4. Electronic Theses and Dissertations (ETDs) - Faculties submissions
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Item Perceived barriers to digitalization by small-scale farmers Gauteng Province(University of the Witwatersrand, Johannesburg, 2022) Choguya, DonaldDigitalization in the fourth industrial revolution era has transformed many industries across the board. However, there are some that have been affected more than the others as depicted in the digital vortex. Lagging is the agricultural sector. This study was a quantitative research study that utilized a sample of 40 small-scale farmers to be representative of the Gauteng Province small-scale farmers. The research related the perceived barriers to digitalization and its impact to the agricultural activities of small-scale farmers in Gauteng Province. The data was analysed using the multiple regression analysis and correlation coefficient. Analysis of the results showed a massive gap between small-scale farmers and commercial farmers on the adoption of digitalization. Further analysis indicated that small-scale farmers were less likely to be impacted by digitalization to adopt technological utilization. It was also found that small-scale farmers were contributors to food production. Finally, it was also discovered that small-scale farmers were less established to adapt and adopt to digitalization in their agricultural activities due to various barriers. The recommendations were that there was need to do more research to find ways to bridge the gap to digitalization between small-scale farmers in Gauteng Province and commercial farmers. So that small-scale farmers in Gauteng Province especially the small-scale farmers in rural areas could also be exposed to the digitalization of operations to enable them to improve productionItem Risk factors for caries and periodontal diseases: a comparative4 study among HIV-positive and HIV-negative adults in nyarugenge5 district, Rwanda(University of the Witwatersrand, Johannesburg, 2024) Murererehe, JulienneDental caries and periodontal diseases are among HIV-positive persons' most frequent oral conditions. These common oral diseases contribute to the impairment of general health and well- being. Dental and periodontal problems among HIV-positive individuals are more severe and difficult to manage than dental and periodontal problems among HIV-negative people. Thus, risk factors for caries and periodontal diseases must be controlled for comprehensive oral health and the general well-being of HIV-positive patients. The burden of oral diseases is reported to be high in Rwanda. Nearly 65% of the oral health survey participants had experienced dental caries and above 54% had untreated cavities. In addition, dental calculus was found among 60% of participants. More than 34% had oral debris. Surprisingly, more than 70% of this population has never visited dentists or dental facilities. This evidence gives impetus to undertake more focused investigations on oral diseases in Rwanda, particularly among HIV-positive people. Therefore, this study sought to assess the risk factors for caries and periodontal diseases among HIV-positive and negative adults in Nyarugenge District, Rwanda Methods This research used a mixed-method approach (qualitative embedded design). For the quantitative part, a comparative cross-sectional study was conducted among 200 HIV-positive and 200 HIV- negative adults aged ≥18 years. Consecutive and purposive sampling method was used to select participants for quantitative and qualitative parts of the study respectively. Caries was assessed using the Decayed (D), Missing (M), and Filled Teeth (F) index (DMFT). Periodontal disease was assessed using the Plaque Index (PI), Community Periodontal Index of Treatment Need (CPITN), and Clinical Attachment Loss (CAL). Oral health Related Quality of Life (OHRQoL) was assessed using the oral health impact profile short version (OHIP-14). Descriptive statistics, Chi-square test, t-test, Cronbach alpha, and multiple logistic regression were applied to analyse quantitative data using Stata version 15. For the qualitative data collection, in-depth interviews (IDIs) were conducted among 10 HIV-positive and 11 HIV-negative adults with caries and periodontal diseases using a semi-structured interview guide. Thematic content analysis using an inductive approach was applied for data analysis of IDIs. NVivo software version 11 was used to code and organize the data. Results A higher proportion (50.5%) of HIV-positive adults had experienced caries (DMFT>0) compared to HIV-negative counterparts (40.5%) and the difference was statisticaly significant (p=0.045). The prevalence of D was higher (23.5%) among HIV-positive compared to HIV-negative adults (13.6%) (p=0.011). The Mean (SD) DMFT score among HIV-positive and HIV-negative participants were 2.28 (3.68) and 1.29 (2.21) respectively (p=0.001). The predictors of caries in HIV-positive persons were being female (OR= 2.33; 95%CI= 1.14-4.75), frequent dental visits (OR= 4.50; 95% CI=1.46-13.86) and detectable RNA viral load (OR= 4.50; 95% CI=1.46-13.86). Among HIV-negative participants, the middle age range (36-45 years) [OR= 6.61; 95%CI=2.14- 20.37], and frequent dental visits were significantly associated with caries (OR=3.42; 95%CI: 1.337-8.760). For periodontal status, having dental calculus was the most prevalent item of the CPITN found among HIV-positive 168 (84%) and 182 (92%) HIV-negative individuals. The mean (SD) score for CAL was higher in HIV-positive persons 1.23 (0.95) compared to HIV-negative counterparties 0.99 (0.75). The difference was statistically significant (p=0.003). Being a male was a predictor of having dental plaque and a need for periodontal treatment for both HIV-positive (PI OR: 2.90 (95%CI=1.26-6.66)); (CPITN OR: 3.33 (95%CI=1.14-9.70)) and HIV-negative respondents (PI OR:3.28 (95%CI=1.48-7.28)); (CPITN: OR: 7.78 (95%CI=1.04-58.07)). A higher percentage of HIV-positive individuals had poorer OHRQL than HIV-negative counterparties in all items of OHIP-14 except for OHIP3 (found it uncomfortable to eat any foods because of problems with teeth or mouth) and OHIP-14 items (being totally unable to function because of problems with teeth or mouth). The findings revealed significant results regarding OHIP1 “trouble pronouncing any word” with a prevalence of 11(2.5%) and 9(2.25%) in HIV-positive and HIV-negative participants, respectively. Also, HIV-positive persons had higher percentage 11(2.75%) for the OHIP 13 item “life not satisfying due to teeth and mouth problems” than HIV-negative counterparties 8(2%) and the difference was statistically significant p≤0.05. Moreover, dental caries was significantly associated with poor OHRQoL among HIV-positive and HIV-negative participants for all 14 items of OHIP-14 tool. There was no association between periodontal disease and OHRQoL in both HIV-positive and HIV-negative adults. Two broad domains and five themes emerged from the interviews. The first broad domain was “perceptions on causes of oral diseases” with 2 themes (individuals and external themes). The second broad domain was “perceptions on oral diseases effect” with 3 themes (physical or functional effect, psychological effect and social effect themes). Conclusion and recommendations This research showed a higher prevalence of caries and CAL among HIV-positive adults than HIV- negative counterparts. Also, the mean (SD) PI value was significantly higher in HIV-positive adults compared to the mean PI value in HIV-negative individuals. The reported higher prevalence of caries in HIV-positive persons was associated with being female, detectable viral load, and frequent dental visits. Periodontal disease was associated with older age, being male in HIV-positive and HIV-negative participants. Moreover, HIV-positive adults reported poorer OHRQoL than HIV-negative counterparties. Furthermore, qualitative results revealed individual and external levels factors of oral disease and emphasized the physical/ functional, psychological and social effects of oral diseases on quality of life. Therefore, there is a need for effective oral health interventions specific to HIV-positive persons in Rwanda. The interventions should also raise awareness of the risk of common oral diseases (such as dental caries, and periodontal disease) and provide preventive oral health services among the Rwandan population, especially HIV-positive individuals. There is a need for a collaborative effort to establish programmes for regular and timely screening and management of periodontal disease and dental caries among the general population and specifically, HIV-positive individuals in Rwanda. To ensure timely oral health care among HIV- positive Rwandans, this study provides baseline data to aid policymakers and stakeholders to integrate oral health care services within HIV treatment programmes in RItem Factors contributing to uncontrolled high blood pressure in Ekurhuleni, Johannesburg: the community health workers’ perspectives(University of the Witwatersrand, Johannesburg, 2024) Dawood, Zaheerah; Sekome, KganetsoBackground: Uncontrolled high blood pressure has become a concern in underserved communities of South Africa due to its consequence resulting in rising cardiovascular and cerebrovascular diseases. Community health workers at a primary care level offer door to door services for patients with chronic diseases and are often key in health education, health promotion, and disease monitoring. Understanding the voice of the community health workers regarding factors that contributes to uncontrolled high blood pressure for their patients can provide insight on strategies for future intervention programme from a systems, patient, and community perspectives. Aim: To explore community health workers' perceptions on factors that contribute to uncontrolled high blood pressure in adults living in Ekurhuleni South sub-district, Johannesburg. Methods: A descriptive, qualitative study design was used for this study. In-depth face-to- face interviews were conducted with 22 community health workers from four communities within the South sub-district in Ekurhuleni, Gauteng. The interviews focused on: the community health workers knowledge on measures used to control high blood pressure, the community health workers opinions on barriers and facilitators contributing to uncontrolled high blood pressure for their patients, and lastly their perceptions on strategies which can be used to improve the control of high blood pressure. Data analysis following thematic analysis was used in this study. An inductive approach was used to generate codes, themes, categories and to analyse the data. Results: Analysis of the qualitative data revealed six themes. Community health workers possessed knowledge regarding the symptoms, causes and complications of uncontrolled high blood pressure however, they didn’t fully comprehend the physiological concept of blood pressure and uncontrolled high blood pressure. It can be noted that the type of advises and education which community health workers provided their patients with are generally very contextualized and simple. Multiple barriers included financial, personal, social, system, medication and cultural and traditional issues. Facilitators included government and health workforce assistance, improvement of clinic accessibility, inter and intra collaboration from multiple sources such as media, other health professionals as well as patient centred approaches. Strategies to improve control of high blood pressure included improved team work, awareness creation, holistic healthcare, improved access to clinic facilities, system related improvements and patient initiatives. Conclusion: Community health workers in this study have knowledge regarding the causes, symptoms and complications of uncontrolled HBP. Multiple barriers to controlling high blood pressure included financial, social system, personal, cultural and patient barriers. The facilitators which were identified required a multidisciplinary approach. Interventions which the community health workers provide to patients are reported to be easy to follow and usually contextualized to the patient needs. Strategies required to improve the control of high blood pressure in this community are easy to implement with less assistance required from the health care systemItem A survey of the perceptions and knowledge of anaesthesia and anaesthetists possessed by Grade 12 learners in four Johannesburg districts(University of the Witwatersrand, Johannesburg, 2022) Talane, Pulane AdeliceBackground William J.G Morton (1816-1868) introduced the world to modern anaesthesia when he successfully anaesthetised a patient using Ether at Massachusetts General Hospital in Boston in October 1846. (1) Since then, advances in pharmacology have resulted in the safer use of anaesthetic drugs and technological advances have improved monitoring of patients under anaesthesia. Anaesthetists around the world are now involved in the fields of critical care, trauma and pain management. (2)This has brought a sense professional esprit de corps to the anaesthetic fraternity. Despite this radical growth and development of the speciality, there is still a lack of public knowledge regarding the discipline of anaesthesia, anaesthetists’ expertise, or the role played by the anaesthetist in the chain of health care delivery. (3) Methods A cross sectional study was carried out between June and September 2021 on Grade 12 learners in four Johannesburg districts. A questionnaire consisting of three sections and 26 questions was handed out at pre-selected schools. The first part of the questionnaire acquired demographic data, the second contained questions pertaining to anaesthetists and anaesthesia as a speciality, and the third part pertained to interest in the field of anaesthesia. Results Of the 595 learners that participated in this study, 335 (56.3%) were aware that an anaesthetist administers anaesthesia in the operating room. A considerable number of learners n=344 (57,8%) believed that a nurse monitored and recorded the patient’s vital signs during surgery. Only 95 learners (16%) correctly identified all the duties of the anaesthetist outside of the theatre environment. Overall, learners fared poorly, achieving an average score of 14% for the questionnaire. However, there was a statistically significant correlation between being from a high socioeconomic background and awareness that the anaesthetist administers anaesthesia. A high socioeconomic background was defined as having a suburban residence, a household income comprising a salary instead of social grants and care givers that possessed a university degree. Knowledge regarding the intraoperative duties of the anaesthetist was still poor, regardless of the socioeconomic background of the learner. Previous exposure to anaesthesia did not improve awareness about anaesthesia among the learners. Conclusion This study has shown that awareness regarding anaesthesia and anaesthetists is still lacking despite the radical growth in the field. This lack of awareness cannot be ignored; education of the general public should be intensified in order to empower people to ask the right questions as well as make informed decisions about their perioperative care in the future. More than half of the learners in the study (58.5%) believed that good medical education can reduce the burden of health care costs and medicolegal consequences; and 70% of them would request an anaesthetist to provide them with detailed information about their anaesthetic before the start of surgery. Therefore, despite lack of awareness, the majority of the learners displayed interest and willingness to know more about anaesthesia, and grade 12 learners would be a formidable target group to direct anaesthetic education campaignsItem Assessing the effectiveness of the employee health and wellness programme in Gauteng department of education(University of the Witwatersrand, Johannesburg, 2021) Mhangwani, Chrisen Eddie; Malindini, K.Employee Health and Wellness Programmes (EHWPs) were initiated in the public service since 2009 following the Department of Public Service Employee Health and Wellness Strategic Framework 2008 which was later reviewed in 2019 with the idea to proactively enhance the productivity of employees by providing health enhancing preventive strategies which if not provided, may contribute to ill-health absenteeism which have been identified as having significant direct and indirect costs to organisations. Therefore this study sought to assess the effectiveness of the Employee Health and Wellness Programme (EHWP) in Gauteng Department of Education Head Office by exploring the perceptions of GDE employees towards the programme in averting ill-health absenteeism behaviour. The study adopted the qualitative case study to collect data using investigative in-depth qualitative survey targeting hundred (100) GDE employees to explore and understand their perceptions as described by their responses towards the programme. The sample consisted of participants who had experience in utilising the services provided by the employer sponsored EHWP. The idea of using qualitative survey interviews were informed by its strength to collect rich and dense information from multiple sources which in the context of this study were fifteen GDE Districts and Head Office. As theoretical saturation of information is the guiding principle in collecting qualitative data, the researcher ended up interviewing forty (40) participants as there were no divergent views from the survey interview responses. This was done to ensure the reliability of the study by ensuring that the variability of the responses is maintained. The findings of the study reveal the varying perceptions towards the EHWP in averting ill-health absenteeism behaviour showed that it is good in advancing employees’ health and productivity while others hold the view that its implementation is not tractable. Moreover, the lack of employing monitoring and evaluation strategies in implementation and the ethical dilemmas in the provision of this service, have been cited as hindering the effectiveness of the programmeItem Perceptions of Carbon Capture and Storage as a CO2 emissions reduction technology in South Africa(University of the Witwatersrand, Johannesburg, 2021) Malemane, Gcobisa; Surridge, TonyThis research aimed to establish the perceptions of role-players in South Africa of the Carbon Capture and Storage (CCS) technology. The CCS technology aims to capture CO2 emissions and prevent them from entering the atmosphere. The technology was mandated by Cabinet in 2012. The two role-players chosen for this study are the CO2 emitting Industry and Policy Influencers. The introduction of a new technology presents challenges, especially in its full adoption by those intended to use it. CCS was identified by government as a CO2 reduction technology, but has not been enforced on industry, it has merely been suggested as one of the climate change mitigation options, according to the National Development Plan 2030. Technology alone is not always a factor in its adoption, concerns of regulation, investment, safety and environment always arise. It is therefore of interest to ascertain if the mentioned role-players have the same or a differing understanding and regard for CCS. An aligned perspective is necessary so that each role-player may know its individual contribution to CCS development in South Africa. The study followed a quantitative approach using an electronic platform to reach respondents. The respondents received identical statements and were only differentiated by their sector of employment. The results were analysed using the Fisher’s exact test, suitable for small samples. Statistical significance was determined using p values as evidence against the null hypothesis. Key findings include a sizeable portion of respondents who neither agreed nor disagreed with posed statements. The role-player with the most overall neutral responses was Industry. Policy Influencers seemed to be more confident of their responses. The role-players produced more similar than differing responses. Industry respondents showed a noticeable gap (neutral) in the general knowledge of the CCS technology, compared to the policy influencers’ confidence in the general knowledge of the technology. Both industry and policy influencer are convinced that regulation and cost are potential barriers to the development of the technology in South Africa. Both industry and industry showed neutrality in the notion that CCS will lead to unintended consequences. The key message is that further stakeholder engagement is required between the two role-players, as both the Industry and Policy Influencers are in agreement of what could impede the development of CCS in South AfricaItem An exploration into change management perceptions and approaches of two provincial government departments(University of the Witwatersrand, Johannesburg, 2023) Ndlovu, Zibusiso Khethiwe; Hobden, ChristineChange in the South African public sector is unavoidable due to the turbulent political and economic climate and developing technologies presented to us by the 4th industrial revolution. It is widely acknowledged that organizational change is often plagued by failure, however, this study argues that contextual organisational dimensions such as deep structures and change ownership are frequently overlooked in public sector change management discussions. This prompted a qualitative case study between two Gauteng Provincial Government departments. This design enabled an in-depth exploration of approaches to change management in the two different departments to gain a better understanding of change management approaches within the GPG. Data was collected from recorded 30–60-minute semi-structured interviews with 12 key informants (senior, middle, and junior management staff in the respective provincial departments) identified through purposive criterion & snowball sampling. Interviews were transcribed identifying emerging themes and codes aligned to answering the research questions. Additionally, a desktop review of academic literature, departmental documents, and reports was undertaken to gain deeper contextual understanding and perspective of the GPG change management landscape. The study results revealed that the nature of change is characterised by a lack of ownership and poor reinforcement of change in the GPG. Furthermore, that communication within GPG exists, however, it doesn’t always filter down to the lowest employeesItem Perceptions and experiences of police officers and social workers within South African Police Service when assisting women who survived sexual violence in Mamelodi, Pretoria(University of the Witwatersrand, Johannesburg, 2023-05) Bahula, Ikageng Maphale; Nkala-Dlamini, BusisiweMany women are often reluctant to disclose cases of sexual violence to healthcare workers, police officers, family members etc. mainly due to the stigma attached. Few studies have been conducted to explore the experiences and perceptions of different role players within South African Police Officers (SAPS) when assisting women who survived sexual violence. Therefore, this study aimed to explore the perceptions and experiences of police officers and social workers within SAPS when assisting women who survived sexual violence. This study adopted a qualitative research approach, specifically a multiple case study design. The feminist poststructuralist theory was employed to guide the study. Three different interview guides were used as the research instrument. Individual face-to-face semi-structured interviews were used as the method of data collection. The sample size comprised twenty-five (25) different role players within SAPS in Mamelodi, Pretoria; five (5) client service centre police officers who work at both Mamelodi east and west police stations; ten (10) police officers who work in the special unit addressing sexual violence (FCS) at Mamelodi and ten (10) social workers who assist the survivors of sexual violence at both Mamelodi east and west police stations. The data gathered from the research were analysed using thematic analysis. The perceptions around sexual violence differs. This is influenced by the roles they play, how they have been exposed sexual violence and the school of thoughts. It is important that the service providers are oriented towards the concept and the practice on what sexual violence is. The service providers experience different challenges in different ways. Some challenges can be tackled at the individual level, while other challenges are societal, systematic and structural. Knowledge, attitude and practice of service providers require attention in terms of understanding the legal policies, the protocols and the practices in the sector.Item How Undergraduate Students at the University of Witwatersrand Make Meaning of Non -Disclosure of Suicidal Ideation(University of the Witwatersrand, Johannesburg, 2022-07) Mboweni, Ntwanano Harnelly Charmain; Jithoo, VinithaThe self-concealment of suicidality poses a significant threat to the well-being of university students around the globe. Suicidal concealment greatly exacerbates emotional and psychological distress within this cohort and unabated leads to a suicide death. Suicidality concealment within the university student population presents a perplexing and unique problem to university stakeholders, clinicians, and researchers. University students are in proximity to psychological care that is freely offered on university campuses, and yet more than half of students who contemplate and eventually die by suicide do not take up these services. Even more vexing is that students choose to deny and conceal suicidal distress from intimate support networks. There is an undeniable need to explore the factors that influence students’ decision to conceal suicidal ideation as well as the factors that facilitate disclosure of suicidality within this population. Using a constructivist grounded theory approach the present study explored understanding of concealment concerning suicidal ideation among university students. It focussed on understanding the personal narratives and lived experiences that motivate students to conceal their suicidal thoughts, feelings, and intentions. Focus groups were used to make sense of students’ understanding and meaning making of suicidal thoughts and why talking about suicidal desires is so challenging. The study concluded that suicide and concealment among university students are multifaceted. The reasons for concealing suicidal thoughts reflect both internal motivations, such as feelings of shame, helplessness, feeling isolated, and mental health concerns, and external motivations, such as fear of consequences that may result from telling others. Attitudinal factors, such as being a burden to others, stigma and its consequences, lack of perceived need for help, mistrust, and desire to be self-reliant, emerged more frequently than structural factors, such as lack of access to help. Additionally, several reasons unique to university life, such as academic competence, performance-related anxiety, financial difficulties, and a sense of belonging, emerged. Student voices echoed the need for mental health and suicide literacy programs and greater cohesiveness and a sense of belonging within the university community could encourage greater engagement with emotional distress.Item “Youth Enterprising”: Johannesburg Youth’s Motivation, Perceptions and Experiences Regarding Entrepreneurship and Services Provided by the Government and the Private Sector(University of the Witwatersrand, Johannesburg, 2023-06) Phofi, Caroline; Pretorius, Edmarie; Dube, NkosiyaziEnterprising and entrepreneurship have become one of the solutions to addressing the challenges of the current economic state in South Africa that seem to have proven to lock some of the youth, especially the disadvantaged youth within Johannesburg, in the cycle of poverty, and unemployment. Although the largest group of youth entering the labour market have shown to be educated and suited for South Africa’s global competitiveness, jobs seem to remain competitive in the formal sector. The study aimed to explore youth enterprising, the motivating factors, perceptions, and experiences of youth towards services that the government and the private sector provides. With the significance of entrepreneurship in the South African economy, there is a need to explore and investigate the contribution of entrepreneurs in the economy of South Africa and how can government and private sector support entrepreneurial activities among the youth to curb unemployment and poverty. A qualitative approach based on the interpretive paradigm was employed to explore the topic of youth enterprising. A case study design was best suited to achieving the objectives of the study, which sought to understand youth enterprise regarding youth’s subjectively constructed reality. The selected case studies were selected from five organisations. These organisations mostly engage in youth development programmes aiming to capacitate youth with psycho-social and entrepreneurial skills, and to provide start-up funding. All the participants for the interviews (n=14), focus group discussion (n=8) and respondents of the questionnaire (16) were selected from Organisation A. The four key informants were from the other four organisations (Organisation B, C, D and E) and were only interviewed. Purposive sampling was adopted to select all the 26 research participants comprising of youth, youth workers, managers and key informants, and the 16 youth participants were selected for the structured questionnaire. The methods of data collection were semi-structured interviews, focus group discussions, and a structured questionnaire. Four different semi-structured interview guides were used as research instruments with all these different groups of participants. A focus group guide was adopted to facilitate the focus group discussion with eight youths. A total of 16 youths completed the hard copy of a structured questionnaire. Due to the COVID-19 pandemic and the national restriction, some potential participants did not want to engage in face-to-face interviews, therefore an online questionnaire was offered as an option so that the research could have more participants to validate the data collection. A structured questionnaire was employed to elicit the respondents’ responses to the four aspects related to motivation, ability, entrepreneurial opportunities, and resources associated with basic entrepreneurial success components. Results from the questionnaire were analysed using descriptive statistics. Data from the different interviews and focus group discussions were analysed using thematic analysis. The findings revealed that business and entrepreneurial skills should be integrated not only into economic sciences but also within the education sector's human sciences and social work courses. Participants mentioned that the role of the government and private sector in youth development and entrepreneurial services is vital. The study findings aided with the development of practice principles and guidelines to be used by social workers and other stakeholders in their programmatic interventions with youth entrepreneurs.