A budget and expenditure review of public hospital facilities in the Eastern Cape in transition towards National Health Insurance
- Authors: Ndlovu, Garfield OG
- Date: 2018
- Subjects: Health services administration--South Africa--Eastern Cape Government spending policy--South Africa--Eastern Cape Health services administration
- Language: English
- Type: Thesis , Masters , Public Health Leadership
- Identifier: http://hdl.handle.net/10353/11139 , vital:37174
- Description: The quest to ameliorate and enhance the equitable allocation of resources in the Health Industry remains a global challenge, in particular the distribution of funding resources in public sector health facilities. The need to analyse and understand the appropriation of budget and utilisation of funds by hospital facilities is important in the in the Eastern Cape. The focus of the study seeks to explore recommendations that can be employed in the provincial budgeting process of Hospital Facilities, in a bid to optimise efficiency and improve the funding process as part of the provincial readiness activities towards the realisation of the NHI System and funding approach, wherein the NHI Fund will be a public entity that is not in business to make profit (NHI Booklet 2012: 05). This fund will introduce new systems of paying hospitals and professionals for the services they provide, aiming to be fair to them but to put a stop to unreasonable profits (NHI Booklet 2012: 05). The research has employed the use of descriptive quantitative techniques in order to undertake an expenditure review of existing financial data with respect to the Eastern Cape public Hospitals. The study followed a quantitative descriptive research design, the purpose of this study is that, quantitative research deals in numbers, logic, and an objective stance (Babbie: 2010). The Quantitative aspect of the study found that the data provided, allowed the researcher to organise, synthesise, prioritise and assign value to specific key performance indicators that would be used for the appraisal of hospital facilities in relation to the expenditure patterns based which would present a glimpse into how the Eastern Cape department of health utilises funding resources.
- Full Text:
- Authors: Ndlovu, Garfield OG
- Date: 2018
- Subjects: Health services administration--South Africa--Eastern Cape Government spending policy--South Africa--Eastern Cape Health services administration
- Language: English
- Type: Thesis , Masters , Public Health Leadership
- Identifier: http://hdl.handle.net/10353/11139 , vital:37174
- Description: The quest to ameliorate and enhance the equitable allocation of resources in the Health Industry remains a global challenge, in particular the distribution of funding resources in public sector health facilities. The need to analyse and understand the appropriation of budget and utilisation of funds by hospital facilities is important in the in the Eastern Cape. The focus of the study seeks to explore recommendations that can be employed in the provincial budgeting process of Hospital Facilities, in a bid to optimise efficiency and improve the funding process as part of the provincial readiness activities towards the realisation of the NHI System and funding approach, wherein the NHI Fund will be a public entity that is not in business to make profit (NHI Booklet 2012: 05). This fund will introduce new systems of paying hospitals and professionals for the services they provide, aiming to be fair to them but to put a stop to unreasonable profits (NHI Booklet 2012: 05). The research has employed the use of descriptive quantitative techniques in order to undertake an expenditure review of existing financial data with respect to the Eastern Cape public Hospitals. The study followed a quantitative descriptive research design, the purpose of this study is that, quantitative research deals in numbers, logic, and an objective stance (Babbie: 2010). The Quantitative aspect of the study found that the data provided, allowed the researcher to organise, synthesise, prioritise and assign value to specific key performance indicators that would be used for the appraisal of hospital facilities in relation to the expenditure patterns based which would present a glimpse into how the Eastern Cape department of health utilises funding resources.
- Full Text:
A model of support for divorced professional nurses in the Eastern Cape, South Africa
- Authors: Murray, Daphne
- Date: 2018
- Subjects: Divorce counseling -- South Africa -- Eastern Cape Divorce -- Social aspects -- South Africa -- Eastern Cape Employees -- Counseling of -- South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Doctoral , Nursing
- Identifier: http://hdl.handle.net/10353/10028 , vital:35293
- Description: The purpose of this research study was to develop a support model for divorced professional nurses in the health-care facilities of the Department of Health, Eastern Cape, with guidelines to operationalise the model. Divorce is a process with psychological as well as social implications, and with a series of economic causes it also has implications in terms of the society and culture in which individuals operate. The main causes for divorce are adultery and domestic violence, especially against women and children (Lurea, 2011:99). A need for support from managers in the health-care facilities of the Department of Health, Eastern Cape during the process of divorce was identified by divorced professional nurses, since a lack of support and all the negativity that encompasses divorce could lead to severe depression, which will later have a negative effect on work performance (Abdul Kadir & Bifulco, 2010:858). The literature in this field of study, along with experience, indicates that it is imperative for divorced professional nurses to be supported in the workplace to help them to cope emotionally with their work demands, as prescribed by the South African Nursing Council. An explorative, descriptive and contextual qualitative design with theory generation was used to achieve the purpose of the study. Snowball sampling was employed to select participants, namely divorced professional nurses who were unknown to the researcher. A sample of 21 divorced professional nurses who work in health-care facilities in the Buffalo City Metropolitan Municipality in the Eastern Cape participated in the study. Data was collected by means of individual face-face interviews with divorced professional nurses. The interviews continued until data saturation was reached. Field notes supplemented data that could not be portrayed by audio-taped interviews, such as non- verbal communication in observed interactions. Data analysis was done using Tesch’s approach to open coding in qualitative research. Themes, categories and sub-categories emerged from the data analysis and were fully discussed, becoming fundamental units in the development of the conceptual framework as well as in the model. The researcher did a thorough literature review to conceptualise the identified concepts on which the model was based. The description and evaluation of the model, along with guidelines to operationalise the model, were done in accordance with the method described by Chinn and Kramer (2011:197). The justification of the research, the limitations, and the recommendations for operationalisation of the model of support for divorced professional nurses working in the Buffalo City Metropolitan Municipality of the Department of Health, Eastern Cape Province, and South Africa were indicated accordingly.
- Full Text:
- Authors: Murray, Daphne
- Date: 2018
- Subjects: Divorce counseling -- South Africa -- Eastern Cape Divorce -- Social aspects -- South Africa -- Eastern Cape Employees -- Counseling of -- South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Doctoral , Nursing
- Identifier: http://hdl.handle.net/10353/10028 , vital:35293
- Description: The purpose of this research study was to develop a support model for divorced professional nurses in the health-care facilities of the Department of Health, Eastern Cape, with guidelines to operationalise the model. Divorce is a process with psychological as well as social implications, and with a series of economic causes it also has implications in terms of the society and culture in which individuals operate. The main causes for divorce are adultery and domestic violence, especially against women and children (Lurea, 2011:99). A need for support from managers in the health-care facilities of the Department of Health, Eastern Cape during the process of divorce was identified by divorced professional nurses, since a lack of support and all the negativity that encompasses divorce could lead to severe depression, which will later have a negative effect on work performance (Abdul Kadir & Bifulco, 2010:858). The literature in this field of study, along with experience, indicates that it is imperative for divorced professional nurses to be supported in the workplace to help them to cope emotionally with their work demands, as prescribed by the South African Nursing Council. An explorative, descriptive and contextual qualitative design with theory generation was used to achieve the purpose of the study. Snowball sampling was employed to select participants, namely divorced professional nurses who were unknown to the researcher. A sample of 21 divorced professional nurses who work in health-care facilities in the Buffalo City Metropolitan Municipality in the Eastern Cape participated in the study. Data was collected by means of individual face-face interviews with divorced professional nurses. The interviews continued until data saturation was reached. Field notes supplemented data that could not be portrayed by audio-taped interviews, such as non- verbal communication in observed interactions. Data analysis was done using Tesch’s approach to open coding in qualitative research. Themes, categories and sub-categories emerged from the data analysis and were fully discussed, becoming fundamental units in the development of the conceptual framework as well as in the model. The researcher did a thorough literature review to conceptualise the identified concepts on which the model was based. The description and evaluation of the model, along with guidelines to operationalise the model, were done in accordance with the method described by Chinn and Kramer (2011:197). The justification of the research, the limitations, and the recommendations for operationalisation of the model of support for divorced professional nurses working in the Buffalo City Metropolitan Municipality of the Department of Health, Eastern Cape Province, and South Africa were indicated accordingly.
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A programme of academic support for students at the public nursing college of the Eastern Cape Province in South Africa
- Senti, Nomandithini Innocent
- Authors: Senti, Nomandithini Innocent
- Date: 2018
- Subjects: Nursing -- Study and teaching Nursing -- Study and teaching -- Simulation methods
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: http://hdl.handle.net/10353/10997 , vital:36128
- Description: A comprehensive academic support at the public nursing college is important. Despite this, there is no such support in public nursing colleges in the Eastern Cape Province of South Africa. The aim of the study was to develop an academic support programme for students in order to improve their success in Higher Education. The study endeavoured to answer the following questions: What are the academic support needs of students at the public nursing college in the Eastern Cape of South Africa? What conceptual framework can be developed for the academic support programme of students? What academic support programme can be developed for students at the public nursing college? What guidelines can be developed for implementation of academic support programme of students? The objectives were: to describe academic support needs of students at the public nursing college in the eastern Cape Province of South Africa; to develop a conceptual framework for the academic support programme for students at the public nursing college in the Eastern Cape of South Africa; to develop an academic support programme for students at the public nursing college in the Eastern Cape in south Africa and lastly to describe guidelines for implementation and evaluation of the academic support programme. The research design used in this study was quantitative, qualitative, descriptive, evaluative, and theory generation. The study was conducted according to four phases. Phase one focussed on academic supports needs of the student. Phase two focussed on development of conceptual framework for the students at the public nursing college in Eastern Cape Province. Phase three focussed on the development of the academic support programme for the students, whereas phase four focussed on description of guidelines for implementation and evaluation of the academic support programme. The population of the study consisted of students undergoing training in a four-year programme at the Public Nursing College. The target population was the students in the same programme from level one to level four of training. The sampling technique used was a probability sampling with multi-stage and cluster sampling techniques being utilized. The total sample was n=333 participants. A quantitative self-developed questionnaire was used to collect empirical data. The questionnaire consisted of eight sections. Descriptive data was analysed using Statistic Package of Social Sciences (SPSS) version 24. Exploratory factor analysis was conducted on the descriptive data collected in phase one. Concept analysis and identification were done through the utilisation of exploratory factor analysis. The conceptual framework for the academic support programme was identified through the analysed factors. Fifteen factors were derived from the descriptive data. The conceptual framework of the academic support programme discussed in Chapter 5 was used also in the development of the academic support programme. It is in this chapter that assumptions, context, stakeholders, process, outcome, dynamics and, lastly, the recipient were discussed, along with a description of the programme. The programme was evaluated in accordance with the criteria for programme evaluation. The recommendations brought forward for the academic support programme were: The guidelines have to be tested for the implementation of the programme; benchmarking should be done to compare with other institutions of higher learning regarding their academic support programmes; an academic brochure regarding academic support must be available in the college and should be given to students on arrival as part of a package; and neutral researcher should conduct the same research in the same college.
- Full Text:
- Authors: Senti, Nomandithini Innocent
- Date: 2018
- Subjects: Nursing -- Study and teaching Nursing -- Study and teaching -- Simulation methods
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: http://hdl.handle.net/10353/10997 , vital:36128
- Description: A comprehensive academic support at the public nursing college is important. Despite this, there is no such support in public nursing colleges in the Eastern Cape Province of South Africa. The aim of the study was to develop an academic support programme for students in order to improve their success in Higher Education. The study endeavoured to answer the following questions: What are the academic support needs of students at the public nursing college in the Eastern Cape of South Africa? What conceptual framework can be developed for the academic support programme of students? What academic support programme can be developed for students at the public nursing college? What guidelines can be developed for implementation of academic support programme of students? The objectives were: to describe academic support needs of students at the public nursing college in the eastern Cape Province of South Africa; to develop a conceptual framework for the academic support programme for students at the public nursing college in the Eastern Cape of South Africa; to develop an academic support programme for students at the public nursing college in the Eastern Cape in south Africa and lastly to describe guidelines for implementation and evaluation of the academic support programme. The research design used in this study was quantitative, qualitative, descriptive, evaluative, and theory generation. The study was conducted according to four phases. Phase one focussed on academic supports needs of the student. Phase two focussed on development of conceptual framework for the students at the public nursing college in Eastern Cape Province. Phase three focussed on the development of the academic support programme for the students, whereas phase four focussed on description of guidelines for implementation and evaluation of the academic support programme. The population of the study consisted of students undergoing training in a four-year programme at the Public Nursing College. The target population was the students in the same programme from level one to level four of training. The sampling technique used was a probability sampling with multi-stage and cluster sampling techniques being utilized. The total sample was n=333 participants. A quantitative self-developed questionnaire was used to collect empirical data. The questionnaire consisted of eight sections. Descriptive data was analysed using Statistic Package of Social Sciences (SPSS) version 24. Exploratory factor analysis was conducted on the descriptive data collected in phase one. Concept analysis and identification were done through the utilisation of exploratory factor analysis. The conceptual framework for the academic support programme was identified through the analysed factors. Fifteen factors were derived from the descriptive data. The conceptual framework of the academic support programme discussed in Chapter 5 was used also in the development of the academic support programme. It is in this chapter that assumptions, context, stakeholders, process, outcome, dynamics and, lastly, the recipient were discussed, along with a description of the programme. The programme was evaluated in accordance with the criteria for programme evaluation. The recommendations brought forward for the academic support programme were: The guidelines have to be tested for the implementation of the programme; benchmarking should be done to compare with other institutions of higher learning regarding their academic support programmes; an academic brochure regarding academic support must be available in the college and should be given to students on arrival as part of a package; and neutral researcher should conduct the same research in the same college.
- Full Text:
A trend analysis of perinatal mortalities in Barberton Hospital between 2002 and 2016
- Modupe, Oluwarotimi Folorunsho
- Authors: Modupe, Oluwarotimi Folorunsho
- Date: 2018
- Subjects: Newborn infants -- Mortality Perinatology
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: http://hdl.handle.net/10353/11254 , vital:37630
- Description: Background and aim: There is no doubt that the quantification of data on the new born is imperative towards the design of effective public health policy interventions. However, the trend in under-five mortality rates in Barberton Hospital is not recognised as no empirical investigation has been undertaken to ascertain its position in this regard. A trend analysis of infant and maternal deaths in will therefore shed light on possible factors influencing this trend. The specific objectives of this study were to examine the trend and causes of perinatal mortality in Barberton Hospital from 2002-2016. It was hypothesized that there would be a downward trend in the infant and maternal mortality rates in Barberton Hospital from 2002-2016, possibly as a result of improved medical care. Methods: This retrospective study was conducted in Barberton Hospital, located in the Umjindi sub-district in Mpumalanga Province. The data was drawn from the Perinatal Problem Identification Programme (PPIP) database. Pregnancy related deaths of women, and of children from birth to one year in Barberton Hospital from 1999-2014 were extracted. The population study consists of a record review of all infant and maternal deaths in Barberton Hospital from 2002-2016 and captured in the data on the PPIP. The University of Fort Hare ethical review committee approved the study protocol. In addition, permission to use the data was granted by the Mpumalanga Department of Health after applying for approval for use of the data for academic purposes. The data was then exported into an Excel format document and fed to Statistical Package for Social Sciences (SPSS) program to allow for a more detailed analysis. Results: Over the period under review (2002-2016), a total of 21151 babies were delivered, 20593 babies were alive at discharge, 221 babies died in the first 28 days of delivery, and 337 babies were stillbirths. 18577 were normal weight (≥2500gram), 1581 weighed 2000-2499 grams, 568 weighed 1500-1999grams, 286 weighed 1000-1499 and 139 weighed below 1000grams. All the women who gave birth over the period under review, 27.3percent tested positive to HIV, 40.3 percent tested negative. Of all women that tested positive, 80.2percent received any form of ART. For over half of women that received ART (n=2981), the type of ART they received is unknown. Most women whose baby died were young. One in five women did not have their age captured in the database indicating an important gap that need to be addressed in order to ensure integrity of the database. Of all the 558 perinatal mortality, 75.3 weighed below 2500 grams. Low birth weight is major risk factor for child mortality. Babies weighing less than 2,500 grams are 20 times more likely to die than heavier babies. For all the perinatal deaths, the majority of their mothers received antenatal care services. About 86.6percent were delivered at Barberton Hospital and only 1 child was delivered in transit to the hospital. Of all the 558 deaths, only 7.5 percent was multiple births. Of the 558 babies that died, only 39.6percent were born alive, 37.1percent was macerated stillbirths. The syphilis serology test indicated that most mothers tested negative. The HIV serology test indicated that 28percent of mothers tested positive. The hospital recorded a total of 337 stillbirths between 2002 and 2016. This accounts for 60.2percent of all perinatal mortality over the period. Of all stillbirths, 61.6percent was macerated stillbirths. Yearly analysis of stillbirth rate did not clearly indicate whether stillbirth rate is increasing or declining. Not less than 56 primary obstetric causes of perinatal deaths were identified in this study. Many perinatal deaths were unexplainable due to lack of post-mortem. Idiopathic preterm labour was the main primary obstetric cause of early (34.5percent) and late neonatal (38.9percent) deaths, and the next was labour related intrapartum asphyxia. Labour related intrapartum asphyxia also accounts for 6.8percent of all stillbirths. The main known primary obstetric cause of stillbirth in the Hospital was Proteinuric hypertension/hypertension disorders. Over 60percent of perinatal mortality in Barberton Hospital was due to associated maternal conditions. Only 10.9percent was due to fetal related conditions and 26.4percent was unexplained. Few deaths were due to health system failure and domestic violence. Spontaneous preterm labour (18.4percent), abnormal labour or uterine rupture (14.5percent), maternal hypertension (12.4percent), antepartum haemorrhage (10.2percent) were the main associated maternal conditions causes of perinatal mortality in Barberton Hospital. Similarly, Fetal abnormality and infections were the main associated fetal condition causes of perinatal mortality. Of all the babies that were alive at birth, 85.2percent died due to maternal related conditions. Most neonates died due to spontaneous preterm labour (43.5percent) and abnormal labour or uterine rupture (23.1percent). Maternal HIV, diabetics and syphilis only accounted for a few neonatal deaths. For stillbirth babies that were alive at admission, abnormal labour or uterine rupture (33.1percent) and antepartum haemorrhage (19.7percent) were the main causes of their death. Over 60percent of all of macerated deaths have unexplained causes. Maternal hypertension is the main known cause of macerated stillbirth. For stillbirths that were dead on admission, maternal hypertension (13.1percent), antepartum haemorrhage (26.2percent) and abnormal labour or uterine rupture were the main causes of deaths. The majority of perinatal deaths in the hospital were caused by intrauterine deaths (58.8percent). Extreme multi-organ immaturity (13.1percent), Hyaline membrane disease (7.2percent) and Hypoxic ischaemic encephalopathy (5.2percent) were among the main final causes of perinatal deaths. The main behavioural factor causing perinatal mortality in Mpumalanga province was non-use of antenatal care services. The majority of perinatal mortality (60.4percent) was due to health system related causes. Most perinatal deaths were due to poor management of cases and delayed referral. Conclusion: The findings indicate that while stillbirths have slightly declined, neonatal deaths have not declined over the period. Perinatal have slightly declined in the hospital. The findings of this study also indicate that the majority of perinatal deaths in the hospital were caused by idiopathic preterm labour, unexplained intrauterine deaths, hypertension, and intrapartum asphyxia. Patient and health system related factors contributed significantly to perinatal deaths in the hospital. There is a need for yearly analysis of PPIP data to track progress and identify area for continuous improvement in provision of quality obstetric services. A greater community awareness of risk factors for perinatal deaths and importance of early and regular take up antenatal care services is needed.
- Full Text:
- Authors: Modupe, Oluwarotimi Folorunsho
- Date: 2018
- Subjects: Newborn infants -- Mortality Perinatology
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: http://hdl.handle.net/10353/11254 , vital:37630
- Description: Background and aim: There is no doubt that the quantification of data on the new born is imperative towards the design of effective public health policy interventions. However, the trend in under-five mortality rates in Barberton Hospital is not recognised as no empirical investigation has been undertaken to ascertain its position in this regard. A trend analysis of infant and maternal deaths in will therefore shed light on possible factors influencing this trend. The specific objectives of this study were to examine the trend and causes of perinatal mortality in Barberton Hospital from 2002-2016. It was hypothesized that there would be a downward trend in the infant and maternal mortality rates in Barberton Hospital from 2002-2016, possibly as a result of improved medical care. Methods: This retrospective study was conducted in Barberton Hospital, located in the Umjindi sub-district in Mpumalanga Province. The data was drawn from the Perinatal Problem Identification Programme (PPIP) database. Pregnancy related deaths of women, and of children from birth to one year in Barberton Hospital from 1999-2014 were extracted. The population study consists of a record review of all infant and maternal deaths in Barberton Hospital from 2002-2016 and captured in the data on the PPIP. The University of Fort Hare ethical review committee approved the study protocol. In addition, permission to use the data was granted by the Mpumalanga Department of Health after applying for approval for use of the data for academic purposes. The data was then exported into an Excel format document and fed to Statistical Package for Social Sciences (SPSS) program to allow for a more detailed analysis. Results: Over the period under review (2002-2016), a total of 21151 babies were delivered, 20593 babies were alive at discharge, 221 babies died in the first 28 days of delivery, and 337 babies were stillbirths. 18577 were normal weight (≥2500gram), 1581 weighed 2000-2499 grams, 568 weighed 1500-1999grams, 286 weighed 1000-1499 and 139 weighed below 1000grams. All the women who gave birth over the period under review, 27.3percent tested positive to HIV, 40.3 percent tested negative. Of all women that tested positive, 80.2percent received any form of ART. For over half of women that received ART (n=2981), the type of ART they received is unknown. Most women whose baby died were young. One in five women did not have their age captured in the database indicating an important gap that need to be addressed in order to ensure integrity of the database. Of all the 558 perinatal mortality, 75.3 weighed below 2500 grams. Low birth weight is major risk factor for child mortality. Babies weighing less than 2,500 grams are 20 times more likely to die than heavier babies. For all the perinatal deaths, the majority of their mothers received antenatal care services. About 86.6percent were delivered at Barberton Hospital and only 1 child was delivered in transit to the hospital. Of all the 558 deaths, only 7.5 percent was multiple births. Of the 558 babies that died, only 39.6percent were born alive, 37.1percent was macerated stillbirths. The syphilis serology test indicated that most mothers tested negative. The HIV serology test indicated that 28percent of mothers tested positive. The hospital recorded a total of 337 stillbirths between 2002 and 2016. This accounts for 60.2percent of all perinatal mortality over the period. Of all stillbirths, 61.6percent was macerated stillbirths. Yearly analysis of stillbirth rate did not clearly indicate whether stillbirth rate is increasing or declining. Not less than 56 primary obstetric causes of perinatal deaths were identified in this study. Many perinatal deaths were unexplainable due to lack of post-mortem. Idiopathic preterm labour was the main primary obstetric cause of early (34.5percent) and late neonatal (38.9percent) deaths, and the next was labour related intrapartum asphyxia. Labour related intrapartum asphyxia also accounts for 6.8percent of all stillbirths. The main known primary obstetric cause of stillbirth in the Hospital was Proteinuric hypertension/hypertension disorders. Over 60percent of perinatal mortality in Barberton Hospital was due to associated maternal conditions. Only 10.9percent was due to fetal related conditions and 26.4percent was unexplained. Few deaths were due to health system failure and domestic violence. Spontaneous preterm labour (18.4percent), abnormal labour or uterine rupture (14.5percent), maternal hypertension (12.4percent), antepartum haemorrhage (10.2percent) were the main associated maternal conditions causes of perinatal mortality in Barberton Hospital. Similarly, Fetal abnormality and infections were the main associated fetal condition causes of perinatal mortality. Of all the babies that were alive at birth, 85.2percent died due to maternal related conditions. Most neonates died due to spontaneous preterm labour (43.5percent) and abnormal labour or uterine rupture (23.1percent). Maternal HIV, diabetics and syphilis only accounted for a few neonatal deaths. For stillbirth babies that were alive at admission, abnormal labour or uterine rupture (33.1percent) and antepartum haemorrhage (19.7percent) were the main causes of their death. Over 60percent of all of macerated deaths have unexplained causes. Maternal hypertension is the main known cause of macerated stillbirth. For stillbirths that were dead on admission, maternal hypertension (13.1percent), antepartum haemorrhage (26.2percent) and abnormal labour or uterine rupture were the main causes of deaths. The majority of perinatal deaths in the hospital were caused by intrauterine deaths (58.8percent). Extreme multi-organ immaturity (13.1percent), Hyaline membrane disease (7.2percent) and Hypoxic ischaemic encephalopathy (5.2percent) were among the main final causes of perinatal deaths. The main behavioural factor causing perinatal mortality in Mpumalanga province was non-use of antenatal care services. The majority of perinatal mortality (60.4percent) was due to health system related causes. Most perinatal deaths were due to poor management of cases and delayed referral. Conclusion: The findings indicate that while stillbirths have slightly declined, neonatal deaths have not declined over the period. Perinatal have slightly declined in the hospital. The findings of this study also indicate that the majority of perinatal deaths in the hospital were caused by idiopathic preterm labour, unexplained intrauterine deaths, hypertension, and intrapartum asphyxia. Patient and health system related factors contributed significantly to perinatal deaths in the hospital. There is a need for yearly analysis of PPIP data to track progress and identify area for continuous improvement in provision of quality obstetric services. A greater community awareness of risk factors for perinatal deaths and importance of early and regular take up antenatal care services is needed.
- Full Text:
An assessment of quality health care in the operating theatres of Frere Hospital in the Eastern Cape
- Authors: Bennett, Fabion Charton
- Date: 2018
- Subjects: Medical care Surgical instruments and apparatus -- Safety measures
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: http://hdl.handle.net/10353/13425 , vital:39660
- Description: BACKGROUND: Operating theatres are one of most expensive resources in a hospital. The management of operating theatres is complex due to the conflicting priorities and preferences of all stakeholders. Operating theatres also pose one of the greatest medico legal risks to any hospital. This study was conducted at Frere Hospital in East London to assess the functioning of the operating theatre system. The focus of this study was on Pre-operative categorisation of emergency cases, the utilisation of the World Health Organisation Safety Checklist, compliance to the National Core Standards for Health, the effectiveness of governance and review processes, theatre staffing as well as theatre efficiency indicators (start time/tardiness, utilisation, turn-around time, re-admission to theatre rate, cancellation on day of procedure, slate under/over runs, Anaesthetic time as a percentage of theatre time). OBJECTIVE: The purpose of this study was to promote the adherence to the various operating theatre universal approaches by operating theatre staff with the goal of reducing costs and errors caused by poor quality in operating theatres and improving the overall health system. METHOD: In this research a convergent parallel mixed method research design was applied. The research was non-experimental and descriptive in approach, using a mixed method questionnaire, a structured open ended interview, a structured infrastructure assessment, a structured observation checklist and an audit of patient files for a review of emergency surgical cases. Data was collected during October 2016 and January 2017.The study population consisted of 13 operating rooms across 6 operating theatre suites, surgical management staff as well as clinical and nursing staff in the operating theatres at Frere Hospital in East London. RESULTS: The study showed opportunities for improvement in the overall management of the operating theatres to ensure efficient quality care; the data from the observations, questionnaires, interviews as well as the analysis of the efficiency indicators consistently showed that an effective process of operating theatre governance and performance is non-existent, the Pre- operative categorisation of emergency cases is inconsistently applied, the compliance to the principles of the World Health Organisation Safety Checklist Is very low, theatre nursing staff levels per case is low, staff are also demotivated and theatre efficiency indicators require improvement. During this study, the Paediatric theatre suite appeared to be well run and compliant with opportunity to increase theatre utilisation, the casualty theatre is underutilised and has potential to be utilised as an enabler to improve the efficiency of other theatres. The main theatre and endoscopy suites have opportunities to improve its compliance to universal operating theatre quality and efficiency standards, the Orthopaedics and Obstetrics theatre suites, however, require urgent improvement focus. DISCUSSION: According to the findings, a structured operating theatre governance and performance review processes should be implemented with the intention of ensuring consistency across the management of the 6 operating theatre suites in the hospital. A review of staffing allocation and relative task allocation should be conducted. Interventions should be implemented to increase utilisation rates, improve the pre-operative categorisation of emergency cases, improve the compliance to the principles of the World Health Organisation Safety Checklist, reduce case start time variance/tardiness, reduce cancellation on day of procedure, increase anaesthetic time as a percentage of theatre time by introducing pre- anaesthetic induction prior to the patient being wheeled into the operating room.
- Full Text:
An assessment of quality health care in the operating theatres of Frere Hospital in the Eastern Cape
- Authors: Bennett, Fabion Charton
- Date: 2018
- Subjects: Medical care Surgical instruments and apparatus -- Safety measures
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: http://hdl.handle.net/10353/13425 , vital:39660
- Description: BACKGROUND: Operating theatres are one of most expensive resources in a hospital. The management of operating theatres is complex due to the conflicting priorities and preferences of all stakeholders. Operating theatres also pose one of the greatest medico legal risks to any hospital. This study was conducted at Frere Hospital in East London to assess the functioning of the operating theatre system. The focus of this study was on Pre-operative categorisation of emergency cases, the utilisation of the World Health Organisation Safety Checklist, compliance to the National Core Standards for Health, the effectiveness of governance and review processes, theatre staffing as well as theatre efficiency indicators (start time/tardiness, utilisation, turn-around time, re-admission to theatre rate, cancellation on day of procedure, slate under/over runs, Anaesthetic time as a percentage of theatre time). OBJECTIVE: The purpose of this study was to promote the adherence to the various operating theatre universal approaches by operating theatre staff with the goal of reducing costs and errors caused by poor quality in operating theatres and improving the overall health system. METHOD: In this research a convergent parallel mixed method research design was applied. The research was non-experimental and descriptive in approach, using a mixed method questionnaire, a structured open ended interview, a structured infrastructure assessment, a structured observation checklist and an audit of patient files for a review of emergency surgical cases. Data was collected during October 2016 and January 2017.The study population consisted of 13 operating rooms across 6 operating theatre suites, surgical management staff as well as clinical and nursing staff in the operating theatres at Frere Hospital in East London. RESULTS: The study showed opportunities for improvement in the overall management of the operating theatres to ensure efficient quality care; the data from the observations, questionnaires, interviews as well as the analysis of the efficiency indicators consistently showed that an effective process of operating theatre governance and performance is non-existent, the Pre- operative categorisation of emergency cases is inconsistently applied, the compliance to the principles of the World Health Organisation Safety Checklist Is very low, theatre nursing staff levels per case is low, staff are also demotivated and theatre efficiency indicators require improvement. During this study, the Paediatric theatre suite appeared to be well run and compliant with opportunity to increase theatre utilisation, the casualty theatre is underutilised and has potential to be utilised as an enabler to improve the efficiency of other theatres. The main theatre and endoscopy suites have opportunities to improve its compliance to universal operating theatre quality and efficiency standards, the Orthopaedics and Obstetrics theatre suites, however, require urgent improvement focus. DISCUSSION: According to the findings, a structured operating theatre governance and performance review processes should be implemented with the intention of ensuring consistency across the management of the 6 operating theatre suites in the hospital. A review of staffing allocation and relative task allocation should be conducted. Interventions should be implemented to increase utilisation rates, improve the pre-operative categorisation of emergency cases, improve the compliance to the principles of the World Health Organisation Safety Checklist, reduce case start time variance/tardiness, reduce cancellation on day of procedure, increase anaesthetic time as a percentage of theatre time by introducing pre- anaesthetic induction prior to the patient being wheeled into the operating room.
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An exploration of first-time mothers' experiences of exclusive breastfeeding and support in the Buffalo City Metropolitan, South Africa
- Authors: Dasheka, Zukiswa Theodorah
- Date: 2018
- Subjects: Breastfeeding--South Africa Breastfeeding
- Language: English
- Type: Thesis , Masters , Nursing Science
- Identifier: http://hdl.handle.net/10353/11096 , vital:37130
- Description: There are inadequate child feeding practices worldwide, and this varies amongst the regions. Suboptimal exclusive breastfeeding remains the key contributor to the leading causes of child mortalities, namely, diarrhoea and acute respiratory infections. An infant who is not exclusively breastfed for the first six months of life has fourteen times likelihood of dying of all causes, especially, diarrhoea and pneumonia compared to an exclusively breastfed infant. Worldwide, only 40 percent infants are exclusively breastfed for the first six months of their lives. South Africa, on the other hand, has an alarming figure of only 8 percent infants that are exclusively breastfed for six months. A qualitative approach, with an exploratory, descriptive and contextual research design was chosen to seek deeper understanding and meaning of first-time mothers’ experiences regarding exclusive breastfeeding practices and support’s influence on maintenance of exclusive breastfeeding within their natural environment. First-time mothers were the population for this study while the target population were first-time mothers who had given birth to a live, full term and healthy infant, regardless of the delivery mode in one of the Community Health Centres or hospitals within Buffalo City Metropolitan, South Africa. A non-probability, purposive sample of 10 participants was used. Ethical approval was granted by the University of Fort Hare Research Ethics Committee. The Eastern Cape Department of Health issued the clearance certificate. Informed consent was obtained from participants before data collection. Emotional risk protection was managed by the researcher through stopping of the interviews when the participant seemed emotional affected by the interviews. The relevant ethical considerations were accommodated. Trustworthiness was ensured through observing the principles of transferability, credibility, confirmability and dependability. Data were collected through individual face-to-face interviews using a semi-structured interview guide and conducted at the participant’s home or at the local clinic per participants’ choice. Two audio-recorders were used to capture the data. Data were then analysed according to Creswell’s steps and Tesch’s eight coding steps. Codes, categories, sub-categories and themes were formulated. Findings The key findings were challenges, empowerment, support and resilience during initiation of breastfeeding and diverse support and resilience during maintenance of exclusive breastfeeding. Conclusion All participants agreed on the benefits of breastfeeding, receiving information about exclusive breastfeeding during antenatal care and making a decision to exclusively breastfeed upon delivery. It is evident that the information received by first-time mothers is not congruent with the challenges they faced during initiation. There is a need, therefore, for nurses to find a way of sharing breastfeeding practice with the community members in order to avoid mixed messages which end up confusing to the first-time mother. Furthermore, the education given to the first-time mothers needs to be individualised to focus on individual needs of these mothers. Given the current staffing structure in the delivery centres, nurses are not always enough to give full focus and practical assistance to first-time mothers. It is therefore recommended that peer supporters be available to play this role, post-delivery, before the first-time mother is discharged. The formulation of compulsory supportive group among the first-time mothers was suggested.
- Full Text:
- Authors: Dasheka, Zukiswa Theodorah
- Date: 2018
- Subjects: Breastfeeding--South Africa Breastfeeding
- Language: English
- Type: Thesis , Masters , Nursing Science
- Identifier: http://hdl.handle.net/10353/11096 , vital:37130
- Description: There are inadequate child feeding practices worldwide, and this varies amongst the regions. Suboptimal exclusive breastfeeding remains the key contributor to the leading causes of child mortalities, namely, diarrhoea and acute respiratory infections. An infant who is not exclusively breastfed for the first six months of life has fourteen times likelihood of dying of all causes, especially, diarrhoea and pneumonia compared to an exclusively breastfed infant. Worldwide, only 40 percent infants are exclusively breastfed for the first six months of their lives. South Africa, on the other hand, has an alarming figure of only 8 percent infants that are exclusively breastfed for six months. A qualitative approach, with an exploratory, descriptive and contextual research design was chosen to seek deeper understanding and meaning of first-time mothers’ experiences regarding exclusive breastfeeding practices and support’s influence on maintenance of exclusive breastfeeding within their natural environment. First-time mothers were the population for this study while the target population were first-time mothers who had given birth to a live, full term and healthy infant, regardless of the delivery mode in one of the Community Health Centres or hospitals within Buffalo City Metropolitan, South Africa. A non-probability, purposive sample of 10 participants was used. Ethical approval was granted by the University of Fort Hare Research Ethics Committee. The Eastern Cape Department of Health issued the clearance certificate. Informed consent was obtained from participants before data collection. Emotional risk protection was managed by the researcher through stopping of the interviews when the participant seemed emotional affected by the interviews. The relevant ethical considerations were accommodated. Trustworthiness was ensured through observing the principles of transferability, credibility, confirmability and dependability. Data were collected through individual face-to-face interviews using a semi-structured interview guide and conducted at the participant’s home or at the local clinic per participants’ choice. Two audio-recorders were used to capture the data. Data were then analysed according to Creswell’s steps and Tesch’s eight coding steps. Codes, categories, sub-categories and themes were formulated. Findings The key findings were challenges, empowerment, support and resilience during initiation of breastfeeding and diverse support and resilience during maintenance of exclusive breastfeeding. Conclusion All participants agreed on the benefits of breastfeeding, receiving information about exclusive breastfeeding during antenatal care and making a decision to exclusively breastfeed upon delivery. It is evident that the information received by first-time mothers is not congruent with the challenges they faced during initiation. There is a need, therefore, for nurses to find a way of sharing breastfeeding practice with the community members in order to avoid mixed messages which end up confusing to the first-time mother. Furthermore, the education given to the first-time mothers needs to be individualised to focus on individual needs of these mothers. Given the current staffing structure in the delivery centres, nurses are not always enough to give full focus and practical assistance to first-time mothers. It is therefore recommended that peer supporters be available to play this role, post-delivery, before the first-time mother is discharged. The formulation of compulsory supportive group among the first-time mothers was suggested.
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An intervention for high-risk type 2 diabetic clients during preconception and internatal in re-engineering of primary health care
- Authors: Ngoma, Siphokazi Amanda
- Date: 2018
- Subjects: Diabetes Diabetes Mellitus, Type 2
- Language: English
- Type: Thesis , Masters , (MCur) Nursing
- Identifier: http://hdl.handle.net/10353/10199 , vital:35375
- Description: The South African disease profile has changed significantly and has increasing prevalence of overweight and obesity in relation to body mass index. Type 2 diabetes mellitus is greatly associated with increased body mass index and poses a great health concern for women of childbearing age. Complications of type 2 diabetes mellitus in pregnancy has life-threatening for the mother and baby. South African women have a tendency of avoiding and neglecting routine screening before pregnancy, that is part of preconception care or internatal care. The aim of the study sought to identify women of childbearing age with predisposing factors of type 2 diabetes, in order to intervene, using a lifestyle modification to delay and prevent the occurrence of type 2 diabetes. A quantitative intervention study using parallel group randomized control trials was used. One hundred and forty-six women of childbearing age (18-45 years) were recruited and assigned to either control (n=73 + 9) or experimental group (n=73 +9). using a computer software randomizer application to avoid bias in selection of participants by the researcher. Both groups received health education from the researcher and the dietician from hospital. The control group had no intervention done, whereas the experimental group attended physical activity sessions which were administered by a hired lay coach. The findings showed that both groups are at risk of developing type 2 diabetes although they both groups lose weight. The weight loss of the control group was owed to education during recruitment. Vegetable consumption was minimal to the younger age group than the older age groups. Waist circumference above 105cm consumed less vegetables, a higher waist circumference is associated with insulin resistance. There was also minimal exercises and knowledge about the preconception care. Diabetes prevention is vital for the women of childbearing age as it affects both mother and child. The study recommends lifestyle modification (exercise and healthy diet) to prevent and delay of type 2 diabetes and gestational diabetes mellitus. The study also recommends Preconception care and Re- engineering of Primary health care uses community health care workers for screening high risk women during home visits.
- Full Text:
- Authors: Ngoma, Siphokazi Amanda
- Date: 2018
- Subjects: Diabetes Diabetes Mellitus, Type 2
- Language: English
- Type: Thesis , Masters , (MCur) Nursing
- Identifier: http://hdl.handle.net/10353/10199 , vital:35375
- Description: The South African disease profile has changed significantly and has increasing prevalence of overweight and obesity in relation to body mass index. Type 2 diabetes mellitus is greatly associated with increased body mass index and poses a great health concern for women of childbearing age. Complications of type 2 diabetes mellitus in pregnancy has life-threatening for the mother and baby. South African women have a tendency of avoiding and neglecting routine screening before pregnancy, that is part of preconception care or internatal care. The aim of the study sought to identify women of childbearing age with predisposing factors of type 2 diabetes, in order to intervene, using a lifestyle modification to delay and prevent the occurrence of type 2 diabetes. A quantitative intervention study using parallel group randomized control trials was used. One hundred and forty-six women of childbearing age (18-45 years) were recruited and assigned to either control (n=73 + 9) or experimental group (n=73 +9). using a computer software randomizer application to avoid bias in selection of participants by the researcher. Both groups received health education from the researcher and the dietician from hospital. The control group had no intervention done, whereas the experimental group attended physical activity sessions which were administered by a hired lay coach. The findings showed that both groups are at risk of developing type 2 diabetes although they both groups lose weight. The weight loss of the control group was owed to education during recruitment. Vegetable consumption was minimal to the younger age group than the older age groups. Waist circumference above 105cm consumed less vegetables, a higher waist circumference is associated with insulin resistance. There was also minimal exercises and knowledge about the preconception care. Diabetes prevention is vital for the women of childbearing age as it affects both mother and child. The study recommends lifestyle modification (exercise and healthy diet) to prevent and delay of type 2 diabetes and gestational diabetes mellitus. The study also recommends Preconception care and Re- engineering of Primary health care uses community health care workers for screening high risk women during home visits.
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An intervention study for low risk pregnant women and high risk pregnant women with GDM in Buffalo City Metropolitan Municipality, Eastern Cape, South Africa
- Authors: Vellem, Nonceba Mercy
- Date: 2018
- Subjects: Diabetes in pregnancy -- South Africa Nursing services -- South Africa -- Eastern Cape -- Administration Pregnancy -- Complications
- Language: English
- Type: Thesis , Doctoral , Nursing
- Identifier: http://hdl.handle.net/10353/9723 , vital:34891
- Description: Low risk and high risk pregnant women (HRPW) with gestational diabetes mellitus (GDM) who practise sedentary life style are at risk of overweight and obesity that predispose to gestational diabetes mellitus (GDM). The purpose of the study is to describe the effectiveness of an intervention strategy of modified diet and planned physical activity implemented amongst low-risk and high-risk pregnant women with GDM in Buffalo City Metropolitan Municipality in the Eastern Cape, South Africa. Quantitative experimental intervention design and stratified random sampling was used for drawing a sample of low-risk and high risk pregnant women with GDM. A sample size 291 of LRPW and n=34 HRPW were eligible for the study. The sample frame of the study was taken from the registers of the CHCs, Frere Hospital and Cecilia Makiwane Hospital (CMH). Questionnaires were used to collect data from the low and high risk pregnant with GDM. Descriptive statistics (frequency, percentages, mean and standard deviation) were used for categorical variables. A p-value of < 0.05 was considered statistically significant. The total analysed of LRPW were n=135 and HRPW n=34 all in control group due to miscarriages, phone loss and relocation. LRPW had some risk factors of overweight (6.2 percent), obesity (15.5 percent), family history of diabetes (16.5 percent). HRPW also had overweight and obesity of (14.7 percent) and family history of (26.4 percent) as the Pvalue was statistically significant of weight was 001, MUAC Pvalue of 000 and Pvalue of BMI 000. There were alarming abnormalities of urinalysis of protein, glucose, leucocytes and blood in urine. The LRPW and HRPW had consumption of high content of carbohydrates, vegetables, fats and low in fruit, vegetables and fibre diet. Both LRPW and HRPW were also interested on the education about modified diet benefits (95.1 percent) and modified diet programs networks (87.5 percent). The barriers showed that LRPW and HRPW were low motivation (90 percent) minimal knowledge and benefits of modified diet (93 percent) and socio-cultural issues (86 percent). The majority of participants both LRPW and HRPW showed the interest in the planned physical activity benefits especially frequent education (96.9 percent) and encouragement of social support networks (90.2 percent) and convenient location (89.4 percent). But the HRPW had lower engagement than the LRPW in planned physical activity and is associated with risk of GDM. Although pregnant women were faced with fatigue and low energy (98.6 percent), as pregnancy progresses, minimum information regarding benefits of planned physical activity (87.6 percent) and the socio-cultural influence (77.8 percent). The recommendations are education on frequent use of modified diet and planned physical activity that is available, less economical and within their context. Frequent screening of all pregnant women during pregnancy of BMI, MUAC and weight and educate accordingly. The availability of dietician and physical activity speciality is needed.
- Full Text:
- Authors: Vellem, Nonceba Mercy
- Date: 2018
- Subjects: Diabetes in pregnancy -- South Africa Nursing services -- South Africa -- Eastern Cape -- Administration Pregnancy -- Complications
- Language: English
- Type: Thesis , Doctoral , Nursing
- Identifier: http://hdl.handle.net/10353/9723 , vital:34891
- Description: Low risk and high risk pregnant women (HRPW) with gestational diabetes mellitus (GDM) who practise sedentary life style are at risk of overweight and obesity that predispose to gestational diabetes mellitus (GDM). The purpose of the study is to describe the effectiveness of an intervention strategy of modified diet and planned physical activity implemented amongst low-risk and high-risk pregnant women with GDM in Buffalo City Metropolitan Municipality in the Eastern Cape, South Africa. Quantitative experimental intervention design and stratified random sampling was used for drawing a sample of low-risk and high risk pregnant women with GDM. A sample size 291 of LRPW and n=34 HRPW were eligible for the study. The sample frame of the study was taken from the registers of the CHCs, Frere Hospital and Cecilia Makiwane Hospital (CMH). Questionnaires were used to collect data from the low and high risk pregnant with GDM. Descriptive statistics (frequency, percentages, mean and standard deviation) were used for categorical variables. A p-value of < 0.05 was considered statistically significant. The total analysed of LRPW were n=135 and HRPW n=34 all in control group due to miscarriages, phone loss and relocation. LRPW had some risk factors of overweight (6.2 percent), obesity (15.5 percent), family history of diabetes (16.5 percent). HRPW also had overweight and obesity of (14.7 percent) and family history of (26.4 percent) as the Pvalue was statistically significant of weight was 001, MUAC Pvalue of 000 and Pvalue of BMI 000. There were alarming abnormalities of urinalysis of protein, glucose, leucocytes and blood in urine. The LRPW and HRPW had consumption of high content of carbohydrates, vegetables, fats and low in fruit, vegetables and fibre diet. Both LRPW and HRPW were also interested on the education about modified diet benefits (95.1 percent) and modified diet programs networks (87.5 percent). The barriers showed that LRPW and HRPW were low motivation (90 percent) minimal knowledge and benefits of modified diet (93 percent) and socio-cultural issues (86 percent). The majority of participants both LRPW and HRPW showed the interest in the planned physical activity benefits especially frequent education (96.9 percent) and encouragement of social support networks (90.2 percent) and convenient location (89.4 percent). But the HRPW had lower engagement than the LRPW in planned physical activity and is associated with risk of GDM. Although pregnant women were faced with fatigue and low energy (98.6 percent), as pregnancy progresses, minimum information regarding benefits of planned physical activity (87.6 percent) and the socio-cultural influence (77.8 percent). The recommendations are education on frequent use of modified diet and planned physical activity that is available, less economical and within their context. Frequent screening of all pregnant women during pregnancy of BMI, MUAC and weight and educate accordingly. The availability of dietician and physical activity speciality is needed.
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An investigation into births before arrival in healthcare facilities in uThungulu Health District during a period of 1 April 2014 to 31 March 2015
- Mkhwanazi, Cynthia Nqobile Nokuthula
- Authors: Mkhwanazi, Cynthia Nqobile Nokuthula
- Date: 2018
- Subjects: Childbirth Childbirth at home
- Language: English
- Type: Thesis , Masters , Public Health
- Identifier: http://hdl.handle.net/10353/11161 , vital:37198
- Description: Births Before Arrival (BBAs) in healthcare facilities is a worldwide health challenge. These births results with diverse obstetric and neonatal complications which could be avoided should delivery took place in an accredited environment. Delivery in health facility rate and Births Before Arrival is one of the vital measures used to monitor access as well as quality of Maternal and Child health services. A birth before arrival in health institutions happens accidentally and unattended by skilled health professionals outside the healthcare facilities (Lazic & Takač, 2011). It is found in both developed and developing countries with various adverse outcomes ranging from haemorrhage to death. Important strides had been taken to improve maternal and child health globally but the healthcare facilities are still experiencing an overwhelming number of births before arrival in healthcare facilities. This is a public health concern. The purpose of the study was to identify factors associated with Births before Arrival in UThungulu Health District facilities and determine the prevalence of BBAs and the neonatal and maternal morbidity and mortality associated with it. A retrospective quantitative research design was used. Maternity clinical records Reviews of 238 Births Before Arrival (BBA) in healthcare facilities that occurred between 1 April 2014 to 31 March 2015 were conducted in the six hospitals in UThungulu Health District. The births before arrival data was analysed using SPSS (Statistical Package for Social Science) version 23, for Windows and used for descriptive and inferential analysis. The reasons for BBA included poor ante natal education of mothers on early signs of labour, lack of transport, poor use of maternity waiting areas and some clinics do not conduct deliveries. The majority of study participants were single (unmarried) and this accentuates the importance of strengthening family planning coverage in this area. Poor reporting of early neonatal deaths and stillbirths was one of the significant observations made during the study. Deceased babies were left at home and buried without being registered at home affairs. Taking cognizance of diverse risks and health needs of expectant women would assist the Health department in planning for adequate coverage for provision of suitable pregnancy care that would improve the health of women and their babies.
- Full Text:
- Authors: Mkhwanazi, Cynthia Nqobile Nokuthula
- Date: 2018
- Subjects: Childbirth Childbirth at home
- Language: English
- Type: Thesis , Masters , Public Health
- Identifier: http://hdl.handle.net/10353/11161 , vital:37198
- Description: Births Before Arrival (BBAs) in healthcare facilities is a worldwide health challenge. These births results with diverse obstetric and neonatal complications which could be avoided should delivery took place in an accredited environment. Delivery in health facility rate and Births Before Arrival is one of the vital measures used to monitor access as well as quality of Maternal and Child health services. A birth before arrival in health institutions happens accidentally and unattended by skilled health professionals outside the healthcare facilities (Lazic & Takač, 2011). It is found in both developed and developing countries with various adverse outcomes ranging from haemorrhage to death. Important strides had been taken to improve maternal and child health globally but the healthcare facilities are still experiencing an overwhelming number of births before arrival in healthcare facilities. This is a public health concern. The purpose of the study was to identify factors associated with Births before Arrival in UThungulu Health District facilities and determine the prevalence of BBAs and the neonatal and maternal morbidity and mortality associated with it. A retrospective quantitative research design was used. Maternity clinical records Reviews of 238 Births Before Arrival (BBA) in healthcare facilities that occurred between 1 April 2014 to 31 March 2015 were conducted in the six hospitals in UThungulu Health District. The births before arrival data was analysed using SPSS (Statistical Package for Social Science) version 23, for Windows and used for descriptive and inferential analysis. The reasons for BBA included poor ante natal education of mothers on early signs of labour, lack of transport, poor use of maternity waiting areas and some clinics do not conduct deliveries. The majority of study participants were single (unmarried) and this accentuates the importance of strengthening family planning coverage in this area. Poor reporting of early neonatal deaths and stillbirths was one of the significant observations made during the study. Deceased babies were left at home and buried without being registered at home affairs. Taking cognizance of diverse risks and health needs of expectant women would assist the Health department in planning for adequate coverage for provision of suitable pregnancy care that would improve the health of women and their babies.
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An investigation into factors influencing lack of improvement towards achieving compliance with the quality national core standards in KSD clinics, O.R. Tambo District
- Authors: Mnyamana, Tozama Nobom
- Date: 2018
- Subjects: Health facilities--Standards , Health facilities--South Africa , Medical care--South Africa
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/19498 , vital:43133
- Description: The purpose of this study was to explore factors associated with lack of improvement in the health care provided towards achieving compliance with the National Core Standards (NCS) in King Sabata Dalindyebo (KSD) sub-district clinics, in OR Tambo District in the Eastern Cape. A quantitative design was seen as the most suitable for this study. This method was chosen as the one that would best assist the researcher to meet the objectives of the study. A purposive sampling method was chosen, according to which the researcher selected five sites; all clinics that had been previously inspected for quality standards by the Office of Health Standards Compliance at least once. Participants for the study were all employees of those clinics and one representative of the governing structure of each. Twenty-eight participants in total formed part of the study as two did not return their responses. For collecting data from the participants, self-administered questionnaires were used. Throughout the data collection process, ethical standards of nursing research regarding anonymity, confidentiality and privacy were adhered to. Collected data were analysed using the Statistical Package for the Social Sciences (SPSS) computer software. The distribution of results is presented in tables and bar graphs. The results of the study reveal that a quality-oriented culture is lacking in our clinics with poor participation of clinics teams in quality improvement processes. Leadership and management at clinic level need strengthening. It was also found that there is insufficient capacitation of departmental strategic shift innovations, revealed in the complete absence of information sharing and feedback regarding previous assessments. In addition, there is a shortage of resources including basic equipment in clinics. , Thesis (MPH) -- University of Fort Hare, 2018
- Full Text:
- Authors: Mnyamana, Tozama Nobom
- Date: 2018
- Subjects: Health facilities--Standards , Health facilities--South Africa , Medical care--South Africa
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/19498 , vital:43133
- Description: The purpose of this study was to explore factors associated with lack of improvement in the health care provided towards achieving compliance with the National Core Standards (NCS) in King Sabata Dalindyebo (KSD) sub-district clinics, in OR Tambo District in the Eastern Cape. A quantitative design was seen as the most suitable for this study. This method was chosen as the one that would best assist the researcher to meet the objectives of the study. A purposive sampling method was chosen, according to which the researcher selected five sites; all clinics that had been previously inspected for quality standards by the Office of Health Standards Compliance at least once. Participants for the study were all employees of those clinics and one representative of the governing structure of each. Twenty-eight participants in total formed part of the study as two did not return their responses. For collecting data from the participants, self-administered questionnaires were used. Throughout the data collection process, ethical standards of nursing research regarding anonymity, confidentiality and privacy were adhered to. Collected data were analysed using the Statistical Package for the Social Sciences (SPSS) computer software. The distribution of results is presented in tables and bar graphs. The results of the study reveal that a quality-oriented culture is lacking in our clinics with poor participation of clinics teams in quality improvement processes. Leadership and management at clinic level need strengthening. It was also found that there is insufficient capacitation of departmental strategic shift innovations, revealed in the complete absence of information sharing and feedback regarding previous assessments. In addition, there is a shortage of resources including basic equipment in clinics. , Thesis (MPH) -- University of Fort Hare, 2018
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Analysis of the role of unions in health services delivery at Uitenhage district hospital
- Authors: Tshamase, Nozibele Yvonne
- Date: 2018
- Subjects: Public health Health services accessibility Labor unions
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: http://hdl.handle.net/10353/12348 , vital:39255
- Description: Purpose: According to Khan and Khan (2011:56), a trade union is an organization of employee tasked with activities which include negotiating on behalf of their members for “pay and conditions of employment”. Several authors have purported that these roles extend beyond ensuring not only that the rights of workers are not violated and that their working environment complies with health and safety standards, but also that unions may have an effect on management practices, generally and specifically, on efficiencies and performance (Zulu, 2009; McGuire, 2011; & Dhliwayo, 2012). Health care workers including professionals are organised by the unions in a bid to influence social and economic reforms in the South African democracy. The main aim of this study was to examine the role of public sector unions and how they exercise their functions in delivery of health services Method: A qualitative research method based on phenomenological and case approaches was applied. Semi-structured interviews with open ended questions were used to prompt discussions. Documents were used to obtain complementary data. Senior managers, middle managers, union/employee representatives and employees who are members of the unions in the district hospital of Nelson Mandela Bay health district constituted the target population. Purposive non-probability sampling, which was the preferred method for this study, yielded 16 participants. Results Analysis followed Creswell’s thematic analysis involving coding responses categorising them and identifying themes. This followed repeated and thorough listening to the recorded interviews and transcribing. Themes identified were organisational functioning in line with the service delivery context; worker’s rights protection; negotiating better service conditions; implementing legislation, policies and resolutions; union-management interaction; engaging in strikes and impact on services delivery. Conclusion and Recommendations: The study found that the presence of unions in health care services was necessary because there are various categories of employees – working class – whose interests must be served. The role of the unions leaned heavily towards protection of the rights of the workers. As far as the observation of legislation is concerned, the unions demonstrated knowledge of the legislation applicable to the health care personnel, that is, the BCEA, the LRA and the PSA. The study found that unions were a hindrance to health services delivery in their quest to exercise voice monopoly. The unions tended to exert undue influence on management resulting in lack of discipline and dereliction of duty. The strike actions compromised quality of health care and the rights of citizens to access health care. There was no active participation nor positive contributions in committees where advancement of service delivery standards were deliberated and promoted. Recommendations included training of shop stewards; capacitation and training of managers, and development and communication of departmental labour relations policies.
- Full Text:
- Authors: Tshamase, Nozibele Yvonne
- Date: 2018
- Subjects: Public health Health services accessibility Labor unions
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: http://hdl.handle.net/10353/12348 , vital:39255
- Description: Purpose: According to Khan and Khan (2011:56), a trade union is an organization of employee tasked with activities which include negotiating on behalf of their members for “pay and conditions of employment”. Several authors have purported that these roles extend beyond ensuring not only that the rights of workers are not violated and that their working environment complies with health and safety standards, but also that unions may have an effect on management practices, generally and specifically, on efficiencies and performance (Zulu, 2009; McGuire, 2011; & Dhliwayo, 2012). Health care workers including professionals are organised by the unions in a bid to influence social and economic reforms in the South African democracy. The main aim of this study was to examine the role of public sector unions and how they exercise their functions in delivery of health services Method: A qualitative research method based on phenomenological and case approaches was applied. Semi-structured interviews with open ended questions were used to prompt discussions. Documents were used to obtain complementary data. Senior managers, middle managers, union/employee representatives and employees who are members of the unions in the district hospital of Nelson Mandela Bay health district constituted the target population. Purposive non-probability sampling, which was the preferred method for this study, yielded 16 participants. Results Analysis followed Creswell’s thematic analysis involving coding responses categorising them and identifying themes. This followed repeated and thorough listening to the recorded interviews and transcribing. Themes identified were organisational functioning in line with the service delivery context; worker’s rights protection; negotiating better service conditions; implementing legislation, policies and resolutions; union-management interaction; engaging in strikes and impact on services delivery. Conclusion and Recommendations: The study found that the presence of unions in health care services was necessary because there are various categories of employees – working class – whose interests must be served. The role of the unions leaned heavily towards protection of the rights of the workers. As far as the observation of legislation is concerned, the unions demonstrated knowledge of the legislation applicable to the health care personnel, that is, the BCEA, the LRA and the PSA. The study found that unions were a hindrance to health services delivery in their quest to exercise voice monopoly. The unions tended to exert undue influence on management resulting in lack of discipline and dereliction of duty. The strike actions compromised quality of health care and the rights of citizens to access health care. There was no active participation nor positive contributions in committees where advancement of service delivery standards were deliberated and promoted. Recommendations included training of shop stewards; capacitation and training of managers, and development and communication of departmental labour relations policies.
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Application of health belief model in developing contextual guidelines for adherence to antiretroviral treatment among adolescents and youths in Buffalo City Metropolitan Municipality District, East London, South Africa
- Authors: Mayeye, Bulelwa
- Date: 2018
- Subjects: HIV-positive children--Treatment--Management AIDS (Disease) in adolescence HIV-positive youth
- Language: English
- Type: Thesis , Doctoral , Nursing
- Identifier: http://hdl.handle.net/10353/15572 , vital:40472
- Description: Background: Adhering to the treatment instructions for a long-term illness poses a great challenge to the client especially adolescents and youths. In public health centers it is observed that most adolescents and youths on Ante Retroviral Treatment (ART) do not continue taking ART and do not honor their Art related scheduled appointments at the clinic. An increase loss to follow up among these cohorts is noticeable in Buffalo City Metropolitan Municipality district. Inconsistent adherence to ART may result in the development of resistance mutations. Purpose: The purpose of the study was to develop and describe context – specific antiretroviral treatment guidelines based on the biomedical, cognitive and psychosocial needs of the adolescents and youths at the Buffalo City Metropolitan Municipality district. Methodology: The study was conducted in two phases, phase one consisted of quantitative and qualitative approaches. For phase one an explanatory sequential mixed method of quantitative and qualitative designs was employed. The study was guided by Health Belief Model. The target population were adolescents and youths receiving ART from the selected health facilities in Buffalo City Metropolitan Municipality District in the Province of the Eastern Cape. Participants were chosen based on purposive sampling. A convenience sample of 206 adolescents and youths between the ages of 14 to 24 attending ARV clinics were approached. Ethical considerations, that is, the rights of all the participants were honoured. Data was collected using self administered questionnaires followed by semi-structured interview where face to face interviews were conducted. Reliability validity and trustworthiness of the research was ensured. Quantitative data was analysed through descriptive statistics. For qualitative approach transcrips were coded thematically. In Phase 2, context – specific antiretroviral treatment guidelines were developed to promote adherence to ART by adolescents and youths of Buffalo City Metropolitan Municipality district. Results: About 35percent of the participants indicated low adherence, 31percent for moderate adherence and 34percent for high adherence. A strong correlation between interpersonal relationship and adherence (p = 0.008), a correlation between aspect of care related to clinic and adherence (p = 0.028), a significant correlation between social support and adherence to ART (p = 0.006) and a significant relationship between self- efficacy and adherence to ART (p = 0.000) were obtained. No correlation between demographic status and adherence except for race. Results from the interviews revealed that barriers to adherence were more evident than enabling factors. Recommendations: Health service providers should strengthen ART adherence programmes for adolescents and youths by applying principles as they appear in the context – based guidelines.
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- Authors: Mayeye, Bulelwa
- Date: 2018
- Subjects: HIV-positive children--Treatment--Management AIDS (Disease) in adolescence HIV-positive youth
- Language: English
- Type: Thesis , Doctoral , Nursing
- Identifier: http://hdl.handle.net/10353/15572 , vital:40472
- Description: Background: Adhering to the treatment instructions for a long-term illness poses a great challenge to the client especially adolescents and youths. In public health centers it is observed that most adolescents and youths on Ante Retroviral Treatment (ART) do not continue taking ART and do not honor their Art related scheduled appointments at the clinic. An increase loss to follow up among these cohorts is noticeable in Buffalo City Metropolitan Municipality district. Inconsistent adherence to ART may result in the development of resistance mutations. Purpose: The purpose of the study was to develop and describe context – specific antiretroviral treatment guidelines based on the biomedical, cognitive and psychosocial needs of the adolescents and youths at the Buffalo City Metropolitan Municipality district. Methodology: The study was conducted in two phases, phase one consisted of quantitative and qualitative approaches. For phase one an explanatory sequential mixed method of quantitative and qualitative designs was employed. The study was guided by Health Belief Model. The target population were adolescents and youths receiving ART from the selected health facilities in Buffalo City Metropolitan Municipality District in the Province of the Eastern Cape. Participants were chosen based on purposive sampling. A convenience sample of 206 adolescents and youths between the ages of 14 to 24 attending ARV clinics were approached. Ethical considerations, that is, the rights of all the participants were honoured. Data was collected using self administered questionnaires followed by semi-structured interview where face to face interviews were conducted. Reliability validity and trustworthiness of the research was ensured. Quantitative data was analysed through descriptive statistics. For qualitative approach transcrips were coded thematically. In Phase 2, context – specific antiretroviral treatment guidelines were developed to promote adherence to ART by adolescents and youths of Buffalo City Metropolitan Municipality district. Results: About 35percent of the participants indicated low adherence, 31percent for moderate adherence and 34percent for high adherence. A strong correlation between interpersonal relationship and adherence (p = 0.008), a correlation between aspect of care related to clinic and adherence (p = 0.028), a significant correlation between social support and adherence to ART (p = 0.006) and a significant relationship between self- efficacy and adherence to ART (p = 0.000) were obtained. No correlation between demographic status and adherence except for race. Results from the interviews revealed that barriers to adherence were more evident than enabling factors. Recommendations: Health service providers should strengthen ART adherence programmes for adolescents and youths by applying principles as they appear in the context – based guidelines.
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Assessment of the effect of the down-referral chronic medication distribution system on patients' adherence to chronic medication in the Buffalo City sub-district
- Authors: Ndwandwe, Miriam
- Date: 2018
- Subjects: Health services accessibility Pharmacology Patient compliance
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: http://hdl.handle.net/10353/13248 , vital:39626
- Description: The purpose of the study is to determine the effect of the down referral chronic medication distribution system on patient's adherence to chronic medicine in Buffalo City sub - district by ensuring that chronic patients receive their correct medication on time and in correct quantities every month so that they can take the medication as recommended by the health professional. Adherence to chronic medication lead to better health outcome and reduced hospital re-admission. A non-experimental and descriptive quantitative research methodology was used. A data abstraction form developed by the researcher was used to record data from the medical records of chronically ill patients. The results of the study revealed that most of the chronically ill patients who were admitted to hospital were not adherent to their chronic medication. Patients are non-adherent even if they have chronic medication with them. This was evident in the number of patients who do not remember how many days did they not take their treatment. Others indicated that they share their medication with other family members who suffer from the same chronic condition. The patients' lack of understanding of their chronic condition and the consequences of not taking medication as instructed by the health professional contribute to non-adherence. Strengthening of health promotion programmes to educate the patients about their chronic condition would improve adherence. Most of the chronic conditions are life-style modifiable diseases. Patients must be educated about the changes they can make to improve their quality of life.
- Full Text:
- Authors: Ndwandwe, Miriam
- Date: 2018
- Subjects: Health services accessibility Pharmacology Patient compliance
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: http://hdl.handle.net/10353/13248 , vital:39626
- Description: The purpose of the study is to determine the effect of the down referral chronic medication distribution system on patient's adherence to chronic medicine in Buffalo City sub - district by ensuring that chronic patients receive their correct medication on time and in correct quantities every month so that they can take the medication as recommended by the health professional. Adherence to chronic medication lead to better health outcome and reduced hospital re-admission. A non-experimental and descriptive quantitative research methodology was used. A data abstraction form developed by the researcher was used to record data from the medical records of chronically ill patients. The results of the study revealed that most of the chronically ill patients who were admitted to hospital were not adherent to their chronic medication. Patients are non-adherent even if they have chronic medication with them. This was evident in the number of patients who do not remember how many days did they not take their treatment. Others indicated that they share their medication with other family members who suffer from the same chronic condition. The patients' lack of understanding of their chronic condition and the consequences of not taking medication as instructed by the health professional contribute to non-adherence. Strengthening of health promotion programmes to educate the patients about their chronic condition would improve adherence. Most of the chronic conditions are life-style modifiable diseases. Patients must be educated about the changes they can make to improve their quality of life.
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Assessment of the integrated HIV/AIDS curriculum at a university in the Eastern Cape: views of students and educators
- Terblanche, Delcia Jill Nora
- Authors: Terblanche, Delcia Jill Nora
- Date: 2018
- Subjects: AIDS (Disease) -- Study and teaching , AIDS (Disease) -- Prevention , Universities and colleges
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10353/12359 , vital:39256
- Description: Background: HIV/AIDS is a major global public health problem. The higher education sector too, is affected by the scourge of HIV/AIDS. Universities are considered to be high- risks areas for HIV infection because many students indulged in high risky behaviour link to HIV infection; therefore developing ways to prevent students for acquiring HIV and as well reducing HIV prevalence rates through training and teaching about HIV/AIDS will contribute to change in behaviour of students. Anecdotal evidence suggests that the majority of the students at Fort Hare lack the general awareness and education in HIV/AIDS due to lack of information coupled with their general disadvantaged background with the ultimate result being threatened by high infection rates. The University of Fort Hare (UFH), in a bid to capacitate the academic staff in respect of the laudable initiative to integrate HIV/AIDS in curricula, decided to embark on a pilot study that is anticipated to form fundamental strategies to sustainable HIV/AIDS curricula integration across all faculties, at least by the end of 2030. The university has planned to engage in the curriculum integration process by implementing a two year cycle pilot study during the grant period. Aim: The main aim of the study was to assess the challenges faced by students and educators concerning the integration and implementation of HIV/AIDS curriculum at the University of Fort Hare. Methods: The study adopted a quantitative, explorative descriptive design to examine the challenges associated with the Integrated HIV/AIDS curriculum at the University of Fort Hare. The target population was the educators and students who had training and teaching in the Integrated HIV/AIDS curriculum. A purposive sampling was used to select 487 students and 23 educators from across three departments: Nursing Science, LKA (Life, Knowledge and Action) and Law involved in the HIV/AIDS Curriculum Integration programme at the university. A self-design questionnaire was used for data collection focusing on the demographic profiles of the participants, the teaching strategies and methodologies adopted in the Integrated HIV/AIDS curriculum, the usefulness and relevance of the newly integrated HIV/AIDS curriculum content in addressing the needs of the students and the community, and the challenges faced by the educators and students in the Integrated HIV/AIDS curriculum. Ethical approved was obtained from the Research Ethics Committee of the University of Fort Hare. Permission was obtained from the participants through written consent forms. The data was analysed using descriptive statistics (frequency counts, percentage, means and standard deviations (SD)). The Chi-square test was used to examine the relationship between the variables of interest across the departments. A p-value of 0.05 was set for statistical significant testing. Results: The majority of the participants have adequate knowledge of HIV transmission, as 93.2 percent indicated HIV can be contracted through unprotected sex, sharing of needles (92.1 percent), receiving a blood transfusion that has not been screened for HIV (83.9 percent), sharing razor blades that has not been disinfected (83.0 percent), and having more than one sexual partner (86 percent). Age, gender, race and department were significantly associated with knowledge of route of HIV transmission. The present study indicated that the participants experienced several challenges during the teaching of the Integrated HIV/AIDS curriculum. Time allocated was the biggest challenge (58.3 percent), followed by undated materials, and curriculum overloading and teaching. The study indicated that majority of the students would like to compile a portfolio of evidence in the teaching of HIV, followed by creative arts, DVD/movies, and internet research. The majority of the lecturers preferred to teach HIV/AIDS through expressive arts, followed by role play, and formal lectures. The majority of the participants stated that HIV/AIDS information would be useful to them to apply in their communities and in their profession (97 percent), emphasizing that such knowledge and information will empower them to participate in roadshows and voluntary work at HIV/AIDS Shelters. The findings of this study pertaining to the challenges faced by educators during the implementation of the Integrated HIV/AIDS curriculum revealed that the majority of the participants stated that the HIV information was not updated, heavy workload, and adequate training. The lecturers expressed that they would prefer to teach HIV/AIDS curriculum by expressive art through drawing and creating art that expresses HIV and the relevance in the students’ community. Conclusions: Majority of the students received teaching of HIV as part of a course, and HIV teaching as an integrated component in a subject, while few received it as a stand-alone subject offered by a lecturer/facilitator. The present study indicated that the participants experienced several challenges during the teaching of the Integrated HIV/AIDS curriculum. Time allocated was the biggest challenge (58.3percent), followed by undated materials, and curriculum overloading and teaching. The majority of students preferred HIV/AIDS to be taught by their peers experience in HIV, by face-to face by a person who is HIV/AIDS infected or affected. The majority of the lecturers preferred to teach HIV/AIDS through expressive arts, followed by role play, and formal lectures. The majority of the participants affirmed the relevancy of HIV information taught. They further indicated that the information and knowledge gain would able them to make informed decisions on sexual behaviour. The majority of the participants stated that the HIV information was not updated, heavy workload, and adequate training. Most of the educators used formal lectures, followed by compilation of a portfolio of evidence, storytelling, DVD and movies, and experiential learning in hospitals and clinics in teaching HIV/AIDS integrated curriculum. The lecturers expressed that they would prefer to teach HIV/AIDS curriculum by expressive art through drawing and creating art that expresses HIV and the relevance in the students’ community. It is recommended that student’s involvement in the decision making processes of the integrated HIV/AIDS curriculum at the University of Fort Hare would make the programme more successful. HIV/AIDS resource materials need to be updated regularly and relevant to provide educators with specialized knowledge to be able to teach HIV/AIDS.
- Full Text:
- Authors: Terblanche, Delcia Jill Nora
- Date: 2018
- Subjects: AIDS (Disease) -- Study and teaching , AIDS (Disease) -- Prevention , Universities and colleges
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10353/12359 , vital:39256
- Description: Background: HIV/AIDS is a major global public health problem. The higher education sector too, is affected by the scourge of HIV/AIDS. Universities are considered to be high- risks areas for HIV infection because many students indulged in high risky behaviour link to HIV infection; therefore developing ways to prevent students for acquiring HIV and as well reducing HIV prevalence rates through training and teaching about HIV/AIDS will contribute to change in behaviour of students. Anecdotal evidence suggests that the majority of the students at Fort Hare lack the general awareness and education in HIV/AIDS due to lack of information coupled with their general disadvantaged background with the ultimate result being threatened by high infection rates. The University of Fort Hare (UFH), in a bid to capacitate the academic staff in respect of the laudable initiative to integrate HIV/AIDS in curricula, decided to embark on a pilot study that is anticipated to form fundamental strategies to sustainable HIV/AIDS curricula integration across all faculties, at least by the end of 2030. The university has planned to engage in the curriculum integration process by implementing a two year cycle pilot study during the grant period. Aim: The main aim of the study was to assess the challenges faced by students and educators concerning the integration and implementation of HIV/AIDS curriculum at the University of Fort Hare. Methods: The study adopted a quantitative, explorative descriptive design to examine the challenges associated with the Integrated HIV/AIDS curriculum at the University of Fort Hare. The target population was the educators and students who had training and teaching in the Integrated HIV/AIDS curriculum. A purposive sampling was used to select 487 students and 23 educators from across three departments: Nursing Science, LKA (Life, Knowledge and Action) and Law involved in the HIV/AIDS Curriculum Integration programme at the university. A self-design questionnaire was used for data collection focusing on the demographic profiles of the participants, the teaching strategies and methodologies adopted in the Integrated HIV/AIDS curriculum, the usefulness and relevance of the newly integrated HIV/AIDS curriculum content in addressing the needs of the students and the community, and the challenges faced by the educators and students in the Integrated HIV/AIDS curriculum. Ethical approved was obtained from the Research Ethics Committee of the University of Fort Hare. Permission was obtained from the participants through written consent forms. The data was analysed using descriptive statistics (frequency counts, percentage, means and standard deviations (SD)). The Chi-square test was used to examine the relationship between the variables of interest across the departments. A p-value of 0.05 was set for statistical significant testing. Results: The majority of the participants have adequate knowledge of HIV transmission, as 93.2 percent indicated HIV can be contracted through unprotected sex, sharing of needles (92.1 percent), receiving a blood transfusion that has not been screened for HIV (83.9 percent), sharing razor blades that has not been disinfected (83.0 percent), and having more than one sexual partner (86 percent). Age, gender, race and department were significantly associated with knowledge of route of HIV transmission. The present study indicated that the participants experienced several challenges during the teaching of the Integrated HIV/AIDS curriculum. Time allocated was the biggest challenge (58.3 percent), followed by undated materials, and curriculum overloading and teaching. The study indicated that majority of the students would like to compile a portfolio of evidence in the teaching of HIV, followed by creative arts, DVD/movies, and internet research. The majority of the lecturers preferred to teach HIV/AIDS through expressive arts, followed by role play, and formal lectures. The majority of the participants stated that HIV/AIDS information would be useful to them to apply in their communities and in their profession (97 percent), emphasizing that such knowledge and information will empower them to participate in roadshows and voluntary work at HIV/AIDS Shelters. The findings of this study pertaining to the challenges faced by educators during the implementation of the Integrated HIV/AIDS curriculum revealed that the majority of the participants stated that the HIV information was not updated, heavy workload, and adequate training. The lecturers expressed that they would prefer to teach HIV/AIDS curriculum by expressive art through drawing and creating art that expresses HIV and the relevance in the students’ community. Conclusions: Majority of the students received teaching of HIV as part of a course, and HIV teaching as an integrated component in a subject, while few received it as a stand-alone subject offered by a lecturer/facilitator. The present study indicated that the participants experienced several challenges during the teaching of the Integrated HIV/AIDS curriculum. Time allocated was the biggest challenge (58.3percent), followed by undated materials, and curriculum overloading and teaching. The majority of students preferred HIV/AIDS to be taught by their peers experience in HIV, by face-to face by a person who is HIV/AIDS infected or affected. The majority of the lecturers preferred to teach HIV/AIDS through expressive arts, followed by role play, and formal lectures. The majority of the participants affirmed the relevancy of HIV information taught. They further indicated that the information and knowledge gain would able them to make informed decisions on sexual behaviour. The majority of the participants stated that the HIV information was not updated, heavy workload, and adequate training. Most of the educators used formal lectures, followed by compilation of a portfolio of evidence, storytelling, DVD and movies, and experiential learning in hospitals and clinics in teaching HIV/AIDS integrated curriculum. The lecturers expressed that they would prefer to teach HIV/AIDS curriculum by expressive art through drawing and creating art that expresses HIV and the relevance in the students’ community. It is recommended that student’s involvement in the decision making processes of the integrated HIV/AIDS curriculum at the University of Fort Hare would make the programme more successful. HIV/AIDS resource materials need to be updated regularly and relevant to provide educators with specialized knowledge to be able to teach HIV/AIDS.
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Challenges hindering the implementation of quality supervision in primary health care facilities in Oliver Reginald Tambo District, Eastern Cape Province
- Zamxaka, Nontlantla Caroline
- Authors: Zamxaka, Nontlantla Caroline
- Date: 2018
- Subjects: Hospitals -- Administration , Health services administration , Hospitals -- Business management
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/29256 , vital:77707
- Description: The study investigated the factors that prevent quality supervision in primary health care(PHC) facilities in Oliver Reginald Tambo (O.R. Tambo) district of the Eastern Cape Province of South Africa. The motivation for this study was a concern regarding consistently poor performance by PHC facilities in the province despite regular supervisory visits. The objectives of the study were to explore practices of PHC supervisors in implementing supervision, and to assess perceptions, opinions, and attitudes of PHC supervisors and PHC operational managers with regards to PHC supervisory visits. On search methodology, qualitative approach was predominating whilst quantitative data was supplementing the study. A purposive sample of PHC supervisors and operational managers was drawn from PHC facilities which had a consistent, 100% rate of supervisory visits. The data was analysed thematically. The results revealed systemic and structural challenges that affect the implementation of quality supervision, rendering supervisory visits inefficient. These were: a high workload resulting from inconsistency in the allocation of facilities, as well as the many other responsibilities which supervisors have; a lack of knowledge and experience in supervisors; a lack of health service resources including transport; a high turnover of nurses; lack of support from the district and sub-district leadership and management; lack of collaboration, coordination and integration of activities; and delayed procurement processes resulting in a recurring lack of equipment and medical supplies. The findings of the study brought an understanding of the systemic and structural requirements that need to be made for a functioning quality supervisory system. Successful interventions require strengthening of leadership and governance, and the diligent application of the systems approach to solving problems at facility, district and provincial level. An improvement in leadership and governance should include innovative strategies to utilise the limited resources available without compromising the key objective of quality health care. , Thesis (MPH) -- Faculty of Health Sciences, 2018
- Full Text:
- Authors: Zamxaka, Nontlantla Caroline
- Date: 2018
- Subjects: Hospitals -- Administration , Health services administration , Hospitals -- Business management
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/29256 , vital:77707
- Description: The study investigated the factors that prevent quality supervision in primary health care(PHC) facilities in Oliver Reginald Tambo (O.R. Tambo) district of the Eastern Cape Province of South Africa. The motivation for this study was a concern regarding consistently poor performance by PHC facilities in the province despite regular supervisory visits. The objectives of the study were to explore practices of PHC supervisors in implementing supervision, and to assess perceptions, opinions, and attitudes of PHC supervisors and PHC operational managers with regards to PHC supervisory visits. On search methodology, qualitative approach was predominating whilst quantitative data was supplementing the study. A purposive sample of PHC supervisors and operational managers was drawn from PHC facilities which had a consistent, 100% rate of supervisory visits. The data was analysed thematically. The results revealed systemic and structural challenges that affect the implementation of quality supervision, rendering supervisory visits inefficient. These were: a high workload resulting from inconsistency in the allocation of facilities, as well as the many other responsibilities which supervisors have; a lack of knowledge and experience in supervisors; a lack of health service resources including transport; a high turnover of nurses; lack of support from the district and sub-district leadership and management; lack of collaboration, coordination and integration of activities; and delayed procurement processes resulting in a recurring lack of equipment and medical supplies. The findings of the study brought an understanding of the systemic and structural requirements that need to be made for a functioning quality supervisory system. Successful interventions require strengthening of leadership and governance, and the diligent application of the systems approach to solving problems at facility, district and provincial level. An improvement in leadership and governance should include innovative strategies to utilise the limited resources available without compromising the key objective of quality health care. , Thesis (MPH) -- Faculty of Health Sciences, 2018
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Comparison of contraceptive discontinuation in users of a copper intrauterine device against depot medroxyprogesterone acetate injectable
- Authors: Dekile-Yonto, Nolusindiso
- Date: 2018
- Subjects: Contraceptives Birth control Women's health services
- Language: English
- Type: Thesis , Masters , Magister of Curationis
- Identifier: http://hdl.handle.net/10353/15520 , vital:40422
- Description: The dynamics of continued contraceptive use, switches to alternatives, or the outright failure of contraception is strong indicators of the effectiveness of health care programmes for women or couples (Ali, Cleland & Shah, 2012:6). Furthermore, unplanned pregnancies often lead to undesirable health, economic, social, and psychological consequences for women (Sedgh, Singh & Hussain., 2014). There is a need to better understand the reasons for discontinuation of contraception to enable health care workers to address the gaps in the provision of family planning services. For this reason, the researcher embarked on a follow-up study of a randomised, controlled trial, which compared the effects on depression and sexual functioning of women after childbirth of a Copper Intrauterine Contraceptive Device (Cu-IUD) with Depot Medroxyprogesterone Acetate (DMPA), (Singata-Madliki, 2014:5). The objectives of the follow-up study was to do a once-off follow-up of the original participants, three years after randomisation.
- Full Text:
- Authors: Dekile-Yonto, Nolusindiso
- Date: 2018
- Subjects: Contraceptives Birth control Women's health services
- Language: English
- Type: Thesis , Masters , Magister of Curationis
- Identifier: http://hdl.handle.net/10353/15520 , vital:40422
- Description: The dynamics of continued contraceptive use, switches to alternatives, or the outright failure of contraception is strong indicators of the effectiveness of health care programmes for women or couples (Ali, Cleland & Shah, 2012:6). Furthermore, unplanned pregnancies often lead to undesirable health, economic, social, and psychological consequences for women (Sedgh, Singh & Hussain., 2014). There is a need to better understand the reasons for discontinuation of contraception to enable health care workers to address the gaps in the provision of family planning services. For this reason, the researcher embarked on a follow-up study of a randomised, controlled trial, which compared the effects on depression and sexual functioning of women after childbirth of a Copper Intrauterine Contraceptive Device (Cu-IUD) with Depot Medroxyprogesterone Acetate (DMPA), (Singata-Madliki, 2014:5). The objectives of the follow-up study was to do a once-off follow-up of the original participants, three years after randomisation.
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Developing a model for promoting physical fitness and healthy lifestyle of primary school learners in the Eastern Cape Province, South Africa
- Authors: Gomwe, Howard
- Date: 2018
- Subjects: Physical fitness for children -- South Africa Physical education for children Schools -- Health promotion services
- Language: English
- Type: Thesis , Doctoral , Nursing
- Identifier: http://hdl.handle.net/10353/10050 , vital:35307
- Description: The challenge of low level participation in physical activity and, consequently, limited physical fitness has been acknowledged as being a national public health concern in South African schools. The main aim of this study was to develop a behavioural model for promoting physical fitness and healthy lifestyle of primary school learners in the Eastern Cape Province in South Africa. The first thing was to determine their physical fitness level and body composition then develop a behavioural model based on the findings. The study was conducted in three phases. A quantitative, qualitative and theory-generating research design was conducted using questionnaires, deductive and inductive strategies and literature triangulation. The study involved primary school learners: 356 boys and 520 girls aged 9-14 years old, who were randomly selected. Anthropometric assessments were conducted using ISAK (Marfell-Jones et al., 2006) and EUROFIT (1988) test batteries.The following measurements of body mass, stature, skinfolds (triceps and subscapular), waist circumference and gluteal were taken. The percent BF was calculated from a sum of two skinfolds (triceps and subscapular), using Slaughter et al.‘ s (1988) equation to predict body fat. Physical fitness measurements included sit and reach, push-ups, sit-ups and a 20 metre shuttle run. Physical activity level and sedentary behaviour were assessed by means of self-report questionnaires. Demographic, psychological and environmental variables were also measured by a self-report questionnaire. Six focus group discussions were conducted with school learners. The physical fitness levels were categorized as hypoactive, minimal active and inactive. Sedentary behaviours were categorized by number of minutes spent on sedentary activities. Dietary intake was assessed by a Food Frequency Questionnaire (FFQ). Food intake was classified as healthy, unhealthy/junk and traditional food. Body composition was measured by calculating body mass index (BMI) (weight/height2) and waist-to-hip ratio, respectively. Categories: underweight: 0<18, normal weight: 18, 5<25, overweight: 25<30 or obese: 30 and blood pressure measurements were classified as healthy and unhealthy. The main findings were as follows: underweight 60, 25 percent: normal weight 30, 54 percent: overweight 4, 18 percent: and obese 5, 02 percent: for the peri-urban school learners. Underweight 64, 78 percent: normal 31, 52 percent: overweight 2,83 percent: and obesity 0,87 percent:for the rural school learners. 56,25 percent underweight: 36,93 percent normal weight: 5,68 percent overweight: and 1,14 percent obese for the urban school learners. The mean body mass of learners from three locations were urban 40.0±10.185; peri-urban 39.8±10.181 and rural 38.7±10.279, respectively. (Chi-square = 3.3107; P=0.191). The mean values stature of all the three residences are urban; 144.1 ±10.400 peri-urban 144.4±9.187 and rural 143.7±12.617 (Chi-square = 1.2651; P=0.5312). The mean waist circumference for urban was (78.4±9.493), peri-urban (78.4±9.399) and rural was (77.1±10.214), respectively (Z=2.474;p=0.2903). The triceps value (z=21.4565p <.0001). Urban (13.9±5.589), (12.5±6.023) for peri-urban and (12.1±6.390) for rural. Subscapular (z=4.1151;p=0.1278). Urban area had (9.3±5.426), (9.3±5.463) for peri-urban and (8.9±6.381) for rural. The mean systolic blood pressure of urban school learners was (109.2±19.512), (107.9±19.273) for peri-urban and (107.4±19.488) for rural school learners. Lumbar and hamstring flexibility (z= 57.733; p<.0001). (25.3±5.507) for urban, (23.0±6.435) for peri-urban and (26.9±6.854) for rural. Sit-up (z=9.8414;p=0.0073). (18.3±12.571) for urban, (19.7±12.323) for peri-urban and (21.7±13.782) for rural area. Push-ups (z= 37.7591p=<.00001). (15.8±10.285) for urban, (18.5±11.086) for peri-urban and (20.9±9.981) for rural area. Maximal oxygen intake (z= 163.186p=<.0001). (25.0±6.454) for urban, (29.9±7.225) for peri-urban and (35.5±11.085) for rural area. PA enjoyment (4.1±0.698) for urban, (4.0±0.764) for peri-urban, (4.0±0.799) for rural. With regard to health-related physical fitness, the learners in the rural and peri-urban better than those in urban areas. PA attitude (z=7.5507;p=0.0563), (2.5±0.792) for urban area, (2.6±0.802) for peri-urban and (2.7±0.890) for rural area. Parental role modelling in PA (z=0.3083; p=<.000). (3.1±1.008) for urban area, (3.3±0.916) for peri-urban (3.1±0.981) for rural area. Peer encouragement (z=2.5367; p=0.2813) (3.4±0.893) for urban, (3.3±1.064) for peri-urban, (3.3±1.005) for rural area. Parental encouragement (z= 7.2266p=0.027),(3.7±0.985) for urban area, (3.5±0.906) for peri-urban and (3.7±0.774 ) for rural area. Teacher encouragement (z=2.0069p=0.3668).The mean values for three residences are (3.5±0.802) for urban area, (3.4±0.784) for peri-urban, (3.5±0.733) for rural areas. Most of the school learners in all the three residences prefer unhealthy/junky food. Based on the results, an exploratory factor analysis was conducted on data to identify and analyse the factors for model development. The findings indicated that there is evidence of low level of physical fitness and high prevalence of excessive weight and obesity among primary school learners, the study, therefore, suggests the development of the behavioural model to enhance physical fitness and prevent or reduce overweight/obesity among school learners.
- Full Text:
- Authors: Gomwe, Howard
- Date: 2018
- Subjects: Physical fitness for children -- South Africa Physical education for children Schools -- Health promotion services
- Language: English
- Type: Thesis , Doctoral , Nursing
- Identifier: http://hdl.handle.net/10353/10050 , vital:35307
- Description: The challenge of low level participation in physical activity and, consequently, limited physical fitness has been acknowledged as being a national public health concern in South African schools. The main aim of this study was to develop a behavioural model for promoting physical fitness and healthy lifestyle of primary school learners in the Eastern Cape Province in South Africa. The first thing was to determine their physical fitness level and body composition then develop a behavioural model based on the findings. The study was conducted in three phases. A quantitative, qualitative and theory-generating research design was conducted using questionnaires, deductive and inductive strategies and literature triangulation. The study involved primary school learners: 356 boys and 520 girls aged 9-14 years old, who were randomly selected. Anthropometric assessments were conducted using ISAK (Marfell-Jones et al., 2006) and EUROFIT (1988) test batteries.The following measurements of body mass, stature, skinfolds (triceps and subscapular), waist circumference and gluteal were taken. The percent BF was calculated from a sum of two skinfolds (triceps and subscapular), using Slaughter et al.‘ s (1988) equation to predict body fat. Physical fitness measurements included sit and reach, push-ups, sit-ups and a 20 metre shuttle run. Physical activity level and sedentary behaviour were assessed by means of self-report questionnaires. Demographic, psychological and environmental variables were also measured by a self-report questionnaire. Six focus group discussions were conducted with school learners. The physical fitness levels were categorized as hypoactive, minimal active and inactive. Sedentary behaviours were categorized by number of minutes spent on sedentary activities. Dietary intake was assessed by a Food Frequency Questionnaire (FFQ). Food intake was classified as healthy, unhealthy/junk and traditional food. Body composition was measured by calculating body mass index (BMI) (weight/height2) and waist-to-hip ratio, respectively. Categories: underweight: 0<18, normal weight: 18, 5<25, overweight: 25<30 or obese: 30 and blood pressure measurements were classified as healthy and unhealthy. The main findings were as follows: underweight 60, 25 percent: normal weight 30, 54 percent: overweight 4, 18 percent: and obese 5, 02 percent: for the peri-urban school learners. Underweight 64, 78 percent: normal 31, 52 percent: overweight 2,83 percent: and obesity 0,87 percent:for the rural school learners. 56,25 percent underweight: 36,93 percent normal weight: 5,68 percent overweight: and 1,14 percent obese for the urban school learners. The mean body mass of learners from three locations were urban 40.0±10.185; peri-urban 39.8±10.181 and rural 38.7±10.279, respectively. (Chi-square = 3.3107; P=0.191). The mean values stature of all the three residences are urban; 144.1 ±10.400 peri-urban 144.4±9.187 and rural 143.7±12.617 (Chi-square = 1.2651; P=0.5312). The mean waist circumference for urban was (78.4±9.493), peri-urban (78.4±9.399) and rural was (77.1±10.214), respectively (Z=2.474;p=0.2903). The triceps value (z=21.4565p <.0001). Urban (13.9±5.589), (12.5±6.023) for peri-urban and (12.1±6.390) for rural. Subscapular (z=4.1151;p=0.1278). Urban area had (9.3±5.426), (9.3±5.463) for peri-urban and (8.9±6.381) for rural. The mean systolic blood pressure of urban school learners was (109.2±19.512), (107.9±19.273) for peri-urban and (107.4±19.488) for rural school learners. Lumbar and hamstring flexibility (z= 57.733; p<.0001). (25.3±5.507) for urban, (23.0±6.435) for peri-urban and (26.9±6.854) for rural. Sit-up (z=9.8414;p=0.0073). (18.3±12.571) for urban, (19.7±12.323) for peri-urban and (21.7±13.782) for rural area. Push-ups (z= 37.7591p=<.00001). (15.8±10.285) for urban, (18.5±11.086) for peri-urban and (20.9±9.981) for rural area. Maximal oxygen intake (z= 163.186p=<.0001). (25.0±6.454) for urban, (29.9±7.225) for peri-urban and (35.5±11.085) for rural area. PA enjoyment (4.1±0.698) for urban, (4.0±0.764) for peri-urban, (4.0±0.799) for rural. With regard to health-related physical fitness, the learners in the rural and peri-urban better than those in urban areas. PA attitude (z=7.5507;p=0.0563), (2.5±0.792) for urban area, (2.6±0.802) for peri-urban and (2.7±0.890) for rural area. Parental role modelling in PA (z=0.3083; p=<.000). (3.1±1.008) for urban area, (3.3±0.916) for peri-urban (3.1±0.981) for rural area. Peer encouragement (z=2.5367; p=0.2813) (3.4±0.893) for urban, (3.3±1.064) for peri-urban, (3.3±1.005) for rural area. Parental encouragement (z= 7.2266p=0.027),(3.7±0.985) for urban area, (3.5±0.906) for peri-urban and (3.7±0.774 ) for rural area. Teacher encouragement (z=2.0069p=0.3668).The mean values for three residences are (3.5±0.802) for urban area, (3.4±0.784) for peri-urban, (3.5±0.733) for rural areas. Most of the school learners in all the three residences prefer unhealthy/junky food. Based on the results, an exploratory factor analysis was conducted on data to identify and analyse the factors for model development. The findings indicated that there is evidence of low level of physical fitness and high prevalence of excessive weight and obesity among primary school learners, the study, therefore, suggests the development of the behavioural model to enhance physical fitness and prevent or reduce overweight/obesity among school learners.
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Development of health promotion guidelines for weight management among primary health care nurses in the Eastern Cape Province, South Africa
- Authors: Monakali, Sizeka
- Date: 2018
- Subjects: Health promotion Body weight -- Regulation Obesity -- prevention and control
- Language: English
- Type: Thesis , Doctoral , Nursing
- Identifier: http://hdl.handle.net/10353/10006 , vital:35285
- Description: Overweight and obesity have become significant public health threats both globally and in South Africa. PHC professional nurses are first contact to patients and the community as well as key stakeholders in the management and education of obese patients. However, anecdotal evidence seems to question their suitability as good models of the advocated healthy lifestyle behaviours and weight management, as overweight and obesity is also prevalent among the professional nurses. This study examines the prevalence and determinants of overweight and obesity among PHC professional nurses in the Eastern Cape (EC) Province of South Africa. This was a workplace, cross-sectional study involving 203 PHC professional nurses conveniently selected across 41 PHC facilities in EC, South Africa. A WHO STEP wise questionnaire was used to collect demographic and behavioural data. Anthropometric (weight, height and waist circumference [WC]) measurements were taken following a standard protocol. Overweight and obesity was defined as a BMI of 25-29.9kgm-2, and BMI ≥ 30kgm-2, respectively. Seventy six percent of the nurses were obese. An additional 18 percent were overweight. Age, gender, marital status, duration of practice, alcohol use and smoking were significantly associated with obesity. There was no association between physical activity and obesity. After adjusting for confounders, only age more than 30 years (OR=5.2, 95 percentCI=1.6-16.4) and not using alcohol (OR= 4.0 95 percentCI= 1.7-9.1) were significant and independent predictors of obesity among the nurses. In conclusion is an alarmingly high prevalence of obesity among primary healthcare professional nurses in Eastern Cape, South Africa. This shows that PHC professional nurses in EC are not good models of the healthy behaviours, judge be BMI indicator, if they do advocates for healthy weight management to patients. This constitutes a future risk for an increased prevalence of chronic diseases and a handicapped healthcare workforce. There is a need to implement measures to promote healthy lifestyle behaviour and weight management among professional nurses in this setting.
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- Authors: Monakali, Sizeka
- Date: 2018
- Subjects: Health promotion Body weight -- Regulation Obesity -- prevention and control
- Language: English
- Type: Thesis , Doctoral , Nursing
- Identifier: http://hdl.handle.net/10353/10006 , vital:35285
- Description: Overweight and obesity have become significant public health threats both globally and in South Africa. PHC professional nurses are first contact to patients and the community as well as key stakeholders in the management and education of obese patients. However, anecdotal evidence seems to question their suitability as good models of the advocated healthy lifestyle behaviours and weight management, as overweight and obesity is also prevalent among the professional nurses. This study examines the prevalence and determinants of overweight and obesity among PHC professional nurses in the Eastern Cape (EC) Province of South Africa. This was a workplace, cross-sectional study involving 203 PHC professional nurses conveniently selected across 41 PHC facilities in EC, South Africa. A WHO STEP wise questionnaire was used to collect demographic and behavioural data. Anthropometric (weight, height and waist circumference [WC]) measurements were taken following a standard protocol. Overweight and obesity was defined as a BMI of 25-29.9kgm-2, and BMI ≥ 30kgm-2, respectively. Seventy six percent of the nurses were obese. An additional 18 percent were overweight. Age, gender, marital status, duration of practice, alcohol use and smoking were significantly associated with obesity. There was no association between physical activity and obesity. After adjusting for confounders, only age more than 30 years (OR=5.2, 95 percentCI=1.6-16.4) and not using alcohol (OR= 4.0 95 percentCI= 1.7-9.1) were significant and independent predictors of obesity among the nurses. In conclusion is an alarmingly high prevalence of obesity among primary healthcare professional nurses in Eastern Cape, South Africa. This shows that PHC professional nurses in EC are not good models of the healthy behaviours, judge be BMI indicator, if they do advocates for healthy weight management to patients. This constitutes a future risk for an increased prevalence of chronic diseases and a handicapped healthcare workforce. There is a need to implement measures to promote healthy lifestyle behaviour and weight management among professional nurses in this setting.
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Exploring experiences of student nurses regarding the implementation of community-based education at the nursing college in the Eastern Cape
- Authors: Sefatsa, Thenjiwe
- Date: 2018
- Subjects: Community education -- South Africa -- Eastern Cape Nurses -- Education -- South Africa -- Eastern Cape Community development -- South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Masters , Nursing Science
- Identifier: http://hdl.handle.net/10353/10657 , vital:35653
- Description: The aim of the study was to explore the experiences of student nurses regarding the implementation of CBE and allow them to tell their story of how CBE impacted to their academic experience. Purposive non-probability sampling was the method of choice. The following research question guided this study: What are the experiences of nursing students at the nursing college on the implementation of CBE as a teaching-learning strategy? The participants in this study were the fourth year students registered in the four year diploma and have been exposed to CBE, according to regulation 425 of the Nursing Act, 2005(Act No.33 of 2005). Fifty (50) students voluntarily participated in the focus groups discussions. Data analysis was done concurrently with data collection. Data was analysed manually as it was categorised into themes, categories, and subcatagories. For this study, a category system/ template was developed to code the data according to the categories, therefore related concepts were grouped together to facilitate the coding process. The final analysis led to the development of a report presenting the interpretation and presentation of results. RESULTS The study results revealed that students had benefited from CBE as a teaching learning strategy. Furthermore, participants reported that CBE had an impact in their training in terms of acquisition of skills, personal and professional growth and correlation of theory to practice. Discussions of findings, along with recommendations for practice conclude the study. Suggestions might be made to improve ways in the implementation of CBE in the nursing college
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- Authors: Sefatsa, Thenjiwe
- Date: 2018
- Subjects: Community education -- South Africa -- Eastern Cape Nurses -- Education -- South Africa -- Eastern Cape Community development -- South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Masters , Nursing Science
- Identifier: http://hdl.handle.net/10353/10657 , vital:35653
- Description: The aim of the study was to explore the experiences of student nurses regarding the implementation of CBE and allow them to tell their story of how CBE impacted to their academic experience. Purposive non-probability sampling was the method of choice. The following research question guided this study: What are the experiences of nursing students at the nursing college on the implementation of CBE as a teaching-learning strategy? The participants in this study were the fourth year students registered in the four year diploma and have been exposed to CBE, according to regulation 425 of the Nursing Act, 2005(Act No.33 of 2005). Fifty (50) students voluntarily participated in the focus groups discussions. Data analysis was done concurrently with data collection. Data was analysed manually as it was categorised into themes, categories, and subcatagories. For this study, a category system/ template was developed to code the data according to the categories, therefore related concepts were grouped together to facilitate the coding process. The final analysis led to the development of a report presenting the interpretation and presentation of results. RESULTS The study results revealed that students had benefited from CBE as a teaching learning strategy. Furthermore, participants reported that CBE had an impact in their training in terms of acquisition of skills, personal and professional growth and correlation of theory to practice. Discussions of findings, along with recommendations for practice conclude the study. Suggestions might be made to improve ways in the implementation of CBE in the nursing college
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Exploring women's experience of fundal pressure during the second stage of labour
- Authors: Okafor, Uchenna Benedine
- Date: 2018
- Subjects: Labor (Obstetrics) Childbirth
- Language: English
- Type: Thesis , Masters , Magister of Curationis
- Identifier: http://hdl.handle.net/10353/15532 , vital:40424
- Description: Background and Aim: Despite the use of fundal pressure globally, there is a scarcity of information available on how women experience the application of uterine fundal pressure (UFP) during the second stage of labour. The aim of study was to explore the experiences of women concerning UFP application during the second stage of labour. Understanding women’s perception about UFP is important in informing the generation of new ideas to improve on the application of UFP for better outcomes. Methods: This was a qualitative, interpretive, and phenomenological analysis designed to explore the experiences of women regarding the application of UFP during the second stage of labour. Hermeneutics was applied to interpret the participants’ descriptions of their experiences as they tried to make sense of their exposure to UFP; bearing this in mind, the participants’ own interpretation was not distorted. The researcher immersed herself in each transcript, in order to make sense of each participant’s experiences and to gain a sense of what the participant had experienced during UFP application. Each interview was transcribed and analysed independently; and the convergences and divergences of themes were identified without losing the original meaning of each participant’s description before moving on to the subsequent interviews. The target population was women who had had UFP during second stage of labour. A purposive sampling method was used to select three women who were admitted to the DVDHMOU during the research period and who met the inclusion criteria. Information was collected through individual face-to-face interviews and semi-structured interview guide. The principal question was framed as: “Can you please share with me how you felt when the midwives pushed on your tummy to get the baby out”? An audio tape was used to record the interviews, and a notepad was used to make notes of gestures such smiles or other facial expressions. After each interview, the recorded interview was transferred onto a laptop and a file was opened for the interviewee, identified by a pseudonym. The interviews were transcribed verbatim as Word documents. Trustworthiness was maintained by applying the principles of credibility, transferability, dependability and conformability. Ethical approval was granted by the Ethical Committee of the University of Fort Hare. Permission to conduct the study was sought from the Eastern Cape Research Committee and Buffalo City Metropolitan Health District. Informed consent was obtained from the participants prior to data collection. Each interview was analysed separately after completion. Data was analysed using thematic content analysis applicable to interpretative phenomenological analysis (IPA) studies using six steps: reading and re-reading; initial noting; developing emergent themes; searching for connections across the emergent themes; moving to the next case; and lastly, looking for patterns across cases. Findings: The findings of this study indicated that the informants had feelings of fear, loneliness, worry and tearfulness; but also happiness associated with UFP during second stage of labour. They were also worried and expressed fear and anxiety concerning their infants; and their ability to give birth increased as they get tired in the process of pushing during UFP application. However, seeing their infants for the first time took most of the worries away, and all informants expressed relief when the birthing process was over. They also felt that their birthing experience was a very painful event; and were left alone, and they had not been given anything to drink or eat during labour. Midwives threatened them that their inability to pushing appropriately, could cause the death of their infants, leaving them with feelings of guilt and despair when their babies did not cry directly after birth. The findings demonstrated that midwives did not properly inform women what to expect during the second stage of their labour, whilst the midwives expected birthing mothers to know what was happening to them and how to react. Women in labour therefore depended almost entirely on information received from family members, and went into labour with preconceived ideas about labour pain. Although women do experience pain during the second stage of labour, the application UFP increased their pain. Four main themes emerged from the analysis, which are: perceived severity of UFP pain,emotional/physical reaction to UFP pain, perceptions of UFP and perception of midwives care and treatment. Conclusion: The uterine fundal pressure is not a pleasant experience for the women in the second stage of labour. Labouring women experienced pain, fear, and anxiety. However, they felt a sense of happiness after delivery. Before the application of UFP during the second stage of labour, midwives should explain to women the process of UFP application and what they can expect to happen; and where possible, and after explaining the procedure, midwives should get written permission before they apply the intervention during labour.
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- Authors: Okafor, Uchenna Benedine
- Date: 2018
- Subjects: Labor (Obstetrics) Childbirth
- Language: English
- Type: Thesis , Masters , Magister of Curationis
- Identifier: http://hdl.handle.net/10353/15532 , vital:40424
- Description: Background and Aim: Despite the use of fundal pressure globally, there is a scarcity of information available on how women experience the application of uterine fundal pressure (UFP) during the second stage of labour. The aim of study was to explore the experiences of women concerning UFP application during the second stage of labour. Understanding women’s perception about UFP is important in informing the generation of new ideas to improve on the application of UFP for better outcomes. Methods: This was a qualitative, interpretive, and phenomenological analysis designed to explore the experiences of women regarding the application of UFP during the second stage of labour. Hermeneutics was applied to interpret the participants’ descriptions of their experiences as they tried to make sense of their exposure to UFP; bearing this in mind, the participants’ own interpretation was not distorted. The researcher immersed herself in each transcript, in order to make sense of each participant’s experiences and to gain a sense of what the participant had experienced during UFP application. Each interview was transcribed and analysed independently; and the convergences and divergences of themes were identified without losing the original meaning of each participant’s description before moving on to the subsequent interviews. The target population was women who had had UFP during second stage of labour. A purposive sampling method was used to select three women who were admitted to the DVDHMOU during the research period and who met the inclusion criteria. Information was collected through individual face-to-face interviews and semi-structured interview guide. The principal question was framed as: “Can you please share with me how you felt when the midwives pushed on your tummy to get the baby out”? An audio tape was used to record the interviews, and a notepad was used to make notes of gestures such smiles or other facial expressions. After each interview, the recorded interview was transferred onto a laptop and a file was opened for the interviewee, identified by a pseudonym. The interviews were transcribed verbatim as Word documents. Trustworthiness was maintained by applying the principles of credibility, transferability, dependability and conformability. Ethical approval was granted by the Ethical Committee of the University of Fort Hare. Permission to conduct the study was sought from the Eastern Cape Research Committee and Buffalo City Metropolitan Health District. Informed consent was obtained from the participants prior to data collection. Each interview was analysed separately after completion. Data was analysed using thematic content analysis applicable to interpretative phenomenological analysis (IPA) studies using six steps: reading and re-reading; initial noting; developing emergent themes; searching for connections across the emergent themes; moving to the next case; and lastly, looking for patterns across cases. Findings: The findings of this study indicated that the informants had feelings of fear, loneliness, worry and tearfulness; but also happiness associated with UFP during second stage of labour. They were also worried and expressed fear and anxiety concerning their infants; and their ability to give birth increased as they get tired in the process of pushing during UFP application. However, seeing their infants for the first time took most of the worries away, and all informants expressed relief when the birthing process was over. They also felt that their birthing experience was a very painful event; and were left alone, and they had not been given anything to drink or eat during labour. Midwives threatened them that their inability to pushing appropriately, could cause the death of their infants, leaving them with feelings of guilt and despair when their babies did not cry directly after birth. The findings demonstrated that midwives did not properly inform women what to expect during the second stage of their labour, whilst the midwives expected birthing mothers to know what was happening to them and how to react. Women in labour therefore depended almost entirely on information received from family members, and went into labour with preconceived ideas about labour pain. Although women do experience pain during the second stage of labour, the application UFP increased their pain. Four main themes emerged from the analysis, which are: perceived severity of UFP pain,emotional/physical reaction to UFP pain, perceptions of UFP and perception of midwives care and treatment. Conclusion: The uterine fundal pressure is not a pleasant experience for the women in the second stage of labour. Labouring women experienced pain, fear, and anxiety. However, they felt a sense of happiness after delivery. Before the application of UFP during the second stage of labour, midwives should explain to women the process of UFP application and what they can expect to happen; and where possible, and after explaining the procedure, midwives should get written permission before they apply the intervention during labour.
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