Dissertation submitted in partial compliance with the requirements for the Master's Degree of Technology: Nursing, Technikon Natal, 2002. / The Integrated Management of Childhood Illness (IMCI) is an approach that aims to reduce the mortality and morbidity in children under the age of five years. When this programme was initiated, the conditions targeted were acute respiratory infections, diarrhoea, fevers associated with malaria and measles and malnutrition. As a result of the HIV pandemic in South Africa, the identification of children who are symptomatic of HIV infection was included. This study evaluates the use of the HIV portion of the IMCI algorithm by nurses in selected, public sector, primary health clinics in KwaZulu Natal. IMCI nurses were observed as they used the IMCI approach while consulting with sick children. Data was collected in relation to the accuracy with which the nurses used the algorithm and the extent to which the HIV portion of the algorithm was used to guide their management decisions when consulting with the children. Seventy-two observations were undertaken. In-depth interview were conducted with 13 IMCI nurses to establish factors that influenced the use of the HIV portion of the algorithm. The study showed a poor level of accuracy when using the HIV portion of the algorithm. In addition, as a result of poor accuracy when using the algorithm to assess and classify for symptomatic HIV infection, it appeared that nurses were not using the HIV portion of the algorithm to guide management decisions regarding children who were possibly symptomatic of HIV infection. I A general poor level of knowledge about HIV infection was identified which the researcher felt could be one of the factors influencing the use of the HIV portion of the algorithm. Death anxiety, low level of counselling skills and burnout also seemed to play some role in the use of the HIV portion of the algorithm.Recommendations were made to adapt future training of IMCI nurses and include an HIV training course and a course on growth monitoring of children in this age group. Further recommendations to continually evaluate the practice of nurses were made. Future areas for research were suggested. / M

A Research Report submitted to the Faculty of Humanities, University of the Witwatersrand, Johannesburg, in partial fulfilment of the requirements of the Degree of Master of Arts, Applied Ethics for Professionals. Johannesburg, 2017 / Many asylum seekers and refugees in South Africa reportedly find it difficult to access basic health care services. The issue about foreign nationals in relation to health care can be considered from different angles. The concept of access, though, points to gate-keeping. Gate-keeping is the practice that guides decision making about who has access to what and to what extent they might enjoy benefits. In this essay, the question of whether gate-keeping is a morally justifiable practice in South Africa in relation to asylum seekers and refugees’ right to basic health care services is explored. It is concluded that carefully considered and consistently implemented gate-keeping might be a morally justifiable practice that could contribute to ensuring that resources are distributed fairly. It is also argued that the kind of gate-keeping often observed is inconsistent with human rights and Ubuntu precepts. These moral frameworks seem to be the main ones shaping the view of most South Africans as well as our institutional arrangements. Considering the current South African context in which asylum seekers and refugees have difficulty in accessing basic health care services, patriotic bias claims are considered. However, it is concluded that partiality towards compatriots ought not to hold sway when any human being’s basic needs are at stake. / MT2018

Thesis (M. A. (Social Work)) --University of Limpopo, 2017. / This study investigates experiences of parents of children living with physical and intellectual disabilities in South Africa’s Limpopo province. The study utilized a sample of 14 participants drawn using purposive sampling. An interview schedule with a set of questions was used to collect data. The results suggest that both positive and negative experiences are encountered by parents of children living with disabilities. Problems which children encounter on a daily basis have got also similar implications on their parents or guardians. This study has revealed that parents face many challenges ranging from personal, social, economic and financial. The study found out that it is actually more expensive, mental draining for parents of children living with disabilities to look after them. It emerged in the study that community negative attitudes on children with disabilities hinders their progress and results in social exclusion. The study also revealed that the majority of the parents believe that witchcraft had a hand in disabling their children. It also emerged that most of the parents of children living with disabilities hoped for a cure of the disabilities medically, traditionally and spiritually. However the study confirms that parents of children living with disabilities go through a cycle of denial fear, guilty, depression and acceptance after discovering that their child is disabled.

Thesis (Ph.D. (Nursing Science)) -- University of Limpopo, 2018 / Introduction: Health care workers have a pivotal role in the management of Human Immune Deficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) and their well-being is consequently crucial as it could impact negatively on the quality of caregiving. With the development of a care and support model, the needs of health care workers can be identified and catered for, and quality patient care will be rendered through well-cared and supported health care workers. Purpose: The purpose of this study was to develop a care and support model for health care providers of patients diagnosed with HIV and AIDS in the public hospitals of the Limpopo Province. A key step in the development of a model for care and support is to explore and describe the experiences of professional nurses regarding care and support they receive while providing care to HIV and AIDS patients in the public hospitals of Limpopo Province Methods: A qualitative, descriptive, exploratory and contextual design was the method used which guided the development of the model. The population of the study were the professional nurses in five public hospitals from each district of the Limpopo Province. These hospitals were selected because they all shared similar characteristics of having clinics where HIV and AIDS patients receive care. The sample was purposively selected. The sample size was 20 professional nurses which was determined by data saturation, meaning that four professional nurses who worked for 24 months or more per public hospital were selected. Data were collected through face-to-face interviews and an audiotape was used to record all unstructured interview sessions conducted. Analysis of data were done through using an open-coding method in accordance with Tech’s qualitative data methodology to develop a model. Results: The research findings revealed emotional and physical strain due to shortage of staff and heavy workload which was exacerbated by staff turnover and high absenteeism. Exhaustion, fatigue, development of work-related vi illnesses and increased level of stress were also challenges experienced which led to increased customer complaints and decreased quality of service provided to patients. Many professional nurses were not trained in the management of patients with HIV and AIDS, but were expected to execute their activities competently. There was also lack of counselling, debriefing sessions, recognition and rewarding systems for the health professionals who were taking care of those patients. Recommendations: This Care and Support Model provides strategies to be used by the managers in public hospitals of Limpopo Province to enhance care and support to health care providers of HIV and AIDS patients. The model should be implemented at various public hospitals throughout Limpopo Province and feedback provided so that it could be further developed and refined. Conclusion: The results indicated that health care providers of HIV and AIDS patients were deprived of the necessary care and support during provision of care to HIV and AIDS patients. A model for care and support as a strategy to assist the managers to offer care and support to health care providers of HIV and AIDS has been developed. The model is a contribution to the nursing management, the government and it serves as a guideline for improving the quality of patient care through well-cared and supported health care workers.

M. Tech. Graphic Design / Fetal Alcohol Syndrome is a congenital syndrome cased by excessive consumption of alcohol by the mother during pregnancy, characterized by retardation of mental development and of physical growth. Lack of public information and intervention is one of the reasons why the syndrome persists in townships and rural areas. This study was undertaken in response to the lack of public knowledge within high-risk communities concerning Fetal Alcohol Syndrome. The study hypothesized that embedding persuasive techniques within health communication material would create effective health communication campaigns that would be well received by target audiences.

M. Tech. Business Information Systems / Field-based healthcare is the provisioning of healthcare outside a traditional healthcare facility whose location is fixed. Although healthcare is not location and time dependent, the delivery of the service is often constrained to particular location and time. That is, although data accuracy and timely access to medical information is vital, healthcare service providers are not mobile enough to provide the on-demand healthcare service to patients. With restricted mobility, mistakes, unavailability and inaccuracy of information can have life-threatening consequences. To this point, this mini-dissertation argues that Mobile Information Technology (IT) Innovation could leverage field-based healthcare. Thus Mobile IT is considered essential to reducing medical errors, enhancing patient safety and improving quality of healthcare service delivery. Mobile IT can also be leveraged to meet ICT infrastructural challenges of field-based healthcare. That is, to enhance this service delivery, Mobile IT innovation will include the use of mobile devices such as mobile phones, smart phones, pocket computers, wireless networks and other technologies such as Radio Frequency Identification, smart cards, as well as information systems accessed through these technologies. In recent years, cases of Mobile IT application in healthcare service, particularly in South Africa, suggest the use of Mobile IT for disease management, monitoring as well as evaluation of patient care activities. There is a need for an empirical study to highlight the determinant factors that influence Mobile IT innovation for field-based healthcare. In response to this need, this study captured and unraveled the complexity of Mobile IT innovation for field-based healthcare through a case study conducted at a healthcare service provider.

The focus of this study was the exploration of parents and caregivers experiences of raising children with ADHD and their experiences of services at a public sector hospital. There is a paucity of scholarly studies conducted on this topic in South Africa. The context of the study is the public sector hospital where the researcher is employed as a social worker. Through her interactions with the parents and caregivers of ADHD affected children she became aware of the challenges that they were exposed to and this prompted her to undertake the study. This was a qualitative study and a purposive sample was used. Semi-structured interviews were conducted with 21 participants and one focus group was conducted as a method of triangulation, with six participants. This study was guided by two theoretical frameworks, namely the bio-psychosocial and ecosystems approaches. The main conclusions drawn from the findings of the study were that many participants experienced a lack of support from their families and from the hospital. Participants did not have sufficient knowledge of the comprehensive treatment plan available in the management of ADHD. Health care professionals failed to engage in mutual decision making with participants, related to ADHD treatment and they neglected to address the concerns of participants regarding their children. A further finding was that the referral process to allied health professionals was inconsistent. Participants also experienced difficulties with the hospital administrative processes. Based on the findings, the recommendations include the need for more comprehensive support which includes medical and psychosocial support for participants. The limited knowledge base of participants with regard to the nature, causes and the use of medication for ADHD should be addressed by the health care providers. This could be achieved through participant education on the disorder at the initial stages of diagnosis. ADHD should be managed in a more collaborative and co-ordinated manner at the health care facility through an actively interdependent team. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2010.

Nationally there has been an increase in the number of children requiring care and protection who have been placed in foster care in South Africa. This increase has also been evident at the Child and Family Welfare Society of Pietermaritzburg. Many of the children needing care and protection are placed in foster care with their grandparents. The aim of this study was therefore to explore the experiences and support networks of grandparents and their adolescent foster grandchildren. The study was guided by the ecological framework. This was a qualitative study with the purpose being descriptive. Semi-structured interviews were conducted with 10 adolescent foster children and one focus group discussion was conducted with 8 grandmothers. Although the plan was to include both grandparents in the study, it became evident at the sampling stage that many of the children were placed with their grandmothers, even if the grandfather was present. A significant finding of the study was that it was mainly grandmothers, rather than both grandparents, who had the responsibility for caring and nurturing the children in their care. Although five of the adolescents lived with both their grandmothers and their grandfathers; grandfathers were not seen as playing a significant role in their lives. Grandmothers were the decision-makers, responsible for discipline and a source of support for the adolescents. Grandmothers experienced financial and housing difficulties. Adolescents expressed feelings of loneliness and loss in relation to their parents. Social workers have focused mainly on assisting grandmothers to access the foster care grant and grandmothers and adolescents have not received grief and bereavement counseling and therapeutic services. Recommendations include the need for social workers to respond to the therapeutic needs of adolescents and the employment of social service professionals. Recommendations at a policy level include the improvement of the partnership between the Department of Social Development and NGOs. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2011.

Over the past decade, chronic illnesses have increased significantly in developing regions around the world, with implications for health service provision. Research shows that morbidity follows a social gradient in many countries around the world. Though various studies highlight the importance of socioeconomic status as a predictor of a person’s morbidity and mortality experience, there is a dearth of data and literature in the South African context. This study aimed to address this gap by examining the association between socioeconomic status and diabetes and hypertension among participants aged 35 years and older. This was achieved by undertaking the analysis of secondary data from the National Income Dynamic Study. The findings of the study reveal that there is a significant relationship between socioeconomic factors and chronic health outcomes of individuals. People with lower levels of education were more likely to have a chronic illness than those with higher levels of education. However, interestingly the lowest rates of prevalence were found in the unemployed category in South Africa. This draws attention to the need for further research on employment and chronic disease prevalence. An important finding of the study was the relatively higher prevalence of chronic conditions in rural areas and among the Black/African population. This data suggests that changes in lifestyle and behavior in the context of globalization and urbanization may be contributing to changes in the health profile of these communities. Policy makers need to acknowledge that chronic diseases are no longer the preserve of the wealthy with diseases such as diabetes and hypertension evident across all sectors of South African society. By addressing the causes of chronic conditions policies and programs can aim to prevent the emergence of future epidemics. In the long-term, sustainable progress will only be achieved with greater attention directed towards the socioeconomic factors underlying the health profile of the country. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2011.

Many people in South Africa are aware of the need for intervention and rehabilitation of disabled children. The lack of resources in the state healthcare system has necessitated a move towards capacity building and empowerment of community members to reduce the burden of responsibility on the healthcare system. Such engagement of community members in healthcare initiatives also has the potential of re-integrating disabled people back into society. The implementation of these strategies is undertaken largely by non-governmental organisations. One such NGO, the Child Development and Resource Centre (CORC) provides a service to children with multiple disabilities and their caregivers for whom no other resources are available. In attempting to increase the range of its impact on disabled people in Kwazulu-Natal, a training programme was developed to deal with the needs of the caregivers. The purpose of this study is to describe, evaluate and recommend changes of this nine module training course facilitated by the CDRC. The target population was the primary caregivers of disabled children living in peri-urban and rural areas and educare workers from non-profit organisations who were involved in service delivery to such families. The purpose of the training programme was to raise community awareness around disability, to sensitise and educate individuals to the needs of the disabled, and to empower caregivers in caring for disabled children in their communities. The CDRC training programme was subjected to on-going evaluation and monitoring throughout the entire process. Based on an action research model, programme evaluation was implemented and data was gathered from three sources: observation notes on each of the nine modules, evaluation forms completed by the participants, and focus group discussions with the participants. / Thesis (M.Ed.)-University of Natal, Pietermaritzburg, 2001.