Browsing by Author "Du Plessis, L. M."
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- ItemAssessing the utilization of a child health monitoring tool(Health and Medical Publishing Group, 2017) Blaauw, Renee; Daniels, L.; Du Plessis, L. M.; Koen, N.; Koornhof, H. E.; Marais, M. L.; Van Niekerk, E.; Visser, J.Objective: The study assessed the implementation of growth monitoring and promotion, immunisation, vitamin A supplementation, and deworming sections of the Road-to-Health Booklet. Caregivers and health care workers knowledge, attitudes and practices were investigated as well as health care workers perceptions of barriers undermining implementation. Methods: A cross-sectional descriptive study was conducted on a proportional sample of randomly selected Primary Health Care facilities across six health districts (35%; n=143) in the Western Cape Province. Health care workers involved in the implementation of the Road-to-Health Booklet, children (0-36 months) and CGs were included. Information was obtained through scrutiny of the Road-to-Health Booklet, observation of consultations and structured questionnaires. Results: A total of 2442 children, 2481 caregivers and 270 health care workers were recruited. Weight (94.7%) measurements were performed routinely. Less than half (40.2%) of caregivers reported that their child’s growth was explained. Sixty-eight percent of health care workers correctly identified criteria for underweight, whereas only 55% and 39% could do so for stunting and wasting respectively. Road-to-Health Booklet sections were completed adequately for immunization (89.3%), vitamin A supplementation (94.6%) but not for deworming (48.8%). Most health care workers (94%) knew the correct regimes for vitamin A supplementation and deworming, but few caregivers knew when treatment was due for vitamin A supplementation (16.4%) and deworming (26.2%). Potential barriers identified related to inadequate training, staff shortages and limited time. Conclusion: Focussed effort and resources should be channelled towards health care workers training and monitoring regarding growth monitoring and promotion to optimize utilization of the Road-to-Health Booklet. Mobilisation of community health workers is needed to strengthen community awareness of preventative health interventions.
- ItemHealth-promoting schools as a service learning platform for teaching health-promotion skills(Health & Medical Publishing Group, 2014-03) Du Plessis, L. M.; Koornhof, H. E.; Daniels, L. C.; Sowden, M.; Adams, R.Background. Health sciences students have traditionally been taught their practical skills in community health facilities. However, clinics and hospitals are not necessarily ideal settings for teaching students health-promotion skills. Objective. To explore health-promoting schools (HPSs) to teach Stellenbosch University (SU) undergraduate dietetic students health-promotion skills. Methods. In this descriptive, cross-sectional study, students completed structured reflective journals and conducted interviews with teachers. The chief professional nurse interviewed the school principals. Results. The students were positive about HPSs, but only fully understood its implementation and practice after entering the school setting. They felt that they could play a role in increasing its efficacy. The teachers were positive about the initiative and thought that they had adequate knowledge to take it further, but were open to gaining more knowledge and insight. Teachers and students had similar views on the role that students could play in HPSs, including educating learners, parents and teachers on health and nutrition, assisting with growth monitoring and promotion, developing educational tools, obtaining various resources for schools, planning menus, budgeting for meals, and growing vegetables. Resources required by the schools could best be addressed by a team of healthcare professionals in collaboration with government departments and with community support. Conclusion. HPSs offer extensive opportunities where SU undergraduate dietetic students, and possibly other healthcare profession students, could serve the needs of communities while learning and practising health-promotion skills.
- ItemImplementation of the Road-to-Health-Booklet health promotion messages at primary health care facilities, Western Cape Province, South Africa(Health and Medical Publishing Group, 2017) Du Plessis, L. M.; Blaauw, Renee; Koornhof, H. E.; Marais, M. L.Background: Age-specific health promotion messages appear in the Road-to-Health-Booklet, an assessment and monitoring tool for child health in South Africa. Healthcare workers should communicate health promotion messages to caregivers at each clinic visit. Objective: This investigation, part of a larger Road-to-Health-Booklet survey, assessed the implementation of health promotion messages and identified barriers to its successful implementation. Methods: A cross-sectional descriptive study with analytical components was conducted in the Western Cape Province. Knowledge and practices of caregivers and healthcare workers were assessed at 143 randomly selected primary health care facilities. Information was obtained through questionnaires; direct observation of consultations and recording of health promotion material in facilities. Results: In total, 2442 children (0-36 months; mean age 6.26 ± 6.24 months.); 2481 caregivers and 270 healthcare workers were included. Caregivers' educational level varied, with only 24.3% completing Grade 12. Healthcare workers had a median of five years (0.5 - 37.0 years) work experience in primary health care. All healthcare workers indicated that health promotion messages are important, however, messages were only conveyed in 51% of consultations observed. If communicated, health promotion messages were age-appropriate in 97% of cases. Barriers to the implementation of health promotion messages hinged on time and staff constraints, workload and language barriers. Various forms of health promotion material were available in facilities. Conclusions: Sub-optimal implementation of the health promotion messages in the Road-to-Health-Booklet are apparent despite healthcare workers realising the importance of health promotion. Barriers to optimal implementation must be urgently addressed by the National Department of Health and healthcare workers in partnership with caregivers and supported by society to promote child health and care.
- ItemObservations on the (un-) constitutionalty of section 118(3) of the local government: systems act 32 of 2000(Juta Law Publishing, 2006-03) Du Plessis, L. M.INTRODUCTION: Can section 118(3) of the Local Government: Municipal Systems Act1 (‘‘the act’’) withstand constitutional scrutiny – in terms of section 25(1) of the Constitution,2 to be more exact? The Constitutional Court – in Mkontwana v Nelson Mandela Metropolitan Municipality; Bissett v Buffalo City Municipality; Transfer Rights Action Campaign v MEC for Local Government and Housing, Gauteng3 (‘‘the Mkontwana case/ judgement’’) – left this question open, expressly and deliberately.4 In the same breath the court found that section 118(1) of the act, the operational stable companion of section 118(3), is not unconstitutional. It has therefore become significant to reflect on the likely constitutional fate of section 118(3) which, at present and at best, can but be guesstimated.
- ItemOor hoe juriste werk met tekste ... en tekste met hulle : enkele gedagtes oor die postmodernisering van Christelik-reformatoriese regsdenke(Scriber Editorial Systems, 2000) Du Plessis, L. M.In this article it is argued that postmodern, Christian-Reformational legal scholarship is possible, in principle, and indeed necessary. Reformational legal scholars are enjoined to account for the implications of the linguistic turn in legal interpretation, namely that meaning is not discovered in a text, but is made in dealing with the text. The meaning of “text” in the light of postmodern insights that traverse the notion of law-texts as autonomous bearers of meaning, is compared with traditional lexicographic notions of the signifier “text". According to the former insights a law-text is a signifier whose possible meanings in specific situations are generated as a result of a dynamic and complex interplay between the text and multifarious other signifiers. A basic distinction is made between narrative and normative lawtexts and the relevance of this distinction is explained.
- Item‘‘Subsidiarity’’: What's in the name for constitutional interpretation and adjudication?(Juta Law Publishing, 2006-02) Du Plessis, L. M.INTRODUCTION: ‘‘I would lay it down as a general principle that where it is possible to decide any case, civil or criminal, without reaching a constitutional issue, that is the course which should be followed.’’ This seemingly unspectacular dictum comes from the minority judgment in the controversial Mhlungu case, one of the earliest judgments of the South African Constitutional Court. Though it is not often cited (both in the literature and the case law) the said dictum seems to articulate a ‘‘principle’’ of considerable significance. The purpose of this article is to show that this dictum and the ‘‘principle’’ to which it refers are commensurate with and indeed a verbalisation of the notion of subsidiarity which, subject to caveats, has a constructive role to play in constitutional interpretation and adjudication. It will moreover be argued that (and shown why) it is desirable to name (and thereby explicitly recognise) the hitherto unnamed ‘‘Mhlungu principle’’ as an instance of adjudicative subsidiarity, and to distinguish it from other forms of subsidiarity which are also of interpretive and adjudicative significance.
- ItemWhat does an enabling environment for infant and young child nutrition look like at implementation level? Perspectives from a multi-stakeholder process in the Breede Valley Sub-District, Western Cape, South Africa(BioMed Central, 2018-02-13) Du Plessis, L. M.; McLachlan, M. H.; Drimie, S. E.Background: Breede Valley is a sub-district of the Cape Winelands district, Western Cape Province, South Africa. The administrative capital of the district is situated in the semi-rural town Worcester. Findings of a baseline survey in Worcester revealed poor infant feeding practices and childhood under- and overnutrition, with particular concern over high levels of stunting and low dietary diversity. Maternal overweight and obesity was high. These characteristics made the site suitable to study multi-sectoral arrangements for infant and young child nutrition (IYCN). The purpose of this study was to explore elements of an enabling environment with key stakeholders aimed at improving IYCN at implementation level. Methods: Focus group discussions and interviews were conducted with representatives from two vulnerable communities; local and district government; higher education institutions; business; and the media in the Breede Valley. Audio recordings were transcribed and data were analysed with the Atlas.TI software programme. Results: The participants viewed knowledge and evidence about the first 1000 days of life as important to address IYCN. The impact of early, optimal nutrition on health and intellectual development resonated with them. The IYCN narrative in the Breede Valley could therefore be framed around nutrition’s development impact in a well-structured advocacy campaign. Participants felt that capacity and resources were constrained by many competing agendas spreading public resources thinly, leaving limited scope for promotion and prevention activities. “People” were viewed as a resource, and building partnerships and relationships, could bridge some shortfalls in capacity. Conversations about politics and governance elicited strong opinions about what should be done through direct intervention, policy formulation and legislation. A lead government agency could not be identified for taking the IYCN agenda forward, due to its complexity. Participants proposed it should be referred to a local, informal, inter-governmental body where directors and senior managers meet to address issues of cross-cutting importance. Conclusion: The study illustrated that knowledge and evidence; politics and governance; and capacity and resources, elements of the international definition of an enabling environment, also apply at implementation level. In addition, our findings indicated that a people-centred approach is critical in shaping the enabling environment at this level.