The dissertation investigates how non-profit organisations (NPOs) can function more efficiently by sharing resources and services. The design responds with the strategy of service integration, by transforming the facilities of POPUP, a single NPO, into a shared services hub for multiple NPOs. POPUP is a People Upliftment Programme in Salvokop, Pretoria, and serves the under-privileged communities of Pretoria with skills development courses. The dissertation aims to create restorative environments for these students and explores the theoretical approaches of regenerative design, biophilic design and restorative environmental design. The premise of the investigation is that humanity has an inherent inclination towards nature and that a healthy human-nature connection enables the healing process. Furthermore, the dissertation follows a contextual approach that responds to the railway heritage significance of Salvokop, the urban condition of disconnection from the Central Business District, as well as the self-restoration of the natural landscape. The study seeks to regenerate the human-nature connection, a manifestation of the connection between the current natural landscape and the urban condition. In this way, restorative environments are created that contribute to the regeneration of people. / Dissertation MArch(Prof)--University of Pretoria, 2014 / Architecture / MArch(Prof) / Unrestricted

Opening part of this paper is dedicated to the ongoing shift in social communication paradigm. An introduction to the subject of new media, web 2.0 concepts and social network sites phenomenon is followed by a discussion of integration possibilities of particular web 2.0 services. Some concerns about privacy, security, legislative framework and general openness of such system are discussed afterwards. A real case study of community virtualization process is introduced in the second part of this thesis. The case takes place in community of local non-profit club of youth and children. First, it is carried out an analysis of the communication receiver groups and the message types. We also describe the ongoing project of launching a new web site (made from several integrated web 2.0 services) and partial results of pilot implementation. Finally, the plan of the next integration steps is designed.

Through a case study about the impact of IT adoption in a residential aged care organisation, this thesis examines the increasing pressure for service integration as mainstreamed through reform policies. Specifically, the research investigates the role of IT in facilitating the 1997 aged care reform agenda of 'ageing in place' focusing on the levels of transformation from the policy context to the organisational/management context, and to the context of service provision by care staff. A single embedded case study (Yin, 1993) is used in order to meet the general objective to capture the dynamics of the impact of ageing in place in the three social contexts. The research is informed by social constructionism, a theoretical framework that emphasises the significance and effects of language in shaping social realities (Ainsworth, 2001; Hosking, 1999). The framework, therefore, justifies the qualitative analysis of both written (i.e., policy documents) and spoken (i.e., interviews with staff) texts to address meaning in relation to context. Changing technologies can result in altered societal structures (Betz, 2003) at all levels, from the very complex to the very basic. As such, it is important to understand a few basic premises of technology. First, technology is a human invention to improve the well-being of society (Ayres, 1996). Consequently, technological inventions that improve the quality of life are seen by people as a necessity for modern living. In the case of ageing, modernisation and technological advances effectively resulted in people becoming healthier and living longer (Department of Health and Aged Care [DHAC], 2000). Second, technology is a human means to control nature (Betz, 2003). As such, technological advances can be seen as a modernising process of predicting and regulating the effects of the trends existing in the environment, such as ageing. Ageing in the twenty first century presents a challenge to government's development policies because ageing is depicted as a steady force with a long-term economic impact (Johnson, 1999). Third, a technology becomes powerful when it is sponsored by the market (Betz, 2003; Hughes, 1983). Unless a technology is backed by business, it lacks the influence on a large scale. Fourth, technology is used to enable change. By using IT, governments, business and the community are co-operating through a paradigm similar to the business sector. As a result, the service environment is shifting towards more business-like approaches. To sustain the changes brought by a different paradigm and modes of operation, the rhetoric of technology is employed. Therefore, the purpose of the study is to investigate the use of IT in processes of organisational adaptations to reform, which requires the examination of: a) specific meaning of IT as used in long-term care policies for older people since the last structural reform, b) the rationale behind the introduction of a new IT system into a residential care organisation, and c) the meaning of IT as articulated by care staff who have experienced a change in technology. The first paper represents a rhetorical analysis at the macro or policy level. There is a significant influence of a global political actor in developing proactive strategies on ageing, which results in a new, multi-organisational approach in delivering government-subsidised services, such as residential care. Three key institutional texts were selected to represent international to local policy development since the time ageing became a global concern. Since then, ageing is also viewed as a human rights issue. Using Burke's pentad, an analytic framework to analyse rhetoric in texts (Stillar, 1998), these institutional texts are seen to employ the rhetoric of 'technology for sustainability' to justify changes to policy approaches that seek long-term viability. Technology, in the name of sustainable development ensures support for economic growth, which balances the long-term effects of population ageing. The existence of a global force, such as population ageing, allows the intervening powers of the UN in mainstreaming ageing into development policies. Accordingly, it initiates corresponding actions at national (Australian Commonwealth Government) and state (Queensland Government) levels. IT is a medium of communication, knowledge transfer, and standard practice at these levels of actions. The second paper represents a qualitative analysis at the meso or organisational level. This paper explores the cogent rationale in the introduction of a computer-based, care documentation system in a large residential aged care organisation. Twenty two staff, from every level of the organisation, were interviewed to get an insight into the role of IT in substantive changes to organisational structure and modes of service provision. Responses from staff indicate external and internal influence that pressured the organisation to change. In the bid to sustain the future of aged care, the industry is changing through the introduction of new structure of service delivery. The Aged Care Structural Reform instigated a shift towards sustainable service provision that is consumer-driven, with a fixed cost compliance mechanism and performance criteria that are tied to funding. Facing the requirement for evidence to corroborate funding, a residential care organisation changed its structure of service delivery by introducing a new strategic direction. IT is part of this new strategic direction, planning, and operations of a changed service environment. The third paper represents a qualitative analysis at the micro or individual level to examine the impact of IT at frontline service delivery. This study is also based on interviews with twenty-two staff, across the organisational structure; however, this time the focus is more on staff who are involved in providing direct care to older residents at the organisation. The reason behind this is that IT has always been a management tool which handles management priorities such as financial planning and performance monitoring. The themes arising from the interviews indicate discord at the level of service delivery from the introduction of a new technical system. It also points to the idea that staff generally refer to ethical ideas and future promise of the new system. In summary, these three papers attached to this thesis support the notion that the meaning of technology is socially constructed. First, technology in the aged care sector has particular reference to improving or enhancing the well-being of older people, and in this case, the provision of high quality services that fulfil the needs of older people. Second, IT has an important role in meeting the evidence-based requirement, such as in the use of information in manipulating the use of resources required for the ageing population. Third, the meaning of IT is conceived from the context requiring its use such as the need to use resource efficiently to ensure long-term sustainability, which were emphasised in the last reform. Fourth, IT is used to enable structural changes in organisations to implement generic practices originated from the business sector, requiring the use of strong rhetoric such as balance and future. The limit of this case study is that these dimensions of technology can only be applied to the specific context of aged care and is not generalisable to other political contexts. However, the strength of the study rests on the macro-, meso- and micro-analysis of the meaning of technology. Therefore, future studies should investigate and compare the dimensions of technology in other contexts.

Magister Administrationis - MAdmin / The complex and multi-facet decentralisation process of Primary Health Care services in the Cape Metro District of the Western Cape will be critically assessed in this thesis. Primary Health Care is the provision of promotive; preventative; curative and rehabilitative services within the community setting. South Africa initially adopted the Primary Health Care strategy in 1978 as a member state of the World Health Organisation but this was during the Apartheid regime which did very little about implementing the strategy. In 1994 the Government of National Unity (GNU) came into power and there was a renewed commitment to implementing Primary Health Care in order to render health care services to the previously underprivileged masses. The GNU set an eight year time frame for the full implementation of this process from the date of commitment. Now more than ten years later an assessment of the process is necessary to determine if the objectives of the process has been achieved. An independent organisation such as the Health System Trust has in 1998 and 2003 provided some form of evaluation of the process and this will also be discussed in thesis. The District Health system is part of a unitary Provincial Health System that is decentralised to enable the centre (Provincial Management) and the periphery (District and Sub-district Management) to function more effectively and cooperatively. The District Health System is the management structure for primary health care services as this system allows for interaction of all the role-players involved in delivering health care at district level as it puts in place a decentralised Health Management team who is responsible for the planning, managing, implementing and monitoring of the Primary Health Care Package of care at district level. In summary the district is the place where community needs and national priorities are reconciled. This thesis will therefore show the disjuncture that exists between the Primary Health Care policy intent, the policy implementation and the service delivery outcomes on the ground level. The general objective is to do a critical assessment of the Quality of Decentralised Primary Health Care Services in the Cape Metro District of the Western Cape. More specific objectives for the research include: Defining and discussing the Primary Health Care Approach and the District Health System using the target indicators currently used by the City of Cape Town and the Provincial government of the Western Cape Health department to assess the impact of this process. To document the implementation process of the District Health System in the Cape Town Metro District as a case study while analysing the findings in terms of successes, constraints, challenges; and make recommendations for the way forward. The methodology of the study is of a qualitative and descriptive nature. The research design is a case study of the Cape Metro District. The target population will be all those accessing primary health care services in this district. The sample technique is selected by convenience. Data will be gathered directly and indirectly by doing observation and semi – structured interviews and the administration of questionnaires. The framework criteria for assessing the quality would for example include key indicators such as for example the ratio of Professional Nurse to patient; number of health services per three kilometre radius as per the Comprehensive Service Plan 2007 goals and the availability of essential drugs as per primary health care protocol. This directly relates to the key elements that underpin the District Health System namely: equity, access, quality, effectiveness, efficiency, sustainability, overcoming fragmentation, intersectoral approach and community participation. The main findings indicate that not enough resources have been allocated to the decentralising process causing much delay in its implementation. Shortages of health professionals, infrastructure constraints and poor adherence to legislation also contribute to the delay in implementation. This is why to date the four health districts of the Cape Town Metro District is not fully functional and the quality of the service they provide do not fully adhere to the 2010 Health Care Plan Model.

La conception d’un produit ou d’un service en Santé est un processus complexe et risqué. Il doit intégrer dans les phases précoces de conception les normes, les contraintes réglementaires, les données de surveillance et d’évaluation de la sécurité jusqu’à l’autorisation de mise sur le marché pour les dispositifs médicaux, mais également les préférences des utilisateurs experts : professionnels de santé ou non-experts : patients. Dans le marché compétitif des nouveaux produits ou services en Santé, l’enjeu pour les ingénieurs est de faire coïncider les besoins des utilisateurs à leur contexte et usages tout en intégrant toutes les parties prenantes du système de soin. Innovation médicale, technologique et organisationnelle, la télémédecine (TM) est l’utilisation des nouvelles technologies pour délivrer des actes médicaux. L’objectif de cette thèse est la mise au point d’une méthodologie centrée sur les utilisateurs et leurs usages pour concevoir, développer, intégrer et valider une application dermatologique de la TM : la télédermatologie. L’opportunité de validation de cette méthodologie pour intégrer et déployer un service innovant dans un service de dermatologie y est également discutée. / Designing product or services for healthcare system is highly complex, costly and risky. It combines constraints such as being a multi decisional and multilevel system with specific financial model linked to the state the healthcare system organization belongs to. In the highly marketing-time sensitive context of innovative products or services, there is challenge for designers to be able to match the new design to the users’ needs, answering to their context or usages while integrating all system stakeholder components. Telemedicine (TM) is the use of ITtechnologies to provide medical care or medical advice. It is considered a care delivery transformation combining medical, technological and organizational innovation. Using the example of Teledermatology a dermatological application of TM, this PhD develops a methodology based upon users contexts and usages to design integrate and provide an assessment model to decision makers. The opportunity to implement and integrate the service in French department of dermatology is discussed.