An investigation into births before arrival in healthcare facilities in uThungulu Health District during a period of 1 April 2014 to 31 March 2015
- Mkhwanazi, Cynthia Nqobile Nokuthula
- Authors: Mkhwanazi, Cynthia Nqobile Nokuthula
- Date: 2018
- Subjects: Childbirth Childbirth at home
- Language: English
- Type: Thesis , Masters , Public Health
- Identifier: http://hdl.handle.net/10353/11161 , vital:37198
- Description: Births Before Arrival (BBAs) in healthcare facilities is a worldwide health challenge. These births results with diverse obstetric and neonatal complications which could be avoided should delivery took place in an accredited environment. Delivery in health facility rate and Births Before Arrival is one of the vital measures used to monitor access as well as quality of Maternal and Child health services. A birth before arrival in health institutions happens accidentally and unattended by skilled health professionals outside the healthcare facilities (Lazic & Takač, 2011). It is found in both developed and developing countries with various adverse outcomes ranging from haemorrhage to death. Important strides had been taken to improve maternal and child health globally but the healthcare facilities are still experiencing an overwhelming number of births before arrival in healthcare facilities. This is a public health concern. The purpose of the study was to identify factors associated with Births before Arrival in UThungulu Health District facilities and determine the prevalence of BBAs and the neonatal and maternal morbidity and mortality associated with it. A retrospective quantitative research design was used. Maternity clinical records Reviews of 238 Births Before Arrival (BBA) in healthcare facilities that occurred between 1 April 2014 to 31 March 2015 were conducted in the six hospitals in UThungulu Health District. The births before arrival data was analysed using SPSS (Statistical Package for Social Science) version 23, for Windows and used for descriptive and inferential analysis. The reasons for BBA included poor ante natal education of mothers on early signs of labour, lack of transport, poor use of maternity waiting areas and some clinics do not conduct deliveries. The majority of study participants were single (unmarried) and this accentuates the importance of strengthening family planning coverage in this area. Poor reporting of early neonatal deaths and stillbirths was one of the significant observations made during the study. Deceased babies were left at home and buried without being registered at home affairs. Taking cognizance of diverse risks and health needs of expectant women would assist the Health department in planning for adequate coverage for provision of suitable pregnancy care that would improve the health of women and their babies.
- Full Text:
- Authors: Mkhwanazi, Cynthia Nqobile Nokuthula
- Date: 2018
- Subjects: Childbirth Childbirth at home
- Language: English
- Type: Thesis , Masters , Public Health
- Identifier: http://hdl.handle.net/10353/11161 , vital:37198
- Description: Births Before Arrival (BBAs) in healthcare facilities is a worldwide health challenge. These births results with diverse obstetric and neonatal complications which could be avoided should delivery took place in an accredited environment. Delivery in health facility rate and Births Before Arrival is one of the vital measures used to monitor access as well as quality of Maternal and Child health services. A birth before arrival in health institutions happens accidentally and unattended by skilled health professionals outside the healthcare facilities (Lazic & Takač, 2011). It is found in both developed and developing countries with various adverse outcomes ranging from haemorrhage to death. Important strides had been taken to improve maternal and child health globally but the healthcare facilities are still experiencing an overwhelming number of births before arrival in healthcare facilities. This is a public health concern. The purpose of the study was to identify factors associated with Births before Arrival in UThungulu Health District facilities and determine the prevalence of BBAs and the neonatal and maternal morbidity and mortality associated with it. A retrospective quantitative research design was used. Maternity clinical records Reviews of 238 Births Before Arrival (BBA) in healthcare facilities that occurred between 1 April 2014 to 31 March 2015 were conducted in the six hospitals in UThungulu Health District. The births before arrival data was analysed using SPSS (Statistical Package for Social Science) version 23, for Windows and used for descriptive and inferential analysis. The reasons for BBA included poor ante natal education of mothers on early signs of labour, lack of transport, poor use of maternity waiting areas and some clinics do not conduct deliveries. The majority of study participants were single (unmarried) and this accentuates the importance of strengthening family planning coverage in this area. Poor reporting of early neonatal deaths and stillbirths was one of the significant observations made during the study. Deceased babies were left at home and buried without being registered at home affairs. Taking cognizance of diverse risks and health needs of expectant women would assist the Health department in planning for adequate coverage for provision of suitable pregnancy care that would improve the health of women and their babies.
- Full Text:
Secrets that kill : reflections on violation of cultural rights enshrined in the constitution and human rights through traditional circumcision
- Authors: Mlisa, Lily Rose Nomfundo
- Date: 2018
- Subjects: Human rights--South Africa Circumcision Circumcision--Law and legislation
- Language: English
- Type: Thesis , Masters , Public Health
- Identifier: http://hdl.handle.net/10353/11150 , vital:37176
- Description: The study was based on four research objectives: (1) to identify philosophy, psychology, cultural reasons behind the harsh and traumatic experiences of young Xhosa boys and their mothers during ukwaluka (male circumcision) as a mark for transition to manhood; (2) to review perceptions concerning the role of mothers during the male circumcision (MC) process (3) identify cultural and psycho-social construction and meaning of MC and (4) to explore recommended possible strategies on managing MC-related traumas and deaths in the Sub-Saharan region and Eastern Cape Province in particular. Desktop literature review methodology was followed. An in depth literature review was conducted on diverse website search engines using a set of inclusion criteria. Published articles from 1995 to 2015 were selected. Thematic content analysis was used to categorise and interpret emerging themes from the reviewed articles as aligned to set research objectives. Results revealed diverse philosophical and cultural perceptions around MC, its construction and meaning among different cultures whether circumcising or non-circumcising cultures. In addition, various reasons are laid out for the harsh treatment given to initiates in different settings. Results also indicated that the MC is no longer a secret due to social media profuse publications about it. The impact of education and health care benefits around medical male circumcision (MMC) has influenced women from both non-circumcising and circumcising cultures to accept it. It is recommended that MC should continue under strict observation of prescribed protocols to lessen or prevent malpractices in the process. MMC is also highly recommended. In addition, the government and traditional leaders have to continue to conduct capacity building of traditional surgeons, prospective initiates and initiates including nurses and family members about crucial protocols and health matters around MC. Finally, results recommend best practices that could be learnt from other circumcising cultures to restore the respect of MC in the Eastern Cape, as well as inclusion of women in the MC process management.
- Full Text:
- Authors: Mlisa, Lily Rose Nomfundo
- Date: 2018
- Subjects: Human rights--South Africa Circumcision Circumcision--Law and legislation
- Language: English
- Type: Thesis , Masters , Public Health
- Identifier: http://hdl.handle.net/10353/11150 , vital:37176
- Description: The study was based on four research objectives: (1) to identify philosophy, psychology, cultural reasons behind the harsh and traumatic experiences of young Xhosa boys and their mothers during ukwaluka (male circumcision) as a mark for transition to manhood; (2) to review perceptions concerning the role of mothers during the male circumcision (MC) process (3) identify cultural and psycho-social construction and meaning of MC and (4) to explore recommended possible strategies on managing MC-related traumas and deaths in the Sub-Saharan region and Eastern Cape Province in particular. Desktop literature review methodology was followed. An in depth literature review was conducted on diverse website search engines using a set of inclusion criteria. Published articles from 1995 to 2015 were selected. Thematic content analysis was used to categorise and interpret emerging themes from the reviewed articles as aligned to set research objectives. Results revealed diverse philosophical and cultural perceptions around MC, its construction and meaning among different cultures whether circumcising or non-circumcising cultures. In addition, various reasons are laid out for the harsh treatment given to initiates in different settings. Results also indicated that the MC is no longer a secret due to social media profuse publications about it. The impact of education and health care benefits around medical male circumcision (MMC) has influenced women from both non-circumcising and circumcising cultures to accept it. It is recommended that MC should continue under strict observation of prescribed protocols to lessen or prevent malpractices in the process. MMC is also highly recommended. In addition, the government and traditional leaders have to continue to conduct capacity building of traditional surgeons, prospective initiates and initiates including nurses and family members about crucial protocols and health matters around MC. Finally, results recommend best practices that could be learnt from other circumcising cultures to restore the respect of MC in the Eastern Cape, as well as inclusion of women in the MC process management.
- Full Text:
The land restitution programme on Rural Livelihoods in the Amathole District, Eastern Cape: The case of Cata Community land claim.
- Authors: Mnqandi, Nomgqibelo Beauty
- Date: 2018
- Subjects: Restitution -- South Africa -- Eastern Cape Land tenure -- South Africa -- Eastern Cape Land reform -- South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Masters , M Soc Sc
- Identifier: http://hdl.handle.net/10353/10453 , vital:35475
- Description: The history of South Africa has been shaped by the dictatorial laws of the apartheid regime which ushered an order of domination and segregation, ostensibly to perpetuate social inequality along racial lines. In the process the white minority intended to stifle the potential of the black communities and render them subservient and unable to question or stand against white domination. To this effect the white minority instituted discriminatory laws such as The Native Land Act of 1913, among others, in a bid to give impetus to the dispossession of black communities of their land. The dispossessed people were eventually forcefully removed from their land and posted to the middle of nowhere, at the so-called Ciskei and Transkei territories. In these homelands, as these states were called, the black South Africans started to feel the pinch of apartheid more. The worst of all, these people were impoverished since they had no jobs. It is only after the emergence of the democratic dispensation, in 1994, that the transformative action was taken even though it failed to deliver as expected. In the process, the Department of Rural Development and Land Reform was established with a mission to transform and redress the evils of the past by either giving the dispossessed back their land, alternative land or financial compensation, among other arrangements. However, since it was difficult to give people back their land, the most popular option became financial compensation. This choice, it has been argued, was influenced by the high levels of poverty, high unemployment rate, low rural household incomes and poor levels of education – instances which may have led to the beneficiaries attaching little or no value towards land ownership and other possible means of land restitution. As such, ii the majority of the community thought that financial compensation would lead to sustainable livelihood and would, therefore, not allow such opportunity to slip off their hands. However, more than two decades after the emergence of the democratic dispensation, the popular financial compensation has not yielded the expected results. Yet there is a Cata community which, being among the first members of the society to successfully claim for land restitution opted for land restoration and financial compensation award was given to claimants to pay for houses that were demolished during the betterment process. Out of the award, the Cata community took a calculated risk and invested 50% of the compensation money towards the development and improving the livelihood of the Cata community. This being the case, the study sought to explore to what extent the restitution programme (with the financial compensation option) could succeed in improving the livelihoods of the Cata community. In a way, while this statement is the main objective of the study, it also satisfies the key question of the study. It will ensure that the Cata community, in their attempt to lead sustainable livelihoods, will become creative and ensure that people have good paying jobs, they budget and rationalise before using money; and that they are even prepared to take calculated risks in order to succeed, just as the Cata communities have done. No doubt this would ensure that every member of the society enjoys and is regaled by the fruits and transformative actions of the new democratic dispensation. Qualitative research methodology has been selected to conduct research of this study because it requires a researcher to dig deep to the research problems and give out rich research findings with insight because community experiences can only be understood qualitatively not through the statistics. The main findings of this study among others are that financial compensation should be linked with iii development in order to sustain livelihoods of the rural poor as the case has been with Cata community. A number of communities who opted financial compensation did not lead a sustainable livelihood instead they either became poorer or fell victims of poverty because they fail to use their financial compensation award wisely.
- Full Text:
- Authors: Mnqandi, Nomgqibelo Beauty
- Date: 2018
- Subjects: Restitution -- South Africa -- Eastern Cape Land tenure -- South Africa -- Eastern Cape Land reform -- South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Masters , M Soc Sc
- Identifier: http://hdl.handle.net/10353/10453 , vital:35475
- Description: The history of South Africa has been shaped by the dictatorial laws of the apartheid regime which ushered an order of domination and segregation, ostensibly to perpetuate social inequality along racial lines. In the process the white minority intended to stifle the potential of the black communities and render them subservient and unable to question or stand against white domination. To this effect the white minority instituted discriminatory laws such as The Native Land Act of 1913, among others, in a bid to give impetus to the dispossession of black communities of their land. The dispossessed people were eventually forcefully removed from their land and posted to the middle of nowhere, at the so-called Ciskei and Transkei territories. In these homelands, as these states were called, the black South Africans started to feel the pinch of apartheid more. The worst of all, these people were impoverished since they had no jobs. It is only after the emergence of the democratic dispensation, in 1994, that the transformative action was taken even though it failed to deliver as expected. In the process, the Department of Rural Development and Land Reform was established with a mission to transform and redress the evils of the past by either giving the dispossessed back their land, alternative land or financial compensation, among other arrangements. However, since it was difficult to give people back their land, the most popular option became financial compensation. This choice, it has been argued, was influenced by the high levels of poverty, high unemployment rate, low rural household incomes and poor levels of education – instances which may have led to the beneficiaries attaching little or no value towards land ownership and other possible means of land restitution. As such, ii the majority of the community thought that financial compensation would lead to sustainable livelihood and would, therefore, not allow such opportunity to slip off their hands. However, more than two decades after the emergence of the democratic dispensation, the popular financial compensation has not yielded the expected results. Yet there is a Cata community which, being among the first members of the society to successfully claim for land restitution opted for land restoration and financial compensation award was given to claimants to pay for houses that were demolished during the betterment process. Out of the award, the Cata community took a calculated risk and invested 50% of the compensation money towards the development and improving the livelihood of the Cata community. This being the case, the study sought to explore to what extent the restitution programme (with the financial compensation option) could succeed in improving the livelihoods of the Cata community. In a way, while this statement is the main objective of the study, it also satisfies the key question of the study. It will ensure that the Cata community, in their attempt to lead sustainable livelihoods, will become creative and ensure that people have good paying jobs, they budget and rationalise before using money; and that they are even prepared to take calculated risks in order to succeed, just as the Cata communities have done. No doubt this would ensure that every member of the society enjoys and is regaled by the fruits and transformative actions of the new democratic dispensation. Qualitative research methodology has been selected to conduct research of this study because it requires a researcher to dig deep to the research problems and give out rich research findings with insight because community experiences can only be understood qualitatively not through the statistics. The main findings of this study among others are that financial compensation should be linked with iii development in order to sustain livelihoods of the rural poor as the case has been with Cata community. A number of communities who opted financial compensation did not lead a sustainable livelihood instead they either became poorer or fell victims of poverty because they fail to use their financial compensation award wisely.
- Full Text:
Exploring the experience of family members living with individuals who abuse alcohol and/or substances: Study conducted in Khayelitsha, Western Cape
- Authors: Modise, Badise
- Date: 2018
- Subjects: Alcoholism , Substance abuse , Family violence
- Language: English
- Type: Thesis , Masters , MSoc
- Identifier: http://hdl.handle.net/10353/13116 , vital:39466
- Description: The constant, excessive and frequently uncontrollable abuse of alcoholic beverages and drug related substances continues to have many devastating effects on family members of the abusers. The impact can be explored in various ways, but the findings are likely to be hand in glove regardless of the causes associated with this phenomenon. This study aimed to explore the experiences of family members living with individuals who abuse alcohol and/or substances through case studies conducted in Khayelitsha, in the Western Province of South Africa. The study was conducted to gain greater insight into the experiences of the family members in order to provide the appropriate assistance to help them deal with these issues. From the data that was captured and analysed, it was clear that alcohol and substance abuse inflicted profound suffering on family members. It contributes to high levels of interpersonal conflict, domestic violence, child abuse and neglect, financial problems as well as health issues for all parties involved - causing extreme emotional pain and suffering. Living with an alcohol or substance abuser inevitably results in financial burden, dysfunctional relationships and family life in addition to impacting on safety needs. Furthermore, the results have shown that family members of alcohol and substance dependents develop psychological and mental distress; anxiety, and insomnia. Likewise, the family members develop psychophysiological symptoms such as high-blood pressure and chronic headaches. With regards to rehabilitation, family members reported exclusion from rehabilitation programs and lost their belief in self-rehabilitation or detoxification.
- Full Text:
- Authors: Modise, Badise
- Date: 2018
- Subjects: Alcoholism , Substance abuse , Family violence
- Language: English
- Type: Thesis , Masters , MSoc
- Identifier: http://hdl.handle.net/10353/13116 , vital:39466
- Description: The constant, excessive and frequently uncontrollable abuse of alcoholic beverages and drug related substances continues to have many devastating effects on family members of the abusers. The impact can be explored in various ways, but the findings are likely to be hand in glove regardless of the causes associated with this phenomenon. This study aimed to explore the experiences of family members living with individuals who abuse alcohol and/or substances through case studies conducted in Khayelitsha, in the Western Province of South Africa. The study was conducted to gain greater insight into the experiences of the family members in order to provide the appropriate assistance to help them deal with these issues. From the data that was captured and analysed, it was clear that alcohol and substance abuse inflicted profound suffering on family members. It contributes to high levels of interpersonal conflict, domestic violence, child abuse and neglect, financial problems as well as health issues for all parties involved - causing extreme emotional pain and suffering. Living with an alcohol or substance abuser inevitably results in financial burden, dysfunctional relationships and family life in addition to impacting on safety needs. Furthermore, the results have shown that family members of alcohol and substance dependents develop psychological and mental distress; anxiety, and insomnia. Likewise, the family members develop psychophysiological symptoms such as high-blood pressure and chronic headaches. With regards to rehabilitation, family members reported exclusion from rehabilitation programs and lost their belief in self-rehabilitation or detoxification.
- Full Text:
A trend analysis of perinatal mortalities in Barberton Hospital between 2002 and 2016
- Modupe, Oluwarotimi Folorunsho
- Authors: Modupe, Oluwarotimi Folorunsho
- Date: 2018
- Subjects: Newborn infants -- Mortality Perinatology
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: http://hdl.handle.net/10353/11254 , vital:37630
- Description: Background and aim: There is no doubt that the quantification of data on the new born is imperative towards the design of effective public health policy interventions. However, the trend in under-five mortality rates in Barberton Hospital is not recognised as no empirical investigation has been undertaken to ascertain its position in this regard. A trend analysis of infant and maternal deaths in will therefore shed light on possible factors influencing this trend. The specific objectives of this study were to examine the trend and causes of perinatal mortality in Barberton Hospital from 2002-2016. It was hypothesized that there would be a downward trend in the infant and maternal mortality rates in Barberton Hospital from 2002-2016, possibly as a result of improved medical care. Methods: This retrospective study was conducted in Barberton Hospital, located in the Umjindi sub-district in Mpumalanga Province. The data was drawn from the Perinatal Problem Identification Programme (PPIP) database. Pregnancy related deaths of women, and of children from birth to one year in Barberton Hospital from 1999-2014 were extracted. The population study consists of a record review of all infant and maternal deaths in Barberton Hospital from 2002-2016 and captured in the data on the PPIP. The University of Fort Hare ethical review committee approved the study protocol. In addition, permission to use the data was granted by the Mpumalanga Department of Health after applying for approval for use of the data for academic purposes. The data was then exported into an Excel format document and fed to Statistical Package for Social Sciences (SPSS) program to allow for a more detailed analysis. Results: Over the period under review (2002-2016), a total of 21151 babies were delivered, 20593 babies were alive at discharge, 221 babies died in the first 28 days of delivery, and 337 babies were stillbirths. 18577 were normal weight (≥2500gram), 1581 weighed 2000-2499 grams, 568 weighed 1500-1999grams, 286 weighed 1000-1499 and 139 weighed below 1000grams. All the women who gave birth over the period under review, 27.3percent tested positive to HIV, 40.3 percent tested negative. Of all women that tested positive, 80.2percent received any form of ART. For over half of women that received ART (n=2981), the type of ART they received is unknown. Most women whose baby died were young. One in five women did not have their age captured in the database indicating an important gap that need to be addressed in order to ensure integrity of the database. Of all the 558 perinatal mortality, 75.3 weighed below 2500 grams. Low birth weight is major risk factor for child mortality. Babies weighing less than 2,500 grams are 20 times more likely to die than heavier babies. For all the perinatal deaths, the majority of their mothers received antenatal care services. About 86.6percent were delivered at Barberton Hospital and only 1 child was delivered in transit to the hospital. Of all the 558 deaths, only 7.5 percent was multiple births. Of the 558 babies that died, only 39.6percent were born alive, 37.1percent was macerated stillbirths. The syphilis serology test indicated that most mothers tested negative. The HIV serology test indicated that 28percent of mothers tested positive. The hospital recorded a total of 337 stillbirths between 2002 and 2016. This accounts for 60.2percent of all perinatal mortality over the period. Of all stillbirths, 61.6percent was macerated stillbirths. Yearly analysis of stillbirth rate did not clearly indicate whether stillbirth rate is increasing or declining. Not less than 56 primary obstetric causes of perinatal deaths were identified in this study. Many perinatal deaths were unexplainable due to lack of post-mortem. Idiopathic preterm labour was the main primary obstetric cause of early (34.5percent) and late neonatal (38.9percent) deaths, and the next was labour related intrapartum asphyxia. Labour related intrapartum asphyxia also accounts for 6.8percent of all stillbirths. The main known primary obstetric cause of stillbirth in the Hospital was Proteinuric hypertension/hypertension disorders. Over 60percent of perinatal mortality in Barberton Hospital was due to associated maternal conditions. Only 10.9percent was due to fetal related conditions and 26.4percent was unexplained. Few deaths were due to health system failure and domestic violence. Spontaneous preterm labour (18.4percent), abnormal labour or uterine rupture (14.5percent), maternal hypertension (12.4percent), antepartum haemorrhage (10.2percent) were the main associated maternal conditions causes of perinatal mortality in Barberton Hospital. Similarly, Fetal abnormality and infections were the main associated fetal condition causes of perinatal mortality. Of all the babies that were alive at birth, 85.2percent died due to maternal related conditions. Most neonates died due to spontaneous preterm labour (43.5percent) and abnormal labour or uterine rupture (23.1percent). Maternal HIV, diabetics and syphilis only accounted for a few neonatal deaths. For stillbirth babies that were alive at admission, abnormal labour or uterine rupture (33.1percent) and antepartum haemorrhage (19.7percent) were the main causes of their death. Over 60percent of all of macerated deaths have unexplained causes. Maternal hypertension is the main known cause of macerated stillbirth. For stillbirths that were dead on admission, maternal hypertension (13.1percent), antepartum haemorrhage (26.2percent) and abnormal labour or uterine rupture were the main causes of deaths. The majority of perinatal deaths in the hospital were caused by intrauterine deaths (58.8percent). Extreme multi-organ immaturity (13.1percent), Hyaline membrane disease (7.2percent) and Hypoxic ischaemic encephalopathy (5.2percent) were among the main final causes of perinatal deaths. The main behavioural factor causing perinatal mortality in Mpumalanga province was non-use of antenatal care services. The majority of perinatal mortality (60.4percent) was due to health system related causes. Most perinatal deaths were due to poor management of cases and delayed referral. Conclusion: The findings indicate that while stillbirths have slightly declined, neonatal deaths have not declined over the period. Perinatal have slightly declined in the hospital. The findings of this study also indicate that the majority of perinatal deaths in the hospital were caused by idiopathic preterm labour, unexplained intrauterine deaths, hypertension, and intrapartum asphyxia. Patient and health system related factors contributed significantly to perinatal deaths in the hospital. There is a need for yearly analysis of PPIP data to track progress and identify area for continuous improvement in provision of quality obstetric services. A greater community awareness of risk factors for perinatal deaths and importance of early and regular take up antenatal care services is needed.
- Full Text:
- Authors: Modupe, Oluwarotimi Folorunsho
- Date: 2018
- Subjects: Newborn infants -- Mortality Perinatology
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: http://hdl.handle.net/10353/11254 , vital:37630
- Description: Background and aim: There is no doubt that the quantification of data on the new born is imperative towards the design of effective public health policy interventions. However, the trend in under-five mortality rates in Barberton Hospital is not recognised as no empirical investigation has been undertaken to ascertain its position in this regard. A trend analysis of infant and maternal deaths in will therefore shed light on possible factors influencing this trend. The specific objectives of this study were to examine the trend and causes of perinatal mortality in Barberton Hospital from 2002-2016. It was hypothesized that there would be a downward trend in the infant and maternal mortality rates in Barberton Hospital from 2002-2016, possibly as a result of improved medical care. Methods: This retrospective study was conducted in Barberton Hospital, located in the Umjindi sub-district in Mpumalanga Province. The data was drawn from the Perinatal Problem Identification Programme (PPIP) database. Pregnancy related deaths of women, and of children from birth to one year in Barberton Hospital from 1999-2014 were extracted. The population study consists of a record review of all infant and maternal deaths in Barberton Hospital from 2002-2016 and captured in the data on the PPIP. The University of Fort Hare ethical review committee approved the study protocol. In addition, permission to use the data was granted by the Mpumalanga Department of Health after applying for approval for use of the data for academic purposes. The data was then exported into an Excel format document and fed to Statistical Package for Social Sciences (SPSS) program to allow for a more detailed analysis. Results: Over the period under review (2002-2016), a total of 21151 babies were delivered, 20593 babies were alive at discharge, 221 babies died in the first 28 days of delivery, and 337 babies were stillbirths. 18577 were normal weight (≥2500gram), 1581 weighed 2000-2499 grams, 568 weighed 1500-1999grams, 286 weighed 1000-1499 and 139 weighed below 1000grams. All the women who gave birth over the period under review, 27.3percent tested positive to HIV, 40.3 percent tested negative. Of all women that tested positive, 80.2percent received any form of ART. For over half of women that received ART (n=2981), the type of ART they received is unknown. Most women whose baby died were young. One in five women did not have their age captured in the database indicating an important gap that need to be addressed in order to ensure integrity of the database. Of all the 558 perinatal mortality, 75.3 weighed below 2500 grams. Low birth weight is major risk factor for child mortality. Babies weighing less than 2,500 grams are 20 times more likely to die than heavier babies. For all the perinatal deaths, the majority of their mothers received antenatal care services. About 86.6percent were delivered at Barberton Hospital and only 1 child was delivered in transit to the hospital. Of all the 558 deaths, only 7.5 percent was multiple births. Of the 558 babies that died, only 39.6percent were born alive, 37.1percent was macerated stillbirths. The syphilis serology test indicated that most mothers tested negative. The HIV serology test indicated that 28percent of mothers tested positive. The hospital recorded a total of 337 stillbirths between 2002 and 2016. This accounts for 60.2percent of all perinatal mortality over the period. Of all stillbirths, 61.6percent was macerated stillbirths. Yearly analysis of stillbirth rate did not clearly indicate whether stillbirth rate is increasing or declining. Not less than 56 primary obstetric causes of perinatal deaths were identified in this study. Many perinatal deaths were unexplainable due to lack of post-mortem. Idiopathic preterm labour was the main primary obstetric cause of early (34.5percent) and late neonatal (38.9percent) deaths, and the next was labour related intrapartum asphyxia. Labour related intrapartum asphyxia also accounts for 6.8percent of all stillbirths. The main known primary obstetric cause of stillbirth in the Hospital was Proteinuric hypertension/hypertension disorders. Over 60percent of perinatal mortality in Barberton Hospital was due to associated maternal conditions. Only 10.9percent was due to fetal related conditions and 26.4percent was unexplained. Few deaths were due to health system failure and domestic violence. Spontaneous preterm labour (18.4percent), abnormal labour or uterine rupture (14.5percent), maternal hypertension (12.4percent), antepartum haemorrhage (10.2percent) were the main associated maternal conditions causes of perinatal mortality in Barberton Hospital. Similarly, Fetal abnormality and infections were the main associated fetal condition causes of perinatal mortality. Of all the babies that were alive at birth, 85.2percent died due to maternal related conditions. Most neonates died due to spontaneous preterm labour (43.5percent) and abnormal labour or uterine rupture (23.1percent). Maternal HIV, diabetics and syphilis only accounted for a few neonatal deaths. For stillbirth babies that were alive at admission, abnormal labour or uterine rupture (33.1percent) and antepartum haemorrhage (19.7percent) were the main causes of their death. Over 60percent of all of macerated deaths have unexplained causes. Maternal hypertension is the main known cause of macerated stillbirth. For stillbirths that were dead on admission, maternal hypertension (13.1percent), antepartum haemorrhage (26.2percent) and abnormal labour or uterine rupture were the main causes of deaths. The majority of perinatal deaths in the hospital were caused by intrauterine deaths (58.8percent). Extreme multi-organ immaturity (13.1percent), Hyaline membrane disease (7.2percent) and Hypoxic ischaemic encephalopathy (5.2percent) were among the main final causes of perinatal deaths. The main behavioural factor causing perinatal mortality in Mpumalanga province was non-use of antenatal care services. The majority of perinatal mortality (60.4percent) was due to health system related causes. Most perinatal deaths were due to poor management of cases and delayed referral. Conclusion: The findings indicate that while stillbirths have slightly declined, neonatal deaths have not declined over the period. Perinatal have slightly declined in the hospital. The findings of this study also indicate that the majority of perinatal deaths in the hospital were caused by idiopathic preterm labour, unexplained intrauterine deaths, hypertension, and intrapartum asphyxia. Patient and health system related factors contributed significantly to perinatal deaths in the hospital. There is a need for yearly analysis of PPIP data to track progress and identify area for continuous improvement in provision of quality obstetric services. A greater community awareness of risk factors for perinatal deaths and importance of early and regular take up antenatal care services is needed.
- Full Text:
The perceptions of professional nurses about the introduction of the National Health Insurance in a private hospital in Gauteng
- Molokomme, Victoria Khabonina
- Authors: Molokomme, Victoria Khabonina
- Date: 2018
- Subjects: Health insurance Hospitals Primary health care
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: http://hdl.handle.net/10353/13057 , vital:39444
- Description: The National Health Insurance is a relatively new concept in South Africa currently being piloted to ensure that all citizens have access to quality and affordable health care regardless of their socio-economic status. This study was prompted by concerns regarding the introduction of the NHI and its implications on the South African health system. Therefore it seeks to determine the professional nurses concerns about the introduction of the NHI in a private hospital in Gauteng and to describe recommendations based on these perceptions. This study used a qualitative, exploratory and descriptive design. Data was collected using a semi-structured individual interview schedule. The sample was purposive consisting of professional nurses employed in a private hospital in Gauteng. Thematic data saturation determined the number of professional nurses interviewed. Data analysis was done with the aid of Creswell’s theory (2014:1996). Ethical considerations were observed and trustworthiness maintained. The results of the study outlined that professional nurse’s perception about the NHI is centred on equal distribution of health services to benefit all South Africans. However, concerns were based on its financial implications for those mandated to pay towards the fund. The feasibility of its implementation in the midst of staff shortage, inadequate resources and its impact on the public health sector was seen as a major challenge. The notion of a joint effort between public and private health sector in creating one health system was anticipated by most participants. The NHI implementation raised concerns about the impact it will have on the private sectors viability in the future. Professional nurse’s non-involvement in policy making, poor communication, lack of transparency, concerns about governance and management were perceived to be stumbling blocks towards efficient and effective implementation of the NHI.
- Full Text:
- Authors: Molokomme, Victoria Khabonina
- Date: 2018
- Subjects: Health insurance Hospitals Primary health care
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: http://hdl.handle.net/10353/13057 , vital:39444
- Description: The National Health Insurance is a relatively new concept in South Africa currently being piloted to ensure that all citizens have access to quality and affordable health care regardless of their socio-economic status. This study was prompted by concerns regarding the introduction of the NHI and its implications on the South African health system. Therefore it seeks to determine the professional nurses concerns about the introduction of the NHI in a private hospital in Gauteng and to describe recommendations based on these perceptions. This study used a qualitative, exploratory and descriptive design. Data was collected using a semi-structured individual interview schedule. The sample was purposive consisting of professional nurses employed in a private hospital in Gauteng. Thematic data saturation determined the number of professional nurses interviewed. Data analysis was done with the aid of Creswell’s theory (2014:1996). Ethical considerations were observed and trustworthiness maintained. The results of the study outlined that professional nurse’s perception about the NHI is centred on equal distribution of health services to benefit all South Africans. However, concerns were based on its financial implications for those mandated to pay towards the fund. The feasibility of its implementation in the midst of staff shortage, inadequate resources and its impact on the public health sector was seen as a major challenge. The notion of a joint effort between public and private health sector in creating one health system was anticipated by most participants. The NHI implementation raised concerns about the impact it will have on the private sectors viability in the future. Professional nurse’s non-involvement in policy making, poor communication, lack of transparency, concerns about governance and management were perceived to be stumbling blocks towards efficient and effective implementation of the NHI.
- Full Text:
Voices of women who have transitioned from a shelter for survivors of domestic violence to independent living
- Authors: Moonieyan, Chrislynn
- Date: 2018
- Subjects: Family violence Shelters for the homeless Homeless persons
- Language: English
- Type: Thesis , Masters , MSoc
- Identifier: http://hdl.handle.net/10353/12939 , vital:39407
- Description: Domestic violence is a devastating social ill in South Africa and especially in the Eastern Cape. There were 12059 cases of domestic violence reported at police stations in the Eastern Cape between 2015 and 2017 (Dayimani, 2017). Domestic violence is broadly defined as any act of abuse resulting in harm or suffering experienced by women enacted by an intimate partner (Goosen & Shaik, 2008). One in four women experience physical violence in their lifetime (Rasool, 2015). Women who experience domestic violence often lack social and economic resources and may have no place to go to escape the abuse. In such cases, shelters are identified as places of safety, providing accommodation and psychosocial support to women and children who have escaped domestic violence. The aim of the study was to explore and understand the experiences of women who have suffered abuse, lived in a shelter for survivors of domestic violence and have then transitioned from life at the shelter back to independent living. Independence is defined as “the freedom to organize your own life, make your own decisions” (Hornby, 2015b) and independent living is a concept of leaving the shelter to live in the community. A phenomenological research design was adopted, with the sample of the study consisting of eight women who had resided at a shelter and three staff members from shelters for domestic violence in the Eastern Cape. Interpretive phenomenological analysis (IPA) was adopted to analyse the data that was collected from the participants during semi-structured interviews. The study found that the reasons women seek help at a shelter include the severity of the abuse, the gravity of the impact of the abuse upon their own wellbeing, the fact that the abuse is accompanied by substance abuse, and also because the children are exposed and experience the abuse. The study also found that in addition to resources such as government services and civil society organisations, the shelters themselves are most supportive to women as they leave the shelter and transition back to independent living. Lastly, the study highlighted that the challenges women face as they transition to independent living were the lack of support and the lack of social and economic resources. Recommendations based on the findings of the study are to advocate to stop domestic violence, to collaborate with various departments to combat domestic violence and lastly to fund shelters and ensure the shelter staff are adequately trained to work with survivors of domestic violence.
- Full Text:
- Authors: Moonieyan, Chrislynn
- Date: 2018
- Subjects: Family violence Shelters for the homeless Homeless persons
- Language: English
- Type: Thesis , Masters , MSoc
- Identifier: http://hdl.handle.net/10353/12939 , vital:39407
- Description: Domestic violence is a devastating social ill in South Africa and especially in the Eastern Cape. There were 12059 cases of domestic violence reported at police stations in the Eastern Cape between 2015 and 2017 (Dayimani, 2017). Domestic violence is broadly defined as any act of abuse resulting in harm or suffering experienced by women enacted by an intimate partner (Goosen & Shaik, 2008). One in four women experience physical violence in their lifetime (Rasool, 2015). Women who experience domestic violence often lack social and economic resources and may have no place to go to escape the abuse. In such cases, shelters are identified as places of safety, providing accommodation and psychosocial support to women and children who have escaped domestic violence. The aim of the study was to explore and understand the experiences of women who have suffered abuse, lived in a shelter for survivors of domestic violence and have then transitioned from life at the shelter back to independent living. Independence is defined as “the freedom to organize your own life, make your own decisions” (Hornby, 2015b) and independent living is a concept of leaving the shelter to live in the community. A phenomenological research design was adopted, with the sample of the study consisting of eight women who had resided at a shelter and three staff members from shelters for domestic violence in the Eastern Cape. Interpretive phenomenological analysis (IPA) was adopted to analyse the data that was collected from the participants during semi-structured interviews. The study found that the reasons women seek help at a shelter include the severity of the abuse, the gravity of the impact of the abuse upon their own wellbeing, the fact that the abuse is accompanied by substance abuse, and also because the children are exposed and experience the abuse. The study also found that in addition to resources such as government services and civil society organisations, the shelters themselves are most supportive to women as they leave the shelter and transition back to independent living. Lastly, the study highlighted that the challenges women face as they transition to independent living were the lack of support and the lack of social and economic resources. Recommendations based on the findings of the study are to advocate to stop domestic violence, to collaborate with various departments to combat domestic violence and lastly to fund shelters and ensure the shelter staff are adequately trained to work with survivors of domestic violence.
- Full Text:
Incidence and antibiogram fingerprints of members of the Enterobacteriaceae family recovered from river water, hospital effluents and vegetables in Chris Hani and Amathole District Municipalities in the Eastern Cape Province
- Authors: Mpaka, Lindelwa
- Date: 2018
- Subjects: Enterobacteriaceae
- Language: English
- Type: Thesis , Masters , MSc (Microbiology)
- Identifier: http://hdl.handle.net/10353/14549 , vital:40003
- Description: The worldwide problem of antimicrobial resistance has limited the spectrum of the current affordable and effective antimicrobials. Infections associated with resistant microorganisms impose a major threat to public health and economic stability. Globally, about 700 000 deaths every year can be accredited to antimicrobial resistance. The leading mechanism of resistance amid bacterial pathogens is the extended spectrum beta-lactamases production, which inhibits spectrum activity of several antimicrobial agents. The rise in antimicrobial resistance has compelled an urgent need of developing means of combatting resistance issue amid diseasecausing microbes. The main aim of this study is to evaluate the incidence and antibiogram fingerprints of Enterobacteriaceae recovered from hospital effluents, river water and vegetables in the Eastern Cape Province. A total of eighteen antibiotics from ten different antimicrobial classes were used to determine antibiogram profiles of the MALDI-TOF confirmed isolates. From the MALDI-TOF confirmed isolates, 60% of Enterobacter spp. and E. coli isolates displayed resistance against colistin, while Citrobacter spp. and Klebsiella spp. displayed 90% and 60% resistance against this antimicrobial respectively. These findings outline the need for the development of new antimicrobials. About 75.5% (25/33) of the presumptive Enterobacter spp. were confirmed by MALDI-TOF with 79.2% (19/24), 66.7% (2/3), 66.7% (4/6) been confirmed vegetables, hospital effluents and river water samples respectively. Likewise, about 77.8% (21/27) were confirmed as Citrobacter spp. of which 92.3% (12/13), 66.7% (2/3) and 63.6% (7/11) were from vegetables, hospital effluents and river water samples respectively. These results show that the selected vegetables were highly contaminated with resistant bacteria and thus unsafe to consume uncooked vegetable. Also river water was higly contaminated with resistant microbes, which also shows that these rivers are not fit to be used 17 as drinking water sources and recreational activities. Colistin is an antimicrobial used as a last resort of antibiotics because it exhibits broad-spectrum activity. However from the findings of the work at present, this is no longer the case. The spectrum of this antimicrobial is now reduced by Enterobacteriaceae members. To the best of my knowledge; relatively few resources have been provided to understanding, preventing, and controlling increasing antimicrobial resistance on global, national and local levels.
- Full Text:
- Authors: Mpaka, Lindelwa
- Date: 2018
- Subjects: Enterobacteriaceae
- Language: English
- Type: Thesis , Masters , MSc (Microbiology)
- Identifier: http://hdl.handle.net/10353/14549 , vital:40003
- Description: The worldwide problem of antimicrobial resistance has limited the spectrum of the current affordable and effective antimicrobials. Infections associated with resistant microorganisms impose a major threat to public health and economic stability. Globally, about 700 000 deaths every year can be accredited to antimicrobial resistance. The leading mechanism of resistance amid bacterial pathogens is the extended spectrum beta-lactamases production, which inhibits spectrum activity of several antimicrobial agents. The rise in antimicrobial resistance has compelled an urgent need of developing means of combatting resistance issue amid diseasecausing microbes. The main aim of this study is to evaluate the incidence and antibiogram fingerprints of Enterobacteriaceae recovered from hospital effluents, river water and vegetables in the Eastern Cape Province. A total of eighteen antibiotics from ten different antimicrobial classes were used to determine antibiogram profiles of the MALDI-TOF confirmed isolates. From the MALDI-TOF confirmed isolates, 60% of Enterobacter spp. and E. coli isolates displayed resistance against colistin, while Citrobacter spp. and Klebsiella spp. displayed 90% and 60% resistance against this antimicrobial respectively. These findings outline the need for the development of new antimicrobials. About 75.5% (25/33) of the presumptive Enterobacter spp. were confirmed by MALDI-TOF with 79.2% (19/24), 66.7% (2/3), 66.7% (4/6) been confirmed vegetables, hospital effluents and river water samples respectively. Likewise, about 77.8% (21/27) were confirmed as Citrobacter spp. of which 92.3% (12/13), 66.7% (2/3) and 63.6% (7/11) were from vegetables, hospital effluents and river water samples respectively. These results show that the selected vegetables were highly contaminated with resistant bacteria and thus unsafe to consume uncooked vegetable. Also river water was higly contaminated with resistant microbes, which also shows that these rivers are not fit to be used 17 as drinking water sources and recreational activities. Colistin is an antimicrobial used as a last resort of antibiotics because it exhibits broad-spectrum activity. However from the findings of the work at present, this is no longer the case. The spectrum of this antimicrobial is now reduced by Enterobacteriaceae members. To the best of my knowledge; relatively few resources have been provided to understanding, preventing, and controlling increasing antimicrobial resistance on global, national and local levels.
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Women's knowledge and attitudes towards discontinuation of the Long-acting reversible contraceptive (Implanon) in Buffalo City Municipality, South Africa
- Authors: Mrwebi, Khungelwa Patricia
- Date: 2018
- Subjects: Contraceptives Birth control Women's health services
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: http://hdl.handle.net/10353/11206 , vital:37231
- Description: Unintended pregnancy remains a public health concern worldwide despite the availability of many contraceptives options. The South Africa Government introduced Implanon —a Long-acting Reversible Device— with aim to cost effectively prevent unplanned pregnancy. There are concerns that the implementation of this contraceptive option was without prior piloting to test for level of acceptance and attitude towards this contraception. Also, there is paucity of evidence on knowledge of women and their attitude to implanon as well as duration of use and reasons for discontinuation of implanon in South Africa. The present study address this gap by assessing the women’s knowledge of and attitude to implanon as well as reasons for implanon discontinuation in Buffalo City Municipality in South Africa. This prospective observational study administered a pre-validated questionnaire to 189 women who had removed implanon in the reproductive health clinic in one regional hospital and a primary health centre in Buffalo City Municipality. Descriptive statistics were used to analysis the study data. The average duration for implanon use among the participants was 11.2 months. Most participants had poor knowledge of implanon and implanon knowledge was significantly associated was with age. Most participants opined that implanon use is associated with heavy bleeding (60.7), irregular frequent bleeding (84.3percent), and weight gain (67percent). The main reason for implanon discontinuation was its side effects (71.3 percent). Other reasons for discontinuation of implanon are poor or wrong positioning (3.2percent), want to become pregnant (4.3percent). Some participants discontinued implanon because they were on treatment; 24 participants on ARV drug, one on antipsychotic drugs, and one on TB drugs. Experience of heavy bleeding (39.9percent) was the most stated side of implanon leading to implanon discontinuation. The study concluded that women, even though adopted implanon, lack knowledge of implanon mechanism of action and side effects. Poor knowledge of implanon side effects could explain its early discontinuation among women in South Africa. Provider should prioritise comprehensive counselling of clients on implanon side effects and mechanism of action in order to realise the benefit of implanon in this population.
- Full Text:
- Authors: Mrwebi, Khungelwa Patricia
- Date: 2018
- Subjects: Contraceptives Birth control Women's health services
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: http://hdl.handle.net/10353/11206 , vital:37231
- Description: Unintended pregnancy remains a public health concern worldwide despite the availability of many contraceptives options. The South Africa Government introduced Implanon —a Long-acting Reversible Device— with aim to cost effectively prevent unplanned pregnancy. There are concerns that the implementation of this contraceptive option was without prior piloting to test for level of acceptance and attitude towards this contraception. Also, there is paucity of evidence on knowledge of women and their attitude to implanon as well as duration of use and reasons for discontinuation of implanon in South Africa. The present study address this gap by assessing the women’s knowledge of and attitude to implanon as well as reasons for implanon discontinuation in Buffalo City Municipality in South Africa. This prospective observational study administered a pre-validated questionnaire to 189 women who had removed implanon in the reproductive health clinic in one regional hospital and a primary health centre in Buffalo City Municipality. Descriptive statistics were used to analysis the study data. The average duration for implanon use among the participants was 11.2 months. Most participants had poor knowledge of implanon and implanon knowledge was significantly associated was with age. Most participants opined that implanon use is associated with heavy bleeding (60.7), irregular frequent bleeding (84.3percent), and weight gain (67percent). The main reason for implanon discontinuation was its side effects (71.3 percent). Other reasons for discontinuation of implanon are poor or wrong positioning (3.2percent), want to become pregnant (4.3percent). Some participants discontinued implanon because they were on treatment; 24 participants on ARV drug, one on antipsychotic drugs, and one on TB drugs. Experience of heavy bleeding (39.9percent) was the most stated side of implanon leading to implanon discontinuation. The study concluded that women, even though adopted implanon, lack knowledge of implanon mechanism of action and side effects. Poor knowledge of implanon side effects could explain its early discontinuation among women in South Africa. Provider should prioritise comprehensive counselling of clients on implanon side effects and mechanism of action in order to realise the benefit of implanon in this population.
- Full Text:
An evaluation of the impact of the biogas digesters project at Melani village, Eastern Cape, South Africa
- Authors: Mthimunye , Thabiso Vincent
- Date: 2018
- Subjects: Biogas
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: http://hdl.handle.net/10353/14561 , vital:40014
- Description: A study was conducted in Melani rural community of Raymond Mhlaba district in Eastern Cape, with the aim of identifying types of energy sources and households energy utilization. Melani village (32°43’29” S, 27°07’35” E) is 13 km away from Alice, the closest town and its household population is about 350. The survey was conducted with 50% of the randomly chosen households using semi-structured questionnaires and some onset CTA-A hobo current transducers were installed in three households to measure electricity used for either cooking, heating or lighting. The survey shows that electricity (supplied by Eskom) is the main source of energy for cooking, lighting and heating, while paraffin and candles are also used for lighting. The data collected using the data acquisition system has also shown that each household consumes an average of 140 kWh of electricity per month. Assuming this amount of energy being used throughout the year, on average the households consume 1680 kWh of electricity per year. The research concludes that there is a need to promote sustainable energy resources and technologies such as the use of biogas digesters as an alternative source of energy since the households has on average 20 of cattle, 10 of goats, 10 sheep and 4 donkeys. The research has also shown that the economic analysis of the biogas project is financially feasible. The Net present value was high and positive showing the feasibility of the investment on the project. The payback period was implying that the project pays itself off within the service life or within a set payback limit, which must be shorter than the technical service period of 5 years. The research has further shown that the emission factor for carbon dioxide for every 1MWh of electrical energy saved is 1.07 kg and consequently a corresponding volume of avoidance water is 1.40 KL. This can be mentioned that this monthly cost saving in the electrical energy consumption can go a long way in improving the social and economic welfare of the people. More so, it also vi plays a key role in the reduction of the global warming potential and the amount of air pollutant in the atmosphere. The avoidance water also contributed greatly in reducing the total volume of water used in the cooling towers of the coal power generation plant.
- Full Text:
- Authors: Mthimunye , Thabiso Vincent
- Date: 2018
- Subjects: Biogas
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: http://hdl.handle.net/10353/14561 , vital:40014
- Description: A study was conducted in Melani rural community of Raymond Mhlaba district in Eastern Cape, with the aim of identifying types of energy sources and households energy utilization. Melani village (32°43’29” S, 27°07’35” E) is 13 km away from Alice, the closest town and its household population is about 350. The survey was conducted with 50% of the randomly chosen households using semi-structured questionnaires and some onset CTA-A hobo current transducers were installed in three households to measure electricity used for either cooking, heating or lighting. The survey shows that electricity (supplied by Eskom) is the main source of energy for cooking, lighting and heating, while paraffin and candles are also used for lighting. The data collected using the data acquisition system has also shown that each household consumes an average of 140 kWh of electricity per month. Assuming this amount of energy being used throughout the year, on average the households consume 1680 kWh of electricity per year. The research concludes that there is a need to promote sustainable energy resources and technologies such as the use of biogas digesters as an alternative source of energy since the households has on average 20 of cattle, 10 of goats, 10 sheep and 4 donkeys. The research has also shown that the economic analysis of the biogas project is financially feasible. The Net present value was high and positive showing the feasibility of the investment on the project. The payback period was implying that the project pays itself off within the service life or within a set payback limit, which must be shorter than the technical service period of 5 years. The research has further shown that the emission factor for carbon dioxide for every 1MWh of electrical energy saved is 1.07 kg and consequently a corresponding volume of avoidance water is 1.40 KL. This can be mentioned that this monthly cost saving in the electrical energy consumption can go a long way in improving the social and economic welfare of the people. More so, it also vi plays a key role in the reduction of the global warming potential and the amount of air pollutant in the atmosphere. The avoidance water also contributed greatly in reducing the total volume of water used in the cooling towers of the coal power generation plant.
- Full Text:
The nexus between savings, investment and foreign capital in South Africa : an application of the Feldstein-Horioka puzzle
- Authors: Mtolo, Inga
- Date: 2018
- Subjects: Investments, Foreign -- South Africa Saving and investment -- South Africa Capital movements -- South Africa
- Language: English
- Type: Thesis , Masters , MCom
- Identifier: http://hdl.handle.net/10353/8968 , vital:34177
- Description: This study investigates the relationship between savings, investment and foreign capital in South Africa, with special focus on the application of the Feldstein-Horioka theory. South Africa is a country that is still faced with relatively low saving levels. Given the low savings experienced by the country, available literature has alluded that foreign capital has played a greater role as the major driver of private investment expenditure in South Africa. Based on this background, the study empirically investigates the relationship between savings, investment and foreign capital utilising the Autoregressive Distributed Lag Model estimation technique for the period 1965 to 2015. The empirical results revealed that there is a positive and significant relationship between savings and investment in South Africa. The empirical results also show that for the period 1995 to 2015, the different types of external financial flows utilized in the study and investment have a positive relationship. These results have been consistent with our apriori expectations and other prior studies. This suggests that, in the case of South Africa, apart from interest rates, there are other factors that determine investment. The positive relationship between investment and foreign capital flows suggest that policies which are aimed at attracting the different types of foreign financial flows should be implemented.
- Full Text:
- Authors: Mtolo, Inga
- Date: 2018
- Subjects: Investments, Foreign -- South Africa Saving and investment -- South Africa Capital movements -- South Africa
- Language: English
- Type: Thesis , Masters , MCom
- Identifier: http://hdl.handle.net/10353/8968 , vital:34177
- Description: This study investigates the relationship between savings, investment and foreign capital in South Africa, with special focus on the application of the Feldstein-Horioka theory. South Africa is a country that is still faced with relatively low saving levels. Given the low savings experienced by the country, available literature has alluded that foreign capital has played a greater role as the major driver of private investment expenditure in South Africa. Based on this background, the study empirically investigates the relationship between savings, investment and foreign capital utilising the Autoregressive Distributed Lag Model estimation technique for the period 1965 to 2015. The empirical results revealed that there is a positive and significant relationship between savings and investment in South Africa. The empirical results also show that for the period 1995 to 2015, the different types of external financial flows utilized in the study and investment have a positive relationship. These results have been consistent with our apriori expectations and other prior studies. This suggests that, in the case of South Africa, apart from interest rates, there are other factors that determine investment. The positive relationship between investment and foreign capital flows suggest that policies which are aimed at attracting the different types of foreign financial flows should be implemented.
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An exploration of the effects of government financial subsidies on the performance of schools and learners in the OR Tambo District Municipality
- Mtyida, Thembani Justice Zolisa
- Authors: Mtyida, Thembani Justice Zolisa
- Date: 2018
- Subjects: School budgets -- South Africa -- Eastern Cape School management and organization Education -- South Africa -- Finance
- Language: English
- Type: Thesis , Masters , MPA
- Identifier: http://hdl.handle.net/10353/9198 , vital:34304
- Description: An exploration of the effects of government financial subsidies on the performance of schools and learners in the OR Tambo District Municipality Under the Direction of: Prof EOC Ijeoma. As much as the awarded fiscal resources have been critical for improving the quality of learning and education as well as the performance of schools, there are still often inhibitors that affect the extent to which such fiscal packages are able to induce achievement of the desired educational outcomes. Thematic analysis of the interview findings revealed the limitations undermining the extent to which the allocated fiscal resources are able to influence the achievement of the desired positive educational outcomes and these are linked to poor school financial management, poor planning and budgeting, poor school governance and corruption and theft of funds. The other limitations that mar the effective performance of certain schools to achieve the desired educational outcomes were also noted to arise from the shortage of teachers for critical subjects, poor motivation of teachers in rural areas, poor learners’ welfare and poor infrastructure. To respond to these challenges, it is argued that the OR Tambo District Department of Education must develop special fiscal packages for teachers in the rural areas, develop special fiscal packages for teachers of special subjects such as science and mathematics, invest in the educational infrastructure and facilities, and proactively develop school managers. Future research can explore a framework for monitoring and evaluation of the effects of educational fiscal grants on the performance of schools and learners.
- Full Text:
- Authors: Mtyida, Thembani Justice Zolisa
- Date: 2018
- Subjects: School budgets -- South Africa -- Eastern Cape School management and organization Education -- South Africa -- Finance
- Language: English
- Type: Thesis , Masters , MPA
- Identifier: http://hdl.handle.net/10353/9198 , vital:34304
- Description: An exploration of the effects of government financial subsidies on the performance of schools and learners in the OR Tambo District Municipality Under the Direction of: Prof EOC Ijeoma. As much as the awarded fiscal resources have been critical for improving the quality of learning and education as well as the performance of schools, there are still often inhibitors that affect the extent to which such fiscal packages are able to induce achievement of the desired educational outcomes. Thematic analysis of the interview findings revealed the limitations undermining the extent to which the allocated fiscal resources are able to influence the achievement of the desired positive educational outcomes and these are linked to poor school financial management, poor planning and budgeting, poor school governance and corruption and theft of funds. The other limitations that mar the effective performance of certain schools to achieve the desired educational outcomes were also noted to arise from the shortage of teachers for critical subjects, poor motivation of teachers in rural areas, poor learners’ welfare and poor infrastructure. To respond to these challenges, it is argued that the OR Tambo District Department of Education must develop special fiscal packages for teachers in the rural areas, develop special fiscal packages for teachers of special subjects such as science and mathematics, invest in the educational infrastructure and facilities, and proactively develop school managers. Future research can explore a framework for monitoring and evaluation of the effects of educational fiscal grants on the performance of schools and learners.
- Full Text:
Preparation, characterization and in vitro analysis of polyamidoamine drug conjugates containing ferrocene and platinum analogues
- Authors: Mugogodi, Ansley
- Date: 2018
- Subjects: Ferrocene
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: http://hdl.handle.net/10353/10145 , vital:35360
- Description: Polyamidoamine drug conjugates were prepared from analogues of ferrocene and platinum. Standard reaction procedures were followed in the synthesis of platinum and ferrocene analogues. Michael addition reaction of amines to the activated double bonds of methylenebisacrylamide was applied for preparation of the water soluble polyamidoamine carriers onto which drug analogues were attached. The drug release studies of the conjugates were evaluated at different pH environments. The results obtained from drug release studies showed that rate of drug release was variable depending on the conjugate and pH environment. Mathematical drug release models by Korsmeyer-Peppas were used to determine the drug release characteristics of the ferrocene and platinum based drugs from polyamidoamine drug conjugates. Cytotoxicity potential of the analogues and polyamidoamine drug conjugates was tested on selected cell lines. Cisplatin was used as the standard for comparison of the IC50 values obtained for the compounds tested for cytotoxicity activity. The results from six polymer drug conjugates tested for cytotoxicity activity showed that conjugation of analogues to polyamidoamine carrier enhanced the activity of the analogues in some of the polyamidoamine drug conjugates. Various techniques such as Fourier Transform Infrared (FTIR) spectroscopy, Proton Nuclear Magnetic Resonance spectroscopy (1H NMR), Scanning Electron Microscopy (SEM), transmission electron microscopy (TEM), Transmission Electron Microscopy (TEM) and Energy Dispersive X-ray (EDX) spectroscopy were employed for the characterization of the ferrocene and platinum analogues, polyamidoamine carriers and drug conjugates.
- Full Text:
- Authors: Mugogodi, Ansley
- Date: 2018
- Subjects: Ferrocene
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: http://hdl.handle.net/10353/10145 , vital:35360
- Description: Polyamidoamine drug conjugates were prepared from analogues of ferrocene and platinum. Standard reaction procedures were followed in the synthesis of platinum and ferrocene analogues. Michael addition reaction of amines to the activated double bonds of methylenebisacrylamide was applied for preparation of the water soluble polyamidoamine carriers onto which drug analogues were attached. The drug release studies of the conjugates were evaluated at different pH environments. The results obtained from drug release studies showed that rate of drug release was variable depending on the conjugate and pH environment. Mathematical drug release models by Korsmeyer-Peppas were used to determine the drug release characteristics of the ferrocene and platinum based drugs from polyamidoamine drug conjugates. Cytotoxicity potential of the analogues and polyamidoamine drug conjugates was tested on selected cell lines. Cisplatin was used as the standard for comparison of the IC50 values obtained for the compounds tested for cytotoxicity activity. The results from six polymer drug conjugates tested for cytotoxicity activity showed that conjugation of analogues to polyamidoamine carrier enhanced the activity of the analogues in some of the polyamidoamine drug conjugates. Various techniques such as Fourier Transform Infrared (FTIR) spectroscopy, Proton Nuclear Magnetic Resonance spectroscopy (1H NMR), Scanning Electron Microscopy (SEM), transmission electron microscopy (TEM), Transmission Electron Microscopy (TEM) and Energy Dispersive X-ray (EDX) spectroscopy were employed for the characterization of the ferrocene and platinum analogues, polyamidoamine carriers and drug conjugates.
- Full Text:
PhD graduates' perceptions of supervision contact sessions at the University of Fort Hare, Eastern Cape, South Africa
- Authors: Muleya, Ekem
- Date: 2018
- Subjects: University of Fort Hare Graduate students Doctoral students
- Language: English
- Type: Thesis , Masters , MSoc
- Identifier: http://hdl.handle.net/10353/12914 , vital:39401
- Description: PhD supervision is mostly studied from the supervisor and education institutions’ point of view in South Africa. The role and what exactly transpires during supervision contact sessions, how it influences or contributes to the successful completion of a PhD degree has been under researched. The government of South Africa through the NDP has clear targets in terms of raising the annual number of people who graduate with PhDs, however the processes and the actual ingredients contributing to the increase are not being adequately examined. The purpose of this study was to investigate the contribution of supervision contact sessions in enabling a doctoral candidate to successfully complete a doctoral degree. Specifically this study sought to find out how supervision meetings enable a PhD candidate to finish the PhD degree successfully. This exploratory study sought to address the question through pin-pointing the specific benefits PhD candidates derive from supervision contact sessions and at the same time documenting the challenges faced in these meetings. Findings from this study point to the fact that supervision contact sessions are crucial in empowering a PhD candidate to finish his or her studies. Candidates benefit from both technical (professional) and social (emotional) support through supervision meetings with their supervisors and most importantly supervisors also assist and advise their candidates with regard to funding for their studies. In the main, PhD candidates prefer to meet frequently with their supervisors to discuss their PhD work however they in some instances encounter challenges in trying to set up meetings with their supervisors. Challenges also come during the actual supervision sessions due to the unequal relationship between supervisor and candidate. Given the role of supervision meetings in PhD completion, it is important to note some measures which can assist in terms of making supervision meetings more beneficial to a PhD candidate.
- Full Text:
- Authors: Muleya, Ekem
- Date: 2018
- Subjects: University of Fort Hare Graduate students Doctoral students
- Language: English
- Type: Thesis , Masters , MSoc
- Identifier: http://hdl.handle.net/10353/12914 , vital:39401
- Description: PhD supervision is mostly studied from the supervisor and education institutions’ point of view in South Africa. The role and what exactly transpires during supervision contact sessions, how it influences or contributes to the successful completion of a PhD degree has been under researched. The government of South Africa through the NDP has clear targets in terms of raising the annual number of people who graduate with PhDs, however the processes and the actual ingredients contributing to the increase are not being adequately examined. The purpose of this study was to investigate the contribution of supervision contact sessions in enabling a doctoral candidate to successfully complete a doctoral degree. Specifically this study sought to find out how supervision meetings enable a PhD candidate to finish the PhD degree successfully. This exploratory study sought to address the question through pin-pointing the specific benefits PhD candidates derive from supervision contact sessions and at the same time documenting the challenges faced in these meetings. Findings from this study point to the fact that supervision contact sessions are crucial in empowering a PhD candidate to finish his or her studies. Candidates benefit from both technical (professional) and social (emotional) support through supervision meetings with their supervisors and most importantly supervisors also assist and advise their candidates with regard to funding for their studies. In the main, PhD candidates prefer to meet frequently with their supervisors to discuss their PhD work however they in some instances encounter challenges in trying to set up meetings with their supervisors. Challenges also come during the actual supervision sessions due to the unequal relationship between supervisor and candidate. Given the role of supervision meetings in PhD completion, it is important to note some measures which can assist in terms of making supervision meetings more beneficial to a PhD candidate.
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The reliability of firearm identification in South Africa : a comparative perspective
- Authors: Mutsavi, Tanyarara
- Date: 2018
- Subjects: Forensic sciences Firearms -- Identification
- Language: English
- Type: Thesis , Masters , Law
- Identifier: http://hdl.handle.net/10353/10850 , vital:35860
- Description: Crime has become a well-known and worrying fact of life in South Africa. It constrains the ability of citizens to participate actively and meaningfully in all spheres of social and economic life. In many cases where a crime is committed, a firearm is involved. In order to fight gun crime there is a need for the perpetrators to be prosecuted. For prosecution to take place, there must be evidence to link the suspects to the committed crime. This is when firearm identification as a form of expert scientific evidence comes into play. This type of evidence links the bullets and cartridges recovered from the crime scene to the suspect.s firearms through the process of matching which is done by using a comparison microscope. Expert scientific evidence like firearm identification evidence, needs to be scientifically reliable because unreliable evidence may lead to the conviction of the innocent and exoneration of the guilty. Case law, authoritative reports and other literature have shown that firearm identification is not scientific and therefore it is not reliable. This is a disturbing position, considering the fact that this type of evidence is still being used in courts and no alternative has been found thus far to replace it. This study therefore proposes some reforms and recommendations which have been registered in authoritative reports which assist South Africa in dealing with firearm identification evidence. To achieve reliability, some writers have suggested that South Africa should adopt the US approach with regard to admissibility where judges play a .gate keeping. role by making sure that expert evidence is reliable before it enters the court. However, this study argues that scientific reliability, in South Africa, should not be a criterion for admissibility, but should rather be a central factor in deciding what weight should be attached to the expert evidence given in a particular case. The reason for this is that, in South Africa, the jury system is not used and therefore the judge does not have to exercise a .gate keeping. role, as he or she will be the final arbiter as to whether the evidence is reliable. In this context, reliability is considered during cross-examination. Cross-examination by the defence is crucial and this study proposes some possible cross-examination questions that can be helpful in testing the reliability of firearm identification evidence.
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- Authors: Mutsavi, Tanyarara
- Date: 2018
- Subjects: Forensic sciences Firearms -- Identification
- Language: English
- Type: Thesis , Masters , Law
- Identifier: http://hdl.handle.net/10353/10850 , vital:35860
- Description: Crime has become a well-known and worrying fact of life in South Africa. It constrains the ability of citizens to participate actively and meaningfully in all spheres of social and economic life. In many cases where a crime is committed, a firearm is involved. In order to fight gun crime there is a need for the perpetrators to be prosecuted. For prosecution to take place, there must be evidence to link the suspects to the committed crime. This is when firearm identification as a form of expert scientific evidence comes into play. This type of evidence links the bullets and cartridges recovered from the crime scene to the suspect.s firearms through the process of matching which is done by using a comparison microscope. Expert scientific evidence like firearm identification evidence, needs to be scientifically reliable because unreliable evidence may lead to the conviction of the innocent and exoneration of the guilty. Case law, authoritative reports and other literature have shown that firearm identification is not scientific and therefore it is not reliable. This is a disturbing position, considering the fact that this type of evidence is still being used in courts and no alternative has been found thus far to replace it. This study therefore proposes some reforms and recommendations which have been registered in authoritative reports which assist South Africa in dealing with firearm identification evidence. To achieve reliability, some writers have suggested that South Africa should adopt the US approach with regard to admissibility where judges play a .gate keeping. role by making sure that expert evidence is reliable before it enters the court. However, this study argues that scientific reliability, in South Africa, should not be a criterion for admissibility, but should rather be a central factor in deciding what weight should be attached to the expert evidence given in a particular case. The reason for this is that, in South Africa, the jury system is not used and therefore the judge does not have to exercise a .gate keeping. role, as he or she will be the final arbiter as to whether the evidence is reliable. In this context, reliability is considered during cross-examination. Cross-examination by the defence is crucial and this study proposes some possible cross-examination questions that can be helpful in testing the reliability of firearm identification evidence.
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The role of migrants in the Pan Africanist struggle for liberation from 1962 to 1963 : the case of Cofimvaba
- Authors: Mwanda, Sindiswa Christina
- Date: 2018
- Subjects: South Africa -- History -- 1962-1963 South Africa -- Politics and government -- 1962-1963
- Language: English
- Type: Thesis , Masters , History
- Identifier: http://hdl.handle.net/10353/9883 , vital:35107
- Description: The perspective of South African liberation history needs to be balanced by recalling events that might otherwise be overshadowed by the subsequent electoral dominance of the African National Congress since 1994. This study is concerned with one such: the Cofimvaba struggles of 1962-3 which was organised by Cofimvaba migrants under the ideology of the Pan Africanist Congress. Whereas previous historians have based their accounts mainly on trial records, this thesis strives to recover the migrants’ own perspective through intensive and detailed interviews with the surviving veterans. It aims to provide an accurate historical account of the role played by migrant labourers, thereby correcting the historical distortions arising from overreliance on official sources to record the memories and perceptions of the struggle veterans, as exemplified by transcripts of interviews with and thereby provide some balance to the overall perspective of South African liberation history. The thesis opens with a description of the situation on the ground in Cofimvaba and Western Thembuland which gave rise to resistance. It continues with a discussion of the Pan-African Congress, especially in the Western Cape, the labour centre where most Cofimvaba migrants were concentrated. It proceeds to a detailed narrative of the events in Cofimvaba, more especially the battle of Ntlonze. The final chapter concludes with a critical reassessment of previous historical work, showing that the role of the migrants and the non-elite require greater appreciation and respect.
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- Authors: Mwanda, Sindiswa Christina
- Date: 2018
- Subjects: South Africa -- History -- 1962-1963 South Africa -- Politics and government -- 1962-1963
- Language: English
- Type: Thesis , Masters , History
- Identifier: http://hdl.handle.net/10353/9883 , vital:35107
- Description: The perspective of South African liberation history needs to be balanced by recalling events that might otherwise be overshadowed by the subsequent electoral dominance of the African National Congress since 1994. This study is concerned with one such: the Cofimvaba struggles of 1962-3 which was organised by Cofimvaba migrants under the ideology of the Pan Africanist Congress. Whereas previous historians have based their accounts mainly on trial records, this thesis strives to recover the migrants’ own perspective through intensive and detailed interviews with the surviving veterans. It aims to provide an accurate historical account of the role played by migrant labourers, thereby correcting the historical distortions arising from overreliance on official sources to record the memories and perceptions of the struggle veterans, as exemplified by transcripts of interviews with and thereby provide some balance to the overall perspective of South African liberation history. The thesis opens with a description of the situation on the ground in Cofimvaba and Western Thembuland which gave rise to resistance. It continues with a discussion of the Pan-African Congress, especially in the Western Cape, the labour centre where most Cofimvaba migrants were concentrated. It proceeds to a detailed narrative of the events in Cofimvaba, more especially the battle of Ntlonze. The final chapter concludes with a critical reassessment of previous historical work, showing that the role of the migrants and the non-elite require greater appreciation and respect.
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An assessment of IDP implementation and sustainable development : the case of the housing sector in Mangaung Metropolitan Municipality
- Authors: Mwatenga, John
- Date: 2018
- Subjects: City planning Sustainable development Housing
- Language: English
- Type: Thesis , Masters , MCom
- Identifier: http://hdl.handle.net/10353/13447 , vital:39667
- Description: This research study assessed the implementation of the Integrated Development Plan and sustainable development in Mangaung Metropolitan Municipality. The study intended to achieve the following objectives: i) to identify factors affecting the provision of dwelling units in the Mangaung Metropolitan Municipality and their effect on sustainable development in the Mangaung Metropolitan Municipality; to assess the perceptions of the municipality and the community on the role of the IDP as a tool for development; iii) to suggest strategies that can be adopted to improve IDP implementation for sustainable development in the area. The literature reviewed in the study was drawn from several researchers. The sustainable development theory, the incremental planning model and the rational planning model underpinned the study. Although three theories were used, the sustainable development theory was the major theory adopted in this study. The mixed research methods are used to collect the primary data for this study. The use of both quantitative and qualitative methods is deemed most appropriate for this research study, as most researchers regard them as best methods in answering the research questions. The use of mixed methods has the assumption that both approaches can complement each other and help in avoiding unnecessary shortcomings. Since the study collected both quantitative and qualitative data, an interview guide and questionnaires were used. Interviews were conducted with three (3) municipal officials as well as (2) councillors from Mangaung metropolitan municipality (MMM), whereas questionnaires were distributed to (90) community members. The analysis of the study made the following conclusions about the IDP implementation and sustainable development in Mangaung metropolitan municipality. Firstly, there is satisfactory majority understanding among the participants regarding Integrated Development Plan and its related processes. The respondents have a common view that the IDP is a key tool that buoys development and that continued implementation challenges halt every form of development within the municipal area. Secondly, there is implementation of the IDP in Mangaung metropolitan municipality (MMM); nevertheless, the extent of implementation has not had the anticipated effect on the general populace in communities, given the ineffectiveness and inefficiencies in resource utilisation. Thirdly, it was also discovered that the municipality currently has serious housing backlogs that have brought auxiliary challenges thus impeding developmental efforts of MMM. Fourthly, the study also concluded that the causes of housing backlogs are: apartheid legacy, influx of foreign nationals, lack of oversight monitoring, heightened poverty, corruption, poor governance, insufficient budget, ineffective IDP implementation, urbanisation, natural population; unemployment and lack of capacity and skills can be regarded as the major contributors to housing shortages currently plaguing MMM. Thus the study recommended that an oversight, monitoring and evaluation policy, good governance, public participation, utilisation of PPPs and implementation of environmental management policy will go a long way in enhancing IDP implementation towards attaining sustainable development in the Mangaung metropolitan municipality.
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- Authors: Mwatenga, John
- Date: 2018
- Subjects: City planning Sustainable development Housing
- Language: English
- Type: Thesis , Masters , MCom
- Identifier: http://hdl.handle.net/10353/13447 , vital:39667
- Description: This research study assessed the implementation of the Integrated Development Plan and sustainable development in Mangaung Metropolitan Municipality. The study intended to achieve the following objectives: i) to identify factors affecting the provision of dwelling units in the Mangaung Metropolitan Municipality and their effect on sustainable development in the Mangaung Metropolitan Municipality; to assess the perceptions of the municipality and the community on the role of the IDP as a tool for development; iii) to suggest strategies that can be adopted to improve IDP implementation for sustainable development in the area. The literature reviewed in the study was drawn from several researchers. The sustainable development theory, the incremental planning model and the rational planning model underpinned the study. Although three theories were used, the sustainable development theory was the major theory adopted in this study. The mixed research methods are used to collect the primary data for this study. The use of both quantitative and qualitative methods is deemed most appropriate for this research study, as most researchers regard them as best methods in answering the research questions. The use of mixed methods has the assumption that both approaches can complement each other and help in avoiding unnecessary shortcomings. Since the study collected both quantitative and qualitative data, an interview guide and questionnaires were used. Interviews were conducted with three (3) municipal officials as well as (2) councillors from Mangaung metropolitan municipality (MMM), whereas questionnaires were distributed to (90) community members. The analysis of the study made the following conclusions about the IDP implementation and sustainable development in Mangaung metropolitan municipality. Firstly, there is satisfactory majority understanding among the participants regarding Integrated Development Plan and its related processes. The respondents have a common view that the IDP is a key tool that buoys development and that continued implementation challenges halt every form of development within the municipal area. Secondly, there is implementation of the IDP in Mangaung metropolitan municipality (MMM); nevertheless, the extent of implementation has not had the anticipated effect on the general populace in communities, given the ineffectiveness and inefficiencies in resource utilisation. Thirdly, it was also discovered that the municipality currently has serious housing backlogs that have brought auxiliary challenges thus impeding developmental efforts of MMM. Fourthly, the study also concluded that the causes of housing backlogs are: apartheid legacy, influx of foreign nationals, lack of oversight monitoring, heightened poverty, corruption, poor governance, insufficient budget, ineffective IDP implementation, urbanisation, natural population; unemployment and lack of capacity and skills can be regarded as the major contributors to housing shortages currently plaguing MMM. Thus the study recommended that an oversight, monitoring and evaluation policy, good governance, public participation, utilisation of PPPs and implementation of environmental management policy will go a long way in enhancing IDP implementation towards attaining sustainable development in the Mangaung metropolitan municipality.
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Correlations between the occurence of virulent helicobacter pylori strains and chronic disease conditions in dyspeptic patients hospitalized in Chris Hani Baragwanath Hospital, Gauteng Province, South Africa
- Authors: Mzukwa, Asisipho
- Date: 2018
- Subjects: Helicobacter pylori infections Helicobacter pylori Bacterial diseases
- Language: English
- Type: Thesis , Masters , Microbiology
- Identifier: http://hdl.handle.net/10353/10885 , vital:35905
- Description: Introduction: Individuals predisposed to different chronic disease conditions such as type 2 diabetes mellitus (T2DM), hypertension (HPT) and human immunodeficiency virus (HIV) might be susceptible to persistent H. pylori colonization, which overtime encourages infection with virulent strains. The presence of different types of H. pylori virulence factors especially cagA, dupA and various combinations of vacA subtypes (s1/m1, s2/m1 and s2m2) confer a higher risk of gastric disease development. Aim: This study seeks to recover H. pylori from gastric biopsy specimen from patients with different chronic disease conditions referred to the GIT unit at Chris Hani Baragwanath Academic Hospital, Soweto, and confirm them and further determine the presence of virulent H. pylori strains in patients with T2DM, HPT and HIV. Methods: Gastric biopsies were obtained from 101 patients with different chronic disease conditions after obtaining consent between August 2017 and February 2018. H. pylori was isolated on selective Colombia blood agar. Presumptive isolates were identified following standard microbiology and biochemical technique. These isolates were confirmed by polymerase chain reaction (PCR) targeting the glmM gene. The H. pylori positive samples were further screened for cagA, dupA and vacA genotypes. Results: H. pylori was recovered from 26 patients, of which 8 were patients with T2DM, 10 with HPT and 8 with HIV. There was no correlation between H. pylori infection and the chronic conditions, but the majority of H. pylori positive participant carried virulent H. pylori strains. The cagA and the dupA genes were more prevalent in T2DM and HPT patients, however the association between these genes and the 2 chronic conditions was not significant. The vacA subtypes common in hypertensive patients compared to the other conditions were the s1m1, s1m2, and s2m2 and the association between these vacA forms and hypertension was significant. Majority of HIV infected patients were found to carry non-virulent H. pylori strains. Conclusion: The prevalence of H. pylori among the general population of patients with T2DM, HPT and HIV was low. Although infected patients are found to be carrying virulent strains of H. pylori, there is no significant association established between the virulent strains and the chronic conditions. Furthermore, HIV-infected patients were found to be carrying non-virulent strains of H. pylori.
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- Authors: Mzukwa, Asisipho
- Date: 2018
- Subjects: Helicobacter pylori infections Helicobacter pylori Bacterial diseases
- Language: English
- Type: Thesis , Masters , Microbiology
- Identifier: http://hdl.handle.net/10353/10885 , vital:35905
- Description: Introduction: Individuals predisposed to different chronic disease conditions such as type 2 diabetes mellitus (T2DM), hypertension (HPT) and human immunodeficiency virus (HIV) might be susceptible to persistent H. pylori colonization, which overtime encourages infection with virulent strains. The presence of different types of H. pylori virulence factors especially cagA, dupA and various combinations of vacA subtypes (s1/m1, s2/m1 and s2m2) confer a higher risk of gastric disease development. Aim: This study seeks to recover H. pylori from gastric biopsy specimen from patients with different chronic disease conditions referred to the GIT unit at Chris Hani Baragwanath Academic Hospital, Soweto, and confirm them and further determine the presence of virulent H. pylori strains in patients with T2DM, HPT and HIV. Methods: Gastric biopsies were obtained from 101 patients with different chronic disease conditions after obtaining consent between August 2017 and February 2018. H. pylori was isolated on selective Colombia blood agar. Presumptive isolates were identified following standard microbiology and biochemical technique. These isolates were confirmed by polymerase chain reaction (PCR) targeting the glmM gene. The H. pylori positive samples were further screened for cagA, dupA and vacA genotypes. Results: H. pylori was recovered from 26 patients, of which 8 were patients with T2DM, 10 with HPT and 8 with HIV. There was no correlation between H. pylori infection and the chronic conditions, but the majority of H. pylori positive participant carried virulent H. pylori strains. The cagA and the dupA genes were more prevalent in T2DM and HPT patients, however the association between these genes and the 2 chronic conditions was not significant. The vacA subtypes common in hypertensive patients compared to the other conditions were the s1m1, s1m2, and s2m2 and the association between these vacA forms and hypertension was significant. Majority of HIV infected patients were found to carry non-virulent H. pylori strains. Conclusion: The prevalence of H. pylori among the general population of patients with T2DM, HPT and HIV was low. Although infected patients are found to be carrying virulent strains of H. pylori, there is no significant association established between the virulent strains and the chronic conditions. Furthermore, HIV-infected patients were found to be carrying non-virulent strains of H. pylori.
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A budget and expenditure review of public hospital facilities in the Eastern Cape in transition towards National Health Insurance
- Authors: Ndlovu, Garfield OG
- Date: 2018
- Subjects: Health services administration--South Africa--Eastern Cape Government spending policy--South Africa--Eastern Cape Health services administration
- Language: English
- Type: Thesis , Masters , Public Health Leadership
- Identifier: http://hdl.handle.net/10353/11139 , vital:37174
- Description: The quest to ameliorate and enhance the equitable allocation of resources in the Health Industry remains a global challenge, in particular the distribution of funding resources in public sector health facilities. The need to analyse and understand the appropriation of budget and utilisation of funds by hospital facilities is important in the in the Eastern Cape. The focus of the study seeks to explore recommendations that can be employed in the provincial budgeting process of Hospital Facilities, in a bid to optimise efficiency and improve the funding process as part of the provincial readiness activities towards the realisation of the NHI System and funding approach, wherein the NHI Fund will be a public entity that is not in business to make profit (NHI Booklet 2012: 05). This fund will introduce new systems of paying hospitals and professionals for the services they provide, aiming to be fair to them but to put a stop to unreasonable profits (NHI Booklet 2012: 05). The research has employed the use of descriptive quantitative techniques in order to undertake an expenditure review of existing financial data with respect to the Eastern Cape public Hospitals. The study followed a quantitative descriptive research design, the purpose of this study is that, quantitative research deals in numbers, logic, and an objective stance (Babbie: 2010). The Quantitative aspect of the study found that the data provided, allowed the researcher to organise, synthesise, prioritise and assign value to specific key performance indicators that would be used for the appraisal of hospital facilities in relation to the expenditure patterns based which would present a glimpse into how the Eastern Cape department of health utilises funding resources.
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- Authors: Ndlovu, Garfield OG
- Date: 2018
- Subjects: Health services administration--South Africa--Eastern Cape Government spending policy--South Africa--Eastern Cape Health services administration
- Language: English
- Type: Thesis , Masters , Public Health Leadership
- Identifier: http://hdl.handle.net/10353/11139 , vital:37174
- Description: The quest to ameliorate and enhance the equitable allocation of resources in the Health Industry remains a global challenge, in particular the distribution of funding resources in public sector health facilities. The need to analyse and understand the appropriation of budget and utilisation of funds by hospital facilities is important in the in the Eastern Cape. The focus of the study seeks to explore recommendations that can be employed in the provincial budgeting process of Hospital Facilities, in a bid to optimise efficiency and improve the funding process as part of the provincial readiness activities towards the realisation of the NHI System and funding approach, wherein the NHI Fund will be a public entity that is not in business to make profit (NHI Booklet 2012: 05). This fund will introduce new systems of paying hospitals and professionals for the services they provide, aiming to be fair to them but to put a stop to unreasonable profits (NHI Booklet 2012: 05). The research has employed the use of descriptive quantitative techniques in order to undertake an expenditure review of existing financial data with respect to the Eastern Cape public Hospitals. The study followed a quantitative descriptive research design, the purpose of this study is that, quantitative research deals in numbers, logic, and an objective stance (Babbie: 2010). The Quantitative aspect of the study found that the data provided, allowed the researcher to organise, synthesise, prioritise and assign value to specific key performance indicators that would be used for the appraisal of hospital facilities in relation to the expenditure patterns based which would present a glimpse into how the Eastern Cape department of health utilises funding resources.
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Assessment of the effect of the down-referral chronic medication distribution system on patients' adherence to chronic medication in the Buffalo City sub-district
- Authors: Ndwandwe, Miriam
- Date: 2018
- Subjects: Health services accessibility Pharmacology Patient compliance
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: http://hdl.handle.net/10353/13248 , vital:39626
- Description: The purpose of the study is to determine the effect of the down referral chronic medication distribution system on patient's adherence to chronic medicine in Buffalo City sub - district by ensuring that chronic patients receive their correct medication on time and in correct quantities every month so that they can take the medication as recommended by the health professional. Adherence to chronic medication lead to better health outcome and reduced hospital re-admission. A non-experimental and descriptive quantitative research methodology was used. A data abstraction form developed by the researcher was used to record data from the medical records of chronically ill patients. The results of the study revealed that most of the chronically ill patients who were admitted to hospital were not adherent to their chronic medication. Patients are non-adherent even if they have chronic medication with them. This was evident in the number of patients who do not remember how many days did they not take their treatment. Others indicated that they share their medication with other family members who suffer from the same chronic condition. The patients' lack of understanding of their chronic condition and the consequences of not taking medication as instructed by the health professional contribute to non-adherence. Strengthening of health promotion programmes to educate the patients about their chronic condition would improve adherence. Most of the chronic conditions are life-style modifiable diseases. Patients must be educated about the changes they can make to improve their quality of life.
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- Authors: Ndwandwe, Miriam
- Date: 2018
- Subjects: Health services accessibility Pharmacology Patient compliance
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: http://hdl.handle.net/10353/13248 , vital:39626
- Description: The purpose of the study is to determine the effect of the down referral chronic medication distribution system on patient's adherence to chronic medicine in Buffalo City sub - district by ensuring that chronic patients receive their correct medication on time and in correct quantities every month so that they can take the medication as recommended by the health professional. Adherence to chronic medication lead to better health outcome and reduced hospital re-admission. A non-experimental and descriptive quantitative research methodology was used. A data abstraction form developed by the researcher was used to record data from the medical records of chronically ill patients. The results of the study revealed that most of the chronically ill patients who were admitted to hospital were not adherent to their chronic medication. Patients are non-adherent even if they have chronic medication with them. This was evident in the number of patients who do not remember how many days did they not take their treatment. Others indicated that they share their medication with other family members who suffer from the same chronic condition. The patients' lack of understanding of their chronic condition and the consequences of not taking medication as instructed by the health professional contribute to non-adherence. Strengthening of health promotion programmes to educate the patients about their chronic condition would improve adherence. Most of the chronic conditions are life-style modifiable diseases. Patients must be educated about the changes they can make to improve their quality of life.
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