Thesis (MFamMed)--Stellenbosch University, 2015. / ENGLISH SUMMARY: Background: Sub Saharan Africa is home to approximately two thirds of the world’s population of HIV positive individuals. In view of the socioeconomic challenges of the region governments have provided antiretroviral therapy free to improve chances of survival among patients. However, adherence to antiretroviral therapy is recognised as more important in predicting patient survival. Aim: The study aimed to describe the prevailing factors that influence adherence to antiretroviral therapy. Methods: The study design was carried out using three methods of data collection. Focus group discussions, semi structured interviews and a questionnaire format. Setting: This study has been conducted among adult patients attending the Dora Nginza Hospital Adult wellness clinic. Results: The methods highlighted factors that influence antiretroviral therapy revealing psychosocial factors – lack of family support, not wanting to take medicines in front of people outside the home; patient factors – co morbidities that disturb patient adherence to therapy, a lack of trust in the patient-care giver relationship, fear of the drug side effects; socioeconomic factors – patients’ inability to afford food or transport costs to clinic appointments. In the semi structured interviews, 25% of patients self reported on poor adherence while in the questionnaire 5% of patients reported poor adherence. In assessing the effect of adherence to therapy on CD4 count and viral load there was a general increase in CD 4 count and a drop in viral load indicating clinical improvement in patients on therapy. Recommendation: There is a need for clinicians developing a health relationship with patients to facilitate adherence. The interventions designed to help patients in adherence to therapy should involve the patients in question in the designing of these interventions. Conclusion: Adherence monitoring is an important aspect of managing patients on antiretroviral therapy. The factors highlighted are similar to findings of other studies in similar contexts i.e. resource poor settings. / AFRIKAANSE OPSOMMING: Opsomming nie beskikbaar.

South Africa is a country with 11 official languages including English. English, however, dominates the educational sector, as medium of instruction. This is despite a plethora of research that shows the cognitive advantages of mother tongue instruction and language policies that promote additive bilingual approaches. As subtractive language approaches characterise poor schooling contexts, the outcomes for students are poor. This is because they do not develop proficiency in any language. The abolition of apartheid in South Africa and the advent of democracy in 1994 resulted in dramatic changes in the education system. Nevertheless, the medium of instruction from Grade four has remained English. Consequently, for the majority of the population the education is in their second language. This study takes place in the higher education setting of a TVET college, namely the Dower Campus in Port Elizabeth. It focuses specifically on Level 2 (first year) Life Orientation students to consider the effect English has, as medium of instruction, on the academic performance of students. There is concern about the status of TVET colleges. Even though the higher education sector has transformed, these skills based colleges are still given inferior status in the eyes of the general public and students themselves. These students may be particularly at risk of success given that they have lower entry requirements than other students in the higher education sector. The subject Life Orientation was used to examine the effect of English on student performance. Life Orientation has come under scrutiny for its usefulness and it cognitive value. This study argues that it is a valuable subject for students at colleges, equipping them with knowledge to succeed at studies and in society at large. However, the pass rates for Life Orientation have been consistently low. The study wanted to probe the role of English in this performance. To address the aims and objectives of this study, relevant literature and various multilingual approaches were reviewed to determine which strategies might be most effective in helping students cope with English as medium of instruction. The study also presents a case for the development of indigenous languages as medium of instruction. The study used a mixed methods approach, that is both qualitative and quantitative methods, to explore the use, attitude and perceptions of English among lecturers and students. The research used an interpretive approach and the study took the form of a case study. The researcher took the stance of being a non-participant observer. Qualitative data was obtained through the use of interviews while quantitative data was obtained through the use of questionnaires. The interviews were recorded and transcribed by a transcriber. Data was analysed using a thematic approach. The results showed that majority of the students did not speak English frequently nor had it as a home language yet they all had a positive regard for the language. Many factors were responsible for student performance in Life Orientation such as attitude to subject, theoretical versus practical components of the subject and student background. However, the medium of instruction played a large role in this performance. Though lecturers foregrounded the importance of English as medium of instruction, they recognise that it was a barrier to understanding and affected student performance. Analysis of the lecturer interviews and the questionnaires with students revealed that students were experiencing difficulty speaking, reading and writing in English. Lecturers adapted their teaching strategies when teaching by including translanguaging strategies of code-switching to facilitate understanding. The data also indicated that code switching was considered by the lecturers to be the most suitable method in teaching to student. Code-meshing and written translations of material were not strategies employed by lecturers. Students indicated that they would prefer to write assignments drafts initially in mother tongue. The findings also suggested that it was necessary for the lecturer to use a variety of multilingual strategies to ensure that students enjoy success in Life Orientation. Based on the findings, this study makes recommendations regarding the teaching and learning of English to students which includes the use of multilingual classroom strategies, collaboration with language lecturers and development of a multilingual language policy to aid in the understanding and acquisition of English terminology used in LO content. Such a language policy should also seek to develop indigenous languages as mediums of instructions at the college.

The poor academic performance of Engineering Science N3 students at the Port Elizabeth College for Further Education and Training prompted me to conduct this study. The aim thereof was to investigate the influence that a co-operative learning strategy would have on the test results of students who enrolled for this programme. The hypothesis being tested in this study was whether co-operative learning strategies would improve the test results of science students in the N3 Engineering Science class. A literature review on co-operative learning, its principles as well as the role of the lecturer as facilitator was conducted. In addition, the different types of co-operative learning techniques were investigated so that an approach conducive to the needs of students studying at Further Education and Training Colleges could be selected. The Student Team Achievement Divisions (STAD) technique was deemed to be the most suitable approach. Both qualitative and quantitative data gathering techniques are employed in this study. Interviews were carried out with fellow lecturers at the Port Elizabeth College to determine what teaching strategies are generally implemented in the N3 class. Experimental research involving two groups of 30 students was then conducted to determine the results of students. The one group (experimental) was subjected to an intervention, namely the STAD co-operative learning technique while the other group (control) was taught using the traditional method of talk and chalk. This intervention took place over a period of ix two weeks. However, prior to the co-operative learning intervention and before students were divided into groups, they were taught as a single group for a period of two weeks. The total time spent on this experiment was therefore four weeks. Student test scores gathered from the experiment was statistically analysed and reported on in chapter five. These results indicated that the experimental group out-performed the control group by a significant margin. The higher academic achievement of students in the experimental group could only be attributed to the alternative teaching strategy (STAD) which was absent in the teaching of the control group. This proved the hypothesis.

Rationale: There is limited research available in South Africa that explores the breastfeeding experience among adolescent mothers; most of the studies were conducted in developed countries. One such study relating to the above mentioned developed countries stated that social and commitment factors influence the decision to breastfeed by adolescents. Furthermore, while adolescent mothers appreciate the benefits of breastfeeding, pain, public exposure and perceived complexities related to breastfeeding create barriers for them. The researcher was unable to ascertain if similar ambiguities exist among adolescent mothers in South Africa, and in the Eastern Cape (EC) in particular with its high rates of adolescent pregnancy. In order to attempt to develop age appropriate recommendations to assist adolescent mothers with their breastfeeding journey, the researcher undertook this research study to answer the following question: What are the breastfeeding experiences of adolescent mothers in the Nelson Mandela Bay Heath District (NMBHD)? Aim: The research aim was to determine the experiences of adolescent mothers regarding breastfeeding in NMBHD. Methods: The study implemented a qualitative research approach. To enhance the design, the researcher utilised an explorative, descriptive and contextual research design. The ethical principles that guided this study were autonomy, nonmaleficence, beneficence and justice. Fourteen adolescent mothers, attending PHC facilities in the NMBHD participated in the study. Participants were chosen from a purposive sampling technique and data were collected from semi-structured interviews, compromising of individual interviews. The researcher analysed the data using the using the eight steps of the Tesch analysis technique. Data was also analysed by an independent coder. Results obtained from the Tesch approach were compared to that of the independent coder results. Thereafter, the major themes and sub-themes that related to the study objectives were identified. Results: Three themes and 10 sub-themes were identified. Lack of knowledge and poor adherence to EBF, perceived breastmilk insufficiency, as well as incorrect infant feeding advice given by maternal mothers and grandmothers were associated with early introduction of complementary feeding. Most participants were motivated to breastfeed due to its economic and bonding benefits, as well as seeing their infant‟s progress in growth. Challenges of breastfeeding mentioned by the participants include: lack of support from the fathers of their infants and from health care providers, breast milk leakage, and the foul smell associated with the leaking of breast milk. The participants of the study also had suggestions to help improve the support given to adolescent mothers by health care providers in PHC facilities. Conclusions and recommendations: In conclusion, this study‟s findings revealed that adolescent mothers may need extra age appropriate education and support to assist them in breastfeeding successfully at PHC facilities, the community and schools. Maternal mothers and grandmothers were found to be the primary source of a support network for most adolescent mothers as opposed to health care providers who were categorised as being the secondary source of support. Thus, breastfeeding promotion tailored at maternal mothers and grandmothers would be beneficial in improving their knowledge about the recommended infant feeding practices and consequently aid in providing appropriate support and advice to adolescent mothers. Additionally, training and attitude modification of health care providers is needed to provide adolescent mothers with age-appropriate, effective and sensitive care and counselling.

Collecting blood from repeat blood donors is cost effective and safer compared to other donor types. At the end of 2012, 84% of the SANBS donor panel were inactive or lapsed. There is a lack of research available on lapsed donors in the South African context and available research is mostly quantitative with subtle contradictions. Donors who donated blood in 2012 at fixed site donor centres in Port Elizabeth, and did not return in 2013, were studied. A descriptive analysis was done and a random sample of 78 lapsed donors were selected to participate in a face-to-face interview. Interviews were digitally recorded and transcribed. A grounded model was developed from various existing theories to seek out and conceptualise social patterns and structures of lapsed blood donors through a process of comparison. There were 10 062 donors who donated blood in 2012 and 4 923 became lapsed during 2013. Analysis of sub groups showed a higher proportion of donors who became lapsed in the following sub-categories: new donors (95%), re-joined donors (64%), black donors (63%), donors younger than 40 (61%), female donors (52%). The feedback received from the 11 participants highlighted peer pressure as the biggest motivator. Of the six communication theories applied, The Social Penetration Theory highlighted the cost-minus-benefit ratio which played a big role in a donor’s motivation and decision to return. The AIDA Marketing Model application described lapsed donor behaviour most comprehensively and it highlighted a missing step which was created as part of a Grounded Model and is called the AIDAA Model. The role and existence of peer pressure is directly linked to donor motivation and is categorised as an Action Motivator in the AIDAA Model. The new model creates additional recruitment opportunities which has not been explored and applied strategically before.

This thesis investigates the policing activities of the South African Police (SAP) in Port Elizabeth from the formation of the SAP in 1913 to the creation of two separate police districts in the city in 1956. It begins with the recruitment and training of police personnel, outlining the difficulty in obtaining sufficient white recruits for most of the period while at the same time stressing the ease with which the Force was able to obtain black recruits. The preponderance of Afrikaner policemen serving in Port Elizabeth from the 1920s onwards is made clear, as is the para-military nature of the SAP, which was maintained and reinforced as a result of training methods and the process of socialisation. As state servants, police personnel were expected to serve loyally and obediently a state becoming increasingly repressive towards its black citizens. Generally inadequate conditions of service remained the norm throughout the period yet the SAP’s commitment to the state never wavered, bar one isolated, short-lived incidence. The administration and functioning of policing in Port Elizabeth is explored by focussing on specific organisational features pertinent to the city and the changes wrought by the police hierarchy to deal with the city’s demographic and spatial expansion. The SAP tended to employ three different forms of policing in the city as a result of its apartheid-driven agenda which compelled it to differentiate between the various population groups in terms of maintaining law and order. The privileged white community experienced routine, civil policing whereas the black community was policed largely in a socially and politically oppressive manner; this was in line with government policy. On the whole, however, the more brutal and sinister nature of policing was yet to come to the fore although this thesis does point towards the increasingly repressive nature of policing in South Africa during the apartheid era.

A number of mostly informal areas in Nelson Mandela Bay have experienced rapid expansion over the past decade or so. Census data available for these areas is outdated and does not provide enough information for local authorities to accurately plan for tasks such as service delivery management and resource allocation. In this dissertation, a GIS based demographic and Quality of Life study of informal settlements and previously disadvantaged areas within Nelson Mandela Bay is undertaken to address this issue. The study aims to integrate GIS technology into a demographic and Quality of Life survey to significantly improve the collection, analysis, interpretation, display and management of survey data and to provide the accurate and necessary updates required between census collections. Data relating to informal settlements were captured from aerial photographs and satellite imagery and demographic and Quality of Life data were collected from field surveys. The results demonstrated that the use of GIS technology provided more accurate information for demographic variables, including the number of dwellings, dwelling type, size of the population and population dynamics. A specific demographic trend observed through spatial analysis included the identification of backyard shacks predating formal structures in settlements. The analysis and representation of the Quality of Life field survey data in GIS demonstrated how residents' perceptions of problems and issues in their neighbourhoods are better interpreted, understood and managed when analyzed within a spatial context. This research concluded that GIS based demographic and QOL studies are vital for providing accurate social and spatial information for municipalities, particularly in urban environments of developing countries, and for providing the necessary updates to censuses occurring every ten years.

The business environment and the economy of the society today are continuously witnessing the impact of globalisation. Telecommunication advancement and transportation has greatly made the impact of globalisation to be felt. Globalisation though argued to have its merits and its demerits have resulted in fierce competition amongst businesses. The banking industry is not isolated from these competitions. Any business wishing to survive and stay profitable in the recent world must be able to compete in the global economy. Hence, for any bank to sustain itself and remain profitable it must be able to withstand the competition in the environment it operates. To be able to compete in the banking industry means delivering better services to customers than competitors. This study presents how the South African banks can satisfy their customers and remain profitable in the face of competition. The South African banking industry consists of local and foreign banks and these banks compete for customers in the environment in which they are located. Increase in different branches by different banks has made the competition even fierce. In other to suggest recommendations for the South African banks to satisfy their customers and become profitable, the researcher identified some problem areas that need to be improved upon. These include customer loyalty, relationship banking and electronic banking. These variables were researched to understand how they affect the banks and the customers and where tested using both a qualitative and a quantitative analysis to ascertain if the customers were satisfied with the banks‟ approach of managing these variables. The results indicated that the customers were satisfied to a lesser extent. Any bank wishing to satisfy its customers and remain profitable in other to compete in the industry needs to satisfy the customer to a large extent. Therefore, recommendations where suggested based on the empirical results to help improve the banking industry‟s ways of attracting and retaining customers. The former will lead to customer satisfaction which again will lead to increased profitability.

The primary objective of this study is to determine the viability of opening a speciality top end, Ethnic cosmetic and toiletry retailer in the Greenacres Mall of Port Elizabeth, in order to meet the cosmetic and toiletry needs of Ethnic consumers, having moved from rural places of work and dwelling, to urban areas of work and dwelling. In order to achieve the above mentioned primary objective, the following secondary objectives will be pursued: • To investigate the current and forecast Ethnic cosmetic and toiletry trends in the United States of America, in order to serve as a benchmark in the development of a top end, speciality Ethnic cosmetic and toiletry retail store model, for the Greenacres Shopping Mall in Port Elizabeth, South Africa; • to identify whether a top end, speciality Ethnic cosmetic and toiletry store model for the Greenacres Shopping Mall in Port Elizabeth, South Africa, would be a viable business venture; • to investigate current and forecast Ethnic cosmetic and toiletry trends in South Africa, in order to reveal the shortfalls of retailers targeting this market segment; and • to identify the best business model for an organisation or individual wanting to grow their business through targeting the Ethnic cosmetic and toiletry consumer

This study is a qualitative review to identify factors impacting on the management of student development and support at Nelson Mandela Metropolitan University in a developing country. For the purpose of the study student development and support includes all developmental and supportive services and interventions for rural and urban students within an institution of higher learning, regardless of the current structuring of the functions. The study first contextualises the scenario of a developing country in terms of the socio-economic, political, higher education, labour and other factors that set the scene for student development and support and then continues with a systematic exposition of factors that have direct relevance and impact on the future of student development and support. A systematic investigation of NMMU by means of interviews with student affairs professionals make it possible to identify factors that have direct relevance and impact on the future management and provision of student development and support. The result of the study is a construction of the specific factors identified on the international, national and institutional levels as well as the intricate relationships between rural and urban students. This research provides a potential framework for future management and provision of strategic focus areas for student development and support functions within NMMU and higher education in a developing country to ensure that it effectively positions the function within higher education as a key component of the core agenda.