Dissertations / Theses: 'Community health services – South Africa – Eastern Cape'

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Mfundisi, Nokwamkela Pearl. "Client satisfaction with midwifery services rendered at Empilweni Gompo and Nontyuatyambo community health centres in the Eastern Cape, South Africa." Thesis, University of Fort Hare, 2013. http://hdl.handle.net/10353/d1006902.

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The aim of this study was to investigate whether patients were satisfied with midwifery services rendered at the two Community Health Centres in the Eastern Cape Province.The study sites were Empilweni Gompo and Nontyatyambo Community Health Centres. Descriptive quantitative study design was employed, using a questionnaire with closed and open ended questions as the data collecting tool. Likert Scale was used to measure the following variables: quality care variables to measure level of satisfaction with midwifery services rendered and to determine positive and negative perceptions regarding quality of care received during antenatal, labour and postnatal period. Non-random convenience sampling of sixty pregnant women, thirty from each Community Health Centre, with two or more antenatal subsequent visits and forty postpartum women, twenty from each health facility, six hours after delivery if there were no complications. Out of 60 participants interviewed n=60 (100 percent) agreed that individual counseling and importance of HIV testing was explained.The majority of participants n=53(88 percent) disagreed that they were educated about focused antenatal visits. Out of 60 participants interviewed n=41(68 percent) agreed that delivery plan formed part of their ANC visits and n=18 (30 percent) disagreed. Of the 60 participants interviewed n=11(18 percent) agreed that they were told that they had the right to choose labour companions and n=48 (80 percent) disagreed.Out of 60 participants interviewed n=23 (38 percent) stated that they waited a long period of time without being attended to by midwives. In general, the study revealed high satisfaction level with intrapartum and postnatal care due to functional accessibility of both Community Health Centres. Both health centres delivered normal healthy babies and mothers. However, the participants were dissatisfied with antenatal care rendered at the two facilities. The researcher’s recommendations were based on the closing of gaps that were identified with regard to the implementation of Basic Antenatal Care; birth companions: health education deficiency; community involvement and participation.

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Hepburn, Mary Patricia. "An exploration of environmental understanding among primary health care providers in an Eastern Cape community." Thesis, Rhodes University, 1999. http://hdl.handle.net/10962/d1003415.

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This study explores environmental understanding among the health care practitioners serving a rural community in the Eastern Cape Province in South Africa. During the preliminary phases of the research, the decision was made to adopt a participatory approach to the inquiry as far as was possible. Semi-structured interviews, participant observation and focus group discussions were the techniques chosen to focus the participants' thinking about: the meaning of environment, environmental issues and problems which impact on health, and, environmental education in practice. Comparisons between the recently transformed health education idea proposed by the World Health Organization (WHO), known as "health promotion", and a popular environmental education model are made. It is argued that many of the obstacles to effective health education described by the participants in the study can be overcome by using environmental educationlhealth promotion approaches. The findings show that the health practitioners studied relate to a wide range of environmental issues with varying levels of engagement. They are influenced by changing values, their feelings about indigenous knowledge, and their notions about how people should respond to the environment. An urgent need for more and better communication among the different levels of health practitioners is identified. Finally, it is recommended that health care practitioners be supported with opportunities for professional development which can lead to a confident, seIfreflective approach to health education.

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Zonke, Lulama Henrietta. "The newly qualified professional nurses' proficiency in utilizing psychiatric nursing skills in mental health institution and community health care facilities." Thesis, University of Fort Hare, 2012. http://hdl.handle.net/10353/d1001098.

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The aim of this study was to determine the ability and proficiency of the newly qualified professional nurses in utilising psychiatric nursing skills at Chris Hani District Psychiatric Health Care Services in the Eastern Cape, South Africa. The research method was a qualitative, phenomenological approach. A purposive sample of newly qualified professional nurses and supervisors participated in the study. The data were collected through interviews and focus group discussions, using semi – structured interview guides. Interviews responses were recorded on the interview guide. Data were analysed using the computer software Atlas ti and manually. Positive and negative themes were identified. Ethical considerations were ensured by means of privacy, anonymity and confidentiality. Ethical clearance was obtained from the University of Fort Hare and permission from the Provincial Department of Health and Chris Hani District Health and Mental Health Institution at Queenstown was sought. The findings revealed that newly qualified professional nurses performed well, according to the perception of their supervisors. Newly qualified professional nurses were faced with challenges such as shortage of resources, mental illness not considered as a priority and lack of skills development. The study also revealed that newly qualified professional nurses focussed on the curative aspect of ailments, rather than preventive care. However community health workers (CHW) focussed on the preventive aspect of care. Limitations and recommendations based on the findings of the study are presented.

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Dlatu, Ntandazo. "The integration of mental health care services into primary health care system at King Sabata Dalindyebo Municipality Clinics." Thesis, Walter Sisulu University, 2012. http://hdl.handle.net/11260/d1008290.

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Introduction: Primary Health care refers to care which is based on the needs of population. Mental health care provided within general primary care services is the first level of care within the formal health system. There is no research in King Sabata Dalindyebo, carried out on issues around integration of mental health with primary health care. The present study is initiated to overcome this gap. Aim of the study: The aim of the study was to investigate the level of knowledge, implementation and barriers of integrating mental health care services into primary health care system at King Sabata Dalindyebo clinics, in Mthatha region. Methods: This descriptive cross-sectional study was conducted at King Sabata Dalindyebo Clinics, between January 2010 and December 2011. A 10% random sample of all health professionals from King Sabata Dalindyebo was interviewed concerning their demographic characteristics, education/ qualifications, general and further training in psychiatry, awareness about Mental Health Care Act 17 of 2002 and mental health care services characteristic related to the integration of mental health care services into primary health care system. For data analysis, the means of continuous variables across 2 groups were compared using Student-t test. The proportions (%) of the categorical variable across 2 groups were compared using Chi-square test. Results: A total of 52 health professionals (40.4% males, 59.6 females, 59.6 married, 3 doctors, 49 nurses, mean age 36.9± 8 years range 23 years-52 years), were surveyed. The participants were characterized by low level of qualification in specialization, further training in psychiatry, and by very low awareness about Mental Health Care Act 17 of 2002. Furthermore, there was no implication of expects (Regional psychiatrist, psychologist, social worker) and co-ordination of mental health care services. Working in remote and disadvantaged area, health workers with lower education qualification, absence of a coordinator for mental health care services and absence of workshop on Mental Health Care Act 17 of 2002 were determinants of lower awareness about Mental Health Care Act 17 of 2002. However, there was a good to excellent framework for potential implementation of mental health care services into primary health care system. The government support in infrastructures, drugs availability, transport and equipment was evident. Patients were helped within abroad based ethical, human rights and psycho-social framework. Conclusion: There is a lack of improving human capacity for mental health in terms of continuous training in mental health issues, policies, organisation and development. Globally, the integration of mental health care service in King Sabata Dalindyebo is non-optimal.

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Ndlebe, Siphokazi. "An assessment of the quality of family planning services rendered to adolescents by health workers at Mdantsane clinics, Mdantsane, Eastern Cape Province, S.A." Thesis, University of Fort Hare, 2011. http://hdl.handle.net/10353/407.

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Family planning services are rendered at no cost in all clinics in Mdantsane. Mdantsane is situated in the Eastern Cape and falls under Amathole District Municipality. The high rate of adolescent pregnancy in the area raises a question as to whether the family planning services are adequate. This issue reflects on the quality of family planning service delivery. According to Roux (1995:94), a quality service is a safe, easily available and readily acceptable service, delivered by well trained family planning personnel through well planned programmes. Aims and Objectives: To assess the quality of family planning service delivery by health providers to adolescents; determine the opinions of adolescents regarding accessibility, friendliness of staff, privacy, confidentiality, reproductive health information and resources at Mdantsane clinics from June to July 2009. Method: A questionnaire was designed to collect data. The questionnaire was administered on the adolescents utilizing the reproductive health services at eleven primary health clinics in Mdantsane. A sample consisting of 110 adolescent youth between 19 and 24 years was selected by using random sampling. A response of “yes” will indicate that the participant is satisfied with the specific item, while a response of “no” will indicate dissatisfaction with that item. A specially designed spreadsheet was developed to analyze the data. Data was analyzed by using the Microsoft Excel 2007 Version 6. Results: The results from this research study suggest that there is a definite need for improvement of adolescent reproductive health services at Mdantsane clinics. It is clear that the current available maternal and child health programmes, school health services and reproductive health services are not able to meet the adolescent sexual and reproductive needs. Conclusion: The research findings from this study indicated the constraints to good quality family planning health care service delivery. Satisfaction responses from the five categories: health facility amenities, accessibility, staff characteristics, availability of sexual and reproductive health services and availability of educational material accessibility were mostly below 70%. The responses regarding the question on the “full information about the available contraceptives”showed the least level of satisfaction. Deficiencies in physical facilities and equipment, disruptions in supplies, insufficient information provided to clients and providers‟ insensitivity to the feelings and needs of the clients are issues that discourage adolescents from utilizing contraceptive services. Recommendations: Adolescents need a safe and supportive environment that offers information and skills to equip them on all aspects related to sexual and reproductive health issues. To satisfy adolescent reproductive needs, the following key elements should be improved: accessibility of reproductive health services, friendliness of clinic staff, availability of information about reproduction and sexuality and maintenance of issues regarding confidentiality and anonymity. Quality requires the presence of trained personnel in well-equipped clinics where clients are treated courteously. To avoid issues of courtesy bias, there is a need to conduct a similar survey utilizing alternative community settings, namely homes of participants or a school.

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Morton, David Gerard. "A critical assessment of the quality of community home-based care." Thesis, Nelson Mandela Metropolitan University, 2012. http://hdl.handle.net/10948/1606.

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Volunteer home-based caregivers are critical role players in South Africa‘s health care system and in the South African government‘s strategy to fight HIV and AIDS. In order to achieve the aims that the government seeks to attain, it is important that the care and treatment provided to patients receiving community home-based care (CHBC) be of a high quality. While the need for quality care is supported by government and civil society, research indicates that it is not clear whether quality care is indeed being provided and therefore there is a need for research into the quality of CHBC. The research aimed to undertake a critical assessment of CHBC programmes to determine the quality of care provided by volunteer caregivers using social capital theory as a theoretical framework. The study examined the quality of CHBC by analysing the context of CHBC, by investigating the support that volunteer caregivers and their clients receive and by discussing the support that volunteer caregivers and their clients still need. The study used one-on-one in-depth interviews and focus groups to obtain relevant data. The participants included volunteer caregivers, clients and supervisors who took part in the one-on-one interviews. The focus groups consisted of key informants and supervisors respectively. The quantitative data consisted of descriptive statistics which helped describe the participants. The qualitative data was coded and themes and sub-themes were developed. The data was also analysed by an independent coder. The results showed that poverty, and the related problems of poor living conditions and a lack of food security affects the quality CHBC. In addition, unemployment and the problem of stipends also affect quality CHBC. Certain socio-economic factors were also found to lead people to choose to become volunteer caregivers and unemployment was found to be an important driving force behind the choice to undertake volunteer caregiving. Furthermore, the volunteer caregivers in the sample received organisational support from their supervisors and their fellow caregivers or peers. They also received social support from their families and their communities. Regarding the clients of the volunteer caregivers, it was found that they received a number of types of support including psycho- iv social counselling, spiritual counselling and care of a holistic nature. In addition, the study found that there is a need for standardised quality training of volunteer caregivers, which will equip them with multiple skills. It was also found that volunteer caregivers require mentoring and quality supervision in order to be able to provide quality CHBC to their clients. Government has the ability to put the necessary systems and structures in place, such as a scope of practice for volunteers, standardised training and monitoring and evaluation, to enable CHBC and its relevant role players to operate at optimum levels. It also has the authority to make the changes and to enforce rules. Furthermore, it has the ability to unite CHBC organisations and can create the necessary conditions that can lead to increased social capital. Furthermore, the study recommends that two additional dimensions of quality care be added to existing dimensions of quality in health care. The first is the holistic approach to caregiving and the second is social support systems, namely supervisor/mentor and peer support and family and community support. This second dimension is also closely linked to social capital and the networks that make up CHBC.

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Shiri, Clarris. "Patient education : the effect on patient behaviour." Thesis, Rhodes University, 2006. http://eprints.ru.ac.za/1348/.

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Webber, Fiona. "A study of the prevalence of refractive errors and of patients requring refractive services at 15 eye clinics in the Amathole, Chris Hani, Joe Gqabi and O. R. Tambo districts of the Eastern Cape." Thesis, University of Fort Hare, 2012. http://hdl.handle.net/10353/d1001100.

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This is a study on the prevalence of refractive errors and patients requiring refractive services at 15 eye clinics in the Amathole, Chris Hani, Joe Gqabi and OR Tambo District Municipalities of the Eastern Cape. This is an area characterised by extreme poverty where the cost of an eye examination and prescription spectacles remains financially unobtainable for most. Optometry services are provided mainly by private optometrists who service the small proportion of the population that can afford them. Adults and children remain house bound or are labelled as dull and unproductive simply because they don’t have access to an eye examination and a pair of spectacles. Purpose The purpose of the study is to identify patients with refractive errors and those requiring refractive services at the 15 eye clinics in the Eastern Cape. Another purpose is to describe the refractive services that are available to patients attending health facilities, where the eye clinics are conducted. Lastly, the purpose is to explore the possibility of nurses providing refractive services independently or under the supervision of optometrists to supplement the lack to refracting and dispensing services. Study Method A quantitative and qualitative non-experimental descriptive design was used. Research involved the analysis of Vision Care’s eye clinic records collected from 15 eye clinics from January 2010-June 2010. Semi-structured interviews were conducted with 30 nurses working at the 15 health facilities where the eye clinics were conducted using purposive sampling. The quantitative data was analysed using excel spreadsheets and graphs and qualitative data was analysed using coding and categorizing methods. Conclusion According to Vision Care’s data of the patients assessed, 19.2 percent had a refractive error and 54 percent of the patients required refractive services. It is estimated that 71.41 percent of the patients had a refractive error according to the optometrist. Although there were some organisations active in the eradication of cataracts, there was little healthcare available in the form of refraction services. xiv Patients needed to travel an average of 63.8kms to access refraction services against the backdrop of poor roads, poverty and unemployment. 28 out of 30 nurses either ‘strongly agreed’ or ‘agreed’ that nurses could be trained to perform refractions and dispense spectacles. 29 out of 30 nurses thought that this would have a positive impact on eye care. Further research is necessary to assess the feasibility of implementing a nurse operated refractive program and whether it should be within their scope of practice to refract and dispense spectacles.

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Zakaza, Nompucuko. "IsiXhosa storytelling (iintsomi) as an alternative medium for maternal health education in primary healthcare in the Eastern Cape." Thesis, Rhodes University, 2015. http://hdl.handle.net/10962/d1017188.

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The aim of this study is to explore the introduction of IsiXhosa (iintsomi) as an alternative method in the maternal health education in rural Primary Health Care in the Eastern Cape. An informal preliminary observation of a maternal health lesson by the researcher indicated a further need for maternal health educators to introduce storytelling into the health content themes. To re-inforce the maternal health educator lesson on the causes of teenage pregnancy, lifestyles for pregnant women, causes of miscarriage and termination of pregnancy, the Community Health Workers can undoubtedly use isiXhosa iintsomi in selected clinics and maternal waiting homes. As a readily available resource that cuts across all literacy barriers, iintsomi (isiXhosa) fosters a cross-cultural consultation which enables the healthcare worker to convey messages that make sense to the rural women. While the conventional methods of teaching have a tendency to create tension and lack of participation, use of folktale (iintsomi) have huge potential to bring lesson enjoyment; a meaningful interaction and story sharing by the maternal health educator, the pregnant women and greater community; access to important health messages; and strengthened utilisation of Primary Health Care. The study therefore suggests that there is a place for isiXhosa iintsomi: From the Fireplace into the Workplace.

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Mbengo, Nomatshawe. "Communication at the health care coalface: lessons from selected clinics in Port Elizabeth." Thesis, Rhodes University, 2012. http://hdl.handle.net/10962/d1002166.

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This thesis analyses the state of health care in South Africa with particular reference to a clinic and the Provincial Hospital in Port Elizabeth, Eastern Cape. The complexities of health care provision in a diverse sociolinguistic environment where certain languages are emphasized over others, forms the cornerstone of the research. The research focuses on health care in a complex multi-cultural environment. The goal of the research is to present a coherent and robust translation framework for the development of suitable materials to enhance communication across language and cultural barriers in the health care sector. A model (based on research completed in the USA) is presented as a possible alternative in the final chapter of the thesis.

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Erstad, Ida. "The resurgence of tuberculosis in South Africa: an investigation into socio-economic aspects of the disease in a context of structural violence in Grahamstown, Eastern Cape." Thesis, Rhodes University, 2007. http://hdl.handle.net/10962/d1002653.

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This thesis is an investigation into the socio-economic constraints that influence the decisions of tuberculosis sufferers in the health seeking process and therapeutic management of tuberculosis in Grahamstown, the Eastern Cape. It is shown that structural violence influences experiences and perceptions of tuberculosis at all levels. Management of tuberculosis in the formal health sector is explored at local levels and related to national and global strategies of health care. The role of health workers, and particularly voluntary health workers, is explored and it is shown that they work within a context of growing burden of sickness and co-infections and a lack of government commitment to deal with increasing TB and HIV incidences. Kleinman’s notion of explanatory models is explored and it is evident that although knowledge of the aetiology of tuberculosis is well-known to patients and general members of the communities, they are nevertheless victims of increased stigmatisation and marginalisation as a result of illness. The importance of social support in curing tuberculosis is explored using Janzen’s concept of therapy managing groups. Social capital is a fundamental component in adhering to biomedical therapy, but is commonly weak among the structurally poor. The availability of temporary social grants for people living with TB influences health seeking behaviour. In a context of structural poverty the sick are faced with what Nattrass terms “perverse incentives”, having to choose between the right to health and the right to social security, both guaranteed in the South African Constitution, for him/herself and dependants. Although adherence to biomedical therapy is essential in curing tuberculosis, it is shown throughout this thesis that ignoring wider structural causes of disease limits the patient’s ability to get well. The ethnography shows that the right to health is a social and economic right which is not the reality for most South Africans.

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Mduba, Nomasomi Cynthia. "Challenges facing health professionals in OR Tambo health district municipalities." Thesis, University of Fort Hare, 2010. http://hdl.handle.net/10353/278.

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My motivation to conduct this study was triggered by my exposure to the challenges which form the basis of this study. Being employed in the same environment as the respondents, it became natural for me to resolve to investigate the challenges facing these Health Professionals with the purpose of not only establishing what the challenges are but simultaneously propose remedial solutions to mitigate their impact. This study is both qualitative as well as quantitative to make sure that both the numerical as well as the social issues which impact these professionals‘ work were captured in the study. The assumptions from which the study moved were largely confirmed by the respondents. The recommendations which the researcher proposes to mitigate the challenges are informed by her own experience as well as the responses which were elicited from the respondents. While the study does contribute in a way to the body of knowledge, it is cautioned in the concluding chapter that recommendations made must be considered with this caution in mind as the study was limited to a specific environment – the OR Tambo District Health Municipality.

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Kama, Zukiswa Shirley. "An evaluation of access to health care : Gugulethu Community Health Clinic." Thesis, Cape Peninsula University of Technology, 2017. http://hdl.handle.net/20.500.11838/2456.

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Thesis (MTech (Public Management))--Cape Peninsula University of Technology, 2017.
The purpose of this study was to examine the problem of access to health care centres in the Western Cape and to forward recommendations that will improve access to health care facilities in the Western Cape. The first objective of the study was to identify trends in primary health care looking at Nigeria, with the view of learning lessons of experience. Secondly, the study provided an overview of the South African health care system. The study further examined the problems around access to Gugulethu Community Health Clinic. The research objectives were directly linked to the composition of chapters. The study utilised a mixed-method approach of quantitative and qualitative approaches. This method is called multi-method approach. The purpose of combining the two approaches was to understand the research problem from a subjective and objective point of view, as well as to provide an in-depth understanding of a research topic, which led to more reliable research results. Data collection was acquired by utilising a structured questionnaire and personal observations. Two groups of respondents participated in the study inter alia: the patients and the staff of Gugulethu Community Health Clinic.

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Richardson, Naomi. "A preliminary investigation into the use of biomarkers and a fish community index to assess estuarine health in selected Eastern Cape estuaries." Thesis, Rhodes University, 2008. http://hdl.handle.net/10962/d1007480.

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The aims of this study were to determine the potential use of biomarkers at multiple levels of biological organisation together with a fish community bioindicator to assess the estuarine health status of three temporarily open/closed estuaries. The estuaries investigated were the East Kleinemonde (EK), Old Woman's (OW) and Mtana (MTN), all of which are situated in the Eastern Cape Province. Three biomarkers, the acetylcholinesterase (AChE) assay, lipid peroxidation (LPx) assay, liver histopathology and a condition factor were used to determine sub-organism health and one bioindicator, the Estuarine Fish Community Index (EFCI), was used as a bioindicator of community health. The estuarine-dependent marine species Rhabdosargus holubi was selected as an indicator species for the sub-organism level analyses. The results from the community analyses indicated that the EK and OW estuaries were in 'good' condition, while the MTN was found to be in 'moderate' condition. Histological analyses revealed that R. holubi from all three estuaries showed signs of pathological changes to the liver, with the fish from the MTN eliciting the highest occurrence of these changes. The LPx assay found that R. holubi from both the OW and MTN showed signs of oxidative damage in the liver tissue, but those from the EK did not appear to be affected. The AChE assay showed that only the fish from the OW had been affected by anticholinesterase compounds. A laboratory study was undertaken using R. holubi as a positive control for the AChE and LPx assay. The fish were exposed to 3 μg/L chlorpyrifos, a known cholinesterase inhibitor, for six hours and their tissues were examined for changes to LPx levels and AChE activities. AChE activity was significantly inhibited (Mann Whitney U test, Z = 3.65, n = 38, P < 0.001) by the exposure, but LPx levels were not significantly affected. A composite index incorporating the biomarkers at different biological levels of organisation was developed. The index was designed to assist managers and scientists to determine whether the ichthyofauna of a system was being affected by environmental stressors and what management interventions could be undertaken to ameliorate the water quality in an estuary. The index was applied to the three estuaries investigated during the present study and both the OW and MTN were assessed to be in need of immediate management intervention. The fish in the OW were found to be stressed at all the sub-organism levels measured and the reason for this was hypothesised to be as a result of golf course activities in this adjacent estuary. A number of management actions are proposed to reduce the sub-organism stress observed in the fish from the OW. The livers of fish from the MTN were shown to be under stress; however the causative agent of this stress was unknown because there is no formal development in the MTN catchment. However, a possible contaminant source is proposed and management interventions to alleviate the stress on the biota of the MTN are suggested. The EK does not require immediate management intervention, however, continuous routine monitoring is recommended to ensure that conditions do not deteriorate. Shortcomings of the index were outlined and a number of suggestions were made in terms of other measures of biological health which could be incorporated into the index.

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Ndudula, Mziwoxolo Rutherford. "An analysis of the politics-administrative interface and its impact on delivery of municipal services: a case of the Mnquma Local Municipality." Thesis, University of Fort Hare, 2013. http://hdl.handle.net/10353/d1007043.

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The study took a qualitative approach to the analysis of the effect of the politics-administrative interface on municipal service delivery. It was a case study of the Mnquma local municipality in the Eastern Cape Province. The researcher developed a keen interest in researching on the topic because the political infighting and clashes between politicians and administrators of the municipality have caused a public outcry for the root causes of the infighting to be effectively addressed and redressed. It is hoped that the findings and recommendations of the study will help, reshape public policy implementation, service delivery and fostering of mutual cooperative relations between politicians and administrators both at local government level and any other sphere of government in South Africa. The study, is categorized into five chronological chapters, with chapter one (introduction and background), chapter two (literature review), chapter three (research design and methodology), chapter four (data analysis, interpretation and presentation) and chapter five (conclusions and recommendations). The researcher used a sample size of 40 respondents who were selected using snowball sampling, a non-random sampling design spread accordingly over both politicians and administrators. Data collection was made possible through an open-ended questionnaire, interviews, observations and documentary analysis. Various reports and media statements were also used to augment this empirical study. The study also used an in-depth qualitative data analysis technique which was descriptive in nature and the study made numerous deductions and findings based on the collected and collated data. Findings of the study were, inter alia, too much politicization of the public sector, interference between politicians and administrators into each other’s affairs and vice versa and adverse effects of cadre deployment which are damaging service delivery. The study made numerous recommendations which included, inter alia, training and development of administrators and politicians on their respective roles and responsibilities, enforcement of the politics-administrative interface as a mutually beneficial approach to service delivery, need for proper interpretation of Acts and policy documents and the enforcing of section 139 interventions into municipalities.

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Kose, Zamakayise Zukisa. "The experiences of men who have sex with men (MSM) in accessing public primary health care services in the Eastern Cape province, South Africa." Thesis, Nelson Mandela Metropolitan University, 2016. http://hdl.handle.net/10948/4698.

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Background: Research has shown that men who have sex with men (MSM) experience stigma, discrimination, negative and judgmental attitudes and homophobia when accessing health care services. This has resulted in limited uptake of existing HIV and AIDS services. Further, the experiences serve as barriers to seeking and accessing public primary health care services. Negative psychological outcomes and in unique cases, adverse mental health outcomes have resulted from these experiences. Aim: The study aimed to explore and describe the experiences of a sample of MSM when accessing public health care services in Nelson Mandela Bay Municipality (NMBM). Method: A purposive sample of twenty-one MSM aged 22 to 30+ years, mainly black who lived in NMBM participated in semi-structured in-depth interviews. The study used the exploratory-descriptive qualitative design and thematic analysis was used to summarize findings. Findings: Findings from the study showed that MSM experience internalized stigma, perceived stigma, experienced stigma and HIV related stigma, resulting in minority stress. Experiences with health care services included long waiting time, lack of supplies, being attended to by different health care providers, health care provider insensitivity, comfort with health care provider and a need for integrating health services for MSM with general health services. Effects of stigma expressed by the men were non-disclosure of sexual orientation, reluctance to use public health facilities, negative mental health outcome and conformity to society. Conclusion: The study suggests that MSM public health services need to be improved and barriers to health access among MSM need to be addressed. Lastly, there is a need to address the health, psychological and social effects of stigma suffered by MSM.

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Mostert, Zhan. "The impact of pharmaceutical care services on the management of asthma patients in a primary health care clinic." Thesis, Nelson Mandela Metropolitan University, 2007. http://hdl.handle.net/10948/574.

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Optimal management of a chronic disease, like asthma, requires the active participation of patients. To achieve this, patients require education about asthma. Many of the recommended components of asthma care and management might not be effective without adequate patient education. Pharmacists in community, hospital and clinic practice are well placed to provide continued information and reinforcement of key messages, in order to improve compliance with medication and the outcomes of asthma management plans. Pharmacists may be able to increase medication adherence with patient counselling and monitoring systems and by facilitating communication with physicians. However, regardless of this, it remains uncertain whether pharmacist-patient interactions improve patient outcomes, and in spite of recommendations for teamwork and a multidisciplinary approach in the education of asthma patients, medical doctors and nurses are still largely responsible for carrying out the greatest part of patient education. The objectives of this study were therefore to determine the impact of pharmaceutical care services at a primary health care level on the management and well-being of asthmatic patients; to determine the effect of complex or multi-faceted pharmaceutical interventions, in patients with asthma, on lung function, asthma knowledge, attitudes and perceived self-management efficacy, asthma related quality of life and asthma control; and to determine the extent to which pharmacotherapeutic interventions, with regards to medication changes and dosage changes, are accepted and implemented by doctors. A randomised-control study was conducted at a primary health care clinic in the Eastern Cape. A total of 120 patients were allocated to two groups of sixty patients each (a Control Group and an Intervention Group). Baseline values were measured and follow-up interviews and post-intervention data collection were conducted three months afterwards for each group. Patients in the Control Group were attended to by the clinic staff as usual. Patients in the Intervention Group were educated on their disease by a pharmacist. The use of a customised 500ml plastic bottle as a spacer was suggested and each patient’s medication was evaluated against the Standard Treatment Guidelines for the management of asthma in adults at the primary health care level and where necessary, prescribing recommendations were made. Following assessment of the medication regimens of the patients in the Intervention Group, a total of 49 prescribing recommendations were made, of which 73 percent were accepted by both the doctor and patient. After educating the patients in the Intervention Group on inhaler technique, a significant improvement in technique was observed at the 3-month follow-up assessment (p<0.05). Using a short form of the Asthma Quality of Life Questionnaire (AQLQ(S)), a significant improvement post-intervention in mean total quality of life score (p<0.05) and mean average quality of life score (p<0.05) in the Intervention Group, were demonstrated. An improvement in mean activity limitation score in the Intervention Group post-intervention was also recorded for the activity limitation subscale of the AQLQ(S) (p<0.05). On measuring changes in asthma related knowledge, attitudes and self-efficacy, using a questionnaire (KASE-AQ), a significant improvement in mean knowledge score in the Intervention Group after the intervention (p<0.05) was also shown. With regards to lung function, both vital capacity (percent FVC) and expiratory flow volumes (percent FEV1) improved significantly in the Intervention Group (p<0.05). This study therefore demonstrated that multi-faceted pharmacist interventions, including medication assessment, asthma education, education on inhaler technique and the provision of medication aids in the form of spacers, can significantly improve the management of asthma patients and improve their well-being and quality of life.

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Matwa, Princess Nonzame. "Assessing the implementation of the government funded community health worker programme in selected clinics of the Eastern Cape Province, South Africa." Thesis, University of the Western Cape, 2007. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_5921_1258012215.

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From 2004 the Eastern Cape Department of Health (ECDoH) started implementing the new community health worker (CHW) programme in all its clinics, but so far little is known about its implementation process, its successes and challenges. The aim of this study was to assess the implementation of the new government funded CHW programme at three clinics of the Eastern Cape Province.

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Alao, Abiodun Oyebimpe. "The impact of ICTs for agricultural development in the rural community: a case study of Alice, Eastern Cape, South Africa." Thesis, University of Fort Hare, 2010. http://hdl.handle.net/10353/236.

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This study investigates the impact of ICTs for agricultural development in the Alice rural community. The rationale for carrying out the study has to do with the limited access to ICTs by farmers residing in this rural community which in turn affects their productivity and increase in the volume of agricultural production. The core argument of the study is that the use of ICTs has positive spinoffs on agricultural development which leads to improvement in the quality and quantity of agricultural production. Conversely lack of access to ICTs can result in inability to enhance agricultural productivity in rural areas such as Alice. Furthermore, it is argued herein that technological information devices such as ICTs are essential communication and information tools; and as such, should be regarded as useful communication media for disseminating relevant agricultural information to farmers residing in rural communities. In conducting this study theoretical frameworks such as Rogers’ diffusion of innovation and development theories encompassing both the participatory approach and development support communication were presented and argued for as approaches suitable for the study. Triangulations of research methods, such as, qualitative and quantitative methods, were utilized for the collection of data for this study. As is common practice, the triangulation method was used in cross checking and supplementing data/information collected through the utilization of each of the methods. Interviews and questionnaires were used as data collection tools for this study owing to their ability to generate clear and precise responses or answers to the questions posed. The key findings of the study show that the limited access to ICTs in the Alice rural community was caused by factors such as low level of literacy, age and language barriers which in turn affected the adoption of ICTs amongst the Alice farmers. Amongst the recommendations emanating from this study is the idea that the adoption of ICTs for agricultural information can be fast-tracked through the implementation of telecentres/kiosk and information centers for easy access to information and communication services in the rural community.

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Gazana, Odwa. "The role of telehealth in enhancing access to healthcare services in an under-resourced setting: A case of Mantunzeleni in Eastern Cape Province." Thesis, Cape Peninsula University of Technology, 2015. http://hdl.handle.net/20.500.11838/2399.

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Thesis (MTech (Information Technology))--Cape Peninsula University of Technology, 2016.
The delivery of healthcare services should be of a high standard for everyone. For people in the location of Mantunzeleni this is not the case as there are still challenges that they go through in order to gain access to sufficient healthcare services. The location consists of four villages and the other nine which surround the four, in total this makes thirteen villages that are served by one clinic. These villages are divided by forest, rivers and mountains, people have to cross these and walk long distances to get to the clinic. Gaining access to basic healthcare services in rural areas has never been easy, hence this study seeks to understand the role telehealth could play to help improve the situation. It has been reported in the literature that telehealth has potential to address some of the problems experienced by healthcare service providers located in the rural areas. Research questions were posed to address the problem of limited access to healthcare services of under-served communities in rural areas. The study adopted an interpretive approach to understand how the people using healthcare services in the setting attach meaning to their experiences of the healthcare service. The study therefore seeks to understand how telehealth could improve healthcare service delivery through the participants’ views, perceptions and experiences. The research strategy for this study is a single case study without attempting to generalise the findings. Qualitative data was gathered using unstructured interviews, observations and co-design methods. The current state of telehealth and challenges of healthcare services in rural under-served communities was established through a review of relevant literature. It was important to actively involve the respondents in the research process for them to feel a sense of ownership. Data was analysed using a thematic analysis. The findings revealed the challenges currently hampering the delivery of healthcare in the research setting include poor infrastructure, high cost, the shortage of medical professionals, travelling distance, time management and lack of communication about the services. It was also revealed the role telehealth could play a role to improve access to healthcare and the findings indicate that the nurses feel that extending the healthcare service to include alternative access methods to health information, education and expertise could lead to a sense of appreciation, knowledge gain, dealing with distance problems and improved referrals, cost saving to improve healthcare service delivery.

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Maswana, Gcobani. "Assessing the effect of Public Participation and development communications on service delivery: the case of the department of Social Development in the Eastern Cape (2004-2010)." Thesis, University of Fort Hare, 2013. http://hdl.handle.net/10353/d1006979.

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Public Participation is a critical facet of development communication. The Republic of South Africa (RSA) Constitution 1996 promotes a set of values of good governance setting a framework for the public participation, and democratization of the public sector through instruments such as developmental communication in order to impact better service delivery. Public participation is an effective communication platform of a new democratic South Africa, as such, public participation forms part of the Constitution of the RSA Act (108 of 1996). To necessitate good governance, it is very imperative that the citizenry, being voters to take an active role in the affairs of governance. The credibility, legitimacy, acceptability, support for governance structures and sustainability of any government is dependable mostly on how citizens are participating in the affairs of government.The research topic being-assessing the effect of Public Participation and Development Communications on service delivery:the case of the department of Social Development in the Eastern Cape focused on Ingquza Municipality in O.R.Tambo District of the Eastern Cape.The public administration has positioned financial management and human resources as critical elements for effective and efficient system. The study has identified that the omission of public participation and development communication as a gap that need to be optimally utilized to avoid communication gap that leads to unnecessary service delivery protests. The study position communication as strategic and management function of each and every manager. The importance of Public Participation is that it could help to ensure that the citizens take ownership of processes as an important democratic principle.The imbizo’s as public participation tool and effective communication platform has been proven to be effective. The strengthening of development communication in the department to empower communities through development communication cadres and information dissemination is paramount important. Furthermore this will make sure that there is a continuous feedback on quality assurance programme in implementing political pronouncements that are made during imbizo’s.

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Ndlela, Joshua Bongani. "Community development workers' perceptions of wellness at an HIV / AIDS organisation in Nelson Mandela Bay." Thesis, Nelson Mandela Metropolitan University, 2011. http://hdl.handle.net/10948/1657.

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The general aim of the study was to explore and describe community development workers` perceptions of wellness at an HIV/AIDS organisation in Nelson Mandela Bay, South Africa. The population of 36 community development workers at the Nelson Mandela Bay office of this organisation participated in this study. The sampling technique employed can be described as a census as it involved sampling an entire finite population that included all community development workers in the organisation. These workers are predominantly Xhosa-speaking adults between the ages of 21 and 60 years, and include both males and females. Qualitative data were gathered by means of audio-recorded focus groups, utilising semi-structured interviews. Tesch`s method was used to analyse the data, while Guba`s guidelines were used to enhance the trustworthiness of the research. Focus group interviews with community development workers revealed seven common themes in the experience of working in the HIV/AIDS organisation: (a) participants’ understanding of wellness; (b) organisational factors that impact on wellness; (c) personal factors that impact on wellness; (d) family and community factors that impact on wellness; (e) participants’ wellness; (f) personal coping strategies; and (g) suggestions regarding organisational strategies to enhance employee wellness. It is envisaged that the research findings of this study will be used in future to direct interventions that will be beneficial for the short and long term planning for the wellness of the community development workers of the HIV/AIDS organisation and those around them. It was recommended that the organisation was to develop a workplace wellness programme, increase management support towards the staff wellness and to increase the staff capacity.

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Lupuwana, Pumezo. "Integrating natural sciences and indigenous knowledge systems for rural economic development: a model for rural enterprise development, health and nutrition initiatives in the Eastern Cape, South Africa." Thesis, University of Fort Hare, 2008. http://hdl.handle.net/10353/81.

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This study demonstrated that the demographic profile of the Eastern Cape Province portrayed high levels of poverty and underdevelopment in the mostly rural population. This is despite the fact that the Eastern Cape is characterized by a rich endowment of natural resources, hosting a wide range of natural plant species, numerous rivers, water springs from mountains and no less than six biomes due to the variety of climatic conditions prevalent in the Province. In contrast, the natural resources found in the Province were regarded to have a high potential to grow and transform the economy of the Province. In this study, the integrated approach was conceptualized, developed and implemented in action within the rural communities selected with varying degrees of success, as a function of the material and objective socio-economic conditions prevailing in each community. A model for rural enterprise development based on agricultural production utilizing the principles of Community-Public-Private Partnerships was conceptualized and executed with the assistance of specialist professionals from various disciplines and organizations. Case studies structured on the basis of methodologies derived from the integration of natural sciences and indigenous knowledge systems were conducted to demonstrate the feasibility of the conceptual framework of the study as indicated by the following case studies. The first case study undertaken was the development of agricultural enterprises in the selected rural communities in joint ventures through the commercial production of food and vegetable crops for local markets and to provide nutrition for the rural communities as the first line of therapy against the HIV/AIDS infection and other diseases associated with malnutrition. The second case study was the establishment of an agricultural enterprise in partnership between rural communities, government agencies and agricultural specialist for the commercial production of grain crops, namely, Sorghum alternating with Wheat to satisfy the demand of local markets for these crops. The third case study was the establishment of a community-based enterprise through the commercial production of two Pelargonium plant species, namely, Pelargonium reniforme and P. sidoides. The two species had a high market demand in the pharmaceutical industry; hence, the plant species were V domestically cultivated to satisfy the industry demand and to ensure the survival of the plant species. The enterprise succeeded in sustaining the livelihoods of the rural communities and conserving the plant species. The fourth case study was the commercial production of essential oil-producing plants in six selected rural communities providing employment for some of the members of these communities even though the initial phase of the start-up enterprise was a trial cultivation to determine the suitability of the environmental and climatic conditions for the propagation of the selected essential-producing plants. The demand for essential oils in local and international markets was determined to relatively high. The incorporation of Indigenous Knowledge Systems of the rural communities in the planning and implementation processes in the areas of Commercial Agricultural Production and Primary Health Care resulted in a gradual paradigm shift on the part of rural communities from a dependence mindset to one of self-reliance that is critical for sustainable rural economic development and the improvement of rural livelihoods. An integrated approach in the strategic planning and execution that involved the rural communities by government stakeholders, the academic community and other stakeholders from the Private Sector was piloted. The recognition of Indigenous Knowledge Systems by all the relevant stakeholders and their essential role in rural enterprise development, food production and primary health care as a pre-requisite for a successful transformation agenda was highlighted as never before. An all-inclusive approach that accorded the rural communities the status of equal partnership had a positive impact on most aspects of planning and implementing programmes for sustainable rural economic development and biodiversity conservation. Working in partnership with rural communities was found to be a challenge; hence, an understanding of the sub-cultures and the social dynamics that often manifested themselves in the form of internecine conflicts became necessary for successfully initiating the research programme in the rural communities. Furthermore, recognition of the rural communities as an integral part of the solution towards biodiversity conservation and the sustainable exploitation of natural resources was found to be a critical component for an effective strategy to ensure the continued survival of the endangered plant species. This attitude underpinned the co-operation of the rural communities and the overarching goals of rural transformation towards the consistent and sustainable improvement of rural livelihoods. Theapproach also marked a radical shift from all the preceeding practices in biodiversity conservation and the management of sustainable natural resource utilization. The study demonstrated that the integration of Indigenous Knowledge Systems and Natural Sciences for sustainable rural economic development with the ultimate strategic objective of contributing towards the reduction of poverty, the improvement of the quality and cost-effectiveness of primary health care and adequate food production is feasible.

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Mxoli, Winnifred Nonkonzo. "Women's perceptions and experiences of antenatal care rendered by midwives." Thesis, Nelson Mandela Metropolitan University, 2007. http://hdl.handle.net/10948/575.

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The general health status of pregnant women depends largely on the quality of the antenatal services available to them. The provision of good antenatal services ensures early detection and prompt management of any complication or disease that may adversely affect pregnancy outcome. In order to ensure high quality care, antenatal services need to be evaluated at regular intervals, both from provider and client perspective, to ensure their effectiveness in improving the health status of pregnant women. The midwife, as the first contact person for most pregnant women attending antenatal clinics in South Africa, has the potential to play a major role in improving the health status of these women. However, for the midwife to be effective in achieving this, antenatal services need to be effectively utilized by women. One of the factors that affect utilization of any service is client satisfaction with the service being rendered. This study, therefore, explores the perceptions that pregnant women have of the care that they receive from midwives at the selected antenatal clinics. The objectives of the study are to: {u100083} Explore and describe the perceptions and experiences of pregnant women attending antenatal clinic regarding the care they receive from midwives. {u100083} Make recommendations to assist registered midwives in optimizing the accompaniment of women during the antenatal period. A qualitative, descriptive, exploratory and contextual design was used for the study. The sample was chosen from the target population by means of purposive sampling and data was collected through unstructured interviews with the participants. Before data collection, permission was obtained from the Eastern Cape Department of Health and the Nursing Service Manager of the Gateway clinic, in the district hospital where the research was conducted. The Nursing Service Manager was acting as a Medical Superintendent at the time of the study. Written, informed consent was obtained from all participants before conducting interviews. Trustworthiness was ensured by means of Guba’s model throughout the study, and the aspects of truth value, applicability, consistency and neutrality were considered. Tesch’s eight steps of data analysis were used to analyze the data collected, and four main themes were identified namely: • Women perceive midwives as considerate and knowledgeable • Women perceive midwives as lazy and rude • Women experience mixed emotions about the care they receive from midwives • Though their experiences, women identified certain needs in the services and care they received at the clinic. Conclusions were drawn and recommendations for midwifery practice made based on the results of the study, with the aim of improving antenatal services rendered to pregnant women.

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Mangwanya, Maonei Gladys. "An assessment of the budgeting system in the Eastern Cape Department of Health to ensure effective and efficient health care service delivery." Thesis, University of Fort Hare, 2016. http://hdl.handle.net/10353/2061.

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The National Department of Health is the executive department of the South African government which is assigned to the national health issues of the country. This research was however aimed specifically on the budgeting process within the Eastern Cape Provincial Department of Health. This was provisioned by assessing the significance of the budgeting system and its correlation to efficient and effective healthcare service delivery. The aim of the research was to highlight on how policies have an effect on the budgeting system at the provincial level, considering the provincial health department is responsible for the provision of publicly funded health services. This research assessed the budgeting system in the Eastern Cape Department of Health in an attempt to propagate effective and efficient health service delivery for the general citizenry. This was a qualitative study design which harnessed the merits of secondary data as the main code of the research design which enabled the comprehension of the budgeting system in the Eastern Cape Department of Health. Data was analysed using thematic analysis to examine the distinctive themes and sub-themes identified from within the reviewed literature. The Eastern Cape Province is succumbing to insufficient funding at provincial level and this has a clear-cut reflection on the administration of services within respective departments, particularly the Health Department. This is despite the fact that the Public Finance Management Act, 1999 promotes the objectives of good financial management aimed at maximizing service delivery through the effective use of the limited resources. Resultantly it was fundamental to comprehend on the issues underpinning the scope of budget reporting as well as budget accountability and the effect it has on service delivery in the Eastern Cape Department of Health. Recommendations were thus given based on the discussed and derived themes to ensure that there is an appropriate budgeting system to ensure efficient and effective provision of health care services in the Eastern Cape Department of Health.

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Li, Xiaoyan. "Clinic delivery trends : public health clinics in Cape Town Central district." Thesis, Cape Technikon, 2003. http://hdl.handle.net/20.500.11838/780.

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Thesis (MTech (Environmental Health))--Cape Technikon, 2003
This is a retrospective (descriptive) study ofclinic delivery trends rendered in Cape Town Central District between July 1995 and June 2002. The study describes the history of clinic service delivery in Cape Town Central District, which includes the Primary Health Care model, as well as the District Health system. Clinic delivery trends for the following three periods are determined: I:] Before the implementation ofthe New Health Plan: July 1995 - July 1996; I:] During the implementation of the New Health Plan: July 1997 - June 1998; I:] After the implementation of the New Health Plan: July 1998 - June 2002. The study also determines and compares the nature ofpublic health clinic services delivered during the study period. No official annual health reports were compiled by Cape Town Administration since July 1997. This study therefore serves to determine disease and clinic trends for the periods where no such aonual reports are available. It is important to determine health delivery trends for future strategic plaoning purposes. Changes to the nature and extent ofservices rendered by public health clinics were brought about by the following factors: Cl One approach of Primary Health Care is to refer more patients to public health clinics in order to release pressure from the major tertiary hospitals. If this Primary Health Care (PHC) model is provided appropriately, about 80% ofhealth problems should be solved without referral to another level of care; Cl A number of free public health clinic services have been introduced since the democratization of South Africa in 1994, such as free services to expectant mothers as well as free clinic services to children younger than six years; Cl New clinic services have been added, such as provision ofmedication to stabilized mental health patients; Cl HIV/AIDS has become an international pandemic over the past decade and has shown a 660.8% increase in Cape Town Central District; Cl A limited (19.8%) increase in the population for that area during the study period; Cl Clinic services have been legislated as a nurse driven service since 1997, with an additional emphasis on the curative roles of nurses (traditional roles of nurses at public health clinics were largely preventive and promotive).

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Belemu, Roy Boombe. "Identification of Management skills required by middle Managers to effectively manage a public hospital in the Eastern Cape." Thesis, Port Elizabeth Technikon, 2000. http://hdl.handle.net/10948/19.

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The research problem addressed in this study was to identify what management skills do middle managers require to manage the organisational units effectively. To achieve this objective a theoretical model of management skills required by middle managers to effectively manage a public hospital was developed, using relevant literature in which management skills are identified. The theoretical model consisted of the following categories of management skills whose correct application can promote managerial effectiveness in managing organisational units: General management skills; Technical skills; Human skills; Leadership skills; Financial management skills; Computer skills. Each category of the management skills was broken down into elements that were then analysed using literature identified during the literature study. The model was then used to develop a questionnaire to assess the degree to which managers responsible for running the clinical, nursing and paramedical departments of a public hospital in the Eastern Cape rate the elements in terms of importance. The empirical results obtained indicate that a wide variety of skills are regarded by middle managers as important to performance of their managerial roles. This resulted in the theoretical model being confirmed and the identified management skills being accepted as management skills required by middle managers to effectively manage a public hospital in the Eastern Cape.

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Luyenge, Zukile. "An evaluation of the co-operative interaction between political office-bearers and chief officials in the provision of houses in the Eastern Cape: King Sabata Dalindyebo Local Municipality (2009-2010)." Thesis, University of Fort Hare, 2011. http://hdl.handle.net/10353/567.

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The research seeks to evaluate the co-operative interaction between municipal political office-bearers and chief officials in the rendering of housing services in the King Sabata Dalindyebo local municipality. The introduction provides the general overview of the study and provides a background to the intention of the research to evaluate the co-operative interaction between municipal political office-bearers and chief officials. The problem statements briefly describe the problem identified in the study and the objectives of the study are set. The theoretical framework is provided and the theories used to evaluate the performance are discussed which are classical theory and the system theory. The importance of conducting the research is discussed and the limitations of the study are discussed in the research. Importantly, the study plan directs the researcher in the direction towards the goals of the research. Also the terms used in this study that are not clear were defined to avoid misinterpretation; misunderstanding and confusion of words and terms. The review of the current literature on the theoretical framework and the base for policy making and controlling role of municipal political office-bearers and chief officials in public administration was discussed. The nature of systems theory and the different phases of systems theory were explained. The nature and place of policy making in public administration was discussed as well as policy making alternatives in the public sector. The policy making levels i.e. political policy making level; executive policy making level; administrative/departmental policy making level; operational policy making level were explained and discussed. The co-operative interaction between municipal political office-bearer and chief officials was discussed to understand the administrative and political dichotomy in the public sector. The policy implementation for the rendering of housing services as well as the programming and delegation of authority were discussed in the context of housing service delivery. The legislative framework for housing services in South Africa was discussed as it influence and affects the housing service in King Sabata Dalindyebo Municipality. The role of municipal authorities in the rendering of housing services as well as the housing situation in South Africa together with the obligations of both the provincial and municipalities were discussed. The permission to conduct research was received from King Sabata Dalindyebo local municipality. The scope of the study explains the range or extent of matter to be dealt with in the research and the survey area is dearly provided. The research design which is qualitative and quantitative research are discussed and used in adopting the study. The case study as research strategy is discussed and clarified. The data collection instruments which are interviews, questionnaires and the literature study the subject were briefly explained. Population details and sampling were clearly explained before a sample is provided in the study. The research provides data collection procedures as well as how the data will be analysed. The ethical considerations are discussed. The data analysis and interpretation was conducted to enable the researcher to identify patterns which are consistent within the data. The criteria for data analysis as well the response rate were discussed. The demographics of chief officials and political office-bearers as respondents include their age; year of service, home language, gender, the academic qualification as well as the different stakeholders were analysed. The role of political office-bearers and chief officials in the initiation of policy which the input phase of the Systems theory analysis was conducted and the role of political office-bearers and chief officials in the process phase were analysed and discussed. The co-operative interaction in policy formulation and the steps in the policy formulation were analysed and discussed. Also the analysis was conducted on the delegation of authority to chief officials by the political office-bearers as well as the role of political office-bearers and chief officials in the approval of executive policy. An evaluation of the rendering of - 11 - housing services at Phola park informal settlement as well as the evaluation of housing services as an output phase in policy formulation were analysed and discussed. And lastly, the analysis of the impact of existing legislation or policy on housing services was conducted. The findings of the study were provided and discussed and the concluding remarks were provided to whether the problem is real and whether the hypothesis is true and valid. The recommendations of the study were provided to enable Kind Sabata Dalindyebo local municipality to improve the co-operative interaction between municipal political office-bearers and chief officials to improve housing services and to provide better service delivery. KEYWORDS Administration Citizens Co-operative interaction Effectiveness Efficiency Executive functions Governing functions Municipal authority Municipal chief officials Municipal political office-bearers.

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Ricks, Esmeralda Jennifer. "A holistic healthcare model for higher education campus health services." Thesis, Nelson Mandela Metropolitan University, 2008. http://hdl.handle.net/10948/666.

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Most students are adolescents and young adults, a group characterized by a new-found sense of independence, experimentation with sex and sometimes drugs and a feeling of invincibility (Gayle, Richard, Keeling, Garcia-Tunon, Kilbourne, Narkunas, Ingram, rogers and Curran, 1990:1538). These behavioural, developmental and environmental issues may contribute to premature morbidity, mortality and reduced quality of life for university students (Patrick et al., 1992:260). The ages of staff on the other hand range from young adults to retirement age. The types of health problems that exist among staff who use the campus health service include First Aid treatment on site for injuries on duty and more chronic health problems such as, for example, hypertension and diabetes mellitus. To date there is very little evidence as to whether or not the healthcare needs of students and staff are being met comprehensively or whether the practitioners rendering the service are knowledgeable and complying with the PHC norms and standards developed by the department of Health’s Quality Assurance Directorate. The lack of such empirical data can contribute to misconceptions and hamper the management of public health problems experienced in SA, for example sexually transmitted infections and the transmission of HIV. Thus the purpose of this research was to develop a model that would assist registered nurses employed at a higher education campus health service in the Western Region of the Eastern Cape Province to render a healthcare service relevant to the healthcare needs of the students and staff on campus.

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Kriel, Dora Jenice. "Perceptions of nurses with regard to staffing in the operating rooms of a private hospital." Thesis, Nelson Mandela Metropolitan University, 2017. http://hdl.handle.net/10948/18014.

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Despite a number of research studies showing the correlation between higher nurse staffing levels and improved outcomes, RCN members continues to report lower nurse-to-patient ratios than what research results suggests (RCN, 2011:1). This reflected a general concern within the nursing profession. The operating room requires appropriate staffing which is critical to the safety of surgical patients and quality of patient care. The research study was motivated by the researcher’s own experiences while working in an OR in a private hospital where continuous discussions were held with management about the shortage of skilled staff; and where a shortage of OR nurses resulted in the use of Central Sterilizing Department (CSD) staff to do OR duties. The objective of the study was to explore and describe the perceptions of nurses regarding staffing in the operating rooms of a private hospital in the Nelson Mandela Bay Health District. The researcher used qualitative methods and designs to explore and described the perception of nurses regarding staffing in the operating room (OR) of a private hospital in the Nelson Mandela Bay Health District. The research population of the study included all the nurses working in the OR of a private hospital. The total number of 20 OR nurses was individually interviewed by means of semi-structured interviews. Three main themes emerged that includes nurses ‘perceptions with regard to the implications of inadequate staffing in the OR; nurses experiences towards top management with regard to staffing in the OR and recommendations from participants to improve staffing in the OR. Research findings concluded that nurses have a perception that shortage of OR nurses causes lack of communication, physical, emotional and psychological strain. They also perceived OR nurses to work under unrealistic conditions and to receive added responsibilities due to staff shortages, which affect the overall delivery of quality patient care. Comments included failure of management to attend to staff complaints and the perception of high staff turnover due to a lack of recognition and acknowledgement of overworked staff.

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Mamba, Bonginkosi. "An appraisal of basic infrastructural service delivery and community participation at the local level a case study of three municipalities in the Eastern Cape." Thesis, Rhodes University, 2008. http://hdl.handle.net/10962/d1002692.

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Housing provision plays a vital role in meeting basic needs. Dwellings provide the security required for basic functioning and are thus essential for both human development and the alleviation of poverty. This study examines the levels and quality of basic infrastructural service delivery (electricity, water and sanitation) at local government level, focusing on housing. The local government areas studied include Grahamstown Fort Beaufort and Duncan Village. This was done for the purposes of analyzing the effectiveness of the existing housing policy with regard to the adequacy of scale, its developmental logic, implementation and coordination. Justification for basic infrastructural service delivery is based on the Basic Needs Approach [BNA] which forms the cornerstone of the World Bank’s delivery framework. The paper makes use of two methods: firstly, secondary sources are used to provide an impression of the broad policy framework focusing around basic service delivery with housing as the centrepiece. Specific attention is thus given to Integrated Development Plans (IDPs) as this is the level of policy-making responsible for the delivery of these services to communities. Secondly, previously un-analysed data drawn from a household social exclusion survey (2005-2006) conducted in three Eastern Cape municipalities (Buffalo City, Makana and Nkonkobe – representing respectively urban, small town, and rural areas) are evaluated. The data are analysed two ways – graphically and through a regression analysis – to test four hypotheses regarding basic service delivery. Graphical analysis demonstrates that services differ according to housing type and location. It was found that brick houses seem more likely to have better basic services than either shacks or mud dwellings. The results also show that there are inequalities in the provision of certain basic services such as water and sanitation between Duncan Village and Grahamstown. Overall, the results of this study show that government is still faced with major challenges in addressing housing backlogs.

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Sompani, Thozamile Matthews. "Delivery of environmental health services to Ducats informal settlement." Thesis, Cape Technikon, 2003. http://hdl.handle.net/20.500.11838/796.

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Thesis (MTech (Environmental Health))--Cape Technikon, 2003
This study provides information on the provision of environmental health services to informal housing settlements by local authorities. A standard for Environmental Health Service delivery according to Government policies and legislation has been provided. Actual environmental health services delivered to Ducats informal settlement at the time (1992), have been compared to the services that should have been delivered by law. Baseline data have been compiled by means of questionnaires, in order to assist the different levels of government in addressing the housing and environmental health needs of the Ducat community. The nature of Environmental Health and the history of informal housing, more specific that of the Ducat informal housing settlement, have been determined. Limited environmental health services were rendered to informal housing settlements occupying land illegally during 1992. These environmental health services were limited to basic sanitation, water supply and refuse removal. Only pit latrines or bucket latrines were required as a means of sanitation, tanks for water supply and skips for the disposal of waste. Amatola Regional Services Council however rendered all the environmental health services required. Other environmental health aspects such as pest control, communicable disease control, air pollution control, radiation, occupational health issues, temperature extremes, lighting, ventilation, noise, social environment, food and meat hygiene were not required. This study has provided a set of Government policies and legislation, which should be considered in rendering environmental health services for housing in future. Uncertainty of the past decade, about rendering of Environmental Health services to people occupying land illegally, still persists. The Municipal Structures Act, 117 of 1998 requires the rendering of Environmental Health services by local authorities, but it does not state whether these services should be rendered to people occupying land illegally as well. Since this has been the biggest restriction in providing environmental health services in the past, it is recommended that Government address this uncertainty.

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Davashe, Cikizwa. "An investigation into the impact of performance management and development system on service delivery in the Eastern Cape: a case of the three Buffalo City hospitals." Thesis, University of Fort Hare, 2008. http://hdl.handle.net/10353/307.

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In the Eastern Cape Department of Health the performance management and development system progress reviews are performed in a summative manner. This happens when a supervisor leaves out all the other progress reviews and conducts a final progress assessment and monitoring at the end of the year. It is worse when the performance agreements are not even signed during the start of a financial year, neither does a newly qualified employee sign. As a result employees are not appraised because there are no progress reviews that are entered on the Persal system. Employees miss an opportunity to be sent for training at the same time they are rewarded late or not at all. It is obvious that the managers do not understand the aims and objectives of the PMDS policy. The research was an assessment of the effectiveness of the performance management and development system in inculcating professional behaviour in the nursing staff in the three Buffalo City hospitals, namely, East London Hospital Complex, Grey and Bisho hospital. The aspects of the policy investigated were the performance reviews, the competency framework and the performance incentive scheme. This research is qualitative in nature. Data was collected using unstructured interviews and open ended questions. The population of this study involved selected Performance Management Managers, Quality Assurance Manager, Area Managers, junior nurses and clerks working in the Buffalo City Hospitals. The respondents of the study were selected using the stratified random sampling technique. Descriptive methods were used to analyse data. Confidentiality was highly maintained and consent form even distributed from the start of the research. The three Buffalo City hospitals are practising a balanced scorecard as a performance measurement tool. It is in the form of workplans that are different for different levels of employees such as the performance workplans, standard framework workplan and individual workplans. ix The study discovered that there is poor compliance in performing the performance reviews. The attention is on the appraisal aspect more than the development aspect. Also, there is a delay in taking the employees for training as a result they end up not being trained. The employees are not rewarded according to their performance. The PMDS policy states that employees that get a score of three are entitled to get a one percent and those that are rated a four or a five qualify for a performance bonus. The study found that the PMDS policy is not implemented well. It is recommended that the performance management manager and the quality assurance manager need to apply a radical strategic transformation and change management to address the challenges.

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Molony, Lara. "Water security amongst impoverished households in the Sundays River Valley Municipality : community experiences and perspectives." Thesis, Rhodes University, 2015. http://hdl.handle.net/10962/d1018932.

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Water security is influenced by the complex interplay between ecological, socio-political, governance and water management systems. Achieving water security is essential for ensuring sustainable development, and challenges with water security are closely linked to the overall experience of poverty that many countries throughout the world, including South Africa, confront. These problems can broadly be understood through three main factors: water availability, access and usage; water governance and management underpin these factors. Water insecurity can often be seen in townships within South Africa, where water service delivery and water access is precarious. This study provides a lens into the water security experiences of two poor township communities in the Sundays River Valley Municipality (SRVM) namely Nomathamsanqa in Addo and Aquapark in Kirkwood. The research assessed water security patterns amongst RDP, township and informal settlement households serviced by the SRVM and found that communities face severe water security problems. Specifically, it was found that all township households encounter frequent water shortages, cuts in municipal water supply and water quality concerns. Issues around the payment for water and dissatisfaction with water service delivery also emerged. The purpose of this research was to allow for community experiences and perspectives to be expressed in an academic space that has previously been dominated by water management and policy makers. The study concludes that these communities within the SRVM experience significant challenges in securing safe water and these are largely due to social water scarcity issues and the difficulties the municipality faces concerning water service delivery.

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Nqwemeshe, Nomvuyo. "The structural arrangements in local government and their role in promoting community participation in basic service delivery: a case study of Emalahleni and Intsika Yethu local municipalities in the Chris Hani District Municipality area." Thesis, Rhodes University, 2012. http://hdl.handle.net/10962/d1003103.

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This study analyses the effectiveness of community participation in service delivery. The area of study, the Chris Ham District Municipality (CHDM), is a Water Services Authority, responsible for ensuring access to water services (water and sanitation) by all communities within its jurisdiction. There are eight local municipalities within the CHDM. The objective of this study is to determine whether systems are in place in local government to promote participation by communities in service delivery projects and whether these systems are being utilised efficiently by the role-players concerned. The role-players in this research are people who are involved in community development programmes of the municipality (municipal staff in the relevant departments of the municipalities under study, the social facilitators, civil society organisations, ward committees, ward councillors, traditional authorities as well as the representatives of communities (Project Steering Committees) who are beneficiaries of the projects under study). The projects that are under study were selected from a readily available list of CHDM capital projects that appear in the 2003/2004 financial year funding plan and are running. The findings of the study at both levels (local and district) show that the municipal environment is not conducive to promoting community participation. This is linked to factors such as the structural arrangements, whereby the offices relevant for promoting community participation are not fully occupied, which provided evidence that community participation is not prioritised. There is lack of coordination of programmes within the local government spheres as well within departments of the DM and strategies for community participation have been found to be non-effective. At project level lack of community participation is linked to the utilisation of ward committees as the only mechanism for community participation regardless of its un-equal and party biased representation. This study therefore concludes that although the systems to promote community participation are in place, they are not effective.

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Yako, Elizabeth Matseliso. "Adherence to pre-selected infant feeding practices among mothers on the prevention of mother-to-child transmission (PMTCT) of HIV/AIDS programme in the Amathole region, Eastern Cape." Thesis, University of Fort Hare, 2011. http://hdl.handle.net/10353/d1001091.

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Infant feeding in the context of HIV/AIDS poses a challenge among mothers. The implementation of UNICEF guidelines on infant feeding, which state that “when replacement feeding is acceptable, feasible, affordable, sustainable and safe, avoidance of all breastfeeding by HIV-infected mothers is recommended” (WHO, 2003:12) are not easy to meet. In more developed countries, where these criteria are met, almost all HIV-infected mothers have ceased to breast feed. Consequently, infants of mothers in these countries are less likely to be infected with HIV postnatally. In South Africa, more specifically in the Eastern Cape, infant feeding is a challenge as a number of UNICEF criteria cannot be met. The Eastern Cape is one of the poorest Provinces in South Africa, with a number of rural communities. Earlier studies have shown that, if mothers select either exclusive breast feeding or exclusive formula feeding, this reduces mother-to-child transmission of HIV. A limited number of studies on adherence to the method of infant feeding selected before delivery were found in the literature, hence the need for the current study. The purpose of the study was to explore adherence to exclusive breast feeding and exclusive formula feeding among mothers with HIV infection and to determine the problems that mothers may be facing in implementing their pre-selected methods.

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Amanambu, Rochelle Aneeta. "An investigation of the intention to leave or stay of health care professionals at St. Andrews Hospital." Thesis, Rhodes University, 2014. http://hdl.handle.net/10962/d1011091.

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Background: The demand for and retention of talent worldwide is aggravated by revolutionary trends that include global competition, demographic changes and technological advances. In South Africa this phenomenon according to Frost (2002) is further challenged by the emigration of skilled people; the relative scarcity of specialist and managerial employees; employment equity and affirmative action procedures. But the development of strategies first requires an understanding of the factors which influence decisions to leave or stay particularly in rural and remote areas. St. Andrews Hospital is a rural district hospital in Ugu District, KZN. Its remoteness from urban areas and the lack of resources contributes towards challenges of attracting and retaining health care professionals to the area. It is the aim of this study to identify the ten most prevalent turnover and retention factors in a rural district hospital with the intention of making recommendations towards strategies to mitigate turnover and improve retention of health care professionals. This study will not only serve the local Human Resource Department but may also be used to inform district and provincial policies as well as departments’ decisions in the design or the review of current retention strategies aimed at reducing turnover. Method: The survey method was used to collect the primary data by distribution of self-administered questionnaires to Health Care Professionals at St. Andrews Hospital. Of the one hundred and fifty questionnaires distributed, one hundred and seven were returned (71% response rate) and formed the basis of the study. Results: Based on the impact scores, the top three turnover factors identified were, the way the organisation is led by top management (0.934); the size of the workload (0.862); and the way problems are dealt with by managers in the organisation (0.817). No statistically significant relationships were found between turnover factors and biographical variable. Availability of quality health services was ranked as the external factor that had the highest influence (78%) on turnover, while geographical location was ranked the lowest. The main reason given by respondents for leaving their previous employment was promotion, followed by distance and personal/family reasons. The top three retention factors identified from the impact scores were the quality of relationships with colleagues (1.698); the amount of support received from managers and colleagues (1.484); and the level of engagement and involvement with the job (1.390). This demonstrates that the salary package often thought to be a first priority factor Mobley, Horner and Hollingsworth (1978); Mobley (1982) and Herzberg (2003) is far less of a determining factor at St. Andrews Hospital than management support, job involvement and person-organisation fit as well as the social relationships formed in the workplace. A positive relationship was found between leadership and job dimension factors at the 1% level of significance. This supports the strong social bond (person-organisation fit) formed in the work environment between management and colleagues that supports retention and increases level of commitment. An important result of the study was that 46% of the respondents were thinking of leaving the town within the year while 29% were considering resigning from St. Andrews Hospital within the year. Conclusion: The results reveal a complex interaction of factors impacting on turnover and retention. The Human Resource Management function has a pivotal role to play in improving its ability to attract and retain professionals through developing comprehensive strategies based on external and internal and environmental factors. The study conveys to the St. Andrews Hospital management that turnover and retention factors are unique to the location and the working environment and differs amongst Health Care Professionals – this should be deliberated on when formulating Hospital Human Resource retention policies.

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Vellem, Babalwa Faith. "Assessing the role of cooperatives in poverty alleviation in the Eastern Cape: a the case of Amathole district municipality." Thesis, University of Fort Hare, 2012. http://hdl.handle.net/10353/d1007113.

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The study Assess the role of Cooperatives in Poverty Alleviation in the Eastern Cape Case Study of Amathole District Municipality how cooperatives are conducted in the Amathole District Municipality and establishes the perceptions of staff and members of the public about the service rendered by the municipality, and developing the mechanisms that can be used to identify cooperatives activities and how to improve the services rendered by the municipality, and if there are any challenges, they must be resolved. The research was also to look at how the support from government and other government agencies are used to enhance the cooperatives governance. Lastly, the research was to find the best model for cooperative development and what needs to be done to enhance the capacity of the cooperatives. The literature indicates that staff must be equipped with necessary skills; however it is evident that training and development is essential for the members of the cooperative. Questionnaires and interviews were used as a method of collecting data from the respondents. In this study, both qualitative and quantitative methods were used to analyse the data. The research assumption was that cooperative development is a viable tool for economic development of the rural areas. This can help many South Africans and many communities come out of poverty. However, there are limitations that were caused by the inability of government to co-ordinate cooperative development. Despite the role that cooperatives play in South Africa, cooperatives still experience a number of challenges. These challenges are, amongst others, lack of access to finance, lack of access to market, lack of business skills, lack of infrastructural facilities and lack of knowledge about the cooperative. In view of the challenges facing the cooperatives, the government instituted a number of state departments and parastatals for funding and other necessary support. These are DTI, DEDEA (in the Eastern Cape), ECDC, South African Development Agency (SEDA), Department of Labour and municipalities. The objectives of these support institutions are to provide necessary support needed by cooperatives and to ensure that cooperative development is sustainable.

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Mkentane, Benjamin Zolile. "An investigation of public participation in municipal planning and performance evaluation: a case study of Mnquma Local Municipality." Thesis, University of Fort Hare, 2013. http://hdl.handle.net/10353/d1007119.

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The participation of communities and community organizations in Municipal governance is set in terms of the law as a mechanism to deepen democracy. Municipalities are required to develop a culture of governance that complements representative democracy with community participation. However the participation of communities in local governance has not translated to the strengthening of governance and the deepening of democracy as municipalities have not done enough to involve communities in municipal affaires. Lack of human resources, and financial capacity have been cited as some of the reasons that beset municipalities and undermine citizen participation. Municipalities have taken steps to encourage community participation and these include establishment of structures to enable participation, however without the guidance and financial support of the municipalities these structures are not able to perform their functions. In spite of all the efforts made by municipalities to encourage participation, a culture of community participation has not yet taken root in local government. While the legislative framework provides for communities to participate, practice shows that the implementation of legislation is complex and requires dedicated capacities within the councils to be effective. This can be achieved when municipalities develop their own community participation policies which address their special circumstances, which must be reviewed on a regular basis. Unless communities are empowered with knowledge on the available participation mechanisms, the dream of a culture of participation will remain just that, a dream. Thus civic education coupled with capacity building of officials will assist in ensuring the development of a culture of participation. Council must also develop mechanisms to evaluate the effectiveness of community participation processes and procedures, to avoid a one size fits all approach. It is imperative that councils as the legislative arm of municipalities must lead the process and not leave everything to the executive arm.

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Ndwandwe, Miriam. "Impact analysis of a down-referral chronic medication distribution system for stable chronic patients to primary health care facilities in an Eastern Cape District." Thesis, Nelson Mandela Metropolitan University, 2014. http://hdl.handle.net/10948/d1020644.

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The purpose of the study was to assess the level of patient satisfaction with service provided in the Buffalo City sub-district following the implementation of the down-referral chronic medication distribution system between the tertiary(ELHC) and primary (clinics) levels of health care. The intervention was aimed at improving accessibility and availability of medication to the chronic patients. Research Design: A non-experimental descriptive quantitative research methodology was used. The sampling method for the study was the non-probability purposive sampling. Data was collected using a self-administered questionnaire that was given to respondents as they arrived at the facilities, and who, after completing the questionnaire, gave it back to the researcher. Findings: The results of the study revealed that the patients were generally satisfied about the down-referral chronic medication distribution system. However the patients were not satisfied about the services that they receive from the primary health care facilities when they go to collect their down-referred medication. Lack of communication to the patients regarding their medication by the hospital staff (pharmacists in particular) was a concern for patients. Conclusion: The down-referral chronic medication distribution system can benefit both the patients and the hospitals. Patient will receive their medication closer to their homes and save on the cost of transport. The hospital will have less patient congestion in the outpatient dispensaries and queues and waiting times will be reduced. Some strategies must be sought to improve the services at the primary health care facilities. The hospital should explore various communication methods to put into place, that will save pharmacists time and satisfy the needs of the patients. This would require the health services management from both the hospitals and the primary health care facilities to work together to ensure continued support for the patients.

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Vale, Beth. "Of blood and belonging : the practice of antiretroviral treatment among HIV-positive youth in South Africa's Eastern Cape." Thesis, University of Oxford, 2015. https://ora.ox.ac.uk/objects/uuid:c3db9d98-7d18-4e39-b8ef-344f3bbbdbff.

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HIV-positive adolescents are an increasingly numerous and challenging population in the South African HIV/AIDS epidemic. Their access to, and retention in, ART care has become a pressing public health concern. Comprised of four journal articles, this thesis explores the practice of antiretroviral treatment (ART) among a cohort of HIV-positive adolescents (age 10-19) in South Africa's Eastern Cape. By 'practice', I mean the volatile, situated and relational 'work' that goes into young people's everyday achievement of ART - into consuming daily medication, regularly attending health appointments, and participating in HIV programmes. Through an exploration of the ways in which some HIV-positive adolescents use, appropriate, or reject ART care; this thesis contributes to a much-needed evidence-base on the needs and survival strategies of adolescent ART users. Data for this study was gathered through eight months of multi-method ethnographic fieldwork with 23 HIV-positive youth, their families, and local health workers. The findings elucidate adolescent ART as a complex (and often volatile) form of social incorporation, through which young people negotiate survival, care and moral connection in contemporary South Africa. Enrolling in ART meant being encompassed into a (often hierarchical) set of social relationships, through which adolescents sought belonging, recognition and protection, amid profound insecurity. Through ART and its associated programmes, adolescents and their families attempted to strengthen familial ties, appeal to powerful patrons, petition for care, and access basic resources. Yet these pursuits were often deeply ambivalent, as discipline, blame, and resentment often came encased in the terms of care. At the crux of each article is an attempt to understand how adolescents, often alongside their families, negotiated both the social stakes and possibilities of ART. Through these discussions, we might better be able to grasp the fragility and complexity of young people's retention in ART.

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Booi, Mlungisi Wellington. "Performance management of health professionals : an evaluation research study of health services in the subdistrict of Buffalo City in the Provincial Department of Health in the Eastern Cape." Thesis, Rhodes University, 2015. http://hdl.handle.net/10962/d1020017.

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Integrative Summary In 1997 the Minister of Public Service and Administration of South Africa, Zola Skweyiya, introduced the White Paper on Transforming Public Service Delivery(Department of Public Service and Administration(DPSA,1997: 1). It was premised on what was called Batho Pele (DPSA, 1997: 9), giving effect to Section 197 of the Constitution, Act 108 of 1996 as amended. A linkage to performance management can be found from the assertion made in the White Paper that in future the Batho Pele would form the basis of any assessment of the performance of individual staff and that would contribute to improving the delivery of service (DPSA, 1997:16). Another factor that contributed to the utilisation of a performance management system was the recommendation put forward by the Public Service Commission of South Africa( PSC,2004: 16),that called for public institutions to adopt a clear, comprehensive performance management and evaluation framework for the delivery of public service. That was expected to turn around the ailing public institutions whose record of serving the public with pride and dignity was on the decline. The research aim was to evaluate the effectiveness of the performance management system in creating and resolving role conflict with health professionals employed by the Buffalo City sub-district. The research goal was divided into three objectives, namely: evaluation of the effectiveness of the performance management system as a managerial tool for health managers to manage their subordinates including both professional and support staff, evaluation of the effectiveness of the performance system from the perspective of the health professional as a subordinate and to analyze the functioning and effectiveness of the system in creating and resolving role conflict between professional conduct and organisational requirements. The respondents noted that the implementation of the system was not matched with appointment at managerial level with officials having relevant managerial capacity. Further to that resources at the coal face of service delivery continued to deteriorate and became very scarce and there is no documented proof that has been found of an effort made to check the compatibility of the system to health professionals. The literature identified negative effects that have emanated from the implementation of the performance management system. The study was conducted by interviewing health professionals from the entry level to the management level within the Buffalo City sub-district from three mini hospitals or Health Care Centres. The respondents indicated that there are positives that have been achieved by the implementation of the system, such as the skills gap identification as well as specific targets contained in annual performance contracts. These targets help motivate health professional to focus on that particular direction of activities. Unfortunately it has been clearly documented that the performance management system has also contributed to the development of role conflict in a number of professionals. It has been documented that the system has not been crafted with a health professional in mind and, as such, appears to favour quantity rather than quality of health services as advocated by the codes of practice of different health professionals. There are a number of recommendations that were put forward by the respondents to try to salvage the system and in mitigation of the identified negative factors. For the improvement of the system, the Eastern Cape Provincial Department of Health has to firstly customise the annual contracts to contain only the fundamental information. Secondly need to improve the transparency pertaining to financial pressures facing the Health Department. Thirdly the provision of essential enablers, need to be prioritised. Fourthly there is a need to upgrade the system to incorporate 360 degree feedback. Further research recommendations include a bigger sample incorporating different research methods and to also incorporate searches for measures that can be implemented to improve the system to be more relevant to health professionals. This document is organised and presented in three sections. The first section is the evaluation report with a review of literature, research methodology, findings, discussion and conclusion. The second section is where an indepth literature review is located and the last section details the research methodology.

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Rörich, Eben Eugéne. "An economic evaluation of the winelands health worker programme." Thesis, Stellenbosch : Stellenbosch University, 2002. http://hdl.handle.net/10019.1/52664.

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Thesis (MComm)--Stellenbosch University, 2002.
ENGLISH ABSTRACT: Historically health care in South Africa has been an area of great inequity. Health care was inequitable, inadequate and racially based. In order to redress the gap in the delivery of health care services, created by the previous dispensation of separate development, the National Department of Health has adopted a Primary Health Care (PHC) approach as the guiding principle for the reconstruction of the health system in South Africa. One of the pillars of this approach is the empowerment of communities to participate, thus moving from facility based- to community based health care. The aim of the National Health System (NRS) is to promote health and health knowledge, to provide an equitable, accessible, and appropriate health service, and to empower people to take greater responsibility for their own health. It is constructed around the belief that health for all cannot be achieved simply by improving the formal health system, but that a holistic and multi-sectoral approach is required. This thesis explores the community health worker (CRW) as a possible cost-effective and efficient supplementary service, to the current formal health system, to bridge the gap in the formal health system through the provision of PHC services in a rural setting. This was done through the economic evaluation of a CHW programme operating in the Winelands are of the Western Cape. The aim of this study was to evaluate and analyse the nature, performance, and costs of the programme and place it in context by comparison to other similar programmes. This comparison focused on physical characteristics, goals, and cost structures. It also aims to measure the direct and indirect impact of this type of intervention on the agribusiness sector as well as the local health authorities. The evaluation proceeded from the premise that the CHW programme, if implemented correctly with proper and appropriate training, and adequate post training support, will be a cost-effective and efficient model for the provision ofPHC services in this rural/farming area. The economic evaluation of this CHW programme required it to be viewed from two perspectives. The first component viewed the implementation of the programme from the perspective of the agribusiness sector. This aspect of the study included both a qualitative as well as a quantitative VIew of the costs, benefits (perceived or otherwise), and perceptions of the CHW intervention. The second component assessed the CHW programme within the context of a resource constrained public sector health budget. Since the implementation of this programme implies certain expenditures on the part of the local health authorities, these cost had to be identified and quantified to gauge the effectiveness of that expenditure.
AFRIKAANSE OPSOMMING: Geskikte en doeltreffende gesondheidsdienste in Suid-Afrika se onlangse geskiedenis was nog gereserveer vir 'n uitgesoekte groep mense. Die gesondheidstelsel was ontoereikend, onvoldoende en gebaseer op ras. Daar het 'n gaping ontstaan tussen die dienste wat gelewer is en die werklike behoeftes van die mense wat dit moes gebruik. Ten einde hierdie gaping aan te spreek het die Nasionale Departement van Gesondheid besluit om 'n Primêre Gesondheidsorg (PRe) benadering te volg wat klem plaas op die bemagtiging van plaaslike gemeenskappe deur deelname. Dit was 'n duidelike skuifvanaffasiliteit- na gemeenskap gebaseerde gesondheidsdienste. Die oorkoepelende doel van hierdie verskuiwing in fokus was om voorheen benadeelde gemeenskappe voldoende toegang te gee tot gesondheidsdienste en ook om hierdie dienste aan te pas by die behoeftes van sodanige gemeenskappe. Hierdie tesis ondersoek die Wynland distriksraad se Gemeenskap Gesondheidswerker Program as 'n moontlike koste-effektiewe stelsel vir die lewering van toepaslike primêre gesondheidsdienste in landelike areas. Die doel van die studie was die sistematiese ontleding van die werking en omvang van, en die kostes verbonde aan die implementering en onderhoud van hierdie program. Die studie poog om die impak van hierdie program op die formele landbou sektor asook die plaaslike gesondheidsowerhede te identifiseer en, waar moontlik en prakties wenslik, te kwantifiseer. Die ondersoek sluit in die stelselmatige ontleding van kostes en voordele vir die formele landbou sektor sowel as die plaaslike gesondheidsowerhede. Die kostes asook die kliniese uitkomste geassosieer met die implementasie van die Gesondheidswerker program sal dan in konteks geplaas word deur dit te vergelyk met ander soortgelyke programme wat in die verlede aangepak is. Die vergelyking sal fokus op die fisiese eienskappe, koste struktuur, bronne van ondersteuning en die primêre doel van die intervensie.

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Ward, Kim Lana. "Expanding presumptive male partner management of sexually transmitted infections (STIs) to Western Cape, South African community retail pharmacies." Thesis, University of the Western Cape, 2007. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_2411_1257329598.

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The effect of industrialisation has thrust the pharmaceutical profession into a clinical paradigm where the approcah to pharmaceutical decisions is more disease and patient orientated. Consequently, South African community pharmacies are inundated with requests from the public for advice and treatment on a wide range of medical conditions, including sexually transmitted infections (STI's). Although community pharmacies are often the first port of call for undiagnosed STI, limited diagnostic skills and legally-imposed prescribing restrictions preclude pharmacists from providing the necessary clinical management. The overarching goal of this dissertation was to present objective arguments and evidences (new and existing) around an expanded role for pharmacists in STI partner management.

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Tuswa, Bulelwa Martha. "Experiences of professional nurses working in rural primary health care clinics regarding the nursing management of mentally ill clients in the Eastern Cape." Thesis, Nelson Mandela Metropolitan University, 2016. http://hdl.handle.net/10948/18507.

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In South Africa, mental health care is being integrated into primary health care services. The integration of services was aimed at increasing the accessibility and availability of all health care services at primary health care level. The integration was well intentioned, and it was hoped that mentally ill clients would benefit from having a service near their homes. However, the process of integration is fraught with challenges, for instance, staff shortages, which lead to ineffective nursing management of mentally ill clients at the primary health care clinics. As a result, one professional nurse is often allocated to manage the clinic services on a daily basis with the assistance of an enrolled nurse or auxiliary nurse. The professional nurses therefore experience high levels of stress due to gross staff shortages and lack of time to conduct proper nursing assessments. This led to the research question: “What are the experiences of professional nurses with regards to the nursing management of mentally ill clients in rural primary health care clinics in the O.R. Tambo District in the Eastern Cape?’’ The proposed objectives of the study were to explore and describe the experiences of professional nurses working in rural primary health care clinics with regard to the nursing management of mentally ill clients. The researcher thereafter made recommendations to the district managers regarding effective nursing management of mentally ill clients in rural primary health care clinics. A qualitative, exploratory, descriptive and contextual design was used. The research population comprised of professional nurses working in rural primary health care clinics in the O.R. Tambo District in the Eastern Cape. Purposive sampling was used to identify participants and the sample number was determined by data saturation. Unstructured interviews and observation notes were used to collect data. The eight steps of data analysis suggested by Tesch were utilized to analyze the data. The researcher conducted an in-depth literature review in order to identify research gaps pertaining to the study. To ensure that a high level of validity and reliability was exercised throughout the study, the researcher conformed to Lincoln and Guba’s model of trustworthiness. The study was conducted in an ethical manner and ethical principles were adhered to. Findings: Three themes with subthemes emerged. The study showed that professional nurses experienced challenges related to the nursing management of mentally ill clients. These challenges included shortage of staff, a heavy workload, and lack of resources, lack of in-service training and workshops related to mental health issues coupled with lack of support from the supervisors. Due to the challenges, the mentally ill clients were not getting quality nursing care leading to complications and relapse. Conclusion: It emerged from the study that matters pertaining to mental illness and mental discomfort were still a serious problem in rural areas. The problems were related to the challenges which prevented professional nurses from providing quality nursing care to mentally ill clients with subsequent complications and relapse. Recommendations: Recommendations were made as an effort to ensure that the nursing management of mentally ill clients in rural primary health care clinics is improved. These recommendations were categorized as related to nursing practice, nursing education and nursing research.

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Biggs, Debbie Lynn. "Health promotion needs of stroke patients accessing community health centres in the metropole region of the Western Cape." Thesis, University of the Western Cape, 2005. http://etd.uwc.ac.za/index.php?module=etd&amp.

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Stroke is the third leading cause of death and a major cause of disability in most societies. Individuals with physical disabilities are at risk of secondary complications due to the impact of the disability, which may be exacerbated by poor lifestyle choices. Although disabled persons desire to engage in wellnessenhancing activities, limited programmes based on their health promotion needs&rsquo
assessment have been developed. The aim of the present study is to determine the health promotion needs of stroke patients accessing selected Community Health Centres in the Metropole region of the Western Cape. A cross-sectional survey, utilizing a self-administered questionnaire and in depth interviews with a purposively selected sample was used to collect the data. The quantitative data was analysed using Microsoft Excel ®
. Means, standard deviations and percentages were calculated for descriptive purposes and the chi-square test was used to test for associations between socio-demographic and health-related variables. Audiotape interviews were transcribed verbatim, the emerging ideas were reduced to topics, categories and themes and finally interpreted. In order to qualify for between-method triangulation used in the study, complementary strengths were identified by comparing textual qualitative data with numerical quantitative results and vice versa. The quantitative analysis revealed that the participants were engaging in health risk behaviours such as physical inactivity, substance usage, non-compliance to medication use and inappropriate diet modification. Lack of financial resources, facilities and access to information predisposed them to involvement in risky health behaviours. In-depth interviews supported the quantitative findings and revealed that numerous participants&rsquo
suffered from depression and frustration as a result of having a stroke. The necessary ethical considerations were upheld. The outcome of the study could contribute to the need to develop, encourage and promote wellness-enhancing behaviours and activities to improve the participants&rsquo
health status and ultimate quality of life.

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Mkhencele, Nontando Precious. "Evaluation of the role of support groups in the lives of HIV positive people at Nontyatyambo and Empilweni Gompo Community Health Centres in East London, Eastern Cape." Thesis, University of Fort Hare, 2011. http://hdl.handle.net/10353/d1001094.

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South Africa has the highest number of people living with HIV/AIDS in the world. The estimated 5,7 million South Africans that are living with HIV need comprehensive and holistic care. Psychosocial support is a vital aspect of care for HIV positive people. Support groups have been identified as a basic form of psychosocial support. The aim of this study was to evaluate the role of support groups in the lives of HIV positive people in East London, Eastern Cape. A qualitative study design was implemented using focus group interviews to explore the role of HIV support groups. The research questions were designed to elicit responses pertaining to the needs, expectations and experiences of HIV positive support group attendees. Activities conducted in support groups as well as the attitude of support group members towards recruiting other HIV positive people to join the group were also explored. Findings revealed that the benefits of attending a support group included emotional and psychological support, sense of belonging to a “family”, assistance with disclosure issues, gaining information about HIV and treatment as well as material benefits such as food parcels and job opportunities. The greatest need of support group attendees was assistance in obtaining a Social Support or Disability Grant. A few negative experiences were reported which included: unfulfilled promises by people outside of the group, unfair allocation of grants and food parcels, as well as negative group dynamics at times. Support group members agreed that even though there were few negative experiences, the benefits clearly outweighed the negative experiences. Most participants agreed that they would recommend the support group to other HIV positive people so that they could also enjoy the stated benefits. In summary, the study concluded that support groups are very helpful in the lives of HIV positive people.

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48

Misbach, Sadia. "The implementation of the rehabilitation service package in the Metropole Health District, Western Cape Province, South Africa." Thesis, University of the Western Cape, 2004. http://etd.uwc.ac.za/index.php?module=etd&amp.

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This research investigated the availability and nature of the rehabilitation service at primary health care level rendered by rehabilitation staff in the Metropole district health services. The aim of the study was to determine the extent to which selected elements of the rehabilitation components of the primary health care service package are currently being implemented. In doing so, the study aimed to identify obstacles within the district management as perceived by rehabilitation therapists that hinder the implementation of the rehabilitation programme, so as to make recommendations for future planning.

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49

Van, Driel Adrian Edgar. "An exploratory study into the benefits of the new health care system in South Africa, with specific reference to health care providers in the Western Cape." Thesis, University of the Western Cape, 2005. http://etd.uwc.ac.za/index.php?module=etd&amp.

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The research explored the new health care service vehicle of South African with special reference to health service providers in Western Cape Department of health for the period 1995-2001. A study was made of the District Health System and the shift of emphasis from tertiary and secondary level of health care to the more cost effective Primary Health Care Service rendered at District level.

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50

De, Wet Caroline. "An analysis of the organizational framework of rehabilitation services at a community health centre in the Western Cape." Thesis, Stellenbosch : Stellenbosch University, 2014. http://hdl.handle.net/10019.1/86418.

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Thesis (MHumanRehabSt)--Stellenbosch University, 2014.
ENGLISH ABSTRACT:Background In the past, a lack of policy guidelines in the area of rehabilitation often resulted in underdeveloped or no rehabilitation services in many areas. This led to the development of The South African National Rehabilitation Policy (NRP) which was finalised in 2000. This policy is guided by the principles of development, empowerment and the social integration of persons with disabilities. It aims to provide improved access to rehabilitation services for all and forms part of a strategy to improve the quality of life of persons with disabilities. South Africa ratified the United Nations Convention for the Rights of Persons with Disabilities (UNCRPD) in 2001. The UNCRPD is an international rights based document and focuses on equalisation of opportunities for people with disabilities and their inclusion in development. Aim The aim of thestudy was to describe and analyse the organizational framework of rehabilitation services at the Gugulethu Community Health Centre (CHC) in Cape Town and to determine if the framework used complied with the objectives of the National Rehabilitation Policy. Method This was a case study that made use of both qualitative and quantitative methods of data collection. The Kaplan framework, the objectives of the NRP and the five relevant articles of the UNCRPD were used to design three questionnaires for data collection. The first questionnaire was for service providers and answered by seven participants. The second questionnaire was completed by the Facility Manager of Gugulethu CHC and the third questionnaire was answered by the managers of 2 purposively sampled NGOs in Gugulethu. Qualitative data was collected from interviews held with three of the service providers and the facility manager as well as from two focus groups held with service users. Results The results of the study showed that there was some coherence between the rehabilitation services provided and the objectives of the NRP such as good access to the service for clients coming to the Centre for rehabilitation and adequate resources to provide assistive devices with. However, in other areas there was little or no adherence. Limited evidence of intersectoral collaboration was found. There was no evidence of the inclusion of persons with disabilities in the planning, implementation and managing of rehabilitation services. Similarly services were not monitored and evaluated in a constructive way and while the therapists did engage in skills development activities the suitability of the courses attended for their role is questioned. Conclusion The findings showed a facility based curative rehabilitation service that was accessible for clients who came to the facility, but did not expand to provide community based rehabilitation. Thus it was concluded that the organisation in its current form lacked the ability to effectively address the needs of the community that it served. At Gugulethu Community Health Centre rehabilitation services need to be planned according to community based rehabilitation strategies by the manager, the service providers and the community. Only when implementation of the NRP and UNCRPD takes place will the benefits become tangible to the entire community. Key Words Rehabilitation, Disability, National Rehabilitation Policy, UNCRPD, Organisational capacity.
AFRIKAANSE OPSOMMING: Agtergrond In die verlede het ‘n gebrekaanbeleidsriglyne in die rehabilitasievelddikwelsgelei tot onderontwikkelde of geenrehabilitasiedienste in baiegebiede. Die gevolghiervan was die ontwikkeling van dieSuidAfrikaanseNasionaleRehabilitasieBeleid (NRB) wat in 2000 gefinaliseer is. Die fokusvan hierdiebeleid is ontwikkeling, bemagtiging en die sosialeintegrasie van persone met gestremdhede. Die doel van die NRB is omtoeganklikheid van rehabilitasiediensteviralmalteverbeter en ditvormdeel van die strategieom die lewensgehalte van persone met gestremdhede to verbeter. SuidAfrika het die VerenigdeNasies se Konvensievir die Regte van Persone met Gestremdhede in 2001 bekragtig. HierdieKonvensie is ‘n internasionaleregsgebaseerdedokument and fokus opgelykeregtevirpersone met gestremdhede en hulinsluiting in ontwikkeling. Doelstelling Die doel van die studiewas om die organisatorieseraamwerk van die rehabilitasiedienste by die GugulethuGemeenskapsGesondheidssentrum in Kaapstadtebeskryf enteontleed, ten eindevastestel of die raamwerk, in ooreenstemming is met die doelwitte van die NasionaleRehabilitasieBeleid. Metode `n Gevallestudie is gedoen. Data is deurmiddel van kwantitatiewe en kwalitatiewemetodesingesamel. Die Kaplanraamwerk, doelwitte van die NasionaleRehabilitasieBeleid en toepaslike 5 artikels van die VerenigdeNasie se Konvensievir die Regte van Persone met Gestremdehede is gebruikomdrievraelysteteontwerp. Die eerstevraelys was virdiensverskaffers en sewedeelnemers het ditbeantwoord. Die tweedevraelys is deur die Fasiliteitsbestuurder van GuguletuGemeenskapsGesondheidssentrumbeantwoord en die derdevraelysdeur twee bestuurders van twee doelbewustegekoseNie-staatsOrganisasies in Guguletu. Onderhoude is met drie van die diensverskaffers en die fasiliteitsbestuurdergebruikomkwalitatiewe data in tesamelsowel as twee fokusgroepe met diensverbruikers.Resultate Die resultate van die studietoondatdaarwel ‘n mate van belyningtussenrehabilitasiedienste by die studiesentrum en die doelwitte van die NasionaleRehabilitasieBeleid is. Ditsluit in goeietoeganklikheidna die diensvirklientewat die sentrumbesoekvirbehandeling en voldoendebronneomhulpmiddelstevoorsien.In andergebiede was daaregter min of geenbelyningnie. Daar is min bewyse van intersektoralesamewerking en geenbewyse van die insluiting van persone met gestremdhede in die beplanning, implementering en bestuur van die rehabilitasiedienstenie. Dienste is nie in ‘n opbouendemaniergemonitor of geevalueernie en terwyl die terapeutewelaanontwikklingsprogrammedeelgeneem het, kan die toepaslikheid van die kursussebevraagteken word. Gevolgtrekking Die bevindingswys op ‘n kuratiewerehabilitasiedienswattoeganklik is virklientewatna die sentrum toe kom. Daar word egterniegemeenskapsbaseerderehabilitasieverskafnie.Dus, is die gevolgtrekkingdat die organisasie in syhuidigevormnie die vermoe het om die behoeftes van die gemeenskapwatditdien, effektiefaantespreeknie.Dierehabilitasiedienste by GuguletuGemeenskapssentrummoetbeplan word volgensgemeenskapsgebaseerderehabilitasiestrategiee, deur die bestuurder, diensverskaffers en die gemeenskap. Eerswanneer die NasionaleRehabilitasieBeleid en die VerenigdeNasie se Konvensievir die Regte van Persone met Gestremdhedetoegepas word sal die helegemeenskapbaatvind by rehabilitasie.

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Dissertations / Theses on the topic 'Community health services – South Africa – Eastern Cape'

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