In this study the focus is on Batho Pele (a Sotho translation for 'people first'), an initiative to get people that work in the public services to be service orientated and to strive for excellence towards continuous service delivery improvement (SA, 2004a:8). Batho Pele consist of a framework with two primary functions that apply to this study; service delivery to people as the customers (patients in this study) and the possibility to hold individual public servants (health care personnel in this study) accountable for poor service delivery. This, in fact, implies that poor performance lead to poor service delivery; thus, compliance with the Batho Pele principles plays a pivotal role to improve quality health care service delivery. The purpose of the study was to make recommendations to enhance the current compliance with the Batho Pele principles in a Primary Health Care (PHC) context that would positively improve quality care and patient satisfaction. A non–experimental, quantitative, descriptive study was undertaken within the philosophical framework of the Batho Pele principles as well as the Patients‘ Right Charter. All participants completed a structured questionnaire to determine the level of compliance with the Batho Pele principles as experienced by the patients and viewed by the health care personnel in a PHC context. The data collected, was analysed using descriptive statistics. Four PHC clinics were involved, situated at Umzinyathi District Health in the Kwazulu Natal (KZN) Province of South Africa. The study included two patient–population samples, based on convenience; the participants that visited the clinics (n=132) and the participants visited by the researcher at home (n=101). Fifty– six (n=56) health care personnel who voluntary agreed to participate in the study were an all–inclusive sample. The findings revealed that the patients in the study felt more secure to answer the questions on their experiences regarding compliances with the Batho Pele principles at home and this could be an important consideration when conducting patient satisfaction surveys. It was also clear that patients were more dissatisfied than health care personnel in most questions asked regarding their experience on the compliance with the Batho Pele principles in a PHC context. Recommendations were made in the light of what was contained in the study that can serve as a starting point to address identified shortcomings in nursing practice, nursing education and nursing research. / Thesis (M.Cur.)--North-West University, Potchefstroom Campus, 2011.

In this study the focus is on Batho Pele (a Sotho translation for 'people first'), an initiative to get people that work in the public services to be service orientated and to strive for excellence towards continuous service delivery improvement (SA, 2004a:8). Batho Pele consist of a framework with two primary functions that apply to this study; service delivery to people as the customers (patients in this study) and the possibility to hold individual public servants (health care personnel in this study) accountable for poor service delivery. This, in fact, implies that poor performance lead to poor service delivery; thus, compliance with the Batho Pele principles plays a pivotal role to improve quality health care service delivery. The purpose of the study was to make recommendations to enhance the current compliance with the Batho Pele principles in a Primary Health Care (PHC) context that would positively improve quality care and patient satisfaction. A non–experimental, quantitative, descriptive study was undertaken within the philosophical framework of the Batho Pele principles as well as the Patients‘ Right Charter. All participants completed a structured questionnaire to determine the level of compliance with the Batho Pele principles as experienced by the patients and viewed by the health care personnel in a PHC context. The data collected, was analysed using descriptive statistics. Four PHC clinics were involved, situated at Umzinyathi District Health in the Kwazulu Natal (KZN) Province of South Africa. The study included two patient–population samples, based on convenience; the participants that visited the clinics (n=132) and the participants visited by the researcher at home (n=101). Fifty– six (n=56) health care personnel who voluntary agreed to participate in the study were an all–inclusive sample. The findings revealed that the patients in the study felt more secure to answer the questions on their experiences regarding compliances with the Batho Pele principles at home and this could be an important consideration when conducting patient satisfaction surveys. It was also clear that patients were more dissatisfied than health care personnel in most questions asked regarding their experience on the compliance with the Batho Pele principles in a PHC context. Recommendations were made in the light of what was contained in the study that can serve as a starting point to address identified shortcomings in nursing practice, nursing education and nursing research. / Thesis (M.Cur.)--North-West University, Potchefstroom Campus, 2011.

Doctor Educationis / ‘n Gevallestudie binne die kwalitatiewe metodologiese paradigma is gebruik om die hersiene Arbeidsterapiekurrikulum by die Universiteit van Wes-Kaapland te interpreteer. Die doel van die studie was om te bepaal hoe die hersiene kurrikulum aan die handelingsgerigte wetenskaplike raamwerk van die beroep, die gemeenskapsgebaseerde visie van die veranderde gesondheidsorgbenadering in Suid-Afrika na 1994, en aan die beginsels van studentgesentreerde opleiding voldoen. Eerstens, is konseptuele duidelikheid verkry omtrent die ontplooiende verwikkelinge in die Arbeidsterapieprofessie na ‘n teoretiese raamwerk van handelingsgerigte wetenskap en van transformasie van gesondheidsdienste in die land. Tweedens, deur die proses van konseptuele analise en deur die gebruik van dokumentêre analise, tematiese analise van studente se geskrewe evaluerings en ‘n fokusgroeponderhoud met Arbeidsterapiepersoneel, is die data ge-analiseer. Die konseptuele analise van die hersiene Arbeidsterapiekurrikulum het areas van kurrikulumstruktuur, onderrig en leer, studente-assessering, praktiese opleiding, personeel se professionele ontwikkeling en navorsing ingesluit. Vanuit die konseptuele analise is gevolgtrekkings en aanbevelings gemaak. Die hoofgevolgtrekking wat na aanleiding van my interpretasie en bevinding in die Arbeidsterapiekurrikulummodel voorgestel word, is dat die Arbeidsterapiekurrikulum deur drie teoreties-opvoedkundige vertrekpunte naamlik: handelingsgerigte wetenskap, primêre gesondheidsorgbenadering en studentgesentreerde onderrigbenadering ondersteun word.

The aim of this study was to investigate human-animal interactions in the triad comprising the veterinarian, the animal and the preschool and in so doing to elucidate the role of the veterinarian in the health and education of preschool children. The area of focus was a comparison of preschools in high and low income areas in and around Pretoria by means of qualitative and quantitative observational methods. It was found that all preschools investigated, included animals in the curriculum and a majority visited the zoo. Interactions included direct contact between children and animals kept permanently or temporarily at school, animal themes and topics, animal protagonists in books, videos, toys and games and excursions to the zoo, urban farms, agricultural museums and animal welfare societies. Teachers felt that child-animal interactions contributed positively to the holistic development of the preschool child, but were worried about management of animals at school and the possibility of zoonotic diseases. As protein of animal origin, such as milk, eggs, meat and fish, formed part of the diet of preschool children, this could also result in a risk of zoonotic disease, particularly in developing areas, where meat and milk hygiene were found to be inadequate. In order to address these fears, the literature was reviewed with regard to zoonotic diseases which could affect preschool children in South Africa. Incidence and prevalence were not well documented and the comparative significance could not be assessed. Therefore the comparative morbidity of diseases diagnosed by the paediatric department of a hospital serving the low income areas studied and a private practice serving the high income areas, were investigated. It was discovered that zoonotic disease formed a very minor proportion of diseases diagnosed. The diagnoses were, however, based on symptoms rather than aetiology and zoonotic causes for, in particular, respiratory and gastro-intestinal disease, could not be excluded. In the light of this, criteria were proposed for the prevention of zoonotic disease outbreaks at preschools. An outbreak of zoonotic disease at a preschool was documented and the application of primary health care principles suggested. Constraints were found to be mainly administrative. Co-operation between the departments of Health and Agriculture was complicated by financial implications which had not been budgeted. Despite this, the intervention was successful in controlling the disease and preventing further outbreaks. The presence of a veterinarian as part of the primary health care team was advocated. Within the preschool it was found that teachers lacked knowledge in the fields of animal ethology and management. Cost, ease of management and appeal to children were taken into account in the choice of animals by preschools. Rodents and birds were considered preferable to carnivores. Housing was evaluated and criteria suggested for management systems which would benefit both children and animals. Death and euthanasia of animals kept permanently at preschool was investigated and suggestions made for a teaching strategy to facilitate understanding by children of the abstract concepts of life, death and grief. A method was developed for the analysis of animal content in literature, games and toys at preschools. It was found that animals were central to the theme of a majority of the books and toys. Realistic fiction where anthropomorphic animals were the central protagonists, had most appeal for children and it was suggested that these could be used in veterinary extension materials for prevention of zoonotic diseases or promotion of animal welfare. An evaluation system was proposed which included the input of veterinary ethologists. Animal facilities visited by preschools during excursions were evaluated. It was found that they were not sufficiently child-centred and environmen¬tally safe for young children. It was suggested that veterinary public health officials should become involved in order to improve animal well-being, particularly with regard to handling facilities and hygiene. In conclusion, a schematic representation of the multitude of roles for veterinarians in the holistic development of the preschool child was drawn up. The roles for different veterinary specialities were also tabulated in order to illustrate the important part played by this profession in the health and education of preschool children. / Die doel van die studie was om mens-dier-interaksies in die driehoek tussen veearts, dier en die kleuterskool te ondersoek om sodoende die rol van die veearts in die gesondheid en opvoeding van die voorskoolse kind aan te dui. Kwalitatiewe en kwantitatiewe navorsingsmetodes is gebruik om kleuterskole in die lae en hoë inkomste-gebiede in en om Pretoria te vergelyk. Alle kleuterskole wat ondersoek is, het diere in die kurrikulum ingesluit en die meerderheid skole het uitstappies na die dieretuin onderneem. Kind-dierinteraksies het die volgende ingesluit: direkte kontak tussen kind en dier op skool; diere in temas, stories, boeke, speletjies en speelgoed; asook uitstappies na die dieretuin, landelike museums, stedelike plase en dierwelsynsorganisasies. Onderwyseresse het gemeen dat die interaksies positief bygedra het tot die holistiese ontwikkeling van die voorskoolse kind, maar het kommer uitgespreek oor bestuur en siektes van diere. Omdat proteïene van dierlike oorsprong deel uitmaak van die dieet van voorskoolse kinders, was soönose ook 'n moontlikheid, veral in kinders van ontwikkelende areas waar dit uitgewys was dat higiëne met betrekking tot vleis en melk, nie na wense was nie. 'n Literatuurstudie het aangetoon dat die algemeenheid en omvang van soönotiese siektes, wat moontlik gevaarlik kon wees vir voorskoolse kinders, nie volledig genoeg omskryf was nie. Die vergelykende morbiditeit van siektes by Ga-Rankuwa Hospitaal se kinderafdeling (pasiënte van lae-inkomste gebiede) en 'n private praktyk in die oostelike voorstede van Pretoria (hoë inkomste gebied), is dus ondersoek. Soönotiese siektes het 'n klein deel uitgemaak van die siektes wat gediagnoseer was, maar die diagnose was op simptome, eerder as die etiologie van die siektes, gebaseer. Die vermoede bestaan dat veral siektes wat gediagnoseer is as respiratories en gastro-enteries, 'n soönotiese oorsprong kon gehad het. 'n Uitbreek van 'n soönotiese siekte by 'n kleuterskool is ondersoek en daar is voorgestel dat primêre gesondheidsorgmetodes gebruik word om dit te bekamp. Teenkanting op administratiewe vlak was die belangrikste probleem wat ondervind was, maar ten spyte daarvan kon die ondersoek suksesvol verloop. Die rol van die veearts as deel van die primêre gesondheidspan is ook hierdeur beklemtoon. Binne die kleuterskool is gevind dat daar 'n gebrek aan kennis is oor diere-etologie en dierebestuur. Kostes, praktiese versorgingsmetodes en die stimuluswaarde van diersoorte, was belangrike aspekte in die keuse van diere wat by skole aangehou is. Daarom was knaagdiere, voëls en vissies meer gewild as honde en katte. Die behuising van die diere is geëvalueer volgens voorgestelde kriteria wat tot voordeel van beide diere en kinders kan strek. Die dood en genadedood van diere by twee kleuterskole is ondersoek en voorstelle is gemaak uit 'n opvoedingkundige oogpunt, om die kinders konsepte betreffende lewe, dood en rou te laat begryp en ook om dit te kan verwerk. 'n Metode is ook ontwerp vir die analise van boeke en speelgoed en daar is bewys dat diere 'n hoofrol gespeel het in die meerderheid boeke en speelgoed by voorskole. Kinders het boeke verkies waar die hoofkarakters antropomorfiese diere was en die omgewing vergelykbaar was met die lewenswêreld van kinders. 'n Voorstel is dus gemaak dat sulke karakters gebruik word om veeartsenykunde voorligtingsboodskappe oor soönotiese siektes of dierwelsyn oor te dra aan jong kinders.Stedelike plasies, die dieretuin, landboumuseums en die Dierebeskermingsvereniging in Pretoria is besoek en daar is bevind dat dit nie veilig genoeg vir jong kinders is nie. Daar word dus aanbeveei dat veeartse in diens van plaaslike owerhede se gesondheidsdienste sulke plekke besoek, om voorstelle oor verbeterde veiligheid en higiëne te maak.Ten slote is 'n skematiese voorstelling van die veelsydige rol van veeartsenykundiges in die holistiese ontwikkeling van die voorskoolse kind saamgestel. Die verskillende rolle vir verskillende spesialiteite is ook voorgelê om die belangrike bydrae van veeartsenykunde tot die gesondheid en opvoeding van voorskoolse kinders aan te dui. / Thesis (DPhil)--University of Pretoria, 1995. / Production Animal Studies / unrestricted

The most frequent intervention performed by physicians is the writing of a prescription. Modern medicine has been remarkably effective in managing diseases. Medicines play a fundamental role in the effectiveness, efficiency and responsiveness of health care systems. However, health care expenditure is a great cause for concern and many nations around the world struggle to contain rising health care costs. Pharmaceutical benefit management programmes such as pharmacoeconomics, drug utilisation review (DUR) and disease management have emerged as control tools to ensure cost effective selection and use of medicine. These managed care instruments are often used to determine whether new strategies or interventions, such as the implementation of a managed medicine reference price list, are appropriate and have "value". The general objective of this study was to investigate the influences of the implementation of a managed medicine reference price list on the usage and cost of antibiotic medicine in the private health care sector of South Africa. The research design used in this study was retrospective, non-experimental and quantitative. The data used for the analysis were obtained over a two-year study period (1 May 2001 to 31 April 2003) from the central medicine claims database of Medschem&. Data was analysed according to prevalence, cost and original (innovator) or generic medicine items. For the purpose of this study antibiotics referred to beta-lactams (penicillins, cephalosporins and "others"), erythromycin and other macrolides, tetracyclines, sulphonamides and combinations, quinolones, chloramphenicol and aminoglycosides. The results of the empirical investigation showed the total number of medicine items claimed during the study period amounted to 49098736 medicine items having a total expenditure of R7150344897.00. There was a decrease in the prevalence of original (innovator) products during the two-year period. The prevalence of generic products increased from 25.87% to 32.47%. A total of 4092495 antibiotic medicine items were claimed with a total cost of R526309279.43 representing 7.36% (n = R7150344897.00) of all pharmaceutical products purchased during the two-year period. Original antibiotics had a prevalence of 42.32%, while generic antibiotics constituted 57.68% of all antibiotic products claimed (n = 4092495). However, original (innovator) products contributed 62.32% and generic products 37.68% to the total cost of all antibiotics claimed. It was concluded that the beta-lactam antibiotics represented 56.99% of all antibiotics claimed (n = 4092495) and contributed 52.51% to the total antibiotic expenditure (n = R526309279.43) for the two-year period. The average cost of beta-lactam items ranged between R112.88 * 69.95 and R122.18 + 81.42. The Medschema Price List (MPL) was implemented in May 2001. The aim of this reference pricing system was to allocate a ceiling price to a group of drugs, which are similar in terms of composition, clinical efficacy, safety and quality, with the ultimate goal to reduce medicine expenditure. During the year of implementation of the MPL 62.24% of beta-lactam antibiotics claimed (n = 1303464) were MPL listed. These products contributed 43.25% to the total cost of all beta-lactam antibiotics (n = R157142778.38). Medical aid companies reimbursed R61649211.86 for penicillins claimed and MPL listed. If all penicillin products were claimed at the ceiling price set by the MPL, a cost saving of 2.79% could have been achieved. Cost analysis indicated that it is possible to reduce health care costs by implementing strategies with the aim to reduce medicine cost. Further research, however, is necessary and in this regard recommendations for further research were formulated. / Thesis (M.Pharm. (Pharmacy Practice))--North-West University, Potchefstroom Campus, 2005.

The most frequent intervention performed by physicians is the writing of a prescription. Modern medicine has been remarkably effective in managing diseases. Medicines play a fundamental role in the effectiveness, efficiency and responsiveness of health care systems. However, health care expenditure is a great cause for concern and many nations around the world struggle to contain rising health care costs. Pharmaceutical benefit management programmes such as pharmacoeconomics, drug utilisation review (DUR) and disease management have emerged as control tools to ensure cost effective selection and use of medicine. These managed care instruments are often used to determine whether new strategies or interventions, such as the implementation of a managed medicine reference price list, are appropriate and have "value". The general objective of this study was to investigate the influences of the implementation of a managed medicine reference price list on the usage and cost of antibiotic medicine in the private health care sector of South Africa. The research design used in this study was retrospective, non-experimental and quantitative. The data used for the analysis were obtained over a two-year study period (1 May 2001 to 31 April 2003) from the central medicine claims database of Medschem&. Data was analysed according to prevalence, cost and original (innovator) or generic medicine items. For the purpose of this study antibiotics referred to beta-lactams (penicillins, cephalosporins and "others"), erythromycin and other macrolides, tetracyclines, sulphonamides and combinations, quinolones, chloramphenicol and aminoglycosides. The results of the empirical investigation showed the total number of medicine items claimed during the study period amounted to 49098736 medicine items having a total expenditure of R7150344897.00. There was a decrease in the prevalence of original (innovator) products during the two-year period. The prevalence of generic products increased from 25.87% to 32.47%. A total of 4092495 antibiotic medicine items were claimed with a total cost of R526309279.43 representing 7.36% (n = R7150344897.00) of all pharmaceutical products purchased during the two-year period. Original antibiotics had a prevalence of 42.32%, while generic antibiotics constituted 57.68% of all antibiotic products claimed (n = 4092495). However, original (innovator) products contributed 62.32% and generic products 37.68% to the total cost of all antibiotics claimed. It was concluded that the beta-lactam antibiotics represented 56.99% of all antibiotics claimed (n = 4092495) and contributed 52.51% to the total antibiotic expenditure (n = R526309279.43) for the two-year period. The average cost of beta-lactam items ranged between R112.88 * 69.95 and R122.18 + 81.42. The Medschema Price List (MPL) was implemented in May 2001. The aim of this reference pricing system was to allocate a ceiling price to a group of drugs, which are similar in terms of composition, clinical efficacy, safety and quality, with the ultimate goal to reduce medicine expenditure. During the year of implementation of the MPL 62.24% of beta-lactam antibiotics claimed (n = 1303464) were MPL listed. These products contributed 43.25% to the total cost of all beta-lactam antibiotics (n = R157142778.38). Medical aid companies reimbursed R61649211.86 for penicillins claimed and MPL listed. If all penicillin products were claimed at the ceiling price set by the MPL, a cost saving of 2.79% could have been achieved. Cost analysis indicated that it is possible to reduce health care costs by implementing strategies with the aim to reduce medicine cost. Further research, however, is necessary and in this regard recommendations for further research were formulated. / Thesis (M.Pharm. (Pharmacy Practice))--North-West University, Potchefstroom Campus, 2005.

Section 27(1)(a) of the Constitution of the Republic of South Africa, 1996, entrenches everyone's right of access to health care services. The purpose of this dissertation is to determine the manner in which this right must be interpreted and implemented in order to alleviate poverty to the optimal extent possible, in South Africa. As a point of departure, the relationship between poverty and health, as well as the theoretical basis of poverty, is addressed in terms of soft law. Thereafter, the theoretical basis of the right of access to health care service is analysed and explained from both an international and a South African perspective. This is followed by an investigation into international law. The manner in which the United Nations International Covenant on Economic, Social and Cultural Rights is interpreted and implemented and whether or not this contributes to poverty alleviation, is investigated. This is followed by an analysis of the right in terms of the Constitution and case law. Particular attention is paid to the manner in which the courts interpret the right of access to health care services. It is then determined whether the state is implementing the right in such a manner as to contribute to the optimal alleviation of poverty, in South Africa. Finally, a conclusion is reached and recommendations are made as to ways in which the right can be interpreted and implemented to reduce poverty to the optimal extent possible, in South Africa. / Thesis (LL.M.)--North-West University, Potchefstroom Campus, 2010.

Section 27(1)(a) of the Constitution of the Republic of South Africa, 1996, entrenches everyone's right of access to health care services. The purpose of this dissertation is to determine the manner in which this right must be interpreted and implemented in order to alleviate poverty to the optimal extent possible, in South Africa. As a point of departure, the relationship between poverty and health, as well as the theoretical basis of poverty, is addressed in terms of soft law. Thereafter, the theoretical basis of the right of access to health care service is analysed and explained from both an international and a South African perspective. This is followed by an investigation into international law. The manner in which the United Nations International Covenant on Economic, Social and Cultural Rights is interpreted and implemented and whether or not this contributes to poverty alleviation, is investigated. This is followed by an analysis of the right in terms of the Constitution and case law. Particular attention is paid to the manner in which the courts interpret the right of access to health care services. It is then determined whether the state is implementing the right in such a manner as to contribute to the optimal alleviation of poverty, in South Africa. Finally, a conclusion is reached and recommendations are made as to ways in which the right can be interpreted and implemented to reduce poverty to the optimal extent possible, in South Africa. / Thesis (LL.M.)--North-West University, Potchefstroom Campus, 2010.

Text in English with Abstracts in English and Afrikaans / Health promotion is an educational tool that can be used to educate and create awareness of health issues through various media forms. The purpose of this study was to explore the use of TB Proof South Africa‘s Facebook page in creating TB awareness. The literature on TB, social media, health promotional campaigns and health promotional models was reviewed to contextualise this study. A qualitative case study approach was used to collect data from TB Proof South Africa‘s Facebook page. Data was collected using three data collection methods; namely, online ethnographic observation, textual analysis and visual analysis. The findings indicate that TB Proof South Africa‘s Facebook page creates awareness of TB. Results from this study also suggested collaboration between South African healthcare professionals and traditional health practitioners in the fight against tuberculosis. The study advocates the need for comparative studies to explore the use of other health-related Facebook pages. / Gesondheidsbevordering is ʼn opvoedkundige werktuig wat gebruik kan word om op te voed en bewustheid van gesondheidskwessies deur middel van verskeie mediavorme te skep. Die doel van hierdie studie was om die gebruik van TB Proof South Africa se Facebook-blad in die skepping van TB-bewustheid te verken. Leesstof oor TB, sosiale media, gesondheidsbevorderingsveldtogte en gesondheidsbevorderingsmodelle is beoordeel om hierdie studie te kontekstualiseer. ‘n Kwalitatiewe gevallestudiebenadering is gebruik om data van TB Proof South Africa se Facebook-blad in te samel. Data is ingesamel deur gebruikmaking van drie data-insamelingsmetodes, naamlik aanlyn etnografiese waarneming, teksontleding en visuele ontleding. Die bevindings dui daarop dat TB Proof South Africa se Facebook-blad bewustheid van TB skep. Resultate van hierdie studie beveel ook samewerking tussen Suid-Afrikaanse gesondheidsorgberoepslui en tradisionele gesondheidspraktisyns in die stryd teen tuberkulose aan. Die studie bepleit die behoefte aan vergelykende studies om die gebruik van ander gesondheidsverwante Facebook-blaaie te verken. / Communication Science / M.A. (Communication)

Comprehensive management in the neonatal nursery involves medical treatment of the infant, as well as developmental care and the provision of guidance, counselling and information to the family who are part of the decision-making process regarding the infant’s care. Neonatal communication intervention is of utmost importance in a country such as South Africa, which has an increased prevalence of infants at risk for disabilities and where the majority of these infants live in poverty. Speech-language therapists fulfil an important role in the neonatal nursery and are an integral part of the team involved with the high risk neonatal population. Local literature showed a dearth of information on the current service delivery and roles of speech-language therapists and audiologists in neonatal nurseries in the South African context. From an asset-based perspective it appears that the South African population receiving services in neonatal nurseries have unique characteristics. This provides speech-language therapists with ample opportunity to intervene, providing that intervention is well-timed in the neonatal nursery context. The country-wide initiative to implement the evidence-based technique of kangaroo mother care indicates that speech-language therapists should recognise its importance and develop communication based materials and tools to complement this successful neonatal intervention. The aim of the research was to establish whether speech-language therapists have needs for assessment and intervention tools/materials in this context. The study furthermore aimed to compile a locally relevant neonatal communication intervention instrument/tool for use by speech-language therapists in the neonatal nurseries of public hospitals in South Africa in order to propose a solution to address the shortage of tools in the public health context. The study entailed descriptive, exploratory research. During Phase 1, a survey was received back from 39 speech-language therapists and two audiologists in six provinces. The data revealed that participants performed different roles in neonatal nurseries, which were determined by the environment, tools, materials and instrumentation available to them. Many participants were inexperienced, but were resourceful in their attempts to develop and adapt tools/materials. Participants expressed a need for culturally appropriate and user-friendly instruments for parent guidance and staff/team training on the topic of developmental care. During Phase 2 a tool for parent guidance titled “Neonatal communication intervention programme for parents” was compiled for use by speech-language therapists and justified by participants’ roles and needs as well as current early communication intervention (ECI) literature. The programme was piloted by three participants. Certain suggestions for enhancements of the programme were made such as providing a glossary of terms, adapting the programme’s language and terminology, and providing more illustrations. The programme complied with the guiding principles for best practice in ECI (ASHA, 2008) and can therefore contribute to neonatal care of high risk infants in South Africa. Speech-language therapists and audiologists must contribute to neonatal care of high risk infants to facilitate optimal health and development and to support their families. AFRIKAANS : Omvattende intervensie in die neonatale sorgeenheid behels mediese behandeling van die neonaat, sowel as ontwikkelingstoepaslike sorg en die verskaffing van leiding, berading en inligting aan die gesin wat deel is van die besluitnemingsproses rakende die baba se sorg. Neonatale kommunikasie intervensie is van uiterste belang in Suid-Afrika aangesien daar ‘n hoër prevalensie van babas is wat ‘n risiko het vir ontwikkelingsafwykings en aangesien die meerderheid van hierdie babas in armoede leef. Spraak-taalterapeute vervul ‘n belangrike rol in die neonatale sorgeenheid en is ‘n integrale deel van die span wat betrokke is by die hoërisiko neonatale populasie. Plaaslike literatuur dui op ‘n tekort aan inligting rakende die huidige dienslewering van die spraak-taalterapeut en oudioloog in neonatale sorgeenhede in die Suid-Afrikaanse konteks. Vanuit ‘n bate-benadering kom dit voor of die Suid-Afrikaanse populasie wat dienste in neonatale sorgeenhede ontvang, unieke eienskappe het. Dit bied genoegsame geleenthede aan spraak-taalterapeute om intervensie te verskaf, solank die behandeling betyds in die neonatale sorgeenheid konteks aanvang neem. Daar is ‘n landswye inisiatief om die bewysgerigte tegniek van kangeroe moedersorg toe te pas. Spraak-taalterapeute moet dus die belang daarvan herken en kommunikasie gebasseerde terapiemateriaal ontwikkel om hierdie suksesvolle neonatale intervensie te komplementeer. Die navorsing se doel was om vas te stel hoe wyd spraak-taalterapeute en oudioloe ‘n behoefte aan evaluasie en intervensie instrumente en –materiaal in hierdie konteks het. Die navorsing het verder ten doel gestel om ‘n relevante terapie instrument saam te stel vir spraak-taalterapeute in die neonatale sorgeenhede as ‘n moontlike oplossing vir die tekort aan relevante terapiemateriaal in die plaaslike publieke gesondheidsorgkonteks. Die studie het beskrywende, eksplorerende navorsing behels. Gedurende Fase 1 is ‘n vraelys terug ontvang van 39 spraak-taalterapeute en twee oudioloë in ses provinsies. Die data het aangedui dat deelnemers verskillende rolle in hierdie konteks vervul, wat beïnvloed was deur die omgewing, die instrumentasie en materiaal wat tot hulle beskikking was. Die meerderheid van die deelnemers was onervare, maar was vindingryk in hulle pogings om terapiemateriaal aan te pas en te ontwikkel. Deelnemers het ‘n behoefte vir kultureel toepaslike- en gebruikersvriendelike instrumente en materiaal uitgedruk met die oog op ouerleiding en personeel/span opleiding oor die onderwerp van ontwikkelingstoepaslike sorg. Gedurende Fase 2 is ‘n terapie instrument naamlik “Neonatale kommunikasie intervensie program vir ouers” saamgestel vir die gebruik in die neonatale sorgeenhede deur spraak-taalterapeute. Die samestelling van hierdie program is verantwoord deur die deelnemers se rolbeskrywing en behoeftebepaling van Fase 1, sowel as deur huidige vroeë kommunikasie intervensie (VKI) literatuur. Die program is deur drie deelnemers in ‘n loodsstudie geëvalueer. Voorstelle vir die verbetering van die program is verskaf, naamlik die byvoeging van ‘n terminologielys, aanpassing van die program se taalgebruik en terminologie en verskaffing van meer illustrasies. Die program het ooreengestem met die beginsels vir beste praktyk in VKI (ASHA, 2008) en kan daarom tot neonatale sorg van hoërisikobabas in Suid-Afrika bydra. Spraak-taalterapeute en oudioloë moet bydra tot neonatale sorg van hoërisiko neonate om sodoende optimale gesondheidsorg en ontwikkeling te fasiliteer en gesinne te ondersteun. Copyright / Dissertation (MCommunication Pathology)--University of Pretoria, 2010. / Speech-Language Pathology and Audiology / unrestricted