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1
Bija, Yanelisa. "Determinants of under-five mortality in South Africa: A logistic regression." University of the Western Cape, 2019. http://hdl.handle.net/11394/6985.
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Magister Philosophiae - MPhilWhile several interventions have been implemented over the past decade to combat child mortality, under-five mortality remains a challenge especially in Sub-Saharan Africa. Global-ly, child mortality has decreased to half from 12.7 million in 1990 to 5.9 million per year in 2015. Despite these remarkable gains, more than 16,000 children are dying daily in the world (World Health Organisation, 2015). Previous studies on child survival have examined the contributing factors of child deaths and HIV/AIDS epidemic and socio-economic differentials such as the level of education, type of place of residence,and mother’s occupational status were identified as the contributing factor towards the high rate of under-five mortality. How-ever, there is a paucity of studies focusing on the impact of socio-economic and demographic factors on under-five mortality. Hence this study aims to explore the impact of socio-economic and demographic factors on under-five mortality in South Africa. There are underlying factors or background determinants (including direct and indirect) of under-five mortality. These factors influence under-five mortality in South Africa, and the direct causes are called proximate determinants or demographic factors. The conceptual framework of Mosley and Chen (1984) was adopted to explore the ways of influence of the underlying factors on under-five mortality in their study of determinants of child survival.
2
Lomalisa, Litenye. "Causes of maternal deaths and severe acute maternal morbidity in a regional hospital in the Northwest Province of South Africa." Thesis, University of the Western Cape, 2006. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_7030_1254736307.
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Despite all measures taken by the South African government since 1994, there is a contiuous increase of maternal mortality in the country and the Northwest Province is amongst the highest. Studies to date combining the review of maternal deaths and severe acute maternal morbidity (SAMM) have been conducted primarily in urban areas. The aim of this study was to determine the causes of death and avoidable factors for maternal mortality and severe acute maternal morbidity in a rural regional hospital from 01/01/2005 to 30/04/2006.
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Sobamowo, Theophilus Oluwadayo. "A clinical audit on the quality of care and the outcome of patients with pregnancy induced hypertension within a primary-secondary care pathway: the Wesfleur-New Somerset Hospital Axis, Cape Town, South Africa." Master's thesis, Faculty of Health Sciences, 2020. http://hdl.handle.net/11427/32989.
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Background: Pregnancy Induced Hypertension (PIH) and its complications contribute to a significant burden of disease both in developed and developing countries of the world. Unfortunately, PIH has no cure, the delivery of the baby and the placenta is required. Early detection of pregnancy induced hypertension and close monitoring remains the key to achieving a favourable outcome. This study aimed to determine the quality of care given to women diagnosed with Pregnancy Induced Hypertension (PIH) within a care pathway spanning peri-urban primary and urban secondary level facilities. Methods: This was a retrospective clinical audit of medical records of patients diagnosed with PIH. It was conducted in the Wesfleur -New Somerset Hospital drainage area, using a locally validated data extraction tool, based on the South African Maternal Care Guidelines. The data were analyzed using descriptive methods to report on the frequencies and proportions of the variables, and analyzed to report on statistical significance of correlations. Results: The prevalence rate of pregnancy induced hypertension in this study was 12%. The overall pregnancy induced hypertension complication prevalence in the study for mothers was 7.7%, and that of babies was 30.7%. Facilities generally performed well according to the audit indicators detailing structures and processes that should be followed, as outlined by the standard guidelines used. Two process indicators were correlated with adverse outcomes: 66.1% of patients were appropriately referred, resulting in statistically better foetal outcomes (p = 0.059); and those who booked early in the pregnancy had less PIH-induced complications than those who booked late (p = 0.012) Conclusion: This study followed a standardized audit methodology and found that the quality of care in this peri-urban area is of a good standard and identified areas for quality improvement and further enquiry to ensure continual improvement in maternal and fetal outcomes.
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Mokgatlhe, Tuduetso M. "Factors associated with maternal mortality in South East Botswana." Thesis, University of the Western Cape, 2012. http://hdl.handle.net/11394/4487.
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Magister Public Health - MPHBackground: Maternal mortality is a significant public health problem world-wide,as it is an important indicator for the functioning of the health system. The maternal mortality ratio for Botswana is higher than other countries with comparable economic growth, despite impressive access to health services. In order to develop relevant programs and policies to reduce maternal mortality, the factors associated with maternal mortality were studied. The study aimed to describe the maternal and health services factors associated with maternal mortality in South East Botswana. Methodology: A quantitative case-control study was used to retrospectively review medical records for 71 cases of maternal deaths and 284 controls randomly selected from mothers who delivered in the same year and at the same health facility, in South East Botswana from 2007 to 2009. Information was collected on the maternal and health services characteristics of the cases and controls including age, level of education, marital status, parity, utilization of health facilities that consist of antenatal care (ANC), type of delivery, complications during pregnancy, type of health facility and ANC provider. Data was analyzed using Predictive Analysis Software (PASW) Version 18.Two-sample t- test, Pearson’s Chi-square test and the Fisher’s exact test were used to test the difference between the proportions of the various categories of variables in cases and controls. Univariate logistic regression analysis was applied to identify the risk factors associated with maternal deaths. A multivariate logistic regression model was estimated to see the joint effects of the identified risk factors for maternal mortality. Hosmer and Lemeshow test was used to test the goodness of fit of the model. Results: The mean age of the maternal deaths was 28.0 ± 5.3 years and they had taken place at a hospital (100%). A large number of deaths occurred before delivery(59.0%). The causes of maternal death included both direct (73%) and indirect causes (27%). Direct causes were the leading causes of death and they were abortion(22.5%) and haemorrhage (18.3%). The maternal characteristics associated with maternal mortality were having complications at delivery (OR=20.91), not receiving ANC (OR=6.31) and delivering by caesarean section (OR= 2.66). The health facility characteristics associated with maternal mortality were delivering outside the health facility (OR=14.78), having been referred from another facility (OR=8.62) and delivering at a general hospital (OR=5.91). The data produced a model with good fit that included one maternal risk factor and three health facility risk factors. These were being admitted with preterm labour, delivering at a general hospital or before arrival at the health facility and having been referred from another health facility. Conclusion: Maternal mortality was associated with both maternal and health facility risk factors. The model developed may be used to identify and manage highrisk women to reduce the number of maternal deaths. It was recommended that, the current system should continue to be monitored and evaluated through the Maternal Mortality Monitoring System (MMMS). Furthermore, the referral and management of complications needs to be strengthened through a multi-sectoral approach.
5
Fantaye, Arone. "Understanding Maternal Care Preferences and Perceptions to Curb Maternal Mortality in Rural Africa." Thesis, Université d'Ottawa / University of Ottawa, 2020. http://hdl.handle.net/10393/40111.
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Background: The underutilization of formal, facility-based maternal care is a major contributor to the high maternal mortality rates among women living in rural Africa. Increasing the use of formal maternal care requires exploration of important maternal health issues affecting community members and comprehension of how they perceive the use of formal and traditional maternal care. This thesis aimed to identify the key factors, challenges, and needs of rural populations for the uptake of formal maternal care. Paper 1 explored rural women's preferred choices for sources of maternal care as well as the factors that contribute to their preferences in Africa. Paper 2 explored elders' perceptions about reasons for the underutilization of maternal healthcare and maternal death, as well as potential solutions to improve formal care use in rural Nigeria.
Methods: 1) In paper 1, a systematic search on Ovid Medline, Embase, CINAHL, and Global Health identified 40 qualitative studies that elicited women's preferences for maternal care in rural Africa. Reviewers collated the findings and reported on patterns identified across findings using the narrative synthesis method. 2) Data were
collected through 9 community conversations with 158 elders in 9 rural Nigerian communities. The data were analyzed inductively through thematic analysis.
Results: 1) A variety of preferences for formal, traditional and both formal and traditional maternal care during antepartum, intrapartum and postpartum periods were identified. The majority of the studies reported preferences for formal antenatal care or a combination of traditional and formal antenatal care. During intrapartum, rural women held a wide range of preferences, including facility-based births, traditional births in a domestic setting, as well as a combination of formal and traditional care depending on the onset of complications. The majority of the studies reported preferences for traditional postnatal care involving traditional attendants, self-care, and cultural rituals that fend off witchcraft. The factors that contributed to these preferences were related to the perceived need of formal or traditional maternal care, accessibility to formal or traditional care, and cultural and religious norms, beliefs and obligations. 2) The perceived reasons for the underuse of formal maternal care included poor qualities of care, physical and financial inaccessibility of facility-based services, and lack of knowledge and awareness. Reasons for women's maternal deaths included malaria and blood displacement, facility-based service deficiencies, uptake of traditional maternal care, and poor community awareness and negligence. Increased access to high-quality care, health promotion and education, community support and supernatural assistance were the proffered solutions.
Conclusions: The major areas that need improvement across rural Africa include human and material resources availability, technical and interpersonal quality of care in health facilities, physical accessibility, financial accessibility, sociocultural accessibility, cultural and religious sensitivity, and community knowledge and
awareness. Generally, the findings reflect the need for multifaceted interventions that engage target populations and consider local contexts, realities, and related needs in order to develop locally acceptable interventions. Such interventions will increase the likelihood of effective and long-lasting positive changes in healthcare utilization and maternal mortality.
6
Machemedze, Takwanisa. "Old age mortality in South Africa." Master's thesis, University of Cape Town, 2009. http://hdl.handle.net/11427/8980.
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Includes bibliographical references (leaves 71-74).This study estimates the mortality of the South African oldest old age population (in five year age groups from age 75 up to the open age interval 100 and above) and in the process re-estimates the numbers of people in the population at these ages at the time of the 1996 and 2001 censuses, and the 2007 Community Survey. In countries where the data on the old age population have been verified, it has been observed that the data are marred by errors in the form of age exaggeration, age digit preference, relative under/over count of the population and under-registration of deaths. These errors have been observed to have the net effect of underestimating mortality of the oldest old age groups. The current research applies the method of extinct generations to estimate indirectly the population numbers at the oldest old age groups (75 up to 100 and above) using data on reported deaths alone. Age heaping and year of birth preference in the reported deaths are assessed using ratios of the probability of death estimated from the data. Age exaggeration in the data on reported deaths is assessed using ratios of deaths compared with same ratios from a standard population. Age heaping and year of birth preference in the census/survey population is assessed using the modified Whipple's Index of age accuracy. The Generalized Growth Balance (GGB) and Synthetic Extinct Generations (SEG+delta) methods are applied to adjust for under reporting of deaths and to assess patterns of age exaggeration in the census/survey population. The difference between the estimates of the completeness of reporting of deaths from the two methods is small (less than 1 per cent) and has been observed to have little impact on the mortality estimates. Final estimates of the completeness of reporting of deaths used are those derived using the SEG+delta method. After re-estimating the population numbers and adjusting for completeness of reporting of deaths, mortality rates were then estimated. Results obtained from the method of extinct generations suggest that there is no systematic difference between the census/ survey population and the population numbers estimated from deaths except at ages 95 and above. Measures of age accuracy show that there are patterns of preferring 1910, 1914, 1918, 1920 and 1930 as the years of birth in the census/survey population and these patterns are also found in the registered deaths. The impact of these errors was investigated and the results show that preference of certain years of birth cause fluctuations in the mortality rates. Patterns observed after applying the SEG+delta method suggest that the completeness of reporting of deaths falls with age at the advanced ages (from age 90 and above) and as a result, the estimated mortality rates above this age are lower than those estimated from the United Nations Population Division (UNPD) and US Census Bureau (USCB) population projections, and Dorrington, Moultrie and Timaeus (2004). Conclusions reached are that the mortality rates for the age groups 75 to 89 derived after re-estimating the population numbers and after allowing for the fall in the completeness of reporting of deaths are lower but not significantly different from those inferred from the UNPD and USCB population projections, and estimates derived by Dorrington, Moultrie and Timaeus (2004). The research recommends mortality estimates from the UNPD since they are the closest to the estimates derived using the published census population numbers for the whole period between the nights of 9-10 October 1996 and 9-10 October 2001. However, the research produced better estimates of the oldest old age population numbers relative to the census/survey numbers.
7
Richman, Ronald David. "Old age mortality in South Africa, 1985-2011." Master's thesis, University of Cape Town, 2017. http://hdl.handle.net/11427/27486.
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Estimating the level and trend in population mortality rates at advanced ages in South Africa is complicated by problems with both the population and death data. Population and death data, particularly in developing countries, often suffer from age misreporting - age exaggeration and digit preference. Also, censuses may under- or overestimate the population and registration of deaths is usually incomplete in developing countries (Dorrington, Moultrie and Timæus 2004). To avoid these problems, the research in this dissertation relies on the method of extinct generations and its extensions (Thatcher, Kannisto and Andreev 2002) to re-estimate the population using only the death data, which is often recorded more accurately than the population data. Since deaths are not reported completely in South Africa, the death data must be corrected before use. Death Distribution Methods (Moultrie, Dorrington, Hill et al. 2013) are used to correct the death data for incomplete registration of deaths. After correction, Near Extinct Generation methods (NEG) are used to re-estimate the population by projecting future deaths of nearly extinct cohorts. After showing that mortality rates produced using the original NEG methods are biased because of age and year of birth heaping present in the South African death data, the NEG methods are adapted to the South African context. The adapted NEG model smooths the age and year of birth heaping in the death data and produces mortality rates that are less biased than the original NEG methods. This model - referred to as the NEG-GAM model in this research - is used to re-estimate the population at each age from 70 and above and to calculate mortality rates since 1985. The population estimates aged 70+ produced using the NEG-GAM model match those from the 2011 census well. It is found that both the population and death data suffer from the same pattern of heaping, that the population and death data are affected by age exaggeration and that the death data are less affected by age exaggeration than the population data. The level and trend in mortality rates calculated using the NEG-GAM model are discussed and compared to the mortality rates in the Human Mortality Database and other studies of South African mortality. The mortality rates produced for the African and Coloured population groups appear too low at the older ages due to age exaggeration in the death data, while those for the Indian and White population groups appear to be reasonable over the entire age range. Mortality appears to be improving in the age range 70-79 for the Coloured, Indian and White population groups and deteriorating slowly for the African population group.
8
Ejidokun, Oluwatoyin Oyindamola. "Maternal anaemia and morbidity in South-Western Nigeria." Thesis, University College London (University of London), 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.338732.
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Sashaw, Jessica Joan Hayden. "Maternal strategies in vervet monkeys." Thesis, Lethbridge, Alta. : University of Lethbridge, Dept. of Psychology, c2012, 2012. http://hdl.handle.net/10133/3400.
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I studied free-ranging vervet monkeys (Chlorocebus aethiops) in South Africa using focal
animal sampling to test current theories of reproduction and maternal investment.
Mothers cope with the energetic costs of lactation by feeding more than non-lactating
females and targeting higher nutrient quality items as their infant ages. The dynamic
nature of mother-infant interactions is highlighted, with infants spending less time in
contact while the mother is moving and foraging. Other troop members “allomother” the
infant primarily in the infant’s first couple of months. The length of investment is
explored, with greater length of interbirth interval in low nutrient quality environments,
larger troop sizes and higher survival rates. Maternal dominance rank and infant sex
significantly influenced time in ventral contact, with low-ranking daughters spending
more time in contact than high-ranking daughters. The findings from this thesis highlight
the complex interaction of ecological and social conditions on maternal investment.xiv, 182 leaves ; 29 cm
10
de, Villiers Marthinus Coenraad. "The changing landscape of infective endocarditis in South Africa." Master's thesis, Faculty of Health Sciences, 2019. http://hdl.handle.net/11427/31498.
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Background. Little is known about the current clinical profile and outcomes of patients with infective endocarditis (IE) in South Africa. Methods. We conducted a retrospective review of the records of patients admitted to Groote Schuur Hospital between 2009 and 2016 fulfilling universal criteria for definite or possible IE, in search of demographic, clinical, microbiological, echocardiographic, treatment and outcome information. Results. 105 patients fulfilled the modified Duke criteria for IE. The median age of the cohort was 39 years (IQR 29-51), with a male preponderance (61.9%). The majority of patients (72.4%) had left-sided native valve endocarditis, 14% had right-sided disease, and 13.3% had prosthetic valve endocarditis. A third of the cohort had rheumatic heart disease. Although 41.1% of patients with left-sided disease had negative blood cultures, the three most common organisms cultured in this subgroup were Staphylococcus aureus (18.9%), Streptococcus spp. (16.7%) and Enterococcus spp. (6.7%). Participants with right-sided endocarditis were younger (29 years (IQR 27-37)), were predominantly intravenous drug users (IVDU; 73.3%) and the majority cultured positive for S. aureus (73.3%) with frequent septic pulmonary complications (40.0%). The overall in-hospital mortality was 16.2%, with no deaths in the group with right-sided endocarditis. Predictors of death in our patients were heart failure (OR 8.16, CI 1.77-37.70; p=0.007) and an age > 45 years (OR 4.73, CI 1.11- 20.14; p=0.036). Valve surgery was associated with a reduction in mortality (OR 0.09, CI 0.02-0.43; p=0.003). Conclusions. Infective endocarditis in a typical teaching tertiary care centre in South Africa remains an important clinical problem. In this setting, it continues to affect mainly young people with post-inflammatory valve disease and congenital heart disease. IE is associated with an in-hospital mortality that remains high. Intravenous drug-associated endocarditis caused by S. aureus is an important IE subset, comprising approximately 10% of all cases, a fact which was not reported 15 years ago, and culture-negative endocarditis remains highly prevalent. Heart failure in IE carries significant risk of death and needs a more intensive level of care in hospital. Finally, cardiac surgery was associated with reduced mortality, with the largest impact in those patients with heart failure.
11
Dust, Kristin. "The effects of education, income, and child mortality on fertility in South Africa /." Burnaby B.C. : Simon Fraser University, 2005. http://ir.lib.sfu.ca/handle/1892/2334.
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Nyide, Thabisile. "Health care services and infant mortality in South Africa Bantusans." DigitalCommons@Robert W. Woodruff Library, Atlanta University Center, 1988. http://digitalcommons.auctr.edu/dissertations/3877.
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The purpose of this study was to investigate the effectiveness of a culturally responsive pedagogy in improving African American middle grades students’ achievement in attitude toward mathematics. Subjects were selected from two intact mathematics classes. Student gains between pre-test and post-test scores on the Quasar Cognitive Assessment Instrument and the Quasar Mathematics Attitude survey were analyzed using a two-tailed t-statistic. The non-equivalent pre-test post-test control group design was used to test group differences between the control group and treatment group. This study found that there was no significant difference between the pre-test and post-test scores of the treatment group and control group on the Quasar Cognitive Assessment Instrument. There was a significant difference found between the groups in attitude toward mathematics. The treatment group did show the more improved attitudes toward mathematics than did the control group. This study concluded that for this middle school urban group of African American students’ the use of culturally responsive pedagogy enabled students to achieve gains at a level comparable to their counterparts whom received traditional instruction. The findings of this study support culturally responsive pedagogy as an instructional method which has the potential to increase mathematics achievement and foster potential attitudes of middle grades African American students in urban school settings.
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Husein, Salah. "Long term mortality after lower extremity amputation in South Africa." Master's thesis, Faculty of Health Sciences, 2019. http://hdl.handle.net/11427/31531.
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Introduction: Long-term mortality after lower extremity amputation is not well reported in low- and middleincome countries. The primary aim of this study was to report 30-day and one-year mortality after lower extremity amputation in South Africa. The secondary objective was to report risk factors for one-year mortality. Methods: This was a retrospective cohort study of patients undergoing lower extremity amputations at New Somerset Hospital from October 1, 2015, to October 31, 2016. A medical record review was undertaken to identify co-morbidities, operation details, and perioperative mortality rate. Outcome status was defined as alive, dead, or lost to follow-up. Outcomes at 30 days and one year were reported. Results: There were 152 patients; 90 (59%) males and the median age (interquartile range, IQR) was 60 (54-67) years. At 30 days, 102 patients were traced and 12 (12%) were dead. At one year, 86 (57%) were traced and 37 (43%) were dead. Conclusion: At this South African hospital, 43% of patients undergoing lower extremity amputations were dead after one year. In resource-constrained settings, mortality data are necessary when considering resource allocation for lower extremity amputations and essential surgical care packages.
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Prinsloo, Megan. "Estimating injury mortality in South Africa and identifying urban-rural differences." Doctoral thesis, Faculty of Health Sciences, 2019. http://hdl.handle.net/11427/30083.
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The overarching aim of this thesis is to utilise national data on injury mortality in South Africa, to conduct advanced statistical analyses to identify urban-rural differences for injury deaths, and to gain insight into the explanatory variables for homicide in metropolitan- and non-metropolitan (metro- and non-metro) areas. The literature review describes the global and national estimates of injury mortality and reports higher rural than urban injury mortality rates for high-income countries. It further discusses a framework for assessing data quality and reviews South Africa’s fatal and non-fatal injury data sources, issues of under-reporting and misclassification of deaths. The risk factors for violence are reviewed, which inform particular hypotheses on the role of age, sex, race, day of week and firearms with regard to homicide. The Injury Mortality Survey (IMS) data, which estimated 52 493 injury deaths nationally in 2009, is utilised for this PhD study. Data quality is assessed using an internationally developed conceptual framework for mortality data. Exploratory and multiple correspondence analysis identified possible associations between metro/nonmetro and other explanatory variables, prior to more sophisticated multinomial logistic regression analysis, which adjusted for age, sex, race and metro/non-metro for each manner of death (homicide, suicide, transport-related and other unintentional injury deaths) to explore particular hypotheses for the differences in the metro/non-metro injury mortality profile. Age-standardised injury mortality rates were calculated to take into account the effects of different age structures for metro- and non-metro populations. Generalized linear models were fitted in relation to particular hypotheses to determine the explanatory variables for homicide deaths in both metro and nonmetro areas. Main findings include a significantly higher likelihood for homicide in metro areas compared to non-metro areas, while transport-related deaths were significantly lower in metro areas. The risk of homicide for Coloureds was higher than Blacks in metro areas, while Blacks, Coloureds and Asians had similar risks of homicide in non- metro areas. Whites had a similar risk and Asians a higher risk of homicide in nonmetro areas compared with metro areas. Firearm use was shown to significantly explain metro/non-metro differences in homicide risks. This study’s most significant knowledge contribution includes the identification of metro/non-metro as a significant predictor of the injury mortality profile in South Africa. The association of metro/non-metro differences in the pattern of homicide for Blacks and Coloureds, also resolved conflicting statements found in the literature regarding race and homicide in South Africa. The results are of considerable significance to national and provincial policy makers. Recommendations are made in relation to the main findings of this study.
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Tsawe, Mluleki. "Utilization of health care services and maternal education in South Africa." University of the Western Cape, 2014. http://hdl.handle.net/11394/4358.
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Magister Philosophiae - MPhilThe importance of maternal health care services cannot be stressed enough. Maternal health services are important in reducing pregnancy-related complications as well as maternal and infant deaths. This study was concerned with investigating the relationship between maternal education and maternal health care utilization. Furthermore, the study aimed to investigate the rates of maternal health care use, the reasons for non-use of maternal health services, as well as the determinants of maternal health care use. Primary data was used from selected areas (Tsolo, Qumbu and Mqanduli), which fall within the O.R. Tambo district in the Eastern Cape Province. Simple random sampling was used (with a structured questionnaire) to study maternal health care use among the sampled women. To analyse this data, univariate, bivariate, and multivariate techniques were employed. The results indicated that maternal education was not statistically significant with antenatal and postnatal services, but the percentages were important in explaining the use of maternal health care services in relation to maternal education. Women with higher levels of education reported higher rates of antenatal and delivery care utilization, while those with lower levels of education reported higher rates of postnatal care use. Access factors, such as transport, payment and distance to health facilities, also played an important role in the use of maternal health care services. It was recommended that the Department of Health implement mobile clinics and centralize health care facilities as this will bring essential health services closer to the communities. Women in the study area also need to be educated about the importance of these services, more particularly pertaining to postnatal care.
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Sibanyoni, Sibongile Success. "A phenomenological study of the experiences of adolescents following maternal HIV-disclosure." Thesis, Rhodes University, 2014. http://hdl.handle.net/10962/d1013125.
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Maternal HIV-disclosure to an adolescent is a controversial issue especially when considering the suitable time and context in which disclosure should take place. Furthermore there have been other considerations such as the adolescent’s emotional maturity as well as gender issues which have played a role in regards to determining whether the adolescent would be able to understand and cope effectively post-disclosure. These considerations formed the basis of this study’s aim and objectives which primarily focused on taking into account the developmental aspects apparent in the adolescent phase. These include adolescent’s relations with their mother, their peers and the meaning attached to having an education and career in their lives. For purposes of this study it was deemed important to actually explore with the adolescent’s the meaning they uphold pertaining to maternal HIVdisclosure. This differs from previous research which has focused predominantly on accessing adolescent’s experiences via their parents and in particular, their mothers. Data of only three participants was included following in-depth interviews being conducted. Data was analysed via Interpretive Phenomenological Analysis (IPA) which enabled an enhanced understanding and meaningful interpretation of the adolescent’s experiences following maternal HIV-disclosure. From the findings it became apparent that most concerns had already been addressed and were similar when compared to previous research that had been conducted. However one notable different finding was that instead of adolescent’s acting in ways that would lead to them self-sabotaging their lives they instead portrayed themselves to be living in a responsible manner. It became apparent rather that it was the adolescent’s mother rather that became more inclined to engage in self-sabotaging behaviours.
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Hunter, Adams Joanne. "Factors influencing migrant maternal and infant nutrition in Cape Town, South Africa." Doctoral thesis, University of Cape Town, 2014. http://hdl.handle.net/11427/12875.
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Includes bibliographical references.Migration is a social determinant of health. The relationships between migration and health are not well understood for the large numbers of migrants in low- and middle-income countries, including South Africa. In particular, nutrition during pregnancy and the first two years of a child’s life impact infant morbidity (e.g. diarrhoea, chronic disease) and mortality, yet little is known about maternal and infant nutrition in relation to migration. Positing that migration alters the family structures that traditionally provide social support and advice for mothers, this study was framed in terms of migrants’ loss of these social supports in Cape Town. This framing provided context for the broader investigation of migrants’ nutrition during pregnancy and the first two years of their infants’ lives. This qualitative study with migrants from the Democratic Republic of Congo (DRC), Somalia, and Zimbabwe included 23 in-depth interviews with recently (<2 years) postpartum women, and nine focus groups with adult men (N=3; n=21) and women (N=6; n=27). While in-depth interviews provided insights into individual nutritional motivations, focus groups provided insights into the social context of nutrition. Language interpretation was used in cases where participants did not speak English. Interviews and focus groups were recorded and transcribed verbatim; bilingual research assistants checked the quality of language interpretation and transcription. Rooted in notions of social constructivism, thematic analysis guided the development of a codebook of themes and subthemes. These analytic themes were grouped in relation to (1) maternal nutrition, (2) infant nutrition, and (3) past and present social support. Thereafter, a “thick description” involved interpreting key themes and producing the narrative that integrated focus group data and in-depth interview data. Analysis of maternal nutrition involved documenting foods consumed during pregnancy, as well as investigating the motivations that undergird nutrition during this period. The findings related to migrant maternal nutrition affirmed and built on previous research, which suggested that pregnant women generally maintained their previous non-pregnant eating habits. While cravings were dominated by self-perceived “traditional” foods of home, that were expensive and hard to find in Cape Town, women also commonly described consumption of fast foods and junk foods during pregnancy. Participants did not mention food scarcity, despite the fact that some migrants appeared to be food insecure. These findings illuminated the role of the nutrition transition in Cape Town, that is, migrants were at risk of consuming energy-dense, nutrient-poor diets, particularly during pregnancy. Secondly, analysis of participants’ experience of breastfeeding, formula feeding, and complementary feeding took place in the context of high rates of breastfeeding initiation but low rates of exclusive breastfeeding in many parts of Africa, including migrants’ countries of origin. In this study, migrants presented the common decision to introduce formula in light of their experiences of Cape Town as a work environment. Participants framed the introduction of formula and complementary food early in an infant’s life as primarily a pragmatic and intuitive decision in response to their infant’s cues. Whereas past studies conducted in LMIC tend to present breastfeeding as an important intervention to improve child “survival”, participants in this study were not primarily concerned with child survival. Rather, they were concerned with their family’s tenuous circumstances in Cape Town. As such, efforts by the health system to promote breastfeeding amongst migrants should emphasize benefits to long-term health as well as the short-term financial costs of formula feeding. However, I argue that this shift cannot occur without recognition of, and attention to, migrants’ pressing short-term needs, including housing, legal work status, and safety. Another important factor influencing maternal and infant nutrition revolved around the loss of social support, particularly the loss of the elder generation. Elder women played a central role in providing physical, social and informational support to new mothers in migrants’ countries of origin. As such, the absence of grandmothers in migrant communities in Cape Town was central to understanding participants’ maternal and infant nutrition decisions. Yet participants focused on the loss of household help, including cooking, rather than on grandmothers’ traditional authority or nutritional advice. Given the relative absence of the older, nonworking, generation in Cape Town, community support was limited by the pressures of work and survival. These pressures seemed to make healthy nutrition during pregnancy, or exclusive breastfeeding very difficult. Given this lack of support, medical providers presented one avenue of additional support. However, migrants were frequently unable to communicate with health care providers, and felt discriminated against and unwelcome in the health care system. The three primary findings relating migration and maternal and infant nutrition in Cape Town suggest several avenues for intervention and further study. Firstly, migrants’ descriptions of energy-dense, nutrient-poor diets suggest a role of policy-makers to improve the overall accessibility, availability, and affordability of more nutritious food to the poor in Cape Town. Recognising that foods from migrants’ countries of origin were of particular cultural and nutritional value, a smaller scale intervention might involve creating space and time for the preparation of “traditional” foods. Secondly, improving infant feeding involves re-orientating migrants towards the long-term benefits of breastfeeding and complementary feeding, and engaging spouses and male partners as integral to this process. Further research is needed to create a strong evidence base for the increasing rates of breastfeeding, both in Cape Town and in other urban centres in LMIC. Thirdly, given self-described social isolation and poor experiences in healthcare settings, free-to-patient medical interpretation may play an important role in connecting migrants to both healthcare services as well as broader social services. The improved communication facilitated by medical interpretation may also play a role in combatting the xenophobia that migrants face, both in the healthcare setting as well as in daily life. Indeed, my recommendations must be part of a broader public health research effort to explicate the negative health consequences of xenophobia. To design appropriate research and interventions for migrants, it is important to acknowledge the overarching roles played by xenophobia, legal status, and the broader socio-economic context in shaping maternal and infant nutrition
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Irlam, James. "A household survey of maternal and child health in the Mount Frere Health District, Eastern Cape." Master's thesis, University of Cape Town, 1998. http://hdl.handle.net/11427/26987.
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A cross-sectional household survey of maternal and child health was conducted in the Mount Frere health district of the Eastern Cape in August / September 1997. The aim was to describe key aspects of maternal and child health to inform the planning activities of the District Health Management Team (DHMT). A participatory process was followed, in order to develop research capacity within the district, and to facilitate interaction between health workers and the community. Methods: Structured questionnaires were used by local research trainees to gather data from each household on: • household demographics; • deaths in household since April 1994; • household access to water and sanitation; • children under five years; • children aged 5 to 15 years; • deliveries in the past 12 months; • knowledge of prevention and transmission of HIV/AIDS. Focus group discussions around the key findings were conducted with community members and clinic nurses to provide a qualitative component. Results: A high proportion of children under the age of 16, high household density, high unemployment, migrant labour, and absent mothers, are some of the defining demographic characteristics which affect the status of maternal and child health in the district. Access to health services is constrained by distance, lack of transport, and poor roads. Registration of births and deaths is poor, and the crude birth and death rates were found to be significantly higher than the " official" provincial rates. Tuberculosis, diarrhoea, trauma and homicide are notable features of the overall mortality profile, although the majority of deaths were classified "ill-defined / unknown". Diarrhoea and pneumonia accounted for half of all infant deaths. Eight out of ten deaths due to diarrhoea in under-fives occurred at home, but knowledge and use of oral rehydration solution is poor. Access to clean drinking water and sanitation is a major concern, with almost three quarters of homes using unprotected sources, a third more than 30 minutes' walk from the nearest source, and a half having no toilet. Areas of the district with particularly poor environmental health indicators were identified. Immunisation coverage among children 1-4 years is poor. Coverage for all vaccines except BCG falls well short of the national target of 90%, and fewer than 1 in 3 children was fully immunised with valid doses at the age of one year. Long intervals between doses and a high "dropout" rate between subsequent doses was observed. The road to health card (RTHC) could be produced for just over a half of under-five children. The proportion of home deliveries is high (45%), and traditional birth attendants (TBAs) therefore play an important role in this community. Nine out of ten mothers had attended antenatal clinic at least once, but almost half reported receiving no tetanus toxoid and no WR test for syphilis during their antenatal visits. More than a half of all mothers was using no family planning method at the time of the survey. Almost all 15-49 year-olds had heard about HIV/AIDS, but one in five did not know how HIV is transmitted, and a third did not know how it could be prevented. Recommendations: A detailed set of recommendations with action points for the DHMT was developed in a district workshop around the following key issues: 1. Improving access to health care, including road access, mobile clinic coverage, and waiting facilities for expectant mothers. 2. Promoting health in the community, by means of integration of health promotion into all health programmes, and more involvement of communities. 3. Improving the quality of care in the existing health facilities and services, including minimising missed opportunities for immunisation, and promoting home-made oral rehydration (sugar-salt) solution. 4. Improving the district health information system, especially the registration of vital events, and the provision of feedback to district health managers. 5. Identifying areas of further research, including the reasons for home deliveries, management of diarrhoea at home, and the use of traditional healers. Conclusion: The participatory research process that was used has helped to build research capacity in the district, to provide a deeper insight into community health problems, to highlight the value of health workers listening to the people they serve, to further collaboration between the disciplines, and to develop specific action plans. This is a process that should be followed in all research conducted in health districts.
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Nyengera, Reason. "Influence of anthropogenic stressors on the behaviour and mortality of the endangered African penguin." Thesis, Nelson Mandela Metropolitan University, 2014. http://hdl.handle.net/10948/3064.
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This study investigated the potential impacts of several anthropogenic stressors on the movement and survival of African penguins in Algoa Bay, taking into account prey availability and environmental conditions (sea surface temperature and chlorophyll productivity). The primary drive for the study was based on the seismic exploration, which took place in the habitat of the endangered African penguin. The research was also carried out to understand how pelagic fishing and prey availability influence the broader behavioural and mortality aspects of penguins. To achieve this goal, I used monthly beach surveys to assess seabird mortality, admissions of penguins in rehabilitation centres and the monitoring of breeding penguins’ movement at sea through individual GPS tracking. In addition, prey distribution and abundance were monitored with acoustic surveys to assess potential changes in relation anthropogenic stressors. Breeding African penguins did not react dramatically to seismic activities, except on St Croix Island where they changed their foraging direction during the seismic period. There was no evidence of a siginficant increase in African penguin carcasses encountered or strandings along the beaches during the period of seismic activity. However, a sharp increase in encounter rate was recorded soon after seismic operations, which may potentially indicate a delay between the effect of seismic activities on penguin mortality and the encounter of the related carcasses after the operation. However, the impact of seismic surveys on penguins may be long-term rather than short term, and additional studies would be needed to reveal long-term effects of seismic activities, if any. Foraging effort of breeding African penguins increased substantially in the presence of commercial fishing activities within close proximity to the colonies. To a greater extent, at-sea movement patterns and counts of beach cast carcasses were largely influenced by prey availability. Penguins spent more time at sea, traveled longer and covered a larger foraging area during periods of relatvely low pelagic fish abundance. There was also a sharp increase in African penguin mortality during periods of low prey availability in the Bay. However, environmental conditions showed some influence over these interactions. Foraging effort of breeding African penguins increased substantially in the presence of commercial fishing activities within close proximity to the colonies. To a greater extent, at-sea movement patterns and counts of beach cast carcasses were largely influenced by prey availability. Penguins spent more time at sea, traveled longer and covered a larger foraging area during periods of relatvely low pelagic fish abundance. There was also a sharp increase in African penguin mortality during periods of low prey availability in the Bay. However, environmental conditions showed some influence over these interactions. For example a red tide event during in period of low prey availability, made it difficult to understand impacts of prey on penguins difficult. Both anthropogenic stressors and environmental conditions influenced African penguins’ behaviour and survival. Due to the worrying trend of African penguins in South Africa for the past few years, all conservation management efforts to increase penguin numbers and limit their mortality are necessary. This study highlights the negative impact of industrial fishing on this Endangered species and the rapid increase in mortality of penguins during times of low prey availability. A network of Marine Protected Areas would certainly increase food availability to African penguins by limiting competition with fisheries, and contribute to increasing the population numbers.
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Darikwa, Timotheus Brian. "Estimating the level and trends of child mortality in South Africa, 1996-2006." Master's thesis, University of Cape Town, 2009. http://hdl.handle.net/11427/11919.
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Includes abstract.Includes bibliographical references (leaves 59-63).
The lack of reliable data for child mortality estimation since 1998 has meant that child mortality rates for South Africa have not been updated for almost ten years now. It is the overall aim of this research to explore the possibility of determining up-to-date estimates of South Africa's infant mortality and under-five mortality rates from the 2007 Community Survey data and to use these results to describe the trend in child mortality rates since 1996.
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Magadzire, Andrew. "Testing the orphanhood method against benchmark mortality rates in South Africa since 1996." Master's thesis, University of Cape Town, 2010. http://hdl.handle.net/11427/5894.
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Includes abstract.Includes bibliographical references (leaves 71-73).
This study utilises the 1996 and 2001 Censuses, and the 2007 Community Survey to test the orphanhood method mortality estimates against consensus estimates of mortality produced using other methods. In all the two censuses and the survey there were questions on the survival status of the respondent’s biological parents. The orphanhood method is widely used in developing countries where the vital registration is incomplete. In countries where the data on survival of parents has been compared with other mortality estimates, it has been observed that the orphanhood method estimates are biased by adoption effect, selection effect and age exaggeration. In the late 1980s and early 1990s, the advent of HIV/AIDS has also biased estimates obtained from the orphanhood method. Non-independence of the mortality of children and their mothers, relationships between HIV infection and fertility, and changes in age-specific mortality result in biases which affect the accuracy of the method. These biases have been observed to have a net effect of underestimating mortality especially female mortality. An adjusted method has been proposed which reduces error, when working with data taken from populations with a significant HIV prevalence. This adjustment can be applied, but further research to identify revised adjustments would further improve the accuracy of the method. The current research applies four variants of the orphanhood method, the regression variant, UN Manual’s two-survey variant, Timaeus’s synthetic cohort variant and the one allowing for HIV/AIDS proposed by Timaeus and Nunn.
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Burrows, Stephanie. "Suicide mortality in the South African context : exploring the role of social status and environmental circumstances /." Stockholm, 2005. http://diss.kib.ki.se/2005/91-631-7810-9/.
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Araborne, Anastasia. "African women as mothers and persons in rhetoric and practice : a critical study of African womanhood, maternal roles, and identities in theological and cultural constructs in the Roman Catholic tradition." Thesis, University of Roehampton, 2017. https://pure.roehampton.ac.uk/portal/en/studentthesis/African-Women-as-Mothers-and-Persons-in-Rhetoric-and-Practice(e2cae8d8-dc49-42df-9961-2f8cf5e482f6).html.
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This thesis adopts maternal well-being as a prism for studying the roles and identities of African women. It critically analyzes the dynamics in culture and religion that militate against women's quest for fullness of life. As its methodology, it adopts narratives of African women as a source and means of theological research based on the anthropological model. This method prioritizes the voices and humanity of previously silenced, excluded, and oppressed women and their conditions of maternal mortality, poverty, and oppression rooted in gender biases and patriarchal stereotypes. Theology has largely ignored the reality of maternal mortality evidenced by the paucity of theological materials. A consequence of the neglect and ignorance of this critical factor is the chasm between the rhetorical use of feminine and maternal symbolisms to represent and define the significance of women in church and society and the concrete realities that confront them as women. Bridging this gap necessitates identifying exemplary icons and models of maternal leadership and wisdom in scripture, traditions, and cultural practices to redefine the status, identity, and role of women. It also entails recognizing and harnessing the unique gifts, qualities, and spirituality of African women for the edification of church, transformation of society, and flourishing of humanity. Of salience is the practice of maternal leadership as a source of a new ethos for church and society through women's capacities and contributions, though a patriarchal mind-set imposes biological motherhood as the sole criterion for defining women's existence and relevance. Maternal leadership and wisdom liberated from a reductionist, biological understanding of motherhood and the highlighting of incarnated roles and identities inspired by maternal values represent innovative and original aspects of this thesis. Only by listening to voices of women can church and society develop a more just, liberating, and inclusive understanding of womanhood and motherhood. Nothing substitutes for the voices of women.
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Leopeng, Makiti Thelma. "Translations of informed consent documents for clinical trials in South Africa: are they readable?" Master's thesis, Faculty of Health Sciences, 2019. http://hdl.handle.net/11427/31021.
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1. Introduction: Obtaining Informed consent is an ethical prerequisite for enrollment in clinical research. There is a perception that Informed consent documents used in biomedical research are lengthy, overly complex and above the reading capability of typical research participants. In South Africa, ethical committees regulating research on human participants (HRECs) are mandated by the Department of Health’s National Health Research Ethics Council’s (NHREC) guidelines to ensure that researchers have made special considerations for vulnerable groups when conducting research. This includes considerations made for populations with low literacy. For example, the Standard Operating Procedure (SOP) of the University of Cape Town’s Human Research Ethics Committee (UCTHREC), requires that the language used in Informed consent documents should be directed at a reading level of grade 6 to 8 and that common, everyday words should be used rather than complex language syntax. The HREC expects researchers to translate the approved English version documents into local languages such as isiXhosa and Afrikaans. Since ethics committee focus approval on the English language consent documents and only acknowledge translated versions, a potential gap in this process is whether the translated versions meet the same required readability levels. This study aims to investigate whether translated versions of English language informed consent documents used at a single busy clinical research site are readable and meet the readability levels specified by UCTHREC. 2. Methodology: A quantitative descriptive statistical design was used to explore readability levels of informed consent documents used at a single clinical research facility based in a semi-rural community. Informed consent documents approved by UCTHREC over the past thirteen years (2004 to 2017) that met the inclusion criteria were analysed for readability. The LIX readability test tool was used to calculate readability scores and the levels of reading difficulty. These scores were then matched to a grade level conversion chart to determine the equivalent number of education years required to be able to easily understand the information. Readability levels were determined for isiXhosa and Afrikaans translations of the documents and compared to the levels of the English document. 3. Results: The results indicate that informed consent documents used at this single clinical research facility, independent of language type, are difficult to read. A total of 259 sub-sections of informed consent documents from 10 different studies were analysed. The analysis showed that informed consent documents were classified as “very difficult to read” according to the LIX readability tool in a large proportion of English, isiXhosa and Afrikaans languages: 41 (16%), 255 (98%), and 85 (33%) of informed consent sections respectively. Of all the subsections of English, isiXhosa and Afrikaans documents respectively, 98 (38%), 0 (0%) and 126 (49%) were classified as “difficult to read”, while 79 (31%), 3 (1%) and 38 (15%) were found to have an “average” readability level. Twenty eight (11%), 1 (0%) and 10 (4%) were found to be “easy to read” and 13 (5%), 0 (0%) and 0 (0%) had a “very easy” readability level. The mean LIX readability scores across English, isiXhosa, and Afrikaans languages were respectively 42.27 (95% CI 41.20 – 43.34) corresponding to a readability level of “average”, 74.64 (95% CI 73.79-75.49), corresponding to “very difficult to read” and 46.73 (95% CI 45.66-47.8) “difficult to read”. These findings suggest a high level of difficulty in reading of the text in the Informed consent documents. 4. Conclusion: Translations of Informed consent documents used at a single busy clinical research site are difficult to read and are written at high school to tertiary reading level. These reading levels are above the recommended level prescribed by the site’s research ethics committee (UCTHREC). Local ethics committees should employ more stringent guidelines and checks to ensure readability of translated informed consent documents. Researchers and Sponsors should include readability outcomes in the design and with submissions of new protocols.
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Urgoiti, Gabriel Jose. "The use of radio and audiotapes as tools for primary health care education in the area of maternal and child health." Master's thesis, University of Cape Town, 1991. http://hdl.handle.net/11427/26676.
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In the following chapters, I will discuss the effectiveness of radio and audiotapes as appropriate tools for health communication particularly suited to reaching deprived and isolated communities. I will refer to the striking achievements in radio and audiotape projects by drawing on the experiences of more than sixty radio and cassette projects concerned with primary health care in developing countries. I will present a detailed description of my Argentinean and South African radio experiences, focussing on how the two programmes came into existence, the different stages they have gone through, the problems and constraints encountered as well as their strengths and successes. I will describe the audiotape project I am involved in, and demonstrate how audiotapes can be used alone or in conjunction with radio for primary health education.
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Mohamed, Ekram. "Assessment of antenatal and intrapartum referrals to Mowbray Maternity Hospital in Cape Town, South Africa." Master's thesis, University of Cape Town, 2017. http://hdl.handle.net/11427/25453.
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Introduction: A continuous and concerning increase in the number of deliveries at Mowbray Maternity Hospital (MMH) has been noted over the years and now comprises a greater proportion of deliveries compared to deliveries conducted by midwives at midwife obstetric units (MOUs). To date there have been no studies assessing the changes in the pattern of deliveries at MMH. This study describes the antenatal and intrapartum referrals at MMH in 2005 and 2013, to identify any changes and whether or not referrals are appropriate. Method: This is a descriptive study with an analytic component involving review of a sample of hospital folders (138 for 2005 and 246 for 2013) of women who delivered at MMH from January to December 2005 and 2013. Results: The mean age of referred women was 27.259 (SD ± 6.277) years and 27.326 (SD ± 6.025) years in 2005 and 2013, respectively, with no significant statistical difference (p = 0.918). There was also no significant statistical difference (p=0.056) in the proportion of coloured, black or white women who delivered at MMH during 2005 and 2013. In 2005, a total of 27 (52.2 %) delivered women were single, 54 (39.1%) were married and two (1.4%) were divorced. In 2013, a total of 178 (72.4%) women were single, 65 (26.4%) were married and three (1.2%) were divorced, with a significant statistical difference (p < 0.001). In 2005, 75 (54.3%) women were unemployed and 46 (33.3%) were employed, whereas in 2013, 172 (69.9%) women were unemployed and 69 (28%) were employed, which shows a significant statistical difference (p < 0.001). In 2005, women mostly resided in Mitchell's Plain (32.6%), Gugulethu (28.3%) or in Khayelitsha (27.5%). In 2013, most women resided in Mitchell's plain (33.7%), Gugulethu (24.4%), Retreat 48 (19.5%) and Southern Peninsula 31 (12.6%), which represents a significant statistical difference (p= 0.001). 2 The median parity for 2005 sample was 1 (IQR: from 0 to 2), while in 2013 it was 1 (IQR: from 0 to 1). Although most women (94.2% versus 95.1%) booked at antenatal clinics in 2005 and 2013 respectively, with no significant statistical difference (p=0.697), the gestational age at first ANC differed significantly (p < 0.001) (median 24 versus 19 weeks). In 2005, the median number of ANC visits was five (IQR: from 4 to 7) visits, whereas the median was six (IQR: from 5 to 8) visits in 2013, with a significant statistical difference (p= 0.013). Over half of referred women (55.8% and 50.8%) in 2005 and 2013 respectively were delivered by normal vaginal delivery. The remainder had either a caesarean section or assisted delivery, with no significant statistical difference (p=0.139). Most women were referred from MOUs in both 2005 and 2013, at 90.6% and 85.45% respectively, with a significant statistical difference (p < 0.001). During both years virtually all pregnancies were considered high risk and the most common reason for referral was previous caesarean section (18.8% versus 19.9% respectively). For both years most pregnancy referrals experienced one, or more, antenatal risk factors, mainly previous caesarean section at 31 (12.5%), obesity at 27 (11%), prelabour rupture of membranes at 26 (10.6%) and HIV at 24 (9.8%) in 2005 and previous caesarean section accounted for 56 (11.1%), prolonged pregnancy for 51 (10.1), obesity for 50 (9.9%), HIV for 50 (9.9%) and tobacco use for 42 (8.3%) in 2013. The difference was statistically significant (p < 0.001). In 2005, the main intrapartum risk factors were fetal distress (23.6%), failure to progress and preterm labour (18% each). In 2013, fetal distress was most common (36.2%), followed by failure to progress (16.7%). The difference is statistically significant (p=0.034). Conclusion: The Cape Town Metro West health system features a functional maternity referral system. Midwives perform well in referring pregnant women who meet the criteria for high risk. There has been an increase in the number of women referred to the MMH over the study period but in this study group all referrals were found to be appropriate and were compliant with relevant obstetric management protocols. It appears there have not been large shifts in the demographics of referred women over the period reviewed. In addition, the change in the referral pathway has seen Southern Peninsula and Retreat referring to MMH but Khayelitsha no longer referring there. Furthermore, there are emerging risk factors that reflect the epidemiological changes currently being observed in the Cape Town Metro West region.
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Forshaw, Timothy James. "An investigation into the validity of life tables used for the calculation of personal injury damages." Thesis, Rhodes University, 2013. http://hdl.handle.net/10962/d1008371.
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Currently in South Africa when an individual is injured due to the acts of another they may claim damages for the losses which they may incur. These can be claimed from a variety of institutions, such as the Road Accident Fund, Workmen's compensation or an individual's private insurance. In all the afore-mentioned cases the calculation of damages are along the same lines, whereby the damages are quantified first, and thereafter reduced to reflect future possibilities that may occur. Traditionally future losses are reduced to reflect the possibility that the claimant may die at an age prior to the loss being incurred. To account for this risk awards for future losses are reduced using standard South African mortality tables. The set of tables currently being used were calculated from the 1985 South African census, and as such encapsulate the mortality of the population at that period. When the tables were calculated no reliable statistics were available for the Black population the result is that the tables currently being used do not contain a sample of the majority of the population. The thesis first examines, in detail, the calculation methods used to arrive at the value for damages to be awarded using the current set of life tables. Thereafter an analysis is conducted looking at differences between racial groups in the country and geographic locations, in order to uncover the mortality differences between groups to confirm or disprove the proposition that the exclusion of the Black population results in lower levels of mortality being reflected in the South African 1984-1986 life tables. This is accompanied by a review of mortality trenps in South African since 1986. Following from the findings of the expected increase in mortality since 1986, alternative life tables shall be used to show what impact these would have on the calculation of damages. Due to the fact that none of the alternatives return satisfactory results, structured settlements shall be reviewed to illustrate how the shortcomings of the lump sum approach can be circumvented, and altogether avoid the problems of out dated life tables being used as a basis for damage calculations.KMBT_363
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Katzenellenbogen, Judy Masha. "An historical demographic investigation into mortality in three historical birth cohorts born between 1837 and 1900 in Mamre, with special reference to life expectancy." Master's thesis, University of Cape Town, 1990. http://hdl.handle.net/11427/27192.
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This thesis reports on an historical prospective study of three Mamre decadal birth cohorts (1837-1846, 1870-1879, and 1900-1909) constructed retrospectively through existing parish records of the Moravian Mission at Mamre in the Western Cape region of South Africa. Nominative data collection techniques were used to gather information needed to determine the infant mortality rates, quinquennial mortality rates and life expectancies of the three cohorts. Issues related to the quality of data – non-registration and follow-up - were investigated. Birth registration was best for the 1837-46 cohort for males and females, with the 1900-1909 registration being next best. Overall, male registration coverage was substantially better than that for females. Infant death registration was best for males in these 2 cohorts, but were poor for females. Based on these data, the infant mortality rates for the cohorts born in 1837-1846, 1870-1879 and 1900-1909 - 196, 182 and 128 per 1000 respectively for males and 160, 172 and 97 per 1000 respectively for females - appeared to be underestimates. There is some evidence of a downward trend for the infant mortality rates with time for males, but this was not statistically significant. Quinquennial mortality rates for the 3 cohorts did not differ statistically, and are similar to the 1935-37 national 'coloured' figures. The life expectancies also did not differ significantly between cohorts. The life expectancies at birth (range 34- 40 years for males and 32-45 years for females) were probably overestimates due to biased IMR's. The life expectancies at age 1 (range 41-44 for males and 37-49 for females) were more representative figures. Life expectancies at age 20 were fairly stable over time (37-45 years) except for females in the 1900-1909 cohort whose life expectancies were substantially higher than earlier figures. All mortality indices investigated in this study consistently showed a lighter burden of mortality in historical Mamre compared to 'coloureds' in the Cape Colony at the turn of the century. This is probably associated with the better housing, environmental, social, economic and educational conditions at the Mamre mission relative to the rest of the Colony in the century after the emancipation of slaves.
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Mdivasi, Vuyokazi. "The ethical conduct of employees in maternity wards at selected public hospitals in the Western Cape, South Africa." Thesis, Cape Peninsula University of Technology, 2014. http://hdl.handle.net/20.500.11838/1645.
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Mini-thesis submitted in partial fulfilment of the requirements for the degree
Master of Technology: Public Management
in the Faculty of Business
at the Cape Peninsula University of Technology
2014Maternity service in South Africa faces particular problems in the provision of care to birthing mothers. Violence and abuse have been reported and maternity death rates are high, being related to inadequate provision of care (Myburgh, 2007:29). Ethical conduct plays a significant role in service delivery in Midwife Obstetrics Units (MOU) in general. This is of particular importance since every patient, especially pregnant women, should to be handled with the utmost care, respect and dignity. The research problem emanates from nurses’ behaviour towards patients in MOU labour wards, where women continue to be victims of abuse. Ironically, it is regrettable that they are abused by those who are supposed to be their advocates. The objectives of the study were to assess if nurses in MOU labour wards conduct themselves ethically when dealing with patients, to determine the perceptions of patients towards nurses during child birth stages, as well as to examine factors in maternity wards that may influence a nurse’s performance when dealing with patients. The study adopted the quantitative research method to answer the research question and data interpretation was based on statistical analysis. This method was deemed to be the most effective for collection of a large quantity of data and numerical (quantifiable) data is considered objective. A Likert-type questionnaire comprising closed-ended questions was the measurement instrument. This was considered to least inconvenience nurses and postnatal patients to whom these questionnaires were administered. Answer choices were graded from 1 to 4, being strongly agree, agree, disagree and strongly disagree. The population comprised nurses and postnatal patients in MOUs in the Western Cape, South Africa. Consecutive sampling was conducted in two selected MOUs, being Michael Mapongwana (MM) and Gugulethu (GG), with 311 questionnaires being distributed to both nurses and postnatal Patients in these two facilities. The findings indicated that the ethical conduct of nurses in both MM and GG maternity wards was relatively good. However, some survey findings revealed some unsatisfactory gaps that exist in what both hospitals currently offer to patients in the areas of individual patient care, communication and baby security certainty. Furthermore, the findings indicated that a significant number of patients who chose to make use of MM and GG hospitals, are satisfied with the standard of service received during their stay. However, there were some discrepancies in terms of senior management service where excellence in the monitoring role emerged as being lacking. There is a need for improvement in the current levels of ethical conduct of nurses in both the MM and GG labour wards. These needs for improvement relate to working conditions, especially linked to the human resource (HR) function, leadership and management functions, and improved monitoring and control mechanisms.
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Lori, Jody Rae. "Cultural Childbirth Practices, Beliefs and Traditions in Liberia." Diss., The University of Arizona, 2009. http://hdl.handle.net/10150/193885.
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Over 500,000 maternal deaths occur globally each year. Over half of these deaths take place in sub-Saharan Africa. The purpose of this study was to understand the sociopolitical and cultural context of childbirth in Liberia including practices, beliefs and traditions that influence maternal health, illness and death. The concepts of vulnerability, human rights related to reproductive health, gender-based violence and war trauma within the theoretical perspectives of global feminism provide the framework for this study. Critical ethnography was used to study 10 cases of severe maternal morbidity and eight cases of maternal mortality. Data collection included participant observation, field notes and semi-structured, in-depth interviews with 54 women, family members and community members. Three major themes derived from the data were Secrecy Surrounding Pregnancy and Childbirth; Power and Authority; and Distrust of the Healthcare System. The interpretive theory, Behind the House, generated from data analysis provides an effective way of understanding the larger social and cultural context of childbirth and childbirth related practices, beliefs and traditions in Liberia. It defines the complexity and challenges women in Liberia face in their reproductive health. This interpretive theory moves beyond the biomedical understanding of birth by contextualizing childbirth as a social as well as a biological process. This study provides a starting point for more relevant, sensitive and culturally congruent public health programs and policies to address maternal morbidity and mortality in this population.
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Makalima, Phaphama. "Female university students’ perceptions of the effects of maternal loss on their identity and intimacy development." Thesis, Nelson Mandela Metropolitan University, 2017. http://hdl.handle.net/10948/18090.
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Early maternal loss and its effects on daughters’ development has generated interest internationally. Yet very few studies have been conducted within South Africa, even though the prevalence of South African children growing up with the loss of their mothers is on the increase particularly due to HIV and Aids. This field of study is particularly important as mothers play a significant developmental role in children’s wellbeing. This study focused on exploring NMMU female students’ perceptions of the effects of maternal loss before adolescence on their identity and intimacy development. A qualitative research approach was followed in order to gain in-depth understanding regarding these perceived effects. A purposive, non-probability sampling method was employed to select participants and semi-structured interviews were conducted with them to explore and describe their perceptions. Attachment theory was utilised to provide a theoretical understanding of the potential impact of such loss on identity and intimacy development. Erikson’s psychosocial development theory was employed to describe the nature of personal identity and intimacy. The role of mothers in the South African context is perceived to be of importance with much focus on daughters’ identity development. Childhood maternal loss for daughters was perceived to effect the identity formation of participants in the study. The majority of participants perceived not having been able to spend enough time with their biological mothers to have limited their self-exploration. The participants perceived that this loss also had an effect on their intimacy as it isolated them from their peers and available support systems due to the fear of experiencing losing a person again in their lives.
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Matji, Joan Nteboheleng. "Association between postnatal maternal nutritional status, maternal HIV disease progression and infant feeding practices in 4 clinics in Pretoria, South Africa." Pretoria: [s.n.], 2009. http://upetd.up.ac.za/thesis/available/etd-03082010-090805/.
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Matizirofa, Lyness. "Perceived quality and utilisation of maternal health services in peri-urban, commercial farming, and rural areas in South Africa." Thesis, University of the Western Cape, 2006. http://etd.uwc.ac.za/index.php?module=etd&.
Full textAbstract:
This investigation aimed to determine factors that influence women's utilisation of maternal health services, with specific focus on the quality of care and services available to disadvantaged communities in South Africa. It used the women's perspectives to assess the quality of maternal healthcare services in peri-urban commercial farming and rural areas with the purpose of understanding why women utilise maternal services the way they do.
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Kahn, Kathleen. "Dying to make a fresh start : mortality and health transition in a new South Africa." Doctoral thesis, Umeå : Univ, 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-928.
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Beamish, Esme Kilroy. "Causes and consequences of mortality and mutilation in the Cape Peninsula baboon population, South Africa." Master's thesis, University of Cape Town, 2009. http://hdl.handle.net/11427/6230.
Full textAbstract:
Includes abstract.Includes bibliographical references (leaves 52-62).
In the Cape Peninsula, South Africa, the population of chacma baboons (Papio ursinus) has become locally fragmented and geographically isolated from all other populations in the Western Cape. A census performed in 1999 revealed a baboon population under severe human predation pressure with high levels of permanent injury and mortality, in addition to an adult sex ratio strongly biased towards females. There was no data on the causes or the distribution of deaths and permanent injuries on the Peninsula to inform management decisions. The aim of this study was thus to: a) quantify the frequency, distribution and causes of permanent injuries (mutilations) and deaths within the Cape Peninsula baboon population, and b) to quantify whether mutilations, affect the behaviour, diet and reproductive success of baboons.
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Shea, Robert F. "An exploration of disclosure and non-disclosure patterns in HIV-infected children in Cape Town, South Africa." Master's thesis, University of Cape Town, 2018. http://hdl.handle.net/11427/29479.
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A cross-sectional, descriptive study combining with open-ended (qualitative) interview questions with quantitative component was conducted to explore disclosure experiences of mothers and caregivers of HIV-infected children. The study was conducted with 102 parents and caregivers at a tertiary hospital in Cape Town delivering care to 303 HIV-infected paediatric patients. The study sample included 102 participants, ranging in age from 16 years to 71 years. The sample included 73 mothers (72%), six fathers (6%), 11 foster-mothers (11%), and 12 caregivers or grandmothers (12%). The median age of participants’ children was 4 (IQR 2-8) years and ranged from five months to 16 years. Only 48 (47%) were old enough for disclosure to be possible. Disclosure or disclosure delay was associated with several factors, including the child’s age or ability to understand, anxiety and guilt about being blamed for infecting the child, fear of exposing the child to stigma, discrimination and social exclusion related to the child disclosing to others, and the hope that the child would be adherent if they understood their illness and the way in which the medication could improve their health outcomes. Only 16 (33%) of 48 participants actually disclosed the child’s HIV status. The results indicate that HIV-disclosure remains a challenging, emotionally-charged experience for mothers and caregivers. The findings of this research, and similar studies, point to the value of integrating disclosure support and planning into routine care for children and adolescents, as well as their parents and caregivers.
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Josephs, Tracey. "Patterns of mortality in children presenting to a tertiary paediatric emergency unit in Sub-Saharan Africa: a cross sectional study." Master's thesis, Faculty of Health Sciences, 2020. http://hdl.handle.net/11427/32283.
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Background Pneumonia, diarrhoea and perinatal factors are the foremost killers of South African children as in other low- and middle-income countries. Poverty, poor access to care and pre-hospital care are reported major pre-hospital factors and lack of triage, poor skills, delays, poor adherence to treatment protocols and inadequate emergency care determining mortality have been reported to increase in-hospital mortality. Objectives To describe the clinical presentation and management of children admitted via the medical emergency unit (MEU) of the Red Cross War Memorial Children's Hospital (RCWMCH) who subsequently died. Methods We did a retrospective study undertaking a cross-sectional review of children who died following admission via RCWMCH MEU in 2008. Demographic information, clinical data, time factors and mortality data were reviewed and summarised by descriptive and inferential statistics. The unit utilised the WHO Emergency Triage Assessment and Treatment (ETAT) triage tool, categorising children into Red (emergency), orange (priority) and Green (non-urgent). Patient management was assessed by means of ETAT and the Integrated Management of Childhood Illness (IMCI) tools, which is used to identify severity of illness and strategize treatment plans accordingly. Results A total of 135 children met the inclusion criteria. The crude mortality rate was of 6.25 per 1000 admissions. Of the 135 children who died, 119 (88%) were under five years of age, 33(24%) were HIV-infected, of whom (88%) were under 5 years old. In 67 (50%), a chronic medical condition could be identified while 67 (50 %) were moderately or severely malnourished. There were 29 (22%) deaths within 24 hours of arrival at the MEU. Fifty-five (41%) presented after hours. Community health centres referred 65 (48%) patients, general practitioners referred 20 (15%) and 38 (28%) were self-referred. Ambulance services provided pre-hospital transport to 69 (51%). The two top presenting illnesses in 88 (65%) of the children were acute respiratory illness and acute gastroenteritis. Prior to referral, oxygen was not provided in 57 (59%) children, 35 (71%) with suspected sepsis did not receive antibiotics and glucose was not checked in 39 (80%) with depressed level of consciousness. The median time to ward transfer was 3.23 (IQR: 2.12-4.92) hours. Twelve deaths (9%) occurred in the MEU, 57 (42%) in PICU, 56 (42%) in medical wards and 10 (7%) in specialist wards. The five most common causes of death were acute respiratory infections in 45 (33%), acute gastroenteritis in 27 (20%), septicaemia 22 (16%), meningitis in 13 (10%) and cardiac conditions in 12 (9%) children. Conclusion The top causes of mortality in this hospital cohort in 2008 were pneumonia, acute gastroenteritis, and septicaemia. Using the IMCI and ETAT standard of care, suboptimal management was identified in pre-hospital management, as well as MEU management. Appropriate training and protocol implementation to improve morbidity and mortality should be undertaken.
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Ozodiegwu, Ifeoma D., Hadii M. Mamudu, Liang Wang, Rick Wallace, Megan Quinn, Ying Liu, and Henry V. Doctor. "Country-Level Analysis of the Association Between Maternal Obesity and Neonatal Mortality in 34 Sub-Saharan African Countries." Digital Commons @ East Tennessee State University, 2019. https://doi.org/10.5334/aogh.2510.
Full textAbstract:
Background: Prior work examining the association of maternal obesity and neonatal mortality indicate the presence of a positive relationship. However, regional evidence to provide insight on country-level heterogeneities within sub-Saharan Africa (SSA) with nationally representative datasets are non-existent.
Objective: We aimed to determine the relationship between maternal obesity and neonatal mortality at the country level in SSA countries. Moreover, we also estimate regional measures of association to complement previous findings.
Methods: Demographic and Health Survey (DHS) data from 34 SSA countries conducted from 2006–2016 were used for this study. After missing data (36.9% of cases) were addressed with multiple imputations, we identified a total of 175,860 women for the analysis. Complete case and multiply imputed datasets were analyzed individually with multilevel logistic regression models. Potential confounders adjusted for in the regression model included maternal age, level of educational attainment, area of residence, access to prenatal care, birth order and multiple birth (singleton vs twin birth). Regional and country-specific associations were computed, and unadjusted and adjusted odds ratios (ORs), along with the confidence intervals (CIs) were reported.
Findings: Of the total study population, 8,451 (7.6%) were obese. In the regional level analyses, maternal obesity was associated with 40% increased odds of neonatal deaths. This finding was consistent in subgroup analyses by urban and rural residence, and geographic region of residence in SSA. Additionally, obese women were more likely to report neonatal death in the first week of life (OR, days 0–1: 1.39, 95% CI 1.15–1.69; OR, days 2–6: 1.35, 95% CI 1.02–1.79). In the individual country analyses, majority of the countries studied had central estimates supporting elevated odds of neonatal mortality, but the confidence intervals were imprecise.
Conclusion: This study highlights the potential burden of neonatal mortality borne by obese women in SSA. There is, however, a need for longitudinal studies to confirm the results.
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Matanyaire, Sandra D. "The AIDS transition: impact of HIV/AIDS on the demographic transition of black/African South Africans by 2021." Thesis, University of the Western Cape, 2004. http://etd.uwc.ac.za/index.php?module=etd&.
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The first two official AIDS cases were diagnosed in South Africa in 1982. During the same period of the 1980s, the black/African population was experiencing an accelerated fertility decline, following a period of accelerated mortality decline. Demographers invoked the demographic transition theory to explain the observed mortality and fertility decline. According to the demographic transition theory, mortality and fertility rates would continue declining to low, post transitional levels with increasing modernization. The relatively higher prevalence of HIV/AIDS estimated among black/African South Africans is expected to alter their demographic transition. This research investigated the impact of HIV/AIDS on the demographic transition of black/Africans by 2021.
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Derry, Christopher William. "The relationship between the hardness of potable water and cardiovascular and ischaemic heart disease mortality in South African urban areas." Master's thesis, University of Cape Town, 1987. http://hdl.handle.net/11427/25808.
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Studies carried out in a number of countries have revealed statistically significant negative correlations between death rates from cardiovascular disease (CVD) or ischaemic heart disease (IHD), and the hardness of local water supplies, a phenomenon which is known as the "water story". These findings have not, however, been universal and it was decided that a study carried out in South Africa with its high CVD and IHD death rates, might yield meaningful results to contradict or support existing findings. In 1983 a pilot study was thus initiated using a spatial model and a more detailed study began in 1984. This study ultimately involved the correlation of standardized mortality ratios (SMRs) for CVD and IHD with total water hardness and with a number of contributory and associated water quality factors. The study supported the hypothesised "water story", showing the existence of negative correlations between standardized mortality ratios (SMRs) for both CVD and IHD, and the hardness of potable water, whether measured as total hardness or as its two major contributory cations, calcium and magnesium. The level of statistical significance at which this correlation occurred, however, varied with differences in methodological approach. A "population-unweighted" methodology, which was applied to enable comparison with a number of previously published studies, pointed to potassium (a known hypertension normalisor) in permanently hard water as being an important factor. Problems inherent to each methodological approach have been discussed as has the need for improved data. In this regard, the need for a National water quality data bank has been emphasised.
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Flisher, Alan John. "Studies in behavioural epidemiology." Master's thesis, University of Cape Town, 1994. http://hdl.handle.net/11427/26740.
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Collection of papers submitted to the Faculty of Medicine, University of Cape Town, in
fulfilment of the requirements of Part III of the Degree Master of Medicine in Psychiatry.The following five papers are included in this collection. Paper 1. Flisher AJ, Joubert G, Yach D. Mortality from external causes in South African adolescents, 1984 - 1986. South African Medical Journal 1992; 81: 77-80. Paper 2. Flisher AJ, Chalton DO. High school dropouts in a working-class South African community: selected characteristics and risk-taking behaviour. Journal of Adolescence (in press). Paper 3. Flisher AJ, Roberts MM, Blignaut RJ. Youth attending Cape Peninsula day hospitals. Sexual behaviour and missed opportunities for contraception counselling. South African Medical Journal 1992; 82: 104-106. Paper 4. Flisher AJ, Parry CDH. Suicide in South Africa. An analysis of nationally registered mortality data for 1984-1986. Acta Psychiatrica Scandinavica (in press). Paper 5. Flisher AJ, Parry CDH, Bradshaw D, Juritz J. Suicide in South Africa - seasonal variation. Acta Psychiatrica Scandinavica (to be submitted) .
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Mee, Paul. "Who died, where, when and why? : an investigation of HIV-related mortality in rural South Africa." Doctoral thesis, Umeå universitet, Epidemiologi och global hälsa, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-108610.
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Background South Africa has experienced the most severe consequences of the HIV/AIDS pandemic. Every community has been affected in some way, many experiencing huge increases in mortality,particularly before antiretroviral therapies (ART) were readily available. However, the micro-level understanding of the HIV epidemic in South Africa is weak, because of a lack of detailed data for most of the population. This thesis is based on detailed individual follow-up in the Agincourt Health and Demographic Surveillance Site (HDSS) located in the Agincourt subdistrict of Mpumalanga Province and investigates micro-level determinants of HIV epidemiology and the impact of treatment provided. Methods The Agincourt HDSS has followed a geographically defined population since 1992,approximately the time when the HIV/AIDS epidemic first became apparent. This population based surveillance has included capturing details of all deaths, with cause of death determined by verbal autopsy, as well as the geographical location of individual households within the overall Agincourt area. Background information on the roll-out of ART over time was also recorded. Results A comparison immediately before and after the major roll-out of ART showed a substantial decrease in HIV-related mortality, greater in some local communities within the area than others. Individual determinants associated with a decreased risk of HIV/AIDS mortality included proximity to ART services, as well as being female, younger, and in higher socioeconomic and educational strata. There was a decrease in the use of traditional healthcare sources and an increase in the use of biomedical healthcare amongst those dying of HIV/AIDS between periods before and after the roll-out of ART. Conclusions Understanding micro-level determinants of HIV/AIDS infection and mortality was very important in terms of characterising the overall epidemic in this community. This approach will enable public health interventions to be more effectively targeted towards those who need them most in the continuing evolution of the HIV/AIDS epidemic.
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Navaratnarajah, Paramalingam Kandasamy. "Child malnutrition mortality at St Barnabas Hospital is high - is it due to practices and attitudes of staff?: a study in a rural district hospital." Thesis, University of the Western Cape, 2004. http://etd.uwc.ac.za/index.php?module=etd&.
Full textAbstract:
The case fatality rate for malnutrition at St Barnabas Hospital over the past years has been around 38%. The rates in other district hospitals in the Eastern Cape province were found to be in excess of 30%. In June 2000, the Eastern Cape Department of Health introduced a protocol for in-patient management of children with severe malnutrition, with the aim of reducing case fatality rate below 10%. St Barnabas Hospital introduced the Eastern Cape protocol in August 2003. An evaluation was done in November 2003 to assess the protocol's impact on the case fatality rate. The rate remained high, at 37.5%. This study descibed the current practices and attitudes of the nurses as St Barnabas Hospital paediatric ward, in the management of severely malnourished childen.
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Visser, Elke. "The impact of South Africa's largest photovoltaic solar energy facility on birds in the Northern Cape, South Africa." Master's thesis, University of Cape Town, 2016. http://hdl.handle.net/11427/20843.
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Renewable energy is a promising alternative to alleviating fossil fuel-based dependencies, but its development can require a complex set of environmental trade-offs for bird communities in the area, ranging from effective and physical habitat loss to direct collision-related mortality. The wide variation in the nature and significance of predicted impacts of utility-scale photovoltaic (PV) facilities on birds, and the low levels of confidence attending these predictions, has emphasised the need for scientific research. This study assesses the risks to bird populations and guilds at one of South Africa's largest PV developments. Firstly, in order to identify functional and structural changes in bird communities in and around the development footprint, bird transect data were gathered, representing the solar development, boundary, and untransformed landscape. Secondly, to assess the risk of collision mortality with solar-related infrastructure, representative samples (core vs. edge) were surveyed for bird carcasses and other signs of collision for three months covering 20-30% of the facility at search intervals of 4, 7 and 14 days. In order to account for potential biases in carcass detection, searcher efficiency and carcass persistence trials were conducted. The distribution of birds in the landscape changed, from a shrubland to open country and grassland bird community, in response to changes in the distribution and abundance of habitat resources such as food, water and nesting sites. These changes in resource availability patterns were detrimental to some bird species and beneficial to others. Shrubland specialists, such as the black-chested prinia (Prinia flavicans) and chestnut-vented tit-babbler (Parisoma subcaeruleum), appeared to be negatively affected by the presence of the PV facility. In contrast, open country/grassland and generalist species, especially species such as the Cape sparrow (Passer melanurus) and familiar chat (Cercomela familiaris), were favoured by its development. Utility-scale PV facilities inevitably will not substitute for the natural habitats they have replaced, but might offer opportunities for climate protection that do not necessarily conflict with nature conservation. Monitoring success of avian mortality was significantly influenced by variation in detection rates by size class (60 and 95% for birds <100 g and >100 g, respectively) and the location of carcasses relative to the solar panel units (65 and 90% for birds adjacent and under the units, respectively) as well as decreasing persistence rates per search interval (57, 53, and 40% after 4, 7, and 14 days, respectively). Only injuries associated with non-fatal collision of large-bodied birds with the underside of the panels and entrapment between fencing could be concluded with reasonable certainty. An extrapolated fatality estimate of 4.53 fatalities.MW⁻¹.yr⁻¹ (95% CI 1.51-8.50), short study period, and lack of comparable results from other sources made it difficult to provide a meaningful assessment on avian mortality at PV facilities. Despite these limitations, the few bird fatalities that were recorded might suggest that there is no significant link with collision-related mortality at the study site. In order to fully understand the risk of solar energy development on birds, further collation and analysis of data from solar energy facilities across spatial and temporal scales, based on scientifically rigorous research designs, is required.
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Mukondeleli, Livhuwani Ellen. "Factors associated with maternal mortality in South Africa (2003-2008)." Diss., 2015. http://hdl.handle.net/11602/285.
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Nabukalu, Doreen. "Mortality in women of reproductive age in rural South Africa." Thesis, 2012.
Find full textAbstract:
A research report submitted to the Faculty of Health Sciences, University of the
Witwatersrand, Johannesburg, in partial fulfilment of the requirements of the award of
the Masters in Science in Epidemiology in the field of Population-based Field
Epidemiology
April 2012Objective: To determine the causes of death and associated risk factors in women of reproductive age in rural South Africa. . Methods: The study population comprised all female members aged 15-49 years of 11 000 households of a rural South African Health and Demographic Surveillance Site from 2000-2009. Deaths and person-years of observation (pyo) were determined for individuals between 01 January 2000 and 31 December 2009. Cause of death was ascertained by verbal autopsy interviews, based on ICD-10 coding; cause of death were broadly categorized as AIDS/TB causes, Non-communicable causes, Communicable/maternal/perinatal/nutrition causes, Injuries and another category of undetermined (unknown) causes of death. Overall and cause specific mortality rates (MR) with 95% confidence intervals (CI) were calculated. Cox proportional hazard regression (HR, 95% CI) was used to determine risk factors associated with overall and cause-specific mortality. Results: 42703 eligible women were included; 3098 deaths were reported for 212607 person-years (pyo) of observation. Overall MR was 14.57 deaths/1000 pyo (CI;14.07-15.09), increasing from 2000-2003 (2003: MR;18.15, CI;16.41-20.08) and subsequently decreasing (2009: MR; 9.59, CI;8.43-10.91) after introduction of antiretroviral treatment (ART) for HIV in public health system facilities in South Africa in 2004. Mortality was highest for AIDS/TB (MR;10.66, CI;10.23-11.11) and the cause of death for 73.1% of all recorded deaths. Maternal mortality was 0.07 (CI; 0.04-0.11). Women aged 30-34 years had the highest MR due to AIDS/TB (MR; 20.34/1000 pyo), women aged 45-49 years due to other causes (MR; 4.29/ 1000 pyo). v In multivariable analyses, external migration status was associated with increased hazards of all cause mortality (HR; 1.87, CI; 1.56-2.26) and other causes of mortality (HR; 1.782, CI; 1.24-2.57). Self reported poor health was significantly associated with increased hazards of all cause mortality (HR; 11.052, CI; 4.24-28.82) but not with mortality due to other causes. Positive HIV status was associated with increased hazards of all cause mortality (HR; 8.53, CI; 6.81-10.67) and other causes of mortality (HR; 2.84, CI; 1.97- 4.09). Conclusion. AIDS was the main cause of death in the current study, with mortality rates declining since introduction of ART for HIV in public health facilities in the surveillance area in 2004. Further ART roll-out, increased community awareness and sensitisation messages are still needed to reduce the spread of HIV and other sexually transmitted diseases.
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Nagai, Richard Afedi. "Levels and factors associated with maternal death in Agincourt, a rural sub-district of Mpumalanga Province, South Africa." Thesis, 2012. http://hdl.handle.net/10539/11309.
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M.Sc. (Med.) (Epidemiology and Biostatistics), Faculty of Health Sciences, University of the Witwatersrand, 2011Introduction: The reduction of maternal death is a high priority for the international community, especially in view of the increased attention to Millennium Development Goal 5 Maternal mortality in developing countries has been estimated at 400 per 100,000 live births whereas levels in most developed countries are below 25 per 100,000 live births. According to the World Health Organization (WHO), at least 500,000 women worldwide die every year from complications of pregnancy, abortions and delivery. Objectives: The study main objectives were to establish the maternal mortality ratio and trend from 1993 to 2006 in the rural Agincourt sub-district; to describe the main causes of death of women of reproductive age from 1993 to 2006; and to identify socio-demographic factors associated with maternal death among rural pregnant women 15-49 years. Methods: A retrospective cohort design was employed using secondary data collected as part of the Agincourt health and socio-demographic surveillance system. The total cohort size of 25,061 women who were pregnant was identified. Logistic regression was used in ascertaining which factors were associated with maternal death. Results: Seventy maternal deaths were identified. There was an increasing risk of maternal death with increasing maternal age and parity. The maternal mortality ratio for the 14-year period was 287/100,000 live births and the trend was statistically significant. HIV/AIDS, respiratory tuberculosis and other ill-defined conditions were the major causes of death across the age groups with over 70% of all deaths of women of reproductive age related to HIV/TB. Conclusion: Maternal mortality ratio increased per year from 1993 to 2006. Communicable diseases (largely HIV/AIDS) have emerged as the most common causes of death of women of reproductive age in the Agincourt sub-district, with major risk factors being increasing maternal age, complication during delivery, antenatal care visits and mother’s socio-economic
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Buwembo, Peter. "Factors associated with under-5 mortality in South Africa : trends 1997- 2002." Diss., 2009. http://hdl.handle.net/2263/28242.
Full textAbstract:
The objective of this study is to investigate the trends in relative contribution each selected factor makes to the chance of a child’s death over time in South Africa for children born 5 years preceding 1997 and 5 years preceding 2002. Attention was paid to the role played by socio-economic factors, biological and maternal factors, environmental factors, nutrient deficiency factors and health seeking behaviour factors. The study investigates whether the association of a specific factor to under-5 mortality persist over time. Data from the 1997 October Household Survey and the 2002 General Household Survey were used. Births that occurred in the five years preceding each survey were analysed in relation to the survival of the child and socio-economic factors, biological and maternal factors, environmental factors, nutrient deficiency factors and health seeking behaviour factors. Logistic regression was used to determine the relative contribution of each factor for the two periods under review. Under-5 mortality was significantly associated with eight factors during 1993-1997 period namely; mother’s education, mother’s place of residence, sex, birth order, birth interval, mother’s age at the time of delivery of the subject child, nutrient deficiency and place of delivery. However, during the 1998-2002 period only five factors were significantly associated with under-5 mortality. These were mother’s education, sex, birth interval, type of dwelling and place of delivery. This suggests changing patterns in factors associated with under-5 mortality between the two birth cohorts: 1993-1997 and the 1998-2002 birth cohorts.Dissertation (MSocSci)--University of Pretoria, 2010.
Sociology
unrestricted
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Makumi, Anne Njeri. "Association between maternal factors and survival patterns of children, in rural Kwazulu-Natal, South Africa, 2004-2011." Thesis, 2014.
Find full textAbstract:
Globally, child mortality is a great concern, especially in resource-limited settings.
The Millennium Development Goal (MDG) 4 was set with an aim to reduce under-5
child mortality by two-thirds between 1990 and 2015. This study examines mortality
trends in infants, 1-4 and above 5-year-old children in rural KwaZulu-Natal, South
Africa, the causes of death as well as the association of maternal HIV status and
Antiretroviral Treatment (ART) usage to child mortality.
We use a longitudinal birth cohort study design of children born between 1st January
2004 and 31st December 2010, in the Africa Centre Demographic Surveillance Area
(DSA) in rural KwaZulu-Natal, South Africa. Children had to have been resident in
the DSA at the time of birth.
A total of 12,413 children born in the study period were eligible for this study. The
main outcome measure was mortality either in infancy, the 1-4 year period or at 5 and
above years of age, while assessing its association with maternal HIV and
Antiretroviral Treatment uptake (ART) status on a time-varying basis. A total of 619
children died during the study period and mortality was observed to be highest in the
infant group with 67% of the children dying in infancy. Fifteen percent of mothers
were HIV positive at the time of birth of the child, about 59% were HIV negative
while the HIV status of the rest was unknown.
There was a three-fold increase in mortality observed for both infants and 1-4 year
olds, who had mothers who were HIV infected compared to children whose mothers
were HIV negative (p<0.05). Children whose mothers were on Antiretroviral
Treatment (ART) however had a reduced mortality compared to those whose mothers
were not on treatment. Infants and 1-4year olds whose mothers HIV status was not
reported had a two-fold increase in mortality. Low maternal education, single
motherhood, multiple births and parity of four or more children were also associated
with increased child mortality.
We concluded that although mortality varied by the age of the child, children born to
mothers who were HIV positive had higher mortality rates than children born to HIV
negative mothers but being on Anti Retroviral Treatment (ART) reduced children
mortality. Interventions targeting HIV positive pregnant women and mothers should
be carried out in the study area, with specific emphasis on reducing child mortality
associated with maternal HIV status.
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Netshikweta, Livhuwani. "Perceived factors contributing to maternal mortality among women in health services in Musina Municipality, Limpopo Province." Diss., 2018. http://hdl.handle.net/11602/1172.
Full textAbstract:
MCurDepartment of Advanced Nursing Science
● BACKGROUND Maternal Mortality rate is defined as the death of a woman while pregnant within 42 days of termination of pregnancy irrespective of the duration/site of the pregnancy. South Africa like any other country, has high maternal mortality rate. Most deaths are caused by factors attributed to pregnancy and childbirth in health facilities. It is the practice in all public hospitals and clinics that women are discharged ±6 hours after delivery hence most problems are not detected thus the complications they may be having such as thromboembolism or sepsis that may arise during the post-partum period. ● AIM OF THE STUDY The purpose of the study was to determine perceived factors contributing to maternal mortality among women in rural areas of Musina Municipality within Limpopo Province. ● METHODS A quantitative, descriptive, exploratory, cross- sectional research was used to conduct the study. The target population consisted of all pregnant and lactating women who attended the sampled clinics (ANC) in Musina Municipality. Self- Administered questionnaire was used to collect data from the women who met the criteria for inclusion. A total of 342 women were recruited to participate in this research from all five (5) health iv facilities. Collected data was analysed using SPSS Version 23.0 computer software with the assistance of a Statistician. ● FINDINGS Findings of this study revealed that majority of the respondents 215 (53.0%) reported late booking for Ante-Natal Care (ANC), among the late booking 120 (25.0%) commenced ANC attendance at second trimester, while 95 (12%) commenced ANC at last trimester and only attended once only. Minority of the respondents 127 (24.2%) reported that they never attended ANC because of various reasons cited such as not accessing clinic because of distance and not having transport. Majority 232 (83.5%) of the respondents revealed that professional nurses ‘attitudes and unwelcoming postures make them to report during labour than attending ANC. Of the respondents, 49 (17.6%) reported lack of knowledge on engorged breast and mastitis. Various socioeconomic and knowledge factors influenced women, (28.5%) women indicated long distance to health facility, while (12.5%) arrived in labour ward with head on perineum because labour started suddenly, lack of money and transport by (48.4%). ● RECOMMENDATION Recommendation was made on the importance of in-service training of professional midwives on interpersonal relation, proper assessment of women to detect any complications. Recommended workshops for training and different courses in order to broaden their knowledge relating to pregnancy and childbirth and management of pre and post-partum. Also awareness sessions for women about dangers signs during puerperium were recommended. ● CONCLUSION This study has identified several factors that have an important influence on maternal mortality in the study area. Among these are variables such as place of consultation/diagnosis, the person who pays the treatment costs, awareness of pregnancy complications and knowledge of the place of ANC treatment, among others.
NRF