This thesis reports on an historical prospective study of three Mamre decadal birth cohorts (1837-1846, 1870-1879, and 1900-1909) constructed retrospectively through existing parish records of the Moravian Mission at Mamre in the Western Cape region of South Africa. Nominative data collection techniques were used to gather information needed to determine the infant mortality rates, quinquennial mortality rates and life expectancies of the three cohorts. Issues related to the quality of data – non-registration and follow-up - were investigated. Birth registration was best for the 1837-46 cohort for males and females, with the 1900-1909 registration being next best. Overall, male registration coverage was substantially better than that for females. Infant death registration was best for males in these 2 cohorts, but were poor for females. Based on these data, the infant mortality rates for the cohorts born in 1837-1846, 1870-1879 and 1900-1909 - 196, 182 and 128 per 1000 respectively for males and 160, 172 and 97 per 1000 respectively for females - appeared to be underestimates. There is some evidence of a downward trend for the infant mortality rates with time for males, but this was not statistically significant. Quinquennial mortality rates for the 3 cohorts did not differ statistically, and are similar to the 1935-37 national 'coloured' figures. The life expectancies also did not differ significantly between cohorts. The life expectancies at birth (range 34- 40 years for males and 32-45 years for females) were probably overestimates due to biased IMR's. The life expectancies at age 1 (range 41-44 for males and 37-49 for females) were more representative figures. Life expectancies at age 20 were fairly stable over time (37-45 years) except for females in the 1900-1909 cohort whose life expectancies were substantially higher than earlier figures. All mortality indices investigated in this study consistently showed a lighter burden of mortality in historical Mamre compared to 'coloureds' in the Cape Colony at the turn of the century. This is probably associated with the better housing, environmental, social, economic and educational conditions at the Mamre mission relative to the rest of the Colony in the century after the emancipation of slaves.

Thesis (MMed)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: Objective: The aim of the study was to determine the outcome of critically ill neonates and children admitted to a general intensive care unit in a large regional hospital (Worcester) in the Western Cape. A secondary aim of the study was to determine the risk factors for death in these neonates and children. Methodology: This was a retrospective descriptive survey of all paediatric admissions (under 13 years of age; July 2008 till June 2009) to an intensive care unit at a large regional hospital in Worcester, South Africa. Data collected included: demography, admission time, length of stay, diagnoses, interventions and outcome. Outcome was defined as successful discharge, death or transfer to a central hospital. Results: There were 194 admissions including children and neonates. The files of 185 children and neonates were analysed, while 8 children were excluded due to incomplete data set and one patient was a surgical admission. The male: female ratio was 1.3: 1 and the majority of patients (83%) admitted, were younger than 12 months of age at admission with a mean age of 8.5 months (median age 3.7 months; range 0 to 151 months). The majority (70%) of admissions were successfully discharged, nearly a quarter (24%) transferred to central hospitals in Cape Town and only 6% died (all younger than 5 years of age). Causes of death included acute lower respiratory tract infections (33%), acute gastroenteritis (25%), birth asphyxia complicated by pulmonary hypertension (16%) and prematurity (16%). Patients requiring airway assistance, were more likely to experience an adverse event (p=0.0001) and invasive ventilation was associated with an increased risk for a poor outcome (p=0.00). Conclusion: The majority of children requiring access to a paediatric ICU are younger than one year of age. The common causes of death are acute lower respiratory tract infections, acute gastroenteritis, prematurity and neonatal asphyxia. A regional hospital in South Africa should offer intensive care to children as the majority of their admissions can be successfully cared for without transfer to tertiary hospitals. To our knowledge, this is the first study reporting admissions and outcome of neonates and children cared for in a mixed intensive care unit in a large regional hospital in South Africa. This study suggests that large regional hospitals in South Africa should have mixed intensive care units to improve child survival.

The first two official AIDS cases were diagnosed in South Africa in 1982. During the same period of the 1980s, the black/African population was experiencing an accelerated fertility decline, following a period of accelerated mortality decline. Demographers invoked the demographic transition theory to explain the observed mortality and fertility decline. According to the demographic transition theory, mortality and fertility rates would continue declining to low, post transitional levels with increasing modernization. The relatively higher prevalence of HIV/AIDS estimated among black/African South Africans is expected to alter their demographic transition. This research investigated the impact of HIV/AIDS on the demographic transition of black/Africans by 2021.

The purpose of this study was to describe and evaluate the strategies used to reduce maternal mortality of the Fezile Dabi District in the Free State Province, South Africa. A quantitative descriptive study was conducted at three hospitals to describe and evaluate the strategies. Data collection was done by using the Maternal and Neonatal Programme Effort Index (MNPI) self-administered questionnaire. The study population comprised of 71 (midwives (52), doctors (13), management-operational managers (6). The overall response rate for the three hospitals was (43.5%). The study indicated that programme efforts for maternal health are similar across the three hospitals, however, there are particular areas in each hospital that need more attention. The ratings of all the strategies generally showed weak to partial effort. The findings revealed general poor performance under the following strategies: postpartum care, training arrangements, information, education, communication and hospital protocols. Based on the study results, the quality of maternal health care need to be improved / Health Studies / M. A. (Public Health)

The first two official AIDS cases were diagnosed in South Africa in 1982. During the same period of the 1980s, the black/African population was experiencing an accelerated fertility decline, following a period of accelerated mortality decline. Demographers invoked the demographic transition theory to explain the observed mortality and fertility decline. According to the demographic transition theory, mortality and fertility rates would continue declining to low, post transitional levels with increasing modernization. The relatively higher prevalence of HIV/AIDS estimated among black/African South Africans is expected to alter their demographic transition. This research investigated the impact of HIV/AIDS on the demographic transition of black/Africans by 2021.

Thesis (MTech (Business Administration))--Cape Peninsula University of Technology, 2018. / Research findings indicate that between 42% and 56% of people dying between the ages of 25 to 70 are most likely to die out of a preventable cause. Most of these illnesses are chronic illnesses, directly a result of lifestyles that people have adopted over long periods. Whilst it has been difficult to cure some of the diseases, it has been however possible to treat the ailments. Consequently, patients who have followed faithfully the treatment regimes have lived far longer than would have been expected. Because these illnesses needed continued treatment, they are therefore referred to as chronic illnesses. It is expected therefore that the patients should regularly go for medical check-ups as well as take their medicines continuously. Chronic illnesses are an increasing cause of morbidity and mortality in Metro District primarily because most chronic patients die even though their deaths are preventable. The research findings presented here are a result of a survey of 200 chronic-patients in the Metro-District in Cape Town using mixed qualitative and quantitative methods. The objectives of the studies were primarily to establish reasons for the noticed defaulting rate amongst the patients. Because the medication was subsidised by the government and the patients got the treatment at no cost, it was expected that few, if any, would default. The findings indicated that close of 40% of the patients’ default and various reasons were provided ranging from forgetting, no transport money, no one to accompany them to the outlets to absence from town. The findings provide valid information to be used by the district to address the high rate of chronic medicines defaulting.

Child pedestrian injury and mortality is an issue of significant public health concern in the city of Johannesburg, Gauteng, in South Africa. Since there is a paucity of studies in the last decade or more on fatal childhood traffic and non-traffic injuries in Johannesburg, this study aspires to address the disproportion in this domain of research, and provide more recent, and comprehensive empirical evidence over a ten-year period. The overarching aim of this study was to describe and examine the magnitude, circumstances, and neighbourhood characteristics of fatal pedestrian injuries among children (0-14 years) in Johannesburg for the period from 2001 to 2010. More specifically, the objectives of the study were: firstly, to provide a comprehensive epidemiological description of the magnitude, trends and occurrence of pedestrian mortality among children; secondly, to describe and examine the epidemiology of child pedestrian mortality in relation to children as motor vehicle passengers; thirdly, to describe and examine child pedestrian mortality in relation to non-traffic injuries, in particular, burns and drowning; and fourthly, to assess the influence of neighbourhood characteristics on child pedestrian mortality. The study conceptualised pedestrian road safety within an ecological systems framework. The study used quantitative descriptive, and multivariate logistic regression methods of analysis to examine child pedestrian mortality data. The study drew on data from the National Injury Mortality Surveillance System (NIMSS) and the Census 2001. The main findings indicated that black, male children aged 5 to 9 years (11.02/100 000) are the most vulnerable, and that mortality occurred predominantly during the afternoons and early evenings (12h00-16h00 and 16h00-21h00), over weekends, during school holidays, and to a lesser extent, during non-holiday months. In addition, neighbourhood characteristics that reflected concentrations of disadvantage, single female-headed households and residentially stable areas were associated with child pedestrian mortality. The study findings highlight the need for critical action in terms of investment in child pedestrian safety research, and appropriate prevention initiatives guided by stringent evidenced-based studies, and the design of safe pedestrian, vehicular and urban environments. / Psychology / D. Phil. (Psychology)

Child pedestrian injury and mortality is an issue of significant public health concern in the city of Johannesburg, Gauteng, in South Africa. Since there is a paucity of studies in the last decade or more on fatal childhood traffic and non-traffic injuries in Johannesburg, this study aspires to address the disproportion in this domain of research, and provide more recent, and comprehensive empirical evidence over a ten-year period. The overarching aim of this study was to describe and examine the magnitude, circumstances, and neighbourhood characteristics of fatal pedestrian injuries among children (0-14 years) in Johannesburg for the period from 2001 to 2010. More specifically, the objectives of the study were: firstly, to provide a comprehensive epidemiological description of the magnitude, trends and occurrence of pedestrian mortality among children; secondly, to describe and examine the epidemiology of child pedestrian mortality in relation to children as motor vehicle passengers; thirdly, to describe and examine child pedestrian mortality in relation to non-traffic injuries, in particular, burns and drowning; and fourthly, to assess the influence of neighbourhood characteristics on child pedestrian mortality. The study conceptualised pedestrian road safety within an ecological systems framework. The study used quantitative descriptive, and multivariate logistic regression methods of analysis to examine child pedestrian mortality data. The study drew on data from the National Injury Mortality Surveillance System (NIMSS) and the Census 2001. The main findings indicated that black, male children aged 5 to 9 years (11.02/100 000) are the most vulnerable, and that mortality occurred predominantly during the afternoons and early evenings (12h00-16h00 and 16h00-21h00), over weekends, during school holidays, and to a lesser extent, during non-holiday months. In addition, neighbourhood characteristics that reflected concentrations of disadvantage, single female-headed households and residentially stable areas were associated with child pedestrian mortality. The study findings highlight the need for critical action in terms of investment in child pedestrian safety research, and appropriate prevention initiatives guided by stringent evidenced-based studies, and the design of safe pedestrian, vehicular and urban environments. / Psychology / D.Phil. (Psychology)

MCur / Department of Advanced Nursing Sciences / See the attached abstract below