Birthweight is powerful predictor of infant growth and survival. Premature birth and intrauterine growth retardation of birthweight. Maternal environment is important underlying determinant of birthweight. Common lifestyle risk factors include maternal under-nutrition, smoking, alcohol and social factors and stress. The Winelands/West Coast region has high rates of low birthweight. In addition, alcohol abuse and smoking are major problems in this area. The aim of this quantitative case-control study was to determine the epidemiology of low birthweight, related to lifestyle behaviours in pregnant women, with particular attention to lifestyle factors such as alcohol, smoking, and stress-related factors. / Master of Public Health - MPH

Birthweight is powerful predictor of infant growth and survival. Premature birth and intrauterine growth retardation of birthweight. Maternal environment is important underlying determinant of birthweight. Common lifestyle risk factors include maternal under-nutrition, smoking, alcohol and social factors and stress. The Winelands/West Coast region has high rates of low birthweight. In addition, alcohol abuse and smoking are major problems in this area. The aim of this quantitative case-control study was to determine the epidemiology of low birthweight, related to lifestyle behaviours in pregnant women, with particular attention to lifestyle factors such as alcohol, smoking, and stress-related factors.

Stellenbosch University. Faculty of Medicine and Health Sciences. Interdisciplinary Health Sciences. Family Medicine and Primary Care. / Thesis (MFamMed) -- Stellenbosch University, 2010. / Bibliography / ENGLISH ABSTRACT: Introduction: This thesis summarises the findings of a medical audit on the management of Cryptococcal Meningitis (CM). The study population of HIV positive adults (N = twenty five) were admitted during November 2009 – June 2010 to five hospitals of the Cape Winelands (East) District, Western Cape, South Africa. In the context of the HIV pandemic, CM has become the most common cause of community-acquired meningitis, and has poor outcomes if left untreated. The South African HIV Clinician Society has published treatment guidelines in 2007. These guidelines have been used by the audit team to compile a list of measurable criteria (with set targets) to evaluate the structure, process and outcome of CM management. A pilot audit (2008) at the regional hospital has demonstrated that certain target standards were not met. Aims and Objectives: The aim was to improve the quality of the clinical care of HIV-patients diagnosed with CM in the Cape Winelands (East) district. The objectives included the review of the audit criteria and target standards, demonstrating improvement in quality of CM care at the Level 1 and 2 hospitals, identifying new interventions based on the findings and providing recommendations to the health facilities. Methods In 2009, the researcher formed a new audit team, reviewed the audit criteria and held teaching interventions based on the national treatment guidelines. An intervention, based on the findings of the pilot audit, aimed at improving the clinical team’s adherence to the treatment guidelines. Results The audit identified the following areas that did not meet the target standards: the availability of Amphotericin B (Ampho B) and spinal manometers; the use of manometry in all initial lumbar punctures (LPs); completing fourteen days of the required Ampho B treatment; renal monitoring in patients on Ampho B; commencement of antiretroviral treatment (ART) by week four; and, the two-month survival figures post-diagnosis. The re-audit at the Level 2 hospital highlighted the need for improved medical record keeping to aid the audit process. Arrangement of inpatient ART counselling happened more consistently at the Level 1 hospitals. Adherence to the ART target and measures to prevent Ampho B related morbidity is comparable to that of the Level 2 hospital. The audit has also provided insight to the researcher and audit team on the practical challenges of conducting a prospective data collection technique across different care settings. Recommendations Level 1 hospitals should continue to manage CM patients. The availability of spinal manometers and closer adherence to renal monitoring require attention. Formal feedback to the audit team and clinical teams is planned. A multimodal interdisciplinary Quality Improvement approach (such as an integrated care pathway) is recommended and a future re-audit is encouraged to assess improved adherence to the CM management guidelines. The buy-in of stakeholders (management, health care workers and patients), the ongoing support of an audit team and a committed Quality Improvement environment will allow the medical audit process to become ingrained in the South African public healthcare setting. / AFRIKAANSE OPSOMMING: Inleiding Hierdie tesis bied ‘n opsomming van die sleutelbevindinge van ‘n mediese oudit van Cryptokokkale Menigitis (CM) sorg. Die studie groep van MIV-positiewe volwassenes (N = vyf-en-twintig) het binne-pasiënt behandeling ontvang gedurende November 2009 tot Junie 2010 in vyf hospitale van die Kaapse Wynland (Oos) distrik. In die konteks van die MIV pandemie het CM die mees algemene oorsaak van gemeenskapsverworwe meningitis geword, en het swak uitkomste indien onbehandeld. Die Suid-Afrikaanse HIV Clinici Vereniging het in 2007 behandelingsriglyne gepubliseer. Hierdie riglyne het die oudit span gebruik om ‘n lys van meetbare kriteria (met teiken standaarde) saam te stel om die struktuur, proses en uitkoms fasette van CM sorg te evalueer. ‘n Proef oudit (2008) by die streekshospitaal het getoon dat sekere teiken standaarde nie behaal was nie. Doelstelling Die doelstelling was om die kwaliteit van kliniese sorg van MIV-pasiënte met CM (in die Kaapse Wynland (Oos) distrik) te verbeter. Die doelstelling sluit in die hersiening van die oudit kriteria, die bevesting van verbetering in kwaliteit CM sorg by vlak 1 en 2 hospitale, identifisering van nuwe ingreep-moontlikhede gebaseer op die bevindinge en die verskaffing van toepaslike aanbevelings aan die gesondheidsorg fasiliteite. Metodes Die navorser het in 2009 ‘n nuwe oudit span gevorm, die oudit kriteria hersien en opleidingsingrepe geskoei op die nasionale riglyne gefasiliteer. Opleidingsingrepe, gebaseer op bevindinge van die proef oudit, het ten doel gehad dat die kliniese span die nasionale riglyne nakom. Resultate Die oudit het die volgende areas uitgelig waar daar nie aan die teikenstandaarde voldoen was nie: the beskikbaarheid van Amphotericin B (Ampho B) en spinale manometers; die gebruik van manometrie in alle aanvanklike lumbaal punksies (LPs); voltooi van die veertien dae Ampho B behandelingsteiken; nierfunksie monitoring van pasiënte op Ampho B; aanvang van anti-retovirale behandeling teen week vier; en, die twee maande oorlewing post-diagnose syfers. Die opvolg oudit by die vlak 2 hospitaal bevestig die belang van verbeterde kliniese notas om die oudit proses te vergemaklik. Die reël van binne-pasiënt ART berading gebeur meer bestendig in Vlak 1 hospitale. Bereiking van die ART teiken en maatreëls om Ampho B verwante morbiditeit te voorkom, is vergelykbaar met die bevindinge by die vlak 2 hospitaal. Die oudit het die navorser en die oudit span ingelig rakende die praktiese uitdagings om ‘n prospektiewe data insamelingsmetode te poog in verskillende kliniese kontekste. Aanbevelings Vlak 1 hospitale kan steeds CM pasiënte versorg. Die beskikbaarheid van spinale manometers en deeglike nierfunksie monitering sal die behaling van teiken standaarde vergemaklik. Formele terugvoer aan die oudit span en kliniese span word beoog. ‘n Multimodale interdissiplinêre Kwaliteitsverbeterings benadering (soos ‘n geïntegreerde sorgplan) word aanbeveel en ‘n toekomstige oudit word aangemoedig om verbetering in toepassing van die CM riglyne te evalueer. Dit is belangrik om die sleutelspelers (bestuur, gesondheidswerkers en pasiënte) te betrek. Verder word voortgesette ondersteuning van die oudit span en ‘n toegewyde omgewing van kwaliteitsverbetering aanbeveel. Sodoende sal die oudit proses in Suid-Afrikaanse publieke sorg geintegreer word.

Thesis (MPhil)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: Global economic conditions are forcing donor and development agencies to reduce aid to developing countries and communities. This reduction is resulting in less developmental programmes for disadvantaged communities. To ensure that developmental programmes are implemented successfully and cost effectively, implementing agents will have to ensure that they improve their developmental communication. It is also becoming important that those who are to benefit from developmental programmes convey or identify exactly what their needs are. There should be very little speculation from development agencies about what the needs of the disadvantaged are. It is becoming necessary to review current developmental tools, methods and systems, and also to explore what other measures can be applied to ensure that speculation or time and money wasting exercises are eliminated. This study attempts to look at two things that will influence effective development communication. The first is to examine if community radio is still as an efficient developmental communication tool as perhaps two decades ago. Secondly, it looks at the possibility to tailor-make information for those who need develop, especially in the context of evolving technology.

The study aims to evaluate the Entrepreneurial Seed Fund Programme (ESFP) of the Cape Winelands District Municipality (CWDM). This Programme aims to provide seed funding to emerging and established businesses in order to start and/or grow their businesses. The Programme provides funding through a grant-in-kind by procuring the goods and equipment that the business needs. The businesses qualifying for the funding are not solely focusing on profit-making; they are addressing social issues through business activities in their communities. The population of the study includes five successful and unsuccessful beneficiaries and a questionnaire was designed in order to determine the contributing factors to the success or failure of the business and if the objectives of the Programme was realised. In conclusion, the ESFP can be regarded as a sustainable programme which contributed to job creation and social upliftment. The ESFP should be strengthened with a small business incubation programme in order to enhance its sustainability. / Public Administration & Management / M. Tech. (Public Management)

The study aims to evaluate the Entrepreneurial Seed Fund Programme (ESFP) of the Cape Winelands District Municipality (CWDM). This Programme aims to provide seed funding to emerging and established businesses in order to start and/or grow their businesses. The Programme provides funding through a grant-in-kind by procuring the goods and equipment that the business needs. The businesses qualifying for the funding are not solely focusing on profit-making; they are addressing social issues through business activities in their communities. The population of the study includes five successful and unsuccessful beneficiaries and a questionnaire was designed in order to determine the contributing factors to the success or failure of the business and if the objectives of the Programme was realised. In conclusion, the ESFP can be regarded as a sustainable programme which contributed to job creation and social upliftment. The ESFP should be strengthened with a small business incubation programme in order to enhance its sustainability. / Public Administration and Management / M. Tech. (Public Management)