Browsing by Author "Malatji, Hlologelo"
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Item Community-orientated primary health care: Exploring the interface between community health workers, the healthcare system and communities in South Africa(University of the Witwatersrand, Johannesburg, 2024) Malatji, Hlologelo; Goudge, Jane; Griffiths, FrancesBackground: To achieve universal health coverage, low and middle income countries (LMICs) are extending primary health care (PHC) services using community health worker (CHW) programmes. However, CHWs are marginalized within the healthcare system. Community-orientated primary health care (COPC) and supportive supervision are two interventions being used to strengthen CHW programmes. Primary aim: To understand whether and how the COPC and supportive supervision approaches strengthen CHW programmes in South Africa. Methods: Data was collected between 2016 and 2019 using qualitative methods in nine PHC facilities in rural and semi-urban areas of Mpumalanga and Gauteng provinces, South Africa. Purposive and snowball sampling techniques were used to recruit participants. The participants included: CHWs, supervisors, facility staff members and community members. Data was collected using focus group discussions, individual interviews and observations, and was analysed thematically. Findings: In line with the COPC approach, there were efforts to engage communities in the implementation of the CHW programmes but community members prioritised other challenges such as lack of housing and running water. In some facilities, in-service training increased CHWs knowledge and skills but challenges such as lack of supervision, lack of resources and outsourced employment without benefits demotivated the CHWs (Paper 1 / Objective 1, Published). In response to challenges, in the semi-urban sites, CHWs unionised to present their grievances to government. This resulted in an increase in stipend but not permanent government employment. During the height of the COVID-19 pandemic, when decision- makers recognised the essential role of CHWs higher remuneration was secured. CHWs in rural areas were not active in demanding permanent employment (Paper 2 / Objective 2, Published). Supportive supervision provided by a nurse mentor over 14 months, (1) trained CHWs and their supervisors resulting in increased knowledge and new skills, (2) addressed their fears of learning and failing and (3) established operational systems to address inefficiencies in CHW core activities (household registration and medication delivery). The intervention was disrupted by union activities. The communities’ demonstrated little interest in the functioning of CHW programmes (Paper/ Objective 3, Published). Conclusion: Both the COPC approach and supportive supervision can reduce marginalisation of CHW within the health systemItem Evaluation of an Employment Guarantee to address youth unemployment: A case study of young people participating in Community Work Programmes in Gauteng Province, South Africa(University of the Witwatersrand, Johannesburg, 2021) Waseem, Carrim; Wotela, Kambidima; Malatji, HlologeloYouth unemployment in South Africa is a crisis that requires new thinking and solutions. An employment guarantee is an abstract proposition that has gained recognition globally, particularly in India through the adoption of the Mahatma Gandhi National Rural Employment Guarantee Act which has guaranteed 50 million rural households work for up to 100 days per annum. South Africa has battled high levels of unemployment since the dawn of democracy in 1994. Various policy mechanisms have been designed to respond to the growing numbers of the unemployed. From a public employment perspective, two large scale programmes have been implemented – the Expanded Public Works Programme from 2004 onwards and the Community Works Programme (CWP) since 2010. The Community Works Programme is closer to an employment guarantee as it does not specify an exit point for its participants. The programme currently has an estimated 250 000 participants across 254 local municipalities. Although youth unemployment is high, youth participation in the Community Works Programme is lower than that of their adult counterparts. This research considers whether employment guarantee for young people could be an effective mechanism to help reduce these unemployment numbers. The research considers an employment guarantee from two distinct perspectives in a descriptive quantitative strategy. Firstly, from the perspective of young people participating in the Community Works Programme; their benefits, experiences, perceptions, skills development and ultimately whether the CWP has improved their quality of life. Secondly, from the perspective of young work seekers – and specifically their willingness to participate in a state sponsored employment guarantee programme with design and features like that of CWP. The research finds that CWP is contributing to the improvement of quality of life for young people and that young people who find themselves outside the labour market have an interest in participating in a public employment guarantee. Three are however fiscal and absorption challenges which would need to be overcome. It is recommended that in designing youth employment strategies policy makers consider public employment guarantees as part of the design mixItem Residential care and cultural identity : exploring the challenges experienced by adolescent boys living at Epworth Child and Youth Care Centre in Lambton, Germiston(2017) Malatji, HlologeloTeenage pregnancy is a growing social problem in South Africa and has, over the years extended to schools, particularly public schools. This is evident by the fact that each and every year, a significant number of teenage girls drop out of school because of pregnancy related issues. This is further exacerbated by a massive shift occurring in affected learners' lives following childbirth. They are expected to continue with school while at the same time cope with parental responsibilities related to teenage motherhood. It should be noted some learners do re-engage with education following the birth of their children. However, very little is known about the challenges they are confronted with after making the decision to go back to school. Thus the aim of this study was to explore the challenges experienced by teenage mothers when they re-engage with secondary school education after giving birth. The study adopted a qualitative research approach. A snowball sampling technique was used to sample 15 teenage mothers, while a purposive sampling technique was used to select 2 key informants. A semi-structured interview schedule was utilised as the research tool, with indepth one-on-one interviews used as a method of data collection. The collected data was analysed using thematic content analysis. Findings derived from the study revealed the desire to have a better future and the fear of being the black sheep of the family motivated teenage mothers to re-engage with school following child birth. However, it was also found reengaging with school after giving birth was a challenge for teenage mothers. This was alluded to by the lack of parental involvement in teenage mothers' day to day activities, hostile educators and the pressure of having to catch-up with missed work. In conclusion, even though some teenage mothers re-engage with education after giving birth, it is not an easy road to travel as it does severely affect teenage girls' access to education. Therefore, support is required from various stakeholders to support teenage mothers who decide to go back to school following the birth of their children. Recommendations related to policy improvement and future research are provided.Item Transformational leadership and employee engagement at CHAL hospitals in Lesotho(University of the Witwatersrand, Johannesburg, 2021) Doti, Mmello; Wotela, Kambidima; Malatji, HlologeloPurpose: This study aimed at improving services at CHAL health facilities and to add to the studies that were conducted previously on the impact of transformational leadership on employee engagement. The impact was investigated through attempting to find relationships between key aspects of transformational leadership, employee engagement and productivity. The aim was to continuously explore ways to enhance profitability and efficient ways of delivering meaningful services for CHAL Health facilities. Research Design, methodology & approach: The study was done from data collected from the employees of two CHAL Hospital. A quantitative study was conducted using the following measures: Cronbach Alpha coefficient for reliability and Correlation Matrix to measure the correlations between variables under transformational leadership and employee engagement domains. Findings and recommendations: The main finding of the study was that transformational leadership has positive relationship with employee engagement. It was also established that employee engagement is a perfect strategy to enhance organisational performance, competitiveness and efficiency. Future recommendation was to acquire leadership skills for all levels of management and establish a goal oriented organisational culture for improving employee engagement