Medication adherence: a review of policy and education in South Africa
- Authors: Nyoni, Cynthia Nomagugu
- Date: 2023-10-31
- Subjects: Patient compliance South Africa , Drugs Administration Study and teaching (Higher) , Pharmacist and patient South Africa , Pharmaceutical policy South Africa , Patient education South Africa , Medication adherence
- Language: English
- Type: Academic theses , Master's theses , text
- Identifier: http://hdl.handle.net/10962/419548 , vital:71653
- Description: Medication adherence is a patient's active and voluntary participation in following all the recommendations and instructions agreed upon with a health care provider such as a pharmacist. Adherence is a multidimensional phenomenon determined by the interplay of five factors: patient-related factors, socioeconomic factors, condition-related factors, health system-related factors, and therapy-related factors. Medication non-adherence is a problem in many countries, especially low to middle-income countries, including South Africa (SA). In low to middle-income countries, non-adherence is often worse due to insufficient health resources and inequities in access to health care. Medication adherence is a global problem and has raised the need for research and review. Many healthcare professionals, especially pharmacists, have an essential role in promoting medication adherence. This study described, explained and evaluated the policies in SA relating to the pharmacist's role in promoting medication adherence. Furthermore, it described medication adherence-related education at four universities in South Africa. The study was qualitative, and a two-phased approach was employed. In the first phase, a document analysis of the pharmacist’s role in supporting medication adherence was conducted as described in national policies and guidelines in SA. A total of 38 documents were analysed, including critical documents such as the South African Pharmacy Council Good Pharmacy Practice Manual and Associated SAPC rules (GPP) manual, National Drug Policy (NDP), Standard treatment guidelines (STGS) and Integrated Adherence Guidelines. The READ approach was used in conducting the document analysis and involved (1) preparing materials, (2) extracting data, (3) analysing data, and (4) distilling findings. The critical roles of pharmacists in medication adherence that were identified were in drug use, supply and management, dispensing, therapeutic drug monitoring, pharmacovigilance, pharmaceutical care, and special programmes like antimicrobial stewardship (AMS), multi-drug resistant tuberculosis (MDR-TB) care and antiretroviral treatment (ARV) and chronic conditions. In the second phase, in-depth interviews were conducted with lecturers to investigate and report on the inclusion of medication adherence and the teaching thereof in the curriculum of the Bachelor of Pharmacy Degree (BPharm) in pharmacy institutions in SA. Purposive sampling was used, and seven lecturers from four different institutions participated in the interviews. The interviews were conducted via Zoom® and were transcribed and analysed using thematic analysis. The teaching of medication adherence in the BPharm curriculum of the respective interviewed pharmacy institutions was explored. It was found that the topic of medication adherence was integrated into all subjects throughout the curriculum and not taught as a formal course. Although medication adherence is taught in many disciplines, it is predominantly in pharmacy practice in all institutions. The teaching methods identified included lectures, case studies, workshops, tutorials, practicals, readings, tasks, assignments and videos. The perceived effectiveness of the teaching methods was explored; also the time spent teaching medication adherence and the time efficiency. Student understanding, interest and engagement with the topic were explored and determined through their assessment performance and class attendance. In conclusion, from policies, the pharmacist's role concerning adherence is indirectly integrated into many other roles. It is often not distinguishable from that of other healthcare professionals and is often implied as part of a more generic role. Pharmacy students are educated on medication adherence and the skills and knowledge required to identify, monitor and support patient adherence to therapy. However, there is scope to increase the course content on medication adherence. There is a need to identify effective strategies for preparing pharmacists to assist patients in medication adherence. , Thesis (MPharm) -- Faculty of Pharmacy, 2023
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- Authors: Nyoni, Cynthia Nomagugu
- Date: 2023-10-31
- Subjects: Patient compliance South Africa , Drugs Administration Study and teaching (Higher) , Pharmacist and patient South Africa , Pharmaceutical policy South Africa , Patient education South Africa , Medication adherence
- Language: English
- Type: Academic theses , Master's theses , text
- Identifier: http://hdl.handle.net/10962/419548 , vital:71653
- Description: Medication adherence is a patient's active and voluntary participation in following all the recommendations and instructions agreed upon with a health care provider such as a pharmacist. Adherence is a multidimensional phenomenon determined by the interplay of five factors: patient-related factors, socioeconomic factors, condition-related factors, health system-related factors, and therapy-related factors. Medication non-adherence is a problem in many countries, especially low to middle-income countries, including South Africa (SA). In low to middle-income countries, non-adherence is often worse due to insufficient health resources and inequities in access to health care. Medication adherence is a global problem and has raised the need for research and review. Many healthcare professionals, especially pharmacists, have an essential role in promoting medication adherence. This study described, explained and evaluated the policies in SA relating to the pharmacist's role in promoting medication adherence. Furthermore, it described medication adherence-related education at four universities in South Africa. The study was qualitative, and a two-phased approach was employed. In the first phase, a document analysis of the pharmacist’s role in supporting medication adherence was conducted as described in national policies and guidelines in SA. A total of 38 documents were analysed, including critical documents such as the South African Pharmacy Council Good Pharmacy Practice Manual and Associated SAPC rules (GPP) manual, National Drug Policy (NDP), Standard treatment guidelines (STGS) and Integrated Adherence Guidelines. The READ approach was used in conducting the document analysis and involved (1) preparing materials, (2) extracting data, (3) analysing data, and (4) distilling findings. The critical roles of pharmacists in medication adherence that were identified were in drug use, supply and management, dispensing, therapeutic drug monitoring, pharmacovigilance, pharmaceutical care, and special programmes like antimicrobial stewardship (AMS), multi-drug resistant tuberculosis (MDR-TB) care and antiretroviral treatment (ARV) and chronic conditions. In the second phase, in-depth interviews were conducted with lecturers to investigate and report on the inclusion of medication adherence and the teaching thereof in the curriculum of the Bachelor of Pharmacy Degree (BPharm) in pharmacy institutions in SA. Purposive sampling was used, and seven lecturers from four different institutions participated in the interviews. The interviews were conducted via Zoom® and were transcribed and analysed using thematic analysis. The teaching of medication adherence in the BPharm curriculum of the respective interviewed pharmacy institutions was explored. It was found that the topic of medication adherence was integrated into all subjects throughout the curriculum and not taught as a formal course. Although medication adherence is taught in many disciplines, it is predominantly in pharmacy practice in all institutions. The teaching methods identified included lectures, case studies, workshops, tutorials, practicals, readings, tasks, assignments and videos. The perceived effectiveness of the teaching methods was explored; also the time spent teaching medication adherence and the time efficiency. Student understanding, interest and engagement with the topic were explored and determined through their assessment performance and class attendance. In conclusion, from policies, the pharmacist's role concerning adherence is indirectly integrated into many other roles. It is often not distinguishable from that of other healthcare professionals and is often implied as part of a more generic role. Pharmacy students are educated on medication adherence and the skills and knowledge required to identify, monitor and support patient adherence to therapy. However, there is scope to increase the course content on medication adherence. There is a need to identify effective strategies for preparing pharmacists to assist patients in medication adherence. , Thesis (MPharm) -- Faculty of Pharmacy, 2023
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The memory altar
- Alexander-McKenna, Hilary Jane
- Authors: Alexander-McKenna, Hilary Jane
- Date: 2022-04-07
- Subjects: Creative writing (Higher education) South Africa , Diaries -- Authorship , South African fiction (English) 21st century , South African essays (English) 21st century , South African essays (English) History and criticism , South African fiction (English) History and criticism , Yuknavitch, Lidia Criticism and interpretation , American fiction Criticism and interpretation , COVID-19 (Disease) in literature
- Language: English
- Type: Academic theses , Master's theses , text
- Identifier: http://hdl.handle.net/10962/263533 , vital:53636
- Description: My thesis is a novella that casts a sideways glance at the real world that at times seems stranger than fiction. The novella is written as a work of realistic fiction, with a plot, characters, timelines and location placed in present time, reflecting real current events. My work is strongly influenced by writers such as Ivan Vladislavić whose Portrait with Keys uses a slice of life narrative voice that observes overlays of public and private realities; Marguerite Duras’ use of cinematic storytelling and deeply personal exposure in The Lover and Yann Andréa Steiner; Kate Zambreno’s depiction of inner chaos against the chaos of an anonymous city in Green Girl; Otessa Moshfegh who makes the minutiae of the day-to-day seem significant in My Year of Rest and Relaxation; and Samuel Beckett’s finely crafted streams of consciousness, in his works of prose and drama, revealing the intimate perspectives of insiders. , Thesis (MA) -- Faculty of Humanities, School of Languages and Literatures, 2022
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- Authors: Alexander-McKenna, Hilary Jane
- Date: 2022-04-07
- Subjects: Creative writing (Higher education) South Africa , Diaries -- Authorship , South African fiction (English) 21st century , South African essays (English) 21st century , South African essays (English) History and criticism , South African fiction (English) History and criticism , Yuknavitch, Lidia Criticism and interpretation , American fiction Criticism and interpretation , COVID-19 (Disease) in literature
- Language: English
- Type: Academic theses , Master's theses , text
- Identifier: http://hdl.handle.net/10962/263533 , vital:53636
- Description: My thesis is a novella that casts a sideways glance at the real world that at times seems stranger than fiction. The novella is written as a work of realistic fiction, with a plot, characters, timelines and location placed in present time, reflecting real current events. My work is strongly influenced by writers such as Ivan Vladislavić whose Portrait with Keys uses a slice of life narrative voice that observes overlays of public and private realities; Marguerite Duras’ use of cinematic storytelling and deeply personal exposure in The Lover and Yann Andréa Steiner; Kate Zambreno’s depiction of inner chaos against the chaos of an anonymous city in Green Girl; Otessa Moshfegh who makes the minutiae of the day-to-day seem significant in My Year of Rest and Relaxation; and Samuel Beckett’s finely crafted streams of consciousness, in his works of prose and drama, revealing the intimate perspectives of insiders. , Thesis (MA) -- Faculty of Humanities, School of Languages and Literatures, 2022
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An exploration of how schools and teachers interpret and implement the Language in Education Policy for their classroom practice: a case study
- Authors: Sibanda, Sikhumbuzo
- Date: 2021-10-29
- Subjects: Language policy South Africa , Education and state South Africa , Critical discourse analysis , Native language and education South Africa Kuruman , Educational change South Africa , South Africa Colonial influence , South African Language in Education Policy
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10962/192035 , vital:45190
- Description: This case study explored how schools and teachers interpret and implement the Language in Education Policy for their classroom practices. Scholars like Alexander and Block (2012) note that the South African Language in Education Policy (LiEP) is one of the advanced policies globally. Other scholars like Perry (2015) and Ngcobo (2015) state that the policy in South Africa has failed when it comes to implementation. It is against this background that the research explored how schools and teachers interpret and implement the Language in Education Policy for their classroom practice in three primary schools in Kuruman, Northern Cape. The research methodology was qualitative and it used a case study approach. The study is informed and framed by the Language Policy framework and the CDA (Critical Discourse Analysis). The research sites were three Grade 4 classes and the participants were three teachers, three principals and three SGB Chairpersons from three different schools (one school in deep rural, another in semi-urban and the third in urban) in Kuruman. This case study, located in the interpretive paradigm, employed individual semi-structured interviews, non-participant classroom observations, document analyses and field notes for data collection. The study revealed that teachers are not versed in LiEP and their classroom practice is therefore not based on policy but on their own perceptions. Classroom practices were incongruent with what the Language in Education Policy requires. Even other documents which support the Language in Education Policy like the school language policies, were not used as guiding documents for classroom practice. Lastly, this study revealed that, despite a plethora of literature on how practice engages and disengages with Language in Education Policy (LiEP), the deconstruction of colonial and apartheid education is still a challenge especially in language use, perceptions of mother tongue instruction and the hegemony of English. One of the recommendations of this study is that teachers must be taught to use Languages of Learning and teaching required in their areas and they should also be given continuous professional development courses on policies so as to improve their practice. Language Policy Units should be set up within the provincial and district Departments of Education that would support the implementation of LiEP. , Thesis (MEd) -- Faculty of Education, Education, 2021
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- Authors: Sibanda, Sikhumbuzo
- Date: 2021-10-29
- Subjects: Language policy South Africa , Education and state South Africa , Critical discourse analysis , Native language and education South Africa Kuruman , Educational change South Africa , South Africa Colonial influence , South African Language in Education Policy
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10962/192035 , vital:45190
- Description: This case study explored how schools and teachers interpret and implement the Language in Education Policy for their classroom practices. Scholars like Alexander and Block (2012) note that the South African Language in Education Policy (LiEP) is one of the advanced policies globally. Other scholars like Perry (2015) and Ngcobo (2015) state that the policy in South Africa has failed when it comes to implementation. It is against this background that the research explored how schools and teachers interpret and implement the Language in Education Policy for their classroom practice in three primary schools in Kuruman, Northern Cape. The research methodology was qualitative and it used a case study approach. The study is informed and framed by the Language Policy framework and the CDA (Critical Discourse Analysis). The research sites were three Grade 4 classes and the participants were three teachers, three principals and three SGB Chairpersons from three different schools (one school in deep rural, another in semi-urban and the third in urban) in Kuruman. This case study, located in the interpretive paradigm, employed individual semi-structured interviews, non-participant classroom observations, document analyses and field notes for data collection. The study revealed that teachers are not versed in LiEP and their classroom practice is therefore not based on policy but on their own perceptions. Classroom practices were incongruent with what the Language in Education Policy requires. Even other documents which support the Language in Education Policy like the school language policies, were not used as guiding documents for classroom practice. Lastly, this study revealed that, despite a plethora of literature on how practice engages and disengages with Language in Education Policy (LiEP), the deconstruction of colonial and apartheid education is still a challenge especially in language use, perceptions of mother tongue instruction and the hegemony of English. One of the recommendations of this study is that teachers must be taught to use Languages of Learning and teaching required in their areas and they should also be given continuous professional development courses on policies so as to improve their practice. Language Policy Units should be set up within the provincial and district Departments of Education that would support the implementation of LiEP. , Thesis (MEd) -- Faculty of Education, Education, 2021
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Exploring affordances and hindrances when using Grade 8 Physical Science learners’ home language to mediate learning of chemical bonding
- Shilongo, Wilhelm Nghidiputate
- Authors: Shilongo, Wilhelm Nghidiputate
- Date: 2021-10
- Subjects: Science Study and teaching (Secondary) Namibia , Code switching (Linguistics) , Chemical bonds , Education, Bilingual Namibia , Native language and education Namibia , Socio-cultural theory
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10962/191079 , vital:45056
- Description: It seems code-switching from English to learners’ home language is a regular practice in Namibian schools. That is, science teachers mediate specific challenging science topics such as chemical bonding through code-switching from English to learners’ home languages. Based on anecdotal evidence and on Grade 10 Examiners’ Reports for previous years, chemical bonding is one of the challenging key concepts in Physical Science, and yet it is an important concept in the study of chemistry. Therefore, the purpose of this interventionist study was to investigate how the use of learners’ home language enables and/or constrains Grade 8 Physical Science learners’ sense making of the topic, chemical bonding. The study is a convergent parallel mixed method case study and was underpinned by an interpretive paradigm. It was conducted with 17 Grade 8 learners in a rural school, where I teach, in the Oshana region. I used a diagnostic test to elicit learners’ prior knowledge on this topic, a post-intervention test, observation, reflections, focus group interview and stimulated recall interviews as my data collection methods. I used Vygotsky’s (1978) Socio-Cultural Theory as my theoretical framework to help explain how learners make sense of the concept of chemical bonding when learners’ home language is used in a Physical Science class. To analyse the quantitative data obtained, I used a descriptive statistics and inferential statistics method. In the descriptive statistics, data were compiled into graphs, tables, and other visual representations, while for the inferential statistics, a t-test was used to establish the significant difference of the data collected. On the other hand, a thematic approach to analyse the qualitative data was employed to come up with sub-themes and themes. The findings of the study revealed that learners’ home language stimulates learners’ interest to learn new concepts, and enhances learners’ understanding and participation during the science lessons. Another finding of the study revealed that learners’ prior knowledge in chemical bonding contained some misconceptions. Furthermore, the findings of the study also revealed that learners learn best when their prior knowledge are elicited before they are introduced to new concepts in their science classrooms. The study recommends that learners’ home language should be incorporated into Physical Science lessons, especially when the teachers are teaching challenging concepts such as chemical bonding. , Thesis (MEd) -- Faculty of Education, Education, 2021
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- Authors: Shilongo, Wilhelm Nghidiputate
- Date: 2021-10
- Subjects: Science Study and teaching (Secondary) Namibia , Code switching (Linguistics) , Chemical bonds , Education, Bilingual Namibia , Native language and education Namibia , Socio-cultural theory
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10962/191079 , vital:45056
- Description: It seems code-switching from English to learners’ home language is a regular practice in Namibian schools. That is, science teachers mediate specific challenging science topics such as chemical bonding through code-switching from English to learners’ home languages. Based on anecdotal evidence and on Grade 10 Examiners’ Reports for previous years, chemical bonding is one of the challenging key concepts in Physical Science, and yet it is an important concept in the study of chemistry. Therefore, the purpose of this interventionist study was to investigate how the use of learners’ home language enables and/or constrains Grade 8 Physical Science learners’ sense making of the topic, chemical bonding. The study is a convergent parallel mixed method case study and was underpinned by an interpretive paradigm. It was conducted with 17 Grade 8 learners in a rural school, where I teach, in the Oshana region. I used a diagnostic test to elicit learners’ prior knowledge on this topic, a post-intervention test, observation, reflections, focus group interview and stimulated recall interviews as my data collection methods. I used Vygotsky’s (1978) Socio-Cultural Theory as my theoretical framework to help explain how learners make sense of the concept of chemical bonding when learners’ home language is used in a Physical Science class. To analyse the quantitative data obtained, I used a descriptive statistics and inferential statistics method. In the descriptive statistics, data were compiled into graphs, tables, and other visual representations, while for the inferential statistics, a t-test was used to establish the significant difference of the data collected. On the other hand, a thematic approach to analyse the qualitative data was employed to come up with sub-themes and themes. The findings of the study revealed that learners’ home language stimulates learners’ interest to learn new concepts, and enhances learners’ understanding and participation during the science lessons. Another finding of the study revealed that learners’ prior knowledge in chemical bonding contained some misconceptions. Furthermore, the findings of the study also revealed that learners learn best when their prior knowledge are elicited before they are introduced to new concepts in their science classrooms. The study recommends that learners’ home language should be incorporated into Physical Science lessons, especially when the teachers are teaching challenging concepts such as chemical bonding. , Thesis (MEd) -- Faculty of Education, Education, 2021
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Towards Reconfiguring the Agricultural Expert System (AES) for Black Small to Medium Farmer Development for Commercialization: A progressively focused policy literature review and social learning dialogue in the Eastern Cape Raymond Mhlaba Local Municipality
- Authors: Maqwelane, Lwanda
- Date: 2021-10
- Subjects: Farms, Small South Africa Amathole District Municipality , Minority farmers , Public-private sector cooperation South Africa Amathole District Municipality , Social learning South Africa Amathole District Municipality , Agricultural expert system (AES) , Black small to medium farmers (BSMF)
- Language: English
- Type: Masters theses , text
- Identifier: http://hdl.handle.net/10962/188876 , vital:44794
- Description: This study focuses on the agricultural expert system (AES), its inherited and potential reframing capabilities for the development, growth and transition of black small to medium farmers (BSMF) into the commercial sector. The study was conducted as a critical analytical policy review of implemented policies pre-and post 1994 that subsequently highlighted the thematic continuities and discontinuities of policy reform and the subsequent impact on BSMFs using the AES as a conceptual lens. The study aimed working with stakeholders in the AES in the Raymond Mhlaba Local Municipality as a case study to critically engage and question the AES and its contemporary framing and potential reframing and continued impact on the BSMFs development. This was conducted through a dialogical social learning process in partnership with diverse voices that cut across the contemporary agrarian landscape that included “universities, think tanks, vocational training providers, standards-setting agencies, trade associations that provide specialized training, education, information, research and technical support” (Porter, 2000, p.17). The data for the social learning dialogue process was generated through an iterative analysis of dialogical social learning workshops, focus groups and semi-structured interviews. The analysis focused on the framing (Chapters 2, 3, and 5) and reframing of the AES (Chapter 6). Through dynamic engagement within the knowledge hub (contextual social learning and literature), the study surfaces a potential alternative discourse that actively includes the BSMFs as a crucial component of the commercial sector AES as the analysis shows these are largely excluded. This alternative discourse occurred through dialogical interactions with all participants via a pro-actively constituted social learning process, enriched and deepened by literature as indicated above. Main recommendations of the study are: 1. The AES must be framed to address the holistic value chain of BSMFs to help address underlying policy dualism, 2. Public Private Partnerships are needed to support BSMFs development and these should adopt a social learning approach that is reflective of complex realities 3. There is need for better understanding of roles and contributions of stakeholders in the AES to avoid duplications. , Thesis (MEd) -- Faculty of Education, Education, 2021
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- Authors: Maqwelane, Lwanda
- Date: 2021-10
- Subjects: Farms, Small South Africa Amathole District Municipality , Minority farmers , Public-private sector cooperation South Africa Amathole District Municipality , Social learning South Africa Amathole District Municipality , Agricultural expert system (AES) , Black small to medium farmers (BSMF)
- Language: English
- Type: Masters theses , text
- Identifier: http://hdl.handle.net/10962/188876 , vital:44794
- Description: This study focuses on the agricultural expert system (AES), its inherited and potential reframing capabilities for the development, growth and transition of black small to medium farmers (BSMF) into the commercial sector. The study was conducted as a critical analytical policy review of implemented policies pre-and post 1994 that subsequently highlighted the thematic continuities and discontinuities of policy reform and the subsequent impact on BSMFs using the AES as a conceptual lens. The study aimed working with stakeholders in the AES in the Raymond Mhlaba Local Municipality as a case study to critically engage and question the AES and its contemporary framing and potential reframing and continued impact on the BSMFs development. This was conducted through a dialogical social learning process in partnership with diverse voices that cut across the contemporary agrarian landscape that included “universities, think tanks, vocational training providers, standards-setting agencies, trade associations that provide specialized training, education, information, research and technical support” (Porter, 2000, p.17). The data for the social learning dialogue process was generated through an iterative analysis of dialogical social learning workshops, focus groups and semi-structured interviews. The analysis focused on the framing (Chapters 2, 3, and 5) and reframing of the AES (Chapter 6). Through dynamic engagement within the knowledge hub (contextual social learning and literature), the study surfaces a potential alternative discourse that actively includes the BSMFs as a crucial component of the commercial sector AES as the analysis shows these are largely excluded. This alternative discourse occurred through dialogical interactions with all participants via a pro-actively constituted social learning process, enriched and deepened by literature as indicated above. Main recommendations of the study are: 1. The AES must be framed to address the holistic value chain of BSMFs to help address underlying policy dualism, 2. Public Private Partnerships are needed to support BSMFs development and these should adopt a social learning approach that is reflective of complex realities 3. There is need for better understanding of roles and contributions of stakeholders in the AES to avoid duplications. , Thesis (MEd) -- Faculty of Education, Education, 2021
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