MCur / Department of Advanced Nursing Science / Background: Perinatal and neonatal mortality rates remain high in South Africa especially in rural areas and townships where the majority of poor people live. With regard to perinatal and neonatal mortality, South Africa like many other developing countries has failed to achieve MDG 4 and 5 by 2015 regardless of many efforts by the governments. To achieve the SDG which replaced MDGs for child health, it is necessary for the South African public and private health care to reduce substantially perinatal and new born deaths, particularly in rural areas. There are many factors that contribute to a high perinatal mortality rate in public hospitals in rural areas. To understand these factors, a study was conducted with midwives from selected public hospitals in Limpopo, Vhembe district which experiences the highest perinatal mortality rates in South Africa. Purpose and methodology: The purpose of this research study was to assess factors contributing to high perinatal mortality rates in the selected public hospitals in Vhembe district. A quantitative, descriptive, exploratory and cross-sectional design was used to collect data from the sampled hospitals in the Vhembe district. Hospitals were purposively sampled based on the statistics of monthly deliveries. The target population consisted of all registered midwives who had been working in the maternity units for at least two years. Cochrane's formula was used to determine the sample from the target population for each hospital. A random sample of 110 respondents was selected upon which a questionnaire was administered to each by the researcher. Responses from the close-ended and open-ended questions was grouped and analysed quantitatively by means of Statistical Package for Social Sciences 23.0 (SPSS). Results and findings: Results were presented in frequency tables and graphs revealed that most of the midwives lacked knowledge and skills in a number of key areas needed for them to operate efficiently in the maternity wards. There was also high staff turnover which led to a few midwives being overworked. The utilisation of guidelines and protocols in maternity was left to individual midwives as the hospitals did not evaluate the use of it. Conclusions: Lack of key skills in assisting women in labour, and poor use of guidelines and understaffing were the main contributing factors to high perinatal mortality rates in the selected public hospitals of Vhembe district. Midwife attitudes were not a contributory factor. / NRF

This study sought to determine if ANC and PMTCT services are utilized within the first trimester of pregnancy by the women in East Ekurhuleni sub-district. Quantitative descriptive research was conducted on 390 eligible pregnant women and data collection was done using structured questionnaires. The results indicated that women start ANC late despite their knowledge of first trimester as the best time to start ANC. Actions that would motivate them to start ANC early were explored and barriers were identified. / Health Studies / M.A. (Public Health)

Medicinal plants of Thulamela municipality are experiencing challenges due to human activities, resulting in some of the medicinal plants becoming difficult to find, declining, endangered or even extinct. Unsustainable harvesting is threatening the survival of certain medicinal plant species used as a source of primary healthcare in the area. This study investigates aspects related to traditional healers' perceptions with regard to collection, ethnobotanical importance and conservation status of indigenous medicinal plants used by traditional healers around Thulamela municipality. Information on medicinal plants was gathered by means of semi-structured interviews, field walks, personal observation and a literature review. A total of 90 medicinal plant species, which belong to 47 families, from a total of 82 genera commonly used by traditional healers to treat different ailments, were recorded. About 87% of traditional healers indicated that some medicinal plants are difficult to find; only 13% of healers did not experience difficulties in finding some medicinal plants. / Environmental Sciences / M. Sc. (Ornamental Horticulture)

The child protection system includes foster care. Yet some foster children are neglected, physically or emotionally abused and are used to obtain Foster Care Grants. The essence of this study is to develop a thorough and comprehensive understanding from the frame of reference of social workers on the factors that contribute to the neglect and abuse of foster children as well as their suggestions about possible interventions. The qualitative research approach was applied. The researcher utilised purposive sampling to select social workers. Semi-structured interviews were conducted to gather information and data was analysed. It is clear from the findings that the foster care system needs to be reviewed to minimise or stop neglect and abuse of foster children. / Social Work / M.A. (Social Work)

Palliative care is one of the crucial services provided by social workers to improve the quality of life of people suffering from life-threatening illnesses. It is an inter-disciplinary medical care giving approach which focuses on relieving symptoms and stress of life threatening illness. To my knowledge there is limited guidelines on how social workers should intervene in providing palliative care services. Therefore, this study will the explore experiences of social workers in rendering palliative care services to people faced with life-threatening illnesses. The study will follow a qualitative research approach. Purposive and snowball sampling will be employed to frame the sample of social workers who render palliative care services. Ethical issues regarding informed consent, confidentiality/anonymity and management of information will be considered and attended to. Data will be collected through semi structured interviews and analysed in terms of Tesch eight steps. The Guba and Lincoln’s model will be employed for data verification (Lincoln and Guba in Schurink, Fouché and de Vos 2011:419-421). / Social Work / M.A. (Social Work)

PhD (Health Studies) / Department of Public Health / Introduction: Quality healthcare provision is a fundamental need in the life of a person since it helps develop a positive self-image. Healthcare has always been an important issue for society, both economically and culturally. Contrary, dissatisfactions and litigations laid by clients/patients and relatives against the government due to poor service provision become unmanageable. The purpose of the study was the development of strategies to facilitate provision of quality healthcare services in public healthcare facilities in Limpopo province, South Africa. Methods: Qualitative and quantitative methods were adopted for the study. Population for the qualitative study was constituted by professional nurses, and stakeholders (Hospital boards and Clinic health Committees) who were, purposively selected from the randomly sampled hospitals and clinics. Focus Group discussion and questionnaires were conducted to collect data. Analysis. The qualitative data was analysed qualitatively. Population for quantitative study consisted of Clients as stakeholders and professional nurses from randomly sampled hospitals and clinics. The qualitative results were used in the development of questions for questionnaire used in the quantitative approach. For the quantitative approach a self-administered questionnaire was used to collect data from the respondents. Data collection was carried out by means of two instruments for clients and professional nurses. Analysis was done using SPSS 25 version with the assistance of a Professional Statistician. The researcher used the Strength, Weaknesses, Opportunities and Threats analysis to develop strategies for enhancing quality healthcare service provision in the Department of health. The interaction between Strengths, Weaknesses, Opportunities and Threats was analysed and used to develop strategies to facilitate provision of quality health care services in public health care facilities in Limpopo Province. Conclusion Findings of this study is expected to inform nursing education and nursing practice to review curricular on what to emphasize when training the nursing students. The findings will also inform senior management when planning for improvement of health care provision improvement. / NRF

Public demands have forced countries to explore new ways of rendering primary health care to reach the poor who are not within reach of the modern health care systems. New categories of health care personnel, like lay health workers emerged. There are vast differences in the roles of these lay health workers as was revealed with an extensive literature search. The phenomenology qualitative research method was used to investigate perceptions of farm lay health workers regarding their roles in rural areas. A convenience, non-random sample (N=5) was used for focus group discussions and in-depth interviews to collect data. The latter revealed five main themes associated with the role of farm lay health workers: (1) community link; (2) carer; (3) community developer; (4) counsellor and (5) role model. Guidelines were formulated to enhance the role of lay health workers in the rural Western Cape Province and to improve the quality of care to rural communities / Health Studies / M.A. (Health Studies)

Decisions made by social workers during the rendering of services play a crucial role in foster care. This study employed a qualitative approach to explore the factors that influence the decisions made by social workers when rendering foster care services, and to develop a matrix to guide decision-making. A collective case study design, informed by the explorative, descriptive and contextual designs, was used. The intuitive, analytic and mixed theories of decision-making served as the conceptual framework of the study. The populations of the study were social workers rendering foster care services in government and non-governmental organisations (NGOs) and their supervisors. One case file of each social worker sampled, was consulted as an additional data source. The sampling technique was purposively sampling with a set of criteria to enable data optimisation. Triangulation of data collection methods was utilised, namely, case file analysis and semi-structured interviews with social workers and supervisors. Case studies are context-based and the data collection occurred in the natural settings of the participants. Ethical clearance was obtained for the study and before the commencement of data collection participants were fully briefed about the study and informed consent was obtained. The data collection instruments, a guide of case file analysis and two interview guides, were piloted twice in both government and NGOs. The data collection was audio recorded and an independent transcriber was used to transcribe the data to control for researcher-influence on the manipulation of the data. Trustworthiness was addressed by ensuring credibility, transferability, dependability and confirmability of the data collected. Both the top down or deductive data analysis approach, and the bottom up or inductive approach were adopted to analyse the data. Findings on the social workers’ decision-making processes, decisions made, factors influencing decision-making and the nature of decisions were explored and described in the assessment phase (including the intake, prevention and early intervention, as well as the investigation stages), the placement phase and the supervision phase of foster care services. These findings and the participants’ suggestions on what a decision-making matrix should address, were synthesised and the matrix to guide the decision-making of social workers rendering foster care services was developed. / Social Work / D. Phil (Social Work)

Text in Afrikaans / Die MIV/vigs-pandemie in Suid-Afiika- van die ergste in die wereld- toon geen tekens van afname nie. Miljoene kinders is reeds of wees gelaat of hewig geaffekteer deur die magdom impakte daarvan op gesinne en gemeenskappe. Die epidemie het voortdurend stygende sterftesyfers tot gevolg en die hewige las van die siekte rus swaar op MIV-positiewe sowel as MIV-negatiewe individue. Verder word tradisionele ondersteuningsnetwerke oorbelaai en/of gaan hulle tot niet. Gesinne en gemeenskappe verloor hul ekonomiese, sosiale en kulturele lewensvatbaarheid. Die pandemie hou, veral onder die armes, 'n geweldige bedreiging vir die gesondheid, welstand en regte van babas, kinders en jongmense in. 'n Groot gedeelte van die impak van MIV/vigs hou verband met die feit dat sommige kinders en hul gesinne beperkte toegang tot die elemente van 'n gesonde omgewing en goeie gesondheid het. Regerings, gemeenskappe en gesinne wat deur MIV/vigs geraak word, het minder tyd, energie en finansiële hulpbronne beskikbaar om op voorkomende gesondheidsorg te fokus. Benewens die impak op gesondheidstatus, word kinders se omstandighede ook as gevolg van MIV/vigsverwante probleme bemoeilik. Dit sluit verhoogde gesinsarmoede, 'n hoer risiko van verlating en weeslating, geforseerde migrasie, onterwing, sielkundige trauma, uitsluiting en diskriminasie, en fisiese en seksuele mishandeling in. Die derde vlaag van die epidemie, welke vlaag nou betree word, word gekenmerk deur 'n ontsettende hoe sterftesyfer, 'n ontploffing in die getal sorgbehoewende en weeskinders en 'n verhoging in menslike pyn en lyding. Die reg speel 'n baie belangrike rol in die beperking van hierdie impak van die MIV/vigs-pandemie op die lewens van alle kinders. MIV/vigs-reg is in die proses van evolusie of vorming en reeds bestaande teorieë kan aangewend word ten einde sekere vrae te beantwoord en probleme daaromtrent aan te spreek. Tog is daar 'n dringende behoefte aan MIV/vigs-spesifieke wetgewing en teorieë ten einde die impak van die pandemie op alle vlakke suksesvol te beheer. Verder het die Kinderreg so 'n mate van ontwikkeling bereik dat daar algemeen aanvaar word dat kinders 'n spesiale belangegroep binne die gemeenskap vorm. Die regsreëls met betrekking tot kinders verander gedurig en is ook nie geskik om volgens die tradisionele wyse, as privaat- of publiekreg, geklassifiseer te word nie. In die hieropvolgende proefskrif word die impak van MIV/vigs op sekere publiekregtelike, maar oorwegend privaatregtelike aspekte van die Suid-Afiikaanse kinderreg ondersoek, sowel as enkele metodes waarop die reg moontlik hierdie impak kan absorbeer en hanteer. Daar word ook in aparte hoofstukke na die impak van MIV/vigs op die lewens van kinders. sorgbehoewende kinders, egskeiding en die ouer-kind-verhouding verwys The HIV/aids pandemic in South Africa - one of the worst in the world - does not seem to be decreasing. Millions of children have already been either orphaned or heavily affected by the numerous impacts on families and communities associated with it. The epidemic brings on an ever-increasing mortality rate and the extreme burden thereof weighs down heavily on HIV-positive as well as HIV-negative individuals. Traditional support networks are further being heavily burdened or perish entirely. Families and communities lose their economical, social and cultural viability. The pandemic threatens, especially among the poorest, the health, wellbeing and rights of infants, children and young people. The impact of HIV/aids is to a great extent the result of the fact that some children and their families do not have sufficient access to a healthy environment and good health. Governments, communities and families affected by HIV/aids have less time, energy and financial resources available in order to enable them to focus on preventive healthcare. In addition to the impact on health status, children's circumstances are also being encumbered by HIV/aids-related problems, including family poverty, a higher risk of being abandoned or orphaned, forced migration, disinheritance, psychological trauma, ostracism and discrimination and physical and sexual abuse. The third wave of the epidemic, which wave is presently being experienced, is characterised by a high mortality rate, an increasing amount of children in need of care and orphaned children and an increase in human pain and suffering. The law plays an important role in the limitation of the impact of the HIV/aids pandemic on the lives of children. HIV/aids law is in the process of evolution or forming and existing theories can be used in order to answer certain questions and address certain issues relating to it. However, there is an urgent need for HIV/aids-specific legislation and theories in order to successfully manage the impact of the pandemic on all levels. Child law has also reached such an extent of development that children is now viewed as a special interest group within the community. The legal principles regarding children change constantly and cannot be classified in the traditional way, which is either as private or public law. In this thesis the impact of HIV/aids on certain aspects of the public and private law pertaining to children is examined. Ways in which the impact can be absorbed and managed by the law is also examined. The impact of HIV/aids on divorce, the parent-child relationship, children in need of care, and the impact of HIV/aids on the lives of children is examined in separate chapters. / Jurisprudence / LL. D.

The purpose of this study was to develop an empowerment model for families of mentally handicapped children in Moletši district in Limpopo Province. To achieve this purpose, the study consisted of four steps, namely exploring the meaning of empowerment in the context of families with mentally handicapped children; developing and describing a model for empowerment of such families; formulating guidelines for the implementation of the model, and evaluating the implementation of the model. A qualitative, explorative, descriptive and contextual theory-generative design was used. The population of the study was all families who had mentally handicapped children in Moletši district of the Polokwane and Aganang municipalities. Semi-structured interviews, assessment guides and case studies were conducted with the families to evaluate the effectiveness of the model and whether the families reached self-efficacy in the care, treatment and rehabilitation of their mentally handicapped children. Non-probability, purposive sampling was used in order to obtain relevant information from the correct participants. Concepts were identified and analysed, which led to the development of the model for empowerment of families with mentally handicapped children. The model was applied in practice, where the families’ problems were identified and planned for, and the plans were put into action by means of case studies, and monitoring and evaluation was done through observation, interviews, discussion and meetings.The results revealed that the families proved to be independent and reached self-efficacy in the care, treatment and rehabilitation of their mentally handicapped children. The model is a unique contribution to nursing education, research, administration and practice and sets guidelines for a new field in the practice of psychiatric nursing. / Health Studies / D. Litt. et Phil.