4. Electronic Theses and Dissertations (ETDs) - Faculties submissions
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Item Maternal death at Leratong Regional Hospital: a six-year retrospective review, South Africa(University of the Witwatersrand, Johannesburg, 2021-11) Motau, Tumelo Ngaka; Chauke, LawrenceBackground: The aim of the study was to systematically examine the main causes of maternal deaths and contributing factors at Leratong Regional Hospital in order to recommend strategies that can assist in reducing maternal mortality at this level of healthcare. Objectives: The objectives of the study were to: determine the institutional maternal mortality rate at Leratong Regional Hospital between 2012 to 2017, compare the trend (year on year) in the iMMR over the study period, describe the profile of women who died during the period under study, describe the clinical and surgical management of the women who died, and to determine the leading causes of maternal deaths, contributing factors and avoidable factors. Methods: A hospital based retrospective study based on patient clinical records at Leratong hospital. It included all the maternal deaths that occurred at Leratong Regional Hospital during the six-year study period (2012-2017). Results: There was a total of 78 maternal deaths with 32441 live births giving the MMR of 240 per 100 000 live births. However only 74 files could be analysed. The results showed that there was a rise in the maternal mortality rate over a six years period. The majority (70, 94.5%) of the women who died were African, aged between 20-35 years (56, 76%), multigravida (54,73%) with a parity of three or more (23, 31%). Obstetric haemorrhage was the leading cause of maternal death particularly postpartum haemorrhage (11.14%) followed by non-pregnancy related infections, sepsis and eclampsia. Conclusion: Maternal mortality has decreased according to recent confidential enquiry into maternal death in South Africa (2017-2019) However our study did not demonstrate a decline but rather an increase in the maternal mortality rate at Leratong. It showed that most of the maternal deaths were avoidable and the need for urgent interventions in terms of education, improving access to health care facilities, intensifying health care worker skills training and better transport systems between health care facilities is important.Item Interactional Dynamics During Residential Robbery: Victims’ Accounts and Reflections(University of the Witwatersrand, Johannesburg, 2021) Quinn, Caroline; Eagle, GillianSeveral studies highlight the importance of documenting interactional elements of violent crime. While a range of studies focus on perpetrators’ accounts of what transpired during the commission of robberies and other forms of violent crime, there has been a notable oversight in establishing victims’ narratives surrounding such events. This study had a broad over- arching focus on establishing what appeared to either escalate or deescalate violence during a residential robbery from the survivors/victims’ perspective. In addition to this focus, it was further aimed to establish the cognitive appraisals that victims/ survivors reported as salient during the incident, as well as their reported motivations for behaviours they exhibited. Moreover, the study aimed to highlight any socio-demographic features that the victims perceived to be significant in their interaction with perpetrators. An exploratory approach to the research study was undertaken whereby semi-structured interviews were conducted with eight adult South African participants. The data was processed and presented by means of a thematic analysis and contextualized from a primarily realist paradigm. Five superordinate themes were identified across participants’ accounts, including: (1) Comprehending the Nature of the Interpersonal Interaction, (2) Negotiation of Dominance and Submission, (3) Cognitive Processing and Evaluation during the Event, (4) Awareness of Demographic and Socio-Cultural Aspects of the Interchange, and (5) Advice & Post Hoc Observations. These main themes were elaborated through subthemes that aimed to capture nuances across participants’ narratives. The findings suggested that although positioned in a subjugated role participants attempted to moderate or affect the interaction between themselves and the perpetrators. This was mainly achieved by verbally and behaviorally demonstrating compliance in order to mitigate further risk. In addition, participants described more complex ways of responding to perpetrators which appeared to be based on idiosyncratic evaluations of their particular situation. Participants were aware of limited agency but appear to have negotiated some means of retaining or displaying agency within situational constraints. Across all eight participants’ accounts, it was evident that participants acted in accordance with an assessment of their situation and responded in a manner that was perceived to result in ensuring the greatest likelihood of survival. References to race, gender, age and socioeconomic status did not feature as strongly in participants’ accounts as anticipated.Item COVID-19 and health care worker exposure at Chris Hani Baragwanath Academic Hospital(University of the Witwatersrand, Johannesburg, 2021-12-05) Glatt, Sara Chaya; Menezes, Colin; Winchow, Lai ling; Tsitsi, MerikaBackground: Health care workers (HCWs) are at an increased risk of acquiring coronavirus disease 2019 (COVID-19). Appropriate risk assessments and testing are essential to reduce transmission and avoid workforce depletion. Objective: Investigate the risk of COVID-19 infection among HCWs at Chris Hani Baragwanath Academic Hospital who fulfil the Person Under Investigation (PUI) case definition or had exposure to a confirmed COVID-19 contact. Methods: A retrospective review of HCW records was conducted over a two month period. Data collected included demographics, exposure type, risk level, and COVID-19 test result. Frequency distribution tables, bivariate analyses and univariate and multivariate analyses were conducted. Results: Among the 1111 HCWs reviewed, 643 were tested with 35.6% positive results. PUI’s accounted for 62.4% of positive cases. Symptomatic HCWs with no known contact were at a greater risk of infection than those with a patient exposure (p=0.000). Risk of testing positive was higher after a patient exposure (p=0.000) compared to a co-worker contact. Conclusion: There is a higher positivity rate among HCWs than the general population. The presence of symptoms warrants testing. Nosocomial transmission was derived from patient more than co-worker contacts.Item Epidemiology of laboratory-confirmed SARS-CoV-2 hospitalized cases in a tertiary hospital, Gauteng Province, South Africa, 1 April 2020 to 31 March 2021(University of the Witwatersrand, Johannesburg, 2021-12) Sikhosana, Mpho Lerato; Makatini, ZinhleGauteng Province (GP) was the most affected province in South Africa during the first year of the COVID-19 pandemic. We aimed to describe the epidemiology of COVID-19 cases admitted in one of the largest quaternary hospitals in the province during the two pandemic waves. We used data from the national hospital surveillance system, DATCOV, that recorded COVID-19 admissions at Charlotte Maxeke Johannesburg Academic Hospital in (GP) from 5 March 2020 to 27 March 2021. We used multivariable logistic regression to determine a) factors associated with hospitalization in the second compared to the first pandemic wave, and b) factors associated with in-hospital mortality. There were 1861 cases admitted during the study period. The mean age of the cases was 50 (IQR 37-61), 51.80% were females, and 58.68% were black. Of the total number of admissions, 2.10% were healthcare worker, 53.85% of whom were nurses. On admission, 91.99% of cases were admitted at a general ward while 5.86% were admitted at an intensive care unit. Overall, 10.59% of the cases required intensive care during their hospital stay. The case fatality ratio was the highest (28.54%) during wave 2 and lowest during pre-wave (11.49%). Compared to the first wave, factors associated with hospitalization during the second wave included age >80 years (adjusted odds ratio [aOR] 3.43, 95% CI 1.07-10.98) compared to ages 0-19 years, as well as being of other race (aOR 5.63, 95%CI 1.84-17.20) compared with White race. Regarding in-hospital mortality, associated factors included age groups 60-79 (aOR 4.53, 95%CI 1.03-19.86) and >80 (aOR 9.63, 95%CI 1.93-48.01) compared to ages 0-19 years; male sex (aOR 1.55, 95%CI 1.16-2.08); presence of an underlying comorbidity (aOR 1.99, 95%CI 1.45-2.71) 106 as well as being admitted during the second wave (aOR 1.54, 95%CI 1.12-2.10). Our study found that there was a higher risk of mortality during the second compared to the first wave, and other factors associated with mortality included older age, being male as well as having an existing comorbidity. These findings will help inform prevention strategies required to prevent high mortality rates during future waves of infection.Item The impact of digital ecosystems on customer loyalty in South African life insurance companies: A customer’s perspective(University of the Witwatersrand, Johannesburg, 2021) Muthama, Georginah M.; Nyamajiwa, Michael T.The concept of life insurance has been in existence for thousands of years, with a business model that has remained relatively the same. Persistency or customer retention in South African life insurance companies is an ongoing concern. Advancement in technology has provided new opportunities to life insurance companies, such as online sales, improvement in service offering, and the increase in brand awareness. The literature indicates that digital ecosystems offer a new value proposition for life insurance companies to create loyal customers. This study was motivated by the high number of policy cancellations, unmet premiums and lapsed policies experienced across the insurance industry in South Africa. The study proposed that customer loyalty can be increased with the implementation of digital ecosystems, specifically in terms of the value propositions related to ease of doing business, loyalty programs and digital platforms. The purpose of this study was to determine whether the value proposition provided by digital ecosystems can create loyal customers. A quantitative research approach was used in this study. Data was collected using surveys whereby the respondents gave their responses on a structured-self-completion questionnaire that were distributed via email and WhatsApp. A random sample of n=57 was achieved. The Cronbach’s Alpha test showed there was good internal consistency reliability for the independent variables, but the dependent variable has poor internal consistency. Exploratory Factor Analysis (EFA) was conducted and the factor loadings higher than 0.40 indicate that the constructs were valid. Multiple regression was applied to test the four research hypotheses. The results indicate that there is a statistically significant relationship between digital ecosystems and customer loyalty. Regarding individual value proposition items of digital ecosystems, ease of doing business does not have a significant relationship with customer loyalty, nor does digital platforms. Loyalty iv programs has a significant relationship with customer loyalty. The final conclusion of this research is thus that digital ecosystems do provide a value proposition which can increase customer loyalty. When a digital ecosystem consists of different value propositions, in this case, ease of doing business, loyalty programs and digital platforms, loyal customers can be created.Item Proposing the establishment of a tourist-generated-video library for destination marketing by tourism organisations(University of the Witwatersrand, Johannesburg, 2021) Lehutjo, TshepoTourist-generated media content is a phenomenon that has become increasingly popular in recent years on social media platforms; to a point where many travel bloggers have even taken it on as a full-time occupation to meet the growing customer/tourist demand for it. On the other hand, tourism organisations and the industry at large have not been at the ready to take advantage of these technological developments. The prevailing explanation for this contrast is that tourism organisations do not have the know-how nor the time to invest in these technologies as they are typically staffed by small, specialised teams. As a result, entrepreneurs may investigate this identified gap to assist tourism organisations in meeting customer demands for: authentic tourist-generated videos while these customers are in the discovery and decision- making process of before their travel journey. Data was gathered remotely through publicly available platforms on the Internet, using a close-ended questionnaire to capture responses. The responses were then processed to generate descriptive statistics to elaborate on the following: the proportion of South African tourism organisations currently using the Facebook platform was determined to gauge the size of the market. Further, the extent of video use and other factors on the platform was determined, within the attraction and engagement constructs of the Digital Marketing Framework. This was done to understand how and when tourist-generated videos are used, if at all, and what other methods tourism organisations apply to attract or engage customers. Based off the findings, which show that South African tourism organisations have a low social media engagement rate with tourists and make very little use of video (which is proven to be more engaging and better for sales conversion) as a form of media content – be it tourist generated or not. This research thus proposes the use of a tourist-generated-video library that tourism organisations will pay to access so that they may use such videos to market destinations on their social media profiles and websites.Item Impact of financial intermediaries on economic growth(University of the Witwatersrand, Johannesburg, 2021) Ayodele, Ademola EmmanualThis study investigates the impact of financial intermediaries on economic growth in Nigeria between 1986 and 2017. The study uses Gross Domestic Product as the dependent variable and also used Money Supply (MS), Credit to Private Sector, Lending Rate (LR) and Total Credit (TC) as independent variables coupled with the use of Auto Regressive Distributed Lag (ARDL) model as method of analysis. The result revealed that only money supply is statistically significant with economic growth in both the short run and long run. However, Credit to Private Sector, Lending Rate and Total Credit assert a negative effect on economic growth while money supply has positive effect on economic growth. Also, the granger causality test shows a unidirectional causality from GDP to both CPS and TC also from MS to GDP. Meanwhile, the direction of causality is inconclusive between LR and GDP. Hence, through the preponderance of empirical proofs from various places around the world and the findings of this study, it can be inferred that financial intermediaries have a significant impact on economic growth. The study therefore, recommends that the financial intermediaries should properly monitor credit provide to sectors in the economy in other to ensure that these sectors profitably use such credit to boost the economy.Item Would You Drink It? An Exploratory Study Gauging the Public’s Perceptions and Attitudes on the Use of Reclaimed Wastewater in South Africa(University of the Witwatersrand, Johannesburg, 2021) Prins, Franciscus X.; Thatcher, Andrew; Etale, AnitaIncreasing population figures globally, and in South Africa, and other factors, such as climate change could result in countries and regions suffering severe water scarcity. Alternative water sources, such as wastewater reclamation, are available which could bridge the supply and demand gap. Historically consumers have been against the use of water from water reclamation plants. This study aimed to determine consumers’ attitudes and key trade-offs toward alternative water sources, and to inform policy-and decision-makers for improved future public engagement. This could potentially improve the support for, and success, of future water reclamation plants. With the use of traditional surveys consumers’ willingness to consider alternative water sources are often determined after having assumed that they have existing knowledge of often complex topics. In this study, a decision pathway design allowed for information provision within an adaptive online survey with a set of linked questions. This encouraged the deliberate construction of opinions and views. In this way, respondents’ choices were more likely to be based on correct information before being asked to provide their opinions. By selecting one pathway information was revealed about respondents’ trade-offs and reasoning processes. Quantitative data were collected, and various demographical variables and responses were explored. Respondents’ most preferred water alternatives were provided at two points (at the start and at the end of the survey). The data revealed that there were changes between respondents most preferred alternative at the start and end of the survey. Furthermore, under situations of severe water scarcity most South African consumers would be in support of direct reclamation, however, respondents’ level of trust in the government, and the associated level of affect, could play a determining factor in the future successful implementation and operationalisation of water reclamation plants.Item Consumption, Femininity and the City in the Real Housewives of Johannesburg: A Content Analysis of a Franchise(University of the Witwatersrand, Johannesburg, 2021) Hellberg, Tessa; Iqani, MehitaThe following study explores how consumption, femininity and theorizations of the city are presented to the audience in The Real Housewives of Johannesburg. While the Real Housewives franchise is a global text with numerous iterations in a range of countries, The Real Housewives of Johannesburg is the first South African (and African) version of the programme. The study begins with an outline of the ways in which the city is represented, before moving to define the ‘spirit’ of Johannesburg. As will be demonstrated through the findings of a quantitative content analysis, this is inherently tied to automobility. By way of a subsequent textual analysis, challenges to automobility are also discussed, along with an analysis of luxury consumption in Johannesburg, and the ways in which it is racialized. This research then considers how the postfeminist undertones for which the Real Housewives is known translate into a South African context. Issues like sexual respectability are explored in-depth, as is the concept of being the ‘perfect’ hostess. The thesis concludes with a note concerning how The Real Housewives of Johannesburg highlight local South African cultures through glocalization of a global media text.Item Composing Augmented Spaces(University of the Witwatersrand, Johannesburg, 2021) Ferreira, Jaco Louwrens; Harris, Cameron; Crossley, JonathanThis dissertation explores the notion of place as sensed, conveyed and created through soundscape composition. This is done by looking at works in the genre of soundscape composition and a concert presentation that took place in the Great Hall at the University of the Witwatersrand, Johannesburg. Spatiality in electroacoustic music is explored in relation to theories centred around the notion of place and practically applied to my concert presentation of Sound Spaces. Different forms of spatiality are explored from a compositional perspective with considerations for the listening space, the space created and occupied by the music itself and the methods of diffusion that allows for an augmentation of space. Sound Spaces forms the basis of my investigation of how spatiality in electroacoustic music and soundscape composition can be used to engage with the notion of place as created through the musical experience and illustrates how the notion of place can be incorporated as an active compositional domain in soundscape composition and electroacoustic music.