Includes bibliographical references (leaves 52-54). / The study was done to establish a profile of farm workers' health; and to investigate the extent to which the health of farm workers may be impaired by identified factors, both environmental and non-environmental.

Exclusive breastfeeding is recognised as a key child survival strategy in the South African context and the Baby Friendly Hospital Initiative (BFHI) accreditation for maternity facilities is recommended by the National Department of Health (NDOH) as crucial to improving the standards of care required for optimal support for mothers to successfully breastfeed. The Cape Winelands District in the Western Cape is a region that needs to improve the accreditation rate for its facilities. Key informant interviews were conducted within rural maternity services in the Breede Valley Sub-District. Interviews identified the barriers and enablers related to the health system building block 'information'. An additional goal was to examine communication and how information was disseminated throughout all levels of the health system to achieve the aim of successful policy implementation of the BFHI. Findings demonstrated that personal experiences of healthcare personnel may impact on the information offered to mothers. In addition, the operational manager of a facility possessed significant influence to ensure a policy was implemented and adhered to. Recommendations include advocating for education promoting breastfeeding in all healthcare programmes especially during the antenatal period by providing consistent, non-conflicting messages. Management should provide vision and strong leadership around implementation of the BFHI policy and ensure effective communication strategies around significant changes in the policy. Implementing BFHI is a complex context specific activity and to ensure optimal implementation of "Step three" (inform pregnant women of the benefits and management of breastfeeding) it is necessary to examine this particular area by using the recommendations as a framework in order to probe further.

Includes bibliographical references (leaves 68-75). / Since many of the diabetic complications can be prevented by good management, healthcare delivery ought to be of the highest quality possible. Therefore, continuous assessment and improvement of quality of care is important in order to give people with diabetes the care they deserve. This study aimed to develop a multi-faceted, indicator-based audit tool to evaluate the structural, process and outcome dimensions of quality of care for Type 2 diabetes at primary level in Cape Town metropole region.

Includes bibliographical references (leaves 91-94). / Khayelitsha (Site B), Michael Mapongwana, lnzame Zabantu and Mzamomhle community health centres in Khayelitsha and Phillipi are overcrowded and overburden with clients. Some of the clients attending these community health centres (CHC's) present with minor health ailments. As a result of overburdening, health care professionals are unable to deal properly with more serious ailments and health education. It is assumed that there is lack of knowledge related to management of minor health ailments in the home situation. This problem of overcrowding of CHC's with clients presenting with minor health ailments was discussed in the community health forums that constituted of health managers from the above mentioned community health centres, clinical facilitators from University of Cape Town, students and older people. In these discussions, it was assumed that due to migration and urbanization, there has been a breakdown in traditional family units whereby in households of clients presenting with minor health ailments, there might be a lack of support from older people. Older people had perceptions that minor health ailments can be contained within the home situation using the indigenous health knowledge carried by them. This knowledge is carried by word of mouth from generation to generation. Nothing has been documented about this knowledge. Ideas were discussed on how minor health ailments could be managed within the home situation and how a relationship could develop between older people and the health professionals in the CHC's that are overcrowded. The community health forum concluded that the first step of dealing with the overcrowding of the community health centres, would be to explore the indigenous health knowledge that is carried by the older people for the management of minor health ailments. A descriptive study was conducted using qualitative and quantitative methods of data collection. Four focus groups with nine participants in each were conducted using an interview schedule. The data was analysed quantitatively and qualitatively to gain understanding of indigenous health knowledge used by older people living in Khayelitsha and Phillipi. Results of the study showed that older people had an extensive knowledge related to management of minor health ailments. According to the participants, there was no distinction between minor and major ailments, all ailments could be managed within the home situation using indigenous health knowledge. The management. strategies that were used by older people were in different forms namely, plants, objects, waste products, artificial foods, other natural resources and belief system. Older people mentioned that their comprehensive approach of managing any ailments resulted from a scarcity of nearby health resource. In the present climate in Khayelitsha and Phillipi where CHC's are overcrowded with clients presenting with minor health ailments and exhausting the present health resources, one could envisage a future whereby indigenous health knowledge could be integrated in the present health dispensation for the management of minor health ailments. Hence the researcher is making recommendations to the management of community health centres to start initiating discussions on how indigenous health knowledge could be integrated into the present health system of community health centres in Khayelitsha and Phillipi.

The problem identified in this study was the inconsistency in the implementation of the triage system in this institution. We therefore wish to develop an understanding towards issues contributing to the irregular use of the triage system and wish to better understand the reasons behind this inconsistency. Through the knowledge of barriers, we could then work towards the optimal use of this system. This would be beneficial towards the reduction of overcrowding as well as the reduction of waiting times for patients accessing the EA [Emergency Areas].

Includes bibliographical references. / Tobacco is a leading risk factor for the global burden of disease in both developed and developing countries. The morbidity and mortality caused by tobacco can be prevented efficaciously and cost-effectively by active intervention from health professionals. In developing countries, a limited number of studies have explored tobacco usage and training in smoking cessation and prevention amongst health professions students. This pilot study evaluated: 1. tobacco use patterns; 2. knowledge, attitudes and beliefs towards tobacco use and tobacco control; 3. environmental tobacco smoke exposures; and 4. training in smoking cessation and prevention amongst health professions students in South Africa.

Includes abstract. / Includes bibliographical references. / The overconsumption of alcohol is one of the leading preventable causes of many adverse health, psychological, and social problems. Alcohol consumption patterns for South Africa from various findings were reported and compared to global levels and patterns. It was illustrated that psychosocial factors are controversial yet generally regarded as having an important role to play in understanding population health problems and alcohol consumption patterns. Risk factors for problematic and binge drinking among women in South Africa were identified. The aim of this study was to explore psychosocial factors and their associations with problematic and binge drinking behaviour among women who currently drink between 18 - 44 years of age in an urban and rural setting in South Africa.

Includes abstract. Includes bibliographical references.

Includes abstract. / Includes bibliographical references. / A food composition database needs to be reflective of the commonly consumed foods eaten by the population, in order for it to be comprehensive. The South African Food Data System (SAFOODS) is one of a few food composition databases used amongst nutrition researchers and academia nationally for dietary intake analysis of South Africans. The SAFOODS comprises of 37% truly analysed South African nutrient values, which provides for an improved analysis when using this food composition database to analyse dietary intake data of South Africans. Indigenous vegetables and traditional recipe foods are limited within the current SAFOODS, resulting in nutrition researchers making assumptions when coding dietary records comprising of these foods eaten in selected study areas. The aim of this cross-sectional descriptive study was to collect and evaluate the different assumptions made by researchers when analysing food intake data inclusive of indigenous vegetables and traditional recipe foods, when utilising the South African food composition database for dietary analysis. In addition, it aims to record how these assumptions could possibly over or under report on actual dietary intake. Forty (40) nutrition researchers, actively engaged in dietary intake studies across the nine provinces of South Africa, were conveniently selected for this study. These researchers were all linked to an academic institution and consisted of dietitians and nutritionists. A questionnaire was completed, assumptions recorded by the nutrition researchers for indigenous vegetables and traditional recipe foods not found within SAFOODS. The study investigator further entered assumptions reported by participants of the study into a sample menu dataset. Information received from participants‟ were compared to a reference meal analysis report and analysed results compared for energy and macronutrients (carbohydrate, fat, protein) and micronutrients (vitamin A and C, iron, magnesium and sodium).

Includes bibliographical references. / [Introduction] The first patients started on antiretroviral therapy (ART) in the Western Cape Province public health service began treatment as early as January 2001. These patients were funded jointly by non-government sources, such as the Desmond Tutu Foundation (DTF) and Medecins Sans Frontieres (MSF), and the state, on account of the then limited availability of government funding for ART. The government funded rollout of ART in South Africa began in April 2004. Concerns about poor adherence and viral resistance led to a nationwide emphasis on the development of a good monitoring system for ART. The Provincial Government of the Western Cape (PGWC) has, in conjunction with the World Health Organization (WHO). developed a monitoring system to provide quarterly outcome data for patients on ART. [Aims and Objectives] This study aims to describe and describe and analyse routine data produced on defined clinical and immunological outcomes of patients on ART by the monitoring system, thus assessing the feasibility of an ART programme in the public health sector in the Western Cape Province. [Methods] This study reviewed patient information captured in both the paper based monitoring system and electronic databases. Data on all patients started on ART since January 2001 until June 2005 was included in the study. The monitoring system, developed by the WHO, uses paper-based ART registers at clinics to capture relevant patient information. All patients less than 15 years of age were classified as chitdren. The baseline data recorded in the monitoring system is limited to the percentage of children with a baseline CD4 percentage < 15% and the percentage of children who were treatment-experienced.