Low uptake and early removal of Implanon NXT among women of reproductive age in Limpopo
- Magomani, Nandu Victoria https://orcid.org/ 0000-0001-5473-9984
- Authors: Magomani, Nandu Victoria https://orcid.org/ 0000-0001-5473-9984
- Date: 2021-11
- Subjects: Contraceptive drug implants
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/21849 , vital:51829
- Description: Implanon NXT also referred to as subdermal Implant, is a long-acting subdermal contraceptive method available in the South African public health care system since 2014. The implant was introduced to broaden the choice for women of childbearing age to delay or prevent unwanted pregnancies. Following a surge in popularity, reports of early removals and frequent adverse effects led to a significant decrease in its uptake in the country. Insufficient knowledge on Implanon, poor management of side effects, poor counseling by health care workers, and lack of partner support were the main themes that were picked from the interview, influencing uptake or early removals of the Implanon. The major concerning side effect reported was uncontrolled and irregular heavy bleeding The purpose of the study was to explore the factors associated with low uptake and early removals of Implanon NXT among women of reproductive age in one district in Limpopo province. A qualitative research design was used, primarily as exploratory and descriptive in nature. Participants were identified using non-probable, purposeful voluntary sampling. Data collection was achieved using open-ended structured interviews with sixteen (16) women aged from18-49. Data was analysed using thematic method of organizing data into categories, followed by coding and sorting the data to identify patterns and interpret the meanings and responses. An independent consultant was involved to confirm the thematic areas identified after which consensus discussions took place to finalize the analysed data. From the results, it appeared that there was a need that Implanon should be marketed by use of digital platforms and print media for information sharing. These platforms should be utilized by DOH from the National, provincial, district, facility and community levels. There should be clear protocol on how to manage different kinds of side effects, and this information should be rolled out to the implementation level. Health Care workers should provide client education and counselling services to the clients about the effectiveness of the method. Male partner involvement is crucial to provide support for women on contraceptives and to support their contraceptive choices. Mentorship will help providers to attain their proficiency in Implanon counselling, insertions, and removals. Lastly, availing adequate and effective youth-friendly services to enable young people to open up more about challenges and options that can be explored. For the adolescents and youth, these services should be provided by trained providers not at the general unit, where there is a mixture of adult population and the elderly, but at youth zones to enhance the uptake of Implanon NXT. Recommendations are for clinical practice area, for generic student education as well as for further research. The conclusions confirm that the government need to revitalise the Implanon program, to drive the uptake and reduce early removals. Training of health workers and mentorship should emphasize more comprehensive counselling, provide adequate information on what is to be expected and more importantly, how to treat and manage the side effects. That early removals due to side effects become the last option as information need to be widely available to all users utilising the traditional methods and modern methods such as digital platforms to spread the correct information and create demand for the Implanon. The functional service-provision-based youth-friendly services which will cater for the needs of young women and adolescents is highlighted as it provides a comfortable and conducive environment to provide and receive a comprehensive sexual reproductive health and rights services. , Thesis (MPH) -- Faculty of Health Sciences, 2021
- Full Text:
- Date Issued: 2021-11
- Authors: Magomani, Nandu Victoria https://orcid.org/ 0000-0001-5473-9984
- Date: 2021-11
- Subjects: Contraceptive drug implants
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/21849 , vital:51829
- Description: Implanon NXT also referred to as subdermal Implant, is a long-acting subdermal contraceptive method available in the South African public health care system since 2014. The implant was introduced to broaden the choice for women of childbearing age to delay or prevent unwanted pregnancies. Following a surge in popularity, reports of early removals and frequent adverse effects led to a significant decrease in its uptake in the country. Insufficient knowledge on Implanon, poor management of side effects, poor counseling by health care workers, and lack of partner support were the main themes that were picked from the interview, influencing uptake or early removals of the Implanon. The major concerning side effect reported was uncontrolled and irregular heavy bleeding The purpose of the study was to explore the factors associated with low uptake and early removals of Implanon NXT among women of reproductive age in one district in Limpopo province. A qualitative research design was used, primarily as exploratory and descriptive in nature. Participants were identified using non-probable, purposeful voluntary sampling. Data collection was achieved using open-ended structured interviews with sixteen (16) women aged from18-49. Data was analysed using thematic method of organizing data into categories, followed by coding and sorting the data to identify patterns and interpret the meanings and responses. An independent consultant was involved to confirm the thematic areas identified after which consensus discussions took place to finalize the analysed data. From the results, it appeared that there was a need that Implanon should be marketed by use of digital platforms and print media for information sharing. These platforms should be utilized by DOH from the National, provincial, district, facility and community levels. There should be clear protocol on how to manage different kinds of side effects, and this information should be rolled out to the implementation level. Health Care workers should provide client education and counselling services to the clients about the effectiveness of the method. Male partner involvement is crucial to provide support for women on contraceptives and to support their contraceptive choices. Mentorship will help providers to attain their proficiency in Implanon counselling, insertions, and removals. Lastly, availing adequate and effective youth-friendly services to enable young people to open up more about challenges and options that can be explored. For the adolescents and youth, these services should be provided by trained providers not at the general unit, where there is a mixture of adult population and the elderly, but at youth zones to enhance the uptake of Implanon NXT. Recommendations are for clinical practice area, for generic student education as well as for further research. The conclusions confirm that the government need to revitalise the Implanon program, to drive the uptake and reduce early removals. Training of health workers and mentorship should emphasize more comprehensive counselling, provide adequate information on what is to be expected and more importantly, how to treat and manage the side effects. That early removals due to side effects become the last option as information need to be widely available to all users utilising the traditional methods and modern methods such as digital platforms to spread the correct information and create demand for the Implanon. The functional service-provision-based youth-friendly services which will cater for the needs of young women and adolescents is highlighted as it provides a comfortable and conducive environment to provide and receive a comprehensive sexual reproductive health and rights services. , Thesis (MPH) -- Faculty of Health Sciences, 2021
- Full Text:
- Date Issued: 2021-11
Treatment adherence among tuberculosis patients in Nelson Mandela District, Eastern Cape Province
- Authors: Sohuma, Ntombifikile
- Date: 2019-09
- Subjects: Patient compliance , Tuberculosis -- Patients , Tuberculosis -- Mortality
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/22957 , vital:53254
- Description: Tuberculosis (TB) morbidity and mortality rates remain high globally and are even higher in Africa. The key factor that continues to drive the burden of disease is poor compliance / adherence to treatment regimens. This study aimed to identify determinants that continue to drive poor treatment adherence among low-income communities in South Africa. Methods A cross-sectional survey was conducted, drawing on TB patients who were defaulting on treatment. An assessment tool with several socio-economic and disease-related determinants was administered to participants. Data was entered into MS Excel and analysed in SPSS version 24. Results Regarding health services factors generally, all participants agreed that health service delivery was conducted in a conducive environment and that facilities were reasonably close to their places of residence. Participants demonstrated that health workers do not provide adequate information regarding medications that patients receive. Of patients cited, 11percent indicated that they stopped medications owing to health services. When questioned, participants reported that health workers shouted at them for coming late (e.g. after lunch) and that waiting times were very long. Approximately 85percent of the study participants were more likely to adhere poorly to TB medication owing to various factors such as comorbidities and personal perceptions of wellbeing / health status. Comorbidities are high among patients, with 58percent taking other medication while on TB treatment. Self-prognosis on wellbeing is significantly high, and 44percent reported a tendency to stop medication when they were seemingly in recovery. The unemployment rate among respondents was 78percent, with limited education: 69percent had below matric. Of the respondents, 40percent showed an unsatisfactory perception of their social and economic life, 55percent were somewhat satisfied and only 5percent were very satisfied. These indicators constitute a highly vulnerable community that depends heavily on subsidised healthcare from the state. Adherence to TB treatment is mainly influenced by poverty, the health service provider–patient relationship and perceived stigma. Limited family support was noted towards the treatment of patients. , Thesis (MPH) -- Faculty of Health Sciences, 2019
- Full Text:
- Date Issued: 2019-09
- Authors: Sohuma, Ntombifikile
- Date: 2019-09
- Subjects: Patient compliance , Tuberculosis -- Patients , Tuberculosis -- Mortality
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/22957 , vital:53254
- Description: Tuberculosis (TB) morbidity and mortality rates remain high globally and are even higher in Africa. The key factor that continues to drive the burden of disease is poor compliance / adherence to treatment regimens. This study aimed to identify determinants that continue to drive poor treatment adherence among low-income communities in South Africa. Methods A cross-sectional survey was conducted, drawing on TB patients who were defaulting on treatment. An assessment tool with several socio-economic and disease-related determinants was administered to participants. Data was entered into MS Excel and analysed in SPSS version 24. Results Regarding health services factors generally, all participants agreed that health service delivery was conducted in a conducive environment and that facilities were reasonably close to their places of residence. Participants demonstrated that health workers do not provide adequate information regarding medications that patients receive. Of patients cited, 11percent indicated that they stopped medications owing to health services. When questioned, participants reported that health workers shouted at them for coming late (e.g. after lunch) and that waiting times were very long. Approximately 85percent of the study participants were more likely to adhere poorly to TB medication owing to various factors such as comorbidities and personal perceptions of wellbeing / health status. Comorbidities are high among patients, with 58percent taking other medication while on TB treatment. Self-prognosis on wellbeing is significantly high, and 44percent reported a tendency to stop medication when they were seemingly in recovery. The unemployment rate among respondents was 78percent, with limited education: 69percent had below matric. Of the respondents, 40percent showed an unsatisfactory perception of their social and economic life, 55percent were somewhat satisfied and only 5percent were very satisfied. These indicators constitute a highly vulnerable community that depends heavily on subsidised healthcare from the state. Adherence to TB treatment is mainly influenced by poverty, the health service provider–patient relationship and perceived stigma. Limited family support was noted towards the treatment of patients. , Thesis (MPH) -- Faculty of Health Sciences, 2019
- Full Text:
- Date Issued: 2019-09
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