Thesis (MPhil)--Stellenbosch University, 2004. / ENGLISH ABSTRACT: Very little attention has been paid in South Africa to the situations where grandmothers have become surrogate parents to their grandchildren and other vulnerable children who have been left destitute due to the HIV/Aids epidemic. These women, who are in great need of support are not directly factored into Aids-related policy and care strategies, even though they play a vital role in assuming the roles of surrogate parents to their grandchildren. Clearly elderly women are valuable resources and are both crucial and valuable for the role they play in the care of both Aids sufferers and Aids orphans. Grandmothers who assume such care-giving roles are not receiving specific and targeted support from government structures. Instead they only benefit peripherally from the legislation within the jurisdiction of Department of Social Development and the programs that are established by them. This study determined where government social and welfare polices can improve the quality of life of black female pensioners who are taking care of their orphaned grandchildren and other vulnerable children. Policy makers need to recognise that grandmothers are increasingly obliged to assume care-giving responsibilities for dying adult children and later for orphans, when their own physical and cognitive abilities may be declining. Instead of using their state pensions to enjoy their old age and spend their money on looking after their health, proper housing etc., black female pensioners are forced to assume additional responsibilities in looking after orphaned grandchildren and other vulnerable children who require food, clothing, proper housing, education etc. Such expenses imply that their pensions are not put to their intended uses. Due to their advanced age they find it increasingly difficult to earn income to support young children. Until now the South African government has done little to support older women who find themselves in such precarious circumstances and to recognise their invaluable contributions. Various recommendations are made in the report to improve this situation. / AFRIKAANSE OPSOMMING: Baie min aandag is tot dusver nog in Suid-Afrika geskenk aan die omstandighede waar grootmoeders hulself bevind in die posisie van surrogaat ouer vir hul kleinkinders en ander kwesbare kinders wat haweloos gelaat is as gevolg van die HIVNigs epidemie. Hierdie vroue wat ondersteuning dringend nodig het, is nie regstreeks in berekening gebring by die verskeie Vigs beleide en ander versorginstrategiee en maatreels nie, al speel hulle 'n beslissende rol as surrogaat ouers vir hulle kleinkinders. Dit is duidelik dat bejaarde vroue 'n waardevolle hulpbron is en 'n onskatbare en onmisbare rol speel by die versorging van sowel Vigs Iyers as kinders wat weens Vigs ouerloos is. Grootmoeders wat hierdie versorgingsrolle aanvaar, ontvang geen spesifieke en doelgerigte ondersteuning van regeringstrukture nie. Instede daarvan trek hulle net voordeel uit wetgewing binne die jurisdiksie van Department van Openbare Welsyn en die programme wat daaruit mag voortvloei. Hierdie studie het vas gestel hoe die bestaande open bare en welsynsbeleide aangepas kan word om die lewenskwalitiet van swart vroulike pensioenarise wat vir hul ouerlose kleinkinders en ander kwesbare kinders sorg, te verbeter. Beleidmakers moet besef dat grootmoeders toenemend verplig word om om te sien na die versorging van hul eie sterwende volwasse kinders en mettertyd die versoging van dieselfde gestorwenes se kinders wat wees agtergelaat word. Hierdie toedrag van sake ontvou in 'n stadium wanneer hierdie vroue se eie fisiese krag en kognitiewe vaardighede waarskynlik reeds aan die afneem is. Instede daarvan dat hierdie vroue die staatspensioen gebruik om hul oudag te geniet en om te sien na hulle eie gesondheid, behoorlike behuising edm., is swart vroulike pensioenarisse verplig om hierdie beperkte fondse aan te wend vir die versorging, voeding, behuising en onderrig van hul ouerlose kleinkinders en ander kwesbare kinders. Sulke onkostes impliseer dat hul pensioen nie aangewend word vir die doel waarvoor dit ingestel is nie. Weens hul hoe ouderdom is dit vir hierdie vroue al hoe moeiliker om 'n inkomste te genereer om vir jong kinders te sorgo Tot nog toe het die Suid-Afrikaanse regering weinig gedoen om ouer vroue wat hulself in hierdie benarde omstandighede bevind, te ondersteun of om hul onskatbare bydrae te erken. Verskeie voorstelle word in hierdie verslag gemaak om die situasie te verbeter.

Thesis (MPhil) -- Stellenbosch University, 2001. / ENGLISH ABSTRACT: Legislation encourages local government! municipalitiesl local authorities in South Africa, to fulfil a development role. One of the main objectives of municipalities performing a development role is to empower communities, especially previously disadvantaged communities. This study argues that the services delivered by municipalities are an essential component of a development orientation. In view of this fact, the study proposes an operational framework, whereby community empowerment can be achieved through municipal service delivery. The operational framework suggest that for community empowerment to be achieved through municipal service delivery, requires that the empowerment enabler (municipalities or departments within municipalities) should assure that: disadvantaged communities have access to services, services must be delivered in a non-discriminatory manner, the community should understand the rationale as to why the service is delivered, opportunity should be given for community participation in the delivery process, there should be a constant information channel between the giver (enabler) and receiver of services, and human resources from the local community should be utilised where possible in the delivery process. Lastly, a descriptive evaluation is undertaken of the health department's approach (at the Stellenbosch Municipality) to the delivery of primary healthcare services and service infrastructure. The purpose of the evaluation is to ascertain whether the principles as proposed in the operational framework are present in the health department's approach to service delivery. The evaluation reveals that most of the proposed principles of the operational framework features in the health department's approach to the delivery of primary healthcare services and services infrastructure. Thereby, concluding that the health department follows to a certain extent an approach to service delivery that could ultimately lead to community empowerment. / AFRIKAANSE OPSOMMING: Wetgewing vereis dat plaaslike regering/ plaaslike owerhede/ munisipaliteite in Suid-Afrika, 'n ontwikkelingsrol moet vervul. Een van die doelstellings van 'n ontwikkelingsrol vir munisipaliteite, is om gemeenskappe te bemagtig, spesifiek gemik op agtergeblewe gemeenskappe. Hierdie studie argumenteer dat die dienste gelewer deur munisipaliteite 'n essensiële komponent vorm van 'n ontwikkelings-orientasie. Gevolglik, stel hierdie studie 'n operasionele raamwerk voor, waarvolgens gemeenskapsbemagtiging bewerkstellig kan word deur middel van munisipale dienslewering. Die operasionele raamwerk stel voor dat om gemeenskapsbemagting deur dienslewering te bewerkstellig, vereis dat die bemagtiger (munisipaliteite of departemente binne munisipaliteite) moet toesien dat: agtergeblewe gemeenskappe toegang het tot diente, dienste moet gelewer word op 'n niediskriminerende wyse, die gemeenskap moet verstaan waarom die diens gelewer word, geleentheid moet geskep word vir gemeenskapsdeelname aan die diensleweringsproses, 'n kommunikasie kanaal tussen die ontvanger en leweraar (bemagtiger) van dienste, moet geskep word en laastens moet daar van plaaslike arbeid (waar moontlik), in die diensleweringsproses gebruik word. Laastens word 'n beskrywende evaluering onderneem na die Gesondheidsdepartement (by die Stellenbosch Munisipaliteit) se benadering tot die lewering van primêre gesondheidssorgdienste asook diens infrastruktuur. Die doel van die evaluering is om te bepaal of enige van die faktore, soos beskryf in die operasionele raamwerk, teenwoordig is in die gesondheidsdepartement se benadering tot dienslewering. Die resultate van die ondersoek toon aan dat die meeste van die faktore, soos voorgestel in die operasionele raamwerk, wel teenwoordig is in die gesondheidsdepartement se benadering tot dienslewering. Gevolglik kan daar afgelei word dat die gesondheidsdepartement wel tot 'n mate, 'n benadering tot dienslewering volg, wat kan lei tot gemeenskapsbemagtiging.

Thesis (PhD)--Stellenbosch University, 2015. / ENGLISH ABSTRACT: This study is a pastoral care strategy for the affirmation of the dignity of the poor Black older persons. In this study there is a discussion of how the poor Black older persons suffered the defacement of their dignity under Apartheid and how to a large extent their dignity is still being defaced under the new democratic dispensation in South Africa. These poor Black older persons are victims of various forms of older person abuse. They experience the prejudice of ageism intensely as it is exacerbated by racism; and with no appropriate medical and health strategies in place to provide quality health care; and with inappropriate housing, social services, and residential care services, their dignity is denied. Due to past discriminatory laws and policies these vulnerable older persons suffer the consequences of low levels of formal education within an environment of engineered poverty and racial discrimination which made it impossible for them to enter into quality employment which would enable them to provide adequately for old age. The deprivation thus experienced made it difficult for them to flourish economically and otherwise. At present they are still marginalised and they experience intense forms of loneliness. These poor Black older persons continue to suffer humiliation and indignity in spite of legislation and policies purporting to ensure their well-being. Within a society embracing a neo-liberalist philosophy they are considered unimportant as they do not contribute productively to the economic well-being of the community and are therefore relegated to the lowest ranks of society. With the effacement of their dignity through socially constructed systems their human development is seriously hampered, resulting in a disintegration of human wholeness. The inequality that the poor Black older persons suffer is an indictment against humanity as these older persons have the right to feel at home on the planet. Due to the fact that they are not recognised as having been created in the image and likeness of God, their uniqueness and distinctness as human beings are denied, their identities distorted, and they are not considered worthy citizens. In order to affirm the dignity of the poor Black older persons a practical theological methodology as proposed by Osmer (2008) and consisting of four tasks, has been employed. The notion of a moral economy for the affirmation of the dignity of these poor Black older persons has been utilised. With the moral economy orientation linked with a Liberation Theology methodology the dignity of the poor Black older persons is affirmed as a personal attribute based on the older persons being a category of people being carried into old age by God, enjoying privileged positions of honour and respect, and being eschatological signs and symbols of God’s goodwill towards restored communities in Christ. Within a moral economy the values of reciprocity, responsibility, and interdependence are used to affirm the dignity of these older persons intergenerationally and contextually. / AFRIKAANSE OPSOMMING: Hierdie studie is ʼn pastorale sorg strategie vir die bevestiging van die menswaardigheid van die arm Swart ouer persone. In hierdie studie word daar aangedui hoe die arm Swart ouer persone se menswaardigheid onder Apartheid en in ‘n groot mate in die nuwe demokratiese dispensasie geskend is. Die arm Swart ouer persone het die slagoffers geword van verskeie vorms van misbruik. Die diskriminasie teen ouderdom word intensief deur hulle ervaar soos dit vererger word deur rassisme; en met geen behoorlike mediese en gesondheidstrategieë in plek om in die behoefte van hierdie kwesbare ouer persone te voorsien nie; en met gebrekkige behuising, sosiale dienste en onvoldoende plekke van sorg vir ouer mense, is die menswaardigheid van hierdie ouer mense erg misken. Weens historiese diskriminerende wette en regeringbeleid ly hierdie kwesbare ouer persone die gevolge van lae vlakke van formele opvoeding binne ‘n omgewing waar armoede kunsmatig geskep is en waar rassediskriminasie geheers het. Hierdie omstandighede het dit vir hulle onmoontlik gemaak om kwaliteit werk te kry wat hulle in staat sou stel om toepaslik vir die ouderdom voor te berei. Die ontberinge wat gevolglik gely word, maak hulle ekonomiese en andersydse ontwikkeling onmoontlik. Hulle is gemarginaliseerd en ly aan intense eensaamheid. Hierdie arm Swart ouer persone gaan voort om vernedering en onmenswaardighede te ly ongeag van wetgewing en beleidstukke bedoel vir hul welsyn. Binne die gemeenskap wat ‘n neoliberalisties filosofie aanvaar, word hierdie ouer mense misken omdat hulle nie produktief tot die ekonomiese welvaart van die gemeenskap bydra nie, en daarom word hulle beskou as sonder enige sosiale kapitaal wat hulle dan sosio-ekonomies op die laagste vlak van die gemeenskap sonder enige erkenning van hulle menswaarde en menswaardigheid plaas. Met die skending van hul menswaardigheid deur sosiaal gekonstrueerde sisteme word hul menslike opbloei ernstig gestrem wat lei tot die disintegrasie van menslike heelheid binne die demokratiese bestel van die Republiek van Suid- Afrika. Die ongelykheid wat die arm Swart ouer mense ly is ‘n klag teen die mensdom omdat hierdie ouer mense ontuis voel op die planeet. Hierdie groep is na die beeld van God geskape, maar hulle uniekheid en besondersheid word miskien. Om die menswaardigheid van hierdie arm Swart ouer mense na te gaan, is ’n praktiese teologiese metodologie gebruik soos voorgestel deur Osmer (2008) en word die vier teologiese take soos deur hierdie metodologie voorgestel, gevolg. Betreffende die vierde taak van hierdie metodologie is die konsep van ’n morele ekonomie gebruik vir die bevestiging van die menswaardigheid van die arm Swart ouer persone. Met die skakel van hierdie morele ekonomiese oriёntering met die Bevrydingsteologiese metodologie is die menswaardigheid van die arm Swart ouer persone bevestig as ’n persoonlike eienskap gebaseer of die feit dat hulle ’n kategorie van mense is wat deur God in die ouderdom gedra word, wat dan bevoorregte posisies van eer en respek geniet as eskatologiese tekens en simbole van God se toegeneëntheid teenoor herstelde gemeenskappe in Christus. Binne ’n morele ekonomie word die waardes van wedersydsheid, verantwoordelikheid, en interafhanklikheid gebruik om die menswaardigheid van hierdie ouer mense intergenerasioneel en kontekstueel te bevestig.

Thesis (MA)--University of Stellenbosch, 2002. / ENGLISH ABSTRACT: The aim of this pilot study was to do a needs analysis with a selected group of nurses with regard to the following three aspects: nurses' experiences of their involvement in termination of pregnancy (TOP) services, the effects of their involvement in TOP service provision on a personal, familial and career level, as well as their needs with regard to support. An important aspect of the needs analysis was to develop a questionnaire which can be used as basis for future research purposes. A qualitative, explorative, descriptive and contextual research design was applied in order to conduct this study. Participants were recruited from a health care facility in the Western Cape, v~ and the small sample group (seven out of a possible fifteen) consisted of a selected group of nurses who are currently involved in performing TOPs, as well as nurses involved in pre- and/or post-procedure care of patients. Each participant completed a self-administered biographical dataand semi-structured questionnaire, which was compiled specifically for the purpose of the pilot study. Specific guidelines according to previous research findings were incorporated. The results of the pilot study revealed that most of the participants experience some sort of cognitive, emotional and/or behavioural reaction before, during and after TOP procedures are performed. -Feelings of anxiety, sadness, anger, depression and guilt were reported in some cases, as well as moral-ethical conflicts. With regard to the effect on a personal, familial and career level, it was confirmed that the work has an effect on the majority of respondents' personal life and career to a certain extent, although family life did not seem te be affected significantly. The results conveyed that the majority of the nurses experienced that the impact of their work with TOPs seemed to be different from that of their other nursing duties. It was found that participating nurses are in need of some sort of support service, and that the practicality of the services which are currently provided, should be investigated further. Although the ability to generalise the results, was limited by the small research sample, valuable information was gained with regard to nurses' needs for support, as confirmed by other South African research findings. Suggestions for improvements in the questionnaire, as well as other further research possibilities, are provided. / AFRIKAANSE OPSOMMING: Die doel van hierdie loodsstudie was om 'n behoeftebepaling te doen met 'n geselekteerde groep verpleegpersoneel met betrekking tot die volgende drie aspekte: verpleegpersoneel se ervaring van hul betrokkenheid by terminasie van swangerskap (TOP) dienste, die effek van hul betrokkenheid by TOP diensvoorsiening op 'n persoonlike, gesins- en beroepsvlak, sowel as hul behoeftes met betrekking tot ondersteuning. 'n Belangrike aspek van die behoeftebepaling was om 'n vraelys saam te stel wat as basis vir toekomstige navorsingsdoeleindes sou kon dien. 'n Kwalitatiewe, eksploratiewe, beskrywende en kontekstuele navorsingsontwerp is toegepas ten einde hierdie loodsstudie uit te voer. Deelnemers is gewerf by 'n gesondheidsorgfasiliteit in die Wes-Kaap en die klein steekproef (sewe uit 'n moontlike vyftien) het bestaan uit 'n geselekteerde groep verpleegpersoneel wat tans betrokke is by die uitvoering van terminasie van swangerskappe, sowel as verpleegsters wat betrokke is in pre- en/of post-prosedurele versorging van pasiente. Elke respondent het 'n selfgeadministreerde biografiese en semi-gestrulctureerde vraelys voltooi, wat spesifiek vir die doel van die loodsstudie saamgestel is. Spesifieke riglyne op grond van vorige navorsingsbevindinge is geinkorporeer. Die resultate van die loodsstudie het aan die lig gebring dat die meeste van die respondente een of ander kognitiewe, emosionele en/of gedragsreaksie ervaar voor, tydens en na die uitvoering van TOP prosedures. Gevoelens van angs, hartseer, woede, depressie en skuld is gerapporteer in sornmige gevalle, sowel as moreel-etiese konflikte. Wat betref die effek op 'n persoonlike, gesins- en beroepsvlak, is dit ook bevestig dat die werk 'n effek blyk te he op respondente se persoonlike en beroepslewe tot 'n sekere mate, alhoewel dit geblyk het dat gesinslewe nie beduidend bemvloed word nie. Dit het ook uit die resultate van die studie geblyk dat die meerderheid van verpleegsters die impak van hul werk met TOP as anders as die van hul ander verplegingstake ervaar. Daar is bevind dat deelnemende verpleegpersoneel 'n behoefte het aan een of ander tipe ondersteuningsdiens en dat die praktiese aspekte van die dienste wat tans voorsien word, verder ondersoek behoort te word. Alhoewel die veralgemeenbaarheid van die resultate deur die klein steekproef beperk word, is waardevolle inligting bekom met betrekking tot verpleegpersoneel se behoeftes aan ondersteuning, soos bevestig deur ander Suid-Afrikaanse navorsingsbevindinge. Aanbevelings vir verbeteringe aan die vraelys, sowel as verdere navorsingsmoontlikhede word gemaak.

Thesis (MA)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: The topic of perinatal depression (i.e. depression during and after pregnancy) remains a subject of continued research interest, as a broad literature body reports that a large proportion of women suffering from this mental disorder do not receive appropriate treatment. This is worrisome, firstly, because mental health treatment is often readily available to the public and at no cost. Secondly, untreated perinatal depression not only holds dangerous consequences for the mother but also for the infant and the rest of the family. It is therefore important to identify those factors that act as barriers to mental health care utilization for perinatal depression. Although this is a persistent problem within the South African context, to date, little is known about the barriers to the utilization of available mental health services experienced among pregnant South African women. For this reason, the Perinatal Mental Health Project (PMHP) aims to provide mental health services at the same location where women receive obstetric services. However, despite their efforts, the number of women who decline available treatment is still of great concern. The present study offers a unique perspective on counselling for perinatal depression appointment-keeping barriers as it provides a holistic view of these barriers that exist not only within the women but also in their multi-levelled environments. Secondly, it addresses the problem of nonattendance to mental health care treatment offered by the PMHP and consequently also addresses the gap in South African research on the topic. The sample for this study was selected from PMHP files of those patients who failed to attend scheduled counselling appointments. The participants included in this study were selected by means of purposeful sampling to participate in face-to-face and telephonic semi-structured interviews. Participants were assured of confidentiality and anonymity. The semi-structured interviews were audio-recorded and transcribed after which transcriptions were entered into MS Word for textual analysis. Transcriptions were thematically analysed. The main themes that emerged from the present study included individual-related barriers, social-related barriers, institution-related barriers, community-related barriers and poverty-related barriers. The results of the present study reflect the motivations for depressive pregnant women to decline available and free mental health services provided by the PMHP, according to five main themes. These themes were then discussed according to Bronfenbrenner’s (1977; 1979) Ecological Systems Theory, which categorised the main themes identified according to the different systems operating within the patient’s environment, i.e. the individual-, micro-, meso-, exo-, and macrosystem. The individual system comprised the individual-related barriers, which included poor mental health, and ambivalent feelings toward the pregnancy. The microsystem comprised the social-related barriers, which included low social support and self-help strategies. Community-related barriers were considered within the mesosystem of the patient’s ecological environment, with stigma and pity as sub-barrier. The exosystem comprised the institution-related barriers, including referral protocol barriers, lack of information provided by the nurses, and nurses’ attitudes as experienced by participants. Lastly, poverty-related barriers were considered within the macrosystem, with financial life hardship, constant child-care demands, and transportation barriers as sub-barriers. The significance of this study lies in the original perspective offered on mental health care appointment-keeping behaviour within the South African context. Future research could, in addition to conducting interviews with hospital patients, include health care professionals and focus groups as this will allow for triangulation of the perspectives of all significant players. Also, having identified the problems and concerns with regards to attending counselling appointments, future research direction may be aimed at creating interventions designed to reduce the identified barriers to mental health care service use. / AFRIKAANSE OPSOMMING: Perinatale depressie (d.w.s. depressie voor en na swangerskap) bly ʼn onderwerp van voortdurende navorsings belang, aangesien ʼn breë navorsingsveld aandui dat ʼn groot proporsie van vroue wat aan hierdie geestesversteuring lei, nie die gepaste behandeling ontvang nie. Dit is kommerwekkend, eerstens, aangesien behandeling vir geestesgesondheid meestal openlik verkrygbaar is aan almal sonder enige koste. Tweedens, onbehandelde perinatale depressie hou nie slegs gevaarlike gevolge vir die moeder in nie, maar ook vir die baba en die res van die gesin. Dit is daarom belangrik om daardie faktore te identifiseer wat as hindernisse optree tot geestesgesondheid sorg diensgebruik vir perinatale depressie. Alhoewel dit ʼn voortdurende probleem binne die Suid-Afrikaanse konteks is, is daar tot op hede geen navorsing wat hindernisse tot gebruik van beskikbare geestesgesondheidsdienste bekend gemaak nie, veral wat ervaar word onder swanger Suid-Afrikaanse vroue nie. Vir hierdie rede, beoog die Perinatal Geestesgesondheid Projek (Perinatal Mental Health Project - PMHP) om geestesgesondheidsdienste te lewer by dieselfde plek waar vroue verloskundige dienste kan ontvang. Nietemin, ten spyte van hul pogings, is die getal vroue wat beskikbare behandeling van die hand wys steeds van groot kommer. Dié studie bied ʼn unieke perspektief op hindernisse tot berading vir perinatale depressie afspraak-ooreenkoms gedrag, aangesien dit ʼn algehele uitkyk bied op hindernisse wat nie slegs binne die vroue bestaan nie, maar ook in hul veelvlakkige omgewings bestaan. Tweedens, spreek dit die probleem van nie-bywoning van geestesgesondheidsbehandelingsdienste wat aangebied word deur die PMHP aan en gevolglik ook die gaping wat binne Suid-Afrikaanse navorsing rakende dié onderwerp bestaan. Die steekproef vir die studie was gekies van PMHP lêers van daardie pasiënte wat nie hul geskeduleerde terapie afsprake bygewoon het nie. Die deelnemers ingesluit in die studie is deur middel van doelgerigte-steekproefneming geselekteer om aan aangesig-tot-aangesig of telefoniese semi-gestruktureerde onderhoude deel te neem. Deelnemers is van hul vertroulikheid en anonimiteit van die proses verseker. Die semi-gestruktureerde onderhoude was oudio-opgeneem en transkripsies is daarvan gemaak, waarna die transkripsies in MS Word gelaai is vir tekstuele analise. Transkripsies is tematies geanaliseer. Die hooftemas wat na vore gekom het, sluit in individuele-verwante hindernisse, sosiale-verwante hindernisse, institusie-verwante hindernisse, gemeenskapsverwante hindernisse en armoede-verwante hindernisse. Resultate van dié studie reflekteer die motiverings van depressiewe swanger vroue om beskikbare en gratis geestesgesondheidsdienste wat verskaf is deur die PMHP van die hand te wys, volgens die vyf hooftemas. Hierdie temas is toe volgens Bronfenbrenner (1972) se Ekologiese Sisteemteorie verdeel in die verskillende sisteme teenwoording in die pasiënt se omgewing, naamlik die individuele-, mikro-, meso-, ekso-, en makrosisteem. Die individuele sisteem het die individuele-verwante hindernisse ingesluit, wat swak geestesgesondheid, en teenstrydige gevoelens teenoor die swangerskap omvat het. Die mikrosisteem het die sosiale-verwante hindernisse ingesluit, wat swak sosiale ondersteuning, en self-help strategieë omvat het. Gemeenskapsverwante hindernisse is binne die mesosisteem van die pasiënt se ekologiese omgewing beskou, en het stigma en jammerte as sub-hindernisse ingesluit. Die eksosisteem het die institusie-verwante hindernisse ingesluit, wat verwysing protokol hindernisse, gebrek aan inligting verskaf deur die verpleegsters, en verpleegsters se houdings soos ervaar deur die deelnemers omvat het. Laastens is die armoede-verwante hindernisse binne die makrosisteem beskou, en het finansiële lewens swaarkry, konstante kindersorg eise, en vervoer-verwante struikelblokke as sub-hindernisse ingesluit het. Die belang van dié studie lê in die oorspronklike perspektief van geestesgesondheidsbehandeling dienste afspraak-ooreenkoms gedrag binne die Suid-Afrikaanse konteks, wat aangebied is. Toekomstige navorsing kan, bykomend tot die voer van onderhoude met hospitaal pasiënte, fokus daarop om gesondheidsorg kenners en fokus groepe in te sluit, aangesien dit die triangulasie van perspektiewe moontlik maak van al die belangrike rolspelers. Ook, aangesien die probleem en bekommernisse rakende bywoning van terapie afsprake reeds geïdentifiseer is, mag toekomstige navorsing in die rigting beweeg met die doel om intervensies te omskep wat beoog om die geïdentifiseerde hindernisse tot geestesgesondheidsorg diensgebruik te verminder.

Thesis (MPA (School of Public Management and Planning))--University of Stellenbosch, 2009. / This study examines the key success factors in the Public Private Partnerships (PPP) field in the Healthcare Sector in South Africa. It gives health departments insight into the factors which should be considered when using PPP procurement and when looking at possible PPP opportunities. The development of PPP’s around the world has urged governments to look at alternative service delivery methods because of increased pressures on government budgets. Public Private Partnerships presents governments with a means of generating private funds for health service delivery whilst government manages the relationship via a negotiated PPP agreement to monitor the quality of services rendered. Different PPP models are applied all over the world depending on the specific needs of countries. Different factors impact on the success of these partnerships and it is essential that government share knowledge and best practices. The study showed that in order for PPP’s to be successful the public institution must do its homework thoroughly and that the legal framework should be conducive for private sector involvement in service delivery. The study showed that the government of a country plays a pivotal role in the PPP process by giving the necessary political support to ensure the trust of foreign investors. The legislative framework is a critical factor in the advancement of PPP procurement and the allocation of risk as an important consideration when pursuing this type of procurement. The study examined three concluded PPP Health Sector agreements in South Africa and looked at lessons learnt, mistakes which were made and what should be avoided in the future. The three PPP’s in South Africa in this study were the first though there are other health sector PPP agreements concluded. The other PPP’s are still in the commencement stage and it is too early to make an assessment at this stage. However, the three case studies conducted give departments a clear picture of the process, the lessons learnt and the impediments in the PPP process. The uniqueness of the South African Health sector also prompted the Government to look at a model which will be best suited to the local market. Best practices from other countries provide useful information and lessons learnt from other countries are also important in a developing PPP environment.

Thesis (M Social Work (Social Work))--University of Stellenbosch, 2009. / AFRIKAANSE OPSOMMING: „n Beskrywende studie met „n verkennende inslag is in die studie gebruik om meer kennis en begrip oor die bydrae van maatskaplike werkers tot die aanpassing van „n pleegkind in middelkinderjare in „n pleegsorgplasing, te verkry. Die navorser het bewus geraak van die toename in die gebruik van pleegsorg vir „n sorgbehoewende kind in middelkinderjare, sowel as die tekort aan literatuur in Suid-Afrika oor die bydrae wat die maatskaplike werker lewer tot sodanige aanpassing binne „n pleegsorgplasing. Die genoemde aspekte het gedien as motivering vir die studie. Die bydrae wat maatskaplike werkers het tot die aanpassing van „n pleegkind in middelkinderjare in „n pleegsorgplasing is ondersoek. Die doel van die studie is om ʼn beter begrip te ontwikkel vir die bydrae wat maatskaplike werkers tydens pleegsorgplasing tot die aanpassing van ʼn middeljare pleegkind kan maak. Die literatuurstudie het die aard van pleegsorg ten opsigte van die pleegkind in middelkinderjare weergegee, waarna pleegsorg as „n proses beskryf is: van voorkomende dienste tot permanensieplasing. Spesifieke aandag is gegee aan die pleegkind in middelkinderjare se ontwikkelingsproses asook die bydrae wat die maatskaplike werker maak tot die aanpassing van die pleegkind in middelkinderjare in „n pleegsorgplasing. Aangesien die literatuur meestal konsentreer op die maatskaplike werker betrokke by „n pleegsorgplasing van „n pleegkind in middelkinderjare, het die steekproef bestaan uit 22 maatskaplike werkers wat by twee nie-regeringsinstansies in die Wes-Kaap en Suid-Kaap werksaam is. Die deelnemers is ten minste „n jaar reeds as geregistreerde maatskaplike werkers werksaam en het ook ondervinding in pleegsorgplasings. In die studie is daar gebuik gemaak van die kombinasie van ‟n kwalitatiewe en kwantitatiewe navorsingsbenadering, te wete „n geskeduleerde, semi-gestruktureerde vraelys wat beide oop en geslote vrae inhou wat uiteengesit is op inligting wat verkry is uit die literatuurstudie. Die ondersoek het „n bygedra gelewer tot die uitbreiding van kennis en inligting in die maatskaplikewerkpraktyk ten opsigte van die bydrae wat maatksaplike werkers lewer tot die aanpassing van „n pleegkind in middelkinderjare binne „n pleegsorgplasing. Die resultate het grotendeels die literatuurstudie bevestig, te wete dat maatskaplike werkers „n breë spektrum van dienslewering tydens die pleegsorgproses implementer, asook die ouderdom en ontwikkelingsvlak van „n pleegkind in ag neem tydens „n pleegsorgplasing. Eersgenoemde dienste word gerig tot die pleegouers, biologiese ouers, asook die betrokke pleegkinders ten einde dienslewering in die verband te bevorder. Maatskaplike werkers se aandeel in die aanpassingsproses van „n pleegkind in middelkinderjare blyk wisselend te wees. Beperkte tyd en „n groot werkslading verhoed maatskaplike werkers om op „n kontinue basis ondersteuning vir die aanpassing van „n pleegkind in middelkinderjare, sowel as vir die pleegouers in „n pleegsorgplasing te bied. In die aanbevelings is daar gefokus op drie areas insluitende, die bydrae van „n maatskaplike werker, pleegkinders en pleegsouers. Die behoefte aan meer opleiding in die gebied van pleegsorg en ondersteuning in „n pleegsorgplasing, aan maatskaplike werkers, pleegouers en pleegkinders is geïdentifiseer as die sentrale temas. As aanbeveling vir verdere navorsing kan gefokus word op verskeie faktore wat bydraend is tot onsuksesvolle aanpassing binne „n pleesorgplasing met die oog op „n in-diepte beskrywing van hierdie fenomeen, asook die daarstelling van riglyne aan die hand waarvan die aanpassingsproses van pleegkinders en pleegouers tot groter effektiwiteit bevorder kan word. Dit beteken ook dat die rol van die maatskaplike werker met betrekking tot die tersaaklike onderwerp aangepas kan word ten einde sodanige aanpassing meer effektief aan te spreek. / ENGLISH ABSTRACT: A descriptive study with an exploratory design has been used in order to obtain more information and insight on the contribution that social workers make with regards to foster children in their mid-childhood years‟ adjustment within foster care placements. The researcher became aware of the increase in the use of foster care for vulnerable children in their mid-childhood years, as well as the shortage of literature in South Africa with regards to the contribution that social workers make towards these children adjusting to a foster care placement. The abovementioned aspects lead to the motivation for this study. The contribution that social workers make towards foster children in their mid-childhood years‟ adjustment within foster care placement was studied. The aim of this study is to gain insight into the contribution that social workers make towards foster children in mid-childhood years, adjusting within foster care placements. The literature study gave a description of the nature of foster care with regards to a foster child in his/her mid-childhood years. Foster care was described as a process: from preventative services to permanency placement. Specific attention was given to the foster child in mid-childhood years‟ development process as well as the contribution that social workers make towards a foster child in mid-childhood years‟ adjustment within a foster care placement. As the literature focused mainly on the social worker‟s contribution to the foster child in mid-childhood years‟ adjustment within a foster care placement, the sample consisted of twenty-two social workers working at two non-government organisations in the Western- and Southern- Cape regions. The participants have been registered as social work practitioners for at least one year and have had at least one year of experience in the process of foster care. A combination of both a qualitative and quantitative research methodology design was used in this study that consisted of a scheduled, semi-structured questionnaire which held both open- and closed ended questions. These questions were based on information retrieved from the literature study. The study made a contribution to the expansion of insight and knowledge in the social work practice with regards to the social workers‟ contribution to foster children in mid-childhood year‟s adjustment within foster care. The results of the literature study relatively confirmed the results of the study with regards to social workers‟ broad scale of service delivery during a foster care placement, as well as the consideration for the age and developmental phase of a foster child during the process of a foster care placement. First mentioned services are focused on the foster parents, biological parents as well as the foster children in order to enhance service delivery. Social workers‟ contribution to the adjustment of a foster child in mid-childhood years within a foster care placement seems to vary. Limited time and work overload prevent social workers to continuously support foster children in mid-childhood years as well as their foster parents. The recommendations focused on three areas including the contribution of a social worker, foster children and foster parents. The need for more training in the field of- and support in the area of foster care with regards to social workers, foster parents and foster children was identified as the fundamental themes. It is recommended that future research should focus on several contributing factors to ineffective adjustment within foster care placements with the aim of in-depth description of this phenomenon. Furthermore, the creation of guidelines concerning the enhancement of the adjustment process of foster children and foster parents that will lead to successful foster care placement is also recommended. This means that the role of the social worker with regards to the subject matter should adapt accordingly in order to enhance the adjustment within foster care placements.

Thesis (M Social WOrk (Social Work)--University of Stellenbosch, 2007. / This research provides an overview of foster care and investigates the support and training of foster parents as well as the issues foster parents need to manage on a regular basis. The basic premise for this research is the importance of social workers becoming aware of the issues foster parents manage on a regular basis as well as the support and training needs of foster parents. It is important for foster parents to receive support as well as social workers and family care organisations to develop and implement appropriate training programmes for foster parents on an ongoing basis. Fostering affects and requires the involvement of the entire foster family as well as relevant role players and professionals. It is therefore necessary to consider the foster parents and foster family as part of the larger fostering arena, and not to be supported and trained in isolation. The nature of the foster placement will inevitably influence the development of the foster child, meeting the needs of the foster child as well as the effect that the placement has on the foster family. The purpose of this research is to broaden the theoretical knowledge of professionals working with foster parents, and specifically social workers and family care organisations, in identifying foster parent’s training and support needs. This research report includes an investigation of the issues foster parents and foster families manage on a regular basis as well as the nature of and benefits of support and training for foster parents. Knowledge of these issues foster parents manage while fostering will increase the awareness and the ability of the social worker or other professionals to provide training and support to the relevant foster parents.

Thesis (M Social Work (Social Work))--University of Stellenbosch, 2006. / An exploratory study with a descriptive design has been used in order to get more information and insight about the tendency of grandmothers as kinship caregiver (family foster parent) for their grandchildren. The researcher became aware of the increase in the use of the grandmother as a kinship caregiver, as well as the shortage of literature in South Africa. The abovementioned aspects lead to the motivation for the study. The experience of the grandmother in Kayamandi as kinship caregiver was studied. The aim of the study is to provide guidelines to social workers for service rendering to grandmothers as kinship caregivers. The literature study gave a historical overview of foster care and kinship care in both the United States of America (USA) and South Africa. Foster care was described as a process: from preventative services to permanency planning. Specific attention was given to the grandmother as kinship caregiver. As the literature in the USA focused on the Afro-American, it was decided to do the study in Kayamandi, where the grandmother as kinship caregiver is mostly isiXhosa-speaking. The sample consists out of 15 grandparents who are either Afrikaans or English speaking. The mixed methodology design model was used by mixing qualitative as well as quantitative research: structured interviews based on structured questionnaires. The study enabled the researcher to draw up a profile of the grandmother as kinship caregiver as well as the family foster child in Kayamandi. The results of the literature confirmed the results of the study; the experience of the grandmother as kinship caregiver is marked with mixed feelings, but is overall a positive experience. The recommendations focused on three areas; the grandmother, the grandchild and the experience of the grandmother as kinship caregiver. The central theme for both grandmother and grandchild was the need for support. It is recommended that future research focus on the development of support programs aimed specifically at grandparents as kinship caregivers.

Thesis (MSocialWork)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: According to the South African Constitution, every child has the right to parental care, family care or an approriate form of alternative care. In 2005 in South Africa over 3.4 million orphans did not have access to this right. This was as a result of a shortage of alternative care options. The motivation for this study emerged because foster care is the first placement option for family-based care in South Africa. However there is still a gap in South African literature on the recruitment of foster parents, especially the recruitment of non-relative foster parents and foster parents for cluster foster care homes. Without the knowledge of how to recruit and train foster parents effectively, many children in need of care would stay void of their constitutional rights in this regard. To explore the methods of recruitment, selection and training of foster parents, a combination of quantitative and qualitative research approaches were utilised. Together with that approach an exploratory design, was used. This was done to explore the research topic in literature and examine the views of social workers on the recruitment, selection and training of foster parents. In the literature study the nature and structure of foster care was examined in the context of the South African legislation, followed by an outline of the criteria of children in need of care according to the Children's Act (38/2005). The different phases of the foster care process were discussed according to the tasks and responsibilities of the social worker during this process. Then the different methods of recruitment, selection and training of foster parents were discussed individually on the basis of national and international literature. The exploratory research design was used for the purpose of the empirical study to investigate and analyse the views of social workers regarding the recruitment, selection and training of foster parents. Finally conclusions and recommendations were made based on the findings of the empirical study in order to recommend ways for social workers to be more effective in recruitment, selection and training of foster parents for the large number of children in need of alternative care. / AFRIKAANSE OPSOMMING: Elke kind in Suid-Afrika het die reg volgens die Grondwet (1996:1255) tot ouerlike sorg, familiesorg, of andersins tot gepaste alternatiewe sorg. In 2005 het 3.4 miljoen weeskinders in Suid-Afrika nie toegang gehad tot hierdie reg nie, as gevolg van `n tekort aan alternatiewe sorg opsies. Die motivering vir hierdie studie is omdat pleegsorg die eerste plasingsopsie as gesinsgebaseerde-sorg in Suid-Afrika is terwyl daar ʼn leemte in Suid-Afrikaanse literatuur bestaan oor die werwing van pleegouers, spesifiek die werwing van nie-familie lede as pleegouers en pleegouers vir groep pleegsorg skemas. Indien nie genoeg pleegouers gewerf en opgelei word as versorgers van sorgbehoewende kinders nie, word die reg van ouerlike sorg steeds van vele sorgebehoewende kinders weerhou. Om metodes van werwing, keuring en opleiding van pleegouers te ondersoek is ʼn kombinasie van kwantitatiewe en kwalitatiewe navorsingsbenaderings gebruik, tesame met `n verkennende ontwerp om eers die navorsingskwessie in die literatuur te verken en dan te ondersoek wat die sienings van maatskaplike werkers is oor die werwing, keuring en opleiding van pleegouers. Eerstens word die aard en struktuur van pleegsorg in die konteks van die Suid-Afrikaanse wetgewing ondersoek, gepaardgaande met `n definieering van die kriteria van sorgbehoewendendheid van kinders volgens die Kinderwet (38/2005). Die verskillende fases van die pleegsorg proses is volgens die take en verantwoordelikhede van die maatskaplike werker bespreek. Tweedens is die verskillende metodes van werwing, keuring en opleiding van pleegouers afsonderlik bespreek aan die hand van nasionale en internasionale literatuur. Die verkennende navorsingsontwerp is vir die doel van die empiriese studie gebruik om die sienings van maatskaplike werkers oor die werwing, keuring en opleiding van pleegouers te ondersoek en te ontleed. Laastens word daar gevolgtrekkings en aanbevelings geformuleer wat gebaseer is op die bevindinge van die studie ten einde maatskaplike werkers te lei om meer effektief pleegouers te werf, keur en op te lei vir die groot aantal sorgbehoewende kinders wat volgens die Grondwet(1996:1255) die reg het op ouerlike sorg.