There is a growing sense of apathy and lack of focus amongst the youth, which contributes to the threat of social integration. Constructive alternatives are therefore needed to curb gangsterism, drug abuse and other criminal activities among youth at risk. It has become imperative to challenge the present situation in which crime has become one of the most attractive options facing our youth. Through a programme of contructive engagement, a substantial difference can be made in their rehabilitation and ultimately their active participation in building a safer society. A strong emphasis should be placed on the development and implementation of effective restorative justice principles, alternative sentencing and community-based rehabilitation programmes, particularly for young people in marginalised communities.

HIV-positive adolescents are an increasingly numerous and challenging population in the South African HIV/AIDS epidemic. Their access to, and retention in, ART care has become a pressing public health concern. Comprised of four journal articles, this thesis explores the practice of antiretroviral treatment (ART) among a cohort of HIV-positive adolescents (age 10-19) in South Africa's Eastern Cape. By 'practice', I mean the volatile, situated and relational 'work' that goes into young people's everyday achievement of ART - into consuming daily medication, regularly attending health appointments, and participating in HIV programmes. Through an exploration of the ways in which some HIV-positive adolescents use, appropriate, or reject ART care; this thesis contributes to a much-needed evidence-base on the needs and survival strategies of adolescent ART users. Data for this study was gathered through eight months of multi-method ethnographic fieldwork with 23 HIV-positive youth, their families, and local health workers. The findings elucidate adolescent ART as a complex (and often volatile) form of social incorporation, through which young people negotiate survival, care and moral connection in contemporary South Africa. Enrolling in ART meant being encompassed into a (often hierarchical) set of social relationships, through which adolescents sought belonging, recognition and protection, amid profound insecurity. Through ART and its associated programmes, adolescents and their families attempted to strengthen familial ties, appeal to powerful patrons, petition for care, and access basic resources. Yet these pursuits were often deeply ambivalent, as discipline, blame, and resentment often came encased in the terms of care. At the crux of each article is an attempt to understand how adolescents, often alongside their families, negotiated both the social stakes and possibilities of ART. Through these discussions, we might better be able to grasp the fragility and complexity of young people's retention in ART.

This study examines the impact of children’s grants on household access to food, education and health care. In the face of increased poverty and socio-economic inequalities, social grants are a critical poverty alleviation intervention implemented by the government of South Africa. The children’s grants are offered as part of the social security system which is provided for in the Republic of South Africa Constitution of 1996 and the Social Assistance Act of 2004. The basic needs conceptual framework is the lens informing the focus of the study. Among other major findings, the study reveals that (a) childrens grants play a critical role in improvement of access to food, health care and education, (b) childrens grants are used as collateral, to access short term loans, and (c) social networks and home gardens play a significant role in aiding children’s grants to ensure household access to food, education and health care.

The purpose of the study was to investigate the lived experiences of young people living with mental healthcare users (MHCUs) in order to gain insight into their needs and how their daily coping can be maximised. A qualitative, descriptive phenomenology study was undertaken, with face-to-face, audiorecorded individual in-depth interviews conducted with 10 participants aged between 19 and 23 years, at their homes. Participants were recruited from one of the local health clinics in Dikgale area, Limpopo province, where the MHCUs collect medication and attend follow-up medical reviews. Non-probability purposive sampling technique was used to select the sample size. The following were the objectives of the study:  To explore and describe the lived experiences of young people living with MHCUs.  To determine the coping strategies of young people living with MHCUs. Five themes and 12 sub-themes emerged from the study. The findings of the study revealed that young people were faced with psychological effects, caring demands and responsibilities, effects on their schooling performance, and lack of coping and support. The study results informed recommendations to the psychiatric nursing services on the needs and support to be provided to these young people in order to ensure maximum coping in their life situation. / Health Studies / M.A. (Nursing Science)