Thesis (PhD)--Stellenbosch University, 2002. / ENGLISH ABSTRACT: A community-based growth monitoring (GM) project was established in a rural village in KwaZulu-Natal. The project is an example of community-based activities that were based on a participatory approach of problem assessment and analysis. The first phase of the study comprised of a situation assessment. The aim was to evaluate the nutritional status and related factors of children aged 5 years and younger. It included a cross-sectional survey (questionnaire and anthropometric measurements), focus group discussions and interviews with key informants. From a nutritional point of view, the situation assessment identified a need for regular GM of infants and small children, increased availability of foods rich in micronutrients, and nutrition education. Relevant findings of the situation assessment were used during a project planning workshop that was attended by community representatives. The community's concern about the health of the preschool children and the lack of health facilities, and the need for regular weighing of their children prompted the establishment of a community-based GM project. The GM project was run by nutrition monitors, through home-based centres (named Isizinda). Monthly activities at the Isizinda included GM, nutrition education, and recording of morbidity and mortality data. Children who were either in need of medical attention or showed growth faltering were referred to the nearest clinic. During the latter half of the study, the GM project was integrated with a household food production project and the Isizinda served as promotion and training centres for agricultural activities. Project activities were continuously monitored by reviewing the attendance register, scrutinising the Isizinda files, observation and staff meetings. Community meetings (at least twice a year) allowed for two-way feedback and addressing questions and concerns. Acceptability of the GM activities was measured in terms of attendance and maternal perceptions. The coverage of the Isizinda project was estimated at approximately 90% and at least 60% of these children were adequately covered. The Isizinda data showed an equal distribution of child contacts over the various age categories and was representative of the community. The attendance data suggest that community-based GM is a viable option to be used for screening and nutrition surveillance, and as platform for nutrition education. Most mothers comprehended the growth curve. Positive behavioural changes have been observed in the community and the Isizinda data showed a steady decline in the prevalence of diarrhoea. The Ndunakazi mothers were appreciative towards the Isizinda project because of a better understanding of the benefits of regular GM. They expressed a sense of empowerment regarding the knowledge that they have gained. The community had a strong desire for the project to continue. The Isizinda project showed that community-based GM can provide the infrastructure for developing capacity for agricultural activities within the community. Data from the household food production project showed that maternal knowledge regarding nutritional issues can be improved through nutrition education given at the GM sessions and that, when GM is integrated with agricultural activities, a significant improvement in child malnutrition can be obtained. The Isizinda project falls within the framework of the Integrated Nutrition Programme, and can bridge the gap in areas which lack health facilities. / AFRIKAANSE OPSOMMING: ’n Gemeenskaps-gebaseerde groeimoniteringsprojek is tot stand gebring in ’n landelike gebied in KwaZulu-Natal. Die projek is 'n voorbeeld van gemeenskapsgebaseerde aktiwiteite wat gebaseer was op 'n deelnemende benadering van probleem bepaling en analise. Die eerste fase van die studie was a situasie analise. Die doel was om die voedingstatus en verwante faktore van kinders 5 jaar en jonger te bepaal. Dit het 'n dwarssnit opname (vraelys en antropometriese metinge), fokus groep besprekings en onderhoude met kern persone ingesluit. Uit 'n voedingsoogpunt het die situasie analise 'n behoefte vir gereelde groeimonitoring van babas en klein kinders, verhoogde beskikbaarheid van voedsels ryk in mikronutriente and voedingsvoorligting aangedui. Toepaslike bevindinge van die situasie analise was gebruik tydens ’n beplannings werkswinkel wat deur verteenwoordigers van die gemeenskap bygewoon is. Die gemeenskap se besorgdheid oor die gesondheid van voorskoolse kinders en die gebrek aan gesondheidsfasilitieite, asook hul behoefte om hul kinders gereeld te laat weeg, het aanleiding gegee tot die totstandkoming van ’n gemeenskaps-gebaseerde groeimoniteringsprojek. Die program is gedryf deur monitors deur tuisgebaseerde sentrums (genoem Isizinda). Maandelikse aktiwiteite by die Isizinda het groeimonitering, voedingvoorligting en die insameling van morbiditeit en mortaliteit inligting ingesluit. Kinders wie mediese sorg benodig het of wie groeivertraging getoon het, is na die naaste kliniek verwys. Die groeimoniteringsprojek is tydens die laaste helfte van die studie met ’n huishoudelike voedselproduksieprojek geintegreer en die Isizinda het as promosie- en opleidingsentrum vir die landbou aktiwitiete gedien. Projek aktiwiteite is deurgaans gemonitor deur die bywoningsregister en Isizinda leêrs deur te gaan, waarnemings en personeel vergaderings. Vergaderings met die gemeenskap (ten minste twee per jaar) het voorsiening gemaak vir wedersydse terugvoering en die aanspreek van vrae en besorgdhede. Die aanvaarbaarheid van die groeimoniterings aktiwiteite is gemeet in terme van bywoning en persepsies. Die Isizinda projek het ongeveer 90% van die kinders gedek, van wie ten minste 60% voldoende gemoniteer is. Die Isizinda data het ’n eweredige verspreiding van besoeke oor die verskillende oudersdomgroepe aangetoon. Die Isizinda data was ook verteenwoordigend van die gemeenskap. Die bywoningssyfers dui aan dat gemeenskapsgebaseerde groeimonitoring 'n lewensvatbare opsie is vir sifting en voeding opnames, en as 'n platform vir voedingvoorligting. Meeste moeders kon die groeikaart interpreteer. Positiewe gedragsveranderinge is in die gemeenskap waargeneem en die Isizinda data het ’n geleidelike afname in die voorkoms van diarree getoon. Die Ndunakazi moeders was waarderend teenoor die Isizinda projek as gevolg van 'n beter begrip ten opsigte van die voordele van gereelde groeimonitering. Hulle het 'n gevoel van bemagteging uitgespreek ten opsigte van hul verbeterde kennis. Hulle was mening dat die projek moes voortgaan. Die Isizinda projek het aangetoon dat gemeenskapsgebaseerde groeimonitoring die infrstruktuur kan skep vir die ontwikkeling vir kapasiteit vir landbou aktiwiteite binne die gemeenskap. Inligting van die huishoudelike voedselproduksieprojek het aangetoon dat die moeders se kennis ten opsigte van voedings verwante aspekte verbeter kan word deur voedingvoorligting wat gegee word tydens die groeimonitering sessie en dat, as groeimonitoring geintegreer is met landbou aktwiteite, 'n verbetering in die voedingstatus van die kind verkry kan word. Die Isizinda projek val binne die raamwerk van die Geintegreerde Voedingsprogram en kan die gaping dek in areas waar geen gesondheidsfasilteite is nie.

The overall aim of this study was to evaluate quality of STI services in Umjindi local municipality. A concrete objective was to investigate the health system issues that may have a negative impact in the provision of quality STI service in the local municipality. These include accessibility of the STI services to the community, training of health workers in syndromic management, availability of necessary equipment and supplies for STI management, turn-around time for blood results and infrastructure of the facilities.

Thesis (MPhil(Rehabilitation))--Stellenbosch University, 2012. / ENGLISH ABSTRACT: This is a descriptive, phenomenological, qualitative study which explores the experiences of and coping strategies employed by the parents/caregivers of disabled children in the management of their care, including rehabilitation and schooling. The study was conducted in the rural communities of the Eastern Cape outside Mthatha, where parents/caregivers of disabled children have historically had challenges finding suitable schooling for their intellectually impaired children. In 1999, Happy Home community rehabilitation centre for disabled children was established by Mrs. V.V. Duma, a parent of a disabled child. Study participants comprised of parents or care-givers of the disabled children residing at Happy Home. A total of 37 participants took part in the study, comprising of six focus group discussions of six parents/caregivers per group, and one individual interview. Study findings revealed that parents/caregivers used a variety of coping strategies to manage the care of their disabled children. Both positive and negative coping strategies were used. Negative coping strategies included abandoning the child, which was justified by, for instance, belief that the child had been bewitched by in-laws, or on the pretext that the mother's HIV positive status had been caused by the father, leading to the mother abandoning the child. In cases where both parents had abandoned the baby, or the death of a parent occurred, a caregiver, often a relative, would take responsibility for the child. Positive strategies can be characterized as willingness by parents/caregivers to do whatever it takes to help the children to survive and access better opportunities. The caregivers/parents who adopted positive coping strategies were mainly from Christian backgrounds and consequently believed that a disabled child is God‟s gift. These parents/caregivers seek assistance from a number of different sources to help the disabled child, including from faith healers, traditional healers, and western medical treatments. Cultural influences on the reactions of parents, extended family and the wider community as revealed in the study show that disability is seen in negative terms and that the abuse of women, including while pregnant, is supported as a cultural norm. It was found that stress, abuse, and poverty during pregnancy were perceived by parents to be some of the causes of disability in new born babies. Parents/caregivers experienced barriers to health and rehabilitation including; long distances to health and rehabilitation centres with prohibitive transport costs. It appeared that health care providers did not communicate about children‟s conditions or would not treat sick disabled children. There were also data that indicated that there were some health care providers who were helpful and that parents/caregivers used other resources such as radio programmes to educate them about disability. The study sought to understand the challenges that disabled children and their parents/caregivers experienced. The results of the study indicate that workshops with the health professionals to change their attitudes, and enhance their understanding of disability should be conducted. In addition, community awareness and education campaigns about causes, and signs and symptoms of disabilities; and the issue of cultural norms that impact on the abuse of women and negative attitudes towards disabled children need to be conducted among the communities from which the study participants originate. Furthermore, the study recommends that the Health Science curriculum include a generic module on disability studies to be completed by all health science students, to ensure that as health practitioners such as therapists and nurses, they can be more effective in responding to the needs of disabled children. / AFRIKAANSE OPSOMMING: Die studie is ʼn beskrywende fenomenologiese navorsing, wat die ervaring van ouers/versorgers van gestremde kinders ondersoek; asook die strategiee wat deur hulle aangewent word om te help met die versorging, rehabilitasie en onderrig van gestremde kinders. Die studie het gebruik gemaak van kwalitatiewe data kolleksie metodes. Ouers/versorgers van gestremde kinders wat in Happy Home woon het aan die studie deelgeneem. Ses groepsbesprekings, met ses ouers in elke groep, sowel as individuele onderhoude met elke deelnemer was uitgevoer. In totaal was daar 37 deelnemers in die studie. Die studie was uitgevoer in die plattelandse gemeenskappe buite Mthatha, in die Oos Kaap. Ouers/versorgers van intelektueel gestremde kinders het probleme ondervind om geskikte onderwys te vind vir hulle kinders in hierdie area. Happy Home, `n gemeenskapsrehabilitasie sentrum vir gestremde kinders, is in 1999 deur Mev J.J.Duma, `n ouer van `n gestremde kind, gestig. Daar was bevind dat ouers/versorgers `n veskeidenheid hanterings meganismes, positief en negatief,gebruik om hulle gestremde kinders te versorg. Negatiewe stratigee soos om die kind te verlaat is ingesluit en is geregverdig deur, bevoorbeeld, die geloof dat die kind deur skoonouers betower was, of op die voorwendsel dat die moeder se HIV postief status, veroorsaak deur die vader, die oorsaak was dat die moeder gevolglik die kind verlaat het. In Ingevalle waar beide ouers die baba verlaat hetof waar `n ouer gesterf het, het `n versorger wat gewoonlik `n familielid was, verantwoordelikheid geneem vir die kind. Postiewe strategiee is kenmerkend van ouers/versorgers se gewilligheid om alles moontlik te doen, om die kinders te help om te oorleef en toegang te he tot beter geleenthede. Ouers/versorgers wie positiewe strategiee aangewent het was waarskynlik van Christelike agtergronde en het gevolglik geglo dat ʼn gestremde kind ʼn gesekenk van God is. Sulke ouers/versorgers soek bystand van ʼn verskydenheid hulpbronne, om die gestremde kind te help; insluitend die dienste van ʼn geloofsgeneser, tradisionele genesers, en westerse mediese behandelings. Die studie het gewys dat kulturele invloede op die reaksies van ouers, die familie en die wyer gemeenskap veroorsaak het dat gestremdheid in `n negatiewe lig gesien word en dat die mishandeling van vroue, insluitende swanger vroue, ondersteun word as `n kulturele norm. Daar was bevind dat spanning, mishandeling en armoede gesien word as oorsake van gestremdheid in pas gebore babas. Ouers/versorgers het struikelblokke teegekom met betrekking tot toegang tot gesondheids dienste en rehabilitasie. Dit het lang afstande na gesondheids- en rehabilitasie sentrums asook onbekostigbare vervoer uitgawes ingesluit. Dit het voorgekom asof gesondheidsorg voorsieners nie oor die kinders se toestande gekommunikeer het nie en nie siek gestremde kinders behandel het nie. Daar was data wat daarop gewys het dat sommige gesondheidsorg voorsieners behulpsaam was en dat ouers/versorgers ander hulpbronne soos radio programme gebruik het om hulself in te lig. Die studie het gepoog om die plattelandse konteks en die uitdagings wat gestremde kinders en hulle ouers/versorgers ondervind het te verstaan. Die studie resultate dui daarop dat werkswinkels met gesondheidsorg verskaffers gehou moet word om hulle begrip van gestremdheid te verbeter om sodoende hulle houding teenoor gestremdhied te verander. Daarbenewens moet opleidings en inligtings veldtogte oor die oorsake, tekens en simptome van gestremdheid, oor die impak wat kulturele norme het op die mishandeling van vroue, en oor die negatiewe houdings teenoor gestremde kinders, in die gemeenskappe waarvandaan die studie deelnemers kom gehou word ʼn Verdere aanbeveling is dat die kurrikulum vir Gesondheids Wetenskappe ʼn algemene module oor gestremdheid studies insluit; om voltooi te word deur all studente wie Gesondheids Wetenskappe studeer; sodat terapeute en verpleegsters grooter kennis sal dra van die behoeftes van gestremde kinders.

Thesis (MPhil)--Stellenbosch University, 2005. / ENGLISH ABSTRACT: The HIV/AIDS pandemic is destroying young adults in the prime of their lives. Children not only become orphans, but also gain instant “adult” status – becoming heads of households, breadwinners and customers. Children who fill such roles must be recognised as important stakeholders with regard to business. As limited available estimations suggest that South Africa is home to 800 000 orphans, corporations must realise that it will make good business sense to invest in the country’s AIDS orphans1 today, as these children will constitute both their future clients and employees. This study examines trends in the Corporate Social Responsibility (CSR) initiatives of five major corporations in the South African motor manufacturing sector. AIDS orphans were also involved in the study through participation in three focus group discussions. The evidence reveals that corporations do not recognise AIDS orphans as important stakeholders to business, nor do they see it as their responsibility to carry the burden of care for such children. Orphans felt that corporations in this business sector do not care about their needs and well-being. They regarded companies who were involved in CSR projects in their communities as “caring” and this resulted in the children hosting positive feelings towards involved companies. They even expressed the desire to purchase their brand of motor vehicle, as opposed to competitor’s brands that were not involved (through CSR) in their community, in future. / AFRIKAANSE OPSOMMING: Die MIV/VIGS pandemie is besig om die lewens van jongmense te verwoes. Kinders word nie alleenlik wees gelaat nie, maar word ook oornag volwassenes. Hulle word die hoof van huishoudings, broodwinners en kliënte vir besighede. Kinders wat hierdie rolle vervul moet daarom as belangrike aandeelhouers in die besigheidswêreld erken word. Beperkte skattings veronderstel dat Suid-Afrika tans ongeveer 800 000 weeskinders huisves. Besighede moet, in die lig hiervan, besef dat dit goeie besigheidssin maak om in VIGSWeeskinders1 te belê, aangesien hierdie kinders hul toekomstige kliënte en werknemers is. Hierdie studie ondersoek tendense in besighede se sosiale verwantwoordelikheidsinitiatiewe (“Corporate Social Responsibility Initiatives”), binne die motorvervaardigingsbedryf van Suid- Afrika. VIGS-Weeskinders was ook nouliks by die studie betrokke, deur middel van deelname aan drie fokusgroepbesprekings. Die studie het bewys dat besighede nie VIGSWeeskinders as belangrike aandeelhouers erken nie, en dat dit ook nie as hul plig gesien word om na weeskinders om te sien nie. Weeskinders, daarenteen, was van die opinie dat besighede in dié bepaalde bedryf nie omsien na hul welstand, of probeer om in hul behoeftes te voorsien nie. Kinders het wel besighede wat betrokke is by sosiale verwantwoordelikheidsinitiatiewe in hul gemeenskappe, beskryf as “liefdevol”, en dit het daartoe gelei dat kinders positiewe houdings jeens sulke besighede gehuldig het. Kinders het selfs die behoefte uitgespreek om, eendag eerder handelsmerke se voertuie te koop wat wel sosiale verwantwoordelikheidsinitiatiewe in hul gemeenskappe bedryf, as dié wat niks doen om hul lot te verlig nie.

Submitted in fulfillment of the requirements for the Degree in Master of Health Sciences in Nursing, Durban University of Technology, Durban, South Africa, 2016. / Introduction and Background According to the Declaration of Alma-Ata, maternal and child health care forms an integral component of primary health care. In line with this, the South African national government legislated free maternal and child healthcare services in the public sectors to ensure accessibility and availability of basic health care services to the community of South Africa. However, poor access and utilization of antenatal care services in rural areas continues and contributes to high maternal mortality and morbidity rates and untoward pregnancy outcomes. Aim The aim of this study was to explore the experiences of pregnant women from the KwaMkhizwana rural area regarding antenatal care services in order to identify the factors affecting effective provision of and access to the antenatal care services. Method A qualitative, explorative, descriptive research design, which was guided by Rosenstock’s Health Belief Model, was used to conduct the study. Data were collected by conducting semi-structured interviews with 15 participants who were purposively sampled between February and March 2016 and was analysed using Tesch’s method of data analysis. The sample size was determined by data saturation that was reached after ten interviews were conducted. A total of five additional interviews were conducted to confirm saturation of data. Findings There were five major themes and several sub-themes that emerged from the interviews. The major themes included: 1) availability and accessibility of antenatal care services; 2) established practices by the health post staff to reduce the number of clients; management and administration of the health posts; 3) access to health information by pregnant women; 4) communication between the pregnant women and the health post staff; and 5) socio-cultural taboos and beliefs of the community in the area. Conclusion and Recommendations The information gathered from the participants with regard to their experiences affirms that challenges still exist in this rural community regarding access to health care services, particularly antenatal care services. Recommendations pertaining to policy development, institutional management, practice, and research were made. Some of these recommendations included that several policies that are currently non-existent should be developed in order to promote accessibility of antenatal care service at primary health care level, more primary health care training schools should be established to increase the number of primary health care trained nurses, short courses for training of clinic supervisors should be conducted and that further research studies looking at ANC service accessibility especially in rural areas, focusing on health care workers and management experiences be conducted. / M

The study reports on the perceptions of the midwives and pregnant women of the PMTCT of HIV programme at the antenatal care and maternity ward at the Johan Heyns Community Health Centre. A qualitative approach was adopted to conduct the study. Purposive sampling was used to select participants and was informed by social behavioural theories. Data was collected using interviews and analysed using thematic categorisation. The findings show that at the first PMTCT encounter participants had little to no knowledge of the PMTCT programme, generally displayed a lack of interest, experienced emotional distress, and fear at the thought of having to disclosing their HIV-positive status to their partners/family and had certain trepidations about participating in the PMTCT programme. The participants’ perception on their roles was that their roles were interlinked, midwife needs the recipients (pregnant woman) and pregnant woman needs the provider (midwife) therefore one cannot do PMTCT without the other. The study recommends that the capacity building of pregnant women be optimised, that PMTCT awareness campaigns for women of childbearing age should be a priority and PMTCT skills to be prerequisite for midwives deployed to ANC clinics and maternity ward units. / Health Studies / M.A. (Social Behaviour Studies in HIV/AIDS)

Thesis (MPhil)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: This study examines the level of HIV and AIDS knowledge, attitudes, as well as practices amongst caregivers of HIV infected children in Pretoria, using Kalafong hospital as a case study. The study uses a questionnaire as survey instrument. A total of 30 respondents participated in the study, which took place in October of 2013. The respondents were selected via simple random sampling and the results were analyzed. The results showed a remarkably high level of HIV and AIDS knowledge amongst the respondents, from which it was evident, that: A significant number of caregivers were aware of and able to take care of existing medical conditions arising from HIV in children. Most of the home-based care of children living with HIV was carried out by women in a very disproportionate ratio to men. In this regard, the study offers a range of suggestions and recommendations as well as existing best practices, such as the UNAIDS booklet on caregiving within the context of HIV and AIDS. The study was undertaken with the realization that generalizations cannot be made through extrapolation to the larger society because of limitations, such as the sample size of this study. / AFRIKAANSE OPSOMMING:Hierdie studie ondersoek die vlak van MIV/VIGS kennis, houdings teenoor dieselfde, sowel as praktyke onder versorgers van MIV-besmette kinders in Pretoria, met behulp van Kalafonghospitaal as 'n gevallestudie. Die studie maak gebruik van 'n vraelys as opname instrument. 'n Totaal van 30 respondente het deelgeneem aan die studie, wat in Oktober 2013 plaasgevind het. Die respondente is gekies deur 'n eenvoudige ewekansige steekproefneming en die resultate is ontleed. Die resultate toon 'n merkwaardig hoë vlak van MIV en VIGS kennis onder die respondente. Hierdie kennis, houdings en praktyke opgedoen was voldoende om daarop te let: • 'n beduidende aantal van die versorgers is bewus van en in staat om bestaande toestande in MIV-sorg in kinders te versorg. • Die meeste van die tuisversorging van kinders wat met MIV leef is uitgevoer deur vroue in 'n baie oneweredige verhouding met mans. In hierdie verband bied die studie 'n verskeidenheid van voorstelle en aanbevelings sowel as die bestaande beste praktyke soos die UNAIDS boekie oor versorging binne die konteks van MIV en VIGS. Die studie is gedoen onder die besef dat veralgemenings nie gemaak kan word deur ekstrapolasie na die groter samelewing nie, as gevolg van beperkings soos die monster grootte van hierdie studie

The overall aim of this study was to evaluate quality of STI services in Umjindi local municipality. A concrete objective was to investigate the health system issues that may have a negative impact in the provision of quality STI service in the local municipality. These include accessibility of the STI services to the community, training of health workers in syndromic management, availability of necessary equipment and supplies for STI management, turn-around time for blood results and infrastructure of the facilities.

Thesis (MFamMed)--Stellenbosch University, 2012. / INTRODUCTION: Access to health care, like childhood survival, often depends on where one lives. The infant mortality rate in rural South Africa (SA) is 52.6 per 1000 births, compared to 32.6 per 1000 births in urban areas. Furthermore, three of the four districts in SA with the highest HIV prevalence are rural. These being two commonly used health indicators, it is clear that rural populations have significantly poorer health outcomes than their urban counterparts. About half the world’s population live outside major urban centres, where health services and specialist medical services are concentrated. Rural SA are home to 43.6% of the population, but are served by only 12% of doctors and 19% of nurses. Of the 1200 medical students graduating in the country annually, only about 35 work in rural areas in the long term. There are 30 generalists and 30 specialists/100 000 people in urban areas, compared to an average of 13 generalists and two specialists/100 000 people in rural areas. The question arises whether the poorer access to particularly specialist services is a contributing factor towards poorer outcomes. Specialist outreach to rural communities is one way of improving access to care. In the Eden and Central-Karoo districts of the Western Cape of SA there are one level 2 (regional) hospital and ten level 1 (district) hospitals. All clinical disciplines reach out, with varying frequencies. On average, the four main district hospitals receive 17 specialist outreach visits per month; while the smaller district hospitals receive three specialist visits per month (Appendix 1). A typical outreach visit includes a problem ward round, outpatient session, theatre list for some surgical disciplines and formal/informal educational sessions. In principle, stakeholders agree that specialist outreach and support (O&S) to rural populations is necessary, as it improves access to specialized health care services. In practise however, there are factors that influence whether or not O&S reaches its goals. This in turn affects the sustainability of O&S projects. Understanding these factors would aid recommendations for a suitable model for O&S.

Thesis (MPhil)--Stellenbosch University, 2001. / ENGLISH ABSTRACT: The practice of medicine has always been a big area of interest as a profession. The focus ranges depending on issues at hand - it may be on the educational, training, humanistic, economic, professional ethics and legal aspects. One area of medicine that is under the spotlight around the world is that of the maintenance of clinical competency, followed very closely and almost linked to professional ethics. This study follows the introduction of a system of Continuing Professional Development (hereinafter also referred to as CPD), in South Africa and an overview of how it has been introduced in a few other countries. The main areas of focus being the extrication of inherent values of CPD, relating this aspect to quality improvement in medical health care. The medical profession as well as most of the interested parties, has different perspectives regarding the fact that the system is regulated through legislation. There is also the doubt whether the CPD system will be effective in achieving the goals that it has been set to achieve. Although a system of Continuing Medical Education has been a tradition in all countries, which implies that the CPD system is not totally new as far as the educational principles are concerned, the values accruable need to be exploited. It is the possible success of this kind of evaluations that may foster more understanding of the inherent values in this CPD system. / AFRIKAANSE OPSOMMING: Beroepsgewys het die praktyk van geneeskunde nog altyd groot belangstelling gelok. Die fokus verskuif na gelang van die onderwerpe ter sprake. Dit wissel van opvoedkunde, opleiding, humanisme, ekonomie, en professionele etiek tot regsaspekte. Dwarsoor die wêreld word daar gefokus op die handhawing van kliniese vaardighede, gevolg deur professionele etiek wat ook daarin verweef is. Hierdie studie bespreek die instelling van 'n stelsel van Voortgesette Professionele Ontwikkeling (hierna verwys na as VPO) in Suid-Afrika asook oorsig oor die wyse waarop dit in 'n paar ander lande ingestel is. Die klem lê op die inherente waardes met betrekking tot die verbetering gehalte in mediese gesondheidsorg. Die mediese beroep, asook meeste van die belangegroepe het verskillende opvattings oor die feit dat die stelsel deur wetgewing gereguleer word. Daar is ook twyfel of die VPO-stelsel in sy vooropgestelde doelwitte sal slaag. Wat die opvoedkundige beginsels betref, is die VPO-stelsel nie totaal en al nuut nie. Alhoewel VPO in ander lande tradisie is, is dit nodig om die totstandkoming van waardes te ontgin. Die moontlike sukses van hierdie tipe van evaluasies mag dalk beter begrip ten opsigte van die inherente waardes in die VPO-stelsel bevorder.