Submitted in fulfilment of the requirements for the Degree of Master of Technology in Nursing, Durban University of Technology, Durban, South Africa, 2015 / Brief background: The Expanded Programme on Immunisation (EPI) is one of the most powerful and cost-effective public health programmes to improve child survival. In South Africa the programme remained fragmented because of the system of apartheid until 1995 when the national EPI was formed through the unification of all immunisation services in the country. Since then there have been significant advances in immunisation service delivery in South Africa. Amongst the revisions that were made in 2009 was the change of the EPI schedule. Aim of the study The aim of the study was to investigate the factors that influence the uptake of the revised EPI for children between the ages of 6 to 12 years at Umlazi Township, KwaZulu-Natal in order to improve immunisation coverage. Methodology A descriptive quantitative design was used to conduct the study. A total of ten primary health care clinics were included in the study. Data was collected from child caregivers and health care workers using self-directed questionnaires. Results: It was worth noting that although the results of the study revealed that the EPI coverage for children between the ages 6 to 12 years remained low in Umlazi Township, however, the programme was well-implemented. Several factors that influenced the uptake of the immunisations were identified and these factors could be used to strengthen the EPI programme in Umlazi. Factors that had a negative influence on the uptake of immunisations were also identified and these factors could be used to develop strategies address the challenges.

As Africa faces the challenges of its renewal or renaissance, the HIV/AIDS epidemic poses the greatest potential barrier to the attainment of this vision (Makgoba, 2001 in Dorrington, Bourne, Bradshaw, Laubscher & Timaeus, 2001). The development of an HIV vaccine that is safe, effective and affordable, has been widely contemplated as a necessary supplement to already established interventions. In preparation for HIV vaccine trials in South Africa the current project aimed to assess students' understanding (knowledge and perceptions) and experiences of vaccination in general, and to explore if these were associated with demographics such as motherhood and gender. A parallel aim was to assess students' knowledge and expectations of HIV vaccination and trial participation. A sample of 33 students was recruited from university residences at the University of Natal, Pietermaritzburg. Participants were interviewed via a semi-structured interview schedule. The data collected was then coded and analysed using content analysis, while Chi - square analysis was used to evaluate if demographics such as gender and motherhood were systematically associated with various responses. The results revealed that the vast majority of participants (97%) knew the purpose of vaccination, stating that it was to promote health and prevent illness. Most participants (67%) knew that vaccination works by mobilising the immune system (vaccination mechanism). The vast majority of participants (91%) could name at least one vaccine preventable disease. Uptake of childhood immunisation was reportedly high (88%) while adult uptake of immunisation was low (33%). A significant minority (36%) reported that they had experienced side effects but understood these to be an integral part of vaccination. Thirty percent of participants stated they were willing to participate (WTP) in a hypothetical vaccine trial, 33 % of participants were not WTP and 15% were not sure. Motivations for trial participation were reportedly influenced most by personal incentives of altruism (39%) and barriers such as perceived significant physical risk (61%). In general, knowledge and experiences of vaccination were not associated with gender or with motherhood. The results suggest that more awareness of HIV vaccine trials is needed. In this regard education should emphasise that the prospective vaccine will be preventive, that only healthy people can volunteer and that the HIV vaccine will not guarantee immunity to HIV infection. Suggestions are made for future research into motivations, barriers and incentives to facilitate an ethical process of vaccine trial participation. / Thesis (M.Soc.Sc.)-University of KwaZulu-Natal, Pietermaritzburg, 2004.

MCur / Department of Advanced Nursing Science

This study investigated caregivers' perceptions with regard to vaccine-preventable diseases in terms of six constructs of the Health Belief Model. A qualitative research design that is explorative, descriptive and contextual in nature was employed in order to understand and describe the perceptions influencing access and utilisation of services that lead to missed immunisation opportunities and consequently outbreaks of vaccine-preventable diseases. The data-collection techniques were individual unstructured in-depth interviews, field notes and clinical records. The sample consisted of twenty two (N=22) caregivers who volunteered to be interviewed. The study has highlighted that caregivers' perceptions or cognitive factors play an important role for having children in completing immunisation schedule to protect the public from vaccine-preventable diseases. It is recommended that mass media programmes are needed to address the role of vaccines in reducing high morbidity and mortality rates caused by vaccine preventable diseases and improvement in access to immunisation services. / Health Studies / MPH (Health Studies)

This study explored the attitudes of community members toward the Human Rabies in the Vhembe district of the Limpopo Province, South Africa. This study was underpinned by interpretative phenomenological analysis design. Data were collected using individual interviews of 20 participants and 6 focus groups consisting of six community members each. Both sets of interviews were audio recorded and transcribed verbatim. Data were analysed using interpretive phenomenological analysis framework for data analysis. Three super-ordinate themes emerged from data analysis: attitudes toward the Human Rabies, factors influencing attitudes toward the Human Rabies and tackling the Human Rabies. Results indicate that attitudes toward the Human Rabies has a direct influence on adherence to prevention and care approaches. Attitudes can be influenced by addressing training and educational needs and perceptions of prevention and care approaches. Recommendations are made to enhance adherence to prevention and care approaches for management of the Human Rabies. / Health Studies / M.A. (Health Studies)

This study investigated caregivers' perceptions with regard to vaccine-preventable diseases in terms of six constructs of the Health Belief Model. A qualitative research design that is explorative, descriptive and contextual in nature was employed in order to understand and describe the perceptions influencing access and utilisation of services that lead to missed immunisation opportunities and consequently outbreaks of vaccine-preventable diseases. The data-collection techniques were individual unstructured in-depth interviews, field notes and clinical records. The sample consisted of twenty two (N=22) caregivers who volunteered to be interviewed. The study has highlighted that caregivers' perceptions or cognitive factors play an important role for having children in completing immunisation schedule to protect the public from vaccine-preventable diseases. It is recommended that mass media programmes are needed to address the role of vaccines in reducing high morbidity and mortality rates caused by vaccine preventable diseases and improvement in access to immunisation services. / Health Studies / MPH (Health Studies)

MPH / Department of Public Health

PURPOSE: The purpose of the study was to explore the perception of the R48 trained professional nurses with regard to implementation of the EPI in Tshwane District Gauteng Province. METHODOLOGY: A qualitative research design was followed. Data were collected through in-depth qualitative interviews from a purposive sample of eight (8) R48 trained professional nurses. Eight steps of Tech’s inductive, descriptive open coding technique was followed. FINDINGS: The study established that EPI programme is important in R48 training. The implementation of integrated approach was viewed as beneficial leading to the reduction of diseases. The successful implementation would be more beneficial if it is consistently coupled with support from programme managers and regular in-service on up-dates of new vaccines and technologies are introduced within the programme / Health Studies / M.A. (Nursing Science)