MPH / Department of Public Health / See the attached abstract below

Thesis (M.Ed. (Community and Continuing Education)) -- University of Limpopo, 2022 / This study is an exploration of the educational needs and assets of the visual impaired undergraduate students at a Rural-Based University in South Africa. The research question addressed is What are the educational needs and assets of the visual impaired Undergraduate students at a Rural-Based University in South Africa. The study is underpinned within the interpretivist paradigm. A qualitative research approach was adopted, utilising a case study design. Data was collected through document analysis, semi-structured interviews and observations. Analytic induction in which themes, patterns and categories emerged from the data was deemed appropriate. The study sample was composed of the Director of Reakgona Disability Centre, four the visual impaired undergraduate students from the three faculties of the University of Limpopo (Humanities, Management and Law, and Science and Agriculture), as well as four academic staff members teaching the sampled students. The total study sample comprised nine participants. The study has revealed the existence of a highly inflexible curriculum, lack of assistive devices, poor teaching and assessment strategies, untrained academic staff, poor support from the majority of academic staff members, poor support from a few of the peers with normal sight, difficulties during transition from secondary school to university, and limited library services that led to the marginalisation of the visual impaired undergraduate students. The study also found that the visual impaired undergraduate students possess the following educational assets: the availability of Reakgona Disability Centre, support from the majority of peers with normal sight, support from a few academic staff members, availability of associations and institutions that offer financial assistance to the visual impaired students, and the health clinic that provides health care. Based on the findings of the research some conclusions were drawn. Several recommendations are made to address the educational needs and assets of the visual impaired undergraduate students at a Rural-Based University in South Africa. Suggestions for future research are made to close the gap that exists in research on the education of students with visual impairments

D. Litt et Phil. (Literature and Philosophy) / Eye health promotion is an important aspect of VISION 2020 campaign that aims to eliminate unwarranted cases of avoidable blindness worldwide by the year 2020. Most developing countries, including South Africa, have a serious burden of eye diseases and unwarranted causes of visual impairment and blindness. The purpose of this research therefore was to highlight the lack of an integrated eye health promotion policy in the South African primary health care system which can play a major role in the elimination of this burden of disease and also to make proposals for eye health promotion policy development in South Africa. A combination of quantitative and qualitative research methods was used in this study. Questionnaires and interviews were conducted with all national and provincial health managers of portfolios relevant to eye care. Also, various health policy documents were requested from the National and Provincial Department of Health to ascertain claims of any existing guidelines on eye care. The policy documents and guidelines obtained had no specific reference to eye health promotion. Only 11 (23%) of the managers of provincial health directorates reported that they have integrated vision screening in their health promotion programmes as part of eye health promotion strategies. Eye care managers in the provinces reported that school visits accounted for 75% of eye health promotion programmes target areas. Also, apart from the Northern Cape Province which has no eye care manager and consequently no eye health promotion programmes, the Western Cape Province also does not have eye health promotion programmes and relies mostly on private sector for eye care services. The lack of an integrated eye health promotion policy and most probably the lack of a dedicated directorate that deals with eye health promotion issues may be a contributing factor to the overwhelming lack of integrated eye health promotion activities in South Africa. It is therefore recommended that an integrated eye health promotion model be developed and be part of the South African primary health care system. / Health Studies

Summaries in Afrikaans and English / Text in Afrikaans / Die waarde van visueel-perseptuele skoling of terapie vir visueel-perseptueel gestremde leerlinge as 'n subgroep van leergestremdheid, is reeds vir dekades 'n omstrede aangeleentheid. Hierdie omstredenheid is ondersoek aan die hand van sewe internasionaal erkende psigometriese toetse. Die interne konsekwentheidskoeffisiente van hierdie toetse het vir die huidige studie van 0,62 tot 0,95 gestrek. 'n Faktorontleding van die toetsinterkorrelasies het 'n gemeenskaplike faktor blootgele. Ses toetse was primer visueel-perseptueel, en Goodenough <1926> se skaal is vir die bepaling van intelligensie gebruik. Bykomend hiertoe, is leerlinge se prestasies in hul eerste taal, wiskunde en skrif gebruik om die effek van terapie te bepaal. Proefpersone is as visueel-perseptueel gestremd gediagnoseer deur 'n opvoedkundige sielkundige en 'n visuele skolingsentrum in Pretoria, waar eksper imentele leerlinge terapie ontvang het. Hierdie diagnoses is deur die Test for Visual Analysis Skills wat beduidend tussen normale en visueelperseptueel gestremdes onderskei, bevestig. Die toets se geldigheid vir Suid-Afrikaanse omstandighede is in 'n voorstudie bepaal. Honderd en ses, ses- tot negejarige proefpersone (82 seuns en 24 dogters>, van normale intelligensie, gesigskerpte en gehoor, is betrek. Drie en vyftig het die eksperimentele groep gevorm wat onderverdeel is in 32 wat terapie voltooi het, en 21 wat nie het nie. Hierdie leerlinge is individueel afgepaar met kontroleleerlinge van dieselfde geslag, ouderdom, huistaal, sosio-ekonomiese status en skoolstanderd. Eksperimentele leerlinge het visuele terapie in n breer groepsverband vir een uur per week ontvang. Terapieperiodes het van 4 tot 15 maande gewissel. Die eksperimentele ontwerp was 'n voortoets-natoets-tweegroepontwerp. t-Toetse vir afhanklike (afgepaarde) groepe is uitgevoer op die verskille tussen voor- en natoetstellings, asook tussen die eksperimentele en kontrolegroepe. Geeneen van die primer visueel-oerseptuele meettegnieke het beduidende resultate opgelewer nie. Dit is aanduidend van die ondoeltreffendheid van visueel-perseptuele terapie om die tekorte waarop dit gemik is, reg te stel. Die waarde van visueel-perseptueie terapie is inteendeel beperk tot 'n oorhoofse verbetering in konseptualisering en intellektuele ryping by die groep wat terapie voltooi het. Skrif was die enigste vak wat by dieselfde groep beduidend verbeter het. Hierdie resultaat is egter twyfelagtig vanwee beoordelingstekorte. / The value of visual perceptual training or therapy, to visually perceptually impaired pupils as a subgroup of the learning disabled, has been a controversy far decades. This controversy was investigated by means of seven internationally recognised psychometric tests. The internal consistency coefficients of these tests for the present study ranged from 0,62 to 0,95. A factor analysis of test intercorrelations revealed a common factor. Six tests were primarily visual perceptual, whilst the Goodenough (1926) scale determined intelligence. Additionally, pupils' performance in their first language, mathematics and writing, was used to assess the therapeutic effect. Subjects were diagnosed as visually perceptually impaired by an educational psychologist and a visual training centre in Pretoria where experimental pupils received therapy. These diagnoses were confirmed by the Test for Visual Analysis Skills, which significantly differentiates between the normal and visually perceptually impaired. This test's validity for South African circumstances was determined in a prestudy. One hundred and six, six to nine year old subjects <82 boys and 24 girls>, of normal intelligence, visual acuity and hearing, were involved. Fifty three formed the experimental group which was subdivided in 32 who completed therapy, and 21 who did not. These pupils were individualiy matched with controls of similar sex, age, home language, socio economic status and school standard. Experimental pupils received visual therapy within a broader group context for one hour per week. Therapy periods fluctuated between 4 and 15 months. The experimental design was a pretest-posttest two group design. t-Tests for dependant <matched) groups were conducted on the differences between pre and oosttest scores, as well as between the experimental and control groups. None of the primarily visual perceptual tests revealed significant results. This signifies the inefficiency of visual perceptual therapy to rectify the deficits at which it is directed. The value of visual perceptual therapy is, on the contrary, restricted to an overall improvement in conceptualization and intellectual maturation within the group which completed therapy. Writing was the only subject which improved significantly within the same group. However, this result is dubious, due to evaluation deficits. / Psychology / D.Litt. et Phil. (Psychology)

The aim of this study was to determine the prevalence and causes as well as the risk factors of visual impairment (VI) and blindness among Black South Africans with diabetes mellitus (DM) aged 40 years and older in Mopani District, Limpopo province, South Africa. This was a cross-sectional study in which Black South Africans with DM aged ≥40 years old were examined for VI and blindness. In addition, anthropometric as well as risk factors for VI and blindness were studied. A total of 225 participants were selected from seven Public Health Facilities in Mopani District. Data was collected using standard optometric instruments, anthropometric instruments and structured interviews. Data analysis was done using the Statistical Analysis System (SAS) and Microsoft Excel software packages. The ages of the participants ranged from 40 to 90 years with a mean of 61.5±10.49 years. There were more females (71.5%) than males (28.4%). The prevalence of uncorrected VI and blindness in the right eyes of the participants was 70.7% and 3.6%, respectively. In the left eyes, it was 72% and 3.1%, respectively. However, following optical correction, the prevalence in right eyes was 41.3% and 3.6%, respectively. In the left eyes, it was 42.2% and 3.1%, respectively. Risk factors that were individually associated with VI and blindness include age, educational qualification, monthly income, knowledge of DM types, oral DM treatment (pills), losing weight, compliance to losing weight, family history of DM, physical activity, and date of last eye examination .When logistic regression was used, knowledge of DM types, pills, and compliance to losing weight, family history of DM, monthly income and physical activity remained associated with VI and blindness. The high prevalence of VI in this diabetes population was not primarily due to DM itself, but due to refractive error and cataract, conditions which have effective and easy treatments. A total of 84% of the participants were visually impaired due to either refractive error or cataract or both and only 3.8% due to diabetes retinopathy. It is therefore recommended that appropriate and affordable refraction and cataract surgical services be made available and accessible to this population / Health Studies / D. Litt. et Phil. (Health Studies)

Title: Social exclusion amongst students with visual impairments at UKZN Howard College and Edgewood Campuses. This research used a qualitative study exploring thick descriptions, inside voices and perspectives of “otherization”, powerlessness and voiceless-ness resulting from social exclusionary processes perpetuated by social and university structures and poverty. Convenience sampling was used. Semi structured individual interviews and focus group discussions were used to explore the key research questions focusing on social and university challenges experienced by students with visual impairments at UKZN in their social and university environments. The data was interpreted through The Anti Oppressive Approach (Dominelli, 2002) which gave support to understanding how continuing to ignore marginalized persons with visual impairments out of mainstream systems of development, perpetuated “othering”, powerlessness and voiceless-ness. This study provided evidence of the multi dimensional and multi structural nature of the social exclusionary process with key focus on abuse of power by dominant groups (sighted persons), violation of human rights and visual impairment as confinement as experienced by students with visual impairments either in their social or university environments or both. In addition, this theory looked at the manner in which dominant or superior groups arrange resources around them to benefit them and exclude persons with disabilities. This research also gave a voice to women with visual impairments being oppressed by sighted women as well as poverty as a social exclusionary process. Keywords: Anti Oppressive Theory, Visual Impairments, Social Exclusion / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2011.

The aim of this study was to determine the prevalence and causes as well as the risk factors of visual impairment (VI) and blindness among Black South Africans with diabetes mellitus (DM) aged 40 years and older in Mopani District, Limpopo province, South Africa. This was a cross-sectional study in which Black South Africans with DM aged ≥40 years old were examined for VI and blindness. In addition, anthropometric as well as risk factors for VI and blindness were studied. A total of 225 participants were selected from seven Public Health Facilities in Mopani District. Data was collected using standard optometric instruments, anthropometric instruments and structured interviews. Data analysis was done using the Statistical Analysis System (SAS) and Microsoft Excel software packages. The ages of the participants ranged from 40 to 90 years with a mean of 61.5±10.49 years. There were more females (71.5%) than males (28.4%). The prevalence of uncorrected VI and blindness in the right eyes of the participants was 70.7% and 3.6%, respectively. In the left eyes, it was 72% and 3.1%, respectively. However, following optical correction, the prevalence in right eyes was 41.3% and 3.6%, respectively. In the left eyes, it was 42.2% and 3.1%, respectively. Risk factors that were individually associated with VI and blindness include age, educational qualification, monthly income, knowledge of DM types, oral DM treatment (pills), losing weight, compliance to losing weight, family history of DM, physical activity, and date of last eye examination .When logistic regression was used, knowledge of DM types, pills, and compliance to losing weight, family history of DM, monthly income and physical activity remained associated with VI and blindness. The high prevalence of VI in this diabetes population was not primarily due to DM itself, but due to refractive error and cataract, conditions which have effective and easy treatments. A total of 84% of the participants were visually impaired due to either refractive error or cataract or both and only 3.8% due to diabetes retinopathy. It is therefore recommended that appropriate and affordable refraction and cataract surgical services be made available and accessible to this population / Health Studies / D. Litt. et Phil. (Health Studies)

Eye health promotion is an important aspect of VISION 2020 campaign that aims to eliminate unwarranted cases of avoidable blindness worldwide by the year 2020. Most developing countries, including South Africa, have a serious burden of eye diseases and unwarranted causes of visual impairment and blindness. The purpose of this research therefore was to highlight the lack of an integrated eye health promotion policy in the South African primary health care system which can play a major role in the elimination of this burden of disease and also to make proposals for eye health promotion policy development in South Africa. A combination of quantitative and qualitative research methods was used in this study. Questionnaires and interviews were conducted with all national and provincial health managers of portfolios relevant to eye care. Also, various health policy documents were requested from the National and Provincial Department of Health to ascertain claims of any existing guidelines on eye care. The policy documents and guidelines obtained had no specific reference to eye health promotion. Only 11 (23%) of the managers of provincial health directorates reported that they have integrated vision screening in their health promotion programmes as part of eye health promotion strategies. Eye care managers in the provinces reported that school visits accounted for 75% of eye health promotion programmes target areas. Also, apart from the Northern Cape Province which has no eye care manager and consequently no eye health promotion programmes, the Western Cape Province also does not have eye health promotion programmes and relies mostly on private sector for eye care services. The lack of an integrated eye health promotion policy and most probably the lack of a dedicated directorate that deals with eye health promotion issues may be a contributing factor to the overwhelming lack of integrated eye health promotion activities in South Africa. It is therefore recommended that an integrated eye health promotion model be developed and be part of the South African primary health care system. / Health Studies / D. Litt et Phil. (Health Studies)

Summaries in Afrikaans and English / Text in Afrikaans / Die waarde van visueel-perseptuele skoling of terapie vir visueel-perseptueel gestremde leerlinge as 'n subgroep van leergestremdheid, is reeds vir dekades 'n omstrede aangeleentheid. Hierdie omstredenheid is ondersoek aan die hand van sewe internasionaal erkende psigometriese toetse. Die interne konsekwentheidskoeffisiente van hierdie toetse het vir die huidige studie van 0,62 tot 0,95 gestrek. 'n Faktorontleding van die toetsinterkorrelasies het 'n gemeenskaplike faktor blootgele. Ses toetse was primer visueel-perseptueel, en Goodenough <1926> se skaal is vir die bepaling van intelligensie gebruik. Bykomend hiertoe, is leerlinge se prestasies in hul eerste taal, wiskunde en skrif gebruik om die effek van terapie te bepaal. Proefpersone is as visueel-perseptueel gestremd gediagnoseer deur 'n opvoedkundige sielkundige en 'n visuele skolingsentrum in Pretoria, waar eksper imentele leerlinge terapie ontvang het. Hierdie diagnoses is deur die Test for Visual Analysis Skills wat beduidend tussen normale en visueelperseptueel gestremdes onderskei, bevestig. Die toets se geldigheid vir Suid-Afrikaanse omstandighede is in 'n voorstudie bepaal. Honderd en ses, ses- tot negejarige proefpersone (82 seuns en 24 dogters>, van normale intelligensie, gesigskerpte en gehoor, is betrek. Drie en vyftig het die eksperimentele groep gevorm wat onderverdeel is in 32 wat terapie voltooi het, en 21 wat nie het nie. Hierdie leerlinge is individueel afgepaar met kontroleleerlinge van dieselfde geslag, ouderdom, huistaal, sosio-ekonomiese status en skoolstanderd. Eksperimentele leerlinge het visuele terapie in n breer groepsverband vir een uur per week ontvang. Terapieperiodes het van 4 tot 15 maande gewissel. Die eksperimentele ontwerp was 'n voortoets-natoets-tweegroepontwerp. t-Toetse vir afhanklike (afgepaarde) groepe is uitgevoer op die verskille tussen voor- en natoetstellings, asook tussen die eksperimentele en kontrolegroepe. Geeneen van die primer visueel-oerseptuele meettegnieke het beduidende resultate opgelewer nie. Dit is aanduidend van die ondoeltreffendheid van visueel-perseptuele terapie om die tekorte waarop dit gemik is, reg te stel. Die waarde van visueel-perseptueie terapie is inteendeel beperk tot 'n oorhoofse verbetering in konseptualisering en intellektuele ryping by die groep wat terapie voltooi het. Skrif was die enigste vak wat by dieselfde groep beduidend verbeter het. Hierdie resultaat is egter twyfelagtig vanwee beoordelingstekorte. / The value of visual perceptual training or therapy, to visually perceptually impaired pupils as a subgroup of the learning disabled, has been a controversy far decades. This controversy was investigated by means of seven internationally recognised psychometric tests. The internal consistency coefficients of these tests for the present study ranged from 0,62 to 0,95. A factor analysis of test intercorrelations revealed a common factor. Six tests were primarily visual perceptual, whilst the Goodenough (1926) scale determined intelligence. Additionally, pupils' performance in their first language, mathematics and writing, was used to assess the therapeutic effect. Subjects were diagnosed as visually perceptually impaired by an educational psychologist and a visual training centre in Pretoria where experimental pupils received therapy. These diagnoses were confirmed by the Test for Visual Analysis Skills, which significantly differentiates between the normal and visually perceptually impaired. This test's validity for South African circumstances was determined in a prestudy. One hundred and six, six to nine year old subjects <82 boys and 24 girls>, of normal intelligence, visual acuity and hearing, were involved. Fifty three formed the experimental group which was subdivided in 32 who completed therapy, and 21 who did not. These pupils were individualiy matched with controls of similar sex, age, home language, socio economic status and school standard. Experimental pupils received visual therapy within a broader group context for one hour per week. Therapy periods fluctuated between 4 and 15 months. The experimental design was a pretest-posttest two group design. t-Tests for dependant <matched) groups were conducted on the differences between pre and oosttest scores, as well as between the experimental and control groups. None of the primarily visual perceptual tests revealed significant results. This signifies the inefficiency of visual perceptual therapy to rectify the deficits at which it is directed. The value of visual perceptual therapy is, on the contrary, restricted to an overall improvement in conceptualization and intellectual maturation within the group which completed therapy. Writing was the only subject which improved significantly within the same group. However, this result is dubious, due to evaluation deficits. / Psychology / D.Litt. et Phil. (Psychology)

MPH / Department of Public Health / See the attached abstract below