Assessing the implementation of long-acting reversible contraceptive implant, Implanon NXT, roll out in East London, Eastern Cape, South Africa.
- Authors: Mdingi, Mildred Mandisa
- Date: 2020
- Subjects: Primary health care
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: http://hdl.handle.net/10353/18452 , vital:42267
- Description: Background: In 2014, South African Department of Health (SADOH) initiated use of Implanon NXT, a type of implant in addition to long-acting reversible contraceptives available in the country to expand contraceptives options for women of reproductive age. After its introduction, there were reports on early removals and frequent side effects. It is therefore vital to identify how successful the implementation of this method was in particular in East London area. Objectives: The purpose of this study was to evaluate how successful the implementation of Implanon NXT roll out was in East London, Eastern Cape. Additionally, the study also aimed to understand the views health care providers have of the Implanon NXT. Methods: A retrospective crosssectional design using existing data from family planning registers and distribution of questionnaires to Health Care Providers responsible for insertion and removal of the method (HCP). Results: February 2014 to March 2019, 1238 Implanon NXT insertions were done and only 266 removals in one study site. Out of the 266 participants, 67.7% of the participants removed the Implanon for reasons other than ill health (side effects), while the remaining 32.3% had experienced side effects and opted for early Implanon removal. Bleeding was the most common side effect reported by 44 of 266 (16.5%) participants. The health care providers who completed questionnaires for this study were overall confident in providing the Implanon NXT services. Conclusion: Implementation of a new contraceptive method requires clear standardised policies and guidelines on counselling and management of side effects. Findings of this study are reassuring that Implanon NXT had a role to play in prevention of unintended pregnancies. Implementation and rollout in one site reviewed has been demonstrated to be successful. The respondents in this study possesses knowledge about the Implanon NXT.
- Full Text:
- Authors: Mdingi, Mildred Mandisa
- Date: 2020
- Subjects: Primary health care
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: http://hdl.handle.net/10353/18452 , vital:42267
- Description: Background: In 2014, South African Department of Health (SADOH) initiated use of Implanon NXT, a type of implant in addition to long-acting reversible contraceptives available in the country to expand contraceptives options for women of reproductive age. After its introduction, there were reports on early removals and frequent side effects. It is therefore vital to identify how successful the implementation of this method was in particular in East London area. Objectives: The purpose of this study was to evaluate how successful the implementation of Implanon NXT roll out was in East London, Eastern Cape. Additionally, the study also aimed to understand the views health care providers have of the Implanon NXT. Methods: A retrospective crosssectional design using existing data from family planning registers and distribution of questionnaires to Health Care Providers responsible for insertion and removal of the method (HCP). Results: February 2014 to March 2019, 1238 Implanon NXT insertions were done and only 266 removals in one study site. Out of the 266 participants, 67.7% of the participants removed the Implanon for reasons other than ill health (side effects), while the remaining 32.3% had experienced side effects and opted for early Implanon removal. Bleeding was the most common side effect reported by 44 of 266 (16.5%) participants. The health care providers who completed questionnaires for this study were overall confident in providing the Implanon NXT services. Conclusion: Implementation of a new contraceptive method requires clear standardised policies and guidelines on counselling and management of side effects. Findings of this study are reassuring that Implanon NXT had a role to play in prevention of unintended pregnancies. Implementation and rollout in one site reviewed has been demonstrated to be successful. The respondents in this study possesses knowledge about the Implanon NXT.
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Contraceptive use and Sex Education among Teenagers in Mdantsane Township, Eastern Cape
- Authors: Ibikunle, Kehinde Olaoye
- Date: 2020
- Subjects: Sex instruction Primary Health Care
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: http://hdl.handle.net/10353/18411 , vital:42263
- Description: Uptake of contraceptives to prevent unwanted pregnancy among sexually active teenagers in South Africa remains low as evidenced by the high prevalence of unwanted pregnancy and unsafe abortions among adolescents. This is happening despite the wide availability of contraceptives which are also offered free of charge and in a context where comprehensive sexuality education is provided from primary school level. There is limited evidence regarding contraceptive use among teenagers in South Africa, which limits the decision making on targeting for promoting use of contraceptives. To address this gap, a quantitative cross sectional study of women aged 13 and above was conducted in Mdatsane Township to investigate the factors associated with contraceptive use among teenagers and compare this with young women aged 20 and above, as well as to assess if there are any associations in the use of contraceptives between the demographic characteristics of the teenagers and their caregivers. The study findings showed that non-use of contraceptives was 53.3%. Teenagers were significantly less likely to use contraceptives, OR 0.31, 95% CI (0.18 – 0.530), more likely to use injectables OR 3.48 95% CI 1.99 – 6.08, more likely to identify partner issues being reason for not using condoms OR 10.60, 95 % CI (2.01 – 55.94). Teenager were more likely to have Termination of unwanted pregnancy on the past (TOP), OR 2.13 95% CI (1.03 – 4.38), and would likely choose Depo/Petogen even if it increases HIV transmission OR 3.65, 95% CI (1.98 – 6.73). Teenagers were more likely to have been exposed to sex education and less likely to have a close relationship with caregivers OR 0.49 95% CI (0.27 – 0.90). In view of these findings it is logical to argue that although teenagers have accessed CSE they have not been able to translate it into action. Hence the need to develop the strategies that can help facilitate behaviour change. Further in-depth studies must be conducted to establish which types of contraceptives are preferred and acceptable to teenagers. Promote self-efficacy of teenagers to be empowered to make own decisions and not put their partners’ preferences on use of contraceptives and continue promoting primary and secondary abstinence while also encouraging delayed sexual debut
- Full Text:
- Authors: Ibikunle, Kehinde Olaoye
- Date: 2020
- Subjects: Sex instruction Primary Health Care
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: http://hdl.handle.net/10353/18411 , vital:42263
- Description: Uptake of contraceptives to prevent unwanted pregnancy among sexually active teenagers in South Africa remains low as evidenced by the high prevalence of unwanted pregnancy and unsafe abortions among adolescents. This is happening despite the wide availability of contraceptives which are also offered free of charge and in a context where comprehensive sexuality education is provided from primary school level. There is limited evidence regarding contraceptive use among teenagers in South Africa, which limits the decision making on targeting for promoting use of contraceptives. To address this gap, a quantitative cross sectional study of women aged 13 and above was conducted in Mdatsane Township to investigate the factors associated with contraceptive use among teenagers and compare this with young women aged 20 and above, as well as to assess if there are any associations in the use of contraceptives between the demographic characteristics of the teenagers and their caregivers. The study findings showed that non-use of contraceptives was 53.3%. Teenagers were significantly less likely to use contraceptives, OR 0.31, 95% CI (0.18 – 0.530), more likely to use injectables OR 3.48 95% CI 1.99 – 6.08, more likely to identify partner issues being reason for not using condoms OR 10.60, 95 % CI (2.01 – 55.94). Teenager were more likely to have Termination of unwanted pregnancy on the past (TOP), OR 2.13 95% CI (1.03 – 4.38), and would likely choose Depo/Petogen even if it increases HIV transmission OR 3.65, 95% CI (1.98 – 6.73). Teenagers were more likely to have been exposed to sex education and less likely to have a close relationship with caregivers OR 0.49 95% CI (0.27 – 0.90). In view of these findings it is logical to argue that although teenagers have accessed CSE they have not been able to translate it into action. Hence the need to develop the strategies that can help facilitate behaviour change. Further in-depth studies must be conducted to establish which types of contraceptives are preferred and acceptable to teenagers. Promote self-efficacy of teenagers to be empowered to make own decisions and not put their partners’ preferences on use of contraceptives and continue promoting primary and secondary abstinence while also encouraging delayed sexual debut
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Exploring challenges in implementing a health referral system in the Buffalo city metropolitan municipality in the Eastern Cape Province”
- Authors: Matolengwe, Aseza
- Date: 2020
- Subjects: Primary health care
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: http://hdl.handle.net/10353/18441 , vital:42266
- Description: The purpose of the study is to explore and describe challenges experienced by health professionals regarding implementation of the referral system used in Buffalo City Metropolitan Municipality (BCMM) in the Eastern Cape Province. A referral system in health care can be defined as a method whereby a health worker with insufficient skills and less resources in the primary health care setting, who has fewer remedies or options to manage medical conditions, seeks assistance from a more senior practitioner in a tertiary setting with better resources to provide guidance in managing the patient or to take over the management of the patient (Eastern Cape Department of Health, 2007:7). A qualitative descriptive explorative contextual design was used to explore and describe the challenges pertaining to the implementation of a referral system in the public health sector in Buffalo City Metropolitan Municipality (BCMM) in the Eastern Cape. A purposive sampling technique was employed with an inclusion criteria of health care professionals who are doctors, professional nurses, pharmacists and specialists. After obtaining ethical clearance from the respective departments, steps for data collection were implemented. Individual interviews were conducted using an interview guide that was prepared by the researcher. Findings in the study indicate that there are challenges in implementing a referral system in relation to infrastructure, workforce capacity, equipment, transport and drug availability. The participants provided suggestions according to their experiences on what they felt the Department of Health in BCMM could do to strengthen the referral system in place. The researcher then provided recommendations to the Department of Health of BCMM. The health referral system in BCMM needs to be strengthened through provision of adequate infrastructure, improving workforce capacity, and availability of medicines and equipment. A monitoring and evaluation plan must be affected by the Eastern Cape Department of Health. Education and training are needed for the health care workers and the community through their involvement in stakeholder meetings
- Full Text:
- Authors: Matolengwe, Aseza
- Date: 2020
- Subjects: Primary health care
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: http://hdl.handle.net/10353/18441 , vital:42266
- Description: The purpose of the study is to explore and describe challenges experienced by health professionals regarding implementation of the referral system used in Buffalo City Metropolitan Municipality (BCMM) in the Eastern Cape Province. A referral system in health care can be defined as a method whereby a health worker with insufficient skills and less resources in the primary health care setting, who has fewer remedies or options to manage medical conditions, seeks assistance from a more senior practitioner in a tertiary setting with better resources to provide guidance in managing the patient or to take over the management of the patient (Eastern Cape Department of Health, 2007:7). A qualitative descriptive explorative contextual design was used to explore and describe the challenges pertaining to the implementation of a referral system in the public health sector in Buffalo City Metropolitan Municipality (BCMM) in the Eastern Cape. A purposive sampling technique was employed with an inclusion criteria of health care professionals who are doctors, professional nurses, pharmacists and specialists. After obtaining ethical clearance from the respective departments, steps for data collection were implemented. Individual interviews were conducted using an interview guide that was prepared by the researcher. Findings in the study indicate that there are challenges in implementing a referral system in relation to infrastructure, workforce capacity, equipment, transport and drug availability. The participants provided suggestions according to their experiences on what they felt the Department of Health in BCMM could do to strengthen the referral system in place. The researcher then provided recommendations to the Department of Health of BCMM. The health referral system in BCMM needs to be strengthened through provision of adequate infrastructure, improving workforce capacity, and availability of medicines and equipment. A monitoring and evaluation plan must be affected by the Eastern Cape Department of Health. Education and training are needed for the health care workers and the community through their involvement in stakeholder meetings
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Knowledge of drowning risks amongst adolescents in the Nelson Mandela Metropole, Eastern Cape Province, South Africa
- Authors: Isaacs, Imeraan
- Date: 2020
- Subjects: Primary health care
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: http://hdl.handle.net/10353/18422 , vital:42264
- Description: The purpose of this research study was to explore and describe the knowledge and the level of awareness of drowning risks amongst adolescents in the Nelson Mandela Metropole, Eastern Cape Province, and South Africa. Drowning is defined as the “process of experiencing respiratory impairment from either submersion or immersion into a water medium” (van Beeck et al 2005:853). Global statistics place drowning as being the third foremost cause of unintentional death worldwide (WHO 2013). The World Health Organization reports that more than 90% of the estimated 370 000 drowning fatalities recorded in 2012 occurred in low and middle income countries (WHO 2014). A qualitative descriptive explorative contextual design was employed in this research study. A non-probability convenience sampling method was used. Adolescents aged 10- 13 years old who attend a public primary school and model C primary school in Nelson Mandela Metropole area in the Eastern Cape Province were the target population who had the specific characteristics of interest and significance to the research phenomenon (Asiamah et al 2017). Four focus group interviews were conducted. The groups consisted of five to ten participants grouped together to discuss the matter. Field notes were also taken by the researcher on what was heard, observed, thought and experienced during the interview process (Streubert & Carpenter 2007). Ethical principles were maintained as well as the concepts of trustworthiness were applied throughout this study.Data analysis was done using Tesch’s approach to open coding in qualitative research. A total of six themes and seven sub-themes arose during the analysis of the data and were completely discussed. The findings suggest that most of the participants are quite aware and knowledgeable of the potential risks that predispose an individual to drowning. The consequences of what happens when a victim is exposed to drowning, however, requires more insight. The risk of being unsupervised as well as not being able to swim was echoed in most of the group interviews. vii A noteworthy finding was the fact that the participants who were involved with some form of water safety programme/s at school were very articulate in their responses to the questions. It was recommended that educational programmes ought to be aligned with current evidence which is reflective of the region’s demographics and dynamics. Even though all researchers do not share the sentiments that swim proficiencies heighten the safety of the individual in and around water, the need for ongoing research initiatives is a significant stimulus that will generate new evidence and inform current preventive strategies. Identification and awareness of drowning risks require a foundation of comprehension in order to better understand and interpret the consequences of these risks. Learn to swim or swim orientation initiatives could potentially assist at primary school level with the safety levels of learners.
- Full Text:
- Authors: Isaacs, Imeraan
- Date: 2020
- Subjects: Primary health care
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: http://hdl.handle.net/10353/18422 , vital:42264
- Description: The purpose of this research study was to explore and describe the knowledge and the level of awareness of drowning risks amongst adolescents in the Nelson Mandela Metropole, Eastern Cape Province, and South Africa. Drowning is defined as the “process of experiencing respiratory impairment from either submersion or immersion into a water medium” (van Beeck et al 2005:853). Global statistics place drowning as being the third foremost cause of unintentional death worldwide (WHO 2013). The World Health Organization reports that more than 90% of the estimated 370 000 drowning fatalities recorded in 2012 occurred in low and middle income countries (WHO 2014). A qualitative descriptive explorative contextual design was employed in this research study. A non-probability convenience sampling method was used. Adolescents aged 10- 13 years old who attend a public primary school and model C primary school in Nelson Mandela Metropole area in the Eastern Cape Province were the target population who had the specific characteristics of interest and significance to the research phenomenon (Asiamah et al 2017). Four focus group interviews were conducted. The groups consisted of five to ten participants grouped together to discuss the matter. Field notes were also taken by the researcher on what was heard, observed, thought and experienced during the interview process (Streubert & Carpenter 2007). Ethical principles were maintained as well as the concepts of trustworthiness were applied throughout this study.Data analysis was done using Tesch’s approach to open coding in qualitative research. A total of six themes and seven sub-themes arose during the analysis of the data and were completely discussed. The findings suggest that most of the participants are quite aware and knowledgeable of the potential risks that predispose an individual to drowning. The consequences of what happens when a victim is exposed to drowning, however, requires more insight. The risk of being unsupervised as well as not being able to swim was echoed in most of the group interviews. vii A noteworthy finding was the fact that the participants who were involved with some form of water safety programme/s at school were very articulate in their responses to the questions. It was recommended that educational programmes ought to be aligned with current evidence which is reflective of the region’s demographics and dynamics. Even though all researchers do not share the sentiments that swim proficiencies heighten the safety of the individual in and around water, the need for ongoing research initiatives is a significant stimulus that will generate new evidence and inform current preventive strategies. Identification and awareness of drowning risks require a foundation of comprehension in order to better understand and interpret the consequences of these risks. Learn to swim or swim orientation initiatives could potentially assist at primary school level with the safety levels of learners.
- Full Text:
Knowledge, attitudes and behaviours of food preparers regarding food preparation in East London, South Africa
- Fundam, Thembeka, van Niekerk, Firstnames
- Authors: Fundam, Thembeka , van Niekerk, Firstnames
- Date: 2020
- Subjects: Primary health care Food service management
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: http://hdl.handle.net/10353/18400 , vital:42262
- Description: Background: Food preparers and food handlers seem to face difficulties in identifying activities that render food unsafe as a result of food contamination during food preparation. Research has shown that food preparation is a global problem and a potential health risk which can result in food-borne diseases as a result of a lack of knowledge on the principles of hygienic practices and negative attitudes when handling food. Aim: This study aims to determine the knowledge, attitudes and behaviours that motivate food preparers in safe food preparation. Method: Building on existing work in understanding this phenomenon it asks: A purposive sample of male and female participants who prepare food at home were asked to complete a questionnaire. The questionnaire items were developed through focus group interviews and after a pilot study, presented to participants to complete. The items were subjected to principal component analysis (factor analysis), yielding a six-factor solution. The factor means, standard deviations were calculated and reliability was determined for each factor using Cronbach’s alpha as a measure of internal consistency. Group differences were determined through independent samples t-tests and anova. Results: The quantitative analysis demonstrated that food preparers have a fair knowledge and perception of how to prevent contamination. However, their behaviour is various aspects of food preparation might at times put them at risk for contamination. With regards to attitude, when comparing groups, people who prepare food with love and care demonstrated a more positive attitude towards food preparation than those who are less passionate to prepare food. On this basis, hygiene education should focus on the perceived threat to health as cues to action in changing attitudes and adherence to recommendations on hygiene. Conclusion: Further research is required to solicit the views of respondents below the age of 18 with regard to food-handling practices in pre-prepared food to ascertain and prevent further contamination and ensure food safety.
- Full Text:
- Authors: Fundam, Thembeka , van Niekerk, Firstnames
- Date: 2020
- Subjects: Primary health care Food service management
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: http://hdl.handle.net/10353/18400 , vital:42262
- Description: Background: Food preparers and food handlers seem to face difficulties in identifying activities that render food unsafe as a result of food contamination during food preparation. Research has shown that food preparation is a global problem and a potential health risk which can result in food-borne diseases as a result of a lack of knowledge on the principles of hygienic practices and negative attitudes when handling food. Aim: This study aims to determine the knowledge, attitudes and behaviours that motivate food preparers in safe food preparation. Method: Building on existing work in understanding this phenomenon it asks: A purposive sample of male and female participants who prepare food at home were asked to complete a questionnaire. The questionnaire items were developed through focus group interviews and after a pilot study, presented to participants to complete. The items were subjected to principal component analysis (factor analysis), yielding a six-factor solution. The factor means, standard deviations were calculated and reliability was determined for each factor using Cronbach’s alpha as a measure of internal consistency. Group differences were determined through independent samples t-tests and anova. Results: The quantitative analysis demonstrated that food preparers have a fair knowledge and perception of how to prevent contamination. However, their behaviour is various aspects of food preparation might at times put them at risk for contamination. With regards to attitude, when comparing groups, people who prepare food with love and care demonstrated a more positive attitude towards food preparation than those who are less passionate to prepare food. On this basis, hygiene education should focus on the perceived threat to health as cues to action in changing attitudes and adherence to recommendations on hygiene. Conclusion: Further research is required to solicit the views of respondents below the age of 18 with regard to food-handling practices in pre-prepared food to ascertain and prevent further contamination and ensure food safety.
- Full Text:
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