South Africa is currently experiencing rapid social change with socio-economic deprivation, influencing the future orientation of adolescents. Research indicates that a lack of future expectations affects present behaviour−diminishing the possibility of socialisation and productivity in adulthood. The objective of this study is to assess the future perceptions of indigent adolescents. The Gestalt paradigm provided the framework for defining the study. This empirical study uses a mixed methodology design combining both the quantitative and the qualitative approaches. A crosssectional survey provided the groundwork in terms of ascertaining the degree of awareness in respect of the future orientation of indigent, urban adolescents whilst a qualitative, semi-structured, one-on-one interview provided an in-depth contextualisation of the problem. The empirical study demonstrated that, although socio-economic deprivations and pervasive social issues do influence the future orientation of adolescents in South Africa, these influences have not eradicated the indigent adolescents’ motivational striving toward a positive and productive future. / Social Work / M. Diac. (Play Therapy)

The aim of the study was to evaluate the level of community participation employed by the City of Tshwane in the implementation of the Indigent Exit Strategy (IES) as a poverty alleviation measure in Olievenhoutbosch. A total of twenty two respondents participated in the research. The first group was ten beneficiaries and the second was ten that was exited from the database. Lastly, two Social Workers coordinating the programme were interviewed as well. The research findings reflect that the IES was not sufficiently rolled out as outlined in the policy and strategy. Capacity building and skills development, assistance to emerging entrepreneurships and other forms of economic development support did not reach out to the broader community as outlined in the IES. The study recommends that: the Indigent Exit Strategy interventions should be made accessible to the registered indigent households so that they can clearly know what is expected of them. / Development Studies / M. A. (Development Studies)

South Africa's transition to constitutional democracy marked the end of a system of government that perpetuated injustice on the basis of race. The previous system of government, underpinned by the principle of parliamentary supremacy, did not only exclude the majority of the population from public governance processes, it also economically exploited the majority of the population. As such, it laid the foundation for widespread poverty and inequalities in access to basic services. The Constitution of the Republic of South Africa, 1996 (the Constitution), is committed to correcting these past injustices and aims to establish a society based on social justice. This constitutional vision finds expression in the notion of transformative constitutionalism. Klare introduced the notion of transformative constitutionalism over a decade ago. For purpose of this thesis, the notion represents the socio-economic and political vision of post-apartheid South Africa to eradicate extreme poverty and inequalities in access to basic services as well as establish a democratic system of government that is inclusive, caring, participatory, representative and accountable. It captures the constitutional commitment to establish and maintain a society based on social justice by inter alia, eradicating poverty and inequalities in access to social services. The realisation of the socio-economic rights entrenched in the Bill of Rights of the Constitution (by all organs of state) is one of the ways in which to contribute towards meeting this transformative constitutional mandate, and by extension, striving towards the attainment of social justice. Although transformative constitutionalism and the achievement of a socially just society remain an ideal, the Constitution as the supreme law in the country, obligates the state, constitutive of public and private entities, to work towards its realisation, to the fullest extent possible. As part of post-apartheid institutional transformation, the Constitution established three spheres of government – national, provincial and local - which are distinct, interrelated and interdependent. All three spheres are obliged to operate in accordance with the principles of co-operative government and intergovernmental relations and are co-responsible for realising a number of constitutional objectives. Since 1996, the Constitution obliges local government (municipalities) to play an expanded "developmental" role. This has marked a move away from local government being regarded as merely a service delivery arm of government. xii The extended function of local government that came about with the constitutional dispensation finds expression in the notion of "developmental local government". This study is based on the premise that developmental local government must and can, together with the authorities in the other two spheres, contribute to transformative constitutionalism and social justice. Primarily, this study questions the extent to which the legal and policy framework on local government in South Africa enable local government (municipalities) to contribute towards realising the constitutional socio-economic rights underpinning the mandate of transformative constitutionalism. This study presents a review of relevant literature in order to establish links between the theoretical concepts underpinning this thesis. It examines the legal and policy framework on "developmental" local government in South Africa and analyses the central legal framework for the realisation of socio-economic rights at the local government level. In addition, the study explores the relevance and potential of local government indigent policies and Integrated Development Plans (IDPs) - as legally prescribed governance instruments - in contributing towards a more just society by examining their underlying legal and policy framework. It further distils from the theories and perspectives of social justice, benchmarks to guide local government towards achieving the transformative constitutional mandate aimed at social justice. Based on the legal, policy and other gaps identified, recommendations are made on how to optimise the potential of IDPs and municipal indigent policies in contributing towards achieving social justice. / PhD (Law), North-West University, Potchefstroom Campus, 2014

South Africa's transition to constitutional democracy marked the end of a system of government that perpetuated injustice on the basis of race. The previous system of government, underpinned by the principle of parliamentary supremacy, did not only exclude the majority of the population from public governance processes, it also economically exploited the majority of the population. As such, it laid the foundation for widespread poverty and inequalities in access to basic services. The Constitution of the Republic of South Africa, 1996 (the Constitution), is committed to correcting these past injustices and aims to establish a society based on social justice. This constitutional vision finds expression in the notion of transformative constitutionalism. Klare introduced the notion of transformative constitutionalism over a decade ago. For purpose of this thesis, the notion represents the socio-economic and political vision of post-apartheid South Africa to eradicate extreme poverty and inequalities in access to basic services as well as establish a democratic system of government that is inclusive, caring, participatory, representative and accountable. It captures the constitutional commitment to establish and maintain a society based on social justice by inter alia, eradicating poverty and inequalities in access to social services. The realisation of the socio-economic rights entrenched in the Bill of Rights of the Constitution (by all organs of state) is one of the ways in which to contribute towards meeting this transformative constitutional mandate, and by extension, striving towards the attainment of social justice. Although transformative constitutionalism and the achievement of a socially just society remain an ideal, the Constitution as the supreme law in the country, obligates the state, constitutive of public and private entities, to work towards its realisation, to the fullest extent possible. As part of post-apartheid institutional transformation, the Constitution established three spheres of government – national, provincial and local - which are distinct, interrelated and interdependent. All three spheres are obliged to operate in accordance with the principles of co-operative government and intergovernmental relations and are co-responsible for realising a number of constitutional objectives. Since 1996, the Constitution obliges local government (municipalities) to play an expanded "developmental" role. This has marked a move away from local government being regarded as merely a service delivery arm of government. xii The extended function of local government that came about with the constitutional dispensation finds expression in the notion of "developmental local government". This study is based on the premise that developmental local government must and can, together with the authorities in the other two spheres, contribute to transformative constitutionalism and social justice. Primarily, this study questions the extent to which the legal and policy framework on local government in South Africa enable local government (municipalities) to contribute towards realising the constitutional socio-economic rights underpinning the mandate of transformative constitutionalism. This study presents a review of relevant literature in order to establish links between the theoretical concepts underpinning this thesis. It examines the legal and policy framework on "developmental" local government in South Africa and analyses the central legal framework for the realisation of socio-economic rights at the local government level. In addition, the study explores the relevance and potential of local government indigent policies and Integrated Development Plans (IDPs) - as legally prescribed governance instruments - in contributing towards a more just society by examining their underlying legal and policy framework. It further distils from the theories and perspectives of social justice, benchmarks to guide local government towards achieving the transformative constitutional mandate aimed at social justice. Based on the legal, policy and other gaps identified, recommendations are made on how to optimise the potential of IDPs and municipal indigent policies in contributing towards achieving social justice. / PhD (Law), North-West University, Potchefstroom Campus, 2014

South Africa is currently experiencing rapid social change with socio-economic deprivation, influencing the future orientation of adolescents. Research indicates that a lack of future expectations affects present behaviour−diminishing the possibility of socialisation and productivity in adulthood. The objective of this study is to assess the future perceptions of indigent adolescents. The Gestalt paradigm provided the framework for defining the study. This empirical study uses a mixed methodology design combining both the quantitative and the qualitative approaches. A crosssectional survey provided the groundwork in terms of ascertaining the degree of awareness in respect of the future orientation of indigent, urban adolescents whilst a qualitative, semi-structured, one-on-one interview provided an in-depth contextualisation of the problem. The empirical study demonstrated that, although socio-economic deprivations and pervasive social issues do influence the future orientation of adolescents in South Africa, these influences have not eradicated the indigent adolescents’ motivational striving toward a positive and productive future. / Social Work / M. Diac. (Play Therapy)

The aim of the study was to evaluate the level of community participation employed by the City of Tshwane in the implementation of the Indigent Exit Strategy (IES) as a poverty alleviation measure in Olievenhoutbosch. A total of twenty two respondents participated in the research. The first group was ten beneficiaries and the second was ten that was exited from the database. Lastly, two Social Workers coordinating the programme were interviewed as well. The research findings reflect that the IES was not sufficiently rolled out as outlined in the policy and strategy. Capacity building and skills development, assistance to emerging entrepreneurships and other forms of economic development support did not reach out to the broader community as outlined in the IES. The study recommends that: the Indigent Exit Strategy interventions should be made accessible to the registered indigent households so that they can clearly know what is expected of them. / Development Studies / M. A. (Development Studies)

Contexte : La mauvaise qualité et la faible utilisation des services de santé contribuent aux taux élevés de morbidité et de mortalité dans plusieurs pays à faible et à moyen revenu. Face à cette situation, le gouvernement du Burkina Faso a testé une intervention novatrice qui combine le financement basé sur la performance (FBP) à des mesures d'équité en santé. Les formations sanitaires ont reçu des prix unitaires pour des services de santé fournis ainsi que des bonus conditionnels à la qualité des soins. Des comités communautaires ont sélectionné les indigents pour leur octroyer des exemptions de paiements des soins. Malgré le peu d’études sur le sujet, des acteurs en santé mondiale craignent que l’intervention puisse avoir des conséquences non intentionnelles importantes. Objectif : Cette thèse vise à accroître les connaissances scientifiques sur les conséquences non intentionnelles du FBP combiné à des mesures d'équité en santé dans un environnement à faible revenu. Méthodes : Nous avons développé un cadre conceptuel basé sur la théorie de la diffusion des innovations. Une étude de cas multiples a été réalisée avec neuf formations sanitaires au Burkina Faso. Cinq mois sur le terrain ont permis d’effectuer 104 entrevues semi-structurées, 266 séances d'observation et des conversations informelles avec un large éventail d'acteurs incluant les prestataires de soins, les patients et les vérificateurs. Les données qualitatives ont été codées avec QDA miner pour faciliter l’analyse thématique. Nous avons également utilisé des données quantitatives du système de gestion pour décrire l'évolution des services et trianguler les résultats. Résultats : La nature et la mise en œuvre de l'intervention ont interagi avec le système social et les caractéristiques de ses membres pour engendrer des conséquences non intentionnelles importantes, dont la plupart étaient indésirables. Les prestataires de soins ont démontré une fixation sur les mesures de rendement, ont falsifié les registres médicaux et ont enseigné de mauvaises pratiques aux stagiaires pour augmenter leurs subsides et bonus. Comme conséquence non intentionnelle désirable, certaines formations sanitaires ont limité la vente de médicaments sans prescriptions pour encourager les consultations. Les vérifications communautaires, durant lesquelles les patients sont retrouvés pour vérifier les services déclarés, ont entraîné la falsification des données de vérification, la perte de la confidentialité des patients et certaines craintes chez les patients, bien que certains étaient heureux de partager leurs opinions. Enfin, les prestataires de soins ont limité les services offerts gratuitement aux indigents, ce qui a déclenché des conflits. Discussion : Cette thèse contribue au développement des connaissances scientifiques sur la façon dont le FBP, combiné à des mesures d'équité, peut engendrer des conséquences non intentionnelles. Les résultats sont utiles pour affiner ce type d’intervention et éclairer une mise en œuvre efficace dans le secteur du financement de la santé. Plus largement, cette thèse démontre la faisabilité et la valeur ajoutée d'utiliser un cadre conceptuel pour étudier les conséquences non intentionnelles. Elle pourra guider les chercheurs à élargir leur angle d’analyse afin de rendre compte des conséquences intentionnelles et non intentionnelles des interventions complexes en santé. / Background: Poor quality and low utilization of healthcare services contribute to high levels of morbidity and mortality in many low- and middle-income countries (LMICs). In response, the government of Burkina Faso tested an innovative intervention that combines performance-based financing (PBF) with health equity measures. Healthcare facilities received unit fees for targeted services and bonuses conditional upon the quality of care. To reduce inequities in access to care, community-based committees selected indigents, i.e., the poorest segment of the population, to offer them user fee exemptions. Facilities were also paid more for services delivered to indigents. Despite the potential of this type of intervention, many global health actors argue that it could lead to important unintended consequences that influence its overall impact. Yet, little attention has been given to studying the unintended consequences of this complex intervention. Objective: This thesis aims to increase the scientific knowledge on the unintended consequences of PBF combined with health equity measures in a low-income setting. Methods: We developed a conceptual framework based on the diffusion of innovations theory. Using a multiple case study design, we selected nine healthcare facilities in Burkina Faso. Over five months of fieldwork, we collected multiple sources of qualitative data including 104 semi-structured interviews, 266 recorded observation sessions, informal conversations and documentation. Participants included a wide range of stakeholders, such as providers, patients, and PBF verifiers. Data were coded using QDA miner to conduct a thematic analysis. We also used secondary data from the PBF routine management system to describe the evolution of services and triangulate results. Results: Interactions between the nature and implementation of the intervention, the nature of the social system, and its members’ characteristics led to important unintended consequences, most of which were undesirable. Providers were fixated on performance measures rather than on underlying objectives, falsified medical registers, and taught trainees improper practices to increase subsidies and bonuses. As a desirable unintended consequence, we found that some facilities limited the sale of non-prescribed medication to encourage patients to consult. Community verifications, in which patients are traced to verify the authenticity of reported services and patient satisfaction, also led to unintended consequences, such as the falsification of verification data, the loss of patient confidentiality, and fears among patients, although some were pleased to share their views. Lastly, health equity measures also triggered changes that were not intended by program planners. For example, providers limited the free services and medication delivered to indigents, which led to conflicts between parties. Discussion: This thesis contributes to the development of scientific knowledge on how PBF interventions, combined with equity measures, can trigger unintended consequences in a low-income setting. The results are useful to inform effective implementation and refine interventions, particularly in the health financing sector. More broadly, this thesis demonstrates the feasibility and added value of using a conceptual framework to study the unintended consequences of complex health interventions. This thesis can inspire and guide future researchers to broaden their analytical horizons to capture both intended and unintended consequences of health interventions.

Most households from rural areas did not have access to basic municipal services prior to the advent of democracy in 1994. The most affected were those from the former homelands and deep rural areas from the former South Africa. Hence, since 1994, the South African government has inherited huge infrastructure backlogs which affect effective delivery of basic municipal services, particularly Free Basic Services (FBS), to alleviate the plight of the rural and poor communities. Municipalities have to be self-sustainable for effective service delivery, even though their revenue base is such that they cannot generate enough income to maintain, extend and sustain basic services. Yet, they are mandated by the Constitution of the Republic of South Africa, 1996 to deliver services to all communities within their areas of jurisdiction, irrespective of whether the beneficiaries of the services contribute to their revenue. For this reason, the national government has committed in the Constitution to allocate funding to municipalities through the equitable share allocations to subsidise the costs of providing FBS to indigent households. However, the impact of the FBS programme on indigent households in the Polokwane Local Municipality has not been significant, given the effective management of the programme. Hence, this study was conducted at the Polokwane Local Municipality to establish the effectiveness of the management of the funding allocated for the provision of FBS. The primary aim of the study was to determine the extent to which the Polokwane Local Municipality effectively manages the provision of FBS and the related funding to establish deficiencies in the system, with a view to improve the effectiveness of FBS delivery to indigent households. The data comprised responses to a questionnaire, semi-structured interviews, documents and studies conducted at the Polokwane Local Municipality. The study highlighted that the Polokwane Local Municipality has developed an indigent policy for the implementation of the FBS programme; however, it is only applied in urban or established areas, thus only covering Polokwane city, Seshego and Westernburg out of a possible 265 settlements. Proper planning is also only done around these three areas, while estimations are made for rural areas or villages in terms of targeted households and budgets. Furthermore, National Treasury provided more than three times the funding budgeted by the municipality to fund the FBS programme. This suggests that the rest of the funds allocated for FBS delivery were used for municipal operations rather than for benefitting indigent households. Therefore, it can be concluded that the Polokwane Local Municipality does not manage the funding allocated for FBS effectively, given the limitations in the registration of indigent households as well as the planning, budgeting and implementation of the FBS programme. Finally, the study could not establish whether the municipality is making any impact on the lives of the indigent households as the municipality has not assessed the impact of the FBS programme on the indigent households since the inception of the programme in 2000. The study will enable the development of proposals and recommendations which can assist in improving the effectiveness of the Polokwane Local Municipality’s management of funding allocated for the provision of FBS. / Public Administration and Management / M. Admin. (Public Administration)

The Extended Public Works Programme (EPWP) is a government programme targeted at unemployed individuals. Public entities at the national, provincial and municipal level implement the EPWP. The City of Tshwane Metropolitan Municipality (CTMM) is one of the entities implementing the EPWP at the local level. This study investigated the implementation of the EPWP within the CTMM with a view to understand the current implementation approach. The CTMM has been unable to achieve their EPWP annual targets since 2009. The CTMM experienced the lack of attaining targets mainly in relation to persons with disabilities (2%), and indigents (50%). Other challenges include the lack of training EPWP participants in specialized skills; the unsustainable nature of the EPWP projects; and un-approval of the draft EPWP policy. This study proposes interventions with regard to the coordination of the EPWP, improved monitoring of projects, training, indigent criteria, and approval of the EPWP policy within the CTMM. / Development Studies / M.A. (Development Studies)

The Extended Public Works Programme (EPWP) is a government programme targeted at unemployed individuals. Public entities at the national, provincial and municipal level implement the EPWP. The City of Tshwane Metropolitan Municipality (CTMM) is one of the entities implementing the EPWP at the local level. This study investigated the implementation of the EPWP within the CTMM with a view to understand the current implementation approach. The CTMM has been unable to achieve their EPWP annual targets since 2009. The CTMM experienced the lack of attaining targets mainly in relation to persons with disabilities (2%), and indigents (50%). Other challenges include the lack of training EPWP participants in specialized skills; the unsustainable nature of the EPWP projects; and un-approval of the draft EPWP policy. This study proposes interventions with regard to the coordination of the EPWP, improved monitoring of projects, training, indigent criteria, and approval of the EPWP policy within the CTMM. / Development Studies / M. A. (Development Studies)