Dissertations / Theses on the topic 'Child health services – Law and legislation'

Thesis (M.Dev. (Management and Law)) -- University of Limpopo, 2013
Section 27 of the Constitution of the Republic of South Africa, 1996 provides that everyone has a right to have access to health care. South Africa embraces the concept of universal health care coverage. Access to health care has four dimensions: geographic accessibility, availability, financial accessibility and acceptability. If there were barriers to access to health care, the stake-holders would be duty-bound to design interventions requisite to address those barriers. The aim of the study was to establish whether health care users enjoy the right to have access to health services at Ratshaatsha Community Health Centre (RCHC). The study used a combination of quantitative and qualitative research designs. While a questionnaire was used to collect quantitative data, focused group discussions and participant observations were employed to collect qualitative data. The following are the main findings of the study. Human rights instruments clearly spell out the indivisible and mutually supportive rights that persons have. There are barriers that often affect the rights to have access to health services at RCHC. For instance, the RCHC is not within a 25 km radius of some of the consumers of health care. The roads that link up the health care users and RCHC are in poor condition. The community is generally poverty-stricken. Many cannot afford, among others, the costs of basic needs, transport fares and opportunity costs. Travelling distance and time, scarce skills and lack of medication and equipment rank among demand-side and supply-side barriers to access to health care. Health care users often choose to consult churches and traditional healers. It is recommended that government should, among others, co-ordinate primary health care services in collaboration with churches and traditional healers; commission research into traditional health medicine and healing procedures and protocols of other health care providers; develop policy on cross-referral of patients; improve community participation; set minimum norms and standards for the delivery of alternative health care services; establish health care management guidelines for churches and traditional healers; integrate health care provisioning into IDPs; and provide health care in an integrated intergovernmental manner.

Thesis (MBA (Business Management))--University of Stellenbosch, 1999.
ENGLISH ABSTRACT: As part of South Africa's transformation, legislative changes have been introduced to support the Constitutional rights of the people, including the right of access to health care. In restructuring the health services, the redistribution of resources between the private and public sector is addressed through a long-term vision which includes a Social Health Insurance scheme. The focus has been shifted to primary health and prevention, with community based services at the centre. Various Acts and regulations have been introduced to give substance to the transformation, including the Acts affecting medical schemes and the pharmaceutical services, labour legislation, education and training. The Bargaining Councils and Occupational health services have been extended to include primary health care, and in many cases this is extended to the dependents of the workers, bringing them into the ambit of the private sector. The proposed redistribution of resources into the public sector has placed the low-wage earner at risk as the cost of private health care increases. The legislation controlling medical schemes and pharmaceutical services are a threat to the viability of the Health Care Funds, particularly in the short-term until the Social Health Insurance has been established. The restrictions placed on dispensing and the measures which are intended to make drugs more affordable also provide a challenge to the low-cost medical funds. The relevant legislation is being subjected to judicial challenges, and the replacement legislation promulgated prematurely, resulting in confusion and uncertainty. It is within this context that the Funds must prepare for the changes ahead. A management consulting case study is presented using the Clothing Industry Bargaining Council of the Western Cape with the Clothing Industry Health Care Fund which provides comprehensive primary health services in Fund owned clinics, factories and through panel doctors. Because of the complexity of the organisation and the issues surrounding the implementation of changes to the pharmaceutical services, Yolles' viable approach to management systems has been used as a framework for the consultancy intervention. This is a newly published approach grounded in chaos theory, which directs the nature of inquiry according to form and the behaviour of the situation, aiming to maintain viability and adaptability. This case study examines the impact of the legislative changes on the health services which are accessed through the workplace, and tests the applicability of the viable approach to management systems.
AFRIKAANSE OPSOMMING: As deel van Suid-Afrika se transformasie is veranderings aangebring aan die wetgewing om die Konstitusionele regte van die mense te ondersteun, insluitend die reg van toegang tot gesondheidsorg. Met die herstrukturering van die gesondheidsdienste, word die verdeling van bronne tussen die privaat en publieke sektor aangespreek deur middel van 'n lang-tenmyn visie wat 'n gemeenskapsgesondheidsversekering insluit. Die lokus het herskuil na primêre gesondheid en voorkoming, met gemeenskapsdienste as sentrum. Verskeie wette en regulasies is voorgestel om as kern van die verandering te dien, insluitende wette wat die mediese skemas en farmaseutiese dienste, asook die werknemer, opleiding en opvoeding beinvloed. Die gesondheidsdienste van die Onderhandelingsrade en die Beroepsgesondheiddienste is uitgebrei om primêre sorg in te sluit. Dit sal ook die afhanklikes van die werkers dek en hulle sodoende binne die privaatsektor betrek. Die voorgestelde herverdeling van bronne in die publieke sekdor veroorsaak dat daar 'n risiko is vir die werker met 'n lae inkomste as gevolg van die stygende koste van gesondheidsorg. Die wetgewing wat mediese skemas en farmaseutiese dienste beheer veroorsaak ook dat die Siekefonds se lewensvatbaarheid bedreig word, veral in die korttenmyn tot tyd en wyl die gemeenskapsgesondheidsversekering gestig word. Die beperkings wat op reseptering geplaas word en die metodes wat beplan word om medisyne meer bekostigbaar te maak, veroorsaak ook 'n uitdaging vir die inkomste mediese fondse. Die relevante wetgewing word tans in die hof betwis, en die plaasvervangende wetgewing is voortydig gepromulgeer, wat verwarring en onsekerheid veroorsaak. Die siekefondse moet hulle binne die konteks voorberei vir die veranderinge wat voorlê. 'n Bestuurskonsultasie gevallestudie is voorgelê, met die hulp van die Klerasienywerheid Gesondheidsorgfonds (Weskaap), wie se siekefonds omvattende primêre gesondheidsdienste lewer binne klinieke, fabrieke en deur gemeenskapsgeneeskundiges. Omdat die organisasie en die omstandighede rondom die veranderings aan die farmaseutiese dienste kompleks is, word Yolles se lewensvatbare benadering (viable approach) as 'n raamwerk gebruik vir die konsultasie. Die model is nuut gepubliseer, en is gebaseer op chaos teorie, wat rigting gee aan die aard van die ondersoek volgens die vorm en die gedrag wat die situasie aanneem. Dit is daarop gemik om lewensvatbaarheid en aanpassingsvermoë te ondersteun. Daar word 'n studie gemaak van die impak wat die veranderings tot wetgewing op gesondheidsdienste wat deur middel van die werksplek bereik word mag hê, en toets die toepaslikheid van Yolles se model in die konteks van bestuurskonsultasie.

Thesis (LLM)--Stellenbosch University, 2012.
Includes bibliography
ENGLISH ABSTRACT: In South Africa gender-based violence (hereafter “GBV”) has reached extreme levels. This violent manifestation of gender inequality is compounded by the fact that women are disproportionately affected by poverty, the HIV/AIDS epidemic and inadequate health care services. This is in spite of South Africa’s progressive constitutional and legislative framework which appears highly conducive to combating gender inequality and GBV. For example, the Constitution protects the right to equality (section 9), human dignity (section 10), life (section 11), freedom and security of the person (section 12) and the right to have access to health care services, including reproductive health (section 27(1)(a)). Extensive legislation has also been enacted for the protection of women. For example, the preamble to the Domestic Violence Act 116 of 1998 (hereafter “DVA”) recognises domestic violence as a serious social evil. While the DVA is notably silent as to the role of the health care sector, the DVA is progressive in that it contains a broad definition of domestic violence, and recognises a wide range of relationships. The Criminal Law (Sexual Offences and Related Matters) Amendment Act 32 of 2007 also seeks to afford complainants of sexual offences “the maximum and least traumatising protection that the law can provide”. In addition to this, South Africa has international law obligations to address GBV and gender inequality. For example, under the Convention on the Elimination of All Forms of Discrimination against Women (1979), States are obliged to address private acts of violence and to remove discrimination against women in all fields, including health. However, despite this progressive framework of rights, some interpretations of these integral rights have been unduly formalistic, in addition to being disengaged from the lived reality of many women. There is also a substantial gap between policy and practice, with the implementation of existing legislation a continuing problem. It is therefore imperative that we analyse the right to have access to health care services through a gender lens so as to transcend a purely legalistic perspective and to interrogate gendered social processes and power relations. This thesis analyses how existing law and policy can be transformed so as to be more responsive to these lived realities and needs of survivors of GBV.
AFRIKAANSE OPSOMMING: Geslagsgebaseerde geweld (hierna ‘GGG’) in Suid-Afrika het uiterste vlakke bereik. Hierdie gewelddadige manifestasie van geslagsongelykheid word vererger deur die feit dat vroue buite verhouding erg deur armoede, die MIV/vigs-epidemie en ontoereikende gesondheidsorgdienste geraak word. Dit is ondanks Suid-Afrika se vooruitstrewende grondwetlike en wetsraamwerk wat op die oog af hoogs bevorderlik vir die bestryding van geslagsongelykheid en GGG voorkom. Die Grondwet verskans, byvoorbeeld, die reg op gelykheid (artikel 9), menswaardigheid (artikel 10), lewe (artikel 11), vryheid en sekerheid van die persoon (artikel 12) en toegang tot gesondheidsorgdienste, met inbegrip van reproduktiewe gesondheidsorg (artikel 27(1)(a)). Omvattende wetgewing oor vrouebeskerming is ook reeds uitgevaardig. Die aanhef tot die Wet op Gesinsgeweld 116 van 1998 (hierna die ‘WGG’) identifiseer, byvoorbeeld, huishoudelike geweld as ’n ernstige maatskaplike euwel. Hoewel die WGG swyg oor die rol van die gesondheidsorgsektor, is dit nietemin vooruitstrewend aangesien dit ’n uitgebreide omskrywing van huishoudelike geweld bevat en ’n wye verskeidenheid verhoudings erken. Die Wysigingswet op die Strafreg (Seksuele Misdrywe en Verwante Aangeleenthede) 32 van 2007 is ook daarop afgestem om klaagsters van seksuele oortredings “die omvattendste en mins traumatiese beskerming te gee wat die wet kan bied”. Daarbenewens verkeer Suid-Afrika onder internasionale regsverpligtinge om GGG en geslagsongelykheid aan te spreek. Ingevolge die Konvensie vir die Uitwissing van Alle Vorme van Diskriminasie teen Vroue (1979), byvoorbeeld, is state verplig om privaat geweldsdade teen te staan en diskriminasie teen vroue op alle gebiede te verwyder, insluitend gesondheid. Nietemin, benewens hierdie vooruitstrewende menseregteraamwerk is sommige interpretasies van hierdie onafskeidbare regte nie net oormatig formalisties nie, maar ook verwyderd van die daaglikse realiteit van baie vroue. Daar is ook ʼn wesenlike gaping tussen beleidsmaatreëls en die praktyk, terwyl die uitvoering van bestaande wetgewing ʼn voortgesette probleem verteenwoordig. Dit is dus gebiedend om die reg op toegang tot gesondheidsorgdienste deur ʼn geslagslens te analiseer om sodoende ʼn bloot regsgedrewe perspektief te bo te gaan en om maatskaplike prosesse en magsverhoudinge in oënskou te neem. Hierdie tesis analiseer hoe bestaande wetsraamwerke en beleidsmaatreëls getransformeer kan word om beter te reageer op die realiteite en behoeftes van oorlewendes van GGG.
Stellenbosch University Hope Project
Bradlow Foundation

Children are largely ignored in medical ethics, which concentrates on adults with capacities that children lack (including competence, or rationality). This thesis answers how medical decisions should be made for unquestionably incompetent children. The dominant approach to medical ethics in the West depends on respect for autonomy and this distorts medical ethics for children in two ways. Firstly, parental decisions for children may be taken to have the same authority as respect for autonomy. Secondly, theories of general well-being have focused on adult’s well-being with an endorsement of the components of that well-being by the adult themselves. This has hindered the development of an objective, impartial, conception of interests, arguably, the best fit for making decisions for very young children. I argue that although children are clearly demarcated from adults in medical ethics, there is not a clear explanation of why this is. For young children others must make decisions or be prepared to override the child’s decisions. More recently, the distinction between adults and children have become blurred, exemplified by the use of terms such as ‘young person’. Children’s rights at best draw attention to children and their interests, but do not help in resolving the medical treatment of incompetent children. The most promising approach depends on articulating an account of children’s interests. For several reasons the best interests standard is not defensible. I argue that a reasoned, or reasonable, agreement upon the child’s interests should determine medical treatment. Neither the child’s parents (nor the clinicians) can be taken to have an incorrigible grasp of the child’s interests, all should justify the reasons for their choices.

Opioid dependence and opioid related deaths are a public health problem which the United States Centers of Disease Control have declared an epidemic. While opioid agonist therapy for opioid addiction has been accepted as the most effective treatment for opioid dependence among academics, and office based buprenorphine treatment has been available in the Unites States for over 10 years, OB buprenorphine faces many barriers to widespread adoption. Empirical data on the geographic distribution of physicians able to prescribe buprenorphine and the prescribing patterns of those physicians show considerable unevenness in access and utilization of treatment services. Federal-level policies have recently been implemented to expand access to opioid agonist therapy, but the medium and long term impacts of these policy changes on individual outcomes, public health, and geographic access equity are not yet clear. This dissertation compares two recent federal level policies on expanding access to buprenorphine treatment: raising the regulatory limit on the number of patients a provider can treat (implemented July, 2016), and extending prescribing privileges to nurse practitioners and physician assistants (implemented February, 2017), using an empirically supported Agent Based Simulation model. Policies are assessed by a novel, at-a-glance, quantitative access equity metric: the Spatial Potential Access Gini Index, in addition to year-end treatment utilization, opioid overdose deaths, and the amount of illicit medication diversion. In the simulation, expanding access by increasing the patient limit did not result in more equitable spatial access, while extending prescribing to NPs and PAs increased both utilization and spatial access equity. This is likely due to empirically supported model assumptions that NPs and PAs providing primary care often serve in medically underserved areas including rural and remote regions. Extending prescribing to these practitioners opens up new treatment locations changing the spatial distribution of treatment opportunities. Changing patient limits does not change the overall spatial distribution of services, so spatial access equity does not change even if overall treatment supply gets better or worse. The primary contribution of this work is the Spatial Potential Access Lorenz Curve and the Spatial Potential Access Gini Index, measures that aggregate individual-level Spatial Potential Access Scores commonly used in health care geography to map and identify areas of access disparity within a region. The equitability of Spatial Potential Access is calculated by using the Lorenz Curve, which is commonly used to characterize the distribution of wealth or income in a society, from which a Gini Index is calculated. The Spatial Potential Access Gini Index allows for direct comparison of complex quantitative information about the geographic distribution of supply and demand in a region with other regions, or in response to policies that impact supply or demand within the region. The measure has potential applications in simulation studies on the spatial allocation of services, allowing equity assessment of policy alternatives, as well as in empirical work, allowing equity comparisons of different regions, or in hybrid studies in which policy experiments are conducted on data-rich maps.

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Bachelors
Health and Public Affairs
Legal Studies

No previous study has attempted to clarify and articulate administrator attitudes regarding DNR orders in the school setting. Administrative school staff are responsible for development and implementation of school policy therefore understanding administrators' attitudes would assist discussion and decision making related to DNR orders in the school setting.

Thesis (LLM.) -- University of Limpopo, 2019
This mini-dissertation seeks to evaluate the best interests of the child as a separate factor that influences the sentencing of a primary caregiver. When a parent is in conflict with the law, the child stands to be affected sentence that the court may impose on the caregiver. A custodial sentence has the potential of affecting the child’s right to parental care. Therefore, in the event where a custodial sentence is appropriate, alternative care of the child by other persons become a possible option. The author recommends that after applying the principles articulated in S v M and making use of a child impact report; the right of the child to parental care should carry more weight. Thus, courts should duly consider the best interest of the child as an independent factor when negative effects to the child are associated with the sentence. Where appropriate, with either a non-custodial sentence or adequate alternative care (in the case of imprisonment).

This study examined the effects of entrepreneurship level and legal regulatory environment on environmental scanning in one component of the health services industry, private practice physical therapy. Two aspects of scanning served as dependent variables: (1) extent to which firms scrutinized six environmental sectors (competitor, customer, technological, regulatory, economic, social-political) and (2) frequency of information source use (human vs. written). Availability of information was a covariate for frequency of source use. Three levels of entrepreneurship were determined by scores on the Covin and Slevin (1986) entrepreneurship scale. Firms were placed in one of three legal regulatory categories according to the state in which the firm delivered services. A structured questionnaire was sent to 450 randomly selected members of the American Physical Therapy Association's Private Practice Section. Respondents were major decision makers, e.g., owners, chief executive officers. The sample was stratified according to three types of regulatory environment. A response rate of 75% was achieved (n = 318) with equal representation from each stratum. All questionnaire subscales exhibited high internal reliability and validity. The study used a 3x3 factorial design to analyze the data. Two multivariate analyses were conducted, one for each dependent variable set. Results indicated that "high" entrepreneurial level firms scanned the technological, competitor and customer environmental sectors to a significantly greater degree than "middle" or "low" level groups, regardless of type of legal regulatory environment. Also, "high" level firms were found to use human sources to a significantly greater degree than did lower level groups. Empirical evidence supporting Miles and Snow's (1978) proposition that "high" level entrepreneurial firms (prospectors) monitor a wider range of environmental conditions when compared to "low" level (defender) firms was presented. The results also confirmed that market and technological environments were scanned most often. Finally, the results added to the construct validity of the Covin and Slevin entrepreneurship scale and provided evidence of its generalizability to small businesses.

The primary research question to be answered from this study was: to what degree have school districts in the County of San Bernardino been able to respond to federal legislation mandating the design and implementation of local school wellness policies. A major finding was that the majority of districts have not yet implemented nutrition and wellness policies.

This project examines the role of immunization registries and their effect on a health care delivery system. Recent efforts to attain coverage of child populations by recommended vaccines have included initiatives by federal and state agencies, as well as private foundations, to develop and implement statewide community-based childhood immunization registries.

If the goal is to achieve better quality, merely increasing nurse staffing levels may not be effective since the variation of the quality-of-care deficiencies explained by exogenous variables was smaller than random variation 5%. If state Medicaid reimbursements can be utilized for financial incentives for better performing nursing homes, nursing homes may improve their productivity by efficiently managing organizational personnel or increasing job satisfaction among nursing practitioners. Lastly, longitudinal analysis, considering variation in length of state staffing policy implementations, is encouraged to investigate the long-term effects of state staffing standards on nurse staffing levels and quality of care.; The purpose of this dissertation is to examine nursing homes' compliance with state minimum nurse staffing standards and its relation to quality-of-care deficiencies. Specifically, this study, reviewing staffing standards from 50 states and the District of Columbia for the year 2007, proposes a unique algorithm to calculate the states' expected nurse staffing levels for individual nursing homes in order to investigate their compliance with the state nurse staffing standards. By using hierarchical linear modeling method, this study attempts to capture the impact of the staffing standards on actual nurse staffing levels under resource dependence perspectives. Path analysis using structural equation modeling was conducted to investigate both direct and indirect effects of the staffing standards on nurse staffing levels and quality-of-care deficiencies. The major findings were as follows: (1) nursing homes in states with higher state staffing standards for the categories of RN, LN, and total nurse were found to have higher RN, LN, and total staffing levels, respectively; (2) higher nurse staffing levels resulting from higher state staffing standards were significantly associated with better quality of care (less quality-of-care deficiencies cited) in nursing homes; and (3) state staffing standards were found to have much stronger contribution to nurse staffing levels than any other organizational or contextual factors while nurse staffing levels, particularly licensed staff, were found to have stronger contribution to quality-of-care deficiencies than any other organizational factors. The study findings suggest that if the goal is to increase nurse staffing levels for better quality, increasing the stringency of both federal and state nurse staffing standards would be the most effective way. However, the staffing standards first need technical changes to reduce their ambiguity and ensure their fairness.
ID: 029810138; System requirements: World Wide Web browser and PDF reader.; Mode of access: World Wide Web.; Thesis (Ph.D.)--University of Central Florida, 2011.; Includes bibliographical references (p. 140]-150).
Ph.D.
Doctorate
Health and Public Affairs

Indiana University-Purdue University Indianapolis (IUPUI)
Children's and adolescents' capacity to provide valid informed consent is one of the key ethical concerns in pediatric research, and the focus of this project. The original contribution to knowledge is the advancement of both conceptual and empirical bioethical approaches to research with vulnerable populations. First, a review of adolescent vulnerability is presented to highlight the complex interplay between capacity and other forms of vulnerability. This review is offered as an interdisciplinary analysis to better understand why the study of vulnerable populations is critical to the ethical advancement of clinical research. Results from this analysis suggest the need for enhanced screening techniques as well as the utilization of specialized staff to identify and reduce the impact of different forms of vulnerability. The primary tasks of the empirical portion of the dissertation were to: (1) Adapt a validated adult competency assessment tool for clinical research, the MacArthur Competency Assessment Tool for Clinical Research, to assess the capacity of children and adolescents to consent to clinical research; (2) Identify predictors that impact children and adolescents’ capacity to provide consent to clinical research; and (3) assess differences and similarities in capacity between healthy and chronically ill children and adolescents. Overall results suggest adolescent capacity to consent to research was similar to adults, and most strongly associated with their family's socioeconomic status as well as their level of health literacy. These findings contrast starkly with the age-based criterion for providing consent currently utilized in assent and consent determinations. These findings also provide insights into ways to ethically involve youth in complex biomedical research.

Child rights, especially the right to health for children, is a concept of human development. The aim of this qualitative study is to explore the obstacles to gender equality in the right to healthcare for children under five years in East Champaran, Bihar, North India. Ten key informant interviews and nine focus group discussions with mothers, fathers, grandmothers and grandfathers were conducted to research the barriers of guardians to accessing healthcare for their children, including their root beliefs and choices, which causes health inequalities. It was found that a strong patriarchal tradition predominates in these communities in North India, which favour sons and disadvantages daughters in healthcare provision. Despite the existing child rights and human rights policies that have been legislated, in India traditional practices that discriminate against female children remain dominant in the society, and limit development in East Champaran, Bihar, North India.
Development Studies
M.A. (Development Studies)

Thesis (LLM. (Labour Law)) -- University of Limpopo, 2013
The South African government gazzetted the Green Paper introducing the NHI on 12 August 2012. This policy seeks to progressively realize the right of access to quality health care services for everyone. Those who cannot provide for themselves will be assisted by government at the expense of the elite. The NHI was first recommended by the Taylor Commission and it has been under the discussion since then. Since this announcement, there has been growing pressure for mandatory health insurance to be included in the development of a comprehensive social security system, as was envisaged by the Taylor Committee of Inquiry. This discussion was further debated at the 52nd conference of the African National Congress (ANC) in Polokwane in December 2007 where numerous resolutions were taken with regard to the NHI. The Freedom Charter of 1955 and also section 27 and 28 also provided some guidance.

Text in Afrikaans
The Convention on the Rights of the Child was adopted by the United Nations General Assembly on 29 November 1989. Included in the inherent rights set out in the Convention is the right to the highest attainable standard of health. In implementing the Convention states parties must refer to the requirements of article 2 of the Convention, which places them under a duty to respect and ensure the rights in the Convention to each child. The term “respect” implies a duty of good faith to refrain from actions which would breach the Convention. The “duty to ensure”, however, requires states parties to take whatever measures are necessary in order to enable children to enjoy their rights. A state party must also review its legislation in order to ensure that domestic law is consistent with the Convention. South Africa showed commitment to protecting and promoting children’s health when it ratified the United Nations Convention on the Rights of the Child in 1995 and subsequently adopted the Constitution of the Republic of South Africa, 1996, which includes provisions guaranteeing the health rights of children. South Africa also showed commitment to give legislative effect to the protection and promotion of children’s health by reviewing the Health Act 63 of 1977 (reviewed as the National Health Act 61 of 2003) and the Child Care Act 74 of 1983 (reviewed as the Children’s Act 38 of 2005). The review of the Child Care Act 74 of 1983 revealed that the act is virtually silent on the issue of child health. This led to the decision to identify and evaluate existing policy and legislation, as well as pending relevant law reform and policy affecting child health in order to assess how well South African legislation addresses the issue. The research showed that although much legislation exists, none provides comprehensively for child health rights. The legislation that does exist contains obvious gaps. Most importantly, there is no reference to the core minimum requirements for the state in providing for the health of children, particularly in the way of health services and nutrition. Further, there is a complete lack of legislation which protects the health needs of disabled children. A comparative study was also undertaken. Legislation of India and Canada were evaluated in order to make recommendations as to how the gaps in South African legislation can be rectified. However, the research showed that South Africa has made far more significant progress in promoting a rightsbased approach to children’s health in legislation. In order to ensure that the health rights of children are protected and promoted, I propose more comprehensive legislative protection.
Private Law
LL.D.

Thesis (LLM. (Labour Law)) -- University of Limpopo, 2013
In the 18th years of our young but thriving democracy, several programmes were established to improve access to health care for disadvantaged groups in South Africa. Although numerous studies have been conducted examining trends on access to health care, considerable controversy remains. Nearly all authors concur that important progress has been made, and that gaps in access to health care narrowed considerably. Some however, go further and conclude that the evidence indicates that all significant gaps have been eliminated and access to health care is universally shared. Evidence on access to health care has important policy implications. If the task of assuming access to health care has been largely accomplished, further expansion of South African health care programmes to promote access would be unwarranted. If selected population groups lag behind others in access to health care, targeted policies to close remaining gaps may be warranted. The introduction of the National Health Insurance Scheme call for the health reform in South Africa and it will change the whole health sector and offers equal benefits on access to quality health care services to everyone in South Africa.

The right to have access to health care services is enshrined in section 27 of the South African Constitution of 1996 as one of the socio-economic rights protected by this Constitution. In order to observe the entitlements in this human right, the South African government has since 1994, embarked on legislation, policies and programmes to improve access to health care services among vulnerable and disadvantaged groups in South Africa. As a result of the measures put in place by the government, enormous progress has been registered since their enforcement, in respect of access to health care services. However, as evident in some reports such as the 7th Report on Economic and Social Rights by the South African Human Rights Commission and studies conducted by the Studies in Poverty and Inequality Institute (SPII), it is revealed that the measures adopted by the government to improve access to health care services have not effectively translated the entitlements of this right to the population of South Africa. This study is motivated by the disclosure of these concerns, irrespective of the measures put in place by the government to achieve universal access to health care services. The study therefore aims at stressing the importance of upholding the right to have access to health care services in the social transformation process of South Africa. In doing so, it will investigate current health care reforms in South Africa and make recommendations on how to effectively interpret and implement section 27 of the Constitution to achieve equal benefits on access to health care services to everyone in South Africa.
Jurisprudence
LL. M.

Text in Afrikaans
Die MIV/vigs-pandemie in Suid-Afiika- van die ergste in die wereld- toon geen tekens van afname nie. Miljoene kinders is reeds of wees gelaat of hewig geaffekteer deur die magdom impakte daarvan op gesinne en gemeenskappe. Die epidemie het voortdurend stygende sterftesyfers tot gevolg en die hewige las van die siekte rus swaar op MIV-positiewe sowel as MIV-negatiewe individue. Verder word tradisionele ondersteuningsnetwerke oorbelaai en/of gaan hulle tot niet. Gesinne en gemeenskappe verloor hul ekonomiese, sosiale en kulturele lewensvatbaarheid. Die pandemie hou, veral onder die armes, 'n geweldige bedreiging vir die gesondheid, welstand en regte van babas, kinders en jongmense in. 'n Groot gedeelte van die impak van MIV/vigs hou verband met die feit dat sommige kinders en hul gesinne beperkte toegang tot die elemente van 'n gesonde omgewing en goeie gesondheid het. Regerings, gemeenskappe en gesinne wat deur MIV/vigs geraak word, het minder tyd, energie en finansiële hulpbronne beskikbaar om op voorkomende gesondheidsorg te fokus. Benewens die impak op gesondheidstatus, word kinders se omstandighede ook as gevolg van MIV/vigsverwante probleme bemoeilik. Dit sluit verhoogde gesinsarmoede, 'n hoer risiko van verlating en weeslating, geforseerde migrasie, onterwing, sielkundige trauma, uitsluiting en diskriminasie, en fisiese en seksuele mishandeling in. Die derde vlaag van die epidemie, welke vlaag nou betree word, word gekenmerk deur 'n ontsettende hoe sterftesyfer, 'n ontploffing in die getal sorgbehoewende en weeskinders en 'n verhoging in menslike pyn en lyding. Die reg speel 'n baie belangrike rol in die beperking van hierdie impak van die MIV/vigs-pandemie op die lewens van alle kinders. MIV/vigs-reg is in die proses van evolusie of vorming en reeds bestaande teorieë kan aangewend word ten einde sekere vrae te beantwoord en probleme daaromtrent aan te spreek. Tog is daar 'n dringende behoefte aan MIV/vigs-spesifieke wetgewing en teorieë ten einde die impak van die pandemie op alle vlakke suksesvol te beheer. Verder het die Kinderreg so 'n mate van ontwikkeling bereik dat daar algemeen aanvaar word dat kinders 'n spesiale belangegroep binne die gemeenskap vorm. Die regsreëls met betrekking tot kinders verander gedurig en is ook nie geskik om volgens die tradisionele wyse, as privaat- of publiekreg, geklassifiseer te word nie. In die hieropvolgende proefskrif word die impak van MIV/vigs op sekere publiekregtelike, maar oorwegend privaatregtelike aspekte van die Suid-Afiikaanse kinderreg ondersoek, sowel as enkele metodes waarop die reg moontlik hierdie impak kan absorbeer en hanteer. Daar word ook in aparte hoofstukke na die impak van MIV/vigs op die lewens van kinders. sorgbehoewende kinders, egskeiding en die ouer-kind-verhouding verwys The HIV/aids pandemic in South Africa - one of the worst in the world - does not seem to be decreasing. Millions of children have already been either orphaned or heavily affected by the numerous impacts on families and communities associated with it. The epidemic brings on an ever-increasing mortality rate and the extreme burden thereof weighs down heavily on HIV-positive as well as HIV-negative individuals. Traditional support networks are further being heavily burdened or perish entirely. Families and communities lose their economical, social and cultural viability. The pandemic threatens, especially among the poorest, the health, wellbeing and rights of infants, children and young people. The impact of HIV/aids is to a great extent the result of the fact that some children and their families do not have sufficient access to a healthy environment and good health. Governments, communities and families affected by HIV/aids have less time, energy and financial resources available in order to enable them to focus on preventive healthcare. In addition to the impact on health status, children's circumstances are also being encumbered by HIV/aids-related problems, including family poverty, a higher risk of being abandoned or orphaned, forced migration, disinheritance, psychological trauma, ostracism and discrimination and physical and sexual abuse. The third wave of the epidemic, which wave is presently being experienced, is characterised by a high mortality rate, an increasing amount of children in need of care and orphaned children and an increase in human pain and suffering. The law plays an important role in the limitation of the impact of the HIV/aids pandemic on the lives of children. HIV/aids law is in the process of evolution or forming and existing theories can be used in order to answer certain questions and address certain issues relating to it. However, there is an urgent need for HIV/aids-specific legislation and theories in order to successfully manage the impact of the pandemic on all levels. Child law has also reached such an extent of development that children is now viewed as a special interest group within the community. The legal principles regarding children change constantly and cannot be classified in the traditional way, which is either as private or public law. In this thesis the impact of HIV/aids on certain aspects of the public and private law pertaining to children is examined. Ways in which the impact can be absorbed and managed by the law is also examined. The impact of HIV/aids on divorce, the parent-child relationship, children in need of care, and the impact of HIV/aids on the lives of children is examined in separate chapters.
Jurisprudence
LL. D.

The purpose of this study was to develop a framework for provision of essential medicines for the district health services. A qualitative descriptive, exploratory and contextual action research design was followed. The data collection was conducted through site visits and semi structured interviews targeting the responsible pharmacists who were purposively selected on the basis of their expert knowledge and experiences from the eight of the nine provinces of the Republic of South Africa which is a developing country with limited resources for provision of healthcare services. The study found that there was no standardised framework for provision of essential medicines for the District Health Services. Based on the site visits and action research findings a proposed framework covering the selection, procurement, warehousing, distribution and management support components for provision of essential medicines for district health services was developed and subjected to national pharmaceutical experts and district health services managers review and critique which is finally presented, after taking into consideration the experts inputs as a proposed framework emanating from the study. The proposed framework will contribute towards improving the provisioning and availability of essential medicines within the district health services.
Health Studies
D.Litt. et Phil. (Health Studies)

This investigation attempts to analyse the applicability of child protection policy and legislation to black families and children in South Africa. The literature study focuses on the nature, scope and implications of child protection and child protection legislation, perspectives on children's and parents' rights, and more specifically on child-care policy and legislation in South Africa. A limited exploratory empirical investigation within the confines of the Child and Family Care Society was undertaken. The researcher had, by way of a case analysis, studied factors influencing the application of child-care legislation ~l:'ld described how legislation is being applied in practice. The application of philosophies and principles inherent in child-care policies, and the evolvement of certain patterns and trends have also been analysed. Specific deficiencies have been identified and recommendations regarding more effective social work practice are highlighted.
Social Work
M.A. (Mental Health)

The scourge of HIV/AIDS is ravaging our communities; many children have lost their parents to this pandemic. The death of parents because of this pandemic has resulted in the emergence of a new phenomenon of child-headed households. This paper seeks to examine the rights of children in child-headed households as entrenched in section 28(1)(b) and (c) of the Constitution. Once the rights of children in child-headed households are ascertained, the state’s duty to give effect to these rights is investigated. In the analysis of the rights, the socio-economic rights jurisprudence of the Constitutional Court is considered. The paper further argues that the state gives effect to the rights of children in child-headed households through legislation and policy. As such, the paper takes a closer look at the legislation and policies that seek to give effect to the rights of children in child-headed households as enumerated in section 28(1)(b) and (c) and gaps in that legislation and policy are highlighted. In conclusion, proposals are made that will assist the state to give effect to the rights of children in child-headed households as set out in the Constitution.
Private Law
LL.M.

The purpose of this research is to explore the need for, and the legal implications of, harmonising labour laws in the Southern African Development Community (SADC). Chapter One highlights a number of factors that call for the harmonisation of labour laws in the SADC region and discusses some of the reasons why labour laws are not well developed in the region. The influence of globalisation on labour standards in southern Africa and the influence of regionalism on the harmonisation of labour laws are discussed at length. The inference that could be drawn from this discussion is that for a regionalisation process in southern Africa to be successful, there is an urgent need to harmonise the region’s labour law system. This thesis confirms that Southern Africa has many lessons to learn from the regional harmonisation of labour law in the European Economic Community and the current European Union. The implementation of international labour standards in southern Africa is investigated. The main areas examined include (1) freedom of association, (2) collective bargaining, (3) forced labour and (4) discrimination. The findings of this investigation show that there is no uniformity in the implementation of International Labour Organisation (ILO) standards in the SADC region and, therefore, it is recommended labour law should be harmonised in terms of ILO standards. In respect of the benefits to be derived from the harmonisation process, an empirical investigation was conducted in the SADC region and the following is recommended: the harmonisation of labour law in the SADC region will help with the implementation of ILO standards, protection of workers against the economic power of employers in the workplace and maintaining similar benefits for migrants in the region.
Mercantile law
LL.D.

Reproductive health is very important as it shapes a woman's whole life. Currently there are a lot of obstacles which deny women their rights to reproductive health. The aim of this research was to find out what obstacles deny women the freedom to enjoy their reproductive health in order to establish a contribution which can be used by the Department of Health to improve their services. Descriptive research was conducted, using a survey approach. Convenience sampling was utilized. Participants were selected from a sample of people attending the reproductive health clinic at a hospital and a clinic in the Northern Province. The findings indicate that women are not enjoying reproductive health rights due to low educational level, cultural and societal constraints, low socio economic status and the negative attitude of the providers, of reproductive health services.
Contraceptives
Family planning
Health and gender
Health rights
Reproductive choice
Reproductive health
Reproductive rights
Reproductive health care
Women's rights
Rural women
Health Science
M.A.Cur.(Nursing Science)

The aim of this explorative study is to establish if psychiatric disorders influence the criminal capacity of child offenders. A qualitative approach was adopted in the study to develop an in-depth understanding of the issues pertaining to criminal capacity assessments for child offenders with psychiatric disorders. The risks associated with various psychiatric disorders in relation to childhood criminality, and the methods that are used to deal with child offenders who suffer from psychiatric disorders, were also explored. The data collection tool for this study was a semi-structured interview schedule. Telephonic and face-to-face interviews were conducted with child justice and mental health experts from four provinces in South Africa, namely, KwaZulu-Natal, Gauteng, Eastern Cape and Western Cape. These experts included psychiatrists, psychologists, social workers, academic professors of law, a criminologist and an advocate. Snowball sampling was employed and although this is a pure qualitative study, the open coding, axial coding and selective coding process from the grounded theory was applied to analyse and interpret the data. The findings from this study indicate that psychiatric disorders are a risk factor associated with the causation of criminal behaviour. A high prevalence of psychiatric disorders, such as intellectual disability, learning disorder, attention deficit hyperactivity disorder, oppositional defiant disorder and conduct disorder, were generally found in children in conflict with the law. The influence and consequences of these psychiatric disorders, in conjunction with environmental and societal factors, were found to influence criminal behaviour and were highlighted as factors that ought to be taken into consideration when determining the criminal capacity of a child who is in conflict with the law. Findings from the study identified that adequate recognition was not granted to the influence of a psychiatric disorder in the assessment of a child‟s criminal capacity. It was established that, in the criminal capacity assessment, the emphasis should not be on the psychiatric disorder per se, but on the effect that the disorder and associated symptoms may have on the child‟s ability to distinguish between the wrongfulness of their actions and to act in accordance with this understanding. Operational challenges and ambiguities identified in the legislative framework pertaining to child offenders with psychiatric disorders were found to negatively influence criminal capacity assessments for children in conflict with the law. The lack of services available to child offenders with psychiatric disorders, as well as child offenders without psychiatric disorders, was found to hamper the best interest of the children in conflict with the law. Lastly, legislative and service recommendations for good practice to deal with child offenders with psychiatric disorder were identified by the experts.
Criminology and Security Science
M.A. (Criminology)

The present study compared the suicidal behaviour and related measures of adolescents in high school in Germany (N=318) and South Africa (N=299). Participants completed a series of self-report measures of the SPS (Suicide Probability Scale), PSS-Fa (Perceived Social Support From Family Scale), PSS-Fr (Perceived Social Support From Friends Scale), SIB (Scale Of Interpersonal Behaviour) and a number of demographic questions. Analyses were conducted using content analysis, correlation coefficients and logistic regression to determine variables related to previous suicide attempts, stepwise multiple regression to account for variables predicting currents suicidal risk; and multivariate analysis of variance (MANOVA) to examine differences among the groups and among suicide attempters and non-attempters. 36 German (11.3%) and 48 South African (16.1%) adolescents reported that they had made previous suicide attempts. German adolescents reported 45 (14.2%) suicide attempts in the family and 82 (25.8%) suicide attempts by friends. South African adolescents reported 43 (14.4%) suicide attempts in the family and 92 (30.7%) suicide attempts by friends. The following variables were associated with previous suicide attempts in the German sample: attempted suicide by friends, a life-threatening event, previous psychiatric contact, the death of a friend, low perceived family support, female gender, attempted suicide in the family, suicide of a friend, and low perceived friend support. The following variables were associated with previous suicide attempts in the South African sample: low perceived family support, death of a friend, attempted suicide by friends, female gender, a life-threatening event, previous psychiatric contact, suicide of friends, and attempted suicide in the family. The following variables for the German sample were found to be significant predictors of current suicidal risk: low perceived family and friend support, previous suicide attempts, suicide attempts in the family, a life-threatening event, suicide attempts of friends, suicide of friends, female gender, and previous psychiatric contact. The following variables for the South African sample were found to be significant predictors of current suicidal risk: previous suicide attempts, low perceived family and friend support, death of a friend, a life-threatening event, previous psychiatric contact, suicide attempts in the family, suicide of friends, and suicide attempts of friends. These findings show that suicidal behaviour is frequent in both countries. Suicidal deaths of friends and family is more prevalent in Germany, whereas religion or belief in god does not protect against suicide attempts in both countries. Results indicate that perceived support from family is a strong protective factor against suicide attempts.
Psychology
M.A. (Psychology)

Women and children are often the most affected by pandemics which have swept through the world, and in this regard the HIV/AIDS pandemics is not an exception. The most common route of HIV infection in HIV positive children under 5 years of age is through Mother-To-Child Transmission (MTCT). In spite of the seriousness of this pandemic, the Constitutional Court has found that the measures taken by the South African government with regard to the Prevention of Mother-To-Child Transmission (PMTCT) has fallen short of what the Constitution requires. This dissertation critically reviews the management of the South African PMTCT programme, and discusses the relevant Court decisions. The study finally clarifies the obligations of the South Africa government in the context of PMTCT under the 1996 Constitution and in terms of international law.
Constitutional,International & Indigenous Law
LL.M. (Legal aspects of HIV/AIDS)

The aim of the study was to determine the causes of IODs in the workplace and to identify possible preventative measures to reduce IODs. A literature review was conducted as part of the study, involving assessment of all related articles and books on the subject of IODs in the workplace. A qualitative research methodology was utilised to conduct the study. The main research instruments were four focus group interviews and eight individual interviews. The study concluded that employees experienced IODs in different ways, with most participants describing negative experiences such as physical pain, undue financial hardship, psychological trauma and lack of support from the employer. A minor percentage experienced IODs in a positive sense in that there is heightened safety awareness in the workplace after an IOD has occurred, and the adoption of a more cautious approach by employees when performing their duties. From a practical and organisational/managerial perspective, the adoption of effective training of security officers and adherence to organisational standard operating procedures will assist in reducing IODs in the workplace. Limitations of the study included the small sample size from the research population, perceived language barriers during the interview processes and non-participation and inputs from managers at the organisation. However, it is hoped that the study will form the basis for further research to broaden the field to include parastatal or public-service entities
Human Resource Management
M. Com. (Human Resource Management)

This study aimed to develop a framework for improved legislation, methods of practice and services used to meet the best interest of child offenders with psychiatric disorders within the South African child justice system. This aim was achieved via a qualitative study, which evaluated child justice and mental health legislation, methods of practice, role-players, and services in South Africa, and compared same to those in Namibia, Botswana, and Nigeria; to establish if the best interest of child offenders with psychiatric disorders are currently met from a South African perspective. Data collection occurred in two phases: a document analysis of legislation, policies, and procedures in the selected comparative jurisdictions; followed by semi-structured interviews with child justice and mental health experts. During phase one the researcher analysed child justice and mental health legislation, human rights protections, and policy related to child justice in Nigeria, Botswana, Namibia, and South Africa. In addition, she interrogated literature relating to child justice and mental health, in comparative jurisdictions. This phase formed the foundation for the semi-structured interview schedule. Purposive and theoretical sampling was used to conduct 24 semi-structured interviews. Data was analysed and interpreted using pure qualitative document and thematic analysis. The overarching findings indicate that the best interest of child offenders with psychiatric disorders, in the South African child justice system, are unprotected. This vulnerable group is not dealt with from an individualised, case-specific, multi-disciplinary perspective; informed by legislation, practice-policy, and a service-orientated approach. Further, certain domestic legislation and methods of practice are inadequate in holistically assessing a child who comes into conflict with the law in the jurisdictions of comparison. Further findings identified that biological, psychological, environmental, cultural, and social factors influence the development of psychiatric disorders in children, which may bring them into conflict with the law. This study further confirmed that Attention Deficit Hyperactivity Disorder, Intellectual Development Disorder, Learning Disorder, Oppositional Defiant Disorder, and Conduct Disorder are prevalent in children who iv come into conflict with the law. Further, substance abuse disorder, depression and attachment disorder were identified as predominant factors affecting children who come into conflict with the law. The influence of these factors, in conjunction with biological, psychological, environmental, cultural, and social factors, were found to predispose children to psychiatric disorders linked to criminal behaviour. Thus, to meet the best interest standard; children in conflict with the law must be dealt with using a multi-factorial approach which considers biological, environmental, social, cultural, and psychological factors. In this way, the behaviour of child offenders with psychiatric disorders will be addressed holistically in a manner that considers all factors influencing behaviour. The empirical data supported the recommendations used to develop a trans-disciplinary framework for child offenders with psychiatric disorders.
Olu phononongo lwesi sifundo lujolise ekuphuhliseni isakhelo somthetho ophuculiweyo, iindlela zokusebenza kunye neenkonzo ukwenzela ukunikezela ezona zilungileyo iimfuno zabantwana abangabaphuli-mthetho benengulo yesifo sengqondo kwinkqubo yobulungisa yabantwana eMzantsi Afrika. Le njongo yaphunyezwa ngokwenziwa kwezifundo ezisemgangathweni ezahlola umthetho wobulungisa kubantwana kunye nomthetho olawula ezempilo ngokwengqondo, iindlela zokusebenza, abathathi-nxaxheba kunye neenkonzo eMzantsi Afrika. Ezi zathi ngoko zathelekiswa nomthetho, umsebenzi abathathi-nxaxheba kunye neenkonzo eNamibia, eBotswana, kunye naseNigeria ukufumanisa ukuba iimfanelo ezizizo zabantwana abangabaphuli-mthetho abaneengxaki zengqondo bayanakekelwa ngoku eMzantsi Afrika. Ukuqokelelwa kweenkcukacha kwenzeka kumanqanaba amabini: uhlalutyo lwemiqulu yomthetho, umgaqo-nkqubo kunye nenkqubo; Ukucazululwa kwamaxwebhu/kwemiqulu omthetho, umgaqo-nkqubo kunye neenkqubo ezikhethiweyo zothelekiso kulawulo lwezobulungisa, lilandelwe ludliwano-ndlebe olungahlelwanga ngokupheleleyo neengcaphephe/neengcali zezobulungisa lwabantwana kunye nemilo yezengqondo. Kwinqanaba lokuqala umphandi ucazulule umthetho wobulungisa kubantwana kunye nempilo yezengqondo, ukhuseleko lwamalungelo oluntu.kunye nemigaqo-nkqubo ehambelana/ enxulumene nobulungisa kubantwana eNigeria, eBotswana, eNamibia naseMzantsi Afrika. Ukongezelela walugocagoca uncwadi olubhekisele kubulungisa babantwana nezempilo yezengqondo kulawulo lwezobulungisa Eli nqanaba libe sisiseko soludwe lwenkqubo yodliwano-ndlebe olungamiselwanga ngokupheleleyo. Isampulu enenjongo neyingcingane yasetyenziswa ukuze kuqhutywe udliwano-ndlebe olungama-24 olungahlelwanga ngokupheleleyo. Ulwazi (idata) lwacalulwa lwacaciswa kusetyenziswa uxwebhu olusemgangathweni kunye nocalulo (analysis) olusemxholweni. Iziphumo ezicacileyo/eziqaqambileyo eziluphahla zibonisa ukuba okukokona kulungele abantwana abangabaphuli-mthetho abaneengxaki zezengqondo, abakhuselekanga kwinkqubo yezobulungisa babantwana eMzantsi Afrika. Eli qela lingakhuselekanga alivelelwa ngokomntu neengxaki zakhe yedwa, ngokwengxaki yakhe ngokuthe ngqo kusetyenziswe indlela ezahlukileyo ezilawulwa ngumthetho, ngumgaqo-nkqubo osebenzayo nokuvelela ngendlela yokuziqhelanisa nemeko. Ukuya phambili, eminye yemithetho yasekhaya neendlela zokusebenza azonelanga ekuhloleni ngokupheleleyo kumntwana ohlangabezana nokuphikisana nomthetho kummandla wothelekiso. Kuphinde kwafunyaniswa ukuba iimeko zozalo, zengqondo, zendawo, zenkcubeko nezentlalo ziyaziphembelela iingxaki zezengqondo ezivelayo ebantwaneni, ezinokwenza baphikisane nomthetho. Olu phononongo luqhubeka lungqina ukuba ukunganiki ngqalelo kwingxaki yokuphaphazela, ingxaki yokukhula kwengqiqo, ingxaki yokufunda, ingxaki yenkcaso yokulungileyo/ ukudelela kunye nengxaki yokuziphatha zixhaphakile kubantwana (abonayo) abaphikisana nomthetho. Ingxaki yokusebenzisa iziyobisi, ingcinezelo kunye nokuxhomekeka ziye zaphawulwa njengeemeko ezixhaphakileyo ezikhathaza abantwana abalwa nomthetho (abonayo). Iimpembelelo zezi meko, zidibene neemeko zozalo, zezengqondo, zendawo, zenkcubeko nezentlalo, zifunyenwe zilungiselela kwangaphambili abantwana kwezi ngxaki zezengqondo zithungelene ekuziphatheni ngokolwaphulo-mthetho. Ngoko ke ukuhlangabezana nomgangatho ofanelekileyo nobalulekileyo, ebhekelela abantwana abaphikisana nomthetho (abonayo) makusetyenzwe ngabo kusetyenziswe indlela ejongene neemeko ezininzi ezibandakanya iimeko zozalo, zendawo, zentlalo, zenkcubeko kunye nezengqondo. Ngale ndlela abantwana abaphula umthetho abanengxaki yezengqondo baya kuncedwa ngokupheleleyo ngendlela ebandakanya zonke iimeko eziphembelela ukuziphatha. Idatha ekholose ngamava avela kumava nokuboniweyo ixhasa izindululo ezenziweyo zokumisa isakhelo esisebenza kulo lonke uqeqesho lomntwana ophikisana nomthetho (owonayo) onengxaki yezengqondo.
Patlisiso ena e reretswe ho hlahisa moralo wa molao o ntlafetseng, mekgwa ya tshebetso le ditshebeletso bakeng sa molemo wa batlodi ba molao bao e leng bana ba nang le mathata a kelello tshebeletsong ya toka ya bana Afrika Borwa. Morero ona o fihletswe ka boithuto ba boleng, bo lekantseng melao ya toka ya bana le ya bophelo bo botle ba kelello, mekgwa ya tshebetso, baamehi le ditshebeletso Afrika Borwa. Tsona di ile tsa bapiswa le melao, tshebetso, baamehi le ditshebeletso dinaheng tsa Namibia, Botswana le Nigeria ho fumana hore na melemo e loketseng ya batlodi ba molao bao e leng bana ba nang le mathata a kelello e ya fumaneha hajwale Afrika Borwa. Pokeletso ya dintlha e etsahetse ka mekgahlelo e mmedi: manollo ya ditokomane tsa molao, melawana le mekgwatshebetso dibakeng tse kgethilweng tsa papiso tsa semolao; ho latetswe ke di-inthavu tse sa hlophiswang le ditsebi tsa toka ya bana le tsa molao wa bophelo bo botle ba kelello. Mokgahlelong wa pele mofuputsi o ile a manolla molao wa toka ya bana le wa bophelo bo botle ba kelello, ditshireletso tsa ditokelo tsa botho le melawana e amanang le toka ya bana dinaheng tsa Nigeria, Botswana, Namibia le South Africa. Ho feta moo, o ile a batlisisa dingolwa tse mabapi le toka ya bana le bophelo bo botle ba kelello dibakeng tse ka bapiswang tsa semolao. Mokgahlelo ona o bile motheo wa lenane la di-inthavu tse sa hlophiswang. Ho sebedisitswe mokgwa wa disampole wa kgetho le wa theho ya thiori ho etsa di-inthavu tse 24 tse sa hlophiswang. Dintlha di manollotswe le ho tolokwa ka manollo e sa tswakwang ya boleng ba ditokomane le ditema. Diphetho tse akaretsang di supa hore melemo e nepahetseng ya batlodi ba molao bao e leng bana ba nang le mathata a kelello ha e ya sireletswa moralong wa toka ya bana wa Afrika Borwa. Sehlopha sena se kotsing ha se sebetswe ka tjhebo ya bo-motho ka mong, ya kgetsi e kgethehileng, ya mafapha a mangata e tshehedistsweng ke molao, molawana wa tshebetso le tjhebo ya tshebetso. Ho feta moo, melao e meng ya lehae le mekgwa ya tshebetso e ne e fokola bakeng sa ho lekola ngwana ka tsela e felletseng, ya iphumanang a le kgahlano le molao dibakeng tsa semolao tse neng di bapiswa. ix Ho boetse ha fumanwa hore dintlha tsa tlhaho, kelello, tikoloho, setso le botjhaba di susumetso tlhaho ya bokudi ba kelello baneng, e leng ho etsang hore ba iphumane ba le kgahlano le molao. Boithuto bona hape bo tiisitse hore bokudi ba tlholeho ya tsepamiso le ketso e fetang tekano, bokudi ba kgolo ya bohlale, bokudi ba ho ithuta, bokudi ba ho ba kgahlano le ba bang le bokudi ba boitshwaro bo bongata bakeng ba iphumanang ba le kgahlano le molao. Bokudi ba tshebediso e mpe ya tahi kapa dithethefatsi, tshithabelo ya maikutlo le bokudi ba kgokahano di fumanwe e le mabaka a mantlha a amang bana ba qwaketsanang le molao. Tshusumetso ya dintlha tsena, hammoho le dintlha tsa tlhaho, kelello, tikoloho, setso le botjhaba, di fumanwe e le hore di pepesa bana ho bokudi ba mafu a kelello a amanngwang le botlokotsebe. Kahoo, e le ho ka fihlella maemo a melemo e nepahetseng, bana ba kgahlano le molao ba lokela ho sebetswa ka mokgwa wa ditsela tse fapaneng tse ngata, o kenyeletsang dintlha tsa tlhaho, tikoloho, setso, botjhaba le kelello. Ka mokgwa ona, batlodi ba molao bao e leng bana ba nang le bokudi ba kelello ba tla shejwa le ho sebetswa ka mokgwa o phethahetseng o kenyelletsang dintlha tsohle tse susumetsang boitshwaro. Dintlha tse bokelleditsweng di tsheheditse ditlhahiso tse sebedisitsweng ho hlahisa moralo wa makala a fapaneng bakeng sa batlodi ba molao bao e leng bana ba nang le bokudi ba kelello.
Criminology and Security Science
D. Phil. (Criminal Justice)

Indiana University-Purdue University Indianapolis (IUPUI)
Health Information Technology (HIT) has become an integral component of healthcare today. The HITECH Act (2009) and Meaningful Use objectives stand to bring wide-sweeping adoption and implementations of HIT in small, medium and large sized healthcare organizations across the country. Though recent literature has provided evidence for the benefits of HIT in the profession, there have also been a growing number of reports exploring the adverse effects of HIT. There has not, however, yet been a systematic account of the adverse effects of HIT in the healthcare system. The current push for HIT coupled with a lack of critical appraisal of the potential risks of implementation and deployment within the medical literature has led to a general unquestioning and unregulated acceptance of the implementation of technology in medicine and healthcare as a positive addition with little or no risk. While the benefits of HIT are clear, a review of the existing studies in the literature would provide a holistic vision of the adverse effects of HIT as well as the types and impact within the nation’s health care system to inform future HIT development and implementation. The development of a general understanding of these adverse effects can serve as a review and summary for the use of informatics professionals and clinicians implementing HIT as well as providing future direction for the industry in HIT implementations. Additionally, this study has value for moving forward in informatics to develop frameworks for implementation and guidelines and standards for development and regulation of HIT at a federal level. This study involves the use of an integrative literature review to identify and classify the adverse effects of HIT as reported in the literature. The purpose of this study is to perform an integrative review of the literature to 1) identify and classify the adverse effects of HIT; 2) determine the impact and prevalence of these effects; 3) identify the recommended actions and best practices to address the negative effects of HIT. This study analyzed 18 articles for HIT-induced error and adverse consequences. In the process, 228 errors and/or adverse consequences were identified, classified and represented in an operational taxonomic schema. The taxonomic representation consisted of 8 master categories and 30 subcategories. Additionally, the prevalence and impact of these errors were evaluated as well as recommendations and best practices in future systems design. This study builds on previous work in the medical literature pertaining to HIT-induced errors and adverse consequences and offers a unique perspective in analyzing existing studies in the literature using the integrative review model of research. It is the first work in combining studies across healthcare technologies and analyzing the adverse consequences across 18 studies to form a cohesive classification of these events in healthcare technology.

The South African Justice System is a broader system that brings law and order to society. This law and order also includes the constitutional rights of the sexually abused children. A special court dealing with cases of children who are sexually abused is functioning throughout the country. The purpose of this study is to develop a framework for social workers working with children in these special courts. The problem identified is that in these courts no framework exists for social workers focusing on the guidance of the child through the processes of the Justice System. This includes the therapeutic guidance by means of brief or directive therapy. The research methodology for this study focused on developmental research by using the Intervention research model of Rothman and Thomas (1994). The phases implemented in the study were Problem analysis and project planning, information gathering and synthesis and design. Qualitative data was gathered by means of semi-structured interviews and integrated in phase two of the research report. A proto-type guideline was developed and needs to be evaluated in future research.
Social Work
M.Diac. (Play Therapy)

Purpose This research project was an attempt to determine situational aspects of HIV and AIDS among the designated farming communities in the Vhembe and Mopani districts of Limpopo Province. Questions arising from the pilot project were premised on the capacity of farmers in these areas to adequately address the daunting reality and prevalence of HIV and AIDS in their communities. Research Design and Methodology The research was designed to facilitate the integration of both qualitative and quantitative approaches. A sample of 228 respondents was involved in a triangulated participatory action research method. To the extent that the data collection techniques were triangulated in both nature and focus, HIV/AIDS-related data and information within the designated farming communities was attained with a maximum degree of validity. The data collection techniques used in this regard were: questionnaires, which were distributed to 228 respondents; participant observation; exploratory investigation; unstructured interviews; naturalistic observation; focus group interviews and discussion; and review of documents. The reviewed documents include (primary) sources on HIV/AIDS by the Department of Health and (secondary) sources of literature by various authors presenting a range of perspectives on HIV/AIDS in farming areas. Findings The results of the study revealed the absence of a coordinated policy on HIV/AIDS in particular, and health in general; and a vacuous prevalence of basic HIV/AIDS-related information. For instance, knowledge on condom usage as a prevention strategy was ostensibly scant. Currently, primary healthcare services in the area are not available. The sampled farm workers themselves unanimously corroborated that there was no HIV/AIDS policy on the SAFM farms. Conclusion Based on the main findings established above, it has become indispensable that comprehensive and multidisciplinary HIV/AIDS policy interventions be initiated by all the relevant stakeholders. Local and provincial healthcare authorities need to provide policy guidelines for the development of such policy, taking the particular needs and circumstances of farm workers. The pervasive degree of insufficient HIV/AIDS knowledge among this group necessitates that such a policy should integrate both a labour perspective and healthcare orientation, rather than perpetuating a separation of the two paradigms. This form of integration ensures that the observance of a human rights dimension becomes a sacrosanct component of the prevention of HIV/AIDS among farm workers, as well as their education concerning their healthcare-related rights as farm employees. Furthermore, the prevalence of a national HIV and AIDS policy is mainly aimed at facilitating broad guidelines, not addressing the specific contexts of every public, corporate and rural employment sector (DoH, 2007: 11-12; Muhlemann, et al., 1992: 479). In order that the education, prevention and treatment initiatives in the Vhembe and Mopani farming communities are achieved, the most important parameters of the policy should indicate: ,,X The systematic institutionalisation of local, provincial, and national HIV and AIDS programmes, notwithstanding the provision of healthcare facilities such as clinics; ,,X The promotion of basic healthcare education in general, and HIV/AIDS awareness and prevention among farm workers in particular; ,,X The development of HIV/AIDS work place policy by SAFM as employer; ,,X The systematic involvement and formation of partnerships between policy makers, local and international funders, HIV/AIDS healthcare workers and practitioners, NGOs and SAFM. As a critical factor and unit of analysis in the study, SAFM is expected to fulfil a developmental function among its employees, their families, and the local communities. This function could be enhanced further with the collaboration between SAFM and other farmers in the distribution of basic information regarding HIV/AIDS and other sexually transmitted diseases at the workplace, as well as extensive healthcare education and training for their farming personnel. Trained personnel, especially managers, are a salient factor in the implementation of organisational health and safety requirements (DoH, 2007: 6, 8; Muhlemann, et al., 1992: 478-479).
Health Studies
D. Litt. et Phil. (Health Studies)

Farm workers in South Africa have limited access to health care and health-related information. In this qualitative study, the implementation of a workplace HIV/AIDS policy was evaluated using data gathered through interviews and observation. It was found that, although the farm workers were knowledgeable about HIV and AIDS, this knowledge was insufficient. It was found that the lives of farm workers are deeply affected by HIV and AIDS. It is also suggested that the agricultural sector is not yet able to deal effectively with HIV and AIDS and that, in this regard, urgent planning is needed in respect of HIV and AIDS policies and interventions
Social Work
M.A. (Social Behaviour Studies in HIV/AIDS)

Despite the fact that albinism affects several South Africans, it is a condition that remains deeply misunderstood. Albinism is steeped in myth and false notions, and is perceived by many as a curse and contamination. For years, persons living with albinism have been treated with doubt and suspicion. Also in schools and in the wider community, children with albinism are subjected to violence and ridicule. In certain areas on the African continent, including Southern Africa, persons living with albinism are killed for the trade in body parts for use as sacramental medicines, or sexually assaulted as a result of the belief that raping them may offer a cure for HIV/AIDS. All of this highlights the extreme vulnerability of persons living with albinism, not to mention the many violations of their fundamental rights that follow from the manner in which they are treated. Within the social context that frames the experience of persons living with albinism, the primary purpose of this study is to highlight some of the pertinent challenges faced by persons living with albinism in South Africa which compromise the full enjoyment of their fundamental rights as enshrined in the South African Constitution. The thesis makes a number of practical recommendations that will assist in promoting the legal position of this vulnerable group, while also contributing to a better understanding of albinism in general which will ultimately change negative perceptions and debunk the myths surrounding the condition.
Jurisprudence
LL. D.

Text in English with abstracts in English, isiZulu, and isiXhosa
South Africa’s education system is in crisis. Problems in education directly impact the country’s economy through its influence on skills development for employability. Young children trapped in an environment under serviced by educational resources and haracterised poor social cohesion cannot reach their full potential. This study, undergirded by Bronfenbrenner’s ecological model, sought to establish whether stateled early childhood development centres (ECDCs) in the Cape Flats can establish social cohesion and foster responsible citizenship and youth resilience. A qualitative study was conducted in selected ECDCs. Focus group interviews with caregivers of children from sampled centres and face-to-face interviews with the owners/managers of centres were augmented by an interview with an official from local government. The study concluded that the sampled ECDCs are merely coping, but restricted by various problems. They cannot function optimally as institutions for community development, although the community holds them in high esteem. Recommendations are made for improvements.
Uhlelo lwemfundo yaseNingizimu Afrika lunezingxaki. Izinkinga ezitholakala kwezemfundo zinomthelela othintana ngqo nezomnotho ngenxa yethonya ezinalo ekuthuthukisweni kwamakhono kuzokwenza abantu ukuba baqasheke. Izingane ezisezincane ezibiyelwe esibayeni esincishwa izimfanelo zezemfundo, ezingenakho nokubumbana okufanele komphakathi, ngeke zakufeza lokho ezinamandla okufinyelele kukho. Ucwaningo olususelwe esibonelweni sikaBronfenbrenner ngobudlelwane bomuntu nesizinda sakhe, lwaluhlose ukuthola ukuthi ngabe izikhungo eziholwa ngumbuso zokuthuthuka kwezingane ezincane (ama-ECDC) eCape Flats ziyakwazi yini ukugxilisa ukubumbana komphakathi, zikhulise kumuntu ukuba yisakhamuzi esiqotho nabasha abakwazi ukuqina bomelele. Kwenziwa ukuhlolisisa ezikhungweni zama-ECDC ezikhethiwe. Kwaba nokuxoxisana namaqembu aqokiwe abanakekeli bezingane zakulezo zikhungo ezikhethiwe, kwabuye kwaba nokuxoxa bukhoma nabanikazi/abaphathi bezikhungo, okwengezwa kukho nesikhulu esivela kuhulumeni wendawo. Lolu cwaningo lwafinyelela ekuthini izikhungo ezikhethiwe zama-ECDC zazipatanisa nje ngoba zazinqindwa yizinkinga ezahlukene, okusho ukuthi zazingakwazi ukusebenza ngokuphelele njengezikhungo zokuthuthukisa umphakathi, noma umphakathi wona wawuzibabaza kakhulu. Kukhona nezincomo ngokungase kwenziwe ukuze isimo sibe ngcono.
Isimo senkqubo yemfundo yoMzantsi Afrika simandundu. Iingxaki ezikhoyo kwezemfundo ziluchaphazela ngqo uqoqosho ngenxa yokuba zinefuthe kuphuhliso lwezakhono ezilungiselela ukuqesheka komntu. Abantwana abaselula abakwazi ukuphuhla ngokugqibeleleyo kuba bavaleleke kwimeko yemfundo eneenkonzo ezingekho mgangathweni nakwisimo esingazinzanga somphakathi. Esi sifundo sisekelwe kwinkqubo kaBronfenbrenner yolwalamano lwezinto eziphilayo nendalo, kwaye sizama ukuqonda ukuba ingaba ukusekwa kwamaziko ophuhliso lwabantwana abancinci (iiearly childhood development centres- ECDCs) eCape Flats kungadala uzinzo eluntwini, kukhuthaze ukuba ubani abe ngummi othatha uxanduva, ulutsha lungathabatheki lula kusini na. Uphando lomgangatho lwenziwe kumaziko iiECDCs ezikhethiweyo. Udliwano-ndlebe namaqela abantu abagcina abantwana kumaziko akhethiweyo kwanabaphathi baloo maziko luxhaswe ludliwano-ndlebe esiphathamandla sorhulumente wendawo. Esi sifundo sifikelele kwisigqibo esithi ezi ECDCs zikhethiweyo ziyazama kodwa zikhonkxwa ziingxaki ezahlukeneyo, nto leyo ithetha ukuthi azikwazi ukusetyenziswa ngokupheleleyo njengamaziko ophuhliso lomphakathi nangona umphakathi wona uzixabise kakhulu. Kunikwe iingcebiso zokuphucula imeko.
Development Studies
M.A. (Development Studies)