Development of a strategy to promote prenatal physical activity participation among women in Buffalo City Municipality, South Africa
- Okafor, Uchenna Benedine https://orcid.org/0000-0002-0435-2041
- Authors: Okafor, Uchenna Benedine https://orcid.org/0000-0002-0435-2041
- Date: 2022-03
- Subjects: Prenatal care , Exercise for pregnant women
- Language: English
- Type: Doctoral theses , text
- Identifier: http://hdl.handle.net/10353/22919 , vital:53218
- Description: Research has proven that prenatal physical activity practice is associated with multiple health benefits; however, most women in South Africa rarely participate in prenatal physical activity. In contrast to more developed countries, there is dearth of research focusing specifically on prenatal physical activity and exercise among South African women. Nevertheless, in order to effectively, and strategically promote such prenatal activity, such information is important to plan for an intervention strategy. The main aim of this study was to assess the level, patterns, and associated factors of prenatal physical activity; beliefs, knowledge, attitudes, perceived benefits, and sources of information women received during pregnancy; and, furthermore, to develop an effective and relevant intervention strategy to facilitate the participation in this particular activity in Buffalo City Municipality, Eastern Cape, South Africa. Methods The study was a mixed-method, cross-sectional study design with both quantitative and qualitative data collection and analyses. The sequential explanatory design was adopted to merge and mix different datasets to be collected and analysed. The quantitative data involved a convenient sample of 1082 pregnant women in 12 randomly selected primary healthcare clinics offering antenatal health services in Buffalo City, Eastern Cape. The Pregnancy Physical Activity Questionnaire was interviewer-administered to women at each antenatal health clinic on pre-specified days, in a designated room allocated to the primary researcher by the health facility manager. The descriptive statistics were frequency distribution, percentages, mean and standard deviation. Furthermore, the bivariate and multivariate analyses were performed on two categories of participants, namely inactive or active, to determine the factors affecting prenatal physical activity behaviour. Furthermore, multiple logistic regression analyses were used to assess associations between physical activity and the predictor variables during pregnancy. Adjusted odds ratios with 95% confidence interval were applied to estimate factors associated with physical activity levels, and the associations between prenatal physical activity levels and socio-demographic, lifestyle, and obstetrics characteristics were determined using a chi-squared analyses. The significance level was set at p = 0.05. In addition, a qualitative descriptive approach was applied, using semi-structured face-to-face interviews with 15 purposively selected pregnant women, as well as 17 midwives offering antenatal health-care services to pregnant women in the 12 selected healthcare clinics. Qualitative data were analysed using a thematic content analysis. To develop the physical activity strategy for the promotion of prenatal physical activity practice, three frameworks were applied, namely the Strength, Weakness, Opportunity and Threat (SWOT), the Political, Economic Growth, Socio-Cultural, Technological, Laws and Environmental (PESTLE), and, lastly, the Build, Overcome, Explore and Minimise (BOEM) analytical frameworks. To facilitate the validation of the strategy, the findings were additionally analysed, after which, appropriate intervention strategies promoting prenatal physical activity were developed by again using the SWOT and PESTLE analytical strategic frameworks. This process involved a purposive sampling of seven experts with knowledge of and a proven academic and scholarly background in prenatal physical activity and maternal health. Next, the developed physical activity strategy was presented to various stakeholders, which included six primary healthcare managers, two midwives, and pregnant women purposively selected in each of the 12 chosen antenatal health clinics for the validation process. The stakeholders discussed, deliberated on, and provided comments and opinions of the feasibility and implementation of the developed prenatal physical activity for promotion of physical activity practices in the Eastern Cape Province. Results The findings of this particular study demonstrated low levels of prenatal physical activity among pregnant women, and, further indicated that the most preferred form of activity was light-intensity and household activities. Only 278 of the women (25.7%) met recommendations for prenatal activity (≥150 min moderate intensity exercise per week). The average time spent in moderate–vigorous physical activity was 151.6 min (95% CI: 147.2– 156.0). Most of the women participated in light exercises with a mean of 65.9% (95% CI: 64.8–67.0), and 47.6% (95% CI: 46.3–48.9) participated in household activities. The majority of the women did not receive physical activity advice during prenatal care sessions (64.7%). Lower age (<19 years) (adjusted odd ratio (AOR) = 0.3; CI: 0.16–0.76), semi-urban residence (AOR = 0.8; CI: 0.55–1.03), lower educational level (AOR = 0.5; CI: 0.20–0.71), unemployment (AOR = 0.5; CI: 0.29–0.77) and nulliparity (AOR = 0.6; CI: 0.28–1.31) were negatively associated with prenatal physical activity, while prenatal physical activity was positively associated with starting physical activity in the first trimester (AOR = 1.9; CI: 1.06–3.31) compared to other trimesters. In addition, the pregnant women were aware of the safety (88.2%) and benefits of physical activity for both mother and baby (79.6%), improved labour and delivery (93.1%), promote energy (89.0%), and should be discontinued when tired (76.6%). However, they also held the contradictory belief that pregnancy is “a time to rest” (56.5%). Furthermore, the most common sources of information about prenatal physical activity were the media, television, the radio and Internet-based websites (70.2%). Most women affirmed that prenatal physical activity reduced infant weight (61.4%), lessen moodiness (90.4), decreased risk of gestational diabetes mellitus (92.9%), pregnancy-induced hypertension (92.5%), and complications at birth (97.8%), while common negative perceptions included musculoskeletal discomfort (82.7%), and back pain (85.7%). The majority of women indicated that prenatal physical activity improved self-image (95.7%), sleep patterns (94.2%), and respiratory function (95.8%). The results from the quantitative data revealed that the major modifiable barriers to prenatal physical activity were tiredness (73.3%), lack of advice from healthcare professionals (nurses/midwives) (64.7%), low energy (64.5%), and non-accessibility to physical activity facilities (63.0%). The results were confirmed in the qualitative data, based on the Ecological Model, in which women also mentioned tiredness, work and household responsibilities, a lack of motivation, and the lack of physical activity advice and information on the relevant recommendations and guidelines. Overall, 62.4% women had high knowledge regarding prenatal physical activity; and half of the women showed a positive attitude toward it (50.1%). Whilst participants had knowledge of other types of antenatal exercises, 80.9% of the women had no knowledge of swimming exercise. Negative attitudes towards physical activity included the feeling of tiredness (67.7%), lack of interest (64.8%), and inadequate information on physical activity (59.5%). In addition, the study highlighted that midwives rarely educate and counsel pregnant women about prenatal physical activity during scheduled antenatal visits, which was attributed largely to the shortage of midwives handling many responsibilities at clinics. Nevertheless, the midwives did express a willingness to provide effective physical activity education and counselling on prenatal physical activity, if supported by relevant training and workshops. Furthermore, they further recommended the use of the Mom Connect application, which is a technological device designed by the National Department of Health, to distribute relevant information about maternal and child health. The prenatal physical activity strategies developed to address the above-mentioned and other barriers associated with prenatal physical activity include the use of scientific and technological innovations to provide basic information on prenatal physical activity to pregnant women by means of Mom Connect, and, by collaborating with the various cellphone and network companies in South Africa. Another strategy was to integrate prenatal physical activity training into the curricula of the existing higher institutions of learning that provide teaching of maternal health in the Eastern Cape Province. Additional strategies included the documentation and subsequent clarification of misconceptions about the safety concerns often associated with prenatal physical activity by making the documents accessible to all women at the clinics in the form of a small pamphlet or booklet. Lastly, stakeholders suggested that the government offer periodic prenatal physical activity campaigns, which should be presented in local community town halls and clinics and by other stakeholders to address the current lack of awareness and effectively eliminate misrepresentations and falsehoods around the safety of prenatal physical activity within geographical setting of the Eastern Cape Province. Conclusion Despite the advantages of prenatal physical activity practices, most pregnant women in South Africa do not participate in moderate-intensity physical activity. Notably, while women perceive prenatal physical activity as beneficial to both mother and baby, such theoretical knowledge is not easily translatable into practice. The predominant sources of information on prenatal physical activity are the television, the radio, and other media, which may be potentially misleading or contradictory to evidence-based physical activity practice. Furthermore, tiredness, a lack of time, work and household responsibilities, and a lack of motivation were major modifiable barriers to prenatal physical activity by the women. In addition, pregnant women rarely receive information on prenatal physical activity. Consequently, to address the needs of the pregnant women as highlighted in this study, a prenatal physical activity intervention strategy was developed and validated by key stakeholders to promote prenatal physical activity and exercise practice among women, taken in account the local context. , Thesis (PhD) -- Faculty of Health Sciences, 2022
- Full Text:
- Authors: Okafor, Uchenna Benedine https://orcid.org/0000-0002-0435-2041
- Date: 2022-03
- Subjects: Prenatal care , Exercise for pregnant women
- Language: English
- Type: Doctoral theses , text
- Identifier: http://hdl.handle.net/10353/22919 , vital:53218
- Description: Research has proven that prenatal physical activity practice is associated with multiple health benefits; however, most women in South Africa rarely participate in prenatal physical activity. In contrast to more developed countries, there is dearth of research focusing specifically on prenatal physical activity and exercise among South African women. Nevertheless, in order to effectively, and strategically promote such prenatal activity, such information is important to plan for an intervention strategy. The main aim of this study was to assess the level, patterns, and associated factors of prenatal physical activity; beliefs, knowledge, attitudes, perceived benefits, and sources of information women received during pregnancy; and, furthermore, to develop an effective and relevant intervention strategy to facilitate the participation in this particular activity in Buffalo City Municipality, Eastern Cape, South Africa. Methods The study was a mixed-method, cross-sectional study design with both quantitative and qualitative data collection and analyses. The sequential explanatory design was adopted to merge and mix different datasets to be collected and analysed. The quantitative data involved a convenient sample of 1082 pregnant women in 12 randomly selected primary healthcare clinics offering antenatal health services in Buffalo City, Eastern Cape. The Pregnancy Physical Activity Questionnaire was interviewer-administered to women at each antenatal health clinic on pre-specified days, in a designated room allocated to the primary researcher by the health facility manager. The descriptive statistics were frequency distribution, percentages, mean and standard deviation. Furthermore, the bivariate and multivariate analyses were performed on two categories of participants, namely inactive or active, to determine the factors affecting prenatal physical activity behaviour. Furthermore, multiple logistic regression analyses were used to assess associations between physical activity and the predictor variables during pregnancy. Adjusted odds ratios with 95% confidence interval were applied to estimate factors associated with physical activity levels, and the associations between prenatal physical activity levels and socio-demographic, lifestyle, and obstetrics characteristics were determined using a chi-squared analyses. The significance level was set at p = 0.05. In addition, a qualitative descriptive approach was applied, using semi-structured face-to-face interviews with 15 purposively selected pregnant women, as well as 17 midwives offering antenatal health-care services to pregnant women in the 12 selected healthcare clinics. Qualitative data were analysed using a thematic content analysis. To develop the physical activity strategy for the promotion of prenatal physical activity practice, three frameworks were applied, namely the Strength, Weakness, Opportunity and Threat (SWOT), the Political, Economic Growth, Socio-Cultural, Technological, Laws and Environmental (PESTLE), and, lastly, the Build, Overcome, Explore and Minimise (BOEM) analytical frameworks. To facilitate the validation of the strategy, the findings were additionally analysed, after which, appropriate intervention strategies promoting prenatal physical activity were developed by again using the SWOT and PESTLE analytical strategic frameworks. This process involved a purposive sampling of seven experts with knowledge of and a proven academic and scholarly background in prenatal physical activity and maternal health. Next, the developed physical activity strategy was presented to various stakeholders, which included six primary healthcare managers, two midwives, and pregnant women purposively selected in each of the 12 chosen antenatal health clinics for the validation process. The stakeholders discussed, deliberated on, and provided comments and opinions of the feasibility and implementation of the developed prenatal physical activity for promotion of physical activity practices in the Eastern Cape Province. Results The findings of this particular study demonstrated low levels of prenatal physical activity among pregnant women, and, further indicated that the most preferred form of activity was light-intensity and household activities. Only 278 of the women (25.7%) met recommendations for prenatal activity (≥150 min moderate intensity exercise per week). The average time spent in moderate–vigorous physical activity was 151.6 min (95% CI: 147.2– 156.0). Most of the women participated in light exercises with a mean of 65.9% (95% CI: 64.8–67.0), and 47.6% (95% CI: 46.3–48.9) participated in household activities. The majority of the women did not receive physical activity advice during prenatal care sessions (64.7%). Lower age (<19 years) (adjusted odd ratio (AOR) = 0.3; CI: 0.16–0.76), semi-urban residence (AOR = 0.8; CI: 0.55–1.03), lower educational level (AOR = 0.5; CI: 0.20–0.71), unemployment (AOR = 0.5; CI: 0.29–0.77) and nulliparity (AOR = 0.6; CI: 0.28–1.31) were negatively associated with prenatal physical activity, while prenatal physical activity was positively associated with starting physical activity in the first trimester (AOR = 1.9; CI: 1.06–3.31) compared to other trimesters. In addition, the pregnant women were aware of the safety (88.2%) and benefits of physical activity for both mother and baby (79.6%), improved labour and delivery (93.1%), promote energy (89.0%), and should be discontinued when tired (76.6%). However, they also held the contradictory belief that pregnancy is “a time to rest” (56.5%). Furthermore, the most common sources of information about prenatal physical activity were the media, television, the radio and Internet-based websites (70.2%). Most women affirmed that prenatal physical activity reduced infant weight (61.4%), lessen moodiness (90.4), decreased risk of gestational diabetes mellitus (92.9%), pregnancy-induced hypertension (92.5%), and complications at birth (97.8%), while common negative perceptions included musculoskeletal discomfort (82.7%), and back pain (85.7%). The majority of women indicated that prenatal physical activity improved self-image (95.7%), sleep patterns (94.2%), and respiratory function (95.8%). The results from the quantitative data revealed that the major modifiable barriers to prenatal physical activity were tiredness (73.3%), lack of advice from healthcare professionals (nurses/midwives) (64.7%), low energy (64.5%), and non-accessibility to physical activity facilities (63.0%). The results were confirmed in the qualitative data, based on the Ecological Model, in which women also mentioned tiredness, work and household responsibilities, a lack of motivation, and the lack of physical activity advice and information on the relevant recommendations and guidelines. Overall, 62.4% women had high knowledge regarding prenatal physical activity; and half of the women showed a positive attitude toward it (50.1%). Whilst participants had knowledge of other types of antenatal exercises, 80.9% of the women had no knowledge of swimming exercise. Negative attitudes towards physical activity included the feeling of tiredness (67.7%), lack of interest (64.8%), and inadequate information on physical activity (59.5%). In addition, the study highlighted that midwives rarely educate and counsel pregnant women about prenatal physical activity during scheduled antenatal visits, which was attributed largely to the shortage of midwives handling many responsibilities at clinics. Nevertheless, the midwives did express a willingness to provide effective physical activity education and counselling on prenatal physical activity, if supported by relevant training and workshops. Furthermore, they further recommended the use of the Mom Connect application, which is a technological device designed by the National Department of Health, to distribute relevant information about maternal and child health. The prenatal physical activity strategies developed to address the above-mentioned and other barriers associated with prenatal physical activity include the use of scientific and technological innovations to provide basic information on prenatal physical activity to pregnant women by means of Mom Connect, and, by collaborating with the various cellphone and network companies in South Africa. Another strategy was to integrate prenatal physical activity training into the curricula of the existing higher institutions of learning that provide teaching of maternal health in the Eastern Cape Province. Additional strategies included the documentation and subsequent clarification of misconceptions about the safety concerns often associated with prenatal physical activity by making the documents accessible to all women at the clinics in the form of a small pamphlet or booklet. Lastly, stakeholders suggested that the government offer periodic prenatal physical activity campaigns, which should be presented in local community town halls and clinics and by other stakeholders to address the current lack of awareness and effectively eliminate misrepresentations and falsehoods around the safety of prenatal physical activity within geographical setting of the Eastern Cape Province. Conclusion Despite the advantages of prenatal physical activity practices, most pregnant women in South Africa do not participate in moderate-intensity physical activity. Notably, while women perceive prenatal physical activity as beneficial to both mother and baby, such theoretical knowledge is not easily translatable into practice. The predominant sources of information on prenatal physical activity are the television, the radio, and other media, which may be potentially misleading or contradictory to evidence-based physical activity practice. Furthermore, tiredness, a lack of time, work and household responsibilities, and a lack of motivation were major modifiable barriers to prenatal physical activity by the women. In addition, pregnant women rarely receive information on prenatal physical activity. Consequently, to address the needs of the pregnant women as highlighted in this study, a prenatal physical activity intervention strategy was developed and validated by key stakeholders to promote prenatal physical activity and exercise practice among women, taken in account the local context. , Thesis (PhD) -- Faculty of Health Sciences, 2022
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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: 2022-03
- Subjects: Pharmacology , Anesthesia in obstetrics
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/23567 , vital:58166
- 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, 2022
- Full Text:
- Authors: Parkies, Limakatso Elizabeth
- Date: 2022-03
- Subjects: Pharmacology , Anesthesia in obstetrics
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/23567 , vital:58166
- 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, 2022
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Exploration of the factors influencing the upscaling of medical male circumcision targets in selected hospitals in eThekwini District, South Africa
- Authors: Tshabalala, Sandile Clement
- Date: 2022-03
- Subjects: Circumcision
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/22005 , vital:51930
- Description: Medical male circumcision has been shown to reduce female to male HIV transmission. This study was designed to examine the underlying factors responsible for, or influencing, the inability of the health care system to achieve the MMC targets in selected hospitals in KZN. The objective of this study to was explore the challenges that lead to failure of the government to meet set targets, regarding the implementation of the MMC programme in the province of KZN, as perceived by the health care workers. Methodology A mixed quantitative and qualitative study where 150 questionnaires were used and in-depth open-ended interviews were conducted. Participants were from Clairwood and Wentworth hospitals in the district of eThekwini, KwaZulu-Natal. Eighteen healthcare workers (nurse managers, doctors, nurses and counsellors) were purposively selected from the two hospitals. Results Findings showed that poor marketing of MMC, in line with the cultural and religious inclination of the catchment populations, had an effect on the targets. The fear of pain by the male clients came out as the biggest factor followed by the fear of having an HIV test done. The six weeks healing period before indulgence in sexual intercourse had a part to play in the reluctance of clients to do MMC. Some clients feared losing the ability to have an erection post MMC and would therefore not come for MMC. Other contributory factors for failure to reach targets included shortage of staff, poor mobilisation by the staff due to lack of training on how to mobilise and how to market MMC, lack of availability of mobilisation and marketing resources, inadequate and inequitable allocated of resources. Other factors include, lack of incentives for staff to stay in the programme or even within the Department, lack of training, cultural and religious beliefs in the community. The staff also felt that the MMC targets were too high. Notwithstanding, the staff members were willing to learn how to market MMC and to mobilise clients. Clients and community education on the importance of MMC and the combination of this process with good sexual behaviour would improve MMC uptake and reduce HIV prevalence and the incidence. Conclusions The fear of pain, fear to do HIV test and the fear to loose erection were the most prominent reasons why the males would not come for MMC procedure. , Thesis (MPH) -- Faculty of Health Sciences, Public Health, 2022
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- Authors: Tshabalala, Sandile Clement
- Date: 2022-03
- Subjects: Circumcision
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/22005 , vital:51930
- Description: Medical male circumcision has been shown to reduce female to male HIV transmission. This study was designed to examine the underlying factors responsible for, or influencing, the inability of the health care system to achieve the MMC targets in selected hospitals in KZN. The objective of this study to was explore the challenges that lead to failure of the government to meet set targets, regarding the implementation of the MMC programme in the province of KZN, as perceived by the health care workers. Methodology A mixed quantitative and qualitative study where 150 questionnaires were used and in-depth open-ended interviews were conducted. Participants were from Clairwood and Wentworth hospitals in the district of eThekwini, KwaZulu-Natal. Eighteen healthcare workers (nurse managers, doctors, nurses and counsellors) were purposively selected from the two hospitals. Results Findings showed that poor marketing of MMC, in line with the cultural and religious inclination of the catchment populations, had an effect on the targets. The fear of pain by the male clients came out as the biggest factor followed by the fear of having an HIV test done. The six weeks healing period before indulgence in sexual intercourse had a part to play in the reluctance of clients to do MMC. Some clients feared losing the ability to have an erection post MMC and would therefore not come for MMC. Other contributory factors for failure to reach targets included shortage of staff, poor mobilisation by the staff due to lack of training on how to mobilise and how to market MMC, lack of availability of mobilisation and marketing resources, inadequate and inequitable allocated of resources. Other factors include, lack of incentives for staff to stay in the programme or even within the Department, lack of training, cultural and religious beliefs in the community. The staff also felt that the MMC targets were too high. Notwithstanding, the staff members were willing to learn how to market MMC and to mobilise clients. Clients and community education on the importance of MMC and the combination of this process with good sexual behaviour would improve MMC uptake and reduce HIV prevalence and the incidence. Conclusions The fear of pain, fear to do HIV test and the fear to loose erection were the most prominent reasons why the males would not come for MMC procedure. , Thesis (MPH) -- Faculty of Health Sciences, Public Health, 2022
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The contribution of efficient financial management on public health service delivery at King Cetshwayo District in KwaZulu Natal
- Authors: Msane, Sihlesabambo Londiwe
- Date: 2022-03
- Subjects: Public health -- Finance
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/21882 , vital:51839
- Description: The aim of this research is to develop strategies that the DOH could put into place to improve its internal controls in financial management in order to contribute towards service delivery at Ngwelezane, Queen Nandi and Eshowe hospitals within King Cetshwayo District. The study used a mix of qualitative and quantitative study methods, however using one research instrument to collect both qualitative and quantitative data from 37 financial managers in these three hospitals. Data analysis using content analysis (of qualitative data) and percentage frequency analysis (of quantitative date) yielded study findings. This study found that financial managers are fairly competent regarding ‘effective communication’, ‘team work’, and ‘financial leadership’; the study results did not show respondents’ clear comprehension of Auditor General findings and processes followed to implement the recommendations in order to assess internal controls; and findings also indicate that financial managers meet objectives of financial management through cash flow, budget forecasts and expenditure. Developing a framework that will guide and monitor the application of financial strategies with the aim of improving service delivery will involve enhancing financial managers’ knowledge of District and Institution Service Delivery Plans, allocating resources properly and efficiently during the budgeting exercise, establishing internal strategies to maximise accountability and transparency, having fraud prevention strategies in these institution, and putting measures in place to be able to forecast budgetary adverse. It is recommended that the Executive Management facilitates strategic break-away sessions for the financial managers to workshop them on practical ways to improve the efficiency of financial management on public health service delivery, as outlined in this study. , Thesis (MPH) -- Faculty of Health Sciences, 2022
- Full Text:
- Authors: Msane, Sihlesabambo Londiwe
- Date: 2022-03
- Subjects: Public health -- Finance
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/21882 , vital:51839
- Description: The aim of this research is to develop strategies that the DOH could put into place to improve its internal controls in financial management in order to contribute towards service delivery at Ngwelezane, Queen Nandi and Eshowe hospitals within King Cetshwayo District. The study used a mix of qualitative and quantitative study methods, however using one research instrument to collect both qualitative and quantitative data from 37 financial managers in these three hospitals. Data analysis using content analysis (of qualitative data) and percentage frequency analysis (of quantitative date) yielded study findings. This study found that financial managers are fairly competent regarding ‘effective communication’, ‘team work’, and ‘financial leadership’; the study results did not show respondents’ clear comprehension of Auditor General findings and processes followed to implement the recommendations in order to assess internal controls; and findings also indicate that financial managers meet objectives of financial management through cash flow, budget forecasts and expenditure. Developing a framework that will guide and monitor the application of financial strategies with the aim of improving service delivery will involve enhancing financial managers’ knowledge of District and Institution Service Delivery Plans, allocating resources properly and efficiently during the budgeting exercise, establishing internal strategies to maximise accountability and transparency, having fraud prevention strategies in these institution, and putting measures in place to be able to forecast budgetary adverse. It is recommended that the Executive Management facilitates strategic break-away sessions for the financial managers to workshop them on practical ways to improve the efficiency of financial management on public health service delivery, as outlined in this study. , Thesis (MPH) -- Faculty of Health Sciences, 2022
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Causes of high staff-turnover amongst professional nurses at selected health facilities in Kwazulu-Natal Province
- Mabaso, Sindisiwe Carol Catherine
- Authors: Mabaso, Sindisiwe Carol Catherine
- Date: 2022-02
- Subjects: Primary health care -- South Africa -- KwaZulu-Natal , Labor turnover -- South Africa -- KwaZulu-Natal
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/21838 , vital:51822
- Description: BACKGROUND: Staff turnover, defined as the total separations from employment, is expensive, can result in lost capacity, and can limit local health departments’ ability to respond to public health needs. Despite the importance of workforce capacity in public health, little is known about workforce turnover in local health departments. This study sought to determine the causes of high staff-turnover amongst professional nurses at selected health facilities in KwaZulu-Natal province and to identify corrective measures. Professional nurses are a critical staff category in any health organisation and make up the backbone of health care system. It is thus vital to ensure that this category is retained for the benefit of health services and its ultimate beneficiary, the patient. Furthermore, Personnel and Salaries System (PERSAL) statistics have shown that the hospitals selected for this study viz., Nkandla Local Municipality (LM) has more that two times (28%) the turnover rates (TORs) for PNs when compared to the district target of 11%, thus the decision to conduct this study at this particular municipality. METHODOLOGY: This research adopted a mixed methods retrospective study where both quantitative and qualitative approach was used to analyse data. The primary data source was the Exit Interview forms completed when a staff member resigns. It consists of three sections viz., section one contained demographics of each respondent with variables such as name PERSAL number, gender, rank, appointment and termination dates; section two contained closed ended statements on potential causes of termination where the respondent answered yes or no to statements such as offered senior position; and section three which was mostly qualitative information where respondents stated own additional views and comments regarding other causes of termination and recommended solutions. Both sections one and two were analysed using quantitative analysis while section three was analysed using qualitative analysis. Qualitative data from comments sections of the exit interview forms was thematically presented and analysed. These results were grouped into five themes namely; Career Progression, Management, Unacceptable or Poor Conditions of Service, Remuneration and Personal Issues. These previously completed exit interview forms were manually analysed in order to determine the causes of high staff-turnover amongst professional nurses at selected health facilities in KwaZulu-Natal province, during the period 2015-2016. Exit interview forms, previously completed by professional nurses for the period 2015 to 2016, were collected from both Nkandla LM district hospitals namely Ekombe and Nkandla. A self-designed spread sheet was used to collate the quantitative data from the exit interview forms which contained personal and demographic data (names, gender, PERSAL numbers, appointment and termination dates, rank, etc.), type of exit, and causes of exit, comments and proposed changes, following which it was manually analysed. RESULTS: A total of 54 participants completed the exit interview forms and selected the causes of service termination which were relevant to them. Ekombe Hospital participants were twelve (12) and Nkandla Hospital participants were forty two (42). Not all professional nurses who exited the service during the study period completed the exit interview form. The exit interview form completion rate was 78% (54/69). Twenty-four percent (13/54) of participants did not complete the exit interview form in full. The quantitative analysis revealed that the gender distribution of participants was mostly female, making 80% (43/54). The majority of participants, 30% (16/54), had 21-25 years’ service prior to exiting. On qualitative data analysis, the majority of participants selected unacceptable or poor conditions of service as the cause of service termination 65% (35/54) participants. This trend was also similar when each hospital participants’ selections were examined. In Ekombe Hospital 83% (10/12) participants’ selected unacceptable or poor conditions of service as the cause of service termination and in Nkandla Hospital this was 60% (25/42) participants. The majority of participants, 78% (42/54), stated that they still intended to re-join the department, and most were seeking employment in the public service. Furthermore, 70% (38/54), of the participants stated they would have stayed had their expectations been met. Further examination of themes and sub-themes derived from the qualitative data of the exit interview forms, the majority of comments, (20 comments), were related to Unacceptable or Poor Conditions of Service as the cause of termination. Sub themes analysis further identified resource shortages as the most common comments related to this determination. CONCLUSION: The leading causes of high staff-turnover amongst professional nurses at selected health facilities in KwaZulu-Natal province was determined to be unacceptable or poor conditions of service. On thematic analysis of qualitative data that emerged from the exit interview forms, the key areas that contributed to this determination included mainly resource constraints issues such as shortage of staff, shortage of equipment, shortage of funds, as well as poor infrastructure. Recommendations for staff retention and improvements in service conditions have been proposed. , Thesis (MPH) -- Faculty of Health Sciences, 2022
- Full Text:
- Authors: Mabaso, Sindisiwe Carol Catherine
- Date: 2022-02
- Subjects: Primary health care -- South Africa -- KwaZulu-Natal , Labor turnover -- South Africa -- KwaZulu-Natal
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/21838 , vital:51822
- Description: BACKGROUND: Staff turnover, defined as the total separations from employment, is expensive, can result in lost capacity, and can limit local health departments’ ability to respond to public health needs. Despite the importance of workforce capacity in public health, little is known about workforce turnover in local health departments. This study sought to determine the causes of high staff-turnover amongst professional nurses at selected health facilities in KwaZulu-Natal province and to identify corrective measures. Professional nurses are a critical staff category in any health organisation and make up the backbone of health care system. It is thus vital to ensure that this category is retained for the benefit of health services and its ultimate beneficiary, the patient. Furthermore, Personnel and Salaries System (PERSAL) statistics have shown that the hospitals selected for this study viz., Nkandla Local Municipality (LM) has more that two times (28%) the turnover rates (TORs) for PNs when compared to the district target of 11%, thus the decision to conduct this study at this particular municipality. METHODOLOGY: This research adopted a mixed methods retrospective study where both quantitative and qualitative approach was used to analyse data. The primary data source was the Exit Interview forms completed when a staff member resigns. It consists of three sections viz., section one contained demographics of each respondent with variables such as name PERSAL number, gender, rank, appointment and termination dates; section two contained closed ended statements on potential causes of termination where the respondent answered yes or no to statements such as offered senior position; and section three which was mostly qualitative information where respondents stated own additional views and comments regarding other causes of termination and recommended solutions. Both sections one and two were analysed using quantitative analysis while section three was analysed using qualitative analysis. Qualitative data from comments sections of the exit interview forms was thematically presented and analysed. These results were grouped into five themes namely; Career Progression, Management, Unacceptable or Poor Conditions of Service, Remuneration and Personal Issues. These previously completed exit interview forms were manually analysed in order to determine the causes of high staff-turnover amongst professional nurses at selected health facilities in KwaZulu-Natal province, during the period 2015-2016. Exit interview forms, previously completed by professional nurses for the period 2015 to 2016, were collected from both Nkandla LM district hospitals namely Ekombe and Nkandla. A self-designed spread sheet was used to collate the quantitative data from the exit interview forms which contained personal and demographic data (names, gender, PERSAL numbers, appointment and termination dates, rank, etc.), type of exit, and causes of exit, comments and proposed changes, following which it was manually analysed. RESULTS: A total of 54 participants completed the exit interview forms and selected the causes of service termination which were relevant to them. Ekombe Hospital participants were twelve (12) and Nkandla Hospital participants were forty two (42). Not all professional nurses who exited the service during the study period completed the exit interview form. The exit interview form completion rate was 78% (54/69). Twenty-four percent (13/54) of participants did not complete the exit interview form in full. The quantitative analysis revealed that the gender distribution of participants was mostly female, making 80% (43/54). The majority of participants, 30% (16/54), had 21-25 years’ service prior to exiting. On qualitative data analysis, the majority of participants selected unacceptable or poor conditions of service as the cause of service termination 65% (35/54) participants. This trend was also similar when each hospital participants’ selections were examined. In Ekombe Hospital 83% (10/12) participants’ selected unacceptable or poor conditions of service as the cause of service termination and in Nkandla Hospital this was 60% (25/42) participants. The majority of participants, 78% (42/54), stated that they still intended to re-join the department, and most were seeking employment in the public service. Furthermore, 70% (38/54), of the participants stated they would have stayed had their expectations been met. Further examination of themes and sub-themes derived from the qualitative data of the exit interview forms, the majority of comments, (20 comments), were related to Unacceptable or Poor Conditions of Service as the cause of termination. Sub themes analysis further identified resource shortages as the most common comments related to this determination. CONCLUSION: The leading causes of high staff-turnover amongst professional nurses at selected health facilities in KwaZulu-Natal province was determined to be unacceptable or poor conditions of service. On thematic analysis of qualitative data that emerged from the exit interview forms, the key areas that contributed to this determination included mainly resource constraints issues such as shortage of staff, shortage of equipment, shortage of funds, as well as poor infrastructure. Recommendations for staff retention and improvements in service conditions have been proposed. , Thesis (MPH) -- Faculty of Health Sciences, 2022
- Full Text:
Exploring socio-economic factors influencing incidences and outcome of multidrug resistance tuberculosis among patients and facility staffs in Makana Sub-District, Eastern Cape
- Cannon, Lesley-Ann https://orcid.org/0000-0002-7635-277X
- Authors: Cannon, Lesley-Ann https://orcid.org/0000-0002-7635-277X
- Date: 2022-02
- Subjects: Multidrug resistance , Tuberculosis
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/26706 , vital:65958
- Description: Background Drug-resistant Tuberculosis (DR-TB) is one of the main causes of global public health crisis, due to the morbidity and mortality rates associated with the disease. This DR TB is a complex illness having direct and indirect impact on finances, social functioning, and quality of life of infected individuals. Major research advances have been made in the diagnosis and treatment of DR-TB. However, minimal information exists on the socio-economic factors influencing the incidence and outcomes. This study aims to fill the gap by exploring the socio-economic factors from both the health care professional and patient perspective in particular settings to gain insights into developing context-specific strategies against the burden of DR-TB. Methodology The study applied a qualitative method to explore the socio-economic factors influencing MDR-TB through key-in-depth interviews (KIIs) and focus group discussions (FGDs). The study enrolled a total of thirty-two (32) consenting participants. The KIIs was conducted for ten (10) healthcare workers and nine (9) MDR-TB patients. Two focus group discussions were done involving seven (7) MDR TB patients and six (6) MDR-TB patients, respectively. The study targeted healthcare workers working in the MDR-TB field and TB patients with the following: GeneXpert Rifampicin resistance and patient confirmed as MDR TB. Eligible participants were selected using a purposive sampling technique from the hospitals` routine data electronic records (EDR-WEB database) and hardcopy registers (drug-resistant TB register) on MDR-TB patients enrolled in care at the study site. Informed consent was obtained from all study participants after thoroughly explaining the purpose. No personal information of participants was used. All responses from respondents were coded during analysis for autonomy and the respondents were not identifiable in any published or unpublished work following this research. The interviews were transcribed, some translated into English, where necessary, and analysed until saturation was reached. Data was coded and analysed using both thematic and content analysis technique. Results There were 3 main themes identified in the study: social factors, economic factors, and other contributing factors. 7 sub- themes were recorded under social factors and 2 subthemes under economic factors. Two independent factors that were also considered to impact MDR-TB were the attitude of healthcare workers, as well as the current COVID-19 pandemic. Conclusion MDR-TB is a major public health concern in the Makana Sub-district of the Eastern Cape. The findings of this study highlight the impact of socio- economic factors on the incidence, spread, defaulter rate and outcomes of MDR-TB. The social areas highlighted by the study participants as affecting the incidence and outcomes of MDR TB were housing and relocation, decreased immunity, stigma, patients’ attitude and lack of support, alcohol and other substance usage and prison/ incarceration. The economic factors identified by the participants were unemployment and job loss and health related expenses. Other factors are those factors contributing to the increased incidence and possible poor outcomes of MDR TB. Healthcare workers impact and attitude and the effects of the covid-19 pandemic were highlighted as additional factors influencing the incidence and outcomes of MDR TB. The management of MDR-TB requires rigorous efforts that should be directed at addressing the socio-economic factors. Therefore, future quantitative studies and important programmatic strategies should be considered to tackle the socio-economic challenges that contribute to the burden of MDR-TB infection in the Makana community. , Thesis (MPA) -- Faculty of Health Sciences, 2022
- Full Text:
- Authors: Cannon, Lesley-Ann https://orcid.org/0000-0002-7635-277X
- Date: 2022-02
- Subjects: Multidrug resistance , Tuberculosis
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/26706 , vital:65958
- Description: Background Drug-resistant Tuberculosis (DR-TB) is one of the main causes of global public health crisis, due to the morbidity and mortality rates associated with the disease. This DR TB is a complex illness having direct and indirect impact on finances, social functioning, and quality of life of infected individuals. Major research advances have been made in the diagnosis and treatment of DR-TB. However, minimal information exists on the socio-economic factors influencing the incidence and outcomes. This study aims to fill the gap by exploring the socio-economic factors from both the health care professional and patient perspective in particular settings to gain insights into developing context-specific strategies against the burden of DR-TB. Methodology The study applied a qualitative method to explore the socio-economic factors influencing MDR-TB through key-in-depth interviews (KIIs) and focus group discussions (FGDs). The study enrolled a total of thirty-two (32) consenting participants. The KIIs was conducted for ten (10) healthcare workers and nine (9) MDR-TB patients. Two focus group discussions were done involving seven (7) MDR TB patients and six (6) MDR-TB patients, respectively. The study targeted healthcare workers working in the MDR-TB field and TB patients with the following: GeneXpert Rifampicin resistance and patient confirmed as MDR TB. Eligible participants were selected using a purposive sampling technique from the hospitals` routine data electronic records (EDR-WEB database) and hardcopy registers (drug-resistant TB register) on MDR-TB patients enrolled in care at the study site. Informed consent was obtained from all study participants after thoroughly explaining the purpose. No personal information of participants was used. All responses from respondents were coded during analysis for autonomy and the respondents were not identifiable in any published or unpublished work following this research. The interviews were transcribed, some translated into English, where necessary, and analysed until saturation was reached. Data was coded and analysed using both thematic and content analysis technique. Results There were 3 main themes identified in the study: social factors, economic factors, and other contributing factors. 7 sub- themes were recorded under social factors and 2 subthemes under economic factors. Two independent factors that were also considered to impact MDR-TB were the attitude of healthcare workers, as well as the current COVID-19 pandemic. Conclusion MDR-TB is a major public health concern in the Makana Sub-district of the Eastern Cape. The findings of this study highlight the impact of socio- economic factors on the incidence, spread, defaulter rate and outcomes of MDR-TB. The social areas highlighted by the study participants as affecting the incidence and outcomes of MDR TB were housing and relocation, decreased immunity, stigma, patients’ attitude and lack of support, alcohol and other substance usage and prison/ incarceration. The economic factors identified by the participants were unemployment and job loss and health related expenses. Other factors are those factors contributing to the increased incidence and possible poor outcomes of MDR TB. Healthcare workers impact and attitude and the effects of the covid-19 pandemic were highlighted as additional factors influencing the incidence and outcomes of MDR TB. The management of MDR-TB requires rigorous efforts that should be directed at addressing the socio-economic factors. Therefore, future quantitative studies and important programmatic strategies should be considered to tackle the socio-economic challenges that contribute to the burden of MDR-TB infection in the Makana community. , Thesis (MPA) -- Faculty of Health Sciences, 2022
- Full Text:
Exploring socio-economic factors influencing incidences and outcome of multidrug resistance tuberculosis among patients and facility staffs in Makana Sub-District, Eastern Cape
- Authors: Cannon, Lesley-Ann Lynnath
- Date: 2022-02
- Subjects: Multidrug resistance , Multidrug-resistant -- tuberculosis
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/23471 , vital:57896
- Description: Drug-resistant Tuberculosis (DR-TB) is one of the main causes of global public health crisis, due to the morbidity and mortality rates associated with the disease. This DR-TB is a complex illness having direct and indirect impact on finances, social functioning, and quality of life of infected individuals. Major research advances have been made in the diagnosis and treatment of DR-TB. However, minimal information exists on the socio-economic factors influencing the incidence and outcomes. This study aims to fill the gap by exploring the socio-economic factors from both the health care professional and patient perspective in particular settings to gain insights into developing context-specific strategies against the burden of DR-TB. The study applied a qualitative method to explore the socio-economic factors influencing MDR-TB through key-in-depth interviews (KIIs) and focus group discussions (FGDs). The study enrolled a total of thirty-two (32) consenting participants. The KIIs was conducted for ten (10) healthcare workers and nine (9) MDR-TB patients. Two focus group discussions were done involving seven (7) MDR-TB patients and six (6) MDR-TB patients, respectively. The study targeted healthcare workers working in the MDR-TB field and TB patients with the following: GeneXpert Rifampicin resistance and patient confirmed as MDR TB. Eligible participants were selected using a purposive sampling technique from the hospitals` routine data electronic records (EDR-WEB database) and hardcopy registers (drug-resistant TB register) on MDR-TB patients enrolled in care at the study site. Informed consent was obtained from all study participants after thoroughly explaining the purpose. No personal information of participants was used. All responses from respondents were coded during analysis for autonomy and the respondents were not identifiable in any published or unpublished work following this research. The interviews were transcribed, some translated into English, where necessary, and analysed until saturation was reached. Data was coded and analysed using both thematic and content analysis technique. There were 3 main themes identified in the study: social factors, economic factors, and other contributing factors. 7 sub- themes were recorded under social factors and 2 subthemes under economic factors. Two independent factors that were also considered to impact MDR-TB were the attitude of healthcare workers, as well as the current COVID-19 pandemic. MDR-TB is a major public health concern in the Makana Sub-district of the Eastern Cape. The findings of this study highlight the impact of socio- economic factors on the incidence, spread, defaulter rate and outcomes of MDR-TB. The social areas highlighted by the study participants as affecting the incidence and outcomes of MDR TB were housing and relocation, decreased immunity, stigma, patients’ attitude and lack of support, alcohol and other substance usage and prison/ incarceration. The economic factors identified by the participants were unemployment and job loss and health related expenses. Other factors are those factors contributing to the increased incidence and possible poor outcomes of MDR TB. Healthcare workers impact and attitude and the effects of the covid-19 pandemic were highlighted as additional factors influencing the incidence and outcomes of MDR TB. The management of MDR-TB requires rigorous efforts that should be directed at addressing the socio-economic factors. Therefore, future quantitative studies and important programmatic strategies should be considered to tackle the socio-economic challenges that contribute to the burden of MDR-TB infection in the Makana community. , Thesis (MPA) -- Faculty of Health Sciences, 2022
- Full Text:
- Authors: Cannon, Lesley-Ann Lynnath
- Date: 2022-02
- Subjects: Multidrug resistance , Multidrug-resistant -- tuberculosis
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/23471 , vital:57896
- Description: Drug-resistant Tuberculosis (DR-TB) is one of the main causes of global public health crisis, due to the morbidity and mortality rates associated with the disease. This DR-TB is a complex illness having direct and indirect impact on finances, social functioning, and quality of life of infected individuals. Major research advances have been made in the diagnosis and treatment of DR-TB. However, minimal information exists on the socio-economic factors influencing the incidence and outcomes. This study aims to fill the gap by exploring the socio-economic factors from both the health care professional and patient perspective in particular settings to gain insights into developing context-specific strategies against the burden of DR-TB. The study applied a qualitative method to explore the socio-economic factors influencing MDR-TB through key-in-depth interviews (KIIs) and focus group discussions (FGDs). The study enrolled a total of thirty-two (32) consenting participants. The KIIs was conducted for ten (10) healthcare workers and nine (9) MDR-TB patients. Two focus group discussions were done involving seven (7) MDR-TB patients and six (6) MDR-TB patients, respectively. The study targeted healthcare workers working in the MDR-TB field and TB patients with the following: GeneXpert Rifampicin resistance and patient confirmed as MDR TB. Eligible participants were selected using a purposive sampling technique from the hospitals` routine data electronic records (EDR-WEB database) and hardcopy registers (drug-resistant TB register) on MDR-TB patients enrolled in care at the study site. Informed consent was obtained from all study participants after thoroughly explaining the purpose. No personal information of participants was used. All responses from respondents were coded during analysis for autonomy and the respondents were not identifiable in any published or unpublished work following this research. The interviews were transcribed, some translated into English, where necessary, and analysed until saturation was reached. Data was coded and analysed using both thematic and content analysis technique. There were 3 main themes identified in the study: social factors, economic factors, and other contributing factors. 7 sub- themes were recorded under social factors and 2 subthemes under economic factors. Two independent factors that were also considered to impact MDR-TB were the attitude of healthcare workers, as well as the current COVID-19 pandemic. MDR-TB is a major public health concern in the Makana Sub-district of the Eastern Cape. The findings of this study highlight the impact of socio- economic factors on the incidence, spread, defaulter rate and outcomes of MDR-TB. The social areas highlighted by the study participants as affecting the incidence and outcomes of MDR TB were housing and relocation, decreased immunity, stigma, patients’ attitude and lack of support, alcohol and other substance usage and prison/ incarceration. The economic factors identified by the participants were unemployment and job loss and health related expenses. Other factors are those factors contributing to the increased incidence and possible poor outcomes of MDR TB. Healthcare workers impact and attitude and the effects of the covid-19 pandemic were highlighted as additional factors influencing the incidence and outcomes of MDR TB. The management of MDR-TB requires rigorous efforts that should be directed at addressing the socio-economic factors. Therefore, future quantitative studies and important programmatic strategies should be considered to tackle the socio-economic challenges that contribute to the burden of MDR-TB infection in the Makana community. , Thesis (MPA) -- Faculty of Health Sciences, 2022
- Full Text:
Factors associated with infant mortality in Sarah Baartman District, Eastern Cape Province, South Africa
- Authors: Muavha, Mukondeleli Selina
- Date: 2022-02
- Subjects: Infants--Mortality
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/22067 , vital:51980
- Description: This study aimed to investigate the factors associated with infant mortality in Sarah Baartman District hospitals. A quantitative descriptive case-control design was used to investigate and describe the association between maternal socio-demographic, infant, environmental factors, and infant mortality. A data abstraction instrument was used to identify cases and their controls, and to retrieve information related to antenatal and obstetric care for the mothers of both cases and controls, as well as some information related to perinatal care for both mother and infant, from the registers in the district hospitals in Sarah Baartman district for the financial years 2015/2016 to 2017/2018. This was followed by structured questionnaires which were hand-delivered, to the mothers of the cases and controls. This study showed that seven maternal socio-demographic factors (educational level, mother’s source of income, religion, where mother took sick child to, frequency of visits by a health care worker within the last one year, number of alive siblings, and history of intrauterine death) were significantly related to infant mortality among the study participants. Among the environmental factors, the type of house, availability of tap and type of toilet were significantly related to infant mortality among the study participants. The study recommends public policies concerning maternal health through targeting mothers for food supplementation and prenatal care to reduce infant mortality rates. Infant mortality in the study area can also be reduced by improving mother’s education because women’s education has spill over effects on fertility and maternal health care behaviour. , Thesis (MPH) -- Faculty of Health Sciences, Public Health, 2021
- Full Text:
- Authors: Muavha, Mukondeleli Selina
- Date: 2022-02
- Subjects: Infants--Mortality
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/22067 , vital:51980
- Description: This study aimed to investigate the factors associated with infant mortality in Sarah Baartman District hospitals. A quantitative descriptive case-control design was used to investigate and describe the association between maternal socio-demographic, infant, environmental factors, and infant mortality. A data abstraction instrument was used to identify cases and their controls, and to retrieve information related to antenatal and obstetric care for the mothers of both cases and controls, as well as some information related to perinatal care for both mother and infant, from the registers in the district hospitals in Sarah Baartman district for the financial years 2015/2016 to 2017/2018. This was followed by structured questionnaires which were hand-delivered, to the mothers of the cases and controls. This study showed that seven maternal socio-demographic factors (educational level, mother’s source of income, religion, where mother took sick child to, frequency of visits by a health care worker within the last one year, number of alive siblings, and history of intrauterine death) were significantly related to infant mortality among the study participants. Among the environmental factors, the type of house, availability of tap and type of toilet were significantly related to infant mortality among the study participants. The study recommends public policies concerning maternal health through targeting mothers for food supplementation and prenatal care to reduce infant mortality rates. Infant mortality in the study area can also be reduced by improving mother’s education because women’s education has spill over effects on fertility and maternal health care behaviour. , Thesis (MPH) -- Faculty of Health Sciences, Public Health, 2021
- Full Text:
Backpack carriage and musculoskeletal pain among primary school learners in King Williams Town, South Africa
- Authors: Moni, Busisiwe
- Date: 2022
- Subjects: Backache -- Prevention , Pediatric rheumatology , Pain -- Treatment
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/26984 , vital:66208
- Description: BACKGROUND: There is rising concern that kids are walking to school with too much weight on their backs. The weight of schoolchildren's backpacks is a persistent and divisive topic in the fields of education and health. Children who carry heavy backpacks are more likely to have back discomfort and musculoskeletal pain, which raises their risk of developing chronic back pain as adults. There is little research on this topic among South African school-age youngsters. The goal of the study was to find out how common low back and other musculoskeletal complaints were among primary school students who used a school bag. RESEARCH AIM: The purpose of the study was to identify the prevalence and location of musculoskeletal discomfort in primary school students in King William's Town, South Africa, and describe their link with backpack use. METHOD: In King Williams Town, Eastern Cape, South Africa, a descriptive cross-sectional survey was conducted among elementary school students between the ages of 9 and 14 years old. A systematic questionnaire and the Cornell Musculoskeletal Questionnaire were used to gather the data (body chart). Age, gender, and schoolbag details (style of backpack, carrying technique, and carrying time) were collected. The learner's waist, hip, and bag circumferences were all measured. On the data, descriptive and interferential statistics were used. FINDINGS: The study's conclusions showed that students' musculoskeletal pain was brought on by the weight of their backpacks or school bags. The majority of the students (89.8percent) complain about the difficulty they experience when lugging their heavy backpacks to class. In addition, 83.4percent of the students had bags that weighed more than 10percent of their body weight. Additionally, a sizable percentage of students (89.8percent) carry a hefty bag to school every day and report feeling fatigued while doing so (90.8percent). 90percent of the students reported feeling discomfort before, during, or after carrying their schoolbags. This pain is related with carrying a schoolbag. The majority of students (53.5percent) felt that their daily pain interferes with their ability to study. In order of severity, the majority of students report having discomfort in their shoulders (82.7percent), lower back (59.9percent), neck (47.0percent), upper back (40.7percent), and upper arm (16.4percent). CONCLUSION: According to the study, there is a link between students' musculoskeletal pain and carrying hefty backpacks or school bags. The shoulders are where musculoskeletal discomfort is most frequently felt. The study supported the findings of the majority of studies cited in the literature that most schoolchildren suffer from musculoskeletal pain because the weight of their backpacks is excessive compared to their size, weight, and age. RECOMMENDATIONS: The study produced a number of recommendations, including that the Department of Basic Education inform teachers, students, parents, guardians, and other key stakeholders about the effects of heavy backpacks or schoolbags on students' musculoskeletal pain. For students' convenience and to lighten the load on their school bags, locker rooms should be available. Teachers, parents, and guardians should also pay attention to the school bags that students are using to make sure that the weight is appropriate for their age and body size. , Thesis (MPA) -- Faculty of Health Sciences, 2022
- Full Text:
- Authors: Moni, Busisiwe
- Date: 2022
- Subjects: Backache -- Prevention , Pediatric rheumatology , Pain -- Treatment
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/26984 , vital:66208
- Description: BACKGROUND: There is rising concern that kids are walking to school with too much weight on their backs. The weight of schoolchildren's backpacks is a persistent and divisive topic in the fields of education and health. Children who carry heavy backpacks are more likely to have back discomfort and musculoskeletal pain, which raises their risk of developing chronic back pain as adults. There is little research on this topic among South African school-age youngsters. The goal of the study was to find out how common low back and other musculoskeletal complaints were among primary school students who used a school bag. RESEARCH AIM: The purpose of the study was to identify the prevalence and location of musculoskeletal discomfort in primary school students in King William's Town, South Africa, and describe their link with backpack use. METHOD: In King Williams Town, Eastern Cape, South Africa, a descriptive cross-sectional survey was conducted among elementary school students between the ages of 9 and 14 years old. A systematic questionnaire and the Cornell Musculoskeletal Questionnaire were used to gather the data (body chart). Age, gender, and schoolbag details (style of backpack, carrying technique, and carrying time) were collected. The learner's waist, hip, and bag circumferences were all measured. On the data, descriptive and interferential statistics were used. FINDINGS: The study's conclusions showed that students' musculoskeletal pain was brought on by the weight of their backpacks or school bags. The majority of the students (89.8percent) complain about the difficulty they experience when lugging their heavy backpacks to class. In addition, 83.4percent of the students had bags that weighed more than 10percent of their body weight. Additionally, a sizable percentage of students (89.8percent) carry a hefty bag to school every day and report feeling fatigued while doing so (90.8percent). 90percent of the students reported feeling discomfort before, during, or after carrying their schoolbags. This pain is related with carrying a schoolbag. The majority of students (53.5percent) felt that their daily pain interferes with their ability to study. In order of severity, the majority of students report having discomfort in their shoulders (82.7percent), lower back (59.9percent), neck (47.0percent), upper back (40.7percent), and upper arm (16.4percent). CONCLUSION: According to the study, there is a link between students' musculoskeletal pain and carrying hefty backpacks or school bags. The shoulders are where musculoskeletal discomfort is most frequently felt. The study supported the findings of the majority of studies cited in the literature that most schoolchildren suffer from musculoskeletal pain because the weight of their backpacks is excessive compared to their size, weight, and age. RECOMMENDATIONS: The study produced a number of recommendations, including that the Department of Basic Education inform teachers, students, parents, guardians, and other key stakeholders about the effects of heavy backpacks or schoolbags on students' musculoskeletal pain. For students' convenience and to lighten the load on their school bags, locker rooms should be available. Teachers, parents, and guardians should also pay attention to the school bags that students are using to make sure that the weight is appropriate for their age and body size. , Thesis (MPA) -- Faculty of Health Sciences, 2022
- Full Text:
Factors influencing the performance of staff members in a tertiary hospital
- Combrink, Cornelius Johannes
- Authors: Combrink, Cornelius Johannes
- Date: 2021-12
- Subjects: Community health services
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/21642 , vital:51737
- Description: Healthcare services within a hospital setting are the basic aspects for the success of service delivery and staff performance in this regard. The paramount component of human resources makes a positive contribution to a healthcare system. Recently, it has been recognised that the performance of healthcare personnel ought to be a key factor for a sustainable performance system. Nevertheless, it is generally known that healthcare workers fail to accomplish the anticipated outcomes of health interventions. This concept leads to the research question: Why is the public sector known for poor service delivery and poor performance? This study aims to determine the factors that impact on the health worker’s performance in a tertiary hospital in South-Africa. A framework will be carefully constructed and cautiously implemented to improve and develop the performance of healthcare workers in this hospital. The vast scope and population involved in this study make a quantitative research approach most suitable, along with a non-probability purposive sampling method. A survey method using an electronic questionnaire that was circulated via a web survey, and a paper-based questionnaire that was distributed within the hospital were used to obtain a diverse perception of the healthcare workers. Data analysis included determining factors, group differences and correlations using the SPSS-27 program. The target population included all healthcare workers in the tertiary hospital – from junior employees to senior management level staff. Statistical data analysis collected for this study revealed four major factors (politics-related resources, resource, training and socioeconomic) that play a major role in the trends of performance culture at the selected tertiary hospital. These results lead to the understanding that the hospital is currently experiencing inadequate human resources management components such as recognition of employees who perform above expectations; execution of a performance appraisal system; lack in implementing the annual salary increase; unfavourable working conditions (lack of resources); troublesome management skills, and insufficient feedback on performance outcomes. These features are directly associated with the quality and degree of the performance of healthcare personnel. Based on the results, a management framework was proposed. The framework consists of activities that will improve the healthcare profession; strengthen expertise and knowledge; develop management skills; enhance knowledge through research and, ultimately, upgrade the performance of healthcare personnel. , Thesis (MPH) -- Faculty of Health Sciences, Public Health, 2021
- Full Text:
- Authors: Combrink, Cornelius Johannes
- Date: 2021-12
- Subjects: Community health services
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/21642 , vital:51737
- Description: Healthcare services within a hospital setting are the basic aspects for the success of service delivery and staff performance in this regard. The paramount component of human resources makes a positive contribution to a healthcare system. Recently, it has been recognised that the performance of healthcare personnel ought to be a key factor for a sustainable performance system. Nevertheless, it is generally known that healthcare workers fail to accomplish the anticipated outcomes of health interventions. This concept leads to the research question: Why is the public sector known for poor service delivery and poor performance? This study aims to determine the factors that impact on the health worker’s performance in a tertiary hospital in South-Africa. A framework will be carefully constructed and cautiously implemented to improve and develop the performance of healthcare workers in this hospital. The vast scope and population involved in this study make a quantitative research approach most suitable, along with a non-probability purposive sampling method. A survey method using an electronic questionnaire that was circulated via a web survey, and a paper-based questionnaire that was distributed within the hospital were used to obtain a diverse perception of the healthcare workers. Data analysis included determining factors, group differences and correlations using the SPSS-27 program. The target population included all healthcare workers in the tertiary hospital – from junior employees to senior management level staff. Statistical data analysis collected for this study revealed four major factors (politics-related resources, resource, training and socioeconomic) that play a major role in the trends of performance culture at the selected tertiary hospital. These results lead to the understanding that the hospital is currently experiencing inadequate human resources management components such as recognition of employees who perform above expectations; execution of a performance appraisal system; lack in implementing the annual salary increase; unfavourable working conditions (lack of resources); troublesome management skills, and insufficient feedback on performance outcomes. These features are directly associated with the quality and degree of the performance of healthcare personnel. Based on the results, a management framework was proposed. The framework consists of activities that will improve the healthcare profession; strengthen expertise and knowledge; develop management skills; enhance knowledge through research and, ultimately, upgrade the performance of healthcare personnel. , Thesis (MPH) -- Faculty of Health Sciences, Public Health, 2021
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The impact of COVID-19 on depression, anxiety, and post-traumatic stress levels in doctors and nurses at a South African health facility
- Authors: Finger-Motsepe, Kelebogile
- Date: 2021-12
- Subjects: COVID-19 (Disease) , Mental health
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/27920 , vital:70880
- Description: Introduction: The emergence of the coronavirus disease of 2019 (Covid-19) has wrought profound and enduring transformations in global health, economic dynamics, and social interactions. However, the comprehensive quantification of the psychological repercussions of the Covid-19 pandemic remains elusive and is poised to compound the preexisting burden of mental health disorders within the general populace. Elevated transmission rates, rapid disease progression within vulnerable demographics, and the absence of definitive curative or preventive measures have collectively contributed to a heightened worldwide state of stress and anxiety. Extensive research has demonstrated that the apprehension and stress associated with Covid-19 are markedly pronounced among healthcare professionals, commonly referred to as front-line workers, in comparison to the general population. The Covid-19-related psychological distress is anticipated to act as a catalyst, exacerbating mental health conditions within high-risk groups. Aims and Objectives: This study endeavours to ascertain the prevalence and severity of depression, anxiety, and post-traumatic stress disorder (PTSD) among medical doctors and nurses employed at a regional hospital in South Africa. Methodology: A cross-sectional investigation was conducted to evaluate the presence of anxiety, depression, and stress symptoms among medical doctors and nurses working at a Regional Hospital situated in the Free State Province of South Africa. A purposive sample of 200 participants, comprising all willing doctors and nurses employed at the study site, was enrolled in the study. Findings: The participants exhibited an average age of 42 years and an average tenure of approximately 72 months at the hospital. The majority of participants were of African descent, with a male-to-female ratio of 1:2.3. Female healthcare workers reported significantly higher instances of PTSD than their male counterparts. In the aggregate, 71.4percent of doctors reported symptoms indicative of depression, 73.2percent reported anxiety-related symptoms, and 19.6percent reported PTSD-related symptoms. Among nurses, 72percent displayed clinically significant symptoms of depression, 81percent exhibited anxiety-related symptoms, and 27.7percent manifested symptoms suggestive of PTSD. A moderately robust positive correlation was discerned between PTSD and Anxiety (p = .000; r = .466) as well as PTSD and Depression (p = .000; r = .315). Additionally, a strong positive correlation was identified between Anxiety and Depression (p = .000; r = .631). A statistically significant disparity (p = .030) in anxiety levels was observed among workers in different risk-prone areas. Nurses reported substantially higher levels of anxiety (p = .039; M = 10.63, sd = 4.03) compared to doctors (M = 9.01, sd = 3.80) and administrators (M = 10.50, sd = 4.32). Moreover, both nurses (M = 27.06, sd = 13.61) and administrators (M = 33.33, sd = 14.44) exhibited significantly higher instances of PTSD (p = .003) than doctors (M = 19.96, sd = 15.03). Conclusions: The healthcare workers under scrutiny reported elevated levels of anxiety and depression attributable to the Covid-19 pandemic, although the prevalence of posttraumatic stress symptoms was comparatively lower within the hospital setting. Furthermore, this study illuminates that depressive, anxiety, and post-traumatic stress symptoms were more prevalent among nurses than doctors. Additionally, healthcare professionals operating in high-risk Covid-19 environments, such as the Covid-19 ward, demonstrated heightened levels of anxiety when juxtaposed with their counterparts stationed in low-risk Covid-19 areas within the healthcare facility. , Thesis (MPH) -- Faculty of Health Sciences, 2022
- Full Text:
- Authors: Finger-Motsepe, Kelebogile
- Date: 2021-12
- Subjects: COVID-19 (Disease) , Mental health
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/27920 , vital:70880
- Description: Introduction: The emergence of the coronavirus disease of 2019 (Covid-19) has wrought profound and enduring transformations in global health, economic dynamics, and social interactions. However, the comprehensive quantification of the psychological repercussions of the Covid-19 pandemic remains elusive and is poised to compound the preexisting burden of mental health disorders within the general populace. Elevated transmission rates, rapid disease progression within vulnerable demographics, and the absence of definitive curative or preventive measures have collectively contributed to a heightened worldwide state of stress and anxiety. Extensive research has demonstrated that the apprehension and stress associated with Covid-19 are markedly pronounced among healthcare professionals, commonly referred to as front-line workers, in comparison to the general population. The Covid-19-related psychological distress is anticipated to act as a catalyst, exacerbating mental health conditions within high-risk groups. Aims and Objectives: This study endeavours to ascertain the prevalence and severity of depression, anxiety, and post-traumatic stress disorder (PTSD) among medical doctors and nurses employed at a regional hospital in South Africa. Methodology: A cross-sectional investigation was conducted to evaluate the presence of anxiety, depression, and stress symptoms among medical doctors and nurses working at a Regional Hospital situated in the Free State Province of South Africa. A purposive sample of 200 participants, comprising all willing doctors and nurses employed at the study site, was enrolled in the study. Findings: The participants exhibited an average age of 42 years and an average tenure of approximately 72 months at the hospital. The majority of participants were of African descent, with a male-to-female ratio of 1:2.3. Female healthcare workers reported significantly higher instances of PTSD than their male counterparts. In the aggregate, 71.4percent of doctors reported symptoms indicative of depression, 73.2percent reported anxiety-related symptoms, and 19.6percent reported PTSD-related symptoms. Among nurses, 72percent displayed clinically significant symptoms of depression, 81percent exhibited anxiety-related symptoms, and 27.7percent manifested symptoms suggestive of PTSD. A moderately robust positive correlation was discerned between PTSD and Anxiety (p = .000; r = .466) as well as PTSD and Depression (p = .000; r = .315). Additionally, a strong positive correlation was identified between Anxiety and Depression (p = .000; r = .631). A statistically significant disparity (p = .030) in anxiety levels was observed among workers in different risk-prone areas. Nurses reported substantially higher levels of anxiety (p = .039; M = 10.63, sd = 4.03) compared to doctors (M = 9.01, sd = 3.80) and administrators (M = 10.50, sd = 4.32). Moreover, both nurses (M = 27.06, sd = 13.61) and administrators (M = 33.33, sd = 14.44) exhibited significantly higher instances of PTSD (p = .003) than doctors (M = 19.96, sd = 15.03). Conclusions: The healthcare workers under scrutiny reported elevated levels of anxiety and depression attributable to the Covid-19 pandemic, although the prevalence of posttraumatic stress symptoms was comparatively lower within the hospital setting. Furthermore, this study illuminates that depressive, anxiety, and post-traumatic stress symptoms were more prevalent among nurses than doctors. Additionally, healthcare professionals operating in high-risk Covid-19 environments, such as the Covid-19 ward, demonstrated heightened levels of anxiety when juxtaposed with their counterparts stationed in low-risk Covid-19 areas within the healthcare facility. , Thesis (MPH) -- Faculty of Health Sciences, 2022
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Assessment of compliance to the maintenance procedure of medical equipment in a selected hospital, Oliver Reginald Tambo District, Eastern Cape Province
- Authors: Mbangata, Mzuyanda
- Date: 2021-11
- Subjects: Equipment health monitoring , Maintenance--Equipment and supplies
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/21871 , vital:51838
- Description: Background Medical equipment assumes a major part in diagnosis, prevention and treatment of diseases as well as illness and rehabilitation of patients. The maintenance of medical equipment is one of the most vital components in quality health care service delivery and it should not be ignored in the hospital. Therefore, it is critical that medical equipment must be maintained, and be in good working condition to ensure it completes its life cycle, also to prevent possible injuries to the patients and clinicians/end-users. Proper maintenance of medical equipment needs compliance with the manufacturer’s recommendations. Inappropriate maintenance of medical equipment leads to medical equipment malfunctioning, decreases the level of medical equipment performance, and wastes money and other resources. The equipment downtime makes health care services not accessible to patients. Maintenance includes the following activities, medical equipment acceptance, preventive maintenance, inspection, calibration and repair following the manufacturer’s recommendations. Aim of the study The purpose of the study was to assess compliance to the maintenance procedures of medical equipment in a selected hospital in Oliver Reginald Tambo District, Eastern Cape Province. Methodology A qualitative descriptive design was used to access information regarding compliance with the maintenance of medical equipment in a selected hospital, in Oliver Reginald Tambo District, Eastern Cape. The compliance was accessed at the selected hospital that has eight departments. The research objectives gave a framework for how the research was to be conducted. The data was collected through semi-structured interviews until data saturation. An open coding Tesch’s qualitative method was used for data analysis. A purposive sampling technique was used to select participants who were knowledgeable and responsible for management of medical equipment maintenance. The participants were experienced clinicians and technicians answerable for medical equipment maintenance and management. The researcher adhered to ethical and trustworthiness principles. Findings The following themes and their related categories emerged as compliance procedures adhered to/applied: i) Determinants of applied procedures; ii) Compliance with maintenance that is facilitate frequent checks, daily regular testing of equipment; iii) Report faulty equipment; iv) Send equipment for repairs; v) Do follow up on repairs; and vi) Keep machines working all the time. Contributory factors to non-compliance included: Unavailability of funds; technical staff shortage; lack of technical training; non-compliance in performance of quality checks; lack of training of end users; lack of set of maintenance plans; and long procurement process. Complications aligned with non-compliance: Inappropriate referral patients; inaccessibility of health care services; and misdiagnosing patients. Recommendations The strengthening of clinical engineering department with human resources (technical staff), finance (funds for spare parts) and physical resources (workspace, testing equipment and tools, service manuals etc.) Prioritise medical equipment maintenance also improvement of maintenance budget allocation and utilization. Provision of training for end users and technical staff. Establishment and implementation of maintenance plan and improvement of procurement processes. Conclusion The selected hospital is partially compliant with the maintenance of medical equipment because the hospital performs only reactive maintenance. It evidently appeared that affected service delivery is initiated by the shortage of technical staff and equipment availability and reliability. The hospital needs to focus and improve on the above mentioned factors affecting medical equipment maintenance. The results showed that improper maintenance of medical equipment contributes to the overcrowding of tertiary hospitals through unnecessary referrals due to medical equipment malfunctioning. The study contributes to improving the maintenance management of medical equipment. , Thesis (MPH) -- Faculty of Health Sciences, 2021
- Full Text:
- Authors: Mbangata, Mzuyanda
- Date: 2021-11
- Subjects: Equipment health monitoring , Maintenance--Equipment and supplies
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/21871 , vital:51838
- Description: Background Medical equipment assumes a major part in diagnosis, prevention and treatment of diseases as well as illness and rehabilitation of patients. The maintenance of medical equipment is one of the most vital components in quality health care service delivery and it should not be ignored in the hospital. Therefore, it is critical that medical equipment must be maintained, and be in good working condition to ensure it completes its life cycle, also to prevent possible injuries to the patients and clinicians/end-users. Proper maintenance of medical equipment needs compliance with the manufacturer’s recommendations. Inappropriate maintenance of medical equipment leads to medical equipment malfunctioning, decreases the level of medical equipment performance, and wastes money and other resources. The equipment downtime makes health care services not accessible to patients. Maintenance includes the following activities, medical equipment acceptance, preventive maintenance, inspection, calibration and repair following the manufacturer’s recommendations. Aim of the study The purpose of the study was to assess compliance to the maintenance procedures of medical equipment in a selected hospital in Oliver Reginald Tambo District, Eastern Cape Province. Methodology A qualitative descriptive design was used to access information regarding compliance with the maintenance of medical equipment in a selected hospital, in Oliver Reginald Tambo District, Eastern Cape. The compliance was accessed at the selected hospital that has eight departments. The research objectives gave a framework for how the research was to be conducted. The data was collected through semi-structured interviews until data saturation. An open coding Tesch’s qualitative method was used for data analysis. A purposive sampling technique was used to select participants who were knowledgeable and responsible for management of medical equipment maintenance. The participants were experienced clinicians and technicians answerable for medical equipment maintenance and management. The researcher adhered to ethical and trustworthiness principles. Findings The following themes and their related categories emerged as compliance procedures adhered to/applied: i) Determinants of applied procedures; ii) Compliance with maintenance that is facilitate frequent checks, daily regular testing of equipment; iii) Report faulty equipment; iv) Send equipment for repairs; v) Do follow up on repairs; and vi) Keep machines working all the time. Contributory factors to non-compliance included: Unavailability of funds; technical staff shortage; lack of technical training; non-compliance in performance of quality checks; lack of training of end users; lack of set of maintenance plans; and long procurement process. Complications aligned with non-compliance: Inappropriate referral patients; inaccessibility of health care services; and misdiagnosing patients. Recommendations The strengthening of clinical engineering department with human resources (technical staff), finance (funds for spare parts) and physical resources (workspace, testing equipment and tools, service manuals etc.) Prioritise medical equipment maintenance also improvement of maintenance budget allocation and utilization. Provision of training for end users and technical staff. Establishment and implementation of maintenance plan and improvement of procurement processes. Conclusion The selected hospital is partially compliant with the maintenance of medical equipment because the hospital performs only reactive maintenance. It evidently appeared that affected service delivery is initiated by the shortage of technical staff and equipment availability and reliability. The hospital needs to focus and improve on the above mentioned factors affecting medical equipment maintenance. The results showed that improper maintenance of medical equipment contributes to the overcrowding of tertiary hospitals through unnecessary referrals due to medical equipment malfunctioning. The study contributes to improving the maintenance management of medical equipment. , Thesis (MPH) -- Faculty of Health Sciences, 2021
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Knowledge, attitudes, and practices of the treatment options for dental caries among the adult patients for dental caries in Buffalo City Metropolitan Municipality, in East London, Eastern Cape, South Africa
- Authors: Veleekizhakethil, Legy
- Date: 2021-11
- Subjects: Dental caries , Periodontics
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/22968 , vital:53257
- Description: Dentistry offers several caries-preventive measures, some of which emphasise not only patient’s responsibility to manage their disease, but also how dental professionals should manage it. Consequently, this study aimed to examine the knowledge, attitudes, and practices of adult patients towards treatment options relating to dental caries in the geographical context of Buffalo City Metropolitan Municipality, situated in the Eastern Cape Province of South Africa. Purpose Firstly, this quantitative study set out to assess the existing oral health knowledge, attitudes, and practices among an adult population visiting dental health facilities in Buffalo City Metropolitan Municipality, in East London, Eastern Cape, South Africa. Secondly, it aimed to examine the prevalence of dental caries, periodontal diseases and tooth associated diseases in this specific setting. Furthermore, the study sought to provide baseline data in order to organise a successful dental prevention programme. The data obtained will determine the layout of policies to be put forward to the Department of Health. Methodology The researcher took a quantitative approach and conducted descriptive surveys from November 2019 to March 2020. A close-ended, structured questionnaire for data collection was designed based on the aspects of knowledge, attitudes, practices and behaviour pertaining to the area of dental caries. A clinical examination of dental status was performed using dental probes, dental mirrors and tooth air-drying. All decay, and missing, filled or restored teeth due to dental caries, along with the presence of calculus, gingival, and periodontal lesions were recorded. Results Participants had an average knowledge score of 80percent with a 95percent confidence interval of (76percent; 84percent). The majority knew the importance of cleaning their teeth (88.9percent), were aware of the effects of sugary diets (80.7percent), avoided sugary foods (64.6percent), and lastly were aware of the causes of dental caries (71.3percent). However it is concerning that most had never visited a dentist, as reflected by 69.1percent of participants agreeing or strongly agreeing. At least 70percent of those who responded were satisfied with their dentists in that they ( the dentists) freely share ideas and opinions and provide advice on options for dental care. The study revealed a high prevalence of dental caries with a ratio of 6.23. Conclusions The majority of the participants affirmed the importance of visiting the dentist for a routine dental examination. In addition, the majority are aware that sugary diets are associated with dental caries. However, there is a high prevalence of dental caries among participants in this setting. Therefore, dentists should provide preventive measures, along with professional restorative and plaque removal, to curb the burden of dental caries and periodontal diseases. The type and extent of preventive measures must be adjusted according to the patient’s individual needs. Dental health professionals must collaborate with other health-care providers to promote preventive dental health. , Thesis (MPH) -- Faculty of Health Sciences, 2021
- Full Text:
- Authors: Veleekizhakethil, Legy
- Date: 2021-11
- Subjects: Dental caries , Periodontics
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/22968 , vital:53257
- Description: Dentistry offers several caries-preventive measures, some of which emphasise not only patient’s responsibility to manage their disease, but also how dental professionals should manage it. Consequently, this study aimed to examine the knowledge, attitudes, and practices of adult patients towards treatment options relating to dental caries in the geographical context of Buffalo City Metropolitan Municipality, situated in the Eastern Cape Province of South Africa. Purpose Firstly, this quantitative study set out to assess the existing oral health knowledge, attitudes, and practices among an adult population visiting dental health facilities in Buffalo City Metropolitan Municipality, in East London, Eastern Cape, South Africa. Secondly, it aimed to examine the prevalence of dental caries, periodontal diseases and tooth associated diseases in this specific setting. Furthermore, the study sought to provide baseline data in order to organise a successful dental prevention programme. The data obtained will determine the layout of policies to be put forward to the Department of Health. Methodology The researcher took a quantitative approach and conducted descriptive surveys from November 2019 to March 2020. A close-ended, structured questionnaire for data collection was designed based on the aspects of knowledge, attitudes, practices and behaviour pertaining to the area of dental caries. A clinical examination of dental status was performed using dental probes, dental mirrors and tooth air-drying. All decay, and missing, filled or restored teeth due to dental caries, along with the presence of calculus, gingival, and periodontal lesions were recorded. Results Participants had an average knowledge score of 80percent with a 95percent confidence interval of (76percent; 84percent). The majority knew the importance of cleaning their teeth (88.9percent), were aware of the effects of sugary diets (80.7percent), avoided sugary foods (64.6percent), and lastly were aware of the causes of dental caries (71.3percent). However it is concerning that most had never visited a dentist, as reflected by 69.1percent of participants agreeing or strongly agreeing. At least 70percent of those who responded were satisfied with their dentists in that they ( the dentists) freely share ideas and opinions and provide advice on options for dental care. The study revealed a high prevalence of dental caries with a ratio of 6.23. Conclusions The majority of the participants affirmed the importance of visiting the dentist for a routine dental examination. In addition, the majority are aware that sugary diets are associated with dental caries. However, there is a high prevalence of dental caries among participants in this setting. Therefore, dentists should provide preventive measures, along with professional restorative and plaque removal, to curb the burden of dental caries and periodontal diseases. The type and extent of preventive measures must be adjusted according to the patient’s individual needs. Dental health professionals must collaborate with other health-care providers to promote preventive dental health. , Thesis (MPH) -- Faculty of Health Sciences, 2021
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Low uptake and early removal of Implanon NXT among women of reproductive age in Limpopo
- Magomani, Nandu Victoria https://orcid.org/ 0000-0001-5473-9984
- Authors: Magomani, Nandu Victoria https://orcid.org/ 0000-0001-5473-9984
- Date: 2021-11
- Subjects: Contraceptive drug implants
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/21849 , vital:51829
- Description: Implanon NXT also referred to as subdermal Implant, is a long-acting subdermal contraceptive method available in the South African public health care system since 2014. The implant was introduced to broaden the choice for women of childbearing age to delay or prevent unwanted pregnancies. Following a surge in popularity, reports of early removals and frequent adverse effects led to a significant decrease in its uptake in the country. Insufficient knowledge on Implanon, poor management of side effects, poor counseling by health care workers, and lack of partner support were the main themes that were picked from the interview, influencing uptake or early removals of the Implanon. The major concerning side effect reported was uncontrolled and irregular heavy bleeding The purpose of the study was to explore the factors associated with low uptake and early removals of Implanon NXT among women of reproductive age in one district in Limpopo province. A qualitative research design was used, primarily as exploratory and descriptive in nature. Participants were identified using non-probable, purposeful voluntary sampling. Data collection was achieved using open-ended structured interviews with sixteen (16) women aged from18-49. Data was analysed using thematic method of organizing data into categories, followed by coding and sorting the data to identify patterns and interpret the meanings and responses. An independent consultant was involved to confirm the thematic areas identified after which consensus discussions took place to finalize the analysed data. From the results, it appeared that there was a need that Implanon should be marketed by use of digital platforms and print media for information sharing. These platforms should be utilized by DOH from the National, provincial, district, facility and community levels. There should be clear protocol on how to manage different kinds of side effects, and this information should be rolled out to the implementation level. Health Care workers should provide client education and counselling services to the clients about the effectiveness of the method. Male partner involvement is crucial to provide support for women on contraceptives and to support their contraceptive choices. Mentorship will help providers to attain their proficiency in Implanon counselling, insertions, and removals. Lastly, availing adequate and effective youth-friendly services to enable young people to open up more about challenges and options that can be explored. For the adolescents and youth, these services should be provided by trained providers not at the general unit, where there is a mixture of adult population and the elderly, but at youth zones to enhance the uptake of Implanon NXT. Recommendations are for clinical practice area, for generic student education as well as for further research. The conclusions confirm that the government need to revitalise the Implanon program, to drive the uptake and reduce early removals. Training of health workers and mentorship should emphasize more comprehensive counselling, provide adequate information on what is to be expected and more importantly, how to treat and manage the side effects. That early removals due to side effects become the last option as information need to be widely available to all users utilising the traditional methods and modern methods such as digital platforms to spread the correct information and create demand for the Implanon. The functional service-provision-based youth-friendly services which will cater for the needs of young women and adolescents is highlighted as it provides a comfortable and conducive environment to provide and receive a comprehensive sexual reproductive health and rights services. , Thesis (MPH) -- Faculty of Health Sciences, 2021
- Full Text:
- Authors: Magomani, Nandu Victoria https://orcid.org/ 0000-0001-5473-9984
- Date: 2021-11
- Subjects: Contraceptive drug implants
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/21849 , vital:51829
- Description: Implanon NXT also referred to as subdermal Implant, is a long-acting subdermal contraceptive method available in the South African public health care system since 2014. The implant was introduced to broaden the choice for women of childbearing age to delay or prevent unwanted pregnancies. Following a surge in popularity, reports of early removals and frequent adverse effects led to a significant decrease in its uptake in the country. Insufficient knowledge on Implanon, poor management of side effects, poor counseling by health care workers, and lack of partner support were the main themes that were picked from the interview, influencing uptake or early removals of the Implanon. The major concerning side effect reported was uncontrolled and irregular heavy bleeding The purpose of the study was to explore the factors associated with low uptake and early removals of Implanon NXT among women of reproductive age in one district in Limpopo province. A qualitative research design was used, primarily as exploratory and descriptive in nature. Participants were identified using non-probable, purposeful voluntary sampling. Data collection was achieved using open-ended structured interviews with sixteen (16) women aged from18-49. Data was analysed using thematic method of organizing data into categories, followed by coding and sorting the data to identify patterns and interpret the meanings and responses. An independent consultant was involved to confirm the thematic areas identified after which consensus discussions took place to finalize the analysed data. From the results, it appeared that there was a need that Implanon should be marketed by use of digital platforms and print media for information sharing. These platforms should be utilized by DOH from the National, provincial, district, facility and community levels. There should be clear protocol on how to manage different kinds of side effects, and this information should be rolled out to the implementation level. Health Care workers should provide client education and counselling services to the clients about the effectiveness of the method. Male partner involvement is crucial to provide support for women on contraceptives and to support their contraceptive choices. Mentorship will help providers to attain their proficiency in Implanon counselling, insertions, and removals. Lastly, availing adequate and effective youth-friendly services to enable young people to open up more about challenges and options that can be explored. For the adolescents and youth, these services should be provided by trained providers not at the general unit, where there is a mixture of adult population and the elderly, but at youth zones to enhance the uptake of Implanon NXT. Recommendations are for clinical practice area, for generic student education as well as for further research. The conclusions confirm that the government need to revitalise the Implanon program, to drive the uptake and reduce early removals. Training of health workers and mentorship should emphasize more comprehensive counselling, provide adequate information on what is to be expected and more importantly, how to treat and manage the side effects. That early removals due to side effects become the last option as information need to be widely available to all users utilising the traditional methods and modern methods such as digital platforms to spread the correct information and create demand for the Implanon. The functional service-provision-based youth-friendly services which will cater for the needs of young women and adolescents is highlighted as it provides a comfortable and conducive environment to provide and receive a comprehensive sexual reproductive health and rights services. , Thesis (MPH) -- Faculty of Health Sciences, 2021
- Full Text:
Retrospective analysis of factors contributing to parasuicide among youth in Buffalo City Metropolitan Municipality, Eastern Cape, South Africa
- Authors: Nganto, Yanga
- Date: 2021-11
- Subjects: Parasuicide -- South Africa
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/22897 , vital:53181
- Description: Parasuicide is a problem that affects the youth locally and globally. Parasuicide has negative psychological impacts on youth. This study was designed to assess elements of parasuicide in the Buffalo City Metropolitan Municipality of South Africa, using records of patients admitted to Frere and Cecilia Makiwane hospitals between 2016 and 2020. The purpose of the study was to conduct a descriptive retrospective review of parasuicide among youth to determine trends, causes, and contributing factors of committing parasuicide. Methods A retrospective, quantitative and descriptive study was conducted with 200 files of patients aged between 18 and 35 years conveniently sampled. These patients diagnosed as committed parasuicide and were admitted at Frere and Cecilia Makiwane hospitals over a period of four years from 1 April 2016 to 31 March 202. Only record files of patients’ residing in East London and Mdantsane catchment area were selected. Raw data was collected for a period of twelve weeks using a developed data collection tool developed in Ms Excel spreadsheet. Results In this sample, the large number of the patients were under 26 years (60.5%), female (57%), single (92.5%), and Black (99.5%). Furthermore, majority of the patients had attained secondary education (89.5%), were unemployed (83%) and living with their families (59%). There were different methods and agents used by participants to commit parasuicide and reasons differed from person to person. Among patients who reported a suicide attempt, organophosphates were most commonly used agent for self-poisoning (47%, n=94), followed by substances such as use of drugs and alcohol (n=57, 28.5%), violence (n=27, 13.5%), corrosive agents including bleach and Jik (n=11, 5.5%), and hydrogen peroxide including acidic sub-stances like battery acid (n=11, 5.5%). The common reason found in the study and indicates participants had psychiatric disorder (34.5%). Conclusion Limiting access to organophosphate agents and other lethal means is an effective strategy that should be adopted to prevent parasuicide among youth. Timely identification of risks or warning signs, social prevention and immediate intervention at the state level will play an important role in controlling parasuicide among youth. Moreover, improving health care services with psychotherapy support would empower youth with skills that would enhance their self-confidence, self-worth and resilience. Consequently, attainment of these attributes would result in the prevention and control of parasuicide amongst youth. , Thesis (MPH) -- Faculty of Health Sciences, 2021
- Full Text:
- Authors: Nganto, Yanga
- Date: 2021-11
- Subjects: Parasuicide -- South Africa
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/22897 , vital:53181
- Description: Parasuicide is a problem that affects the youth locally and globally. Parasuicide has negative psychological impacts on youth. This study was designed to assess elements of parasuicide in the Buffalo City Metropolitan Municipality of South Africa, using records of patients admitted to Frere and Cecilia Makiwane hospitals between 2016 and 2020. The purpose of the study was to conduct a descriptive retrospective review of parasuicide among youth to determine trends, causes, and contributing factors of committing parasuicide. Methods A retrospective, quantitative and descriptive study was conducted with 200 files of patients aged between 18 and 35 years conveniently sampled. These patients diagnosed as committed parasuicide and were admitted at Frere and Cecilia Makiwane hospitals over a period of four years from 1 April 2016 to 31 March 202. Only record files of patients’ residing in East London and Mdantsane catchment area were selected. Raw data was collected for a period of twelve weeks using a developed data collection tool developed in Ms Excel spreadsheet. Results In this sample, the large number of the patients were under 26 years (60.5%), female (57%), single (92.5%), and Black (99.5%). Furthermore, majority of the patients had attained secondary education (89.5%), were unemployed (83%) and living with their families (59%). There were different methods and agents used by participants to commit parasuicide and reasons differed from person to person. Among patients who reported a suicide attempt, organophosphates were most commonly used agent for self-poisoning (47%, n=94), followed by substances such as use of drugs and alcohol (n=57, 28.5%), violence (n=27, 13.5%), corrosive agents including bleach and Jik (n=11, 5.5%), and hydrogen peroxide including acidic sub-stances like battery acid (n=11, 5.5%). The common reason found in the study and indicates participants had psychiatric disorder (34.5%). Conclusion Limiting access to organophosphate agents and other lethal means is an effective strategy that should be adopted to prevent parasuicide among youth. Timely identification of risks or warning signs, social prevention and immediate intervention at the state level will play an important role in controlling parasuicide among youth. Moreover, improving health care services with psychotherapy support would empower youth with skills that would enhance their self-confidence, self-worth and resilience. Consequently, attainment of these attributes would result in the prevention and control of parasuicide amongst youth. , Thesis (MPH) -- Faculty of Health Sciences, 2021
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Barriers to participation in sports among urban adolescents at an International School in Cape Town, South Africa
- Authors: Klaasen, Robyn Jade
- Date: 2021-10
- Subjects: Urban teenagers -- Sports , Sports administration
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/22155 , vital:51991
- Description: The benefits of participating in sport have been well documented and great emphasis has been placed on the role that it plays in the development of character and social skills, apart from physical and psychological benefits. Sport represents an optimal means of enabling children and adolescents to meet their daily requirements for physical activity to maintain health. Conversely, despite all of the widely acknowledged benefits, participation in sport among children and adolescents continues to decline throughout the world. Although a great deal of research has been conducted to identify barriers to participation in sport, most of it has concerned poor, rural, disadvantaged, or other marginalised groups. As a consequence, a large proportion of the research has attributed low rates of participation in sport to practical barriers, which usually take the forms of either logistical problems or a lack of resources. The aim of this study was to identify the barriers to participation in sport among adolescents in an affluent, urban setting, at an international school in Cape Town, South Africa. The Barriers to Sport Participation Questionnaire was used to identify the social, personal, and practical barriers that affected 107 adolescents who were enrolled in the school. The data was analysed by means of the SPSS (IBM, Version 27) software package and seven significant barriers were identified. Fear of academic failure, environmental constraints, and lack of interest were identified as the primary barriers, thereby emphasising the significant influence of personal barriers, rather than practical ones. It was also found that the influence of particular barriers was greater on females than their male counterparts and that the respondents who either did not participate in sport themselves or were from households in which other members did not do so were more adversely affected by some barriers than the others. Significant correlations were found between some grades and certain barriers, the most notable being those between respondents in Grades 7, 9, and 10 and the fear of academic failure barrier. In light of these findings, it could be concluded that the global decline in participation in sport among the youth is a complex problem and that particular barriers, which might not have been identified in previous research, could be particularly influential in affluent environments. As it is evident that as barriers can be specific to particular groups and settings, the optimal means of overcoming them is unlikely to be found through the adoption of a one-size-fitsall approach. Instead, further research and customised interventions are required. , Thesis (HMS) -- Faculty of Health Sciences, 2021
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- Authors: Klaasen, Robyn Jade
- Date: 2021-10
- Subjects: Urban teenagers -- Sports , Sports administration
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/22155 , vital:51991
- Description: The benefits of participating in sport have been well documented and great emphasis has been placed on the role that it plays in the development of character and social skills, apart from physical and psychological benefits. Sport represents an optimal means of enabling children and adolescents to meet their daily requirements for physical activity to maintain health. Conversely, despite all of the widely acknowledged benefits, participation in sport among children and adolescents continues to decline throughout the world. Although a great deal of research has been conducted to identify barriers to participation in sport, most of it has concerned poor, rural, disadvantaged, or other marginalised groups. As a consequence, a large proportion of the research has attributed low rates of participation in sport to practical barriers, which usually take the forms of either logistical problems or a lack of resources. The aim of this study was to identify the barriers to participation in sport among adolescents in an affluent, urban setting, at an international school in Cape Town, South Africa. The Barriers to Sport Participation Questionnaire was used to identify the social, personal, and practical barriers that affected 107 adolescents who were enrolled in the school. The data was analysed by means of the SPSS (IBM, Version 27) software package and seven significant barriers were identified. Fear of academic failure, environmental constraints, and lack of interest were identified as the primary barriers, thereby emphasising the significant influence of personal barriers, rather than practical ones. It was also found that the influence of particular barriers was greater on females than their male counterparts and that the respondents who either did not participate in sport themselves or were from households in which other members did not do so were more adversely affected by some barriers than the others. Significant correlations were found between some grades and certain barriers, the most notable being those between respondents in Grades 7, 9, and 10 and the fear of academic failure barrier. In light of these findings, it could be concluded that the global decline in participation in sport among the youth is a complex problem and that particular barriers, which might not have been identified in previous research, could be particularly influential in affluent environments. As it is evident that as barriers can be specific to particular groups and settings, the optimal means of overcoming them is unlikely to be found through the adoption of a one-size-fitsall approach. Instead, further research and customised interventions are required. , Thesis (HMS) -- Faculty of Health Sciences, 2021
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Experiences of patients with cancer regarding decentralization of oncology services at a selected tertiary hospital in the Eastern Cape
- Authors: Jojo, Lumkile
- Date: 2021-09
- Subjects: Cancer -- Nursing
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/26907 , vital:66080
- Description: Background: Cancer burden is a global public health concern. It is associated with high morbidities and mortalities worldwide. Over the past decade, there has been a constant increase in the incidence of cancer cases affecting mostly low-income countries and middle- income countries. South Africa as a middle-income country is also affected by this cancer rise. The limited access to oncology services contributed to the late presentation and late diagnosis. In the Eastern Cape, oncology services were previously offered in Port Elizabeth and East London only. Oncology unit was recently opened in Mthatha to decentralize oncology services in the province. The purpose of the study was to explore the experiences of patients with cancer regarding decentralization of oncology services at a public tertiary hospital in the Eastern Cape province of South Africa. Objectives were to describe experiences of patients with cancer regarding decentralization of oncology services at a public tertiary hospital in the Eastern Cape, and to describe the quality of oncology services provided by a public tertiary hospital in the Eastern Cape. Methods: a qualitative research approach with a descriptive, explorative, and contextual design was undertaken in this study, to get the perspective of the oncology healthcare service recipients on the decentralization of oncology services at a public tertiary hospital. An interview guide was used to get experiences of the cancer patients attending oncology clinic. Interviews were conducted to 19 participants on a one-to-one basis. With ethical consideration, all COVID-19 protocols were observed. All interviews were transcribed carefully against their audio-recordings. Field notes were also taken by the researcher on what was heard, observed, thought and experienced during the interview process. The concept of trustworthiness was used to ensure rigour throughout this study. Data was analysed by means of thematic analysis. Data was organized into themes using the Tesch’s approach to open coding in qualitative research. Results: seven themes emerged: 1) experience related to a high level of satisfaction with services provided and desired expectations, 2) waiting time, 3) availability of human and material resources, 4) attitude of health care workers, 5) appropriate treatment and care, 6) access to services, and 7) need for improved infrastructural facilities Many patients had positive experiences about decentralization of oncology services in the province. Most patients were happy about travelling short distances, a smaller number of days, using less money and the time it takes to see a doctor. They also expressed their satisfaction on the quality of oncology services rendered in the unit. The waiting times were acceptable, medicines available and staff had positive attitudes towards the patients. The study revealed that, there were complaints about infrastructure, poor hospital record keeping, and lack of resources. The themes which emanated from the recordings of the study showed that patients with cancer, attending oncology clinic at a public tertiary hospital had positive experiences in this decentralized oncology unit. The services rendered at the facility were of acceptable quality. Staff had positive attitude towards their patients. All patients were seen by the doctors within acceptable waiting time, and they all got their prescribed medication. Access to services was much improved in terms of distance, number of days travelled by patients to access the service and time taken to see the doctor for appointments. Conclusion: The hospital must improve its infrastructure, record keeping, security, and expand the services. Put more focus on cancer awareness programs. , Thesis (MPA) -- Faculty of Health Sciences, 2021
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- Authors: Jojo, Lumkile
- Date: 2021-09
- Subjects: Cancer -- Nursing
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/26907 , vital:66080
- Description: Background: Cancer burden is a global public health concern. It is associated with high morbidities and mortalities worldwide. Over the past decade, there has been a constant increase in the incidence of cancer cases affecting mostly low-income countries and middle- income countries. South Africa as a middle-income country is also affected by this cancer rise. The limited access to oncology services contributed to the late presentation and late diagnosis. In the Eastern Cape, oncology services were previously offered in Port Elizabeth and East London only. Oncology unit was recently opened in Mthatha to decentralize oncology services in the province. The purpose of the study was to explore the experiences of patients with cancer regarding decentralization of oncology services at a public tertiary hospital in the Eastern Cape province of South Africa. Objectives were to describe experiences of patients with cancer regarding decentralization of oncology services at a public tertiary hospital in the Eastern Cape, and to describe the quality of oncology services provided by a public tertiary hospital in the Eastern Cape. Methods: a qualitative research approach with a descriptive, explorative, and contextual design was undertaken in this study, to get the perspective of the oncology healthcare service recipients on the decentralization of oncology services at a public tertiary hospital. An interview guide was used to get experiences of the cancer patients attending oncology clinic. Interviews were conducted to 19 participants on a one-to-one basis. With ethical consideration, all COVID-19 protocols were observed. All interviews were transcribed carefully against their audio-recordings. Field notes were also taken by the researcher on what was heard, observed, thought and experienced during the interview process. The concept of trustworthiness was used to ensure rigour throughout this study. Data was analysed by means of thematic analysis. Data was organized into themes using the Tesch’s approach to open coding in qualitative research. Results: seven themes emerged: 1) experience related to a high level of satisfaction with services provided and desired expectations, 2) waiting time, 3) availability of human and material resources, 4) attitude of health care workers, 5) appropriate treatment and care, 6) access to services, and 7) need for improved infrastructural facilities Many patients had positive experiences about decentralization of oncology services in the province. Most patients were happy about travelling short distances, a smaller number of days, using less money and the time it takes to see a doctor. They also expressed their satisfaction on the quality of oncology services rendered in the unit. The waiting times were acceptable, medicines available and staff had positive attitudes towards the patients. The study revealed that, there were complaints about infrastructure, poor hospital record keeping, and lack of resources. The themes which emanated from the recordings of the study showed that patients with cancer, attending oncology clinic at a public tertiary hospital had positive experiences in this decentralized oncology unit. The services rendered at the facility were of acceptable quality. Staff had positive attitude towards their patients. All patients were seen by the doctors within acceptable waiting time, and they all got their prescribed medication. Access to services was much improved in terms of distance, number of days travelled by patients to access the service and time taken to see the doctor for appointments. Conclusion: The hospital must improve its infrastructure, record keeping, security, and expand the services. Put more focus on cancer awareness programs. , Thesis (MPA) -- Faculty of Health Sciences, 2021
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Experiences of patients with cancer regarding decentralization of oncology services at a selected tertiary hospital in the Eastern Cape
- Authors: Jojo, Lumkile Wilmot
- Date: 2021-09
- Subjects: Cancer -- Patients , Oncology
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/23510 , vital:58074
- Description: Background: Cancer burden is a global public health concern. It is associated with high morbidities and mortalities worldwide. Over the past decade, there has been a constant increase in the incidence of cancer cases affecting mostly low-income countries and middle- income countries. South Africa as a middle-income country is also affected by this cancer rise. The limited access to oncology services contributed to the late presentation and late diagnosis. In the Eastern Cape, oncology services were previously offered in Port Elizabeth and East London only. Oncology unit was recently opened in Mthatha to decentralize oncology services in the province. The purpose of the study was to explore the experiences of patients with cancer regarding decentralization of oncology services at a public tertiary hospital in the Eastern Cape province of South Africa. Objectives were to describe experiences of patients with cancer regarding decentralization of oncology services at a public tertiary hospital in the Eastern Cape, and to describe the quality of oncology services provided by a public tertiary hospital in the Eastern Cape. Methods: a qualitative research approach with a descriptive, explorative, and contextual design was undertaken in this study, to get the perspective of the oncology healthcare service recipients on the decentralization of oncology services at a public tertiary hospital. An interview guide was used to get experiences of the cancer patients attending oncology clinic. Interviews were conducted to 19 participants on a one-to-one basis. With ethical consideration, all COVID-19 protocols were observed. All interviews were transcribed carefully against their audio-recordings. Field notes were also taken by the researcher on what was heard, observed, thought and experienced during the interview process. The concept of trustworthiness was used to ensure rigour throughout this study. Data was analysed by means of thematic analysis. Data was organized into themes using the Tesch’s approach to open coding in qualitative research. Results: seven themes emerged: 1) experience related to a high level of satisfaction with services provided and desired expectations, 2) waiting time, 3) availability of human and material resources, 4) attitude of health care workers, 5) appropriate treatment and care, 6) access to services, and 7) need for improved infrastructural facilities. Many patients had positive experiences about decentralization of oncology services in the province. Most patients were happy about travelling short distances, a smaller number of days, using less money and the time it takes to see a doctor. They also expressed their satisfaction on the quality of oncology services rendered in the unit. The waiting times were acceptable, medicines available and staff had positive attitudes towards the patients. The study revealed that, there were complaints about infrastructure, poor hospital record keeping, and lack of resources. The themes which emanated from the recordings of the study showed that patients with cancer, attending oncology clinic at a public tertiary hospital had positive experiences in this decentralized oncology unit. The services rendered at the facility were of acceptable quality. Staff had positive attitude towards their patients. All patients were seen by the doctors within acceptable waiting time, and they all got their prescribed medication. Access to services was much improved in terms of distance, number of days travelled by patients to access the service and time taken to see the doctor for appointments. Conclusion: The hospital must improve its infrastructure, record keeping, security, and expand the services. Put more focus on cancer awareness programs. , Thesis (MPA) -- Faculty of Health Sciences, 2021
- Full Text:
- Authors: Jojo, Lumkile Wilmot
- Date: 2021-09
- Subjects: Cancer -- Patients , Oncology
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/23510 , vital:58074
- Description: Background: Cancer burden is a global public health concern. It is associated with high morbidities and mortalities worldwide. Over the past decade, there has been a constant increase in the incidence of cancer cases affecting mostly low-income countries and middle- income countries. South Africa as a middle-income country is also affected by this cancer rise. The limited access to oncology services contributed to the late presentation and late diagnosis. In the Eastern Cape, oncology services were previously offered in Port Elizabeth and East London only. Oncology unit was recently opened in Mthatha to decentralize oncology services in the province. The purpose of the study was to explore the experiences of patients with cancer regarding decentralization of oncology services at a public tertiary hospital in the Eastern Cape province of South Africa. Objectives were to describe experiences of patients with cancer regarding decentralization of oncology services at a public tertiary hospital in the Eastern Cape, and to describe the quality of oncology services provided by a public tertiary hospital in the Eastern Cape. Methods: a qualitative research approach with a descriptive, explorative, and contextual design was undertaken in this study, to get the perspective of the oncology healthcare service recipients on the decentralization of oncology services at a public tertiary hospital. An interview guide was used to get experiences of the cancer patients attending oncology clinic. Interviews were conducted to 19 participants on a one-to-one basis. With ethical consideration, all COVID-19 protocols were observed. All interviews were transcribed carefully against their audio-recordings. Field notes were also taken by the researcher on what was heard, observed, thought and experienced during the interview process. The concept of trustworthiness was used to ensure rigour throughout this study. Data was analysed by means of thematic analysis. Data was organized into themes using the Tesch’s approach to open coding in qualitative research. Results: seven themes emerged: 1) experience related to a high level of satisfaction with services provided and desired expectations, 2) waiting time, 3) availability of human and material resources, 4) attitude of health care workers, 5) appropriate treatment and care, 6) access to services, and 7) need for improved infrastructural facilities. Many patients had positive experiences about decentralization of oncology services in the province. Most patients were happy about travelling short distances, a smaller number of days, using less money and the time it takes to see a doctor. They also expressed their satisfaction on the quality of oncology services rendered in the unit. The waiting times were acceptable, medicines available and staff had positive attitudes towards the patients. The study revealed that, there were complaints about infrastructure, poor hospital record keeping, and lack of resources. The themes which emanated from the recordings of the study showed that patients with cancer, attending oncology clinic at a public tertiary hospital had positive experiences in this decentralized oncology unit. The services rendered at the facility were of acceptable quality. Staff had positive attitude towards their patients. All patients were seen by the doctors within acceptable waiting time, and they all got their prescribed medication. Access to services was much improved in terms of distance, number of days travelled by patients to access the service and time taken to see the doctor for appointments. Conclusion: The hospital must improve its infrastructure, record keeping, security, and expand the services. Put more focus on cancer awareness programs. , Thesis (MPA) -- Faculty of Health Sciences, 2021
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Experiences of patients on short term drug resistant tuberculosis regimen at Nelson Mandela District TB Specialist Hospital
- Authors: Sempe, Thabo Benedict
- Date: 2021-08
- Subjects: Multidrug-resistant tuberculosis
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/22940 , vital:53224
- Description: The purpose of this research study was to explore and describe the experiences of patients on short-term drug resistant TB treatment in a TB specialist hospital situated in Nelson Mandela District. Patients on XDR-TB treatment face many challenges which include side effects which they find hard to tolerate and they end up stopping the treatment. Socio-economic difficulties of concern include delayed social assistance from the government to support their families, particularly when they are breadwinners. A qualitative, descriptive, explorative contextual design was used in this research study. A non-probability convenience sampling method was employed. The target population for this study consisted of those DR-TB patients who were on short-term regimen and semi-structured individual interviews were conducted. There were twelve participants who voluntary participated in the research study although the first interview was a pilot study. Ethical principles were adhered to throughout the study. A total of seven themes and twenty-seven sub-themes arose during the data analysis and were fully discussed. Confidentiality and anonymity was ensured throughout this research. The research findings showed that the participants shared positive experiences in as far as being able to easily access the health care service. Most participants were moved through a range of emotions which included shock. They felt heartbroken about the devastation and the disruptive nature of this illness to themselves and their family lives and, more seriously, were fearful of the morbidity and mortality thoughts which pervaded their thoughts but their health improved when drug resistant TB treatment was initiated. Many of the participants found it easy to disclose to their friends as they knew they could count on their support at the best and worst of times in their treatment journey. In conclusion the participants provided suggestions regarding their support needs on the journey to recovery from DR-TB. The researcher provided certain recommendations as far as the challenges expressed by the participants and these will contribute to strengthening the DR-TB adherence strategies. , Thesis (MPH) -- Faculty of Health Sciences, 2021
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- Authors: Sempe, Thabo Benedict
- Date: 2021-08
- Subjects: Multidrug-resistant tuberculosis
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/22940 , vital:53224
- Description: The purpose of this research study was to explore and describe the experiences of patients on short-term drug resistant TB treatment in a TB specialist hospital situated in Nelson Mandela District. Patients on XDR-TB treatment face many challenges which include side effects which they find hard to tolerate and they end up stopping the treatment. Socio-economic difficulties of concern include delayed social assistance from the government to support their families, particularly when they are breadwinners. A qualitative, descriptive, explorative contextual design was used in this research study. A non-probability convenience sampling method was employed. The target population for this study consisted of those DR-TB patients who were on short-term regimen and semi-structured individual interviews were conducted. There were twelve participants who voluntary participated in the research study although the first interview was a pilot study. Ethical principles were adhered to throughout the study. A total of seven themes and twenty-seven sub-themes arose during the data analysis and were fully discussed. Confidentiality and anonymity was ensured throughout this research. The research findings showed that the participants shared positive experiences in as far as being able to easily access the health care service. Most participants were moved through a range of emotions which included shock. They felt heartbroken about the devastation and the disruptive nature of this illness to themselves and their family lives and, more seriously, were fearful of the morbidity and mortality thoughts which pervaded their thoughts but their health improved when drug resistant TB treatment was initiated. Many of the participants found it easy to disclose to their friends as they knew they could count on their support at the best and worst of times in their treatment journey. In conclusion the participants provided suggestions regarding their support needs on the journey to recovery from DR-TB. The researcher provided certain recommendations as far as the challenges expressed by the participants and these will contribute to strengthening the DR-TB adherence strategies. , Thesis (MPH) -- Faculty of Health Sciences, 2021
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Knowledge and attitudes of women regarding cervical cancer and papanicolau smear screening in Caleb Motshabi, Bloemfontein
- Authors: Gwavu, Zintle
- Date: 2021-08
- Subjects: Cervix uteri -- Cancer -- South Africa , Pap test
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/21816 , vital:51795
- Description: The aim of the study was to explore the knowledge and attitudes of women in Caleb Motshabi location regarding cervical cancer and Papanicolaou (Pap) smear screening in order for district management to develop a health education programme on cervical cancer and the benefits of screening. Cervical cancer amongst women worldwide has been identified as the fourth most common cancer. A qualitative descriptive explorative contextual design was employed in this research study. A non-probability purposive sampling method was used. Women between the ages of 18-60 years’ old who reside in Caleb Motshabi location were the target population. Four focus group interviews were conducted. The groups consisted of four to six participants grouped together to discuss the matter. Ethical principles were maintained as well as the concept of trustworthiness throughout this study. Data analysis was done using Tesch’s approach to open coding in qualitative research. A total of seven themes and eight sub-themes arose during the analysis of the data and were completely discussed. The findings suggest that the majority of the participants were aware of cervical cancer and Pap smear, but they lacked knowledge of what cervical cancer is or its causes. Although some of the participants had done a Pap smear in their lifetime, knowledge about how and the reasons the procedure is done still lacked. The majority of participants had received information about Pap smear procedure from peers rather than from health care workers. A significant finding was the fact that the participants who had done the procedure were open to attending regular screenings since they had experience on how it is performed. In conclusion It was recommended that educational programmes relating to cervical cancer and Pap smear screening be intensified in the area. This can be done through increasing awareness programmes in the communities and during clinic visits. To try and increase the uptake of the Pap smear screening it was also recommended that mobile clinics should be introduced to encourage women in the communities. , Thesis (MPH) -- Faculty of Health Sciences, 2021
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- Authors: Gwavu, Zintle
- Date: 2021-08
- Subjects: Cervix uteri -- Cancer -- South Africa , Pap test
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/21816 , vital:51795
- Description: The aim of the study was to explore the knowledge and attitudes of women in Caleb Motshabi location regarding cervical cancer and Papanicolaou (Pap) smear screening in order for district management to develop a health education programme on cervical cancer and the benefits of screening. Cervical cancer amongst women worldwide has been identified as the fourth most common cancer. A qualitative descriptive explorative contextual design was employed in this research study. A non-probability purposive sampling method was used. Women between the ages of 18-60 years’ old who reside in Caleb Motshabi location were the target population. Four focus group interviews were conducted. The groups consisted of four to six participants grouped together to discuss the matter. Ethical principles were maintained as well as the concept of trustworthiness throughout this study. Data analysis was done using Tesch’s approach to open coding in qualitative research. A total of seven themes and eight sub-themes arose during the analysis of the data and were completely discussed. The findings suggest that the majority of the participants were aware of cervical cancer and Pap smear, but they lacked knowledge of what cervical cancer is or its causes. Although some of the participants had done a Pap smear in their lifetime, knowledge about how and the reasons the procedure is done still lacked. The majority of participants had received information about Pap smear procedure from peers rather than from health care workers. A significant finding was the fact that the participants who had done the procedure were open to attending regular screenings since they had experience on how it is performed. In conclusion It was recommended that educational programmes relating to cervical cancer and Pap smear screening be intensified in the area. This can be done through increasing awareness programmes in the communities and during clinic visits. To try and increase the uptake of the Pap smear screening it was also recommended that mobile clinics should be introduced to encourage women in the communities. , Thesis (MPH) -- Faculty of Health Sciences, 2021
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