4. Electronic Theses and Dissertations (ETDs) - Faculties submissions

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    Realising the right to healthcare: the legislative frameworks pertaining to private health establishments and private healthcare funding models in South Africa
    (University of the Witwatersrand, Johannesburg, 2024) Labuschagne-Kom, Lindsie; Mahery, Prinslean; Martin, Blake
    The Universal Declaration of Human Rights recognises access to healthcare as a fundamental human right and is guaranteed by the South African Constitution. An analysis of this right reveals that it comprises of two main components, namely financing and delivery of healthcare services. These are fulfilled by the government in the public sector and by private healthcare funders and private health establishments in the private sector. However, an analysis reveals that access to healthcare is substantively inequitable due to the fragmentation of the health system and unveils significant inefficiencies in the private sector that impeded realisation of this right. This dissertation examines the cause of this fragmentation and the inefficiencies within the private healthcare funders and private health establishments market. It investigates how these issues can be resolved to realise the right to healthcare. This study applied a qualitative desktop review of governmental policies, direct and incidental legislation, and multidisciplinary fields of academic reviews such as competition, healthcare, constitutional law and international policies to evaluate the effect of historical, contemporary and prospective policies and legislation, on access to healthcare. This analysis reveals that access to healthcare was historically manipulated to achieve political ideology through a legislative framework that provided the foundation for private funding models and private health establishments to flourish. This occurred at the expense of the public sector and embedded the fragmentation and inefficiencies in the health system. Notwithstanding the enactment of the Constitution, which envisioned a transformed and equal society, access to healthcare remains substantively inequitable. This is due to governmental failings to regulate these stakeholders. Given this state of affairs, the government intends to enact legislative reform through the National Health Insurance Bill to meet its constitutional mandate to realise the right to healthcare. An analysis of the Bill’s framework, however, reveals that it will have a cascading effect with the collapse of the private healthcare funders and private health establishment markets. This will ultimately cause a regression in access to healthcare and impede the practical realisation of this right. An investigation into alternative mechanisms to fulfil the right to healthcare reveals that incorporation and collaboration with private healthcare funders and private health establishments is a pragmatic alternative to the National Health Insurance Bill that will aid with the practical realisation and vindication of this right. These findings indicate the need for government to improve its stewardship of the health system and provide pragmatic solutions to reform the legislative and regulatory frameworks governing these stakeholders to resolve inefficiencies and to foster collaboration to fulfil the right to healthcare.
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    Multidimensional measure of energy poverty in Lesotho
    (University of the Witwatersrand, Johannesburg, 2024) Lehema, Nthati ‘Mabatho; Ye, Yuxiang
    This study employs the Alkire-Foster methodology to assess multidimensional energy poverty in Lesotho, using data from the Household Energy Consumption Survey in Lesotho. The investigation considers three dimensions, cooking, lighting, and water heating in constructing the multidimensional energy poverty index. In terms of the three dimensions, the overall findings indicate that at the national level, approximately 61% of the households experience multidimensional energy poverty. Upon decomposing the Multidimensional Energy Poverty Index (MEPI) by the settlement type, the results indicate that 83.50% of the households in rural areas are multidimensionally energy poor while 51.20% of the peri-urban households are deprived. In the urban areas, only 19% of the households experience energy poverty. In decomposing the MEPI by the gender of the household head, the results demonstrate that around 59.40% of female-headed households exhibit multidimensional energy poverty than their male-headed counterparts with 54.40%, with an average intensity of 91% of the weighted indicators. Decomposition by districts reveals that Butha-Buthe, Mokhotlong, Qacha, and Thaba-Tseka have over 80% of the multidimensionally poor households. Additionally, the study highlights the prevalence of traditional cooking fuels in rural areas, with minimal reliance on electricity. This pattern shifts with urbanization, where traditional fuel consumption decreases.
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    Technology practices to promote equity, access and quality in South African higher education: a multi-case study
    (University of the Witwatersrand, Johannesburg, 2024) Chindomu, Rodwell; Ndlovu, Nokulunga S.
    South Africa is still grappling with the legacy of historical inequalities, which ultimately culminate in large portions of the population being excluded, in both subtle and overt ways, from accessing quality higher education. The study explored the role of technology in nurturing equity, access and quality in the South African higher education context. The study sought to address these seemingly relentless incongruences, which students and institutions are currently experiencing. To achieve this aim, the study employed qualitative methods to explore the technological practices that the selected higher education institutions (HEIs) and academics used to enhance the quality of educational outcomes. The theoretical lens that informed this study was blended from Ertmer et al.’s (2012) espoused and enacted technology practice theory and Hohfeld’s (1919) rights-based theory. Using an in-depth and expansive literature review, analysing of institutional policies and collecting data by means of open-ended questionnaires, the study identified some approaches that HEIs and academics could adopt in leveraging technology to bridge the lingering access, equity and quality gaps in higher education. In so doing, the study made valuable contributions to the emerging debate on how the prevailing equity, access and quality challenges in the South African higher education context could be addressed through technology-driven solutions. Two non-probability sampling techniques were used to select participants from the three case study institutions, four of whom were conveniently sampled. The other four participants, were snowball-sampled with the help of the researcher’s two contacts two state HEIs, who also participated in the study, thus, bringing the number of participants to ten. The researcher also analysed institutional policy documents related to technology usage, which were generally found to be in sync with the practices that were described by the participants. The findings of the study showed that all the HEIs actively promoted technology integration, with one of them having already begun to explore the incorporation of artificial intelligence in teaching and learning spaces. The study also found that the use of digital technology enhanced pedagogical practices, but its deployment in HEIs was still hampered by literacy, generational and socio-economic gaps, among others
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    Investigating the determinants of Digital Financial Inclusion in South Africa
    (University of the Witwatersrand, Johannesburg, 2023) Betha, Tshegofatso; Ndlovu, C.
    Digital Financial Inclusion has emerged as a prominent global agenda, necessitating an exploration of the transformative influence of technology on financial service accessibility. Previous research has attempted to uncover the true factors that impact Digital Financial Inclusion, however, there is further opportunity to better understand the underlying factors. To contribute to the body of knowledge, this study seeks to uncover factors of successful Digital Financial Inclusion that may contribute towards the implementation of key strategies. To achieve this goal, the study employs a multidimensional financial inclusion framework that explores the impact of access, barriers, and usage on Digital Financial Inclusion. Additionally, it expands the framework to include digital readiness and financial literacy, enhancing the depth of the investigation. Utilising a quantitative approach, data for the study was obtained through a self- administered online survey, yielding 231 valid responses for analysis. The Structural Equation Model (SEM) was used to investigate the relationship between user readiness, financial literacy, barriers, access, usage, and Digital Financial Inclusion. The findings indicate insufficient statistical evidence to suggest a significant relationship between user readiness, access and barriers, and Digital Financial Inclusion. However, the study underscores that financial literacy and usage have a positive and significant influence on Digital Financial Inclusion. To enhance Digital Financial Inclusion, financial literacy and usage should be leveraged as key drivers for adoption. Additionally, policy makers, financial service providers and technology developers need to focus on targeted interventions, and inclusive regulatory frameworks
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    Access to finance by black-owned small and medium enterprises operating in the South African agro- processing sector
    (University of the Witwatersrand, Johannesburg, 2022) Tjabadi, Jazzino; Mazonde, Nomusa
    Small and medium enterprises (SMEs) make a meaningful contribution to economic growth, job creation and poverty alleviation. Despite this, there is a low creation and high failure rate of new small businesses in South Africa. Access to finance is considered the main contributing factor, particularly amongst black-owned SMEs. South Africa has identified agro-processing industry as a sector with high potential to spur growth and create jobs because of strong linkage with primary agriculture. Against this background, this study sought to investigate the factors that hinder access to finance by black-owned SMEs operating in the agro-processing sector in South Africa and explore other key factors that threaten their long-term survival. This research contributes to solutions aimed at addressing the root causes attributable to SMEs’ inability to access funding from the formal financial institutions and government agencies. Using qualitative research method, data was collected from black SME entrepreneurs through semi-structured, in-depth interviews and analysed using content analysis. Purposeful sampling was used to identify and select the participants. The insights gained from the research highlights that black-owned SMEs are severely impacted by funding and market access issues, amongst others. The findings revealed that black SME entrepreneurs prefer to use own capital and/or funds from family and friends to start and grow their businesses. Complex processes, unsuitable financial products, high interest rates, unfavourable repayment terms and favouritism in government schemes were found to be amongst the key factors that discourage SMEs from applying for formal institutional finance. Other factors such as limited access to information about available funding sources and access to market opportunities significantly influence the long-term success of black- owned SMEs. To develop a sustainable, long-term financing model for SMEs, it is recommended that government, in partnership with the private financial institutions, establish a small business financing institution for SMEs in the agro-processing industry. To avoid the major deficiencies plaguing the existing government schemes, this should be a private, stand-alone entity funded by the government and private financial sector. The new institution should introduce new, innovative financing solutions that are tailored for start-up and early-stage SMEs.