Psychosocial impact of mental illness on family caregivers of mental healthcare users in Mangaung District
- Authors: Leburu, Maria
- Date: 2021-08
- Subjects: Home care services -- South Africa -- Mangaung -- Psychological aspects , Caregivers -- South Africa -- Mangaung
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/21770 , vital:51750
- Description: The purpose of this research study was to describe the psychosocial impact of mental illness on family caregivers of mental health care users in Mangaung district in order to explore strategies to empower mental health care users and their families to understand and to cope with mental illness problem. A qualitative, descriptive explorative and contextu al design was employed. A nonprobability, purposive sampling method was used to select participants. The target population was family caregivers from Mangaung district, whose ages were 18 years and above who were caring for mentally ill patients in their homes or admitted to a psychiatric institution. . Five focus group interviews were conducted but the first one was a pilot study. Ethical principles were maintained throughout the study as well as the concepts of trustworthiness were applied. Tesch’s approach to open coding in qualitative research was applied during data analysis. A total of six themes and twentynine sub-themes arose during data analysis and were fully discussed. Confidentiality and anonymity was ensured throughout the study. The findings suggested that most of the participants suffered psychosocial problems like stress, depression, stigma and financial constraints, although one participant indicated that she has accepted her situation of caregiving. In conclusion participants suggested that support groups should be established and awareness programmes should be put in place for community members to avoid stigmatising and laughing at caregivers, care users and family members. , Thesis (MPH) -- Faculty of Health Sciences, Public Health, 2021
- Full Text:
- Authors: Leburu, Maria
- Date: 2021-08
- Subjects: Home care services -- South Africa -- Mangaung -- Psychological aspects , Caregivers -- South Africa -- Mangaung
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/21770 , vital:51750
- Description: The purpose of this research study was to describe the psychosocial impact of mental illness on family caregivers of mental health care users in Mangaung district in order to explore strategies to empower mental health care users and their families to understand and to cope with mental illness problem. A qualitative, descriptive explorative and contextu al design was employed. A nonprobability, purposive sampling method was used to select participants. The target population was family caregivers from Mangaung district, whose ages were 18 years and above who were caring for mentally ill patients in their homes or admitted to a psychiatric institution. . Five focus group interviews were conducted but the first one was a pilot study. Ethical principles were maintained throughout the study as well as the concepts of trustworthiness were applied. Tesch’s approach to open coding in qualitative research was applied during data analysis. A total of six themes and twentynine sub-themes arose during data analysis and were fully discussed. Confidentiality and anonymity was ensured throughout the study. The findings suggested that most of the participants suffered psychosocial problems like stress, depression, stigma and financial constraints, although one participant indicated that she has accepted her situation of caregiving. In conclusion participants suggested that support groups should be established and awareness programmes should be put in place for community members to avoid stigmatising and laughing at caregivers, care users and family members. , Thesis (MPH) -- Faculty of Health Sciences, Public Health, 2021
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The implementation of National Core Standards with specific reference to clinical leadership: A case of Frere Hospital
- Authors: Rasi, Wandisa
- Date: 2021-06
- Subjects: Health facilities -- Standards , Health services administration -- Standards
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/21914 , vital:51842
- Description: BACKGROUND: Generally, many people in South Africa have difficulty accessing quality health services due to poor public service. Over 42 million citizens do not have health insurance and are growing sicker as they age. Health facilities, such as public health centers, are their only recourse. Health authorities in South Africa fail to monitor patient care effectively, as evidenced by their uninspiring record on patient experience. Anecdotes of poor patient experiences are extensive with the health ombudsman. The Office of Health Standards Compliance (OHSC) reports horrifying stories of patients sleeping on hospital floors due to the shortage of beds, patients unable to receive critical surgical treatment due to shortage of doctors, medical supplies and equipment failure or lack thereof. A few union protests have highlighted the poor quality of public healthcare. But it is not uncommon for South Africans to voice their displeasure over poor public healthcare. Health services are individualised and there is no specific interest group or community that is affected by this overall unpleasant experience. Indications of the growing public campaign against the deteriorating healthcare system may be as simple as the increasing number of medical legal claims. This study focuses on the implementation of national core standards with specific reference to clinical leadership. This study focuses on the implementation of national core standards with specific reference to clinical leadership. RESEARCH AIM: This research seeks to explore the effectiveness of the implementation of NCSs with specific reference to Clinical Leadership in Frere Hospital. It also wants to assess if the Frere hospital upholds the national core standards METHOD: qualitative research design was used in this study. Semi-structured, individual interviews were conducted. CONCLUSION: The researcher concluded that it is quite evident that the public health sector is complex and that environmental influence affect the ECDOH Functions within the health system. There is a relationship between clinical leadership and service delivery; now, to improve service delivery within the Frere hospital, strong leadership is needed to drive the change towards implementing the NCS. Ultimately, Frere hospital does not uphold the NCSs, and the staff needs to be educated on what is and how it can improve the hospital’s service delivery. RECOMMENDATIONS: Effective public leadership development, high performing and accountable leadership behavioural measurement at the most senior level at the Frere hospital is very empirical in driving effective delivery of services to patients. Effective Performance management, visible leadership role at all management levels. Performance appraisal system needs to be engineered to focus on performance and results. Recognition and Implementation of clinical leadership. Establish a culture and implementation of good governance principles in health institutions. Establish an institution based OHSC office that is visible and implement NCS through Batho Pele Principles. , Thesis (MPH) -- Faculty of Health Sciences, Public Health, 2021
- Full Text:
- Authors: Rasi, Wandisa
- Date: 2021-06
- Subjects: Health facilities -- Standards , Health services administration -- Standards
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/21914 , vital:51842
- Description: BACKGROUND: Generally, many people in South Africa have difficulty accessing quality health services due to poor public service. Over 42 million citizens do not have health insurance and are growing sicker as they age. Health facilities, such as public health centers, are their only recourse. Health authorities in South Africa fail to monitor patient care effectively, as evidenced by their uninspiring record on patient experience. Anecdotes of poor patient experiences are extensive with the health ombudsman. The Office of Health Standards Compliance (OHSC) reports horrifying stories of patients sleeping on hospital floors due to the shortage of beds, patients unable to receive critical surgical treatment due to shortage of doctors, medical supplies and equipment failure or lack thereof. A few union protests have highlighted the poor quality of public healthcare. But it is not uncommon for South Africans to voice their displeasure over poor public healthcare. Health services are individualised and there is no specific interest group or community that is affected by this overall unpleasant experience. Indications of the growing public campaign against the deteriorating healthcare system may be as simple as the increasing number of medical legal claims. This study focuses on the implementation of national core standards with specific reference to clinical leadership. This study focuses on the implementation of national core standards with specific reference to clinical leadership. RESEARCH AIM: This research seeks to explore the effectiveness of the implementation of NCSs with specific reference to Clinical Leadership in Frere Hospital. It also wants to assess if the Frere hospital upholds the national core standards METHOD: qualitative research design was used in this study. Semi-structured, individual interviews were conducted. CONCLUSION: The researcher concluded that it is quite evident that the public health sector is complex and that environmental influence affect the ECDOH Functions within the health system. There is a relationship between clinical leadership and service delivery; now, to improve service delivery within the Frere hospital, strong leadership is needed to drive the change towards implementing the NCS. Ultimately, Frere hospital does not uphold the NCSs, and the staff needs to be educated on what is and how it can improve the hospital’s service delivery. RECOMMENDATIONS: Effective public leadership development, high performing and accountable leadership behavioural measurement at the most senior level at the Frere hospital is very empirical in driving effective delivery of services to patients. Effective Performance management, visible leadership role at all management levels. Performance appraisal system needs to be engineered to focus on performance and results. Recognition and Implementation of clinical leadership. Establish a culture and implementation of good governance principles in health institutions. Establish an institution based OHSC office that is visible and implement NCS through Batho Pele Principles. , Thesis (MPH) -- Faculty of Health Sciences, Public Health, 2021
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Knowledge and perceptions of healthcare workers of the prescripts and implications of the Sexual Offences and Related matters amendment Act 5 of 2015 as applied to adolescent sexual and Reproductive health services in the Buffalo City Municipality
- Authors: Nake, Khanyisile
- Date: 2020-11
- Subjects: Teenagers--Medical care--Law and legislation
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/22885 , vital:53179
- Description: Background: In 2015, South Africa amended its Sexual Offences Act to address several disparities surrounding the issue of consensual sex among minors. The amendment has been faced with mixed reactions from the stakeholders with some supporting it while others opposing it. This study was conducted in clinics in East London to explore the knowledge and perception of healthcare workers about the prescripts of the ‘Criminal Law (Sexual Offences and Related Matters) Amendment Act 5 of 2015 and their implications to adolescent sexual and reproductive health services. The purpose of the study was to explore the knowledge and perception of healthcare workers about the prescripts of the ‘Criminal Law (Sexual Offences and Related Matters) Amendment Act 5 of 2015 and their implications to adolescent sexual and reproductive health services provision in Buffalo City Municipality in the Eastern Cape, South Africa. Methodology: This study applied the qualitative research approach and used a combination of descriptive and exploratory research design. Three clinic managers and nine professional nurses participated in the in-depth interviews. Thirteen general healthcare practitioners responsible for adolescents, sexual and reproductive health participated in key-informant interviews. Data was analysed using thematic analysis. Results: The study found that although healthcare practitioners are aware of the amendment act. However, there was inadequate understanding of the precise implications of this statutory initiative. Many of the participants were not informed of the intent of this act, whilst others suggested that they were not well trained regarding this act due to lack of funding in their respective clinics. Mixed views and perceptions on the impact of this act on their duties, on minors and on the general population were identified. Some were of the view that the Act will make it difficult to control the children while other welcomed it, because it leads to less teenage pregnancies, street abortions, and other similar experiences. Conclusion: In order to overcome these differences in perceptions, the Department of Health must create awareness among staff of the Act and its purpose. Develop initiatives to create understanding of the Act by all members of society to ensure the success of these legislative frameworks. , Thesis (MPH) -- Faculty of Health Sciences, 2020
- Full Text:
- Authors: Nake, Khanyisile
- Date: 2020-11
- Subjects: Teenagers--Medical care--Law and legislation
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/22885 , vital:53179
- Description: Background: In 2015, South Africa amended its Sexual Offences Act to address several disparities surrounding the issue of consensual sex among minors. The amendment has been faced with mixed reactions from the stakeholders with some supporting it while others opposing it. This study was conducted in clinics in East London to explore the knowledge and perception of healthcare workers about the prescripts of the ‘Criminal Law (Sexual Offences and Related Matters) Amendment Act 5 of 2015 and their implications to adolescent sexual and reproductive health services. The purpose of the study was to explore the knowledge and perception of healthcare workers about the prescripts of the ‘Criminal Law (Sexual Offences and Related Matters) Amendment Act 5 of 2015 and their implications to adolescent sexual and reproductive health services provision in Buffalo City Municipality in the Eastern Cape, South Africa. Methodology: This study applied the qualitative research approach and used a combination of descriptive and exploratory research design. Three clinic managers and nine professional nurses participated in the in-depth interviews. Thirteen general healthcare practitioners responsible for adolescents, sexual and reproductive health participated in key-informant interviews. Data was analysed using thematic analysis. Results: The study found that although healthcare practitioners are aware of the amendment act. However, there was inadequate understanding of the precise implications of this statutory initiative. Many of the participants were not informed of the intent of this act, whilst others suggested that they were not well trained regarding this act due to lack of funding in their respective clinics. Mixed views and perceptions on the impact of this act on their duties, on minors and on the general population were identified. Some were of the view that the Act will make it difficult to control the children while other welcomed it, because it leads to less teenage pregnancies, street abortions, and other similar experiences. Conclusion: In order to overcome these differences in perceptions, the Department of Health must create awareness among staff of the Act and its purpose. Develop initiatives to create understanding of the Act by all members of society to ensure the success of these legislative frameworks. , Thesis (MPH) -- Faculty of Health Sciences, 2020
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Usage of traditional medicines and other indigenous practices by childbearing women during pregnancy in Makoni District, Zimbabwe
- Authors: Chituku, Sibongile
- Date: 2020-09
- Subjects: Traditional medicine -- Zimbabwe , Medicinal plants
- Language: English
- Type: Doctoral theses , text
- Identifier: http://hdl.handle.net/10353/20142 , vital:45347
- Description: Use of traditional medicinal plants (TMPs) during pregnancy, labour and delivery is common globally although evidence on their therapeutic effectiveness and safety is scarce. Research relating to indigenous practices and utilisation of traditional medicinal plants by childbearing women during pregnancy in Makoni District, Zimbabwe was carried out. The study included identification of culturally important indigenous knowledge (IK) practices and TMPs used by pregnant women in order to understand how such plants and practices may affect maternal, foetal, labour, and infant outcomes. Four hundred questionnaires were distributed to postnatal mothers in Makoni District, aimed at obtaining information on IK practices associated with utilisation of TMPs by childbearing women during pregnancy. In addition to this, five focused group discussions were carried out between September 2016 and December 2017 with 66 traditional healers from Makoni District. Documented information included names of utilised plants, plant parts used, dosage, methods of preparation and administration, and reasons for use. Voucher specimens of the utilised plant species were collected. Brine shrimp lethality test was used to evaluate potential toxicity of the documented plant species. The collected data were analysed used Epi info version 7.1 and SPSS version 16.5. Quantitative data revealed that 168 (42.0percent) of pregnant women in Makoni District use TMPs and 95 (23.8percent) used traditional practices (including elephant dung) for maternal and childcare. Among the women who used TMPs were those who experienced precipitated and prolonged labour. Correlation was found between demographic factors and utilisation of TMPs. For example, being a Christian was significantly associated with using TMPs with relative risk (RR) value of 8.9. Postnatal mothers who used TMPs during their pregnancy were 82.0percent less likely to have their membranes ruptured artificially, RR = 0.2 and more likely to experience late decelerations during active phase (RR = 2.8) than those who did not use TMPs. The differences between those who used TMPs and those who did not during pregnancy and labour, showed no significant differences in infant outcomes. The ethnobotanical survey revealed that a total of 47 plant species from 27 families and 13 non-plant products were used as herbal, complementary and alternative medicines (CAM) by pregnant women. More than half of all the documented plant species (59.8percent), belonged to the Fabaceae (19.1), Asteraceae, (8.5percent), Convolvulaceae (6.4percent), Asparagaceae, Euphorbiaceae, Malvaceae, Rubiaceae, Vitaceae and Xanthorrhoeaceae (4.3percent each) families. The most used plants were shrubs (40.4percent), trees (27.7percent), climbers (17.0percent), herbs (12.8percent) and a grasses (2.1percent). The most used plant parts were roots (61.7percent), leaves (25.5percent), fruits (12.8percent) and bark (10.6percent). A total of 26 medical conditions were treated with the majority of medicinal plants used to dilate or widen the birth canal (55.3percent) and to augment labour or speed up the delivery process (46.8percent). Interviews with traditional healers revealed that 14.9percent of the documented herbal medicines were used to guard against witchcraft and to prevent the infants’ illnesses. Other major uses of herbal medicines during pregnancy included their use to lower blood pressure or hypertension during pregnancy (12.8percent), to prevent caesarean section (10.6percent) and to loosen or relax muscles during pregnancy (8.5percent). Widely used non-plant products included soil of a burrowing mole (relative frequency citation (RFC) value of 0.61), elephant dung (RFC = 0.59), wasp nest (RFC = 0.32) and soap (RFC = 25). The majority of these non-plant products (22.8percent) were used to dilate birth canal (7.6percent) and augment labour (15.2percent). None of the twenty-five species with (RFC) > 0.05 evaluated for potential toxicity were categorised as toxic, but Albizia amara, Datura stramonium and Ricinus communis were categorised as having medium toxicity levels, nine species as having low toxicity levels while 13 species were categorised as non-toxic. This study provides valuable insights into the use of medicinal plants used by women during pregnancy, labour, delivery and post-delivery in Makoni District, Zimbabwe. Medicinal plants play an integral role in the provision of basic health care in Zimbabwe. However, the brine shrimp lethality test results categorised some of the prescribed species such as Albizia amara, Datura stramonium and Ricinus communis as having medium levels of toxicity and this is a cause of concern regarding utilization of TMPs during pregnancy. Therefore, TMPs used during pregnancy should be subjected to detailed phytochemical, pharmacological and toxicological experiments aimed at identifying some of the potential toxic compounds and side effects associated with intake of TMPs and associated herbal products. , Thesis (PhD(Nursing)) -- Faculty of Health Sciences, 2020
- Full Text:
- Authors: Chituku, Sibongile
- Date: 2020-09
- Subjects: Traditional medicine -- Zimbabwe , Medicinal plants
- Language: English
- Type: Doctoral theses , text
- Identifier: http://hdl.handle.net/10353/20142 , vital:45347
- Description: Use of traditional medicinal plants (TMPs) during pregnancy, labour and delivery is common globally although evidence on their therapeutic effectiveness and safety is scarce. Research relating to indigenous practices and utilisation of traditional medicinal plants by childbearing women during pregnancy in Makoni District, Zimbabwe was carried out. The study included identification of culturally important indigenous knowledge (IK) practices and TMPs used by pregnant women in order to understand how such plants and practices may affect maternal, foetal, labour, and infant outcomes. Four hundred questionnaires were distributed to postnatal mothers in Makoni District, aimed at obtaining information on IK practices associated with utilisation of TMPs by childbearing women during pregnancy. In addition to this, five focused group discussions were carried out between September 2016 and December 2017 with 66 traditional healers from Makoni District. Documented information included names of utilised plants, plant parts used, dosage, methods of preparation and administration, and reasons for use. Voucher specimens of the utilised plant species were collected. Brine shrimp lethality test was used to evaluate potential toxicity of the documented plant species. The collected data were analysed used Epi info version 7.1 and SPSS version 16.5. Quantitative data revealed that 168 (42.0percent) of pregnant women in Makoni District use TMPs and 95 (23.8percent) used traditional practices (including elephant dung) for maternal and childcare. Among the women who used TMPs were those who experienced precipitated and prolonged labour. Correlation was found between demographic factors and utilisation of TMPs. For example, being a Christian was significantly associated with using TMPs with relative risk (RR) value of 8.9. Postnatal mothers who used TMPs during their pregnancy were 82.0percent less likely to have their membranes ruptured artificially, RR = 0.2 and more likely to experience late decelerations during active phase (RR = 2.8) than those who did not use TMPs. The differences between those who used TMPs and those who did not during pregnancy and labour, showed no significant differences in infant outcomes. The ethnobotanical survey revealed that a total of 47 plant species from 27 families and 13 non-plant products were used as herbal, complementary and alternative medicines (CAM) by pregnant women. More than half of all the documented plant species (59.8percent), belonged to the Fabaceae (19.1), Asteraceae, (8.5percent), Convolvulaceae (6.4percent), Asparagaceae, Euphorbiaceae, Malvaceae, Rubiaceae, Vitaceae and Xanthorrhoeaceae (4.3percent each) families. The most used plants were shrubs (40.4percent), trees (27.7percent), climbers (17.0percent), herbs (12.8percent) and a grasses (2.1percent). The most used plant parts were roots (61.7percent), leaves (25.5percent), fruits (12.8percent) and bark (10.6percent). A total of 26 medical conditions were treated with the majority of medicinal plants used to dilate or widen the birth canal (55.3percent) and to augment labour or speed up the delivery process (46.8percent). Interviews with traditional healers revealed that 14.9percent of the documented herbal medicines were used to guard against witchcraft and to prevent the infants’ illnesses. Other major uses of herbal medicines during pregnancy included their use to lower blood pressure or hypertension during pregnancy (12.8percent), to prevent caesarean section (10.6percent) and to loosen or relax muscles during pregnancy (8.5percent). Widely used non-plant products included soil of a burrowing mole (relative frequency citation (RFC) value of 0.61), elephant dung (RFC = 0.59), wasp nest (RFC = 0.32) and soap (RFC = 25). The majority of these non-plant products (22.8percent) were used to dilate birth canal (7.6percent) and augment labour (15.2percent). None of the twenty-five species with (RFC) > 0.05 evaluated for potential toxicity were categorised as toxic, but Albizia amara, Datura stramonium and Ricinus communis were categorised as having medium toxicity levels, nine species as having low toxicity levels while 13 species were categorised as non-toxic. This study provides valuable insights into the use of medicinal plants used by women during pregnancy, labour, delivery and post-delivery in Makoni District, Zimbabwe. Medicinal plants play an integral role in the provision of basic health care in Zimbabwe. However, the brine shrimp lethality test results categorised some of the prescribed species such as Albizia amara, Datura stramonium and Ricinus communis as having medium levels of toxicity and this is a cause of concern regarding utilization of TMPs during pregnancy. Therefore, TMPs used during pregnancy should be subjected to detailed phytochemical, pharmacological and toxicological experiments aimed at identifying some of the potential toxic compounds and side effects associated with intake of TMPs and associated herbal products. , Thesis (PhD(Nursing)) -- Faculty of Health Sciences, 2020
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Knowledge, attitude and behaviors of pregnant women towards pregnancy induced hypertension in Mdantsane Township Buffalo City Health District
- Authors: Peter, Bulelwa Beatrice
- Date: 2020-07
- Subjects: Hypotension in pregnancy , Pregnancy--Complications
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/22930 , vital:53221
- Description: The prevalence of pregnancy-induced hypertension (PIH) deaths is high in the Eastern Cape. Anecdotal evidence indicates that most women fall pregnant because of attitudes towards contraceptives and are seemingly unaware of pregnancy-related complications. Hence, the objective of this study was to examine the knowledge, attitudes and behaviour of pregnant women concerning pregnancyinduced hypertension in the Buffalo City Metropolitan Municipality. Methods: This was a cross-sectional survey involving 200 pregnant women attending antenatal healthcare clinics in Mdantsane, Buffalo City Metropolitan Municipality. A self-administered questionnaire was used for data collection. Collected data were managed and analysed using statistical package for social sciences (SPSS) version 24. Data analysis involved both descriptive (count, frequency, mean and standard deviation) and inferential statistics (Chi-square and logistics regression). For the inferential statistics, the level of significance was set at 0.05. Results: It was observed that the married women were more likely to be aware of PIH compared to single women (OR=2.4 95%CI (1.17; 4.90)). Of the 45 married women, 73.3% were aware of PIH compared to single women. Out of the women who participated in the study, 43.8% showed attitudes indicating they were not aware of this condition and associated complications from high-pressure during pregnancy. Compared to those in their first pregnancy, those who had previous pregnancy were more likely to be aware of PIH (OR=17.1 95 % CI (9.09; 32.15)). Of the 140 previously pregnant women, 83.6 % were aware of PIH compared to those during their first pregnancy. Conclusion: The results of the study indicate that sociodemographic factors play a role in pregnant women 's understanding of PIH. Improving knowledge of PIH among pregnant women requires context-specific strategies. During an antenatal visit, health care providers should implement focussed health education programmes. , Thesis (MA) -- Faculty of Health Sciences, 2020
- Full Text:
- Authors: Peter, Bulelwa Beatrice
- Date: 2020-07
- Subjects: Hypotension in pregnancy , Pregnancy--Complications
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/22930 , vital:53221
- Description: The prevalence of pregnancy-induced hypertension (PIH) deaths is high in the Eastern Cape. Anecdotal evidence indicates that most women fall pregnant because of attitudes towards contraceptives and are seemingly unaware of pregnancy-related complications. Hence, the objective of this study was to examine the knowledge, attitudes and behaviour of pregnant women concerning pregnancyinduced hypertension in the Buffalo City Metropolitan Municipality. Methods: This was a cross-sectional survey involving 200 pregnant women attending antenatal healthcare clinics in Mdantsane, Buffalo City Metropolitan Municipality. A self-administered questionnaire was used for data collection. Collected data were managed and analysed using statistical package for social sciences (SPSS) version 24. Data analysis involved both descriptive (count, frequency, mean and standard deviation) and inferential statistics (Chi-square and logistics regression). For the inferential statistics, the level of significance was set at 0.05. Results: It was observed that the married women were more likely to be aware of PIH compared to single women (OR=2.4 95%CI (1.17; 4.90)). Of the 45 married women, 73.3% were aware of PIH compared to single women. Out of the women who participated in the study, 43.8% showed attitudes indicating they were not aware of this condition and associated complications from high-pressure during pregnancy. Compared to those in their first pregnancy, those who had previous pregnancy were more likely to be aware of PIH (OR=17.1 95 % CI (9.09; 32.15)). Of the 140 previously pregnant women, 83.6 % were aware of PIH compared to those during their first pregnancy. Conclusion: The results of the study indicate that sociodemographic factors play a role in pregnant women 's understanding of PIH. Improving knowledge of PIH among pregnant women requires context-specific strategies. During an antenatal visit, health care providers should implement focussed health education programmes. , Thesis (MA) -- Faculty of Health Sciences, 2020
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Barriers to exclusive breastfeeding for mothers in the Tswelopele Municipality
- Authors: Quebu, Simthandile Rebecca
- Date: 2020-03
- Subjects: Breastfeeding , Infants -- Nutrition
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/27209 , vital:66466
- Description: The purpose of the study was to assess the barriers to exclusive breastfeeding (EBF) of mothers in the Tswelopele Municipality. The South Africa Demographic and Health survey reported the country’s EBF rates among children below six months of age to be at 32 percent for the year 2016. The World Health Organisation endorses the promotion and protection of the practice of EBF throughout the first six months of life, and the addition of complementary foods at six months coupled with breastfeeding up to two years of age. This feeding practise is recommended as the most efficient feeding practice to save infants from various illnesses and mortality across the globe, irrespective of their mother’s HIV status and economic class. A qualitative, contextual, explorative and descriptive research design was employed for this study to achieve the research objectives. The researcher incorporated both purposive and convenience sampling in this study. Purposive sampling was used to select the clinics, and convenience sampling was used to select the participants. Mothers who had infants 6-12 months old who were accessing infant and child health services in the three public health care facilities in the Tswelopele Municipality were a target population. Individual semi-structured interviews were administered, and an audio recorder was utilized to record the interviews with the participants' consent. The researcher throughout this study verbatim transcribed the interview audio tapes, and ethical principles and trustworthiness standards were adhered to. The University of Fort Hare (Ref # 2021=06=12 QuebuS) granted ethical clearance and all participants gave formal consent to voluntarily participate in this research. Tesch's approach for data analysis to open coding in qualitative research was used to analyse the data. Sixteen (16) participants in total took part in this study and the research study was conducted during the whole month of October 2021.During the data analysis, four main themes and thirteen sub-themes emerged, all of which were thoroughly examined. The findings suggest that maternal factors such as extreme pain in the breast, maternal sickness, belief that milk supply is insufficient, lack of EBF knowledge and cultural influences are the key contributors to the success or failure of EBF practice. When mothers have difficulties with breastfeeding, their difficulties can become barriers to EBF. Furthermore, a noteworthy finding is that some participants in this study were eager to breastfeed their babies and maintain EBF for six months; however, their infants had problems that prohibited them from doing so. These issues primarily included infants who refused to breastfeed and breast milk not being tolerated by some infants, as seen by baby vomiting after feeds. It was recommended that breastfeeding education and counselling should be available to mothers and their families from prenatal to postnatal so that they have enough time to make informed infant feeding decisions. Furthermore, an open dialogue with mothers and their families on a realistic understanding of what to expect when they first breastfeed, as well as the exploration of myths, inaccurate information, and concerns can be addressed during the counselling sessions. In conclusion, health professionals should also take into account the culture of mothers, respect cultural customs linked with breastfeeding, and respectfully educate them and their families about traditions that may affect breast-feeding. , Thesis (MPH) -- Faculty of Health Sciences, 2020
- Full Text:
- Authors: Quebu, Simthandile Rebecca
- Date: 2020-03
- Subjects: Breastfeeding , Infants -- Nutrition
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/27209 , vital:66466
- Description: The purpose of the study was to assess the barriers to exclusive breastfeeding (EBF) of mothers in the Tswelopele Municipality. The South Africa Demographic and Health survey reported the country’s EBF rates among children below six months of age to be at 32 percent for the year 2016. The World Health Organisation endorses the promotion and protection of the practice of EBF throughout the first six months of life, and the addition of complementary foods at six months coupled with breastfeeding up to two years of age. This feeding practise is recommended as the most efficient feeding practice to save infants from various illnesses and mortality across the globe, irrespective of their mother’s HIV status and economic class. A qualitative, contextual, explorative and descriptive research design was employed for this study to achieve the research objectives. The researcher incorporated both purposive and convenience sampling in this study. Purposive sampling was used to select the clinics, and convenience sampling was used to select the participants. Mothers who had infants 6-12 months old who were accessing infant and child health services in the three public health care facilities in the Tswelopele Municipality were a target population. Individual semi-structured interviews were administered, and an audio recorder was utilized to record the interviews with the participants' consent. The researcher throughout this study verbatim transcribed the interview audio tapes, and ethical principles and trustworthiness standards were adhered to. The University of Fort Hare (Ref # 2021=06=12 QuebuS) granted ethical clearance and all participants gave formal consent to voluntarily participate in this research. Tesch's approach for data analysis to open coding in qualitative research was used to analyse the data. Sixteen (16) participants in total took part in this study and the research study was conducted during the whole month of October 2021.During the data analysis, four main themes and thirteen sub-themes emerged, all of which were thoroughly examined. The findings suggest that maternal factors such as extreme pain in the breast, maternal sickness, belief that milk supply is insufficient, lack of EBF knowledge and cultural influences are the key contributors to the success or failure of EBF practice. When mothers have difficulties with breastfeeding, their difficulties can become barriers to EBF. Furthermore, a noteworthy finding is that some participants in this study were eager to breastfeed their babies and maintain EBF for six months; however, their infants had problems that prohibited them from doing so. These issues primarily included infants who refused to breastfeed and breast milk not being tolerated by some infants, as seen by baby vomiting after feeds. It was recommended that breastfeeding education and counselling should be available to mothers and their families from prenatal to postnatal so that they have enough time to make informed infant feeding decisions. Furthermore, an open dialogue with mothers and their families on a realistic understanding of what to expect when they first breastfeed, as well as the exploration of myths, inaccurate information, and concerns can be addressed during the counselling sessions. In conclusion, health professionals should also take into account the culture of mothers, respect cultural customs linked with breastfeeding, and respectfully educate them and their families about traditions that may affect breast-feeding. , Thesis (MPH) -- Faculty of Health Sciences, 2020
- Full Text:
Barriers to exclusive breastfeeding for mothers in the Tswelopele Municipality
- Authors: Quebu, Simthandile Rebecca
- Date: 2020-03
- Subjects: Breastfeeding
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/23589 , vital:58192
- Description: The purpose of the study was to assess the barriers to exclusive breastfeeding (EBF) of mothers in the Tswelopele Municipality. The South Africa Demographic and Health survey reported the country’s EBF rates among children below six months of age to be at 32percent for the year 2016. The World Health Organisation endorses the promotion and protection of the practice of EBF throughout the first six months of life, and the addition of complementary foods at six months coupled with breastfeeding up to two years of age. This feeding practise is recommended as the most efficient feeding practice to save infants from various illnesses and mortality across the globe, irrespective of their mother’s HIV status and economic class. A qualitative, contextual, explorative and descriptive research design was employed for this study to achieve the research objectives. The researcher incorporated both purposive and convenience sampling in this study. Purposive sampling was used to select the clinics, and convenience sampling was used to select the participants. Mothers who had infants 6-12 months old who were accessing infant and child health services in the three public health care facilities in the Tswelopele Municipality were a target population. Individual semi-structured interviews were administered, and an audio recorder was utilized to record the interviews with the participants' consent. The researcher throughout this study verbatim transcribed the interview audio tapes, and ethical principles and trustworthiness standards were adhered to. The University of Fort Hare (Ref # 2021=06=12 QuebuS) granted ethical clearance and all participants gave formal consent to voluntarily participate in this research. Tesch's approach for data analysis to open coding in qualitative research was used to analyse the data. Sixteen (16) participants in total took part in this study and the research study was conducted during the whole month of October 2021.During the data analysis, four main themes and thirteen sub-themes emerged, all of which were thoroughly examined. The findings suggest that maternal factors such as extreme pain in the breast, maternal sickness, belief that milk supply is insufficient, lack of EBF knowledge and cultural influences are the key contributors to the success or failure of EBF practice. When mothers have difficulties with breastfeeding, their difficulties can become barriers to EBF. Furthermore, a noteworthy finding is that some participants in this study were eager to breastfeed their babies and maintain EBF for six months; however, their infants had problems that prohibited them from doing so. These issues primarily included infants who refused to breastfeed and breast milk not being tolerated by some infants, as seen by baby vomiting after feeds. It was recommended that breastfeeding education and counselling should be available to mothers and their families from prenatal to postnatal so that they have enough time to make informed infant feeding decisions. Furthermore, an open dialogue with mothers and their families on a realistic understanding of what to expect when they first breastfeed, as well as the exploration of myths, inaccurate information, and concerns can be addressed during the counselling sessions. In conclusion, health professionals should also take into account the culture of mothers, respect cultural customs linked with breastfeeding, and respectfully educate them and their families about traditions that may affect breast-feeding. , Thesis (MPH) -- Faculty of Health Sciences, 2020
- Full Text:
- Authors: Quebu, Simthandile Rebecca
- Date: 2020-03
- Subjects: Breastfeeding
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/23589 , vital:58192
- Description: The purpose of the study was to assess the barriers to exclusive breastfeeding (EBF) of mothers in the Tswelopele Municipality. The South Africa Demographic and Health survey reported the country’s EBF rates among children below six months of age to be at 32percent for the year 2016. The World Health Organisation endorses the promotion and protection of the practice of EBF throughout the first six months of life, and the addition of complementary foods at six months coupled with breastfeeding up to two years of age. This feeding practise is recommended as the most efficient feeding practice to save infants from various illnesses and mortality across the globe, irrespective of their mother’s HIV status and economic class. A qualitative, contextual, explorative and descriptive research design was employed for this study to achieve the research objectives. The researcher incorporated both purposive and convenience sampling in this study. Purposive sampling was used to select the clinics, and convenience sampling was used to select the participants. Mothers who had infants 6-12 months old who were accessing infant and child health services in the three public health care facilities in the Tswelopele Municipality were a target population. Individual semi-structured interviews were administered, and an audio recorder was utilized to record the interviews with the participants' consent. The researcher throughout this study verbatim transcribed the interview audio tapes, and ethical principles and trustworthiness standards were adhered to. The University of Fort Hare (Ref # 2021=06=12 QuebuS) granted ethical clearance and all participants gave formal consent to voluntarily participate in this research. Tesch's approach for data analysis to open coding in qualitative research was used to analyse the data. Sixteen (16) participants in total took part in this study and the research study was conducted during the whole month of October 2021.During the data analysis, four main themes and thirteen sub-themes emerged, all of which were thoroughly examined. The findings suggest that maternal factors such as extreme pain in the breast, maternal sickness, belief that milk supply is insufficient, lack of EBF knowledge and cultural influences are the key contributors to the success or failure of EBF practice. When mothers have difficulties with breastfeeding, their difficulties can become barriers to EBF. Furthermore, a noteworthy finding is that some participants in this study were eager to breastfeed their babies and maintain EBF for six months; however, their infants had problems that prohibited them from doing so. These issues primarily included infants who refused to breastfeed and breast milk not being tolerated by some infants, as seen by baby vomiting after feeds. It was recommended that breastfeeding education and counselling should be available to mothers and their families from prenatal to postnatal so that they have enough time to make informed infant feeding decisions. Furthermore, an open dialogue with mothers and their families on a realistic understanding of what to expect when they first breastfeed, as well as the exploration of myths, inaccurate information, and concerns can be addressed during the counselling sessions. In conclusion, health professionals should also take into account the culture of mothers, respect cultural customs linked with breastfeeding, and respectfully educate them and their families about traditions that may affect breast-feeding. , Thesis (MPH) -- Faculty of Health Sciences, 2020
- Full Text:
Exploring knowledge, attitudes and psychosocial experiences of health care workers regarding covid-19 in Bufalo City Municipality
- Authors: Notununu, Zintle
- Date: 2020-03
- Subjects: Medical personnel and patient , Health services administration , COVID-19 (Disease)
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/23545 , vital:58122
- Description: The purpose of this study was to explore and describe the knowledge, attitude and psychosocial experiences of health care workers regarding Covid-19 in Buffalo City Municipality. Covid-19 is a disease that attacks the respiratory system and functions. It is a highly infectious disease with a lengthy 5-6 sometimes even 14-day incubation period. It is very serious condition and has killed a lot of people including the Health Care Workers A qualitative descriptive explorative contextual design was employed in this research study. The design was relevant for this study to explore and describe the knowledge, attitude, and psychosocial experiences of health workers regarding Covid-19 in Buffalo City Municipality. The non-probability sampling method was used and a convenient sampling technique was used to select the participants. Professional nurses who met the criteria and who were on duty on the day of data collection were included in the study. The researcher interviewed 15 professional nurses and stopped as the data was saturated. A semi-structured Interview guide was used as an instrument to collect data containing open-ended questions. The researcher maintained ethical principles throughout the study. Concepts of trustworthiness of the study were applied throughout the research. Tech’s eight steps approach was used to guide the data analysis process. The findings of this study indicate that health care workers have a high level of knowledge about Covid-19. They know what Covid-19 is, how it started, its signs and symptoms, how to protect themselves from it and its complications. Negative attitudes, fears were noticed from the HCWs and thus the need for psychological support was identified. Feelings of neglect and lack of motivation were also identified. Psychological support for health care workers must be provided to prevent staff burnout. Personal Protective Equipment used in the hospital premises must be left and washed in the hospital laundry to prevent the spread of infection to the families of the HCWs. It was indicated that there are health care workers who experienced chronic illnesses after being diagnosed with Covid-19. These chronic illnesses include diabetes and high blood pressure. It was brought to light that myths circulating on the social media about Covid-19 vaccines are delaying the end of Covid-19 epidemic by putting the health care workers at risk of being infected with it as they will be expected to treat patients diagnosed with Covid-19; therefore, government should develop a policy that will limit people from spreading things that they are not true and cannot prove. In conclusion, community awareness and forced vaccination are recommended to end the Covid-19 virus. Monitory incentives should be provided to motivate health care workers. Their overtime that they have worked during Covid-19 must be paid. The Department of Health and hospital managers must make sure that working conditions are improved. This includes the availability of machines to test for Covid-19. More research needs to be done to find out why some people who were diagnosed with Covid-19 end up having chronic illnesses that they never had previously. , Thesis (MPH) -- Faculty of Health Sciences, 2020
- Full Text:
- Authors: Notununu, Zintle
- Date: 2020-03
- Subjects: Medical personnel and patient , Health services administration , COVID-19 (Disease)
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/23545 , vital:58122
- Description: The purpose of this study was to explore and describe the knowledge, attitude and psychosocial experiences of health care workers regarding Covid-19 in Buffalo City Municipality. Covid-19 is a disease that attacks the respiratory system and functions. It is a highly infectious disease with a lengthy 5-6 sometimes even 14-day incubation period. It is very serious condition and has killed a lot of people including the Health Care Workers A qualitative descriptive explorative contextual design was employed in this research study. The design was relevant for this study to explore and describe the knowledge, attitude, and psychosocial experiences of health workers regarding Covid-19 in Buffalo City Municipality. The non-probability sampling method was used and a convenient sampling technique was used to select the participants. Professional nurses who met the criteria and who were on duty on the day of data collection were included in the study. The researcher interviewed 15 professional nurses and stopped as the data was saturated. A semi-structured Interview guide was used as an instrument to collect data containing open-ended questions. The researcher maintained ethical principles throughout the study. Concepts of trustworthiness of the study were applied throughout the research. Tech’s eight steps approach was used to guide the data analysis process. The findings of this study indicate that health care workers have a high level of knowledge about Covid-19. They know what Covid-19 is, how it started, its signs and symptoms, how to protect themselves from it and its complications. Negative attitudes, fears were noticed from the HCWs and thus the need for psychological support was identified. Feelings of neglect and lack of motivation were also identified. Psychological support for health care workers must be provided to prevent staff burnout. Personal Protective Equipment used in the hospital premises must be left and washed in the hospital laundry to prevent the spread of infection to the families of the HCWs. It was indicated that there are health care workers who experienced chronic illnesses after being diagnosed with Covid-19. These chronic illnesses include diabetes and high blood pressure. It was brought to light that myths circulating on the social media about Covid-19 vaccines are delaying the end of Covid-19 epidemic by putting the health care workers at risk of being infected with it as they will be expected to treat patients diagnosed with Covid-19; therefore, government should develop a policy that will limit people from spreading things that they are not true and cannot prove. In conclusion, community awareness and forced vaccination are recommended to end the Covid-19 virus. Monitory incentives should be provided to motivate health care workers. Their overtime that they have worked during Covid-19 must be paid. The Department of Health and hospital managers must make sure that working conditions are improved. This includes the availability of machines to test for Covid-19. More research needs to be done to find out why some people who were diagnosed with Covid-19 end up having chronic illnesses that they never had previously. , Thesis (MPH) -- Faculty of Health Sciences, 2020
- Full Text:
Leadership competencies of primary health care facility managers at Buffalo City Metropolitan District in the Eastern Cape Province
- Authors: Makinana, Noxolo Beauty
- Date: 2020-02
- Subjects: Primary health care -- Leadership , Facility management
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/22033 , vital:51954
- Description: The study explored and described the perceptions and experiences of Primary Health Care facility managers regarding their leadership and management competencies in the Buffalo City Metro Health District in the Eastern Cape Province. The objectives of this study were to explore and describe the leadership competencies required for facility managers to exercise their leadership in Primary Health Care facilities and to bring about the recommendation. The population of this study comprised of facility managers who are appointed in facility management position permanently or on acting basis during the time of the study, in rural, urban, and semi-urban Primary Health Care facilities (clinics) in Buffalo City Health District. Non-probability convenience sampling was used to select the participants. Two focus group interviews with 10 participants per group were held to collect data. Thematic data analysis was used to analyze the data. The findings were discussed according to themes and subthemes. Four themes and 9 subthemes were identified from the data. Themes include departmental factors, individual factors, and political factors. The subthemes include managers lack of support, need for capacitation of staff, lack of uniformity in exercising leadership, work positions, infrastructure, staff shortages, lack of involvement in decision making, lack of resources, feeling of being a failure, not meeting expectation (workload) role of managers, pressure, the resistance of staff members to change, absenteeism, teamwork, compliance to policies, the 80/20 principle, nurse-patient ratio, and consultation. The trustworthiness of the findings was ensured by focussing on dependability, confirmability, transferability, and credibility. The study concluded that facility managers receive very limited supervision to perform their management duties in their facilities. They also need adequate resources, induction, training and a habitable work environment to ensure that quality care is provided. The study recommended that the Department of Health should have a program for supervision, mentorship, and guiding the facility managers in the Primary Health Care facilities. It should also establish a training and development program on leadership, finance management and technology. Lastly, there should be more accountability by facility managers at the different departmental levels i.e. national, province, district subdistrict, and other internal and external stakeholders. , Thesis (MPH) -- Faculty of Health Sciences, 2020
- Full Text:
- Authors: Makinana, Noxolo Beauty
- Date: 2020-02
- Subjects: Primary health care -- Leadership , Facility management
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/22033 , vital:51954
- Description: The study explored and described the perceptions and experiences of Primary Health Care facility managers regarding their leadership and management competencies in the Buffalo City Metro Health District in the Eastern Cape Province. The objectives of this study were to explore and describe the leadership competencies required for facility managers to exercise their leadership in Primary Health Care facilities and to bring about the recommendation. The population of this study comprised of facility managers who are appointed in facility management position permanently or on acting basis during the time of the study, in rural, urban, and semi-urban Primary Health Care facilities (clinics) in Buffalo City Health District. Non-probability convenience sampling was used to select the participants. Two focus group interviews with 10 participants per group were held to collect data. Thematic data analysis was used to analyze the data. The findings were discussed according to themes and subthemes. Four themes and 9 subthemes were identified from the data. Themes include departmental factors, individual factors, and political factors. The subthemes include managers lack of support, need for capacitation of staff, lack of uniformity in exercising leadership, work positions, infrastructure, staff shortages, lack of involvement in decision making, lack of resources, feeling of being a failure, not meeting expectation (workload) role of managers, pressure, the resistance of staff members to change, absenteeism, teamwork, compliance to policies, the 80/20 principle, nurse-patient ratio, and consultation. The trustworthiness of the findings was ensured by focussing on dependability, confirmability, transferability, and credibility. The study concluded that facility managers receive very limited supervision to perform their management duties in their facilities. They also need adequate resources, induction, training and a habitable work environment to ensure that quality care is provided. The study recommended that the Department of Health should have a program for supervision, mentorship, and guiding the facility managers in the Primary Health Care facilities. It should also establish a training and development program on leadership, finance management and technology. Lastly, there should be more accountability by facility managers at the different departmental levels i.e. national, province, district subdistrict, and other internal and external stakeholders. , Thesis (MPH) -- Faculty of Health Sciences, 2020
- Full Text:
Anthropometric, physiological and biochemical parameters in relation to perceived stress and lifestyle diseases among correctional services staff in the Amathole Region, Eastern Cape, South Africa
- Matshikiza, Ondela Innocent https://orcid.org/0000-0002-9326-6697
- Authors: Matshikiza, Ondela Innocent https://orcid.org/0000-0002-9326-6697
- Date: 2020-01
- Subjects: Correctional personnel , Lifestyles -- Diseases
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/22082 , vital:51981
- Description: Background: The prevalence of overweight and obesity has risen significantly in the past three decades, with marked variations across countries in the levels and trends in overweight and obesity with distinct regional patterns. Physical inactivity has increased in South Africa as the country develops, with increasing urbanization and modernization, technology, and low physical activities at workplaces. Correctional Services staff tend to suffer from chronic diseases such as cardiovascular diseases, type 2 diabetes mellitus, orthopaedic conditions, high cholesterol, overweight, and obesity due to insufficient physical activity engagement. Aims and objectives: The study aimed to assess the anthropometric, physiological, biochemical parameters in relation to stress and lifestyle diseases of correctional services staff in the Amathole region, Eastern Cape, South Africa. Methods: A cross-sectional study was conducted among 81 Correctional Services Staff in the Amathole Region, Eastern Cape, South Africa. The employees' health status, anthropometric, physiological, biochemical parameters, and perceived stress were assessed. Data were analyzed using SPSS version 25.0. Data were expressed as mean +/- SD for quantitative variables or numbers and percentages for categorical variables. An independent sample T-test was used to assess statistical differences between males and female correctional service staff. Pearson correlation was used to determine the relationship strength and linearity of the anthropometric, physiological, and biochemical parameters. A direct logistic regression was employed to predict the indicator variable. Results: The results showed that just over two-thirds (67%) of the participants reported not being ready for exercise. Nearly 94% of the study population were categorized as either overweight, obese, severely obese, or morbidly obese. Approximately three-quarters (74%) of the respondents reported moderate to high- perceived stress levels. Approximately 40% of the population were at risk determined by the Waist to Hip Ratio. Furthermore, waist circumference, 43% and 77% of the study population were categorized as obese, male and female participants, respectively. Over three-quarters, (79%) of the study population were diagnosed with elevated high pressure, stage 1 and 2 hypertension, or a hypertensive crisis. A minimum of 18% and 17.3% of the study population were diagnosed with Pre-diabetic and Type 2 diabetes mellitus, respectively. An analysis of gender group differences showed overweight, obesity, and Body Fat Percentages were prevalent among females. The results further showed a positive increase in abdominal fat accumulation with age; thus, the Weight Circumference of the participants was significantly high. The prevalence of overweight and obesity was common among male and female correctional services staff, with a significantly lower Body Fat Percentage for males compared to females. However, upon further investigation, males' Waist to Hip Ratio was significantly higher than for female correctional services staff. Perceived stress scores for male participants were significantly lower compared to female participants. An analysis of staff member group differences showed that support staff's body fat percentage was significantly lower than top management and middle management groups. There was also a statistical difference in the Waist to Hip Ratio for the three managerial groups. More than three-quarters of the correctional services staff were classified with moderate (65.4%) to highstress levels (8.6%). Direct logistic regression was performed to assess the influence of several independent variables on the likelihood that participants would be classified as Obese. The results indicated that 80.2% of the participants were correctly classified before the model was conducted. Another direct logistic regression analysis was employed to predict stress among Correctional Services Staff found that age made a statistically significant contribution to the model, while the most robust predictor to report high stress was not getting enough exercise. Conclusion: Overweight and obesity are prevalent among Correctional Services Staff, putting them at risk for developing lifestyle-related diseases. Workplace health promotion is significant in preventing non-communicable diseases among Correctional Services Staff to reduce medical costs, increase disability incidents, reduce morbidity, mortality and improve work productivity. The role of physical exercise in the development of stress and decreasing obesity is central to addressing these issues in the workplace. , Thesis (MA) -- Faculty of Health Sciences, Human Movement Science, 2020
- Full Text:
- Authors: Matshikiza, Ondela Innocent https://orcid.org/0000-0002-9326-6697
- Date: 2020-01
- Subjects: Correctional personnel , Lifestyles -- Diseases
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/22082 , vital:51981
- Description: Background: The prevalence of overweight and obesity has risen significantly in the past three decades, with marked variations across countries in the levels and trends in overweight and obesity with distinct regional patterns. Physical inactivity has increased in South Africa as the country develops, with increasing urbanization and modernization, technology, and low physical activities at workplaces. Correctional Services staff tend to suffer from chronic diseases such as cardiovascular diseases, type 2 diabetes mellitus, orthopaedic conditions, high cholesterol, overweight, and obesity due to insufficient physical activity engagement. Aims and objectives: The study aimed to assess the anthropometric, physiological, biochemical parameters in relation to stress and lifestyle diseases of correctional services staff in the Amathole region, Eastern Cape, South Africa. Methods: A cross-sectional study was conducted among 81 Correctional Services Staff in the Amathole Region, Eastern Cape, South Africa. The employees' health status, anthropometric, physiological, biochemical parameters, and perceived stress were assessed. Data were analyzed using SPSS version 25.0. Data were expressed as mean +/- SD for quantitative variables or numbers and percentages for categorical variables. An independent sample T-test was used to assess statistical differences between males and female correctional service staff. Pearson correlation was used to determine the relationship strength and linearity of the anthropometric, physiological, and biochemical parameters. A direct logistic regression was employed to predict the indicator variable. Results: The results showed that just over two-thirds (67%) of the participants reported not being ready for exercise. Nearly 94% of the study population were categorized as either overweight, obese, severely obese, or morbidly obese. Approximately three-quarters (74%) of the respondents reported moderate to high- perceived stress levels. Approximately 40% of the population were at risk determined by the Waist to Hip Ratio. Furthermore, waist circumference, 43% and 77% of the study population were categorized as obese, male and female participants, respectively. Over three-quarters, (79%) of the study population were diagnosed with elevated high pressure, stage 1 and 2 hypertension, or a hypertensive crisis. A minimum of 18% and 17.3% of the study population were diagnosed with Pre-diabetic and Type 2 diabetes mellitus, respectively. An analysis of gender group differences showed overweight, obesity, and Body Fat Percentages were prevalent among females. The results further showed a positive increase in abdominal fat accumulation with age; thus, the Weight Circumference of the participants was significantly high. The prevalence of overweight and obesity was common among male and female correctional services staff, with a significantly lower Body Fat Percentage for males compared to females. However, upon further investigation, males' Waist to Hip Ratio was significantly higher than for female correctional services staff. Perceived stress scores for male participants were significantly lower compared to female participants. An analysis of staff member group differences showed that support staff's body fat percentage was significantly lower than top management and middle management groups. There was also a statistical difference in the Waist to Hip Ratio for the three managerial groups. More than three-quarters of the correctional services staff were classified with moderate (65.4%) to highstress levels (8.6%). Direct logistic regression was performed to assess the influence of several independent variables on the likelihood that participants would be classified as Obese. The results indicated that 80.2% of the participants were correctly classified before the model was conducted. Another direct logistic regression analysis was employed to predict stress among Correctional Services Staff found that age made a statistically significant contribution to the model, while the most robust predictor to report high stress was not getting enough exercise. Conclusion: Overweight and obesity are prevalent among Correctional Services Staff, putting them at risk for developing lifestyle-related diseases. Workplace health promotion is significant in preventing non-communicable diseases among Correctional Services Staff to reduce medical costs, increase disability incidents, reduce morbidity, mortality and improve work productivity. The role of physical exercise in the development of stress and decreasing obesity is central to addressing these issues in the workplace. , Thesis (MA) -- Faculty of Health Sciences, Human Movement Science, 2020
- Full Text:
Perceptions of patients about poor attitudes and behaviours of midwives in the maternity sections in a public hospital of East London South Africa
- Authors: Lawrence, N W
- Date: 2019-11
- Subjects: Midwifery , Nursing ethics , Nurse and patient
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/26918 , vital:66099
- Description: Midwives are largely responsible for maternity care in hospitals. As such, they play a significant role in ensuring the health and well-being of pregnant women and newborn babies. To perform that duty effectively, midwives need to be professional in their conduct. However, there are reports that midwives have displayed poor attitudes and behaviour in South Africa. The main research question was “what are the perceptions of patients about attitudes and behaviours of midwives in the maternity section in a public hospital in East London, South Africa?” The aim of the study was to explore the reasons behind poor attitudes and behaviour of midwives in midwifery practice and suggest interventions that can be introduced to promote professional attitudes and behaviour by midwives in a public hospital in East London. This study used a qualitative approach to collect data. The research instrument that was used for this study was semi-structured interviews. The sample of 20 participants which was purposively selected consisted of women that have used the East London public hospital maternity section. Data was collected using coding and themes emanating from the data generated. Midwives are valued and play a very significant role in providing maternal care. Be that as it may, midwives exhibit poor attitudes and behaviours such as being rude, lack sympathy, and lack of empathy. On the other hand, midwives act professionally and are supportive of patients. There is, therefore, a need for the provision of professional etiquette training services, stress counseling, use of work development strategies and performance management systems, technical training, linkage system of traditional and modern midwives, and the use of internet platforms to increase interaction between midwives and those that need maternity care services. , Thesis (MPA) -- Faculty of Health Sciences, 2019
- Full Text:
- Authors: Lawrence, N W
- Date: 2019-11
- Subjects: Midwifery , Nursing ethics , Nurse and patient
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/26918 , vital:66099
- Description: Midwives are largely responsible for maternity care in hospitals. As such, they play a significant role in ensuring the health and well-being of pregnant women and newborn babies. To perform that duty effectively, midwives need to be professional in their conduct. However, there are reports that midwives have displayed poor attitudes and behaviour in South Africa. The main research question was “what are the perceptions of patients about attitudes and behaviours of midwives in the maternity section in a public hospital in East London, South Africa?” The aim of the study was to explore the reasons behind poor attitudes and behaviour of midwives in midwifery practice and suggest interventions that can be introduced to promote professional attitudes and behaviour by midwives in a public hospital in East London. This study used a qualitative approach to collect data. The research instrument that was used for this study was semi-structured interviews. The sample of 20 participants which was purposively selected consisted of women that have used the East London public hospital maternity section. Data was collected using coding and themes emanating from the data generated. Midwives are valued and play a very significant role in providing maternal care. Be that as it may, midwives exhibit poor attitudes and behaviours such as being rude, lack sympathy, and lack of empathy. On the other hand, midwives act professionally and are supportive of patients. There is, therefore, a need for the provision of professional etiquette training services, stress counseling, use of work development strategies and performance management systems, technical training, linkage system of traditional and modern midwives, and the use of internet platforms to increase interaction between midwives and those that need maternity care services. , Thesis (MPA) -- Faculty of Health Sciences, 2019
- Full Text:
Perceptions of patients about poor attitudes and behaviours of midwives in the maternity sections in a public hospital of East London South Africa
- Authors: Lawrence, N W
- Date: 2019-11
- Subjects: Midwives , Maternity nursing
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/23521 , vital:58085
- Description: Midwives are largely responsible for maternity care in hospitals. As such, they play a significant role in ensuring the health and well-being of pregnant women and newborn babies. To perform that duty effectively, midwives need to be professional in their conduct. However, there are reports that midwives have displayed poor attitudes and behaviour in South Africa. The main research question was “what are the perceptions of patients about attitudes and behaviours of midwives in the maternity section in a public hospital in East London, South Africa?” The aim of the study was to explore the reasons behind poor attitudes and behaviour of midwives in midwifery practice and suggest interventions that can be introduced to promote professional attitudes and behaviour by midwives in a public hospital in East London. This study used a qualitative approach to collect data. The research instrument that was used for this study was semi-structured interviews. The sample of 20 participants which was purposively selected consisted of women that have used the East London public hospital maternity section. Data was collected using coding and themes emanating from the data generated. Midwives are valued and play a very significant role in providing maternal care. Be that as it may, midwives exhibit poor attitudes and behaviours such as being rude, lack sympathy, and lack of empathy. On the other hand, midwives act professionally and are supportive of patients. There is, therefore, a need for the provision of professional etiquette training services, stress counseling, use of work development strategies and performance management systems, technical training, linkage system of traditional and modern midwives, and the use of internet platforms to increase interaction between midwives and those that need maternity care services. , Thesis (MPH) -- Faculty of Health Sciences, 2019
- Full Text:
- Authors: Lawrence, N W
- Date: 2019-11
- Subjects: Midwives , Maternity nursing
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/23521 , vital:58085
- Description: Midwives are largely responsible for maternity care in hospitals. As such, they play a significant role in ensuring the health and well-being of pregnant women and newborn babies. To perform that duty effectively, midwives need to be professional in their conduct. However, there are reports that midwives have displayed poor attitudes and behaviour in South Africa. The main research question was “what are the perceptions of patients about attitudes and behaviours of midwives in the maternity section in a public hospital in East London, South Africa?” The aim of the study was to explore the reasons behind poor attitudes and behaviour of midwives in midwifery practice and suggest interventions that can be introduced to promote professional attitudes and behaviour by midwives in a public hospital in East London. This study used a qualitative approach to collect data. The research instrument that was used for this study was semi-structured interviews. The sample of 20 participants which was purposively selected consisted of women that have used the East London public hospital maternity section. Data was collected using coding and themes emanating from the data generated. Midwives are valued and play a very significant role in providing maternal care. Be that as it may, midwives exhibit poor attitudes and behaviours such as being rude, lack sympathy, and lack of empathy. On the other hand, midwives act professionally and are supportive of patients. There is, therefore, a need for the provision of professional etiquette training services, stress counseling, use of work development strategies and performance management systems, technical training, linkage system of traditional and modern midwives, and the use of internet platforms to increase interaction between midwives and those that need maternity care services. , Thesis (MPH) -- Faculty of Health Sciences, 2019
- Full Text:
Treatment adherence among tuberculosis patients in Nelson Mandela District, Eastern Cape Province
- Authors: Sohuma, Ntombifikile
- Date: 2019-09
- Subjects: Patient compliance , Tuberculosis -- Patients , Tuberculosis -- Mortality
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/22957 , vital:53254
- Description: Tuberculosis (TB) morbidity and mortality rates remain high globally and are even higher in Africa. The key factor that continues to drive the burden of disease is poor compliance / adherence to treatment regimens. This study aimed to identify determinants that continue to drive poor treatment adherence among low-income communities in South Africa. Methods A cross-sectional survey was conducted, drawing on TB patients who were defaulting on treatment. An assessment tool with several socio-economic and disease-related determinants was administered to participants. Data was entered into MS Excel and analysed in SPSS version 24. Results Regarding health services factors generally, all participants agreed that health service delivery was conducted in a conducive environment and that facilities were reasonably close to their places of residence. Participants demonstrated that health workers do not provide adequate information regarding medications that patients receive. Of patients cited, 11percent indicated that they stopped medications owing to health services. When questioned, participants reported that health workers shouted at them for coming late (e.g. after lunch) and that waiting times were very long. Approximately 85percent of the study participants were more likely to adhere poorly to TB medication owing to various factors such as comorbidities and personal perceptions of wellbeing / health status. Comorbidities are high among patients, with 58percent taking other medication while on TB treatment. Self-prognosis on wellbeing is significantly high, and 44percent reported a tendency to stop medication when they were seemingly in recovery. The unemployment rate among respondents was 78percent, with limited education: 69percent had below matric. Of the respondents, 40percent showed an unsatisfactory perception of their social and economic life, 55percent were somewhat satisfied and only 5percent were very satisfied. These indicators constitute a highly vulnerable community that depends heavily on subsidised healthcare from the state. Adherence to TB treatment is mainly influenced by poverty, the health service provider–patient relationship and perceived stigma. Limited family support was noted towards the treatment of patients. , Thesis (MPH) -- Faculty of Health Sciences, 2019
- Full Text:
- Authors: Sohuma, Ntombifikile
- Date: 2019-09
- Subjects: Patient compliance , Tuberculosis -- Patients , Tuberculosis -- Mortality
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/22957 , vital:53254
- Description: Tuberculosis (TB) morbidity and mortality rates remain high globally and are even higher in Africa. The key factor that continues to drive the burden of disease is poor compliance / adherence to treatment regimens. This study aimed to identify determinants that continue to drive poor treatment adherence among low-income communities in South Africa. Methods A cross-sectional survey was conducted, drawing on TB patients who were defaulting on treatment. An assessment tool with several socio-economic and disease-related determinants was administered to participants. Data was entered into MS Excel and analysed in SPSS version 24. Results Regarding health services factors generally, all participants agreed that health service delivery was conducted in a conducive environment and that facilities were reasonably close to their places of residence. Participants demonstrated that health workers do not provide adequate information regarding medications that patients receive. Of patients cited, 11percent indicated that they stopped medications owing to health services. When questioned, participants reported that health workers shouted at them for coming late (e.g. after lunch) and that waiting times were very long. Approximately 85percent of the study participants were more likely to adhere poorly to TB medication owing to various factors such as comorbidities and personal perceptions of wellbeing / health status. Comorbidities are high among patients, with 58percent taking other medication while on TB treatment. Self-prognosis on wellbeing is significantly high, and 44percent reported a tendency to stop medication when they were seemingly in recovery. The unemployment rate among respondents was 78percent, with limited education: 69percent had below matric. Of the respondents, 40percent showed an unsatisfactory perception of their social and economic life, 55percent were somewhat satisfied and only 5percent were very satisfied. These indicators constitute a highly vulnerable community that depends heavily on subsidised healthcare from the state. Adherence to TB treatment is mainly influenced by poverty, the health service provider–patient relationship and perceived stigma. Limited family support was noted towards the treatment of patients. , Thesis (MPH) -- Faculty of Health Sciences, 2019
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Adult circumcision practices of traditional surgeons and nurses in relation to the initiates’ health outcomes/morbidity in the Eastern Cape
- Authors: Dalasa, Siyamthemba
- Date: 2019
- Subjects: Circumcision -- Social aspects
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10353/17029 , vital:40834
- Description: BACKGROUND Despite the adverse outcomes associated with traditional male circumcision, the practice remains prevalent, especially in the Eastern Cape, South, Africa. This study seeks to assess the practices of traditional surgeons and nurses in relation to the prevention and control of infections and their understanding of human physiological mechanisms during circumcision processes. METHOD This study has adopted a qualitative design, which involved conducting 115 semistructured interviews among traditional surgeons, traditional nurses and traditionally circumcised men, and one focus group discussion among traditional nurses. The data generated were transcribed and subjected to thematic content analysis. RESULTS The analysis revealed that both traditional surgeons and nurses demonstrated both poor aseptic techniques and a lack of knowledge of how the human body functions. Their lack of knowledge of basic human physiology meant that they trivialised sepsis in the penile wound. In addition, the seclusion lodges for circumcision and initiates living were unclean and uninhabitable. CONCLUSION The poor aseptic techniques of traditional surgeons and nurses, as well as the uncleanliness of their environment during traditional male circumcision procedures, could expose initiates to infections and morbidity. Environmental health officers should regularly supervise traditional surgeons and nurses in order to prevent the adverse health outcomes associated with the traditional male circumcision practice.
- Full Text:
- Authors: Dalasa, Siyamthemba
- Date: 2019
- Subjects: Circumcision -- Social aspects
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10353/17029 , vital:40834
- Description: BACKGROUND Despite the adverse outcomes associated with traditional male circumcision, the practice remains prevalent, especially in the Eastern Cape, South, Africa. This study seeks to assess the practices of traditional surgeons and nurses in relation to the prevention and control of infections and their understanding of human physiological mechanisms during circumcision processes. METHOD This study has adopted a qualitative design, which involved conducting 115 semistructured interviews among traditional surgeons, traditional nurses and traditionally circumcised men, and one focus group discussion among traditional nurses. The data generated were transcribed and subjected to thematic content analysis. RESULTS The analysis revealed that both traditional surgeons and nurses demonstrated both poor aseptic techniques and a lack of knowledge of how the human body functions. Their lack of knowledge of basic human physiology meant that they trivialised sepsis in the penile wound. In addition, the seclusion lodges for circumcision and initiates living were unclean and uninhabitable. CONCLUSION The poor aseptic techniques of traditional surgeons and nurses, as well as the uncleanliness of their environment during traditional male circumcision procedures, could expose initiates to infections and morbidity. Environmental health officers should regularly supervise traditional surgeons and nurses in order to prevent the adverse health outcomes associated with the traditional male circumcision practice.
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An assessment of school food and nutrition environments for strengthening the integrated school health policy in the Eastern Cape, South Africa
- Authors: Okeyo, Alice Phelgona
- Date: 2019
- Subjects: Nutrition policy -- South Africa -- Eastern Cape School health services -- South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: http://hdl.handle.net/10353/17039 , vital:40836
- Description: The 2012 Integrated School Health Policy (ISHP) offers a framework for adequate school food environment. It aims to contribute to the improvement of the general health of school-going children and to address health barriers to learning in order to improve education outcomes. This study assessed the school food and nutrition environment and critically appraised the position of nutrition within ISHP in order to make recommendations for best practice and promotion of healthy-eating in quintiles 1 – 3 secondary school learners of the Eastern Cape, South Africa. Areas evaluated included the school food environment (National School Food Nutrition Programme, NSNP, tuck-shop, vendor, lunch box, and school vegetable garden); eating practice; nutrition knowledge; and nutrition status. A quantitative and qualitative cross-sectional design was applied in data collection. Data was collected from 1,357 learners at 18 secondary schools in three districts: Buffalo City Metropolitan Municipality, Chris Hani and OR Tambo, using semi-structured questionnaires. Five major food items provided in the school food and nutrition environment included: beans, pap, sour-milk, rice, and samp (maize) (NSNP); chips, sandwich, pap, biscuits, and cake (tuck-shop); chips, sandwich, pap, cake, and pop-corn (vendor); and samp (maize), noodles, fat-cake, chips, and Russian/Viennas (lunch boxes). Only three of the 16 schools had school vegetable gardens which produced vegetables and no fruits. Five most frequently eaten foods for breakfast were porridge, rusks, stiff-pap, bread-with-spread, eggs, and polony. Learners from quintile 3 (60.8percent) significantly ate more cooked porridge than learners from quintiles 1 and 2 (51.9percent) (p = 0.015). Leaners from quintile 3 (59.4percent) significantly ate more brown bread-with-spread than learners from quintiles 1 and 2 (50.4) (p = 0.022). The majority of learners (72.7percent) ate breakfast; more male learners (24.4percent) than female learners (29.1percent) skipped breakfast. The majority (62.2percent) of learners had poor nutritional knowledge; significantly, more male (35percent) than female (27percent) learners had poor nutritional knowledge (p = 0.003). Nutritional knowledge increased with age; significantly more grade 8 learners had poor (42.6percent) nutritional knowledge than grade 12 learners (14.1percent) (p < 0.001). Leaners from quintile 3 had good (23.5percent) nutritional knowledge than learners from quintiles 1 and 2 (15.7percent) (p < 0.001). School lessons, books and television were the most important source for nutritional information to learners. The most significant source was lessons (72.0percent; p < 0.001); followed by television (69.4percent; p < 0.001) and books (67.8percent; p = 0.014), in that ranking order. The majority of learners (64percent) had normal body weight. The prevalence of underweight, overweight and obesity was 13.0percent, 15.0percent and 8.0percent, respectively. The prevalence of overweight and obesity was higher in females than males (21.3percent vs 5.3percent; overweight; p < 0.001)) and (11.6percent vs 1.2percent; obesity; p < 0.001), respectively; while the prevalence in terms of underweight was significantly higher in male (21.3percent) learners than in female learners (8.1percent); p < 0.001. The study indicated that the school food environment was not supported by ISHP. The Integrated School Health Policy did not include on-site package for nutritional assessment, thus, there is need to offer nutritional interventions in schools.
- Full Text:
- Authors: Okeyo, Alice Phelgona
- Date: 2019
- Subjects: Nutrition policy -- South Africa -- Eastern Cape School health services -- South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: http://hdl.handle.net/10353/17039 , vital:40836
- Description: The 2012 Integrated School Health Policy (ISHP) offers a framework for adequate school food environment. It aims to contribute to the improvement of the general health of school-going children and to address health barriers to learning in order to improve education outcomes. This study assessed the school food and nutrition environment and critically appraised the position of nutrition within ISHP in order to make recommendations for best practice and promotion of healthy-eating in quintiles 1 – 3 secondary school learners of the Eastern Cape, South Africa. Areas evaluated included the school food environment (National School Food Nutrition Programme, NSNP, tuck-shop, vendor, lunch box, and school vegetable garden); eating practice; nutrition knowledge; and nutrition status. A quantitative and qualitative cross-sectional design was applied in data collection. Data was collected from 1,357 learners at 18 secondary schools in three districts: Buffalo City Metropolitan Municipality, Chris Hani and OR Tambo, using semi-structured questionnaires. Five major food items provided in the school food and nutrition environment included: beans, pap, sour-milk, rice, and samp (maize) (NSNP); chips, sandwich, pap, biscuits, and cake (tuck-shop); chips, sandwich, pap, cake, and pop-corn (vendor); and samp (maize), noodles, fat-cake, chips, and Russian/Viennas (lunch boxes). Only three of the 16 schools had school vegetable gardens which produced vegetables and no fruits. Five most frequently eaten foods for breakfast were porridge, rusks, stiff-pap, bread-with-spread, eggs, and polony. Learners from quintile 3 (60.8percent) significantly ate more cooked porridge than learners from quintiles 1 and 2 (51.9percent) (p = 0.015). Leaners from quintile 3 (59.4percent) significantly ate more brown bread-with-spread than learners from quintiles 1 and 2 (50.4) (p = 0.022). The majority of learners (72.7percent) ate breakfast; more male learners (24.4percent) than female learners (29.1percent) skipped breakfast. The majority (62.2percent) of learners had poor nutritional knowledge; significantly, more male (35percent) than female (27percent) learners had poor nutritional knowledge (p = 0.003). Nutritional knowledge increased with age; significantly more grade 8 learners had poor (42.6percent) nutritional knowledge than grade 12 learners (14.1percent) (p < 0.001). Leaners from quintile 3 had good (23.5percent) nutritional knowledge than learners from quintiles 1 and 2 (15.7percent) (p < 0.001). School lessons, books and television were the most important source for nutritional information to learners. The most significant source was lessons (72.0percent; p < 0.001); followed by television (69.4percent; p < 0.001) and books (67.8percent; p = 0.014), in that ranking order. The majority of learners (64percent) had normal body weight. The prevalence of underweight, overweight and obesity was 13.0percent, 15.0percent and 8.0percent, respectively. The prevalence of overweight and obesity was higher in females than males (21.3percent vs 5.3percent; overweight; p < 0.001)) and (11.6percent vs 1.2percent; obesity; p < 0.001), respectively; while the prevalence in terms of underweight was significantly higher in male (21.3percent) learners than in female learners (8.1percent); p < 0.001. The study indicated that the school food environment was not supported by ISHP. The Integrated School Health Policy did not include on-site package for nutritional assessment, thus, there is need to offer nutritional interventions in schools.
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Experiences of midwives regarding the use of pharmacological and non-pharmacological labour pain interventions in Lejweleputswa district in Free State
- Parkies, Limakatso Elizabeth
- Authors: Parkies, Limakatso Elizabeth
- Date: 2019
- Subjects: Anesthesia in obstetrics , Labor (Obstetrics) , Pain -- Treatment
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/27187 , vital:66387
- Description: Due to the disabling effects of severe labour pains, labour pain management remains an important topic in midwifery and needs to be reviewed more often. According to studies, various pain relief options, both pharmacological and non-pharmacological, are available to help women cope with pain, but midwives did not employ these techniques adequately because of various experiences. Studies further indicate that, though the limited number of these techniques were employed they were not effective on some women. Thus, the purpose of this research study was to explore and describe midwives’ experiences on pharmacological and non-pharmacological labour pain management in the Lejweleputswa District of the Free State Province. This study employed a qualitative, descriptive, explorative, and contextual design. A purposive sampling technique was used to select the participants. The target population was midwives who work in the maternity wards of the institutions under study with three to five years’ experience in midwifery. Individual, face-face, semi-structured interviews were conducted; these were recorded for the researcher’s reference purposes, so as not to overlook important information. In addition, the researcher made use of field notes, recording in them what was heard, observed, felt, experienced, and thought during the interview. Ethical principles and trustworthiness were maintained throughout this study. Data analysis was done using Tesch’s approach to open coding in qualitative research. Confidentiality and anonymity were ensured throughout the interviews. The nine themes and 19 sub-themes that emerged during data analysis were discussed comprehensively. The findings indicate that midwives use both pharmacological and non-pharmacological methods in managing labour pain. Some methods are effective in relieving pain for certain mothers, while other methods proved ineffective. Midwives administer Pethidine and Phenergan as per doctors’ prescription; non-pharmacological methods, such as back massage, deep breathing exercises, mobilisation, and warm baths or showers are also employed. Midwives provide pharmacological methods to all women in labour, and routinely employ non-pharmacological methods. Although the midwives are willing to manage patients’ pain, they face certain challenges, such as shortage of staff, increased workload, as well as inadequate resources. This leads to inadequate provision of non-pharmacological care. In conclusion, the midwives’ experiences were that both pharmacological and non-pharmacological techniques were used for all labouring women and they had relaxing and calming effects on some women, resulting to them giving birth with ease, although for some they were not effective. In addition, the pharmacological interventions caused drowsiness to some women and babies. The findings will provide evidence-based information to the Free State Department of Health in order to assist policymakers and stakeholders in initiating and developing appropriate policies, guidelines, and interventions that can improve labour pain management. The Free State Department of Health should consider using other opioids and non-opioids in managing labour pain to broaden the scope of pain relief methods available to the midwives. , Thesis (MPH) -- Faculty of Health Sciences, 2019
- Full Text:
- Authors: Parkies, Limakatso Elizabeth
- Date: 2019
- Subjects: Anesthesia in obstetrics , Labor (Obstetrics) , Pain -- Treatment
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/27187 , vital:66387
- Description: Due to the disabling effects of severe labour pains, labour pain management remains an important topic in midwifery and needs to be reviewed more often. According to studies, various pain relief options, both pharmacological and non-pharmacological, are available to help women cope with pain, but midwives did not employ these techniques adequately because of various experiences. Studies further indicate that, though the limited number of these techniques were employed they were not effective on some women. Thus, the purpose of this research study was to explore and describe midwives’ experiences on pharmacological and non-pharmacological labour pain management in the Lejweleputswa District of the Free State Province. This study employed a qualitative, descriptive, explorative, and contextual design. A purposive sampling technique was used to select the participants. The target population was midwives who work in the maternity wards of the institutions under study with three to five years’ experience in midwifery. Individual, face-face, semi-structured interviews were conducted; these were recorded for the researcher’s reference purposes, so as not to overlook important information. In addition, the researcher made use of field notes, recording in them what was heard, observed, felt, experienced, and thought during the interview. Ethical principles and trustworthiness were maintained throughout this study. Data analysis was done using Tesch’s approach to open coding in qualitative research. Confidentiality and anonymity were ensured throughout the interviews. The nine themes and 19 sub-themes that emerged during data analysis were discussed comprehensively. The findings indicate that midwives use both pharmacological and non-pharmacological methods in managing labour pain. Some methods are effective in relieving pain for certain mothers, while other methods proved ineffective. Midwives administer Pethidine and Phenergan as per doctors’ prescription; non-pharmacological methods, such as back massage, deep breathing exercises, mobilisation, and warm baths or showers are also employed. Midwives provide pharmacological methods to all women in labour, and routinely employ non-pharmacological methods. Although the midwives are willing to manage patients’ pain, they face certain challenges, such as shortage of staff, increased workload, as well as inadequate resources. This leads to inadequate provision of non-pharmacological care. In conclusion, the midwives’ experiences were that both pharmacological and non-pharmacological techniques were used for all labouring women and they had relaxing and calming effects on some women, resulting to them giving birth with ease, although for some they were not effective. In addition, the pharmacological interventions caused drowsiness to some women and babies. The findings will provide evidence-based information to the Free State Department of Health in order to assist policymakers and stakeholders in initiating and developing appropriate policies, guidelines, and interventions that can improve labour pain management. The Free State Department of Health should consider using other opioids and non-opioids in managing labour pain to broaden the scope of pain relief methods available to the midwives. , Thesis (MPH) -- Faculty of Health Sciences, 2019
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A budget and expenditure review of public hospital facilities in the Eastern Cape in transition towards National Health Insurance
- Authors: Ndlovu, Garfield OG
- Date: 2018
- Subjects: Health services administration--South Africa--Eastern Cape Government spending policy--South Africa--Eastern Cape Health services administration
- Language: English
- Type: Thesis , Masters , Public Health Leadership
- Identifier: http://hdl.handle.net/10353/11139 , vital:37174
- Description: The quest to ameliorate and enhance the equitable allocation of resources in the Health Industry remains a global challenge, in particular the distribution of funding resources in public sector health facilities. The need to analyse and understand the appropriation of budget and utilisation of funds by hospital facilities is important in the in the Eastern Cape. The focus of the study seeks to explore recommendations that can be employed in the provincial budgeting process of Hospital Facilities, in a bid to optimise efficiency and improve the funding process as part of the provincial readiness activities towards the realisation of the NHI System and funding approach, wherein the NHI Fund will be a public entity that is not in business to make profit (NHI Booklet 2012: 05). This fund will introduce new systems of paying hospitals and professionals for the services they provide, aiming to be fair to them but to put a stop to unreasonable profits (NHI Booklet 2012: 05). The research has employed the use of descriptive quantitative techniques in order to undertake an expenditure review of existing financial data with respect to the Eastern Cape public Hospitals. The study followed a quantitative descriptive research design, the purpose of this study is that, quantitative research deals in numbers, logic, and an objective stance (Babbie: 2010). The Quantitative aspect of the study found that the data provided, allowed the researcher to organise, synthesise, prioritise and assign value to specific key performance indicators that would be used for the appraisal of hospital facilities in relation to the expenditure patterns based which would present a glimpse into how the Eastern Cape department of health utilises funding resources.
- Full Text:
- Authors: Ndlovu, Garfield OG
- Date: 2018
- Subjects: Health services administration--South Africa--Eastern Cape Government spending policy--South Africa--Eastern Cape Health services administration
- Language: English
- Type: Thesis , Masters , Public Health Leadership
- Identifier: http://hdl.handle.net/10353/11139 , vital:37174
- Description: The quest to ameliorate and enhance the equitable allocation of resources in the Health Industry remains a global challenge, in particular the distribution of funding resources in public sector health facilities. The need to analyse and understand the appropriation of budget and utilisation of funds by hospital facilities is important in the in the Eastern Cape. The focus of the study seeks to explore recommendations that can be employed in the provincial budgeting process of Hospital Facilities, in a bid to optimise efficiency and improve the funding process as part of the provincial readiness activities towards the realisation of the NHI System and funding approach, wherein the NHI Fund will be a public entity that is not in business to make profit (NHI Booklet 2012: 05). This fund will introduce new systems of paying hospitals and professionals for the services they provide, aiming to be fair to them but to put a stop to unreasonable profits (NHI Booklet 2012: 05). The research has employed the use of descriptive quantitative techniques in order to undertake an expenditure review of existing financial data with respect to the Eastern Cape public Hospitals. The study followed a quantitative descriptive research design, the purpose of this study is that, quantitative research deals in numbers, logic, and an objective stance (Babbie: 2010). The Quantitative aspect of the study found that the data provided, allowed the researcher to organise, synthesise, prioritise and assign value to specific key performance indicators that would be used for the appraisal of hospital facilities in relation to the expenditure patterns based which would present a glimpse into how the Eastern Cape department of health utilises funding resources.
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A model of support for divorced professional nurses in the Eastern Cape, South Africa
- Authors: Murray, Daphne
- Date: 2018
- Subjects: Divorce counseling -- South Africa -- Eastern Cape Divorce -- Social aspects -- South Africa -- Eastern Cape Employees -- Counseling of -- South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Doctoral , Nursing
- Identifier: http://hdl.handle.net/10353/10028 , vital:35293
- Description: The purpose of this research study was to develop a support model for divorced professional nurses in the health-care facilities of the Department of Health, Eastern Cape, with guidelines to operationalise the model. Divorce is a process with psychological as well as social implications, and with a series of economic causes it also has implications in terms of the society and culture in which individuals operate. The main causes for divorce are adultery and domestic violence, especially against women and children (Lurea, 2011:99). A need for support from managers in the health-care facilities of the Department of Health, Eastern Cape during the process of divorce was identified by divorced professional nurses, since a lack of support and all the negativity that encompasses divorce could lead to severe depression, which will later have a negative effect on work performance (Abdul Kadir & Bifulco, 2010:858). The literature in this field of study, along with experience, indicates that it is imperative for divorced professional nurses to be supported in the workplace to help them to cope emotionally with their work demands, as prescribed by the South African Nursing Council. An explorative, descriptive and contextual qualitative design with theory generation was used to achieve the purpose of the study. Snowball sampling was employed to select participants, namely divorced professional nurses who were unknown to the researcher. A sample of 21 divorced professional nurses who work in health-care facilities in the Buffalo City Metropolitan Municipality in the Eastern Cape participated in the study. Data was collected by means of individual face-face interviews with divorced professional nurses. The interviews continued until data saturation was reached. Field notes supplemented data that could not be portrayed by audio-taped interviews, such as non- verbal communication in observed interactions. Data analysis was done using Tesch’s approach to open coding in qualitative research. Themes, categories and sub-categories emerged from the data analysis and were fully discussed, becoming fundamental units in the development of the conceptual framework as well as in the model. The researcher did a thorough literature review to conceptualise the identified concepts on which the model was based. The description and evaluation of the model, along with guidelines to operationalise the model, were done in accordance with the method described by Chinn and Kramer (2011:197). The justification of the research, the limitations, and the recommendations for operationalisation of the model of support for divorced professional nurses working in the Buffalo City Metropolitan Municipality of the Department of Health, Eastern Cape Province, and South Africa were indicated accordingly.
- Full Text:
- Authors: Murray, Daphne
- Date: 2018
- Subjects: Divorce counseling -- South Africa -- Eastern Cape Divorce -- Social aspects -- South Africa -- Eastern Cape Employees -- Counseling of -- South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Doctoral , Nursing
- Identifier: http://hdl.handle.net/10353/10028 , vital:35293
- Description: The purpose of this research study was to develop a support model for divorced professional nurses in the health-care facilities of the Department of Health, Eastern Cape, with guidelines to operationalise the model. Divorce is a process with psychological as well as social implications, and with a series of economic causes it also has implications in terms of the society and culture in which individuals operate. The main causes for divorce are adultery and domestic violence, especially against women and children (Lurea, 2011:99). A need for support from managers in the health-care facilities of the Department of Health, Eastern Cape during the process of divorce was identified by divorced professional nurses, since a lack of support and all the negativity that encompasses divorce could lead to severe depression, which will later have a negative effect on work performance (Abdul Kadir & Bifulco, 2010:858). The literature in this field of study, along with experience, indicates that it is imperative for divorced professional nurses to be supported in the workplace to help them to cope emotionally with their work demands, as prescribed by the South African Nursing Council. An explorative, descriptive and contextual qualitative design with theory generation was used to achieve the purpose of the study. Snowball sampling was employed to select participants, namely divorced professional nurses who were unknown to the researcher. A sample of 21 divorced professional nurses who work in health-care facilities in the Buffalo City Metropolitan Municipality in the Eastern Cape participated in the study. Data was collected by means of individual face-face interviews with divorced professional nurses. The interviews continued until data saturation was reached. Field notes supplemented data that could not be portrayed by audio-taped interviews, such as non- verbal communication in observed interactions. Data analysis was done using Tesch’s approach to open coding in qualitative research. Themes, categories and sub-categories emerged from the data analysis and were fully discussed, becoming fundamental units in the development of the conceptual framework as well as in the model. The researcher did a thorough literature review to conceptualise the identified concepts on which the model was based. The description and evaluation of the model, along with guidelines to operationalise the model, were done in accordance with the method described by Chinn and Kramer (2011:197). The justification of the research, the limitations, and the recommendations for operationalisation of the model of support for divorced professional nurses working in the Buffalo City Metropolitan Municipality of the Department of Health, Eastern Cape Province, and South Africa were indicated accordingly.
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A programme of academic support for students at the public nursing college of the Eastern Cape Province in South Africa
- Senti, Nomandithini Innocent
- Authors: Senti, Nomandithini Innocent
- Date: 2018
- Subjects: Nursing -- Study and teaching Nursing -- Study and teaching -- Simulation methods
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: http://hdl.handle.net/10353/10997 , vital:36128
- Description: A comprehensive academic support at the public nursing college is important. Despite this, there is no such support in public nursing colleges in the Eastern Cape Province of South Africa. The aim of the study was to develop an academic support programme for students in order to improve their success in Higher Education. The study endeavoured to answer the following questions: What are the academic support needs of students at the public nursing college in the Eastern Cape of South Africa? What conceptual framework can be developed for the academic support programme of students? What academic support programme can be developed for students at the public nursing college? What guidelines can be developed for implementation of academic support programme of students? The objectives were: to describe academic support needs of students at the public nursing college in the eastern Cape Province of South Africa; to develop a conceptual framework for the academic support programme for students at the public nursing college in the Eastern Cape of South Africa; to develop an academic support programme for students at the public nursing college in the Eastern Cape in south Africa and lastly to describe guidelines for implementation and evaluation of the academic support programme. The research design used in this study was quantitative, qualitative, descriptive, evaluative, and theory generation. The study was conducted according to four phases. Phase one focussed on academic supports needs of the student. Phase two focussed on development of conceptual framework for the students at the public nursing college in Eastern Cape Province. Phase three focussed on the development of the academic support programme for the students, whereas phase four focussed on description of guidelines for implementation and evaluation of the academic support programme. The population of the study consisted of students undergoing training in a four-year programme at the Public Nursing College. The target population was the students in the same programme from level one to level four of training. The sampling technique used was a probability sampling with multi-stage and cluster sampling techniques being utilized. The total sample was n=333 participants. A quantitative self-developed questionnaire was used to collect empirical data. The questionnaire consisted of eight sections. Descriptive data was analysed using Statistic Package of Social Sciences (SPSS) version 24. Exploratory factor analysis was conducted on the descriptive data collected in phase one. Concept analysis and identification were done through the utilisation of exploratory factor analysis. The conceptual framework for the academic support programme was identified through the analysed factors. Fifteen factors were derived from the descriptive data. The conceptual framework of the academic support programme discussed in Chapter 5 was used also in the development of the academic support programme. It is in this chapter that assumptions, context, stakeholders, process, outcome, dynamics and, lastly, the recipient were discussed, along with a description of the programme. The programme was evaluated in accordance with the criteria for programme evaluation. The recommendations brought forward for the academic support programme were: The guidelines have to be tested for the implementation of the programme; benchmarking should be done to compare with other institutions of higher learning regarding their academic support programmes; an academic brochure regarding academic support must be available in the college and should be given to students on arrival as part of a package; and neutral researcher should conduct the same research in the same college.
- Full Text:
- Authors: Senti, Nomandithini Innocent
- Date: 2018
- Subjects: Nursing -- Study and teaching Nursing -- Study and teaching -- Simulation methods
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: http://hdl.handle.net/10353/10997 , vital:36128
- Description: A comprehensive academic support at the public nursing college is important. Despite this, there is no such support in public nursing colleges in the Eastern Cape Province of South Africa. The aim of the study was to develop an academic support programme for students in order to improve their success in Higher Education. The study endeavoured to answer the following questions: What are the academic support needs of students at the public nursing college in the Eastern Cape of South Africa? What conceptual framework can be developed for the academic support programme of students? What academic support programme can be developed for students at the public nursing college? What guidelines can be developed for implementation of academic support programme of students? The objectives were: to describe academic support needs of students at the public nursing college in the eastern Cape Province of South Africa; to develop a conceptual framework for the academic support programme for students at the public nursing college in the Eastern Cape of South Africa; to develop an academic support programme for students at the public nursing college in the Eastern Cape in south Africa and lastly to describe guidelines for implementation and evaluation of the academic support programme. The research design used in this study was quantitative, qualitative, descriptive, evaluative, and theory generation. The study was conducted according to four phases. Phase one focussed on academic supports needs of the student. Phase two focussed on development of conceptual framework for the students at the public nursing college in Eastern Cape Province. Phase three focussed on the development of the academic support programme for the students, whereas phase four focussed on description of guidelines for implementation and evaluation of the academic support programme. The population of the study consisted of students undergoing training in a four-year programme at the Public Nursing College. The target population was the students in the same programme from level one to level four of training. The sampling technique used was a probability sampling with multi-stage and cluster sampling techniques being utilized. The total sample was n=333 participants. A quantitative self-developed questionnaire was used to collect empirical data. The questionnaire consisted of eight sections. Descriptive data was analysed using Statistic Package of Social Sciences (SPSS) version 24. Exploratory factor analysis was conducted on the descriptive data collected in phase one. Concept analysis and identification were done through the utilisation of exploratory factor analysis. The conceptual framework for the academic support programme was identified through the analysed factors. Fifteen factors were derived from the descriptive data. The conceptual framework of the academic support programme discussed in Chapter 5 was used also in the development of the academic support programme. It is in this chapter that assumptions, context, stakeholders, process, outcome, dynamics and, lastly, the recipient were discussed, along with a description of the programme. The programme was evaluated in accordance with the criteria for programme evaluation. The recommendations brought forward for the academic support programme were: The guidelines have to be tested for the implementation of the programme; benchmarking should be done to compare with other institutions of higher learning regarding their academic support programmes; an academic brochure regarding academic support must be available in the college and should be given to students on arrival as part of a package; and neutral researcher should conduct the same research in the same college.
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A trend analysis of perinatal mortalities in Barberton Hospital between 2002 and 2016
- Modupe, Oluwarotimi Folorunsho
- Authors: Modupe, Oluwarotimi Folorunsho
- Date: 2018
- Subjects: Newborn infants -- Mortality Perinatology
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: http://hdl.handle.net/10353/11254 , vital:37630
- Description: Background and aim: There is no doubt that the quantification of data on the new born is imperative towards the design of effective public health policy interventions. However, the trend in under-five mortality rates in Barberton Hospital is not recognised as no empirical investigation has been undertaken to ascertain its position in this regard. A trend analysis of infant and maternal deaths in will therefore shed light on possible factors influencing this trend. The specific objectives of this study were to examine the trend and causes of perinatal mortality in Barberton Hospital from 2002-2016. It was hypothesized that there would be a downward trend in the infant and maternal mortality rates in Barberton Hospital from 2002-2016, possibly as a result of improved medical care. Methods: This retrospective study was conducted in Barberton Hospital, located in the Umjindi sub-district in Mpumalanga Province. The data was drawn from the Perinatal Problem Identification Programme (PPIP) database. Pregnancy related deaths of women, and of children from birth to one year in Barberton Hospital from 1999-2014 were extracted. The population study consists of a record review of all infant and maternal deaths in Barberton Hospital from 2002-2016 and captured in the data on the PPIP. The University of Fort Hare ethical review committee approved the study protocol. In addition, permission to use the data was granted by the Mpumalanga Department of Health after applying for approval for use of the data for academic purposes. The data was then exported into an Excel format document and fed to Statistical Package for Social Sciences (SPSS) program to allow for a more detailed analysis. Results: Over the period under review (2002-2016), a total of 21151 babies were delivered, 20593 babies were alive at discharge, 221 babies died in the first 28 days of delivery, and 337 babies were stillbirths. 18577 were normal weight (≥2500gram), 1581 weighed 2000-2499 grams, 568 weighed 1500-1999grams, 286 weighed 1000-1499 and 139 weighed below 1000grams. All the women who gave birth over the period under review, 27.3percent tested positive to HIV, 40.3 percent tested negative. Of all women that tested positive, 80.2percent received any form of ART. For over half of women that received ART (n=2981), the type of ART they received is unknown. Most women whose baby died were young. One in five women did not have their age captured in the database indicating an important gap that need to be addressed in order to ensure integrity of the database. Of all the 558 perinatal mortality, 75.3 weighed below 2500 grams. Low birth weight is major risk factor for child mortality. Babies weighing less than 2,500 grams are 20 times more likely to die than heavier babies. For all the perinatal deaths, the majority of their mothers received antenatal care services. About 86.6percent were delivered at Barberton Hospital and only 1 child was delivered in transit to the hospital. Of all the 558 deaths, only 7.5 percent was multiple births. Of the 558 babies that died, only 39.6percent were born alive, 37.1percent was macerated stillbirths. The syphilis serology test indicated that most mothers tested negative. The HIV serology test indicated that 28percent of mothers tested positive. The hospital recorded a total of 337 stillbirths between 2002 and 2016. This accounts for 60.2percent of all perinatal mortality over the period. Of all stillbirths, 61.6percent was macerated stillbirths. Yearly analysis of stillbirth rate did not clearly indicate whether stillbirth rate is increasing or declining. Not less than 56 primary obstetric causes of perinatal deaths were identified in this study. Many perinatal deaths were unexplainable due to lack of post-mortem. Idiopathic preterm labour was the main primary obstetric cause of early (34.5percent) and late neonatal (38.9percent) deaths, and the next was labour related intrapartum asphyxia. Labour related intrapartum asphyxia also accounts for 6.8percent of all stillbirths. The main known primary obstetric cause of stillbirth in the Hospital was Proteinuric hypertension/hypertension disorders. Over 60percent of perinatal mortality in Barberton Hospital was due to associated maternal conditions. Only 10.9percent was due to fetal related conditions and 26.4percent was unexplained. Few deaths were due to health system failure and domestic violence. Spontaneous preterm labour (18.4percent), abnormal labour or uterine rupture (14.5percent), maternal hypertension (12.4percent), antepartum haemorrhage (10.2percent) were the main associated maternal conditions causes of perinatal mortality in Barberton Hospital. Similarly, Fetal abnormality and infections were the main associated fetal condition causes of perinatal mortality. Of all the babies that were alive at birth, 85.2percent died due to maternal related conditions. Most neonates died due to spontaneous preterm labour (43.5percent) and abnormal labour or uterine rupture (23.1percent). Maternal HIV, diabetics and syphilis only accounted for a few neonatal deaths. For stillbirth babies that were alive at admission, abnormal labour or uterine rupture (33.1percent) and antepartum haemorrhage (19.7percent) were the main causes of their death. Over 60percent of all of macerated deaths have unexplained causes. Maternal hypertension is the main known cause of macerated stillbirth. For stillbirths that were dead on admission, maternal hypertension (13.1percent), antepartum haemorrhage (26.2percent) and abnormal labour or uterine rupture were the main causes of deaths. The majority of perinatal deaths in the hospital were caused by intrauterine deaths (58.8percent). Extreme multi-organ immaturity (13.1percent), Hyaline membrane disease (7.2percent) and Hypoxic ischaemic encephalopathy (5.2percent) were among the main final causes of perinatal deaths. The main behavioural factor causing perinatal mortality in Mpumalanga province was non-use of antenatal care services. The majority of perinatal mortality (60.4percent) was due to health system related causes. Most perinatal deaths were due to poor management of cases and delayed referral. Conclusion: The findings indicate that while stillbirths have slightly declined, neonatal deaths have not declined over the period. Perinatal have slightly declined in the hospital. The findings of this study also indicate that the majority of perinatal deaths in the hospital were caused by idiopathic preterm labour, unexplained intrauterine deaths, hypertension, and intrapartum asphyxia. Patient and health system related factors contributed significantly to perinatal deaths in the hospital. There is a need for yearly analysis of PPIP data to track progress and identify area for continuous improvement in provision of quality obstetric services. A greater community awareness of risk factors for perinatal deaths and importance of early and regular take up antenatal care services is needed.
- Full Text:
- Authors: Modupe, Oluwarotimi Folorunsho
- Date: 2018
- Subjects: Newborn infants -- Mortality Perinatology
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: http://hdl.handle.net/10353/11254 , vital:37630
- Description: Background and aim: There is no doubt that the quantification of data on the new born is imperative towards the design of effective public health policy interventions. However, the trend in under-five mortality rates in Barberton Hospital is not recognised as no empirical investigation has been undertaken to ascertain its position in this regard. A trend analysis of infant and maternal deaths in will therefore shed light on possible factors influencing this trend. The specific objectives of this study were to examine the trend and causes of perinatal mortality in Barberton Hospital from 2002-2016. It was hypothesized that there would be a downward trend in the infant and maternal mortality rates in Barberton Hospital from 2002-2016, possibly as a result of improved medical care. Methods: This retrospective study was conducted in Barberton Hospital, located in the Umjindi sub-district in Mpumalanga Province. The data was drawn from the Perinatal Problem Identification Programme (PPIP) database. Pregnancy related deaths of women, and of children from birth to one year in Barberton Hospital from 1999-2014 were extracted. The population study consists of a record review of all infant and maternal deaths in Barberton Hospital from 2002-2016 and captured in the data on the PPIP. The University of Fort Hare ethical review committee approved the study protocol. In addition, permission to use the data was granted by the Mpumalanga Department of Health after applying for approval for use of the data for academic purposes. The data was then exported into an Excel format document and fed to Statistical Package for Social Sciences (SPSS) program to allow for a more detailed analysis. Results: Over the period under review (2002-2016), a total of 21151 babies were delivered, 20593 babies were alive at discharge, 221 babies died in the first 28 days of delivery, and 337 babies were stillbirths. 18577 were normal weight (≥2500gram), 1581 weighed 2000-2499 grams, 568 weighed 1500-1999grams, 286 weighed 1000-1499 and 139 weighed below 1000grams. All the women who gave birth over the period under review, 27.3percent tested positive to HIV, 40.3 percent tested negative. Of all women that tested positive, 80.2percent received any form of ART. For over half of women that received ART (n=2981), the type of ART they received is unknown. Most women whose baby died were young. One in five women did not have their age captured in the database indicating an important gap that need to be addressed in order to ensure integrity of the database. Of all the 558 perinatal mortality, 75.3 weighed below 2500 grams. Low birth weight is major risk factor for child mortality. Babies weighing less than 2,500 grams are 20 times more likely to die than heavier babies. For all the perinatal deaths, the majority of their mothers received antenatal care services. About 86.6percent were delivered at Barberton Hospital and only 1 child was delivered in transit to the hospital. Of all the 558 deaths, only 7.5 percent was multiple births. Of the 558 babies that died, only 39.6percent were born alive, 37.1percent was macerated stillbirths. The syphilis serology test indicated that most mothers tested negative. The HIV serology test indicated that 28percent of mothers tested positive. The hospital recorded a total of 337 stillbirths between 2002 and 2016. This accounts for 60.2percent of all perinatal mortality over the period. Of all stillbirths, 61.6percent was macerated stillbirths. Yearly analysis of stillbirth rate did not clearly indicate whether stillbirth rate is increasing or declining. Not less than 56 primary obstetric causes of perinatal deaths were identified in this study. Many perinatal deaths were unexplainable due to lack of post-mortem. Idiopathic preterm labour was the main primary obstetric cause of early (34.5percent) and late neonatal (38.9percent) deaths, and the next was labour related intrapartum asphyxia. Labour related intrapartum asphyxia also accounts for 6.8percent of all stillbirths. The main known primary obstetric cause of stillbirth in the Hospital was Proteinuric hypertension/hypertension disorders. Over 60percent of perinatal mortality in Barberton Hospital was due to associated maternal conditions. Only 10.9percent was due to fetal related conditions and 26.4percent was unexplained. Few deaths were due to health system failure and domestic violence. Spontaneous preterm labour (18.4percent), abnormal labour or uterine rupture (14.5percent), maternal hypertension (12.4percent), antepartum haemorrhage (10.2percent) were the main associated maternal conditions causes of perinatal mortality in Barberton Hospital. Similarly, Fetal abnormality and infections were the main associated fetal condition causes of perinatal mortality. Of all the babies that were alive at birth, 85.2percent died due to maternal related conditions. Most neonates died due to spontaneous preterm labour (43.5percent) and abnormal labour or uterine rupture (23.1percent). Maternal HIV, diabetics and syphilis only accounted for a few neonatal deaths. For stillbirth babies that were alive at admission, abnormal labour or uterine rupture (33.1percent) and antepartum haemorrhage (19.7percent) were the main causes of their death. Over 60percent of all of macerated deaths have unexplained causes. Maternal hypertension is the main known cause of macerated stillbirth. For stillbirths that were dead on admission, maternal hypertension (13.1percent), antepartum haemorrhage (26.2percent) and abnormal labour or uterine rupture were the main causes of deaths. The majority of perinatal deaths in the hospital were caused by intrauterine deaths (58.8percent). Extreme multi-organ immaturity (13.1percent), Hyaline membrane disease (7.2percent) and Hypoxic ischaemic encephalopathy (5.2percent) were among the main final causes of perinatal deaths. The main behavioural factor causing perinatal mortality in Mpumalanga province was non-use of antenatal care services. The majority of perinatal mortality (60.4percent) was due to health system related causes. Most perinatal deaths were due to poor management of cases and delayed referral. Conclusion: The findings indicate that while stillbirths have slightly declined, neonatal deaths have not declined over the period. Perinatal have slightly declined in the hospital. The findings of this study also indicate that the majority of perinatal deaths in the hospital were caused by idiopathic preterm labour, unexplained intrauterine deaths, hypertension, and intrapartum asphyxia. Patient and health system related factors contributed significantly to perinatal deaths in the hospital. There is a need for yearly analysis of PPIP data to track progress and identify area for continuous improvement in provision of quality obstetric services. A greater community awareness of risk factors for perinatal deaths and importance of early and regular take up antenatal care services is needed.
- Full Text: