The majority of persons within South Africa (of whom 16% have claimed to have suffered from common mental disorders such as depression) that use medical treatment do so through primary care (Patel et al., 2007; Williams et al., 2007). However, studies have shown that general practitioners (GPs) often overlook, ignore, misdiagnose and even offer inappropriate treatment for mental illness (c.f. Lotrakul & Saipanish, 2009; Qwabe, 2009). Since South Africa is comprised of a multitude of diverse peoples from varying culture backgrounds, cultural diversity needs to be considered within every interaction, especially when GPs consult with individuals with depression. This study, thus, aims to explore GPs’ management of depression by investigating diagnosis or detection, treatment and referral patterns of GPs where their considerations of patient’s cultural worldviews are also investigated. This study utilised a semi-structured interview schedule on a convenient sample of six GP’s. Thematic content analysis was used to analyse salient themes from the data. Eight themes were found, namely: diagnosing, treating and referring patients with depression, cultural implications in general practice, training of GPs, the evolution of the medical field and its practices, disadvantaged communities and access to health care resources as well as the ethics of practice. These results are discussed in relation to local and international literature in the field.

Thesis submitted in fulfilment of the requirements for the degree Master of Technology: Horticulture in the Faculty of Applied Sciences at the Cape Peninsula University of Technology / The high demand for medicinal plants has favoured over-exploitation of wild plants. The search for alternative and sustainable methods of medicinal plant cultivation is imperative and desirable. Biotechnological approaches particularly hydroponic technology has the potential for large scale plant cultivation and production of secondary metabolites. The current study aims at optimizing the production of antimicrobial secondary metabolites by an indigenous South African medicinal plant species (Helichrysum cymosum) through hydroponics N and K fertilization. In Chapter 1, the conceptual framework and justifications of the study are presented. In Chapter 2 the research objective was to discern the optimal potassium (K) supplement level for H. cymosum by evaluating the effects of different hydroponic K levels on growth, K-leaf content, and anti-Fusarium oxysporum f.sp.glycines (Ascomycota: Hypocreales) and total activities. Six weeks old seedlings of H. cymosum were treated with varied concentrations of K in the form of potassium chloride, potassium nitrate and monopotassium phosphate (58.75, 117.5, 235 and 470 ppm). These concentrations were based on a modification of Hoagland’s hydroponic nutrient formula. Plants were maintained under greenhouse conditions and growth parameters (plant height and number of leaves) were recorded weekly. At 8 weeks post treatment, plants were harvested and fresh weights were recorded and tissue nutrient content analysed. Sub-samples of the aerial parts of plants grown in the different treatments were air dried, extracted with acetone and tested against F. oxysporum. Plants exposed to 235 ppm K showed a marked increase in leaf number, plant height and fresh weight. Overall there was no significant difference (P > 0.05) among the treatments with respect to tissue nutrient content; K ranged from 3.56 ± 0.198 to 4.67 ± 0.29 %. The acetone extraction yield increased with increasing K fertilization: 58.75 ppm (16.67 ± 2.35 mg), 117.5 ppm (22.5 ± 4.79 mg), 235 ppm (210 ± 38.5 mg) but dropped to 40 ± 4.08 mg at 470 ppm K. Results from the anti-F. oxysporum bioassay showed that 58.75 and 235 ppm K treatments produced the most bioactive acetone extracts; MIC values of 0.49 and 0.645 mg/l, respectively. Acetone extracts obtained from plants exposed to 235 ppm K yielded the highest total activity, comparatively (P < 0.05). In conclusion, the optimum nutrient K level for growing H. cymosum hydroponically was 235 ppm. Chapter 3 focused on another important macro nutrient N and the objective was to determine the optimum nutrient requirements for growing the medicinal plant, Helichrysum cymosum (L.) (Asteraceae), hydroponically. Experiments were conducted to assess the effects of varied nitrogen (N) concentrations supplied as nitrate and ammonium on growth, tissue nutrient content, antimicrobial and total activities of acetone extracts of aerial parts. Treatments were based on a modified Hoagland’s nutrient formula. Six week old rooted cuttings were treated with 52.5 ppm, 105 ppm, 210 ppm and 420 ppm of N. Leaf number and stem height (cm) were recorded at weekly intervals and leaf analysis conducted. The effects of N treatments on plant growth parameters varied significantly among treatments; 52.5 ppm of N yielded the tallest plants (height) [19.4 ± 0.7 cm], while 105 ppm N yielded the maximum leaf number (68.1 ± 6.2) as well as maximum fresh weight of aerial parts was obtained with 105 ppm (15.12 ± 1.68 g). Nitrogen content of plant tissue ranged between 0.53 ± 0.03 and 4.74 ± 0.29% (d, f, 3, 12; f=14; P ≤ 0.002) depending on treatments. Powdered aerial parts (5 g) of H. cymosum obtained from the different N treatments were extracted with 100 ml of acetone. N treatment significantly affected the yield of crude extracts, which ranged from 87.5 ± 15.5 (52.5 ppm) to 230 ± 23.5 mg (105 ppm). Acetone extracts of plants that were exposed to varied N treatments were screened for anti-Fusarium oxysporum activity using minimum inhibitory concentration (MIC) method. The MIC value (0.073 ± 0.014 mg/ml) obtained with acetone extracts of plants exposed to 52.5 ppm N was significantly lower compared to the MICs of the other N treatments (105 [0.47 ± 0 and 0.705 ± 0.135 mg/ml], 210 [0.234 and 0.47 mg/ml] and 420 ppm [0.29 ± 0.101 mg/ml]) at 24 and 48 hours respectively. However, the total activities of extracts obtained among the four N treatments, which ranged from 0.062 ± 0.02 to 0.26 ± 0.06 ml/g was not statistically different at 24 or 48 hours (P > 0.05). LC-MS analysis of acetone extracts of H. cymosum plants obtained from the four treatments hinted that known anti-microbial agents such as apigenin, quercetin, kaempferol, helihumulone and quinic acids were present in the extracts and the quantity of helihumulone increased with increased nutrient N level. These results suggest that H. cymosum may be cultivated hydroponically and that the antimicrobial activity and/or the phytochemical profile of the crude acetone extracts is affected by nutrient nitrogen levels. Hydroponic cultivation of plants may be able to alleviate to an extent the pressure on wild medicinal plants.

Thesis (M.A. (African Languages)) --University of Limpopo, 2012 / Refer to the document

Thesis (M. A. (Sociology)) -- University of the North, 2000 / Refer to the document / NRF (National Research Foundation)

Thesis (M.Cur.) --University of Limpopo, 2013 / Indigenous knowledge (IK) originated from a particular community within a broader cultural tradition. It is stated that IK is socially transmitted shared knowledge, beliefs, and/or practices that vary systematically across different cultural groups. It is further indicated that IK is a critical determinant of human behaviour and health, and the intergenerational mother in the society. Indigenous forms of communication and organisation are seen as important to family and societal decision-making processes with regard to health related issues like care given to children from birth onwards and curing of childhood illness. The operational plan for Comprehensive HIV and AIDS Care, Management and Treatment (CCMT) South Africa points out that some South African citizens prefer to consult traditional health practitioners (THPs) on a regular basis for their health problems. The study conducted by Peltzer, Phaswana-Mafuya and Treger (2009) points out that THPs use indigenous practices to prevent and heal childhood illnesses. The aim of the study: To determine indigenous practices by mothers of children admitted in the paediatric unit of a Polokwane/Mankweng hospital complex in the Limpopo Province. The objectives of this study: To explore and describe the indigenous practices of mothers of children admitted in a paediatric unit of a Polokwane/Mankweng hospital complex, Limpopo Province, and to recommend guiding principles based on the study findings for healthcare professionals on the strategies that can be used to assist mothers of children admitted in a paediatric unit of a Polokwane/Mankweng hospital complex of the Limpopo Province. Design and Method: A qualitative, descriptive and explorative research design was conducted for the participants to describe the indigenous practices in relation to managing and treating childhood illnesses. Data were collected by means of unstructured one-on-one interviews at the Mankweng/ Polokwane hospital complex with mothers of children admitted at the paediatric unit. Criteria for trustworthiness were observed as stipulated in Babbie and Mouton (2009). Ethical standards by DENOSA (1998) were adhered to in order to ensure the quality of the study. Findings: Three themes with sub-themes emerged from the data analysis, using Tech’s open coding approach (Cresswell 2009:186), i.e. analogous indigenous practices in curing childhood illnesses, believes related to the indigenous healing process and THP treating of HIV infected children. It is recommended that healthcare providers need to have understanding of indigenous belief systems in relation to healthcare, and work towards incorporating this understanding into their service delivery to recognise and to embark upon the journey of working with THPs.

Thesis (M.Sc. (Agriculture)) --University of Limpopo, 2006 / Refer to document / National Research Foundation (NRF) and Cannon Collins Educational Trust Fund of Southern Africa (CCETSA)

M. Tech. Business Information Systems / The acceptance of E-health in South African Hospitals and other developing countries is slow and confusing. Healthcare professionals must be fully engaged in the E-health decision making since they are the main users of E-health systems. It is important to note that using E-health to support the daily work of healthcare professionals can improve healthcare provision and so improve citizens' health. However, investing in affordable E-health applications that can help in realising the benefits of technology and minimizing health costs is not easy. Literature shows that much as there are several studies that have been conducted in respect of technology acceptance, adoption and use, little attention has been given to E-health acceptance in South Africa. Therefore, this study sought to design a model for E-health acceptance for South African hospitals.

South Africa has a high HIV/AIDS prevalence. Due to the unavailability of antiretroviral drugs and South African’s trust in traditional healers for health problems, traditional healers are involved in treating HIV/AIDS. This dissertation outlines traditional healers’ role in HIV/AIDS in Tembisa, a township situated in the East Rand section of Johannesburg. People living with HIV/AIDS, traditional healers and health care workers were interviewed. The dissertation also confirms the high prevalence of HIV/AIDS in Tembisa.. According to the dissertation, a reasonable highest number of People Living with HIV/AIDS (PLWAS) 8 out of 10 consulted Traditional healers to seek treatment of HIV/AIDS Opportunistic infections, although three out of eight indicated that consulting traditional healers was not necessarily their own choice. Two PLWAS do not believe in traditional healers and have never consulted them. Five PLWAS’s view was that Traditional healers can treat opportunistic infections effectively and they indicated their own health bear evidence to such claims. The study had shown that, although traditional healers have shown good rapport with their clients, and have earned positive respect due to their involvement in HIV/AIDS prevention and treatment in their communities, there are also challenges with regards to their work that calls for urgent attention. For an example, a highest number of Traditional healers did misrepresent diseases related to sexual intercourse, and also they could not recognize the symptoms of HIV/AIDS. They also hardly gave all biomedical perspective of transmission of HIV/AIDS without being probed. Both the group that believed in traditional healers and those that do not, as well as Biomedicine indicated that using traditional healers alone without biomedicine is not a realistic option.due to their training that is not homogenous and their profession that is rarely regulated. All the participants interviewed were in support of the strong collaboration between traditional healers and Biomedicine. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2005.

This study was aimed at identifying and exploring the perceptions of traditional healers particularly izangoma and izinyanga, on the integration of their practices into the South African National Health System. The main reason behind this research was to establish the position of traditional healers as well as to study their opinions on the issue of integration. The paucity of previous research studies on the 'perceptions of traditional healers on the integration of their practice-s into the national health care system, was the main motivation behind this study. Participants were drawn from the Pietermaritzburg area and selection was based on purposeful sampling. The data of the study was collected by means of semi-structured interviews, which employed open- ended questions. This study was conceptualized within the African world-view and cosmology. The interactive model design by Maxwell (1996) was employed in the design of this study. According to this model the purpose, conceptual context, research questions and methods as well as issues of validity and reliability, are all essential for the coherence of any qualitative study. The ethical considerations of this study were mainly around the issue of informed consent, and this was negotiated and discussed with the participants until they could understand the process of consent. The results of the study reflect the fact that traditional healers are positive about the process of integration. However, the participants were in favol of integration as a process of collaboration and co-operation as opposed to total integration, which was perceived as a process in which one system w0ll-Id dominate and oppress the other. The participants in this study perceive themselves as equal to their western counterparts because oftheir training and ability to treat "spiritual illnesses". Further, they view their role as that of providing alternative healing as well as acting as a medium between people and their ancestors. Education and negotiations were identified as the possible solutions to most problems in the process of integration. The findings of this study further reveal that there is mistrust and suspicion about western healers form traditional healers. As a result of this, improved collaboration between traditional and modem health care systems seems to be the only process, which could benefit all the people of the country. / Thesis (M.A.)-University of Natal, Pietermaritzburg, 2000.

Merwilla natalensis (Planchon) Speta is ranked as one of the most commonly sold medicinal plants at most of the informal medicinal plant markets found throughout South Africa. The increasing demand for medicinal plants has resulted in over-exploitation of many of the wild populations. Overharvesting has resulted in M. natalensis being declared vulnerable. Although this species is so popular, and reports state that the bulbs are used for a variety of ailments, very little is known about its pharmacological activity or phytochemical composition. Extracts were made from mature M. natalensis bulbs using hexane, dichloromethane, methanol and water. These extracts were screened for antibacterial, anticancer, anti-inflammatory, antischistosomal and anthelmintic activity. Antibacterial activity was evaluated using the minimal inhibitory concentration (MIC) assay. Methanol extracts displayed good antibacterial activity against both Gram-positive (Bacillus subtilis and Staphylococcus aureus) and Gram-negative (Escherichia coli and Klebsiella pneumoniae) bacteria. Anti-inflammatory activity was evaluated using the COX-1 and COX-2 bioassays. Dichloromethane extracts displayed the highest inhibitory activity against both COX-1 and -2 enzymes. (80% and 91% inhibition respectively) Very good activity was displayed against the free-living nematode Caenorhabditis elegans and the schistosomula worms of Schistosoma haematobium using microdilution techniques. Anticancer activity was evaluated using the biochemical induction assay (BIA) in which DNA-damaging properties are tested for. No activity was found using this assay, however, these results do not prove that M. natalensis does not have other anticancer properties. The phytochemical investigation of mature M. natalensis plants showed the bulbs to contain both saponins and bufadienolides. One of the bufadienolides had the same Rf value as proscillaridin A. Cytotoxicity tests reveal M. natalensis to be extremely cytotoxic, yet the bulbs are commonly sold at traditional medicine markets around South Africa. This cytotoxicity may be accredited to the presence of saponins within the bulbs. No alkaloids or tannins were detected in the bulbs. With the growing population in South Africa, there is an increasing demand for traditional medicines. This increasing demand is placing tremendous strain on natural populations growing in the wild. However, as the demand cannot continue to be met other sources are needed. Tissue cultured plants have been grown at two different regions of South Africa. These plants have been grown under different conditions to determine the optimal ones needed to grow M. natalensis as a commercial crop on small-scale farms. Plantlets taken directly from tissue culture were acclimatized successfully for cultivation by means of simple and cost effective methods. Cultivated plants were harvested on a six-monthly basis for a period of two years. Field cultivation produced bulbs of almost marketable size (±300g fresh weight) after 24 months. Bulb size was not dependent on additional fertilizer or irrigation. No significant differences (p<_0.05) were shown in the average dry weights of bulbs grown under different treatments (control, fertilizer without irrigation, fertilizer with irrigation). Leaf senescence and dormancy of young plants were prevented with irrigation. Flowering occurred after 24 months, with the irrigation and fertilizer plot having the most flowering plants. TLC fingerprinting revealed differences in the chemical composition of the bulbs harvested at different stages of growth. Noticeable differences were found between bulbs cultivated at the different growing sites. Pharmacological screenings were done of the harvested bulbs to investigate the effect of age (time of harvest) and growing conditions on antibacterial, anti-inflammatory and anthelmintic activity. Methanol extracts were screened against Gram-positive (Bacillus subtilis and Staphylococcus aureus) and Gram-negative (Escherichia coli and Klebsiella pneumoniae) bacteria. Variations in activity were found. The time of harvest had a significant effect (p<_0.05) on biological activity, with the younger plants being more active. Antibacterial activity decreased with an increase in plants age. Methanol extracts were also screened for anthelmintic activity against Caenorhabditis elegans. Activity was found to increase with plant maturity. Irrigation was found to increase activity at the low rainfall (Fort Hare) site. Bulbs harvested from the irrigation treatment had significantly higher anthelmintic activity (p<_0.05) than bulbs harvested from treatments without irrigation. Dichloromethane extracts from bulbs grown at both sites had high anti-inflammatory activity. There were no significant differences (p<_0.05) in the activity of bulbs harvested from the different treatment plots. The time of harvest had an effect on the inhibition of prostaglandin synthesis by COX-1 enzymes. This study provides not only scientific verification for the use of M. natalensis to some extent as a medicinal plant, but also important data needed to successfully cultivate this species as a crop for small-scale farming. / Thesis (Ph.D.)-University of Natal, Pietermaritzburg, 2003.