3. Electronic Theses and Dissertations (ETDs) - All submissions
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Item 'Renegotiated identities': stories of women who are initiated traditional healers and work in a hospital environment in a different capacity(2009-07-27T09:44:15Z) Human, LeoniThis study aims to explore the experiences of traditional healers who work in a hospital environment in a different capacity. A secondary aim of this inquiry is to look at how participants' perceptions of the interface between traditional and modern medicine in a hospital context influences their practices as both traditional healers and hospital employees. A snowball sampling strategy was employed and five suitable participants were identified through referral and post-interview selection. Participants were selected from a sample of South African-born women who have experienced an ancestral calling and initiation into African traditional healing, have been initiated as an Inyanga/iSangoma (diviner), and are presently working in a different vocational capacity in a hospital environment. All participants work and reside in Gauteng. Data was collected through two semi-structured interviews per participant. Interviews were based on an interview guide. In looking at participants' experience as traditional healers who work in a hospital and how their perceptions on the interface between traditional and modern medicine influence their traditional healing practices, four research questions have been identified: 1. How do participants perceive themselves as a traditional healer? 2. How do participants perceive and experience their work in the hospital? 3. How do participants perceive the interface between traditional and modern approaches to healing in a hospital context? 4. How do participants experience the perceptions of others at work? A qualitative approach was adopted in order to gain an in-depth understanding of participants' experiences. Data analysis was guided by narrative and thematic approaches. Thus results are presented in accordance with principles of narrative and thematic content analysis. Interpretation of data focused on the ways in which these women relate to their role as traditional healer in a different vocational capacity and how their perceptions reflect a broader dialogue on the relationship between traditional and modern healing modalities in a modern health care context. Participants felt empowered by some colleagues who consulted them on traditional healing skills and applied them to patients without constraint upon their working duties. All felt they needed their jobs to support a decent living as full-time work as traditional healers would not provide for all their needs. Implications for future research and collaboration between western and traditional healing systems are considered.Item Organisational capacity affecting adherence to Anti Retroviral Therapy at two public sector sites in Gauteng(2009-02-10T08:01:05Z) Pursell, RebeccaABSTRACT The formulation and approval of the Operational Plan for Comprehensive Care, Management and Treatment for HIV/AIDS in 2003 was a major victory for the roll-out of anti-retroviral therapy (ART) in the public sector in South Africa. Since its initiation in 2004, the ART Programme has expanded rapidly and realised considerable gains in prolonging life. However, it has also faced major constraints and implementation has been uneven across provinces. This study investigates the impact of organisational capacity upon levels of adherence to ART in two public sector sites in Gauteng. The study uses the Chronic Care Model (CCM) proposed by Edward Wagner (2004). The CCM identifies four major components as crucial to effective clinical outcomes for the management of chronic care. These factors are (1) prepared proactive practice teams; (2) delivery systems design; (3) decision support; and (4) clinical information systems. Both sites demonstrated different strengths and constraints. Strengths included the presence of motivated champions leading the ART service, positive patient-provider relationships, shifting of tasks to lower level health workers to deal with the shortage of skilled staff, good relationships with non-governmental organisations and the innovation to deal with challenges in a way that does not compromise the quality of care provided to patients using the CCMT service. Overall constraints that were identified in the two facilities include the shortage of skilled staff, burn-out among staff, a shortage of space, inconsistent data collection and interpretation, as well as poor integration and collaboration between local and provincial government in relation to the shared responsibility for the provision of Tuberculosis (TB) treatment and other related CCMT services. Despite these barriers, levels of adherence exceeded 85% in both sites.