Browsing by Author "Klopper, J M L"

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    A nutritional and socio-economic study of Philippi farm children and their mothers during November 1986
    (1987) Whittaker, Stuart; Klopper, J M L
    A community based survey to determine the nutritional status using anthropometric methods, of children and mothers and to assess certain socio-economic factors was carried out during November and December 1986 in Philippi, a predominantly vegetable farming area. Twenty-one (43%) of the 49 vegetable farms which were included in the study were selected by stratified random sampling. All children in the 0-6 year age group and their parents on the selected farms were included in the sample which consisted of 129 children and 212 parents. Questionnaires were administered and subjects' weights and heights were measured. It was found that 47% of children were below the National Centre for Health Statistics 5th percentile weight for age and 58% were under the 5th percentile height for age. There were 47 child deaths out of 279 births over a six-year period, thirty-four of which had occurred in the first year of life. Twenty eight percent of children had a birth weight of less than 2.5 kg. The number of cases of tuberculosis (10%) and severe diarrhoea (31%) contracted within the first year of life is unacceptably high. Twenty four percent of mothers were malnourished in terms of body mass index and fifty five percent of mothers were illiterate. Fifty nine percent of mothers were regular farm workers who worked for an average of 10.2 hours per day and a wage of R0.44 per hour. Grossly inadequate facilities existed for the care of children while the mothers worked. The average amount spent on food was insufficient to maintain normal nutrition. Although 91.5% of mothers breast fed their children and fed for a mean duration of 13.4 months, breast feeding was not exclusive. Supplementary feeding was introduced on average at 3 months of age. The long working hours of working mothers made it difficult for them to breast feed their children satisfactorily. Acceptance of the family planning services was high and immunisation cover was good. These statistics reflect the effects of extreme poverty and neglect of a community which is totally reliant on its employers for its livelihood. The parents poor educational level, coupled with their meagre financial and other physical resources gives them and their children little opportunity to improve their station in life and leaves them open to the scrounge of malnutrition and disease. Similarly, the dearth of educational and other child care facilities will ensure that this disastrous trend continues. A multidisciplinary approach, including active community involvement of both farmers and workers, to the many physical and social problems is urgently needed if the unacceptable human suffering is to be stopped.
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    Offshore oil and gas in Russia: the legal framework and the implications as at September 1995
    (1996) Vidal, Tillman; Klopper, J M L
    The oil and gas industry in Russia is experiencing serious problems in the wake of the disintegration of the Soviet Union and the old structures with no new structures there to replace them. This applies to the whole of the Russian economy, and the way into a market economy with its regimes and structures is a very slow one in view of the political difficulties subsisting, with a general lack of understanding of the workings of a free market economy and democracy. While the free market economy is what is aspired, the use of the word 'free' in this context is often taken by its literal meaning in Russia. The oil and gas industry which is an important employer and above all foreign currency earner, is in the forefront of development. It is impossible to separate onshore and offshore oil and gas, in that there was a total lack of legislation in the Soviet Union on the oil and gas industry in general. Laws which were introduced were essentially territorial laws attempting to lay down rules and regulations. It is however noteworthy that it is precisely the large offshore projects which have been negotiated for a number of years already or are being negotiated at present, which seem to be a major factor behind the increasing legislative activity in the oil and gas industry, as these are without exception subject to a legal regime for the industry which is acceptable to investors seeking stability rather than a pure maximisation of profits. The attempts in introducing the production sharing legislation are a direct result of these projects as well as proposed legislation on the continental shelf.
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    Regionalization of health services in the Cape Province : a framework
    (1989) Pick, William M; Klopper, J M L
    Post-graduate students specializing in Community Health, are attached to different health authorities during their training. During these attachments they are exposed to the day-to-day management of health services and experience at first hand, the difficulties as well as the successes that are encountered in tending to the health needs of communities. It is also expected that post-graduate students do research projects during their attachments, usually on topics on which the health services managers need information. The topic discussed in this report was an assignment given to the author at the start of his attachment to the department of Hospital (Health) Services of the Cape Provincial Administration. The period of attachment was from February to May 1987. The whole question of the regionalization of health services is a complex one, and it is necessary that any proposals for a system of regionalization benefit from the inputs of many experts in different fields. However, as has been the experience in the United States of America, such inputs are no guarantee -that a successful system of regionalization will result. (1) In the local front, the Department of Works, at the request of the Director of Hospital Services, began an investigation into the existing system of regionalization of hospital services in 1985. This attempt was aborted, possibly because of the magnitude of the task, among other things. (2). What follows hereafter should therefore be seen as merely a framework for the development of a system of regionalization rather than as a blueprint for such a system. Perhaps a few remarks about the age-old problem of line-staff conflict would not be amiss at this stage. During the development of this framework, it became apparent that line officials might be expecting a quick proposal of regions and/ or sub-regions for the delivery of health services based on a purely management approach. As a staff official, the author naturally had different expectations. The report is an attempt to marry the two sets of expectations and it is left to the reader to judge to what extent, if at all, the author has succeeded in this attempt. Much of the data used in the study are new, and computation was done largely by hand. The generation of the data, was therefore time-consuming and much of the first phase of the study was devoted to the generation of the data and collection of data that were available from other sources. The study has proved to be a fascinating one and it is hoped that permission will be obtained to pursue the study in more detail. This report should therefore be seen as a preliminary report which addresses the question of regionalization of health services in the Cape Province in 'macro' terms. And finally, the author hopes that some of the information in this report may prove of value to those responsible for the delivery of health services to the people of the Cape Province.
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    The outpatient situation in the Cape Peninsula
    (1995) Taylor, Stephen Paul; Klopper, J M L; Coetzee, N
    This dissertation is based on a study commissioned by the Cape Provincial Administration's hospital department into ambulatory care in the Cape Peninsula. The aim of the study was to investigate the whole picture of the provision of outpatient services by that hospital department in the Cape Peninsula. The investigation was to specifically isolate and assign problem areas and propose realistic solutions in order to overcome the "implementation gap" between research and policy implementation. The focus of the investigation was to be the Day Hospital Organisation and Paediatric Care. This very broad aim was to be met by five specific objectives which were (i) to determine the demographic characteristics of the population of the Cape Peninsula, (ii) to determine utilisation of ambulatory services; (iii) to quantitate problems, determine resources used, and (iv) determine attitudes to the service as perceived by medical staff. The study consisted of over 20 individual epidemiological investigations. These investigations varied in methods from cross-sectional analyses to simple descriptive epidemiology. Two substantial descriptive studies were performed. The· first was a crosssectional study of doctors' attitudes and practices in all hospital / day hospital ambulatory settings in the Cape Peninsula. The second was a descriptive study of all patients who attended the Day Hospital Organisation in 1987. An overall picture was obtained as to utilisation rates, demography, resources deployed and attitudes of staff. A comprehensive literature review revealed a relative dearth of information concerning the subject in South Africa. Where information was available, it was piecemeal and often operationally directed. A review of organisational and other factors impacting on ambulatory services revealed that although past commissions and National Plans have had noble objectives, those objectives were never attained. Major findings of the study were that although overall attendances to the service had increased by 10 % between 1980 and 1987, the attendance number by whites had decreased by 16 % while that of blacks had increased by 62 %. The Day Hospital Organisation had had a static workload which had only increased with the addition of new clinics in the latter years. The rapid rate of increased attendances placed a burden on many hospitals. Four organisations were rated to have a crisis which in order of severity were: Red Cross Hospital, Conradie Hospital, Day Hospital and Groote Schuur Hospital.