Adult circumcision practices of traditional surgeons and nurses in relation to the initiates’ health outcomes/morbidity in the Eastern Cape
- Authors: Dalasa, Siyamthemba
- Date: 2019
- Subjects: Circumcision -- Social aspects
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10353/17029 , vital:40834
- Description: BACKGROUND Despite the adverse outcomes associated with traditional male circumcision, the practice remains prevalent, especially in the Eastern Cape, South, Africa. This study seeks to assess the practices of traditional surgeons and nurses in relation to the prevention and control of infections and their understanding of human physiological mechanisms during circumcision processes. METHOD This study has adopted a qualitative design, which involved conducting 115 semistructured interviews among traditional surgeons, traditional nurses and traditionally circumcised men, and one focus group discussion among traditional nurses. The data generated were transcribed and subjected to thematic content analysis. RESULTS The analysis revealed that both traditional surgeons and nurses demonstrated both poor aseptic techniques and a lack of knowledge of how the human body functions. Their lack of knowledge of basic human physiology meant that they trivialised sepsis in the penile wound. In addition, the seclusion lodges for circumcision and initiates living were unclean and uninhabitable. CONCLUSION The poor aseptic techniques of traditional surgeons and nurses, as well as the uncleanliness of their environment during traditional male circumcision procedures, could expose initiates to infections and morbidity. Environmental health officers should regularly supervise traditional surgeons and nurses in order to prevent the adverse health outcomes associated with the traditional male circumcision practice.
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- Authors: Dalasa, Siyamthemba
- Date: 2019
- Subjects: Circumcision -- Social aspects
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10353/17029 , vital:40834
- Description: BACKGROUND Despite the adverse outcomes associated with traditional male circumcision, the practice remains prevalent, especially in the Eastern Cape, South, Africa. This study seeks to assess the practices of traditional surgeons and nurses in relation to the prevention and control of infections and their understanding of human physiological mechanisms during circumcision processes. METHOD This study has adopted a qualitative design, which involved conducting 115 semistructured interviews among traditional surgeons, traditional nurses and traditionally circumcised men, and one focus group discussion among traditional nurses. The data generated were transcribed and subjected to thematic content analysis. RESULTS The analysis revealed that both traditional surgeons and nurses demonstrated both poor aseptic techniques and a lack of knowledge of how the human body functions. Their lack of knowledge of basic human physiology meant that they trivialised sepsis in the penile wound. In addition, the seclusion lodges for circumcision and initiates living were unclean and uninhabitable. CONCLUSION The poor aseptic techniques of traditional surgeons and nurses, as well as the uncleanliness of their environment during traditional male circumcision procedures, could expose initiates to infections and morbidity. Environmental health officers should regularly supervise traditional surgeons and nurses in order to prevent the adverse health outcomes associated with the traditional male circumcision practice.
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An assessment of school food and nutrition environments for strengthening the integrated school health policy in the Eastern Cape, South Africa
- Authors: Okeyo, Alice Phelgona
- Date: 2019
- Subjects: Nutrition policy -- South Africa -- Eastern Cape School health services -- South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: http://hdl.handle.net/10353/17039 , vital:40836
- Description: The 2012 Integrated School Health Policy (ISHP) offers a framework for adequate school food environment. It aims to contribute to the improvement of the general health of school-going children and to address health barriers to learning in order to improve education outcomes. This study assessed the school food and nutrition environment and critically appraised the position of nutrition within ISHP in order to make recommendations for best practice and promotion of healthy-eating in quintiles 1 – 3 secondary school learners of the Eastern Cape, South Africa. Areas evaluated included the school food environment (National School Food Nutrition Programme, NSNP, tuck-shop, vendor, lunch box, and school vegetable garden); eating practice; nutrition knowledge; and nutrition status. A quantitative and qualitative cross-sectional design was applied in data collection. Data was collected from 1,357 learners at 18 secondary schools in three districts: Buffalo City Metropolitan Municipality, Chris Hani and OR Tambo, using semi-structured questionnaires. Five major food items provided in the school food and nutrition environment included: beans, pap, sour-milk, rice, and samp (maize) (NSNP); chips, sandwich, pap, biscuits, and cake (tuck-shop); chips, sandwich, pap, cake, and pop-corn (vendor); and samp (maize), noodles, fat-cake, chips, and Russian/Viennas (lunch boxes). Only three of the 16 schools had school vegetable gardens which produced vegetables and no fruits. Five most frequently eaten foods for breakfast were porridge, rusks, stiff-pap, bread-with-spread, eggs, and polony. Learners from quintile 3 (60.8percent) significantly ate more cooked porridge than learners from quintiles 1 and 2 (51.9percent) (p = 0.015). Leaners from quintile 3 (59.4percent) significantly ate more brown bread-with-spread than learners from quintiles 1 and 2 (50.4) (p = 0.022). The majority of learners (72.7percent) ate breakfast; more male learners (24.4percent) than female learners (29.1percent) skipped breakfast. The majority (62.2percent) of learners had poor nutritional knowledge; significantly, more male (35percent) than female (27percent) learners had poor nutritional knowledge (p = 0.003). Nutritional knowledge increased with age; significantly more grade 8 learners had poor (42.6percent) nutritional knowledge than grade 12 learners (14.1percent) (p < 0.001). Leaners from quintile 3 had good (23.5percent) nutritional knowledge than learners from quintiles 1 and 2 (15.7percent) (p < 0.001). School lessons, books and television were the most important source for nutritional information to learners. The most significant source was lessons (72.0percent; p < 0.001); followed by television (69.4percent; p < 0.001) and books (67.8percent; p = 0.014), in that ranking order. The majority of learners (64percent) had normal body weight. The prevalence of underweight, overweight and obesity was 13.0percent, 15.0percent and 8.0percent, respectively. The prevalence of overweight and obesity was higher in females than males (21.3percent vs 5.3percent; overweight; p < 0.001)) and (11.6percent vs 1.2percent; obesity; p < 0.001), respectively; while the prevalence in terms of underweight was significantly higher in male (21.3percent) learners than in female learners (8.1percent); p < 0.001. The study indicated that the school food environment was not supported by ISHP. The Integrated School Health Policy did not include on-site package for nutritional assessment, thus, there is need to offer nutritional interventions in schools.
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- Authors: Okeyo, Alice Phelgona
- Date: 2019
- Subjects: Nutrition policy -- South Africa -- Eastern Cape School health services -- South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: http://hdl.handle.net/10353/17039 , vital:40836
- Description: The 2012 Integrated School Health Policy (ISHP) offers a framework for adequate school food environment. It aims to contribute to the improvement of the general health of school-going children and to address health barriers to learning in order to improve education outcomes. This study assessed the school food and nutrition environment and critically appraised the position of nutrition within ISHP in order to make recommendations for best practice and promotion of healthy-eating in quintiles 1 – 3 secondary school learners of the Eastern Cape, South Africa. Areas evaluated included the school food environment (National School Food Nutrition Programme, NSNP, tuck-shop, vendor, lunch box, and school vegetable garden); eating practice; nutrition knowledge; and nutrition status. A quantitative and qualitative cross-sectional design was applied in data collection. Data was collected from 1,357 learners at 18 secondary schools in three districts: Buffalo City Metropolitan Municipality, Chris Hani and OR Tambo, using semi-structured questionnaires. Five major food items provided in the school food and nutrition environment included: beans, pap, sour-milk, rice, and samp (maize) (NSNP); chips, sandwich, pap, biscuits, and cake (tuck-shop); chips, sandwich, pap, cake, and pop-corn (vendor); and samp (maize), noodles, fat-cake, chips, and Russian/Viennas (lunch boxes). Only three of the 16 schools had school vegetable gardens which produced vegetables and no fruits. Five most frequently eaten foods for breakfast were porridge, rusks, stiff-pap, bread-with-spread, eggs, and polony. Learners from quintile 3 (60.8percent) significantly ate more cooked porridge than learners from quintiles 1 and 2 (51.9percent) (p = 0.015). Leaners from quintile 3 (59.4percent) significantly ate more brown bread-with-spread than learners from quintiles 1 and 2 (50.4) (p = 0.022). The majority of learners (72.7percent) ate breakfast; more male learners (24.4percent) than female learners (29.1percent) skipped breakfast. The majority (62.2percent) of learners had poor nutritional knowledge; significantly, more male (35percent) than female (27percent) learners had poor nutritional knowledge (p = 0.003). Nutritional knowledge increased with age; significantly more grade 8 learners had poor (42.6percent) nutritional knowledge than grade 12 learners (14.1percent) (p < 0.001). Leaners from quintile 3 had good (23.5percent) nutritional knowledge than learners from quintiles 1 and 2 (15.7percent) (p < 0.001). School lessons, books and television were the most important source for nutritional information to learners. The most significant source was lessons (72.0percent; p < 0.001); followed by television (69.4percent; p < 0.001) and books (67.8percent; p = 0.014), in that ranking order. The majority of learners (64percent) had normal body weight. The prevalence of underweight, overweight and obesity was 13.0percent, 15.0percent and 8.0percent, respectively. The prevalence of overweight and obesity was higher in females than males (21.3percent vs 5.3percent; overweight; p < 0.001)) and (11.6percent vs 1.2percent; obesity; p < 0.001), respectively; while the prevalence in terms of underweight was significantly higher in male (21.3percent) learners than in female learners (8.1percent); p < 0.001. The study indicated that the school food environment was not supported by ISHP. The Integrated School Health Policy did not include on-site package for nutritional assessment, thus, there is need to offer nutritional interventions in schools.
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Experiences of midwives regarding the use of pharmacological and non-pharmacological labour pain interventions in Lejweleputswa district in Free State
- Parkies, Limakatso Elizabeth
- Authors: Parkies, Limakatso Elizabeth
- Date: 2019
- Subjects: Anesthesia in obstetrics , Labor (Obstetrics) , Pain -- Treatment
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/27187 , vital:66387
- Description: Due to the disabling effects of severe labour pains, labour pain management remains an important topic in midwifery and needs to be reviewed more often. According to studies, various pain relief options, both pharmacological and non-pharmacological, are available to help women cope with pain, but midwives did not employ these techniques adequately because of various experiences. Studies further indicate that, though the limited number of these techniques were employed they were not effective on some women. Thus, the purpose of this research study was to explore and describe midwives’ experiences on pharmacological and non-pharmacological labour pain management in the Lejweleputswa District of the Free State Province. This study employed a qualitative, descriptive, explorative, and contextual design. A purposive sampling technique was used to select the participants. The target population was midwives who work in the maternity wards of the institutions under study with three to five years’ experience in midwifery. Individual, face-face, semi-structured interviews were conducted; these were recorded for the researcher’s reference purposes, so as not to overlook important information. In addition, the researcher made use of field notes, recording in them what was heard, observed, felt, experienced, and thought during the interview. Ethical principles and trustworthiness were maintained throughout this study. Data analysis was done using Tesch’s approach to open coding in qualitative research. Confidentiality and anonymity were ensured throughout the interviews. The nine themes and 19 sub-themes that emerged during data analysis were discussed comprehensively. The findings indicate that midwives use both pharmacological and non-pharmacological methods in managing labour pain. Some methods are effective in relieving pain for certain mothers, while other methods proved ineffective. Midwives administer Pethidine and Phenergan as per doctors’ prescription; non-pharmacological methods, such as back massage, deep breathing exercises, mobilisation, and warm baths or showers are also employed. Midwives provide pharmacological methods to all women in labour, and routinely employ non-pharmacological methods. Although the midwives are willing to manage patients’ pain, they face certain challenges, such as shortage of staff, increased workload, as well as inadequate resources. This leads to inadequate provision of non-pharmacological care. In conclusion, the midwives’ experiences were that both pharmacological and non-pharmacological techniques were used for all labouring women and they had relaxing and calming effects on some women, resulting to them giving birth with ease, although for some they were not effective. In addition, the pharmacological interventions caused drowsiness to some women and babies. The findings will provide evidence-based information to the Free State Department of Health in order to assist policymakers and stakeholders in initiating and developing appropriate policies, guidelines, and interventions that can improve labour pain management. The Free State Department of Health should consider using other opioids and non-opioids in managing labour pain to broaden the scope of pain relief methods available to the midwives. , Thesis (MPH) -- Faculty of Health Sciences, 2019
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- Authors: Parkies, Limakatso Elizabeth
- Date: 2019
- Subjects: Anesthesia in obstetrics , Labor (Obstetrics) , Pain -- Treatment
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/27187 , vital:66387
- Description: Due to the disabling effects of severe labour pains, labour pain management remains an important topic in midwifery and needs to be reviewed more often. According to studies, various pain relief options, both pharmacological and non-pharmacological, are available to help women cope with pain, but midwives did not employ these techniques adequately because of various experiences. Studies further indicate that, though the limited number of these techniques were employed they were not effective on some women. Thus, the purpose of this research study was to explore and describe midwives’ experiences on pharmacological and non-pharmacological labour pain management in the Lejweleputswa District of the Free State Province. This study employed a qualitative, descriptive, explorative, and contextual design. A purposive sampling technique was used to select the participants. The target population was midwives who work in the maternity wards of the institutions under study with three to five years’ experience in midwifery. Individual, face-face, semi-structured interviews were conducted; these were recorded for the researcher’s reference purposes, so as not to overlook important information. In addition, the researcher made use of field notes, recording in them what was heard, observed, felt, experienced, and thought during the interview. Ethical principles and trustworthiness were maintained throughout this study. Data analysis was done using Tesch’s approach to open coding in qualitative research. Confidentiality and anonymity were ensured throughout the interviews. The nine themes and 19 sub-themes that emerged during data analysis were discussed comprehensively. The findings indicate that midwives use both pharmacological and non-pharmacological methods in managing labour pain. Some methods are effective in relieving pain for certain mothers, while other methods proved ineffective. Midwives administer Pethidine and Phenergan as per doctors’ prescription; non-pharmacological methods, such as back massage, deep breathing exercises, mobilisation, and warm baths or showers are also employed. Midwives provide pharmacological methods to all women in labour, and routinely employ non-pharmacological methods. Although the midwives are willing to manage patients’ pain, they face certain challenges, such as shortage of staff, increased workload, as well as inadequate resources. This leads to inadequate provision of non-pharmacological care. In conclusion, the midwives’ experiences were that both pharmacological and non-pharmacological techniques were used for all labouring women and they had relaxing and calming effects on some women, resulting to them giving birth with ease, although for some they were not effective. In addition, the pharmacological interventions caused drowsiness to some women and babies. The findings will provide evidence-based information to the Free State Department of Health in order to assist policymakers and stakeholders in initiating and developing appropriate policies, guidelines, and interventions that can improve labour pain management. The Free State Department of Health should consider using other opioids and non-opioids in managing labour pain to broaden the scope of pain relief methods available to the midwives. , Thesis (MPH) -- Faculty of Health Sciences, 2019
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