Human Immunodeficiency Virus (HIV) infection and Auto-Immune Deficiency Syndrome (AIDS) have spread globally during the past twenty-eight years and 67% of people living with HIV live in sub-Saharan Africa. HIV and AIDS are now the leading cause of death in this region. Worldwide, it is the fourth biggest killer. Nurses in health institutions in South Africa face challenges as result of increased number of very sick and terminally ill patients who are admitted to the hospital due to HIV and AIDS epidemics. Workloads have increased with no concomitant increase in number of staff to care for the patients. Aim: This study aims to identify dynamics of care of professional patients with HIV and AIDS by nurses and make recommendations that will deal with these problems. Methods: A qualitative study was conducted with the study population drawn from professional nurses who were involved in the care of patients with HIV and AIDS in the medical wards at Ngwelezana Hospital for at least five years. One focus group discussion was also conducted. The sample was selected purposively. Results: The study revealed many issues affecting the care nurses gave to patients with HIV and AIDS and the personal challenges (physical and emotional) they faced in the course of their work. Amongst these are contextual challenges which pertained mainly to health system issues- lack of institutional support and incentives, heavy workload with concomitant increase in number of patients attended to by nurses, training needs of nurses and multidisciplinary team work. Nurses had to deal with personal challenges such as helplessness, frustration, anger, death anxiety, physical and emotional stress. However, there were positive experiences such as empathy and self-actualisation in being able to care for terminally ill patients and seeing some of them get better with treatment. Recommendations: These include the need to address the training needs of nurses about management of HIV and AIDS, institutional support for nurses, critical incident debriefing and community awareness. / Thesis (M.Med.)-University of KwaZulu-Natal, Durban, 2010.

BACKGROUND : Many professional nurses have left the employment to work in developed countries. Quality patient care is declining because the few PNs that are rendering care have limited expertise. Literature review showed that nurse managers have a role to play in retention of staff. PURPOSE : The study aims to analyze the leadership styles and organizational factors toward the retention of professional nurses working in public health facilities. POPULATION : Professional nurses in four public hospitals, four union managers, twelve professional nurses working abroad and representative from SANe. A total of 188 participated in the study which formed part of the 70% of the sample. DESIGN : A Case study design which included both quantitative and qualitative approaches. Observations in the wards and document analysis were done guided by a case protocol. INSTRUMENTS : Revised Nursing Work Index and Revised Conditions of work effectiveness was administered among the professional nurse and chief professional nurses. Chief nursing service managers and union managers were interviewed using interview guides. Focus groups among professional nurses who had overseas experiences were conducted. Reliability was maintained by having a Cronbachs alpha of above 0.70 in all variables except leadership. RESULTS : Cases presented differently in all aspects, except Case C who was consistent in all the variables. The professional nurses in Case C viewed their CNSM as being visible and accessible. Case A and B were similar in terms of the organizational factors. All CNSM verbalized that they were willing to send PNs for educational programmes but the DOH policy was allowing nurses to work anywhere in the province. PNs had little access to resources on time to do tasks and paperwork as compared to access to support and opportunity.CONCLUSION : PNs are willing to stay in their organizations provided they will be given educational and promotional opportunities. There was a relationship between organizational factors and retention. Leadership factors showed a weak negative relationship with other variables. / Thesis (Ph.D.)-University of KwaZulu-Natal, Durban, 2009.

No abstract available. / Thesis (M.Med.)-University of Natal, Durban, 1981.

Introduction In 1996 there were 1,847,440 pupils in 4007 primary schools in KwaZulu-Natal (KZN) who were targeted for school Health Inspection (HI). In the same year there were only 95 school health teams who were visiting schools for HI. The School Health Service (SHS) had been running on a racial basis since the Apartheid era of government, and needed to be reviewed in order to measure its effectiveness and to make it relevant to the new government and its new health policies. Purpose To review HI as a key component of School Health Services (SHS) and make recommendations to improve it's impact on the health of the school child and on health promotion in schools. Objectives To describe the structure, process, output and outcome of HI in KZN; to measure the impact of HI on the health of school children; and to calculate the SHS consultation cost and compare it with other primary health care services. Methodology A cross sectional study involving 21 schools covered by the SHS and 5 schools not covered by SHS was undertaken. The study area was KZN and the sample area was Indlovu region. All health authorities and racial groups participated in the study. Results A total of 212 children and 129 parents were interviewed. Of the children interviewed, 156 pupils (73.5%) had been involved in HI and 56 (26%) had not. The average nurse/pupil ratio was 1:49301. HI coverage was 62%. Of the 156 pupils examined, 108 were referred and 53% of them went for treatment. 93 % of parents interviewed gave a positive comment on HI and 24.8 % of them did not know their children's problems before they were informed by the SHN. Std. 5 pupils interviewed before and after HI were compared and it was found that 57% from the after-HI group went for treatment for their health problems compared to 53% before HI. Subjective feelings improved from 15% pain before HI to 0% after HI. Conclusion HI had a positive influence on encouraging pupils to seek recommended treatment and this is likely to improve their health. / Thesis (M.Med.)-University of Natal, Durban, 2000.

The Natal/KwaZulu Health Services Liaison Committee (HSLC) has been established to co-ordinate health care delivery in Natal and KwaZulu. This body has defined eight geographical Health Planning SubRegions (HPSRs) (Annexure E) of which each is a unit for planning and prioritising health service delivery in respect of its resident population. The HSLC considered that a study of inpatient catchment populations of hospitals under the control of the statutory Health Authorities would provide information which was essential to the planning processes of those authorities. The Department of Community Health was requested by the HSLC to undertake this study. A previous study, co-ordinated by the Department of Community Health (September 1987), dealt with "Outpatient Catchment Populations of Hospitals and Clinics in Natal and KwaZulu" (E DADA). No previous similar study on inpatients has been undertaken in South Africa. The expansion and improvement of basic services - particularly health care, water supply and basic education - should be perceived as essential elements in a strategy designed to enable all residents of a region to meet basic human needs and enjoy a minimum standard of living. Thus increased efforts have to be made to utilise health care resources effectively and efficiently and to plan future facilities carefully with regard to accessibility and appropriateness . This will require careful and objective management by all Authorities responsible for delivering health care to the people of Natal and KwaZulu. Accurately predicting the utilisation of hospital inpatient facilities is critical to efficient resource allocation in Health Services management. Catchment population studies and cross boundary flow characteristics provide valuable information on the utilisation of available facilities. This information is of value in the development of existing health services and the planning of additional health facilities with regard to size, situation and service type. Studies in other areas on utilisation of health service facilities, suggest that distance strongly influences hospital choice in both rural and metropolitan areas (Inquiry 1984 21(1) : 84-95) and this could explain some of the findings of this study with regard to cross boundary flow between Magisterial districts and HPSRs. For the efficient planning of resources, particularly with regard to situation and size, knowledge of the population size and demographic composition are important, as is a knowledge of the profile of disease in a community. The objectives of this study are directed to making available this information to each of the health authorities responsible for health care delivery and thus, to facilitate the management process. / Thesis (M.Med.)-University of Natal, Durban, 1988.

No abstract available. / Thesis (M.PH.)-University of KwaZulu-Natal, 2004.

This is a cross section study of the White elderly patients who attended Addington Hospital, Durban, Out-patient Department during a two week period in July 1985. Screening was by means of systematic sampling, a standard questionnaire was administered to 321 of them and their characteristics and needs were identified. In order to determine the attitudes of the medical and nursing staff who work in Addington Out-Patient Department, a further questionnaire was used. It was found that 88,37% of health professionals did not have a particular leaning towards looking after the elderly, but 88% agreed that the needs of the elderly were different in comparison with other age groups. 92,8% considered that geriatrics is a speciality in its own right. Recommendations are made for a 24 hour community geriatric service, the establishment of day centres to serve the needs of the greater Durban area, and for the establishment of a Chair of Geriatrics at the University of Natal. / Thesis (M.Med.)-University of Natal, 1987.

This commentary is essentially a report on various aspects of assessment of health needs and priorities in a peri-urban black community (mainly African) situated near Pinetown. The study was initially conducted under the auspices of the Pinetown Health Department, and the main findings are as follows (a) The geographical area of Mariannhill II Location includes what the local people call "Impola" and "Tshelimnyama", and sustains a population of 3 000 persons on some 500 hectares. (b) The origins of the population have been found, contrary to popular belief, to be 92% urban and semi-urban, and only 8% rural. (c) Demographic characteristics are those of an established stable community with a high mortality rate and high fertility (135 livebirths per 1 000 women aged 15 - 49 years per annum). The sex ratio is 99.4 males per 100 females, and there are no migratory characteristics. (d) The average number of individuals per household is 9, with a lot of overcrowding per room (not quantified). Of 1 346 adults of working age 43.68% are unemployed. (e) Morbidity and mortality studies conducted both at the level of the community and hospital revealed that children under the age of one year had the most sickness episodes, while the age groups 6.1 to 18 years had the least. (f) The disease profile is that of a typical third world developing country, with predominance of infections, accidents and physical violence. (g) Diarrhea disease constituted about 11% of the profile and was significantly associated with the water source for the household. (h) The most important cause of the 33 deaths reported over a one year period is motor vehicle accidents and physical violence (33.3%). (i) The major health resource is the local St Mary's Hospital with a 55% uptake of sickness episodes from the community. Nearly half of these ended up as in-patients. (j) 60% of children under the age of 6 years were estimated to have been fully immunized, and virtually all of it had been done by the hospital. (k) Community opinion on their problems and needs overwhelmingly pointed at water, clinic and lack of transport facilities as urgent matters. However, careful assessment of community concern pointed to the threat of removal as the most important single community problem, with implications for housing and all the other perceived problems. The majority of the people looked up to the Catholic Mission as a possible source of help to resolve the problem of availability of water. (l) As the study was initiated with a view to interventive strategies, the main findings are discussed against a background of information distilled from several literary sources, and recommendations for action are advanced. (m) Lastly, the most important problem in data collection has been that of inaccessibility of the Pinetown register of births and deaths to the Pinetown Medical Officer of Health. We regret the difficulty, but we hope to update our study when the problem has been overcome. / Thesis (M.Med.)-University of Natal, 1984.

A case control study was performed in 6 cotton mills in KwaZulu-Natal, South Africa. The study used questionnaire and pulmonary function testing results to categorise respiratory symptoms in 52 exposed symptomatic, 30 exposed asymptomatic and 46 unexposed control subjects. These categorisation results were used to explore the relationship between serum IgG subclasses and cotton-specific IgG to byssinosis. No definitive relationships between the serum IgG subclasses and clinical and functional symptoms of byssinosis were found . Whereas, exposed symptomatic (22.72 mg All) subjects had significantly higher (P = 0.01) mean specific IgG concentrations than exposed asymptomatic (15.02 mg All) or unexposed control (13.08 mg All) subjects. A pathoaetiological or marker-aetiological role is indicated for specific IgG in the development of byssinosis. The findings of this research challenged the status quo in terms of the accepted aetiological pathways of byssinosis. In turn the acceptance of a different aetiological pathway provided a possible answer to the varying presentation of the disease and by implication contested the current definition of byssinosis. / Thesis (M.Med.Sc.)-University of Natal, Durban, 2002.

Occupational health is concerned with health in its relation to work and the working environment. This study was undertaken to present an overview of occupational health in South Africa, with national and international perspectives on the discipline, in the light of : (a) the recent commissions of enquiry into aspects of occupational health in South Africa (b) the development of the national and self-governing states (c) new strategies by the authorities in the form of decentralization and deregulation. Information on the health profile of its workers, current legislative and service provisions and on policies for economic development and urbanization is vital for health administrators, occupational health and safety practitioners and policy makers. Data was collected through the use of literature surveys and postal questionnaires to the various interested persons and groups involved with occupational health. The findings reveal that (a) an inadequate occupational health policy exists in that the responsibilities of government(s), employers, workers and health professionals are not defined (b) there is an absence of an organizational and service framework for an occupational health system in South Africa although the morbidity and mortality data are significant (with their concomitant economic and social consequences) (c) there is a lack of financial and human resources for the practice of occupational health in South Africa. Recommendations are made taking into account the developed and developing components of South Africa. / Thesis (M.Med.)-University of Natal, Durban, 1987.