(MBA) North West University, Mafikeng campus, 2005

M. Tech. Business Administration / The subject of absenteeism in human resources management literature has considerably dominated centre stage at a global level. Based on the National Department of Health's 2011 Quarterly Report, absenteeism in the department has for long been claimed to be on the rise. As a result, it has been said to be causing detrimental repercussions on the department's capacity to deliver sufficient health facilities to society as it is constitutionally mandated. It is against the background of these claims that the researcher has been prompted to evaluate the factors causing absenteeism in the National Department of Health and further recommending appropriate remedial measures that can be enforced to minimise and ultimately curb such high rates of absenteeism. The aim of the study is to explore and evaluate the relevant causes of absenteeism in the National Department of Health.

The research is a quantitative descriptive survey. The sample is a stratified random sampling of the workforce (n=4,010) of the four hospitals in Gauteng that fall under the jurisdiction of Tshwane, Ekurhuleni and Johannesburg Metropolitan Councils. The research examines the extent of the impact of age, gender, occupation, salary level, tenure and race on workplace absenteeism. The data were collected in three phases involving auditing of hard copy files, structured interviews and information technology system. The findings of the research reflect high workplace absenteeism in females by 83.2%, age group between 45 to 49 years by 22.35%, salary range of 2 to 3 by 35.3%, African race group by 96.3%, tenure of 11 to 20 years by 44.3%, nurses by 20.8% and administration support by 35.4%. The research found that the mature employee in age and of higher year of tenure presented comparatively with lower rate of absenteeism. / Public Administration / M.A. (Public Administration)

M. Tech. Language practice / At the centre of the messages and information disseminated to the public, there is language. This study investigated the role played by language when health awareness campaigns are planned by the Department of Health (DoH) in South Africa. The background and rationale of the project is discussed, with special reference to the language speakers in Pretoria, since the study was undertaken in this area. Pretoria is a city occupied by residents that are representative of all South African language groups; namely, English, Afrikaans, Sotho, Nguni, Venda, and Tsonga. This coming together of all languages in one small area of the country has indirectly led to the evolution of a language that has never stopped to grow over the years. This language that has evolved in Pretoria is unofficially called Sepitori (Pretoria Sotho); it has become a language of pride, and the communities in and around Pretoria see it as a compromise between Sepedi and Setswana. Since Sotho is widely spoken in Pretoria, the communities have become so attached to this language that anyone who speaks English around them is seen as snobbish, or an elite who normally doesn't get a warm welcome by the average Pretoria township resident, and they are often labeled 'coconuts'. In the health centres of the city and surrounding townships, health information is conveyed mostly in the English language. Through observation, one may say that important information might be ignored by the people visiting public clinics and hospitals, or they might have little or no interest in reading it. This might be because of various reasons which the study will try to find out, as guided by the language policy of South Africa in the DoH. The concern in this study is the language used for the displayed information. The study attempts to assess whether consideration is given to the language(s) of the locals when health awareness campaigns are prepared.

This study used a quantitative approach to evaluate the application of the performance management and development system in the Eastern Cape Department of Health, from the perspective of employees. The evaluation report has three sections that are designed as interrelated but stand-alone documents. Section One is written as a report directed to the Eastern Cape Department of Health. Section Two is a review of the relevant literature that was conducted to review the existing literature related to the application of performance management and development systems, and underpinned the construction of the questionnaire. Section Three provides a description and justification of the design of the research, as well as describing the research procedure followed. Pertinent components of Sections Two and Three are extracted from these sections and included in the report in Section One. The literature review focused on the following areas: the purpose of performance management, components of the performance management process, challenges/ criticism of performance management systems, integration of performance management with other systems and the effectiveness of performance management system. The results revealed that about 74% of employees disagree that management is committed towards the successful application of the performance management system. This finding concurs with the literature. For example, De Waal and Counet (2009:367) argue that one of the problems in the application of performance management system is that the management lacks commitment to the implementation of a performance management system. Systematic sampling (Leedy and Ormrod, 2010) was used to select 120 participants in three Departmental programmes or clusters from grade levels six to 15. The researcher distributed the questionnaires to every fifth person of the population electronically using SurveyBob, which is an on line survey tool. The collected data was then analyzed using Excel software. The findings indicated that although overall employees are not satisfied with the application of the PMDS system in the Eastern Cape Department of Health, there were some successes. Nevertheless, the challenges outweighed successes of the system. The challenges that resulted in the failure of the system include poor communication, a lack of understanding of the system by the employees and a lack of knowledge with regards to the integration of PMDS with other initiatives and plans already in place. Page 4 There were positive views with enabling factors and these were work plans that are mutually agreed upon between the employee and their supervisors and are aligned to departmental strategic priorities. Constraining factors included the low levels of commitment of the management to the application of the PMDS processes, review meetings not being undertaken on a quarterly basis, and a lack of written outcome reviews. The majority of the study participants believe that the PMDS lacks fairness in its implementation. Recommendations were made on the basis of the gaps that were identified so as to improve the application of the performance management system in the Eastern Cape Department of Health. It is therefore recommended that the Department should ensure that training and development of employees on the PMDS takes place to enhance manager’s understanding of the policy. This will enable managers to understand the important role played by performance management in their day to day activities. A performance management and development system needs to be integrated with all other processes to be effective. On-going communication of the PMDS policy should be considered. Accountability of managers to the Accounting Officer and submission of quarterly reports are imperative to ensure their compliance. In conclusion, dissatisfaction outweighs satisfaction of the employees with regards to the implementation of the PMDS system.

Health Professionals are critical in the provision of health services, more especially when it comes to nurses who are next to the patient most of the time. It is critically important for the Eastern Cape Department of Health to ensure that skilled health professionals such as doctors, pharmacists, nurses and the like are retained and the staff turnover regarding this category of staff is appropriately managed. The difficulty to attract and retain health professionals is negatively affecting service delivery in the Eastern Cape department of Health and leaves the department with an unacceptably high vacancy rate. This often put more of a burden on to the health professionals who remain within the organization. Some of them will end up leaving the organization. There is a great shortage of health professionals in South Africa and it becomes easier for the health professionals to get employment elsewhere, particularly in the private sector which appears to have a competitive advantage as compared to the public sector. In this study, both quantitative and qualitative methods were used to gather information through the utilization of a questionnaire and interviews were conducted mainly to confirm the results obtained. The results of the study have assisted to reflect factors that could be influencing the health professionals to leave health facilities of the Eastern Cape Department of Health. The respondents were drawn from the two areas within the Health Department, and these are, Mthatha and Port Elizabeth areas. One hundred (100) questionnaires were issued to the health professionals and sixty three responded. Documents that were received from the department were helpful in determining the turnover rate. The study has revealed that the Eastern Cape Department of Health may succeed in retaining the health professionals if they can be made to feel that their job is important. It appears that health professionals would like to be given enough opportunity to perform their functions and participate in the decision making processes of the department. Some factors may be contributing to the staff turnover and these are, lack of career opportunities to develop, challenges in the workplace, conflict with the management and colleagues. It is always important for the organizations to recognize its employees by giving them space to practice their profession and create a comfortable workplace that could have an impact in influencing the employee to remain within the organization. Employee turnover can be minimized, if employees can be exposed to a healthy workplace environment that will assist if fostering happiness, and in the process, enhance their motivation. It is imperative for the Eastern Cape Department of Health to focus on the training and development of its employees in order to increase the efficiency and competitiveness. As the employees gain the necessary skills to perform their job, productivity may improve. The performance of the employees should be properly managed, and the resultant incentives and rewards must be fairly distributed. This could promote harmony in the workplace and that could help in building relationships among employees. If employees are satisfied, there is an increased chance that they will stay within the organization and it becomes difficult for other competitors to attract them. Employees must be given adequate space to participate in the decision making processes of the organization, and by doing so, their loyalty to the organization could be increased.

This research was instigated by testimony of the failure and the subsequent crisis in the South African public healthcare system. Official investigations had brought to light alarming operational deficiencies in institutions under the aegis of the Gauteng Department of Health. The South African public sector and government departments, in general, are currently challenged by a complex transformation process which has a prime objective to ameliorate public accountability, service delivery and budgetary control. They are likewise faced with the equally labyrinthine and demanding task of establishing a public-sector organisation with meaningful and effective operational processes that are, in addition, expected to synchronise with the modern economy. The researcher is unequivocal: the success of the GDH in responding to the challenges of improving organisational performance and healthcare service delivery depends essentially on their knowledge management strategy. Knowledge, across public-sector organisations, is increasingly being acknowledged, not only as a strategic resource but also as a valuable organisational asset. In the context of this research, knowledge is defined as the experience that resides in the minds of people; termed tacit knowledge (as opposed to formal, codified or explicit knowledge). In an analogous manner, research studies abound with evidence that has identified knowledge management as having an influence on operational performance for healthcare service delivery. Yet, a brief inquest indicated that our overall understanding of the existence of the relationship between knowledge management and operational performance for healthcare service delivery in the South African public sector is, at best, exiguous. With these appraisals in mind, the researcher developed a theoretical model that revealed factors that could influence organisational performance and healthcare service delivery. The model focused on knowledge management capabilities and organisational performance. The prime objective was to operationalise the theoretically derived knowledge management capabilities constructs, identify statistically the enhancing or impeding factors that impact on organisational performance and develop a structural equation model to verify this theoretical paradigm. The ambition of this study was similarly to investigate the use of knowledge management by the Gauteng Department of Health for its transformation to achieve improved organisational performance and healthcare service delivery. This study in essence addressed four research questions: Firstly, what was the level of understanding of knowledge management in the Gauteng Department of Health and related healthcare facilities? Secondly, how were knowledge management strategies and practices aligned with the Gauteng Department of Health strategies and operational objectives? Thirdly, how was knowledge management used by the employees in the Gauteng Department of Health? and fourthly, how could the results of the literature review and the empirical data be used to create a knowledge-management culture and a collaborative working environment for the Gauteng Department of Health? The elemental, hypothesised pursuit governing the study was to determine the existence of a relationship between the use of knowledge management and an improvement in organisational performance and healthcare service delivery. Collaterally, what enabling environment would be instituted by the gatekeepers of the institutional praxes to capacitate other staff members specifically so as to include the succession planning conundrum? To accomplish this and after reviewing the literature, the effective factors in knowledge management were identified, namely, knowledge infrastructure proficiencies and knowledge process capabilities. The research followed the parallel mixed-methods approach in gathering and analysing research data. Data was collected using questionnaires with 496 respondents and interviews with 35 interviewees. The sample used in this study comprised employees of the Gauteng Department of Health and its regional healthcare centres. The survey respondents and interview participants were the general staff and executive/senior managers of the Gauteng Department of Health. These individuals were considered to possess the most comprehensive knowledge about their organisation’s characteristics and strategy, which included knowledge management adoption. In order to identify the relationships between the model elements, appropriate tests were initiated using the Statistical Package for Social Sciences. Exploratory and confirmatory factor analyses and structural equation modelling were utilised and the proposed model was then extracted and content analysis was applied in evaluating the resulting qualitative data. The findings of this study furthermore indicated that knowledge management concepts were not universally understood in the Gauteng Department of Health. A structural equation model development strategy, postulated in the factor analysis, also produced a new best-fitting knowledge management capability model based on the new constructs. The structural equation model suggested that significant factors influencing the improvement of the organisational performance and healthcare service delivery are those of knowledge management capability. The regression analysis showed that most of the inter-correlations were significant, thus confirming the theory that knowledge management capabilities have a direct influence on organisational performance and healthcare service delivery. The research contributed theoretically to a comprehensive understanding of the relationship between knowledge management principles and factors that influence organisational performance and healthcare service delivery. Practically, the research contributed to confirming the use of knowledge management by the Gauteng Department of Health could to the improvement of its overall organisational performance and healthcare service delivery. The study further demonstrated the impact of knowledge management activities as a driving force for organisational change and the effect of knowledge management on the improvement of workforce productivity and organisational effectiveness. The new knowledge management capability model could additionally assist the Gauteng Department of Health determining the extent to which knowledge management is used and where to focus in developing and implementing knowledge management strategy. The study encourages practitioners to take cognisance of the fact that organisations are unique and that the factors which enhance or impede knowledge management are to be thoroughly examined. This case study was endorsed for its significant contribution to regional healthcare system, as well as the broader national healthcare structure. / School of computing / Ph. D. (Information Systems)

The research is a quantitative descriptive survey. The sample is a stratified random sampling of the workforce (n=4,010) of the four hospitals in Gauteng that fall under the jurisdiction of Tshwane, Ekurhuleni and Johannesburg Metropolitan Councils. The research examines the extent of the impact of age, gender, occupation, salary level, tenure and race on workplace absenteeism. The data were collected in three phases involving auditing of hard copy files, structured interviews and information technology system. The findings of the research reflect high workplace absenteeism in females by 83.2%, age group between 45 to 49 years by 22.35%, salary range of 2 to 3 by 35.3%, African race group by 96.3%, tenure of 11 to 20 years by 44.3%, nurses by 20.8% and administration support by 35.4%. The research found that the mature employee in age and of higher year of tenure presented comparatively with lower rate of absenteeism. / Public Administration and Management / M.A. (Public Administration)

The Employee Assistance Programme is regarded as a tool that could assist employees in organisations with both their personal and work-related problems. This has become evident as more employers are offering these services to their employees. The goal of this study was to gain an in-depth understanding of social workers’ views and experiences in rendering EAP services in the Gauteng Department of Health (GDoH). The study used a qualitative research approach by focusing on the explorative, descriptive, and contextual designs. Constructivist theory and the person-environmentfit model formed the framework of this study. Purposeful sampling (a criterion-based sample) was used to select social workers rendering EAP services in the GDOH. Eleven social workers who met the criteria participated in the study and their ages ranged between 33 and 50 years. Data was collected by means of semi-structured interviews. The Tesch’s eight steps of data analysis was used, and data verification was conducted based on the Guba model. The findings in this study indicate that EAP is an important programme. However, it is not prioritised by the GDoH. Consequently, EAP practitioners experience challenges that negatively affect the provision of quality EAP services. Despite the challenges, most of the EAP practitioners nonetheless continue to render these services albeit under difficult circumstances since they love and have a passion for the work they do. / Social Work / M.A. (Social Work)

Thesis (MPH.) -- University of Limpopo, 2021 / Background: Achieving high vaccination coverage is crucial in the control, prevention and elimination of childhood vaccine preventable diseases. The Expanded Program of Immunization (EPI) aims for 95% coverage for each antigen and complete vaccination schedules for 90% of children under 12 months of age. All the vaccines included in the national vaccination schedule (Bacille Calmette Guerin (BCG), Oral Polio Vaccine, Diphtheria-Pertussis-Tetanus (DPT) vaccine, Measles and Hepatitis B vaccine are provided free of charge in the primary health services in South African public health care facilities. Although the coverage of all vaccines in South Africa has increased especially in recent years, the EPI targets has not been achieved yet in some parts of the coutnry and there are still differences within provinces. Therefore, the primary objective of this study was to investigate the prevalence and determinants of childhood immunization coverage at Primary Healthcare facilities, Bushbuckridge, sub district of the Mpumalanga Province, South Africa. The mean age of the children was 1.4±2.5 years (ranged: 1 months to 12 years. Slightly more than half (56%) of the children were less than 6-months. Nearly two-thirds (63%) of the children were females and only 37% were males. Methodology: A cross-sectional descriptive study was conducted among selected Primary Healthcare facilities in Ehlanzeni District, Bushbuckridge Sub- district, Mpumalanga Province. Simple random sampling was used to get a minimum sample size of 426 mothers and/or caregivers paired with their children required for the study. The researcher administered a validated or tested self-designed questionnaires to the participants. Data analysis was done using the STATA statistical software version 12 for Windows (STATA Corporation, College Station, Texas). Results: The mean age of the participants was 34.1±9.2 years ranged from 15 to 57 years. Almost one-third (28.6%) of the mothers and/or caregivers were 40 years and older and the majority (70%) were unmarried. Majority of the participants had secondary ix education with 65.5% and 23.4% had primary education. Nearly eighty per cent (79.2%) of the maternal and/or caregivers were unemployed. The prevalence rate of fully immunized children was 88% and a significant higher proportion of children in the age group 12 years at 57% were likely not to be fully immunized (p<0.05), followed by age group 6 -11 years, 18 months – 5 years, 6-8 months and 9-11 months at 48%, 26%, 17% 13% respectively. No statistical significant relationship was found between maternal and/or caregiver age, marital status, level of education, employment status and immunization coverage of the child. However, participants aged 40 years and older, less educated and unemployed were likely to have missed immunization of their children. Mother and/or caregivers with a tertiary education were 3.46 times more likely to get their children immunized than those with none/primary education [OR = 3.46, (95% CI:0.75;15.9), p<0.2)]. The employed mother and/or caregivers were 2.01 times more likely to get their children immunized than the unemployed mother and/or caregivers [OR = 2.01, (95% CI: 0.82; 4.89), p<0.20]. In the multivariate model, level of education and employment status were found not to be significantly associated with immunization of the child. Conclusion: The overall immunization coverage in the present study was relatively high and significantly decreased with age. At 6 weeks, all age groups between 0-6 weeks were immunized, while at 10 weeks, with exception of children in the age group 10 -13 weeks and 18 months – 5 years. At 6 months, the young children (age 9-11 months) were likely to default or missed measles vaccination. At 6 and 12 years, the Td vaccination coverage was relatively low. Mothers and/ or caregivers who missed child immunization were likely to experience shortage of vaccines at health facility and said it takes the whole day to immunize a child but the result were not significant. Mother and/or caregivers with a tertiary education and employed were more likely to immunize their children than mothers and/or caregivers with primary, secondary education and the unemployed.