An article from this thesis is available in the repository at http://hdl.handle.net/10019.1/97621 / Background: Community Assault (CA) or vigilantism is rife in the township of Khayelitsha. Anecdotal evidence suggests that victims of CA are worse off than other assault cases. However, scientific data on the rate and severity of CA cases is lacking for South Africa. Aims and Objectives: To contribute to CA prevention and management strategies, by estimating the rate of CA among adults in Khayelitsha and comparing the injury severity and survival probability between cases of CA and other assault (non-CA) cases. Methods: We studied 4 health centres in Khayelitsha during July - December 2012. A consecutive case-series was conducted to capture all CA cases during this period and a retrospective folder review was performed on all cases of CA as well as on a control group of non-CA cases to compare injury severity and estimate survival probability. Results: One hundred and forty-eight adult cases of CA occurred (case rate 1.1/1000 person-years) over the study period. The Injury Severity Scores (ISS) in the CA group were significantly higher than in the non-CA group (P<0.001), with a median (Inter Quartile Range) ISS of 3 in CA cases (2-6) and 1 in non-CA cases (1-2). Comparison between the two groups showed that a GCS<15 (20.1% versus 5.4%), referral to the tertiary hospital (33.8% versus 22.6%), and crush syndrome (25.7% versus 0%) were all more common in CA cases. Survival probabilities were similar in both groups: 99.2% in the CA group versus 99.3% in the non-CA group. Conclusion: The rate of CA among adults in Khayelitsha is high, and the severity of injuries sustained by CA victims is substantially higher than in other assault cases.

Magister Artium - MA (Linguistics, Language and Communication) / Despite the spread of digital communication technologies and the integration of mobile phones into everyday life, young children's literacy practices are changing rapidly, and schools are struggling to address the potential of these digital communication technologies for learning. Mobile phones are currently a key consumer item, an image of social capital, and they initiate their users into a portable web of numerous applications including those literacy related. Much research has been done on children's relationship with digital technologies and the implications of this for their literacy learning and education in general, but there is almost no research on this in the global south, and almost none in South Africa. Filling this gap is crucial given the crisis in South Africa in basic education. The main aim for this research is to establish the kinds of digital technology and information systems affordances (internet facilities, tablets, books, magazines, newspapers, radios, TVs, video and computer games, etc.) in the homes of the selected children to explore how these digital technologies and information system affordances could be used to enhance the academic literacy development of 12- to 15-year-old children in informal settlements or townships in Cape Town.

Magister Psychologiae - MPsych / The study sought to explore the priorities and practices of educators with regard to the mediation of moral qualities/democratic virtues related to education for citizenship by means of a case study in one school. In South Africa educators are regarded as among the stakeholders responsible for the mediation of values and morals in children and youth so that they will be effective citizens of democracy. Hence the school is seen as an important context in which this could take place. Citizenship education usually contains a moral element. Practices of moral development generally draw on the work of Kohlberg, which is linked to a Piagetian understanding of development. Vygotsky&rsquo;s approach focuses on the contribution that the context has on cognitive development and suggests that this may also be important for moral development. However there is little evidence available concerning the effectiveness of specific interventions. Two groups of educators and one group of learners were interviewed. Educators were asked what moral qualities/democratic virtues they regarded as important to nurture in the learners at this school and what they did to nurture these virtues. Learners were also asked the same question and what they saw their educators doing in order to mediate these moral qualities/democratic virtues. Any constraints and successes were explored together with what educators thought could be done to improve the situation. The theoretical understanding of the research was constructivist and it followed a qualitative case study approach. Data were collected using semistructured interviews and were analysed using a thematic analysis approach. Before the research was undertaken permission was sought from the Western Cape Education Department and the study was conducted following the guidelines for ethical research set by the American Psychological Association. The main priorities that emerged as moral qualities/ democratic virtues that educators thought were important to nurture, were accountability, respect, and commitment to &ldquo;being good.&rdquo; Socially desirable behaviours that were highlighted were the following: economic initiative, citizenship, and politeness and consideration. Cognitive qualities that they thought were important to nurture were the following: open mindedness, literacy, and numeracy. There were also skills that the educators thought were important to nurture in their learners which did not seem to have a moral dimension. The main practices mentioned were: modelling, active instruction and discussion, and discipline. Educators highlighted the importance of consistency throughout the school. Constraints mentioned were the following: lack of discipline, socio-economic factors, and lack of parental involvement. Supportive factors mentioned were parental support, and consistency and collaboration. / South Africa

Masters in Public Administration - MPA / In this report, housing development and perticipation of communities are examined. Although houses have been build in certain areas of Khayelitsha , there is a slow delivery and there is a lack of public involvement in housing programme to decide about the future of the community. In order for any development to be sustainable it must be driven by affected people with a sense of ownership being engendered to them. This holistic approach for housing development is in line up with the current government policy on the matter. / South Africa

Philosophiae Doctor - PhD / This study analyses the relationship between the manner of citizens’ engagement with the state and the level of service delivery they experience in their everyday lives, as residents of Khayelitsha. The phenomena of so-called ‘service delivery’ protests across South Africa have now become a fixture of South African politics. Khayelitsha is one of the sites with frequent protests in Cape Town and is inhabited by poor people, 70 percent of whom live in informal settlements. While the lack of municipal services is undoubtedly a major problem for many poor people in South Africa, thus far, few studies have been dedicated to investigate empirically this alleged link between service delivery and protest activity. The study utilizes mostly quantitative analysis techniques such as regression analysis and path analysis to discover the form and strength of linkages between the service delivery and participation forms. While residents of informal settlements and therefore poorer services were more prone to engage in protests and thus reinforcing the service delivery hypothesis, this relationship was relatively weak in regression analysis. What is more important than the service delivery variables such as water services was the level of cognitive awareness exemplified by the level of political engagement and awareness on the one hand and level of community engagement in terms of attendance of community meetings and membership of different organizations. In summary the study found relatively weak evidence to support the service delivery hypothesis and stronger evidence for the importance of cognitive awareness and resource mobilization theories in Khayelitsha as the key determinant of protest activity. / South Africa

Magister Economicae - MEcon / Livelihoods are essential for poverty alleviation. A poor person’s life cannot be transformed at all if the person has no means of earning a substantial income to sustain daily living. In today’s world many people rely on human capital for livelihoods. This is usually in the form of skills or educational qualifications that permit an individual to find employment. However, not every person is able to get meaningful employment which can generate an income to allow the person to live above the poverty lines. Generating an income from employment is not a livelihoods strategy that is available to many South Africans as the country has high unemployment rates and an economy that is performing poorly. In addition the overspill of institutionalised inequality from the apartheid era has many South Africans living in poverty. The South African government is promoting Small Micro and Medium Scale Enterprises (SMMEs) as a key strategy for job creation, economic growth for poverty alleviation and a reduction in inequalities. Many poor people in urban areas adopt micro enterprises as a livelihoods strategy. The research assessed the impact of micro enterprises on the livelihoods of low income households in Khayelitsha. The objectives of the research were; (a) to determine the impact that micro enterprises have on the livelihoods of low income households; (b) to ascertain how low income households identify micro enterprises as a livelihoods strategy; (c) to identify how household assets were allocated to livelihoods strategies; (d) to determine how low income households operate micro enterprises; and (e) to identify challenges faced by low income households in earning a livelihood through micro enterprises. A qualitative research design was used for the study because the aims of the research were to get an insight as to how people’s lives had transformed by adopting micro enterprises as a livelihoods strategy. To this end, in-depth interviews and observation data collection methods were employed. A study sample of 22 participants was drawn using non-probability sampling. Grounded theory was used for data analysis. Coded data was entered into an Excel spreadsheet which was used to generate graphs and tables. The findings indicate that micro enterprises as a livelihoods strategy have a positive impact on the livelihoods of many households in Khayelitsha. The impact is more significant because many households who engage in micro enterprises do not have other options for livelihoods strategies. Furthermore, many households reported to be better off operating a micro enterprise rather than being employed. Some households reported dissatisfaction with micro enterprises because they could not determine beforehand how much income would be generated making it difficult to plan monthly household expenditure. None the less micro enterprises enabled households to provide shelter, food, education for children and family members, health care and provision of household furniture. The results also indicate that for many micro enterprise owners the lack of financial capital was the biggest challenge because it prevented capital investment. High competition was also a challenge that a few owners were not able to overcome. On the whole the study concluded that micro enterprises are a good livelihoods strategy for the poor and could keep many South Africans above the poverty line.

Magister Curationis - MCur / The introduction of primary health care in South Africa in 1994 marks a new beginning for the majority of the marginalised population in South Africa during the apartheid era. This introduction has improved access to health care in most communities. Health services are now more decentralised with community health centres that are primarily run by nurses. Violence continues to take its toll in post-apartheid South Africa and the youth remain the most affected group of most communities. It often leaves the youth shattered and traumatised with alarming psychological effects, including poor self-esteem. There is a steady increase of youths who are visiting community health centres to seek health care from nurses with a subsequent increased workload for the nurses at these centres. Previous research has dwelt more on either violence on its own, or the youth affected by violence but very little is known about the nurses caring for these youth victims of violence. It is unclear how nurses who are working at a community health centre experience caring for youth victims of violence. The purpose of this study was to explore and describe the experiences of nurses caring for youth victims of violence at a community health centre in Khayelitsha and to develop guidelines for supporting nurses caring for youth victims. A qualitative, exploratory, descriptive, and contextual design was used. The accessible population (N = 40) included all nurses who are registered under Section 31(1) of the Nursing Act No 33 of 2005 in order to practice nursing or midwifery, and who were working at a community health centre in Khayelisha. Purposive and snowball sampling were used. The data collection method comprised an individual unstructured interview while using an audio recorder and documenting field notes. Tesch's descriptive method of open coding was used for data analysis. Trustworthiness was ensured by means of applicability, dependability, transferability and confirmability. The findings from this study indicated that the experience of nurses who were caring for youth victims of violence was particularly related to a number of factors. These factors included challenges faced by the youth in the community, their socio-economic situation, violence and abuse, gangs, substance abuse, illiteracy, teenage pregnancy; as well as challenges face by nurses, under-preparedness, staff shortage, increase workload, rudeness, and verbal and physical abuse of the nurses. They also emphasised some rewarding experiences. There were some psychological effects on nurses and their emotional responses reported by these nurses. The study also revealed the different coping mechanism these nurses were using and their need for support. Guidelines were developed to support nurses. Recommendations for future implementation are presented in the last chapter. / National Research Fund (NRF)

Masters in Public Administration - MPA / Community participation and awareness in disaster risk management is widely recognized as a cornerstone for disaster risk reduction and effective response and recovery strategies. This goes parallel with the world paradigm shift form relief and response to prevention and mitigation. There is gradually increase of fire and floods in informal settlements and Khayelitsha TR- Section in particular. “From 1995-2005 more than 8554 informal dwelling fire incidents occurred in Cape Town alone, affecting 40 558 households and around 160 000 peoples" (DiMP, 2008). And in 2007 alone floods affected 8,000 households and 38 residents in the Cape Town informal settlement of Khayelitsha; Bongani TR-Section and Phillippi; Phola park (Bouchard et al, 2007). This study analyzed community participation and awareness mechanisms in disaster risk management, its implementation, practice and effectiveness, following the promulgation of the Disaster Management Act No 57 of 2002, taking Khayelitsha TR- Section as a case study. In order to achieve the stated objectives, the researcher employed a combination of both qualitative and quantitative research paradigms. In qualitative context semi-structured interviews were conducted with the key informants disaster management officials and Khayelitsha TR-Section ward structure officials. Quantitative method, 100 structured questionnaires were distributed to Khayelitsha TR-Section residents. Using Khayelitsha TR- Section as a case study the thesis argues that despite the enabling policy and resource allocation for community participation and awareness its implementation proved to be a failure. Most of the mechanisms directed by the act are not implemented and those implemented its practice is not effective to achieve its stated objectives of risk reduction and effective response and recovery to disaster incidents. The study reviewed literature and theories of community participation and awareness in disaster risk management. It reviewed and outlined a policy framework and institutional arrangement for community participation and awareness in disaster risk management in accordance with the Disaster Management Act (No 57 of 2002). It further determined the level of community participation and awareness mechanism implementation. Records the level of community awareness and understanding, it determines the effectiveness of community participation and awareness mechanisms and finally based on the empirical results, literature reviews and theories, the study provides a number of recommendations to enhance and improved of community participation and awareness to disaster risk management officials and policy makers.

Magister Scientiae (Nutrition Management) - MSc(NM) / Despite evidence-based proof on the benefits of breastfeeding, little progress has been made globally to improve breastfeeding rates (The Lancet, 2016), including in South Africa. Despite many attempts to improve breastfeeding rates worldwide, women are still choosing to stop breastfeeding or avoid it due to various factors (The Lancet, 2016). Aim: To explore the factors influencing the exclusive breastfeeding rate within the first 14 weeks postpartum with mothers in the Khayelitsha Eastern Substructure.

Master of Public Health - MPH / Background: HIV remains a global concern. Consequently, global institutions such as the World Health Organisation (WHO) and United Nations Programme on HIV and AIDS (UNAIDS) continue to work towards ending HIV/AIDS by facilitating innovative strategies to improve service delivery of antiretroviral therapy (ART). In 2016 WHO issued the ‘test and treat’ policy recommendation in line with the UNAIDS 2020, 90-90-90 target of reaching 90% people to know their HIV status, get 90% of these on ART treatment and to have 90% of those on treatment virally suppressed. Differentiated Care Models (DCMs) has been put in place for all stakeholders, from global, institutes, government departments and civil society to improve patient access to treatment and retention in care. While various evaluation studies have shown that DCMs improve the retention in care and adherence to medication behaviours of patients on ART, little is known about the patients’ experiences and preferences. The aim of the current study was to explore and compare the experiences of patients in three DCMs (Facility Adherence Clubs [FAC], Community Adherence Club [CAC] and Quick Pharmacy Pick-up [QPUP]) in a community health care facility in a township in Cape Town, South Africa. Methods: An exploratory qualitative study design was used. Data were collected through semi-structured interviews (12) and focus group discussions (6) with purposively selected participants from six DCMs. Thematic analysis was done using Atlas.ti version 8.0. Results: Patients found DCMs easily accessible and convenient and presented positive experiences in relation to the National Health Services (NHS) patients experience principles. FACs and CAC presented attributes of patient-centeredness as prescribed by the NHI. We found that the QPUP model fell short on attributes of patient-centeredness such as coordination and integration of care, information sharing, communication and education, and emotional/psychological support. Conclusions: The principles of DCMs acknowledge the diversity and preference of PLHIV in addressing the barriers they face in accessing ART while empowering these patients to self-manage their disease. Understanding the experiences of patients using DCMs could improve our understanding of how DCMs promote self-management among PLHIV (or not) and some of the challenges faced by the patients using these care models. This understanding could inform strategies to tailor ART delivery services that suit the patients’ needs and enhance their abilities to achieve optimal retention in care and viral suppression.