A research report submitted to the Faculty of Management, University of the Witwatersrand, in partial fulfilment of the requirements for the degree of Master of Management / Rapid Appraisal has gained popularity amongst policy makers, and is used in strategic planning of primary health care services. This study aimed at determining whether Rapid Appraisal is an appropriate planning tool for primary health care services in South Africa. This study compares Rapid Appraisal with a Regional Health Management Information System (ReHMIS), using the Northern Province as a case study, In comparison, Rapid Appraisal took half the time of ReHMIS for data collection, and used less resources in the process, There is significant difference between the two data sets and this is explained by the fact that Rapid Appraisal does not only determine whether the facility is there or not but it also identifies management issues. Rapid Appraisal is an innovative method that engages all the relevant stakeholders in planning their primary health care services, The findings proved that Rapid Appraisal is an appropriate planning tool for primary health care services. / AC2017

A research report submitted in partial fulfilment of the requirements for the degree of Master of Arts in Psychological Research in the Faculty of Humanities, University of the Witwatersrand, Johannesburg, 2017. / Mental ill-health constitutes a substantial burden of disease worldwide, representing more than the burden of disease caused by all cancers combined. However, the provision of mental health care remains inadequate around the world. To address the shortages in mental health care expenditures, the WHO-HEN (2003) proposed treatment priorities and policy goals in different contexts, based on their financial resources. This study investigates the state of mental health treatment provision in high-, middle-, low-income and the South African contexts, in order to assess the efforts that have been made in these contexts to counter the shortages in mental health care provision, and to promote public mental health, following the WHO-HEN (2003) suggestions. This study uses the mixed methods approach to review literature published between 2004 and 2016 within the AJCP, AJP, CMHJ, SAJPs and SAJP. The findings reveal that treatment trends across contexts align with, and extend beyond the WHO-HEN (2003) suggestions in most cases, and that the balanced care approach is progressively being implemented in the delivery of integrated mental health services in highincome countries and South Africa specifically. These results prove that efforts are being made across contexts to provide effective mental health care, and to ensure the promotion of mental health and prevention of mental disorders. / XL2018

This study explores the perceptions of care and support for those with HIV/AIDS by community members within the KwaNgcolosi community who are currently not involved in such care and support, and have no current perceived obligation to do so. The Social Capital framework was used to understand the current community perceptions and dynamics related to current care and support for those who are ill with HIV/AIDS. This was followed with suggestions for how this could be improved, current obstacles to this, and possible personal contributions towards improving the current situation. Data was collected by means of six semi-structured, in-depth focus groups, which were conducted in IsiZulu with the assistance of a translator. These were then transcribed and thematically analysed. Overlapping quantitative data specifically for the themes of social cohesion and trust exists in the form of two social assessment surveys, and so frequency counts were done with applicable survey questions, and compared with data collected from focus group interviews. Focus group discussions revealed a marked difference between perceived ideals of how care and support should be, and what is currently happening within the community. Mistrust and stigma surrounding HIV/AIDS appear to still be prevalent within the community, which hampers community social networks and involvement, and acts as a barrier for those who wish to provide care and support for those who are ill. Triangulation with Social Assessment surveys, revealed a discrepancy between social cohesion as related to HIV/AIDS, and general social cohesion within the KwaNgcolosi community. This social cohesion is not currently leading to collective action, which points to a deficit both in information sharing regarding how to do so, as well as a deficit in Social Bridging. Family members and individuals who are ill may, for various reasons, also prevent community members who wish to become involved, from providing care and support to those who are ill. Reciprocity also affects the social credibility of community initiatives, which are not taken seriously if nothing can be expected in return. Additionally, expectations of economic reciprocity regarding contributions to household expenses negatively affects providing care for family members, who are blamed once they become ill, if they did not contribute to the household while still working. Social norms regarding gendered social and economic expectations also hinder and restrict desires to assist in care and support for those who are ill with HIV/AIDS. The obstacles highlighted by the themes of trust, reciprocity and social norms have resulted in potential barriers to mobilization of social networks, and resources that may be available through these networks. There is a need to provide education to community members according to their perceived contributions, in providing care and support for those with HIV/AIDS, and in keeping with current gendered norms which point towards women undertaking much of the physical aspects of care and support, with men engaging in social and emotional support. However, care should be taken that current destructive gender stereotypes, in which women are expected to undertake primary caregiving roles, are not encouraged and perpetuated. Additionally, education surrounding perceived contributions to HIV/AIDS care and support will increase perceived personal abilities and competence, and act as an enabling factor towards more individuals becoming involved in care and support. Gateways to identified sources for information, such as the Home Based Caregivers and the KwaNgcolosi Clinic should also be tapped, and a flow of information encouraged. However, the current situation is a complex combination of stigma, discrimination and blame towards those who are ill, as well as mistrust from the ill person and their family members, who isolate themselves and block any attempts of care and support from community members. This has resulted in many possibilities and untapped resources within the community. Future initiatives must therefore, from a programme perspective, shift from a focus on current obstacles, to encouraging and developing community members. potential contributions towards care and support for those with HIV/AIDS. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2009.

Thesis (M.Med.(Community Health))--University of Pretoria, 2004. / Summary in English and Afrikaans. Includes bibliographical references ( leaves 102-113). Also available online.

Thesis (MA (History))--University of Stellenbosch, 1988. / Die doel met hierdie studie is tweeledig. Eerstens word gepoog om die Kaapse burgermag-mediese eenhede se rol binne die verdedigingstelsels waarvan hulle op sekere stadia van hul bestaan deel was te ondersoek, hetsy as deel van die Kaapse Koloniale Magte vir die tydperk 1889 - 1913 of as deel van die burgermag-element van die Unieverdedigingsmag, 1913 - 1939. Tweedens word hierdie eenhede se ontwikkelingsgang nagegaan : van die stigting van die Volunteer Medical Staff Corps (VMSC) in 1889 af tot met die uitbreek van die Tweede Wêreldoorlog in 1939. As 'n titel vir hierdie onderwerp is besluit op Die Geskiedenis van die Kaapse Burgermag-mediese eenhede, 1889 - 1939. Die rede daarvoor is dat dit die hele tydperk onder bespreking volledig omskryf die aanloop tot die stigting van die VMSC, sy stigting in 1889, sy rol as 'n vrywilligereenheid, sy omskakeling na twee burgermag-mediese eenhede in 1913 asook hul rol en ontwikkeling in daardie verband tot met die uitbreek van die Tweede Wêreldoorlog in 1939. Aangesien hierdie tydperk van vyftig jaar 'n duidelike beeld rakende hierdie eenhede se rol en ontwikkeling gee, het die keuse daarom geval op 1889 en 1939 as onderskeidelik die begin- en einddatum vir hierdie onderwerp. Met die uitbreek van die Tweede Wêreldoorlog in 1939 het daar in die Kaapprovinsie twee burgermag-mediese eenhede binne die Unieverdedigingsmag gefunksioneer, naamlik 2 Veldambulans en 3 Veldambulans. Beide kan egter hul ontstaansgeskiedenis terugvoer na 21 Oktober 1889, toe. soos hierbo aangedui, die VMSC as die eerste selfstandige mediese eenheid in die Kaapkolonie gestig is. Met sy stigting het die eenheid uit twee kompanies bestaan. te wete A-kompanie en B-kompanie wat onderskeidelik in King William's Town en Kaapstad gesetel was. Daarna het die VMSC by twee verdere geleenthede naamsveranderinge ondergaan. In 1889 is sy naam na die Cape Medical Staff Corps (CMSC) verander en van 1903 af het dit as die Cape Medical Corps (CMC) bekend gestaan. Met die totstandkoming van die Suid-Afrikaanse Geneeskundige Diens (SAGD) in 1913, is die twee kompanies in twee afsonderlike burgermag-mediese eenhede omgeskakel en in die SAGD opgeneem. Dit het eweneens 'n naamsverandering tot gevolg gehad. A-kompanie sou voortaan as 1 Berede Brigade Veldambulans (1 BBVA) bekend staan terwy1 B-kompanie tot No. 1 Kompanie herdoop is. tn 1935 het die twee eenhede weer eens 'n naamsverandering ondergaan toe 1 BBVA tot 2 Veldambulans en No. 1 Kompanie tot 3 Veldambulans herdoop is. Die doel van hierdie studie in ag genome, word die rol en ontwikkeling van hierdie eenhede oor die tydperk van vyftig jaar bespreek. In die eerste hoofstuk word daar, as inleiding, kortliks verwys na die onderskeie militê re organisasies in die Kaapkolonie gedurende die neëntiende eeu waarvan die vrywilliger-mag een was. Daar het egter 'n behoefte bestaan aan voldoende mediese steun vir sy lede waaruit voortgevloei het die stigting van die St John's Ambulance Association en die ambulansafdeling van die King William's Town Volunteer Artillery om hierdie leemte te vul. Vervolgens word gekonsentreer op die stigtingsproses van die VMSC in 1889 asook die groei en ontwikkeling van die eenheid in die jare onmiddellik daarna...

[From Editorial] A variety of papers covering interesting and relevant topics and emanating from several countries are included in this number. Togonu-Bickersteth examines levels of satisfaction with care received from sons and daughters of older Yoruba in rural Nigeria. She finds that contrary to expectations, older women are more satisfied than older men with the assistance received from children. Makoni examines the effects of Alzheimer's disease as the disease progresses on the conversational ability of an older second-language speaker. Cattell reports on exploratory research among Zulu grandmothers and granddaughters in KwaZulu-Natal and finds that older women continue to have important roles in the socialization of granddaughters, especially regarding sexual behaviour. Van Dokkum makes out a case for a durable power of attorney, not yet provided for in South African legislation, which can help to protect older citizens against malpractices or exploitation when, because of impaired mental functioning, they are no longer able to look after their affairs. Lefroy gives an update on the Special Dementia Unit as an alternative residential care facility for afflicted older Australians and examines the advantages of this type of accommodation for individuals. their families and society. Finally, Moller reviews a book written by Nana Araba Apt of Ghana. entitled Coping with old age in a changing Africa. She concludes that readers will learn much from Apt's ideas on building on indigenous institutions to meet the challenges of ageing in Africa.

[From Editorial] This Special Issue of the Journal comprises a selection of papers based on research on ageing in African countries, which were read at the Third Global Conference. The papers were revised and peer reviewed prior to acceptance by the Journal. The theme of the Special Issue is "Ageing in urban and rural Africa." Each of the papers included in the issue deals with a situation of ageing-in-place, a late-life migratory pattern, or the impact, or implications of social forces and social change on older Africans, in either an urban and/or a rural setting, or in both types of settings in Africa. The papers also draw together the main sub-themes and strands of the conference, particularly those relating to the family, ubuntu, urbanization, AIDS, and income security and poverty.

[From Editorial] Each of the papers in this number of SAJG deals with dilemmas and issues in the matter of public and private care for older persons in southern Africa. Three papers deal explicitly with South Africa's social-security system·- specifically the old-age pension. Two papers deal with residential care models. And a sixth paper examines informal caregiving. In an expansive overview of public finance and ageing in South Africa, Van der Berg examines budgetary expenditure on the older population and places the magnitude and function of the social-pension system in perspective. The author briefly traces the historical evolution of the system. In a paper based on extensive archival research, Sagner details the history of the pension from 1920 to 1960 and shows that numerous contemporary pension-related issues are no different to issues of past decades. In her paper, Oakley examines the effects of recent changes in social-welfare policy on the residents and administrators of a home for marginalized older people in a remote South African town. She contends that new policy erroneously assumes that marginalized and historically disadvantaged older individuals are able to live self-sufficiently within the bosom of family - in a spirit of ubuntu. Ackermann and Matebesi report on a study of the experiences of carers of older family members in an African township and consider how these carers, who have few resources, could be assisted and supported in their care giving tasks. Mupedziswa describes the nature and functioning of an alternative residential care model in Zimbabwe - a cooperative living scheme specifically established to enable destitute and socially-impoverished older people to co-reside in a safe and mutually-supportive environment. Moller gives readers an insightful update and analysis of the January 1998 pension payment debacle in the Eastern Cape Province, when the payment of more than 600 000 pensioners was delayed because of provincial-government management errors. Finally, SAJG welcomes Wilson's announcement in a letter to the editor of the establishment of AFRIT A, whose aims are to promote and to co-ordinate linkages between training and research initiatives on ageing and policy structures in African countries.

[From Editorial] Several contemporary building blocks of African gerontology are used in the papers in this number of SAJG. First, Madzingira draws on 1990s' demographic data sources to examine selected levels, patterns and trends of population ageing in Zimbabwe. She briefly outlines implications of population ageing for socio-economic development in the country, and highlights critical areas such as the future of the family as a safety net for elders, inadequate social-security measures, health care provision, trends in consumption of goods and services, and the ageing population structure in the rural areas. Although based on a descriptive modernization theory model, the paper reflects the continued usefulness of the theory in highlighting the effects of structural lag, but avoids a reliance on stereotypes. Staying in Zimbabwe, Mupedziswa takes up feminist issues and critiques the plight of older female informal-sector traders and their gender-based cumulative disadvantage. The author pertinently and sympathetically examines the women's diminished access to power across the lifespan and their dilemma as they become increasingly frail. Refreshingly, he approaches his investigation from a political economy perspective, and considers the interdependence of this gender-differentiated age cohort and the social structure. Moving to Ghana, Adeku in his paper examines socio-demographic factors in the marital status of older persons. His findings highlight the greater proportion of widows in the older population, which gender differential he explains is a function of both a high mortality rate in older men and remarriage. He also specifically examines gender-based inheritance and other wealth transfer patterns - and hence uses both social exchange theory and political economy theory concepts for explanation, as well as draws on feminist theories to analyse the situations of the older women. Staying in Ghana, Darkwa gives his views on the health-care needs and challenges of older Ghanaians who reside in rural areas. Again, the author addresses a political economy issue, and makes suggestions on how the government could bridge the urban-rural health gap and improve both preventive and curative health-care service delivery to the vast majority of the older Ghanaian population which lives in the rural areas. He also introduces an intriguing notion of the role that communication technology can play in the future provision of health care to Africa's elderly. Finally, revisiting demographic and health transitions in Africa, their implications and related issues, Adamchak reviews the World Health Organization's 1997 report on Ageing in Africa, authored by Nana Araba Apt in Ghana. Adamchak evaluates this "overview" report and its relevance, and examines some of the historical and contemporary African gerontology building blocks with which the report is constructed.

[From Editorial] The papers included in this special issue highlight some of the issues of elderliness and old age in Africa outlined above. Using different disciplinary approaches, the papers should appeal to age-old researchers in varied fields. In a discussion of old age and ageing in pre-industrial Africa, Sagner moves away from the rather simplistic images of old age which still beset many African gerontologists. Drawing on the Xhosa-speaking peoples in the 19th century he argues that the experience of later life was shaped by gender, kinship and "class" differences as well as by biographical factors, making for a variety of later-life experiences. He points out that old age was not a clear-cut period of life with unique demographic, economic or social characteristics/ conditions, set apart from earlier life phases. However, he notes that (deep) old age was firmly tied to religious and metaphysical beliefs. He argues that loss of bodily functions in (deep) old age was hardly stigmatizing as the loss was socially constructed as a sign of increasing other-worldliness. By linking old age with superhuman agency, the ideological hegemony of old age remained unbroken, despite bodily decline, even though the latter could herald loss of this-worldly status and, finally, abandonment in the bush. Moller and Sotshangaye discuss contemporary relations between Zulu grandmothers and grandchildren in South Africa's KwaZulu-Natal province. Though the grandmothers whom the two authors interviewed expressed deep concern about losing the respect of their grandchildren, in the eyes of the latter old age is, surprisingly, not denigrated as a possible source of moral guidance. Moller and Sotshangaye point out that strains in the grandmothers-grandchildren relationship are located in the rapidly changing social context which easily tends to outdate the elders' teaching, rather than in the intergenerational politics of the family per se. Paradoxically, however, macro-social changes have also led to a re-strengthening of the grandmothers' moral authority. The paper also shows that successful ageing- in the sense of one's personal happiness in old age - is, at least partly, relational defined. / Moving northwards up the subcontinent to Mozambique, da Silva records the results of a case study on the situation of older people who had to cope with several long-standing wars and natural disasters in their lifetimes. She analyses the repercussions which endured displacements, forced migrations and other war-related life-course experiences had on the lives of today's elderly, both at the personal and social level. In detailing social policy propositions she reminds us that there is a fundamental divergence between how older people are represented in some authoritative discourses and the social reality of old age. To overcome the prevailing negative representations of old age is of utmost practical importance, as the problematicity image encourages non-participatory government approaches and hinders thus the empowerment of the elderly. Turning to a methodological plane, Mommersteeg details some of the problems - and advantages - which the use of interpreters in qualitative research settings entail. In keeping with a hermeneutic approach, he shows that the interpreter is in fact a culture broker, rather than a mere provider of a linguistically correct translation. Mommersteeg's paper illustrates very well that interviews which are mediated through interpreters are not dialogically but triologically constituted, as are their "products" - the storied voices of the interviewees. In her article, Coetzee reports on exploratory field research in an old-age centre outside Bloemfontein in South Africa's Free State province. Based on participant observation and in-depth interviews she finds that elderly residents experience old age negatively. Though this subjective reality partly reflects the residents' difficulties in adjusting to their ageing bodies, it is mainly grounded in her subjects' difficulties to construct a framework within which their present position in the world could be instilled with personal/social meaning. Coetzee' s paper stresses both the relevance of a life course perspective and a gender-sensitive approach to the study of old-age experience.