Thesis (MPhil)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: An exploration of the integrated nature of sustainable development planning and health care was done
in the context of people living and working in the town of Grabouw in the Western Cape. The problem
that was investigated was that people working within local government and community health
networks treated sustainable development planning and health care as separate issues.
The notion of wellness, as different from health, was used as a central theme in the study. It allowed
for an acknowledgement of the multidimensionality and contextual nature of human well-being. The
notion of sustainable community wellness was used to guide the research, and was viewed as a
complex phenomenon. The meanings of sustainable community wellness to people who work and live
within local government and community health networks in Grabouw were observed and documented.
Complexity theory was then used to discuss the observed perspectives on sustainable community
wellness.
Two factors informed the selection of Grabouw as a research site: Firstly, a comprehensive
sustainable development programme was being carried out in the town of Grabouw during the
research. Secondly, a few community health care initiatives were also being implemented at the time.
Community care workers who worked in one of the community health organisations participated as
primary research participants.
The research combined conceptual and empirical research. The conceptual research consisted of a
literature review of perspectives on wellness in Grabouw. The empirical research methods that were
used combined ethnography in the form of participant observation, and participatory action research in
the form of participatory photography. The researcher accompanied community care workers on their
daily visits to patients. The care workers took photographs of aspects of their surroundings that
represented sustainable community wellness, or the lack thereof, to them. Photographs were analysed
through focus group discussions and pertinent themes were subsequently identified.
Three meanings of sustainable community wellness were discovered. The first was the structural,
governmental meaning that gave importance to health and socio-economic statistics, based on the
mortality profile of the area. Wellness was seen from this perspective as a challenge that could be met
with strategic planning. The second meaning was the community-based experience of environmental
factors in Grabouw that had an impact on wellness, such as water, community forums and living
spaces. In this case, wellness was experienced as a rich and diverse set of factors, both social and
environmental. The third meaning was observed as instances where the apparent separate entities of
local government, the community, and the physical environment were seen as one socio-ecological
system, of which sustainable community wellness was an emergent property.
These instances demonstrated the importance of managing the quality of relationships within the
system, the need to enhance the autonomy of people working in the system and the potential of
community care workers to be agents of sustainable community wellness. / AFRIKAANSE OPSOMMING: Ondersoek is gedoen na die geïntegreerde aard van volhoubare ontwikkelingsbeplanning en
gesondheidsorg in die konteks van mense wat in die dorp Grabouw in die Wes-Kaap woon en werk.
Die probleem wat ondersoek is, is dat mense wat in plaaslike regerings- en
gemeenskapsgesondsheidnetwerke werk, volhoubare ontwikkelingsbeplanning en gesondheidsorg as
afsonderlike sake beskou.
Die begrip ‘welstand’, wat in betekenis van ‘gesondheid’ verskil, is as 'n sentrale tema in die studie
gebruik, en is soortgelyk aan die begrip ‘welwees’. Dit het erkenning verleen aan die
meerdimensionele en kontekstuele aard van menslike welwees. Die begrip volhoubare gemeenskapswelstand
wat as 'n komplekse verskynsel beskou is, het die ondersoek gerig. Die betekenis van
volhoubare gemeenskaps-welstand vir mense wat in plaaslike regerings- en
gemeenskapsgesondheidnetwerke in Grabouw woon en werk, is waargeneem en gedokumenteer.
Kompleksiteitsteorie is voorts gebruik om die waargenome perspektiewe op die volhoubare
gemeenskaps-welstand te bespreek. Twee faktore het die besluit om Grabouw as 'n navorsingsgebied
te gebruik, beïnvloed: Eerstens was daar tydens die navorsingstydperk reeds 'n omvattende
volhoubare ontwikkeling program in Grabouw aan die gang. Tweedens was 'n paar
gemeenskapsgesondheidsorg-inisiatiewe ook in dié tydperk aktief. Gemeenskapgesondheidswerkers
wat in een van die gemeenskapsgesondheidsorganisasies gewerk het, was primêre deelnemers aan
die navorsing.
In hierdie ondersoek is konseptuele en empiriese navorsing gekombineer. Die konseptuele navorsing
het uit 'n literatuuroorsig van perspektiewe op welwees in Grabouw bestaan. Die empiriese
navorsingsmetodes wat gebruik is, het etnografie in die vorm van deelnemende waarneming, asook
deelnemende-aksie-navorsing in die vorm van deelnemende fotografie, behels. Die navorser het
gemeenskapsgesondheidswerkers op hul daaglikse besoeke aan pasiënte vergesel. Hierdie werkers
het foto's geneem van die aspekte van hul omgewing wat na hulle mening die volhoubare
gemeenskaps-welstand, of die gebrek daaraan, verteenwoordig. Foto's is tydens
fokusgroepbesprekings ontleed en relevante temas is daardeur geïdentifiseer.
Drie betekenisse van die volhoubare gemeenskaps-welstand het tydens die ondersoek na vore
gekom. Die eerste is die strukturele, regeringsverwante betekenis wat bestaan het uit gesondheidsen
sosio-ekonomiese statistiek, gebaseer op die sterftesyferprofiel van die gebied. Welstand is vanuit
hierdie perspektief gesien as 'n uitdaging wat deur middel van strategiese beplanning aangepak kon
word. Die tweede betekenis is die gemeenskapsgebaseerde ervaring van omgewingsfaktore wat 'n
uitwerking op welstand het, soos water, gemeenskapsforums en leefareas in Grabouw. Welstand is in
hierdie geval ervaar as bestaande uit 'n reeks ryke en diverse faktore wat beide sosiaal en
omgewingsverwant is. Die derde betekenis is waargeneem deur die identifisering van die gevalle wat
die kompleksiteit van die stelsel wat bestudeer is, verteenwoordig het. In hierdie gevalle is die
oënskynlike aparte entiteite van plaaslike regering, die gemeenskap, en die fisiese omgewing gesien
as 'n sosio-ekologiese sisteem waarvan volhoubare gemeenskaps-welstand 'n ontluikende element is. Deur hierdie gevalle is daar aangetoon dat dit belangrik is om die gehalte van die verhoudings binne
die stelsel te bestuur en om die outonomie van die mense wat binne die stelsel werk te ondersteun.
Ten slotte is die potensiaal van gemeenskapsgesondheidswerkers om as agente van die volhoubare
gemeenskaps-welstand op te tree, uitgelig.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:sun/oai:scholar.sun.ac.za:10019.1/19927 |
| Date | 03 1900 |
| Creators | Van Den Berg, Wessel Jan |
| Contributors | Preiser, Rika, Stellenbosch University. Faculty of Economic and Management Scirnces. School of Public Leadership. |
| Publisher | Stellenbosch : Stellenbosch University |
| Source Sets | South African National ETD Portal |
| Language | en_ZA |
| Detected Language | English |
| Type | Thesis |
| Rights | Stellenbosch University |
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