Performance and JSE listing of selected South African hospital operators

The study investigates the relationship between the Johannesburg Stock Exchange Listing Status and performance of selected South African private Hospital Operators covering a 10- year period from 2008-2017. The selected proxies for the hospital performance measured were: Total Annual Revenue, Revenue per Bed per Day, Total Number of Hospital Beds, and EBITDA margin while controlling for Healthcare Inflation and Medically Insured Population, respectively. The specified regression equation was expanded to include simultaneous equations for the proxies of hospital performance. From this system of simultaneous equations, the study estimated the panel regression model using Seemingly Unrelated Regression (SUR). The findings showed that (1) JSE-listed Hospital Operators command higher Total Annual Revenues generated, superior Hospital Bed Numbers, and higher Revenue per Bed per Day compared to their unlisted peers, but their operating efficiency is not superior to that of their unlisted peers. In addition, the study found (2) a positive and statistically significant relationship between JSE Listing Status and Private Hospital Operator Performance for the performance proxies of Total Annual Revenue, Revenue per Bed per Day and Total Number of Hospital Beds, but a positive statistically insignificant relationship in respect of EBIDTA margin, the operating efficiency measure of performance; (3) a positive statistically significant relationship between Medically Insured Population and Private Hospital Operator Performance for the performance proxies of Total Annual Revenue, Revenue per Bed per Day, Total Number of Hospital Beds, but a positive statistically insignificant relationship in respect of the operating efficiency measure of performance; (4) a negative statistically insignificant relationship between Healthcare Inflation and Private Hospital Operator Performance for the performance proxies of Total Annual Revenue, Revenue per Bed per Day, Total Number of Hospital Beds, but a positive also statistically insignificant relationship in respect of the operating efficiency measure of performance. These results corroborate the theoretical predictions and are supported by previous studies. The study has important implications for public bourse listing as a strategic organisational consideration in terms of funding mobilisation for corporate performance and growth strategy. The sizeable macroeconomic contribution of the private hospital sector, and the importance of the medical insurance-private hospital performance nexus, behoves policy makers to ensure that the proposed universal health fund in South Africa must not totally crowd out the development of private health insurance

Grade 12 teachers' attitude towards mass-media transmitted educational supplements

ThesisThe purpose of this research was to investigate the essence of Grade 12 teachers' attitude towards the use of Mass-Media Educational Supplements, to textbooks and teachers as well. Firstly, the study sought to examine Grade 12 teachers' use ofMass-Media in their lessons. Secondly, the study sought to determine problems Grade 12 teachers experience when they apply Mass-Media in their lessons. Lastly, the study sought to determine the cause of problems for Grade 12 teachers when applying Mass-Media. Data were collected from one school in Thabong (Welkom). Two instruments were used to collect the data. The first instrument was the questionnaire which collected primary data, and the second instrument was the interview which collected secondary data to complement the primary data collected through the questionnaires. The results have revealed that Grade 12 teachers do in fact, have a positive attitude towards having to use Mass-Media Educational Supplements. The problem lies with lack of resources at schools, and also the time clashes at school with the time for example on which The Learning Channel is being aired. This study therefore, recommends that problems with regard to the time- table and lack of resources be addressed from a higher level than the school level, and also that Mass-Media supplements being in schools, should be centrally co-ordinated. They should be just left as a loose canon for individual school to decide on themselves what to do with it

Determining the optimal departmental resource allocation at Wispeco Aluminium

Wispeco Aluminium’s Profiling department is used for the production of the aluminium profiles that Wispeco sells to its’ customers nationwide. The production at this department is achieved through the usage of five extrusion machines (EP1-EP5) that run continuously throughout a working shift. The continuous running of these machines is what Wispeco would like to maintain as any stoppage of the machines results in financial losses for the company, an estimated loss of R25248 per hour per machine was highlighted. This figure was calculated using the average production quantity per machine (789kg/hr.) multiplied by the price per kilogram (R32/kg) of aluminium. The only reason that causes the machines to be stopped from running is when there is a shortage of skips within this department. A skip is a material handling component that needs to be readily available next to the extrusion machines after the production of the aluminium profiles by the machines. The problem for this project was to ensure that there is always an availability of skips next to each extrusion machine and therefore the continuous running of the machines can be maintained, of which a total number of 2720 skips is available within the company and is shared by four departments including the Profiling department. The other three departments are Powder coating, Anodizing and Gauteng Stockists (warehouse). To get a clear understanding of the problem, a time study for a single shift (6am-6pm) was performed with the results thereof used as input data to a simulation model using Simio software. The results of the simulation model gave an indication of the instantaneous production quantities for every machine and hence gave an indication of the number of skips needed per machine per production batch. The remaining number of skips was allocated to the remaining three departments based on the average number of skips needed per department, this number was achieved using the daily skip counts performed at each department.Thesis (B Eng. (Industrial and Systems Engineering))--University of Pretoria, 2012

Factors associated with maternal mortality in South East Botswana

Magister Public Health - MPHBackground: Maternal mortality is a significant public health problem world-wide,as it is an important indicator for the functioning of the health system. The maternal mortality ratio for Botswana is higher than other countries with comparable economic growth, despite impressive access to health services. In order to develop relevant programs and policies to reduce maternal mortality, the factors associated with maternal mortality were studied. The study aimed to describe the maternal and health services factors associated with maternal mortality in South East Botswana. Methodology: A quantitative case-control study was used to retrospectively review medical records for 71 cases of maternal deaths and 284 controls randomly selected from mothers who delivered in the same year and at the same health facility, in South East Botswana from 2007 to 2009. Information was collected on the maternal and health services characteristics of the cases and controls including age, level of education, marital status, parity, utilization of health facilities that consist of antenatal care (ANC), type of delivery, complications during pregnancy, type of health facility and ANC provider. Data was analyzed using Predictive Analysis Software (PASW) Version 18.Two-sample t- test, Pearson’s Chi-square test and the Fisher’s exact test were used to test the difference between the proportions of the various categories of variables in cases and controls. Univariate logistic regression analysis was applied to identify the risk factors associated with maternal deaths. A multivariate logistic regression model was estimated to see the joint effects of the identified risk factors for maternal mortality. Hosmer and Lemeshow test was used to test the goodness of fit of the model. Results: The mean age of the maternal deaths was 28.0 ± 5.3 years and they had taken place at a hospital (100%). A large number of deaths occurred before delivery(59.0%). The causes of maternal death included both direct (73%) and indirect causes (27%). Direct causes were the leading causes of death and they were abortion(22.5%) and haemorrhage (18.3%). The maternal characteristics associated with maternal mortality were having complications at delivery (OR=20.91), not receiving ANC (OR=6.31) and delivering by caesarean section (OR= 2.66). The health facility characteristics associated with maternal mortality were delivering outside the health facility (OR=14.78), having been referred from another facility (OR=8.62) and delivering at a general hospital (OR=5.91). The data produced a model with good fit that included one maternal risk factor and three health facility risk factors. These were being admitted with preterm labour, delivering at a general hospital or before arrival at the health facility and having been referred from another health facility. Conclusion: Maternal mortality was associated with both maternal and health facility risk factors. The model developed may be used to identify and manage highrisk women to reduce the number of maternal deaths. It was recommended that, the current system should continue to be monitored and evaluated through the Maternal Mortality Monitoring System (MMMS). Furthermore, the referral and management of complications needs to be strengthened through a multi-sectoral approach

Fifth-year medical students’ perspectives on rural training in Botswana: A qualitative approach

Background. The curriculum of the Faculty of Medicine at the University of Botswana includes rural community exposure for students throughout their 5 years of training. In addition to community exposure during the first 2 years, students complete 16 weeks of family medicine and 8 weeks of public health medicine. However, as a new faculty, students’ experiences and perceptions regarding rural clinical training are not yet known.Objective. To describe the experiences and perceptions of the 5th-year medical students during their rural training and solicit their recommendations for improvement.Methods. This qualitative study used face-to-face interviews with 5th-year undergraduate medical students (N=36) at the end of their family medicine rotation in Mahalapye and Maun villages. We used a phenomenological paradigm to underpin the study. Voice-recorded interviews were transcribed and analysed using Atlas TI version 7 software (USA).Results. Three main themes were identified: (i) experiences and perceptions of the rural training environment; (ii) perceptions of the staff at rural sites; and (iii) perceptions of clinical benefits and relevance during rural training. While the majority of students perceived rural training as beneficial and valuable, a few felt that learning was compromised by limited resources and processes, such as medical equipment, internet connectivity and inadequate supervision.Conclusion. While the majority of students perceived rural training as beneficial, students identified limitations in both resources and supervision that need to be improved. Understanding students’ rural training experiences and perceptions can help the Faculty of Medicine, stakeholders and site facilitators to guide future rural training implementation

High prevalence of albuminuria among adult males living with HIV in Botswana

Chronic HIV disease is associated with a fivefold increase in albuminuria outside of sub-Saharan Africa. However, very little is known about albuminuria risk among people living with HIV (PLWH) in sub-Saharan Africa. Therefore, we conducted a cross-sectional observational HIV clinic-based study of albuminuria among 1533 adults aged 21 years or older between January 2020 and January 2021 in Gaborone, Botswana. Clinical albuminuria was defined using a sex-based albumin‒creatinine ratio (ACR) of 25–355 mg/g for females and 17–250 mg/g for males. The study population mean age was 48.5 (SD 10.3) years, and 764/1533 (49.7%) were female. The overall prevalence of albuminuria was 20.7% (95% CI 18.7%, 22.8%). A higher proportion of males were more likely to be categorized as having albuminuria than females, 25% (95% CI 22.0, 28.2) versus 16.4% (95% CI 13.8,19.2), P value < 0.001. In the final multivariate models, predictors of albuminuria differed by sex group. Larger longitudinal studies are required to evaluate the impact of albuminuria among PLWH with particular emphasis on the effect of sex on the risk of albuminuria

Predictors of risky sexual behaviour among young people in the era of HIV/AIDS: evidence from the 2008 Botswana AIDS Impact Survey III

The objective of this study is to fill in that research gap by investigating factors that are likely to predict Botswana’s young people’s practicing risky sexual behaviour in the era of HIV/AIDS. Data used in this study were obtained from a nationally representative sample of 5,810 young people aged 15 to 29 who had completed an individual questionnaire of the 2008 Botswana AIDS Impact Survey III. Both descriptive and multiple regression analyses were used for analysis. Elevated odds ratio (OR) values were obtained from a linear model analysis, showing statistically significant predictors of risky sexual behaviour among young people who have experienced coerced sex (OR=2.2), substance use (OR=1.8), having had sex before the age of 15 (OR=1.9), being older (OR=1.1) and lack of sexual self-efficacy (OR=1.6). Therefore risk reduction strategies aimed at addressing these potential problems should target young people before they enter adolescence and should develop gender-specific strategies.L&apos;objectif de cette étude est de combler cette lacune-là qui existe dans la recherche tout en examinant les facteurs qui sont susceptibles de prédire la pratique de comportements sexuels à risque chez les jeunes gens du Botswana à l&apos;ère du VIH / SIDA. Les données utilisées dans cette étude ont été obtenues à partir d&apos;un échantillon national représentatif de 5810 jeunes âgés de 15 à 29 ans qui avaient remplir un questionnaire individuel du Botswana AIDS Impact Survey III 2008. Des analyses de régression à la fois descriptive et multiples ont été utilisées pour l&apos;analyse. Les rapports de valeurs de cotes élevé (OR) ont été obtenus à partir d&apos;une analyse du modèle linéaire, montrant des indices statistiquement significatifs de comportements sexuels à risque chez les jeunes qui ont eu des relations sexuelles sous la contrainte (OR = 2,2), la consommation de drogue (OR = 1,8), après avoir eu des relations sexuelles avant l’âge de 15 ans (OR = 1,9), étant plus âgés (OR = 1,1) et le manque d’auto-efficacité sexuelle(OR = 1,6). Par conséquent, les stratégies de réduction de risque destinées à résoudre ces problèmes potentiels devraient cibler les jeunes gens avant qu&apos;ils n’entrent dans l&apos;adolescence et devrait élaborer des stratégies propres à chaque sexe

Impact of Individual, Household and Community Characteristics on Children\u2019s Nutritional Indicators

This study analyzed WHO-standardized nutritional indicators of children from selected households within communities that were sampled from all districts of Botswana. Data from the 2007 Botswana Family Health Survey were fitted into multilevel models that seek to account for variability due to the macro- and micro-units that have been hierarchically selected. This allowed for estimation of different levels of intraclass correlations while simultaneously assessing the model-fit by accounting for the influence on the nutritional indicators due to the fixed variables attributable to these macro- and micro-units. The results show that variation in nutritional status of under-five children in Botswana is a function of characteristics of the households and communities within which they live. As much as 17% of variation is due to differences in the communities and households. Economic status of households holds an important key in predicting the nutritional status of children