An appraisal of strategies to mitigate related to non-communicable diseases of the eye: a case study of Michael Mapongwane Health Clinic in Khayelitsha, Western Cape Metro District
- Authors: Ngcebetsha, Avela Ayanda
- Date: 2022-03
- Subjects: Chronically ill--Care , Ophthalmic nursing
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/22908 , vital:53186
- Description: Preventive and curative eye-care services are a critical component of care for patients diagnosed with chronic diseases. The South African constitution guarantees health as a fundamental human right of all citizens. While most chronically ill patients are managed at the primary health care centers, eye care services are currently contracted to private service providers. The extent to which people, especially the chronically ill patients, have access to eye-care service under the current structure is less understood. The study aims to establish the effectiveness and sustainability of the eye-care service delivery model at the Michael Mapongwane CHC, with specific reference to access to eye-care services. Specifically, the study examined the rate and determinants of eye-care service utilisation, assess user’s satisfaction and perspectives of primary health workers and private service providers regarding the current structure of eye-care services. The study adopted a descriptive and explanatory design, which involved a survey and semi-structured interviews. The survey was conducted among 423 patients attending the two primary health centers selected for this study. Patients with chronic illness were recruited over a period of one month. Overall, 365 patients with chronic illness and 58 patients without chronic illness took part in the study. Descriptive and inferential statistics were used to analyse the quantitative date. Purposive sampling was used to select nine health workers and 10 private eye-care service providers for the semi-structured interviews. The data obtained were transcribed and coded. Thematic content analysis was performed on the qualitative data. The results show that less than half of the respondents (n=168) had ever had an eye test, and an even lower proportion (n=115) had had an eye test in the past two years. Age, female sex, formal rural dwelling, marital status, and income were significantly associated with ever having an eye test done. The results reveal a gross inequality in access to eye care test. Only 19.2% of patients diagnosed with hypertension had had their eyes examined. Even fewer proportions of the patients (8.5%) had had their eyes examined during or after diagnosis for hypertension. Likewise, only one in three patients diagnosed with diabetes has had their eyes examined before or after they were diagnosed with diabetes. The majority of patients who had used the services affirmed that it was easy to access eye care services. While most respondents agreed that waiting time to make an appointment was not too long, over half of them affirmed that waiting to see an eye doctor was too long. Most users were reasonably satisfied with the eye care services received. Primary health care providers highlighted challenges such as work overload, poor infrastructure, and patient’s forgetfulness of the appointment dates as factors affecting access to eye care services in their clinic. The primary challenges the private eye-care service providers experienced were small rooms or inappropriate clinic rooms, language barrier and inadequate support from the clinics. In conclusion, this study has shown that access to preventive and curative health care services was among patients attending primary health care centres, and especially those with chronic illness. The current structure of eye care services makes it difficult for patients to access care and for providers to provide quality care. , Thesis (MPH) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-03
- Authors: Ngcebetsha, Avela Ayanda
- Date: 2022-03
- Subjects: Chronically ill--Care , Ophthalmic nursing
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/22908 , vital:53186
- Description: Preventive and curative eye-care services are a critical component of care for patients diagnosed with chronic diseases. The South African constitution guarantees health as a fundamental human right of all citizens. While most chronically ill patients are managed at the primary health care centers, eye care services are currently contracted to private service providers. The extent to which people, especially the chronically ill patients, have access to eye-care service under the current structure is less understood. The study aims to establish the effectiveness and sustainability of the eye-care service delivery model at the Michael Mapongwane CHC, with specific reference to access to eye-care services. Specifically, the study examined the rate and determinants of eye-care service utilisation, assess user’s satisfaction and perspectives of primary health workers and private service providers regarding the current structure of eye-care services. The study adopted a descriptive and explanatory design, which involved a survey and semi-structured interviews. The survey was conducted among 423 patients attending the two primary health centers selected for this study. Patients with chronic illness were recruited over a period of one month. Overall, 365 patients with chronic illness and 58 patients without chronic illness took part in the study. Descriptive and inferential statistics were used to analyse the quantitative date. Purposive sampling was used to select nine health workers and 10 private eye-care service providers for the semi-structured interviews. The data obtained were transcribed and coded. Thematic content analysis was performed on the qualitative data. The results show that less than half of the respondents (n=168) had ever had an eye test, and an even lower proportion (n=115) had had an eye test in the past two years. Age, female sex, formal rural dwelling, marital status, and income were significantly associated with ever having an eye test done. The results reveal a gross inequality in access to eye care test. Only 19.2% of patients diagnosed with hypertension had had their eyes examined. Even fewer proportions of the patients (8.5%) had had their eyes examined during or after diagnosis for hypertension. Likewise, only one in three patients diagnosed with diabetes has had their eyes examined before or after they were diagnosed with diabetes. The majority of patients who had used the services affirmed that it was easy to access eye care services. While most respondents agreed that waiting time to make an appointment was not too long, over half of them affirmed that waiting to see an eye doctor was too long. Most users were reasonably satisfied with the eye care services received. Primary health care providers highlighted challenges such as work overload, poor infrastructure, and patient’s forgetfulness of the appointment dates as factors affecting access to eye care services in their clinic. The primary challenges the private eye-care service providers experienced were small rooms or inappropriate clinic rooms, language barrier and inadequate support from the clinics. In conclusion, this study has shown that access to preventive and curative health care services was among patients attending primary health care centres, and especially those with chronic illness. The current structure of eye care services makes it difficult for patients to access care and for providers to provide quality care. , Thesis (MPH) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-03
The contribution of efficient financial management on public health service delivery at King Cetshwayo District in KwaZulu Natal
- Authors: Msane, Sihlesabambo Londiwe
- Date: 2022-03
- Subjects: Public health -- Finance
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/21882 , vital:51839
- Description: The aim of this research is to develop strategies that the DOH could put into place to improve its internal controls in financial management in order to contribute towards service delivery at Ngwelezane, Queen Nandi and Eshowe hospitals within King Cetshwayo District. The study used a mix of qualitative and quantitative study methods, however using one research instrument to collect both qualitative and quantitative data from 37 financial managers in these three hospitals. Data analysis using content analysis (of qualitative data) and percentage frequency analysis (of quantitative date) yielded study findings. This study found that financial managers are fairly competent regarding ‘effective communication’, ‘team work’, and ‘financial leadership’; the study results did not show respondents’ clear comprehension of Auditor General findings and processes followed to implement the recommendations in order to assess internal controls; and findings also indicate that financial managers meet objectives of financial management through cash flow, budget forecasts and expenditure. Developing a framework that will guide and monitor the application of financial strategies with the aim of improving service delivery will involve enhancing financial managers’ knowledge of District and Institution Service Delivery Plans, allocating resources properly and efficiently during the budgeting exercise, establishing internal strategies to maximise accountability and transparency, having fraud prevention strategies in these institution, and putting measures in place to be able to forecast budgetary adverse. It is recommended that the Executive Management facilitates strategic break-away sessions for the financial managers to workshop them on practical ways to improve the efficiency of financial management on public health service delivery, as outlined in this study. , Thesis (MPH) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-03
- Authors: Msane, Sihlesabambo Londiwe
- Date: 2022-03
- Subjects: Public health -- Finance
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/21882 , vital:51839
- Description: The aim of this research is to develop strategies that the DOH could put into place to improve its internal controls in financial management in order to contribute towards service delivery at Ngwelezane, Queen Nandi and Eshowe hospitals within King Cetshwayo District. The study used a mix of qualitative and quantitative study methods, however using one research instrument to collect both qualitative and quantitative data from 37 financial managers in these three hospitals. Data analysis using content analysis (of qualitative data) and percentage frequency analysis (of quantitative date) yielded study findings. This study found that financial managers are fairly competent regarding ‘effective communication’, ‘team work’, and ‘financial leadership’; the study results did not show respondents’ clear comprehension of Auditor General findings and processes followed to implement the recommendations in order to assess internal controls; and findings also indicate that financial managers meet objectives of financial management through cash flow, budget forecasts and expenditure. Developing a framework that will guide and monitor the application of financial strategies with the aim of improving service delivery will involve enhancing financial managers’ knowledge of District and Institution Service Delivery Plans, allocating resources properly and efficiently during the budgeting exercise, establishing internal strategies to maximise accountability and transparency, having fraud prevention strategies in these institution, and putting measures in place to be able to forecast budgetary adverse. It is recommended that the Executive Management facilitates strategic break-away sessions for the financial managers to workshop them on practical ways to improve the efficiency of financial management on public health service delivery, as outlined in this study. , Thesis (MPH) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-03
The technical efficiency of SACU Ports: a data envelopment analysis approach
- Authors: Bekebu, Siyanda
- Date: 2021-12
- Subjects: Free ports and zones -- Africa, Southern , Harbors -- Africa, Southern
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/53813 , vital:45982
- Description: There ever growing international trade and increasing congestion of ports led to an increased focus attention on technical efficiency. Seaports are a central and necessary component in facilitating international trade. Yet, there is only limited comprehensive information available on the technical efficiency of African ports. The study investigated the technical efficiency of the SACU ports during the period 2014-2019 using DEA model. The DEA model is effective in resolving the measurement of port efficiency since the calculations are nonparametric and do not need definition or knowledge of a priori weights for the inputs or outputs, as is necessary for estimate of efficiency using production functions. To identify the roots of the technical inefficiency of the SACU ports, the study subdivided technical efficiency into pure technical and scale efficiency. The model used cargo handled, container throughput, ship calls as output variables. Whilst, quay cranes, number of tugboats, draft, quay length and number of quays were used as input variables. The study used the scores of DEA-BCC model as explanatory variables in Tobit model. The results showed that quay cranes and quay length are the cause of technical inefficiencies in the ports. , Thesis (MCom (Economics)) -- Faculty of Business and Economic Sciences, 2021
- Full Text:
- Date Issued: 2021-12
- Authors: Bekebu, Siyanda
- Date: 2021-12
- Subjects: Free ports and zones -- Africa, Southern , Harbors -- Africa, Southern
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/53813 , vital:45982
- Description: There ever growing international trade and increasing congestion of ports led to an increased focus attention on technical efficiency. Seaports are a central and necessary component in facilitating international trade. Yet, there is only limited comprehensive information available on the technical efficiency of African ports. The study investigated the technical efficiency of the SACU ports during the period 2014-2019 using DEA model. The DEA model is effective in resolving the measurement of port efficiency since the calculations are nonparametric and do not need definition or knowledge of a priori weights for the inputs or outputs, as is necessary for estimate of efficiency using production functions. To identify the roots of the technical inefficiency of the SACU ports, the study subdivided technical efficiency into pure technical and scale efficiency. The model used cargo handled, container throughput, ship calls as output variables. Whilst, quay cranes, number of tugboats, draft, quay length and number of quays were used as input variables. The study used the scores of DEA-BCC model as explanatory variables in Tobit model. The results showed that quay cranes and quay length are the cause of technical inefficiencies in the ports. , Thesis (MCom (Economics)) -- Faculty of Business and Economic Sciences, 2021
- Full Text:
- Date Issued: 2021-12
The impact of the exchange rate volatility on unemployment in South Africa
- Nyahokwe, Olivia https://orcid.org/0000-0003-2903-1014
- Authors: Nyahokwe, Olivia https://orcid.org/0000-0003-2903-1014
- Date: 2013
- Subjects: Foreign exchange rates -- South Africa , Unemployment -- South Africa
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/25580 , vital:64336
- Description: Real exchange rate volatility have important effects on production, employment and trade, so it is crucial to understand its impact on unemployment especially on a country like South Africa.This study analyses the impact of the real exchange rate volatility on unemployment and the dynamic adjustment of unemployment rate following shocks to its determinants using quarterly South African data covering the period 2000 to 2010. It begins with a review of literature on the impact of exchange rate volatility on unemployment and provides a brief updated background on the exchange rate and unemployment in South Africa. An empirical model linking the real exchange rate to unemployment is then specified. In contrast to previous analyses, this study augments the cointegration and vector autoregression (VAR) and the GARCH model including analysis with impulse response and variance decomposition analyses to provide robust long run effects and short run dynamic effects on the unemployment rate. The empirical analysis using a variety of specifications,estimation techniques, and robustness tests suggests that exchange rate volatility has a statistically and economically significant impact on employment. The variables that have been found to have a long run relationship with unemployment rate include the real exchange rate, exports ,real interest rate and the gross domestic product.The impulse response functions broadly corroborate the theoretical predictions, but only real interest rate and exports have a significant impact on unemployment in the short run. Results from the variance decompositions are largely similar to those from the impulse response analysis. The real exchange rate and exports are the only variables found to significantly explain the variation in the unemployment. The most interesting result that emerged from this analysis and is supported by previous research is that among other determinants, the real exchange rate explain the largest proportion of the variation in unemployment rate. On balance, the evidence therefore suggests that unemployment rate fluctuations are predominantly equilibrium responses to real exchange rate shocks in comparison with interest rates, economic growth and exports. , Thesis (MCom) -- Faculty of Management and Commerce, 2013
- Full Text:
- Date Issued: 2013
- Authors: Nyahokwe, Olivia https://orcid.org/0000-0003-2903-1014
- Date: 2013
- Subjects: Foreign exchange rates -- South Africa , Unemployment -- South Africa
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/25580 , vital:64336
- Description: Real exchange rate volatility have important effects on production, employment and trade, so it is crucial to understand its impact on unemployment especially on a country like South Africa.This study analyses the impact of the real exchange rate volatility on unemployment and the dynamic adjustment of unemployment rate following shocks to its determinants using quarterly South African data covering the period 2000 to 2010. It begins with a review of literature on the impact of exchange rate volatility on unemployment and provides a brief updated background on the exchange rate and unemployment in South Africa. An empirical model linking the real exchange rate to unemployment is then specified. In contrast to previous analyses, this study augments the cointegration and vector autoregression (VAR) and the GARCH model including analysis with impulse response and variance decomposition analyses to provide robust long run effects and short run dynamic effects on the unemployment rate. The empirical analysis using a variety of specifications,estimation techniques, and robustness tests suggests that exchange rate volatility has a statistically and economically significant impact on employment. The variables that have been found to have a long run relationship with unemployment rate include the real exchange rate, exports ,real interest rate and the gross domestic product.The impulse response functions broadly corroborate the theoretical predictions, but only real interest rate and exports have a significant impact on unemployment in the short run. Results from the variance decompositions are largely similar to those from the impulse response analysis. The real exchange rate and exports are the only variables found to significantly explain the variation in the unemployment. The most interesting result that emerged from this analysis and is supported by previous research is that among other determinants, the real exchange rate explain the largest proportion of the variation in unemployment rate. On balance, the evidence therefore suggests that unemployment rate fluctuations are predominantly equilibrium responses to real exchange rate shocks in comparison with interest rates, economic growth and exports. , Thesis (MCom) -- Faculty of Management and Commerce, 2013
- Full Text:
- Date Issued: 2013
An investigation into the demand for money in South Africa during the period (1990-2009)
- Simawu, Moreblessing https://orcid.org/0000-0003-4413-4660
- Authors: Simawu, Moreblessing https://orcid.org/0000-0003-4413-4660
- Date: 2011
- Subjects: Demand for money -- South Africa , Monetary policy -- South Africa
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/24421 , vital:62789
- Description: A stable money demand function plays a vital role in the analysis of macroeconomics, especially in the planning and implementation of monetary policy. With the use of Johansen cointegration and error correction model estimates, this study examines the existence of a stable long-run relationship between real money demand (RM2 and RM3) and its explanatory variables, in South Africa, for the period 1990-2009. The explanatory variables used in this study are selected on the basis of different monetary theories and empirical works, including the Keynesian, Classical and Friedman’s modern quantity theory of money. Based on these theories, the explanatory variables used in this thesis are real income, an interest rate, the inflation rate ,the exchange rate and foreign interest rate. The signs of the coefficients of the variables are as expected from economic theory. The coefficients of real income, the exchange rate and foreign interest rate are positive, while the coefficients of the interest rate and inflation rate are negative. This study augments the cointegration and vector autoregression (VAR) analysis with impulse response and variance decomposition analyses to provide robust long run effects and short run dynamic effects on the real money demand. In addition a foreign interest rate to capture the impact of capital mobility on money demand in South Africa was used. Results from the Johansen test suggest that real money demand (RM2 and RM3) and its all explanatory variables are cointegrated. Hence, there is a long-run equilibrium relationship between the real quantity of money demanded and five broadly defined macroeconomic components namely, real income, an interest rate, the inflation rate, foreign interest rate and the exchange rate in South Africa. Overall, the study finds that the coefficients of the equilibrium error terms are negative, as expected, and significantly different from zero, implying that 0.16 and 0.1 of the discrepancy between money demand and its explanatory variables is eliminated in the following quarter. Application of CUSUM and CUSUMSQ stability test showed that real money demand (M2 and M3) is stable in South Africa. The impulse response analysis provided evidence that the real M3 money, national income, rate of inflation and the foreign interest rate have a significant impact on the real M3 money demand in the short run. However, remaining variables (the real exchange rate and prime overdraft rate), have only a transitory effect on the real M3 money demand. There was further evidence that real exchange rate, the rate of inflation and the foreign interest rate, have a significant impact on the real M2 money demand in the short run. However, remaining variables (the national income and prime overdraft rate), have only a transitory effect on the real M2 money demand. Results from the variance decompositions of the real money demand are basically similar to those from the impulse response analysis and reveal that the fundamentals explain some, but not all, of the variations of the real money demand. The results showed that the national income explains the largest component of the variation in the real M2 money demand followed by the exchange rate and foreign interest rate. Shocks to the other variables continued to explain an insignificant proportion of the variation in the real M2 money demand. The national income also explains the largest component of the variation in the real M3 money demand followed by the foreign interest rate and exchange rate. Shocks to the other variables continued to explain a less significant proportion of the variation in the real M3 money demand.The study finds that both real M2 and M3 are stable which makes monetary targeting a viable policy option for the SARB. , Thesis (MCom) -- Faculty of Management and Commerce, 2011
- Full Text:
- Date Issued: 2011
- Authors: Simawu, Moreblessing https://orcid.org/0000-0003-4413-4660
- Date: 2011
- Subjects: Demand for money -- South Africa , Monetary policy -- South Africa
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/24421 , vital:62789
- Description: A stable money demand function plays a vital role in the analysis of macroeconomics, especially in the planning and implementation of monetary policy. With the use of Johansen cointegration and error correction model estimates, this study examines the existence of a stable long-run relationship between real money demand (RM2 and RM3) and its explanatory variables, in South Africa, for the period 1990-2009. The explanatory variables used in this study are selected on the basis of different monetary theories and empirical works, including the Keynesian, Classical and Friedman’s modern quantity theory of money. Based on these theories, the explanatory variables used in this thesis are real income, an interest rate, the inflation rate ,the exchange rate and foreign interest rate. The signs of the coefficients of the variables are as expected from economic theory. The coefficients of real income, the exchange rate and foreign interest rate are positive, while the coefficients of the interest rate and inflation rate are negative. This study augments the cointegration and vector autoregression (VAR) analysis with impulse response and variance decomposition analyses to provide robust long run effects and short run dynamic effects on the real money demand. In addition a foreign interest rate to capture the impact of capital mobility on money demand in South Africa was used. Results from the Johansen test suggest that real money demand (RM2 and RM3) and its all explanatory variables are cointegrated. Hence, there is a long-run equilibrium relationship between the real quantity of money demanded and five broadly defined macroeconomic components namely, real income, an interest rate, the inflation rate, foreign interest rate and the exchange rate in South Africa. Overall, the study finds that the coefficients of the equilibrium error terms are negative, as expected, and significantly different from zero, implying that 0.16 and 0.1 of the discrepancy between money demand and its explanatory variables is eliminated in the following quarter. Application of CUSUM and CUSUMSQ stability test showed that real money demand (M2 and M3) is stable in South Africa. The impulse response analysis provided evidence that the real M3 money, national income, rate of inflation and the foreign interest rate have a significant impact on the real M3 money demand in the short run. However, remaining variables (the real exchange rate and prime overdraft rate), have only a transitory effect on the real M3 money demand. There was further evidence that real exchange rate, the rate of inflation and the foreign interest rate, have a significant impact on the real M2 money demand in the short run. However, remaining variables (the national income and prime overdraft rate), have only a transitory effect on the real M2 money demand. Results from the variance decompositions of the real money demand are basically similar to those from the impulse response analysis and reveal that the fundamentals explain some, but not all, of the variations of the real money demand. The results showed that the national income explains the largest component of the variation in the real M2 money demand followed by the exchange rate and foreign interest rate. Shocks to the other variables continued to explain an insignificant proportion of the variation in the real M2 money demand. The national income also explains the largest component of the variation in the real M3 money demand followed by the foreign interest rate and exchange rate. Shocks to the other variables continued to explain a less significant proportion of the variation in the real M3 money demand.The study finds that both real M2 and M3 are stable which makes monetary targeting a viable policy option for the SARB. , Thesis (MCom) -- Faculty of Management and Commerce, 2011
- Full Text:
- Date Issued: 2011
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