Challenges faced by healthcare professionals in reporting near miss incidents in a hospital, at the Amathole District, Eastern Cape Province, South Africa
- Authors: Ntlanganiso, Lindiwe
- Date: 2022-12
- Subjects: Industrial accidents , Accident investigation
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/27094 , vital:66276
- Description: Background Recording and investigation of NMIs can provide valuable information on monitoring and enhancing patient safety in the healthcare facilities. This in turn, can reduce the likelihood of medico-legal claims. Regardless of attempts to establish efficient incident reporting systems across the entire healthcare industry, underreporting of errors persists worldwide. Therefore, not only do near miss incidents serve as early warning signs of impending potential failure in the healthcare system, but they also provide a chance for patient safety improvement. With that in mind, this study was undertaken to investigate challenges faced by health care professionals in reporting near miss incidents at a hospital in the Amathole District, in the Eastern Cape province of South Africa. Aim The aim of the study was to develop recommendations for healthcare management and healthcare professionals on how to better manage NMIs, and by identifying the challenges faced by health care professionals and the impact they have on the quality of care at one state-funded district hospital. Setting The study was conducted with healthcare professionals at a district hospital in the Amathole District, Eastern Cape Province, South Africa. Methods This study used a mixed method study design. Purposive and convenience sampling were used for participants’ selection for the study. Quantitative data was collected using the WHO Near-Miss Approach while individual and focus group interviews with healthcare professionals were carried out for collecting qualitative data. The maternity and neonatal intensive care units were identified as the two high-risk areas from which most medical negligence claims are lodged. The number of complications that occurred in each month of the year 2019 was determined by using components of the WHO near miss approach. The researcher adopted this approach to serve as a baseline assessment. Data was analysed using both Nvivo Version 10 and SPSS Version 20. Findings The challenges that healthcare professionals face in reporting near miss incidents at the study site included lack of knowledge about the reporting tool and system, inability to identify a near miss incident and healthcare professional attitudes and practices. The document review revealed that the NMIs are existent but not reported on the prescribed reporting system, a total of 210 actual incidents had occurred in the maternity and neonatal units of the hospital, which accounts for 62% of the 357 deliveries in the year 2019. Conclusion Based on the study result and findings, the healthcare system should shift towards a proactive rather than a reactive approach to medical and clinical errors. Continuously reducing the incidence of all patient safety incidents requires improved prevention strategies and effective strategies for recovery from possible medico-legal claims. The study further suggests that additional focus should be placed on NMI reporting and investigation so that operative improvement plans can be developed, implemented, monitored and evaluated. In essence, these improvement plans should be designed to progress patient care, reduce avoidable PSIs and reduce medico-legal claims. , Thesis (MCur) -- Faculty of Health Sciences, 2022
- Full Text:
- Authors: Ntlanganiso, Lindiwe
- Date: 2022-12
- Subjects: Industrial accidents , Accident investigation
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/27094 , vital:66276
- Description: Background Recording and investigation of NMIs can provide valuable information on monitoring and enhancing patient safety in the healthcare facilities. This in turn, can reduce the likelihood of medico-legal claims. Regardless of attempts to establish efficient incident reporting systems across the entire healthcare industry, underreporting of errors persists worldwide. Therefore, not only do near miss incidents serve as early warning signs of impending potential failure in the healthcare system, but they also provide a chance for patient safety improvement. With that in mind, this study was undertaken to investigate challenges faced by health care professionals in reporting near miss incidents at a hospital in the Amathole District, in the Eastern Cape province of South Africa. Aim The aim of the study was to develop recommendations for healthcare management and healthcare professionals on how to better manage NMIs, and by identifying the challenges faced by health care professionals and the impact they have on the quality of care at one state-funded district hospital. Setting The study was conducted with healthcare professionals at a district hospital in the Amathole District, Eastern Cape Province, South Africa. Methods This study used a mixed method study design. Purposive and convenience sampling were used for participants’ selection for the study. Quantitative data was collected using the WHO Near-Miss Approach while individual and focus group interviews with healthcare professionals were carried out for collecting qualitative data. The maternity and neonatal intensive care units were identified as the two high-risk areas from which most medical negligence claims are lodged. The number of complications that occurred in each month of the year 2019 was determined by using components of the WHO near miss approach. The researcher adopted this approach to serve as a baseline assessment. Data was analysed using both Nvivo Version 10 and SPSS Version 20. Findings The challenges that healthcare professionals face in reporting near miss incidents at the study site included lack of knowledge about the reporting tool and system, inability to identify a near miss incident and healthcare professional attitudes and practices. The document review revealed that the NMIs are existent but not reported on the prescribed reporting system, a total of 210 actual incidents had occurred in the maternity and neonatal units of the hospital, which accounts for 62% of the 357 deliveries in the year 2019. Conclusion Based on the study result and findings, the healthcare system should shift towards a proactive rather than a reactive approach to medical and clinical errors. Continuously reducing the incidence of all patient safety incidents requires improved prevention strategies and effective strategies for recovery from possible medico-legal claims. The study further suggests that additional focus should be placed on NMI reporting and investigation so that operative improvement plans can be developed, implemented, monitored and evaluated. In essence, these improvement plans should be designed to progress patient care, reduce avoidable PSIs and reduce medico-legal claims. , Thesis (MCur) -- Faculty of Health Sciences, 2022
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Knowledge, attitude and perceptions of pre-hospital emergency care providers concerning pre-hospital clinical practice guidelines in the Mangaung Metropolitan area, Free State, South Africa
- Ramoshaba, Mapule Petronella
- Authors: Ramoshaba, Mapule Petronella
- Date: 2022-12
- Subjects: Emergency medical services
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/27220 , vital:66471
- Description: Background and Introduction. Pre-hospital emergency care provided in a timeous and efficient manner is a pivotal component in improved patient prognosis, after a life altering situation has occurred. This management of patients is rendered prior to arrival at a medical facility. This service is provided by pre-hospital emergency care providers who apply life saving techniques and knowledge within their scopes of practice and then transporting patients to appropriate medical facilities for definitive care. Pre-hospital emergency care providers of all levels of care, namely: Basic life support, Intermediate life support and Advanced life support render emergency care services to patients with a main goal of seeing patients return back to normal life living. For this to be achieved, the providers must be empowered with the best knowledge, appropriate skills and adequate equipment at their disposal. Clinical practice guidelines are recommendations that are based on evidence in order to support beneficial clinical practices. These were introduced in the pre-hospital setting in South Africa in 2018 to review the scopes of practice of all levels of care, and make appropriate changes and additions for the betterment of the patient and the upskilling of pre-hospital emergency care providers. Since the providers are the end users of these guidelines, and are expected to apply them on patients, they are the best candidates to provide clarity on their perceptions, experiences and challenges which leads to the research questions being: What are the perceptions of the Pre-hospital Emergency Care Providers on the Pre-hospital Clinical Practice in the Guidelines? And What are the challenges experienced by the Pre-hospital Emergency Care Providers with regards to the implementation of the Pre-hospital Clinical Practice Guidelines in the application of Pre-hospital emergency medicine? The aim of the study was to explore the perceptions of the Pre-hospital Emergency Care Providers using the implemented Pre-hospital Clinical Practice Guidelines. Methods The study adopted a qualitative research approach with a purposive sampling method used to select the participants. This type of non-probability technique was suitable in the study as it is based on the researcher’s judgement of the participants being knowledgeable on the questions asked. An interview guide was utilised to collect data through semi-structured one on one interviews during which participants perceptions on the Clinical practice guidelines were shared. The data analysis process brought forth themes and sub themes that were aligned to the research findings which yielded the results. Results/findings The results encompassed the participants’ perceptions about pre-hospital clinical Practice Guidelines, as well as their knowledge, attitude, challenges, suggestions and recommendations. These results unearthed some of the reasons for the pre-hospital emergency care providers perceptions towards the guidelines. The majority of PECPS have a positive attitude towards the pre-hospital clinical practice guidelines, but have challenges with the availability of equipment and drugs which is caused by the lack of due diligence in complying with the implementation of the guidelines. Conclusion The recommendations and suggestions from the participants and researcher come with divisive strategies to the implementation of the guidelines and activities to be applied for the smooth implementation of the pre-hospital clinical practice guidelines. The basis for these recommendations and suggestions were the results as per the research findings. , Thesis (MPH) -- Faculty of Health Sciences, 2022
- Full Text:
- Authors: Ramoshaba, Mapule Petronella
- Date: 2022-12
- Subjects: Emergency medical services
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/27220 , vital:66471
- Description: Background and Introduction. Pre-hospital emergency care provided in a timeous and efficient manner is a pivotal component in improved patient prognosis, after a life altering situation has occurred. This management of patients is rendered prior to arrival at a medical facility. This service is provided by pre-hospital emergency care providers who apply life saving techniques and knowledge within their scopes of practice and then transporting patients to appropriate medical facilities for definitive care. Pre-hospital emergency care providers of all levels of care, namely: Basic life support, Intermediate life support and Advanced life support render emergency care services to patients with a main goal of seeing patients return back to normal life living. For this to be achieved, the providers must be empowered with the best knowledge, appropriate skills and adequate equipment at their disposal. Clinical practice guidelines are recommendations that are based on evidence in order to support beneficial clinical practices. These were introduced in the pre-hospital setting in South Africa in 2018 to review the scopes of practice of all levels of care, and make appropriate changes and additions for the betterment of the patient and the upskilling of pre-hospital emergency care providers. Since the providers are the end users of these guidelines, and are expected to apply them on patients, they are the best candidates to provide clarity on their perceptions, experiences and challenges which leads to the research questions being: What are the perceptions of the Pre-hospital Emergency Care Providers on the Pre-hospital Clinical Practice in the Guidelines? And What are the challenges experienced by the Pre-hospital Emergency Care Providers with regards to the implementation of the Pre-hospital Clinical Practice Guidelines in the application of Pre-hospital emergency medicine? The aim of the study was to explore the perceptions of the Pre-hospital Emergency Care Providers using the implemented Pre-hospital Clinical Practice Guidelines. Methods The study adopted a qualitative research approach with a purposive sampling method used to select the participants. This type of non-probability technique was suitable in the study as it is based on the researcher’s judgement of the participants being knowledgeable on the questions asked. An interview guide was utilised to collect data through semi-structured one on one interviews during which participants perceptions on the Clinical practice guidelines were shared. The data analysis process brought forth themes and sub themes that were aligned to the research findings which yielded the results. Results/findings The results encompassed the participants’ perceptions about pre-hospital clinical Practice Guidelines, as well as their knowledge, attitude, challenges, suggestions and recommendations. These results unearthed some of the reasons for the pre-hospital emergency care providers perceptions towards the guidelines. The majority of PECPS have a positive attitude towards the pre-hospital clinical practice guidelines, but have challenges with the availability of equipment and drugs which is caused by the lack of due diligence in complying with the implementation of the guidelines. Conclusion The recommendations and suggestions from the participants and researcher come with divisive strategies to the implementation of the guidelines and activities to be applied for the smooth implementation of the pre-hospital clinical practice guidelines. The basis for these recommendations and suggestions were the results as per the research findings. , Thesis (MPH) -- Faculty of Health Sciences, 2022
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Barriers to utilisation of antenatal care services in Bloemfontein, sub-district of Mangaung Metro, Free State, South Africa
- Montshiwa, Kgalalelo Christine
- Authors: Montshiwa, Kgalalelo Christine
- Date: 2022-11
- Subjects: Prenatal care
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/26995 , vital:66212
- Description: Background: Maternal and child mortality remain a global health problem, regardless of preventative measures put in place. Antenatal care is crucial to decrease maternal and child morbidity and mortality. However, in Bloemfontein, the sub-district of Mangaung Metro in the Free State, it has been identified that women utilise this kind of service sub-optimally. The study aimed to explore and describe barriers to the utilisation of antenatal care by pregnant women in the Bloemfontein sub-district of Mangaung Metro. Methodology: This study was qualitative and used an explorative, descriptive design. Qualitative data was collected by using focus group discussions and key informants’ interviews. Three focus group discussions with twenty-five pregnant and lactating mothers, aged between 18 and 49 years, were conducted. Participants took part in one focus group discussion at each healthcare facility. Four key informant interviews were conducted with four facility managers and one professional midwife who conducted ANC at the clinic at the time of the study in the three healthcare facilities. A thematic analysis process was used to analyse the collected qualitative data under each identified barrier. The STATA version 15 was used in the analysis of the demographic characteristics of the participants. Results: Most of the participants indicated that they are aware of the importance of attending ANC appointments however, they have voiced that the delayed waiting times and staff attitudes contribute to how they feel about visiting a clinic early. Some of the participants mentioned that they have cultural barriers as they still believe that a traditional pregnant woman should not reveal her pregnancy in the early days but must rather wait until her stomach has grown significantly for her to visit the clinic. Two participants indicated that they had unplanned pregnancies and wanted to do an abortion, but their religious beliefs prevented them to choose to terminate their pregnancies. Economically, not all participants complained about their financial situation though the majority were unemployed and single. Participants from the Bloemspruit facility complained of transport as they stay far from the clinic and they are sometimes forced to walk alone which makes it difficult to attend all their booked sessions with their midwives. The results of the study revealed that there are several factors contributing to late antenatal care attendance namely provider and personal factors contributing to late antenatal care attendance in the Bloemfontein sub-district of Mangaung Metro. Personal factors that were found to be contributing to late antenatal care booking were lack of transport, especially for Bloemspruit participants, unwanted pregnancy, lack of financial support, lack of partner support, cultural and religious beliefs, and lack of knowledge. Provider factors that were found to be contributing to late booking were lack of resources like tools of the trade, long waiting times, poor infrastructure, human resources, and midwives’ attitudes. Recommendations. To deploy qualified midwives to conduct antenatal care clinics, to extend the service over the weekends as participants mentioned that they struggle to get time off from work during the week. Health promotion and community awareness campaigns on the importance of antenatal care may increase the utilisation of antenatal care services. , Thesis (MPA) -- Faculty of Health Sciences, 2023
- Full Text:
- Authors: Montshiwa, Kgalalelo Christine
- Date: 2022-11
- Subjects: Prenatal care
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/26995 , vital:66212
- Description: Background: Maternal and child mortality remain a global health problem, regardless of preventative measures put in place. Antenatal care is crucial to decrease maternal and child morbidity and mortality. However, in Bloemfontein, the sub-district of Mangaung Metro in the Free State, it has been identified that women utilise this kind of service sub-optimally. The study aimed to explore and describe barriers to the utilisation of antenatal care by pregnant women in the Bloemfontein sub-district of Mangaung Metro. Methodology: This study was qualitative and used an explorative, descriptive design. Qualitative data was collected by using focus group discussions and key informants’ interviews. Three focus group discussions with twenty-five pregnant and lactating mothers, aged between 18 and 49 years, were conducted. Participants took part in one focus group discussion at each healthcare facility. Four key informant interviews were conducted with four facility managers and one professional midwife who conducted ANC at the clinic at the time of the study in the three healthcare facilities. A thematic analysis process was used to analyse the collected qualitative data under each identified barrier. The STATA version 15 was used in the analysis of the demographic characteristics of the participants. Results: Most of the participants indicated that they are aware of the importance of attending ANC appointments however, they have voiced that the delayed waiting times and staff attitudes contribute to how they feel about visiting a clinic early. Some of the participants mentioned that they have cultural barriers as they still believe that a traditional pregnant woman should not reveal her pregnancy in the early days but must rather wait until her stomach has grown significantly for her to visit the clinic. Two participants indicated that they had unplanned pregnancies and wanted to do an abortion, but their religious beliefs prevented them to choose to terminate their pregnancies. Economically, not all participants complained about their financial situation though the majority were unemployed and single. Participants from the Bloemspruit facility complained of transport as they stay far from the clinic and they are sometimes forced to walk alone which makes it difficult to attend all their booked sessions with their midwives. The results of the study revealed that there are several factors contributing to late antenatal care attendance namely provider and personal factors contributing to late antenatal care attendance in the Bloemfontein sub-district of Mangaung Metro. Personal factors that were found to be contributing to late antenatal care booking were lack of transport, especially for Bloemspruit participants, unwanted pregnancy, lack of financial support, lack of partner support, cultural and religious beliefs, and lack of knowledge. Provider factors that were found to be contributing to late booking were lack of resources like tools of the trade, long waiting times, poor infrastructure, human resources, and midwives’ attitudes. Recommendations. To deploy qualified midwives to conduct antenatal care clinics, to extend the service over the weekends as participants mentioned that they struggle to get time off from work during the week. Health promotion and community awareness campaigns on the importance of antenatal care may increase the utilisation of antenatal care services. , Thesis (MPA) -- Faculty of Health Sciences, 2023
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Perceptions of stakeholders in schools on the implementation of school sport policy in school sport development in the Amathole-west district, Eastern Cape
- Authors: Xakaxa, M Z
- Date: 2022-11
- Subjects: Sports administration , Sports and state
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/27959 , vital:70943
- Description: This study aimed to explore the perceptions of stakeholders in schools regarding the implementation of school sport policy and its impact on school sport development in the Amathole-west district of the Eastern Cape, South Africa. The research sought to examine teachers' knowledge of the Department of Basic Education's school sport policy, assess whether the policy promotes school sport development, identify ways to enhance its implementation in Amathole-west, and propose strategies for the effective implementation of the policy by the Department of Basic Education. Adopting a qualitative interpretivist research approach, the study employed in-depth one-on-one interviews, focus group discussions, and document analysis. A purposive sample of 20 participants was selected, grouped into four focus groups, to contribute valuable insights to the study. Drawing on the Participatory School Governance model and the Social Ecological Model, the findings revealed that teachers, members of the School Management Team, and School Governing Body members perceive sports as essential for learners, as they promote physical health and instill discipline and moral behavior. However, the study also highlighted that teachers and School Governing Body members play a limited role in the implementation of school sport policy and development. Instead, they tend to rely on externally qualified sports experts, resulting in reduced involvement in policy implementation. The study emphasizes the need for improved involvement and investment in school sport policy implementation. Additionally, several strategies were suggested to ensure the effective implementation of school sport policy. These include providing Continued Professional Development (CPD) opportunities for teachers and increasing awareness about the sports policy. In conclusion, this study sheds light on the perceptions of school stakeholders regarding the implementation of school sport policy and the development of school sports in Amathole-west, South Africa. The findings underscore the importance of enhancing teachers' involvement and knowledge in policy implementation and recommend strategies for the successful implementation of the school sport policy , Thesis (MPH) -- Faculty of Health Sciences, 2022
- Full Text:
- Authors: Xakaxa, M Z
- Date: 2022-11
- Subjects: Sports administration , Sports and state
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/27959 , vital:70943
- Description: This study aimed to explore the perceptions of stakeholders in schools regarding the implementation of school sport policy and its impact on school sport development in the Amathole-west district of the Eastern Cape, South Africa. The research sought to examine teachers' knowledge of the Department of Basic Education's school sport policy, assess whether the policy promotes school sport development, identify ways to enhance its implementation in Amathole-west, and propose strategies for the effective implementation of the policy by the Department of Basic Education. Adopting a qualitative interpretivist research approach, the study employed in-depth one-on-one interviews, focus group discussions, and document analysis. A purposive sample of 20 participants was selected, grouped into four focus groups, to contribute valuable insights to the study. Drawing on the Participatory School Governance model and the Social Ecological Model, the findings revealed that teachers, members of the School Management Team, and School Governing Body members perceive sports as essential for learners, as they promote physical health and instill discipline and moral behavior. However, the study also highlighted that teachers and School Governing Body members play a limited role in the implementation of school sport policy and development. Instead, they tend to rely on externally qualified sports experts, resulting in reduced involvement in policy implementation. The study emphasizes the need for improved involvement and investment in school sport policy implementation. Additionally, several strategies were suggested to ensure the effective implementation of school sport policy. These include providing Continued Professional Development (CPD) opportunities for teachers and increasing awareness about the sports policy. In conclusion, this study sheds light on the perceptions of school stakeholders regarding the implementation of school sport policy and the development of school sports in Amathole-west, South Africa. The findings underscore the importance of enhancing teachers' involvement and knowledge in policy implementation and recommend strategies for the successful implementation of the school sport policy , Thesis (MPH) -- Faculty of Health Sciences, 2022
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Analysis of early-phase contact tracing during the coronavirus disease 2019 outbreak in Mangaung Metro, Free State
- Monyobo, Priscilla Kesaletseng
- Authors: Monyobo, Priscilla Kesaletseng
- Date: 2022-09
- Subjects: COVID-19 (Disease) , Contact tracing (Epidemiology) , Public health
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/23533 , vital:58105
- Description: Background and Aim Contact tracing is a critical public health measure for controlling and preventing the spread of infectious diseases. Although the principles underlying this strategy are not novel, understanding the changes in infectiousness of COVID-19 is indeed novel. As are the capacity and operating procedures required to support disease investigation in Mangang Metro during the SARS-CoV-2 (COVID-19) pandemic. On 16 March 2020, the first coronavirus disease case in the area, which led to a larger outbreak, occurred in Mangaung Metro, Free State province, South Africa. To date, Mangaung Metro remains the epicentre of the COVID-19 pandemic and the primary driver of the caseload in the Free State province. The aim of this study was to analyse contact tracing data in Mangaung Metro during the early phase of the COVID-19 outbreak (16 March 2020 – 30 June 2020) in order to measure the viral transmissibility of COVID-19 in the early stages of the outbreak, specifically in the context of Mangaung Metro. Methods A descriptive systematic analysis of index COVID-19 cases and their contacts in Mangaung Metro was conducted. The review period ran from 16 March to 30 June 2020, during which there was a total of 1 001 cases in Mangaung Metro. Data was captured on an Excel spreadsheet using the contact line list variables from the established National Institute of Communicable Disease contact line list framework. The inferential statistics were based on a time series analysis to compare the impact of contact tracing stratified by symptomatology and the root cause of the cases to the overall cases in Mangaung Metro. The study determined whether isolation, quarantine, and contact tracing were able to control outbreaks in the early phase using characteristics of disease transmission and parameters particularised to the COVID- 19 pathogen. Results As of 30 June 2020, the Free State province had a total of 2 072 COVID-19 cases. Mangaung Metro contributed 1 001 cases (48percent) of the total number of cases in the study period. Between March and June 2020, 3 553 contacts were traced in Mangaung Metro. This number translates to at least three investigated and traced contacts per index or laboratory confirmed positive case. From the traced contacts, 1 080 samples were collected and sent for laboratory testing. In April 2020, the greatest number of samples were collected. This high rate in sample collection is posited to be the result of the high rate of contacts traced, as well as the initial clinical guidelines followed for contact tracing. Most positive contacts were discovered in March 2020. One of the possible reasons for the high detection of COVID-19 confirmed positive contacts during the early stages of the outbreak was the focus and importance of contact tracing while the caseload remained relatively low. However, as the outbreak progressed in the Mangaung Metro context, the number and relative percentage of positive cases detected through contact tracing decreased. In total, the positive contacts recorded in March 2020 amounted to 92 (51.3percent), 18 in April (10.5percent), 41 in May (22.9percent), and 28 in June (15.6percent). The March 2020 tracking rate was the highest at 73.2percent, with an average contact tracing rate of 15.5percentby the end of June 2020. Of all the contacts traced, 7.9percent involved healthcare workers in the Free State. Conclusion The study’s findings show that contact tracing was an effective control measure during the early stages of the COVID-19 outbreak in Mangung Metro district. Furthermore, the impact was greatest when the caseload was low and the burden on the healthcare system less severe. Mangaung Metro demonstrated the capability of tracing more contacts in the early-early phase of the outbreak; however, as the outbreak progressed to the latent early phase, the caseload increased and fewer contacts were traced. The consequence of contact tracing not being as effective during the latent early phase relates to the increase in both exposed and untraceable contacts, which in turn fueled the increase of new cases. This further impacted the at-risk and vulnerable population, especially the elderly, who were at an increased risk if not traced in a timely manner, possibly resulting in mortality. , Thesis (MPH) -- Faculty of Health Sciences, 2022
- Full Text:
- Authors: Monyobo, Priscilla Kesaletseng
- Date: 2022-09
- Subjects: COVID-19 (Disease) , Contact tracing (Epidemiology) , Public health
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/23533 , vital:58105
- Description: Background and Aim Contact tracing is a critical public health measure for controlling and preventing the spread of infectious diseases. Although the principles underlying this strategy are not novel, understanding the changes in infectiousness of COVID-19 is indeed novel. As are the capacity and operating procedures required to support disease investigation in Mangang Metro during the SARS-CoV-2 (COVID-19) pandemic. On 16 March 2020, the first coronavirus disease case in the area, which led to a larger outbreak, occurred in Mangaung Metro, Free State province, South Africa. To date, Mangaung Metro remains the epicentre of the COVID-19 pandemic and the primary driver of the caseload in the Free State province. The aim of this study was to analyse contact tracing data in Mangaung Metro during the early phase of the COVID-19 outbreak (16 March 2020 – 30 June 2020) in order to measure the viral transmissibility of COVID-19 in the early stages of the outbreak, specifically in the context of Mangaung Metro. Methods A descriptive systematic analysis of index COVID-19 cases and their contacts in Mangaung Metro was conducted. The review period ran from 16 March to 30 June 2020, during which there was a total of 1 001 cases in Mangaung Metro. Data was captured on an Excel spreadsheet using the contact line list variables from the established National Institute of Communicable Disease contact line list framework. The inferential statistics were based on a time series analysis to compare the impact of contact tracing stratified by symptomatology and the root cause of the cases to the overall cases in Mangaung Metro. The study determined whether isolation, quarantine, and contact tracing were able to control outbreaks in the early phase using characteristics of disease transmission and parameters particularised to the COVID- 19 pathogen. Results As of 30 June 2020, the Free State province had a total of 2 072 COVID-19 cases. Mangaung Metro contributed 1 001 cases (48percent) of the total number of cases in the study period. Between March and June 2020, 3 553 contacts were traced in Mangaung Metro. This number translates to at least three investigated and traced contacts per index or laboratory confirmed positive case. From the traced contacts, 1 080 samples were collected and sent for laboratory testing. In April 2020, the greatest number of samples were collected. This high rate in sample collection is posited to be the result of the high rate of contacts traced, as well as the initial clinical guidelines followed for contact tracing. Most positive contacts were discovered in March 2020. One of the possible reasons for the high detection of COVID-19 confirmed positive contacts during the early stages of the outbreak was the focus and importance of contact tracing while the caseload remained relatively low. However, as the outbreak progressed in the Mangaung Metro context, the number and relative percentage of positive cases detected through contact tracing decreased. In total, the positive contacts recorded in March 2020 amounted to 92 (51.3percent), 18 in April (10.5percent), 41 in May (22.9percent), and 28 in June (15.6percent). The March 2020 tracking rate was the highest at 73.2percent, with an average contact tracing rate of 15.5percentby the end of June 2020. Of all the contacts traced, 7.9percent involved healthcare workers in the Free State. Conclusion The study’s findings show that contact tracing was an effective control measure during the early stages of the COVID-19 outbreak in Mangung Metro district. Furthermore, the impact was greatest when the caseload was low and the burden on the healthcare system less severe. Mangaung Metro demonstrated the capability of tracing more contacts in the early-early phase of the outbreak; however, as the outbreak progressed to the latent early phase, the caseload increased and fewer contacts were traced. The consequence of contact tracing not being as effective during the latent early phase relates to the increase in both exposed and untraceable contacts, which in turn fueled the increase of new cases. This further impacted the at-risk and vulnerable population, especially the elderly, who were at an increased risk if not traced in a timely manner, possibly resulting in mortality. , Thesis (MPH) -- Faculty of Health Sciences, 2022
- Full Text:
Analysis of early-phase contact tracing during the coronavirus disease 2019 outbreak in Mangaung Metro, Free State
- Monyobo, Priscilla Kesaletseng
- Authors: Monyobo, Priscilla Kesaletseng
- Date: 2022-09
- Subjects: Contact tracing (Epidemiology) , Health services administration
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/27006 , vital:66215
- Description: Background and Aim Contact tracing is a critical public health measure for controlling and preventing the spread of infectious diseases. Although the principles underlying this strategy are not novel, understanding the changes in infectiousness of COVID-19 is indeed novel. As are the capacity and operating procedures required to support disease investigation in Mangang Metro during the SARS-CoV-2 (COVID-19) pandemic. On 16 March 2020, the first coronavirus disease case in the area, which led to a larger outbreak, occurred in Mangaung Metro, Free State province, South Africa. To date, Mangaung Metro remains the epicentre of the COVID-19 pandemic and the primary driver of the caseload in the Free State province. The aim of this study was to analyse contact tracing data in Mangaung Metro during the early phase of the COVID-19 outbreak (16 March 2020 – 30 June 2020) in order to measure the viral transmissibility of COVID-19 in the early stages of the outbreak, specifically in the context of Mangaung Metro. Methods A descriptive systematic analysis of index COVID-19 cases and their contacts in Mangaung Metro was conducted. The review period ran from 16 March to 30 June 2020, during which there was a total of 1 001 cases in Mangaung Metro. Data was captured on an Excel spreadsheet using the contact line list variables from the established National Institute of Communicable Disease contact line list framework. The inferential statistics were based on a time series analysis to compare the impact of contact tracing stratified by symptomatology and the root cause of the cases to the overall cases in Mangaung Metro. The study determined whether isolation, quarantine, and contact tracing were able to control outbreaks in the early phase using characteristics of disease transmission and parameters particularised to the COVID- 19 pathogen. Results As of 30 June 2020, the Free State province had a total of 2 072 COVID-19 cases. Mangaung Metro contributed 1 001 cases (48 percent) of the total number of cases in the study period. Between March and June 2020, 3 553 contacts were traced in Mangaung Metro. This number translates to at least three investigated and traced contacts per index or laboratory confirmed positive case. From the traced contacts, 1 080 samples were collected and sent for laboratory testing. In April 2020, the greatest number of samples were collected. This high rate in sample collection is posited to be the result of the high rate of contacts traced, as well as the initial clinical guidelines followed for contact tracing. Most positive contacts were discovered in March 2020. One of the possible reasons for the high detection of COVID-19 confirmed positive contacts during the early stages of the outbreak was the focus and importance of contact tracing while the caseload remained relatively low. However, as the outbreak progressed in the Mangaung Metro context, the number and relative percentage of positive cases detected through contact tracing decreased. In total, the positive contacts recorded in March 2020 amounted to 92 (51.3 percent), 18 in April (10.5 percent), 41 in May (22.9percent), and 28 in June (15.6 percent). The March 2020 tracking rate was the highest at 73.2percent, with an average contact tracing rate of 15.5 percent by the end of June 2020. Of all the contacts traced, 7.9 percent involved healthcare workers in the Free State. Conclusion The study’s findings show that contact tracing was an effective control measure during the early stages of the COVID-19 outbreak in Mangung Metro district. Furthermore, the impact was greatest when the caseload was low and the burden on the healthcare system less severe. Mangaung Metro demonstrated the capability of tracing more contacts in the early-early phase of the outbreak; however, as the outbreak progressed to the latent early phase, the caseload increased and fewer contacts were traced. The consequence of contact tracing not being as effective during the latent early phase relates to the increase in both exposed and untraceable contacts, which in turn fueled the increase of new cases. This further impacted the at-risk and vulnerable population, especially the elderly, who were at an increased risk if not traced in a timely manner, possibly resulting in mortality. , Thesis (MPA) -- Faculty of Health Sciences, 2022
- Full Text:
- Authors: Monyobo, Priscilla Kesaletseng
- Date: 2022-09
- Subjects: Contact tracing (Epidemiology) , Health services administration
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/27006 , vital:66215
- Description: Background and Aim Contact tracing is a critical public health measure for controlling and preventing the spread of infectious diseases. Although the principles underlying this strategy are not novel, understanding the changes in infectiousness of COVID-19 is indeed novel. As are the capacity and operating procedures required to support disease investigation in Mangang Metro during the SARS-CoV-2 (COVID-19) pandemic. On 16 March 2020, the first coronavirus disease case in the area, which led to a larger outbreak, occurred in Mangaung Metro, Free State province, South Africa. To date, Mangaung Metro remains the epicentre of the COVID-19 pandemic and the primary driver of the caseload in the Free State province. The aim of this study was to analyse contact tracing data in Mangaung Metro during the early phase of the COVID-19 outbreak (16 March 2020 – 30 June 2020) in order to measure the viral transmissibility of COVID-19 in the early stages of the outbreak, specifically in the context of Mangaung Metro. Methods A descriptive systematic analysis of index COVID-19 cases and their contacts in Mangaung Metro was conducted. The review period ran from 16 March to 30 June 2020, during which there was a total of 1 001 cases in Mangaung Metro. Data was captured on an Excel spreadsheet using the contact line list variables from the established National Institute of Communicable Disease contact line list framework. The inferential statistics were based on a time series analysis to compare the impact of contact tracing stratified by symptomatology and the root cause of the cases to the overall cases in Mangaung Metro. The study determined whether isolation, quarantine, and contact tracing were able to control outbreaks in the early phase using characteristics of disease transmission and parameters particularised to the COVID- 19 pathogen. Results As of 30 June 2020, the Free State province had a total of 2 072 COVID-19 cases. Mangaung Metro contributed 1 001 cases (48 percent) of the total number of cases in the study period. Between March and June 2020, 3 553 contacts were traced in Mangaung Metro. This number translates to at least three investigated and traced contacts per index or laboratory confirmed positive case. From the traced contacts, 1 080 samples were collected and sent for laboratory testing. In April 2020, the greatest number of samples were collected. This high rate in sample collection is posited to be the result of the high rate of contacts traced, as well as the initial clinical guidelines followed for contact tracing. Most positive contacts were discovered in March 2020. One of the possible reasons for the high detection of COVID-19 confirmed positive contacts during the early stages of the outbreak was the focus and importance of contact tracing while the caseload remained relatively low. However, as the outbreak progressed in the Mangaung Metro context, the number and relative percentage of positive cases detected through contact tracing decreased. In total, the positive contacts recorded in March 2020 amounted to 92 (51.3 percent), 18 in April (10.5 percent), 41 in May (22.9percent), and 28 in June (15.6 percent). The March 2020 tracking rate was the highest at 73.2percent, with an average contact tracing rate of 15.5 percent by the end of June 2020. Of all the contacts traced, 7.9 percent involved healthcare workers in the Free State. Conclusion The study’s findings show that contact tracing was an effective control measure during the early stages of the COVID-19 outbreak in Mangung Metro district. Furthermore, the impact was greatest when the caseload was low and the burden on the healthcare system less severe. Mangaung Metro demonstrated the capability of tracing more contacts in the early-early phase of the outbreak; however, as the outbreak progressed to the latent early phase, the caseload increased and fewer contacts were traced. The consequence of contact tracing not being as effective during the latent early phase relates to the increase in both exposed and untraceable contacts, which in turn fueled the increase of new cases. This further impacted the at-risk and vulnerable population, especially the elderly, who were at an increased risk if not traced in a timely manner, possibly resulting in mortality. , Thesis (MPA) -- Faculty of Health Sciences, 2022
- Full Text:
Clinical governance implementation challenges in the Department of Health, Mpumalanga, South Africa
- Maduna, Patrick Hawkins https://orcid.org/0000-0002-4926-1661
- Authors: Maduna, Patrick Hawkins https://orcid.org/0000-0002-4926-1661
- Date: 2022-09
- Subjects: Clinical competence , Health services administration
- Language: English
- Type: Doctoral theses , text
- Identifier: http://hdl.handle.net/10353/27275 , vital:66532
- Description: Clinical governance (CG) is the system through which health authorities are accountable for continuously improving the quality of their services and safeguarding high standards of care by creating an environment in which clinical excellence flourishes. South Africa is one of the countries where CG has not been successfully implemented. This study sought to explore the CG implementation challenges in the Mpumalanga province, South Africa. The study objectives included the seven pillars of CG. The study was a qualitative and exploratory, using purposive sampling technique to select study participants. A total of twenty-two (22) individuals were selected for the study. Semi-structured interviews were used for data collection. Each interview was transcribed verbatim by the researcher. Confidentiality was ensured through the coding of interviewee names. The content analysis technique was used for data analysis, using the study objectives as themes. The study found general lack of understanding of the concept of CG, poor performance of clinical audits, sub-standard clinical performance and effectiveness, poor clinical risk management, poor patient and public involvement in patient care, lack of evidence-based practice and research, inadequate training and development of healthcare workers, and sub-standard health information management across the department. The researcher recommends that the CG policy be prioritised by the Mpumalanga DOH, that systems be put in place to facilitate policy implementation, and that the departmental staff establishments at all levels, prioritise healthcare professionals in key leadership positions. In conclusion, there are numerous challenges that confront the Mpumalanga Department of Health regarding the implementation of clinical governance, requiring urgent attention. , Thesis (PhD) -- Faculty of Health Sciences, 2022
- Full Text:
- Authors: Maduna, Patrick Hawkins https://orcid.org/0000-0002-4926-1661
- Date: 2022-09
- Subjects: Clinical competence , Health services administration
- Language: English
- Type: Doctoral theses , text
- Identifier: http://hdl.handle.net/10353/27275 , vital:66532
- Description: Clinical governance (CG) is the system through which health authorities are accountable for continuously improving the quality of their services and safeguarding high standards of care by creating an environment in which clinical excellence flourishes. South Africa is one of the countries where CG has not been successfully implemented. This study sought to explore the CG implementation challenges in the Mpumalanga province, South Africa. The study objectives included the seven pillars of CG. The study was a qualitative and exploratory, using purposive sampling technique to select study participants. A total of twenty-two (22) individuals were selected for the study. Semi-structured interviews were used for data collection. Each interview was transcribed verbatim by the researcher. Confidentiality was ensured through the coding of interviewee names. The content analysis technique was used for data analysis, using the study objectives as themes. The study found general lack of understanding of the concept of CG, poor performance of clinical audits, sub-standard clinical performance and effectiveness, poor clinical risk management, poor patient and public involvement in patient care, lack of evidence-based practice and research, inadequate training and development of healthcare workers, and sub-standard health information management across the department. The researcher recommends that the CG policy be prioritised by the Mpumalanga DOH, that systems be put in place to facilitate policy implementation, and that the departmental staff establishments at all levels, prioritise healthcare professionals in key leadership positions. In conclusion, there are numerous challenges that confront the Mpumalanga Department of Health regarding the implementation of clinical governance, requiring urgent attention. , Thesis (PhD) -- Faculty of Health Sciences, 2022
- Full Text:
Clinical governance implementation challenges in the Department of Health, Mpumalanga, South Africa
- Maduna, Patrick Hawkins https://orcid.org/0000-0002-4926-1661
- Authors: Maduna, Patrick Hawkins https://orcid.org/0000-0002-4926-1661
- Date: 2022-09
- Subjects: Clinical competence , Evidence-based medicine , Health services administration
- Language: English
- Type: Doctoral theses , text
- Identifier: http://hdl.handle.net/10353/23600 , vital:58194
- Description: Clinical governance (CG) is the system through which health authorities are accountable for continuously improving the quality of their services and safeguarding high standards of care by creating an environment in which clinical excellence flourishes. South Africa is one of the countries where CG has not been successfully implemented. This study sought to explore the CG implementation challenges in the Mpumalanga province, South Africa. The study objectives included the seven pillars of CG. The study was a qualitative and exploratory, using purposive sampling technique to select study participants. A total of twenty-two (22) individuals were selected for the study. Semi-structured interviews were used for data collection. Each interview was transcribed verbatim by the researcher. Confidentiality was ensured through the coding of interviewee names. The content analysis technique was used for data analysis, using the study objectives as themes. The study found general lack of understanding of the concept of CG, poor performance of clinical audits, sub-standard clinical performance and effectiveness, poor clinical risk management, poor patient and public involvement in patient care, lack of evidence-based practice and research, inadequate training and development of healthcare workers, and sub-standard health information management across the department. The researcher recommends that the CG policy be prioritised by the Mpumalanga DOH, that systems be put in place to facilitate policy implementation, and that the departmental staff establishments at all levels, prioritise healthcare professionals in key leadership positions. In conclusion, there are numerous challenges that confront the Mpumalanga Department of Health regarding the implementation of clinical governance, requiring urgent attention. , Thesis (PhD) -- Faculty of Health Sciences, 2022
- Full Text:
- Authors: Maduna, Patrick Hawkins https://orcid.org/0000-0002-4926-1661
- Date: 2022-09
- Subjects: Clinical competence , Evidence-based medicine , Health services administration
- Language: English
- Type: Doctoral theses , text
- Identifier: http://hdl.handle.net/10353/23600 , vital:58194
- Description: Clinical governance (CG) is the system through which health authorities are accountable for continuously improving the quality of their services and safeguarding high standards of care by creating an environment in which clinical excellence flourishes. South Africa is one of the countries where CG has not been successfully implemented. This study sought to explore the CG implementation challenges in the Mpumalanga province, South Africa. The study objectives included the seven pillars of CG. The study was a qualitative and exploratory, using purposive sampling technique to select study participants. A total of twenty-two (22) individuals were selected for the study. Semi-structured interviews were used for data collection. Each interview was transcribed verbatim by the researcher. Confidentiality was ensured through the coding of interviewee names. The content analysis technique was used for data analysis, using the study objectives as themes. The study found general lack of understanding of the concept of CG, poor performance of clinical audits, sub-standard clinical performance and effectiveness, poor clinical risk management, poor patient and public involvement in patient care, lack of evidence-based practice and research, inadequate training and development of healthcare workers, and sub-standard health information management across the department. The researcher recommends that the CG policy be prioritised by the Mpumalanga DOH, that systems be put in place to facilitate policy implementation, and that the departmental staff establishments at all levels, prioritise healthcare professionals in key leadership positions. In conclusion, there are numerous challenges that confront the Mpumalanga Department of Health regarding the implementation of clinical governance, requiring urgent attention. , Thesis (PhD) -- Faculty of Health Sciences, 2022
- Full Text:
Data management and dispensary: missing link contributing to antiretroviral loss to follow-Up in Lejweleputswa District
- Moatlhodi, Charlotte Motshele
- Authors: Moatlhodi, Charlotte Motshele
- Date: 2022-09
- Subjects: Health services administration , Drug monitoring , Antiretroviral agents
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/26973 , vital:66207
- Description: Background and aim: The widespread use and access to Anti-Retro Viral Treatment (ART) world-wide has contributed to full preventive and therapeutic benefits. An estimated amount of 68percent of HIV positive people received ART in South Africa (SA) as of 2018. However, reports from TIER.Net and DHIS (District Health Information System), indicate that the retention of patients on ART (specifically first line triple combination therapy Tenofovir Emtricitabine Efavirenz (TEE)) continues to decline. Meanwhile, data on TEE dispensed from the dispensary shows increasing quantities patients across the Free State province on a monthly basis. The aim of this study is to determine factors contributing to the discrepancy between Fixed Dose Combination (FDC) TEE dispensing data and patients on FDC TEE captured on TIER.Net and Health Patient Registration System (HPRS), as a means of improving identification and monitoring of patients that carry the potential risk of being lost to subsequent follow-ups (ART collection / clinical visits). Methods: A retrospective, quantitative, and descriptive record review of 382 medical records of HIV positive patients, along with TIER.Net and Health Patient Registration System (HPRS) reports, was conducted at five primary healthcare (PHC) facilities, each representing the five sub-districts found in Lejweleputswa district using a self-designed data collection tool. Descriptive statistics was used to summarise and present data. Results: Sixty five percent the TEE collected from the dispensary was captured on TIER. Net. It could not be determined on none of the medical records whether or not the administrative clerk captured dispensed TEE on the same date of collection from the dispensary on TIER.Net. Subsequently, the actual date of capturing the TEE dispenses on TIER.Net following collection of the treatment from the dispensary could also not be determined. The overall data on TEE dispensed/collected from the dispensary the same was not the same as the data captured on TIER.Net. Thirty five percent of patients were reported to have collected their ART according to dispensary data than that reported on TIER.Net. Eighty percent of the TEE collected from the dispensary was captured on HPRS. Eighty percent of facilities had an area and computer dedicated for HPRS and TIER.Net but none had a backup computer in cases of theft/breakage. None of the facilities had access to back up connectivity, a manual capturing process in the form of paper-based head count registers was instead utilised as back-up. Conclusion: The following factors were found to contribute to the discrepancy between the TEE dispensing data, TIER.net and HPRS: Poor records keeping, unauthorised dispensing of prescriptions, poor data management, delays and non-capturing of ART medical records and infrastructural and human resource challenges that exist in the data management of the patient medical records. There is a need to address these gaps in order to improve reliability of dispensary data, as well as reports from TIER.Net and HPRS, in order to streamline the identification and monitoring of patients at risk of becoming lost to follow-up. , Thesis (MPA) -- Faculty of Health Sciences
- Full Text:
- Authors: Moatlhodi, Charlotte Motshele
- Date: 2022-09
- Subjects: Health services administration , Drug monitoring , Antiretroviral agents
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/26973 , vital:66207
- Description: Background and aim: The widespread use and access to Anti-Retro Viral Treatment (ART) world-wide has contributed to full preventive and therapeutic benefits. An estimated amount of 68percent of HIV positive people received ART in South Africa (SA) as of 2018. However, reports from TIER.Net and DHIS (District Health Information System), indicate that the retention of patients on ART (specifically first line triple combination therapy Tenofovir Emtricitabine Efavirenz (TEE)) continues to decline. Meanwhile, data on TEE dispensed from the dispensary shows increasing quantities patients across the Free State province on a monthly basis. The aim of this study is to determine factors contributing to the discrepancy between Fixed Dose Combination (FDC) TEE dispensing data and patients on FDC TEE captured on TIER.Net and Health Patient Registration System (HPRS), as a means of improving identification and monitoring of patients that carry the potential risk of being lost to subsequent follow-ups (ART collection / clinical visits). Methods: A retrospective, quantitative, and descriptive record review of 382 medical records of HIV positive patients, along with TIER.Net and Health Patient Registration System (HPRS) reports, was conducted at five primary healthcare (PHC) facilities, each representing the five sub-districts found in Lejweleputswa district using a self-designed data collection tool. Descriptive statistics was used to summarise and present data. Results: Sixty five percent the TEE collected from the dispensary was captured on TIER. Net. It could not be determined on none of the medical records whether or not the administrative clerk captured dispensed TEE on the same date of collection from the dispensary on TIER.Net. Subsequently, the actual date of capturing the TEE dispenses on TIER.Net following collection of the treatment from the dispensary could also not be determined. The overall data on TEE dispensed/collected from the dispensary the same was not the same as the data captured on TIER.Net. Thirty five percent of patients were reported to have collected their ART according to dispensary data than that reported on TIER.Net. Eighty percent of the TEE collected from the dispensary was captured on HPRS. Eighty percent of facilities had an area and computer dedicated for HPRS and TIER.Net but none had a backup computer in cases of theft/breakage. None of the facilities had access to back up connectivity, a manual capturing process in the form of paper-based head count registers was instead utilised as back-up. Conclusion: The following factors were found to contribute to the discrepancy between the TEE dispensing data, TIER.net and HPRS: Poor records keeping, unauthorised dispensing of prescriptions, poor data management, delays and non-capturing of ART medical records and infrastructural and human resource challenges that exist in the data management of the patient medical records. There is a need to address these gaps in order to improve reliability of dispensary data, as well as reports from TIER.Net and HPRS, in order to streamline the identification and monitoring of patients at risk of becoming lost to follow-up. , Thesis (MPA) -- Faculty of Health Sciences
- Full Text:
Clinicians knowledge and perceptions of point of care testing (poct) in selected hospitals in the free state, South Africa
- Authors: Watkins, Edgar Jeffrey
- Date: 2022-08
- Subjects: Point-of-care testing , Preventive health services , Medical technology
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/27264 , vital:66487
- Description: Point of care testing (POCT) improves access and equity to health diagnostic services in resource-limited settings like South Africa, where some health facilities do not have on-site laboratories. With recent technological advancements, most traditional laboratory tests can now be conducted on-site at primary health clinics (PHC), hospital wards and clinics. One advantage of the POCT device is that it can be used by a non-medical laboratory expert at the patient’s bed side during hospitalizations or near the patient in the doctor’s consultation rooms. This results in a shorter turnaround time for the availability of test results when compared to that from a specimen sent to a traditional clinical laboratory. Despite the benefits of POCT, many clinicians (doctors and nurses) avoid utilizing POCT for quality assurance reasons. Clinicians believe the results from a POCT device may not be as reliable as the results from tests performed by a medical laboratory scientist in the traditional clinical laboratory. This study used a concurrent mixed method research design to explore clinicians' POCT knowledge and attitudes in a subset of hospitals in the Free state of South Africa. The study population comprised of consenting medical professionals from the ten (10) selected Free State district hospitals (study sites). The findings demonstrated that hospitals in urban areas have easier access to laboratory services. There were two (2) urban study sites that had on-site laboratories which achieved faster Turn-Around-Time (TAT). The participants indicate that they are aware of POCT and routinely use it, but there are far fewer POCT tests available than laboratory tests. When diagnostic options are scarce, point-of-care testing (POCT) can provide a more accurate diagnosis than traditional methods. The improved health care provision and reduced incidence of health complications is the end result. According to the participants, having access to POCT diagnostic services has shown promise in addressing challenges that sometimes present with laboratory-based methods, particularly in settings with limited access to hospitals or when laboratories cannot be accessed. Further, clinicians argue that errors in the usage of POCT may occur due to the quality of these POCTs and improper documentation of the test results by the clinicians. Therefore, poor utilization of POCT by clinicians can be improved if implemented with pre-set strict selection goals and processes to ensure that the right POCT is selected for the right purpose that would reduce resource expenditure by the hospitals and improve patient experiences and health outcomes. , Thesis (MPH) -- Faculty of Health Sciences, 2022
- Full Text:
- Authors: Watkins, Edgar Jeffrey
- Date: 2022-08
- Subjects: Point-of-care testing , Preventive health services , Medical technology
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/27264 , vital:66487
- Description: Point of care testing (POCT) improves access and equity to health diagnostic services in resource-limited settings like South Africa, where some health facilities do not have on-site laboratories. With recent technological advancements, most traditional laboratory tests can now be conducted on-site at primary health clinics (PHC), hospital wards and clinics. One advantage of the POCT device is that it can be used by a non-medical laboratory expert at the patient’s bed side during hospitalizations or near the patient in the doctor’s consultation rooms. This results in a shorter turnaround time for the availability of test results when compared to that from a specimen sent to a traditional clinical laboratory. Despite the benefits of POCT, many clinicians (doctors and nurses) avoid utilizing POCT for quality assurance reasons. Clinicians believe the results from a POCT device may not be as reliable as the results from tests performed by a medical laboratory scientist in the traditional clinical laboratory. This study used a concurrent mixed method research design to explore clinicians' POCT knowledge and attitudes in a subset of hospitals in the Free state of South Africa. The study population comprised of consenting medical professionals from the ten (10) selected Free State district hospitals (study sites). The findings demonstrated that hospitals in urban areas have easier access to laboratory services. There were two (2) urban study sites that had on-site laboratories which achieved faster Turn-Around-Time (TAT). The participants indicate that they are aware of POCT and routinely use it, but there are far fewer POCT tests available than laboratory tests. When diagnostic options are scarce, point-of-care testing (POCT) can provide a more accurate diagnosis than traditional methods. The improved health care provision and reduced incidence of health complications is the end result. According to the participants, having access to POCT diagnostic services has shown promise in addressing challenges that sometimes present with laboratory-based methods, particularly in settings with limited access to hospitals or when laboratories cannot be accessed. Further, clinicians argue that errors in the usage of POCT may occur due to the quality of these POCTs and improper documentation of the test results by the clinicians. Therefore, poor utilization of POCT by clinicians can be improved if implemented with pre-set strict selection goals and processes to ensure that the right POCT is selected for the right purpose that would reduce resource expenditure by the hospitals and improve patient experiences and health outcomes. , Thesis (MPH) -- Faculty of Health Sciences, 2022
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Dietary preference and perceptions of the health implications: A qualitative study on perspectives from outpatients and health care providers at Nontyatyambo Community Health Centre, Eastern Cape, South Africa
- Authors: Chocko, Ronnie J A V
- Date: 2022-08
- Subjects: Diet , Nutrition
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/26764 , vital:65990
- Description: Introduction and background. Poor dietary choices are resulting in an increase of mortality and morbidity rates globally. Epidemiological studies reveal that diets high in animal-sourced foods (ASF) lead to an increased risk of developing cardio-metabolic diseases (CMD). On the other hand, plant-based foods (PBF) have been shown to reduce this risk. Making well informed dietary choices plays an important role in reducing the burden of these diseases. To this end, this study further explores the role that diet plays in maintaining good health by exploring current dietary preferences, perceptions of the health implications of these dietary choices and perceptions of the benefits of PBFs vs ASFs of people in a local South African context. Methodology. This qualitative study was conducted at Nontyatyambo Community Health Centre, Mdantansane, Buffalo City Metropolitan district in the Eastern Cape province of South Africa. A sample of 42 participants was enrolled for the study. A question/interview guide was used to collect data through key-in-depth interviews and focus group discussions. Two audio recorders were used to record the verbal responses of participants. The recorded interviews were transcribed and translated to English. The transcribed data was systematically and thematically analyzed. Results. It was found that all participants in this study were following an omnivorous dietary pattern. A number of participants expressed that they did not like vegetables. In this study, most participants felt that PBFs were healthier than ASFs. Even though they felt PBFs were healthier, none followed exclusively plant-based diet. Conclusion. Transforming dietary patterns to contain more plant-based foods may be a critical factor in reversing harmful effects on public health and the environment. This calls for urgent public health intervention to improve nutritional uptake as a strategy to reduce potential CMD. , Thesis (MPA) -- Faculty of Health Sciences, 2022
- Full Text:
- Authors: Chocko, Ronnie J A V
- Date: 2022-08
- Subjects: Diet , Nutrition
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/26764 , vital:65990
- Description: Introduction and background. Poor dietary choices are resulting in an increase of mortality and morbidity rates globally. Epidemiological studies reveal that diets high in animal-sourced foods (ASF) lead to an increased risk of developing cardio-metabolic diseases (CMD). On the other hand, plant-based foods (PBF) have been shown to reduce this risk. Making well informed dietary choices plays an important role in reducing the burden of these diseases. To this end, this study further explores the role that diet plays in maintaining good health by exploring current dietary preferences, perceptions of the health implications of these dietary choices and perceptions of the benefits of PBFs vs ASFs of people in a local South African context. Methodology. This qualitative study was conducted at Nontyatyambo Community Health Centre, Mdantansane, Buffalo City Metropolitan district in the Eastern Cape province of South Africa. A sample of 42 participants was enrolled for the study. A question/interview guide was used to collect data through key-in-depth interviews and focus group discussions. Two audio recorders were used to record the verbal responses of participants. The recorded interviews were transcribed and translated to English. The transcribed data was systematically and thematically analyzed. Results. It was found that all participants in this study were following an omnivorous dietary pattern. A number of participants expressed that they did not like vegetables. In this study, most participants felt that PBFs were healthier than ASFs. Even though they felt PBFs were healthier, none followed exclusively plant-based diet. Conclusion. Transforming dietary patterns to contain more plant-based foods may be a critical factor in reversing harmful effects on public health and the environment. This calls for urgent public health intervention to improve nutritional uptake as a strategy to reduce potential CMD. , Thesis (MPA) -- Faculty of Health Sciences, 2022
- Full Text:
Colistin utilisation and clinical outcomes at a public hospital in Bloemfontein, South Africa
- Matshediso, Gaalebale Prudence
- Authors: Matshediso, Gaalebale Prudence
- Date: 2022-07
- Subjects: Gram-negative bacteria , Hospital patients
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/26929 , vital:66172
- Description: Background Colistin is an antibiotic used as the last resort in the treatment of multi-drug resistant Gram-negative bacteria. Its use started in the 1950s but was decreased in the 1980s owing to its nephrotoxic side effects. The re-emergence of Colistin utilisation in 2012 in South Africa followed the emergence of multi-drug resistant Gram-negative bacteria. There is a dearth of information on the rationale use of Colistin in South Africa. Aim To describe the use of Colistin and its clinical outcomes at a tertiary hospital in Bloemfontein, South Africa. Methodology A retrospective cross-sectional study was conducted at a tertiary hospital in Bloemfontein between 2015 and 2019. Relevant data was extracted from the medical records of patients treated with Colistin. Stratified random sampling was used in selecting 50percent of the eligible medical records of patients treated with Colistin per stratum. Data was analysed using simple descriptive and inferential statistics. Results Of the total sample (N=69), the majority were neonates (43.5percent), while children constituted the lowest number of patients (18.8percent). The highest contributor to the top diagnosis, septicaemia, were neonates (44.2percent). Adherence to policy and Colistin treatment guidelines was suboptimal, more so in neonates (45.3percent) than in adults (73.7percent) and children (72.3percent). Colistin was used as a last resort in 68.1percent of the participants. Cure was achieved in 26.9percent, 46.2percent and 80percent of adults, children and neonates, respectively. The highest rate of nephrotoxicity was seen in adults (57.7percent). In the multivariate logistic regression model analysis, both adults [adjusted odds ratio (AOR)=25.54, 95percent confidence interval (CI) 2.73-238.65] and children (AOR=8.56, 95percentCI 1.06 – 69.10) had a higher risk of death than neonates. However, there was no significant difference in the odds for mortality by gender, co-morbidities, illness duration prior to admission and adherence to treatmen Conclusions This study found a suboptimal level of compliance with policy and recommended guidelines on the use of Colistin in a South African public sector tertiary hospital. In addition, there were variations in the level of compliance by age categories, with lower levels of compliance in neonates than in children and adults. The odds for mortality by gender, co-morbidities, illness duration prior to admission and adherence to treatment guidelines and policies were found to be insignificant, and age was the only predictor of mortality found in the study. The findings of the study highlight the need for improved clinical governance on antibiotic stewardship and monitoring of use of Colistin across all categories of patients in the hospital. Future studies should examine the contributing factors for suboptimal compliance, with evidence-based recommendations on the use of Colistin in the study setting as well as factors contributing to high mortality in adults. , Thesis (MPA) -- Faculty of Health Sciences, 2022
- Full Text:
- Authors: Matshediso, Gaalebale Prudence
- Date: 2022-07
- Subjects: Gram-negative bacteria , Hospital patients
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/26929 , vital:66172
- Description: Background Colistin is an antibiotic used as the last resort in the treatment of multi-drug resistant Gram-negative bacteria. Its use started in the 1950s but was decreased in the 1980s owing to its nephrotoxic side effects. The re-emergence of Colistin utilisation in 2012 in South Africa followed the emergence of multi-drug resistant Gram-negative bacteria. There is a dearth of information on the rationale use of Colistin in South Africa. Aim To describe the use of Colistin and its clinical outcomes at a tertiary hospital in Bloemfontein, South Africa. Methodology A retrospective cross-sectional study was conducted at a tertiary hospital in Bloemfontein between 2015 and 2019. Relevant data was extracted from the medical records of patients treated with Colistin. Stratified random sampling was used in selecting 50percent of the eligible medical records of patients treated with Colistin per stratum. Data was analysed using simple descriptive and inferential statistics. Results Of the total sample (N=69), the majority were neonates (43.5percent), while children constituted the lowest number of patients (18.8percent). The highest contributor to the top diagnosis, septicaemia, were neonates (44.2percent). Adherence to policy and Colistin treatment guidelines was suboptimal, more so in neonates (45.3percent) than in adults (73.7percent) and children (72.3percent). Colistin was used as a last resort in 68.1percent of the participants. Cure was achieved in 26.9percent, 46.2percent and 80percent of adults, children and neonates, respectively. The highest rate of nephrotoxicity was seen in adults (57.7percent). In the multivariate logistic regression model analysis, both adults [adjusted odds ratio (AOR)=25.54, 95percent confidence interval (CI) 2.73-238.65] and children (AOR=8.56, 95percentCI 1.06 – 69.10) had a higher risk of death than neonates. However, there was no significant difference in the odds for mortality by gender, co-morbidities, illness duration prior to admission and adherence to treatmen Conclusions This study found a suboptimal level of compliance with policy and recommended guidelines on the use of Colistin in a South African public sector tertiary hospital. In addition, there were variations in the level of compliance by age categories, with lower levels of compliance in neonates than in children and adults. The odds for mortality by gender, co-morbidities, illness duration prior to admission and adherence to treatment guidelines and policies were found to be insignificant, and age was the only predictor of mortality found in the study. The findings of the study highlight the need for improved clinical governance on antibiotic stewardship and monitoring of use of Colistin across all categories of patients in the hospital. Future studies should examine the contributing factors for suboptimal compliance, with evidence-based recommendations on the use of Colistin in the study setting as well as factors contributing to high mortality in adults. , Thesis (MPA) -- Faculty of Health Sciences, 2022
- Full Text:
Infant feeding knowledge, attitudes and practices of mothers in private health facilities in Alice town, Eastern Cape, South Africa
- Authors: Oyeniran, Aderonke Adepeju
- Date: 2022-07
- Subjects: Breastfeeding
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/23556 , vital:58132
- Description: Background and aim of the study: Within the global field of health education, it is generally accepted that the topic of breast-feeding is a crucial discussion due to its maternal, infant, and communal benefits. However, certain African countries, such as South Africa, experience certain challenges related to both predictive factors and maternal attitudes to breast-feeding. To improve public awareness and promote the implementation of breast-feeding, these factors should be investigated to highlight the importance of this practice among young mothers. Method: The study utilised a cross-sectional survey by means of a self-administered questionnaire, which was completed by the carefully chosen participants. The collected data were then analysed using a statistical package for social sciences (SPSS) (frequency, percentages, mean and standard deviation) and inferential statistics (logistic regression). The level of significance for the inferential statistics was set at 0.05. Results: A total of 377 infant mothers participated in the study with median age of 30. Most infant mothers that participated in the study were well educated with infant mother 189 having a bachelor’s degree. The findings revealed that mothers of 40 years above are 1.51 times more likely not to breastfeed exclusively compared to mothers of less than 40 years of age (95percent CI, 0.75-2.25). The odds ratio of the incidence of decision in breastfeeding for participants with breastfeeding and formula milk was 1.66 (95percent CI, 0.87-2.53). In term of family support, mothers who don’t receive family support were 3.43 times more likely no to breastfeed. The result also revealed that mothers with breast pain were 0.98 more likely not to breastfeed. Conclusion: This study concludes that infant mothers are well informed about breastfeeding. This study also revealed that factors such as infant mothers’ knowledge about breastfeeding, medical health of both mother and infant and cultural norms can go a long way in influencing the decision of mothers to breastfeeding their infant or not. , Thesis (MPH) -- Faculty of Health Sciences, 2022
- Full Text:
- Authors: Oyeniran, Aderonke Adepeju
- Date: 2022-07
- Subjects: Breastfeeding
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/23556 , vital:58132
- Description: Background and aim of the study: Within the global field of health education, it is generally accepted that the topic of breast-feeding is a crucial discussion due to its maternal, infant, and communal benefits. However, certain African countries, such as South Africa, experience certain challenges related to both predictive factors and maternal attitudes to breast-feeding. To improve public awareness and promote the implementation of breast-feeding, these factors should be investigated to highlight the importance of this practice among young mothers. Method: The study utilised a cross-sectional survey by means of a self-administered questionnaire, which was completed by the carefully chosen participants. The collected data were then analysed using a statistical package for social sciences (SPSS) (frequency, percentages, mean and standard deviation) and inferential statistics (logistic regression). The level of significance for the inferential statistics was set at 0.05. Results: A total of 377 infant mothers participated in the study with median age of 30. Most infant mothers that participated in the study were well educated with infant mother 189 having a bachelor’s degree. The findings revealed that mothers of 40 years above are 1.51 times more likely not to breastfeed exclusively compared to mothers of less than 40 years of age (95percent CI, 0.75-2.25). The odds ratio of the incidence of decision in breastfeeding for participants with breastfeeding and formula milk was 1.66 (95percent CI, 0.87-2.53). In term of family support, mothers who don’t receive family support were 3.43 times more likely no to breastfeed. The result also revealed that mothers with breast pain were 0.98 more likely not to breastfeed. Conclusion: This study concludes that infant mothers are well informed about breastfeeding. This study also revealed that factors such as infant mothers’ knowledge about breastfeeding, medical health of both mother and infant and cultural norms can go a long way in influencing the decision of mothers to breastfeeding their infant or not. , Thesis (MPH) -- Faculty of Health Sciences, 2022
- Full Text:
Infant feeding knowledge, attitudes and practices of mothers in private health facilities in Alice Town, Eastern Cape, South Africa
- Authors: Oyeniran, Aderonke Adepeju
- Date: 2022-07
- Subjects: Infants -- Nutrition , Baby foods , Breastfeeding
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/27139 , vital:66315
- Description: Background and aim of the study: Within the global field of health education, it is generally accepted that the topic of breast-feeding is a crucial discussion due to its maternal, infant, and communal benefits. However, certain African countries, such as South Africa, experience certain challenges related to both predictive factors and maternal attitudes to breast-feeding. To improve public awareness and promote the implementation of breast-feeding, these factors should be investigated to highlight the importance of this practice among young mothers. Method: The study utilised a cross-sectional survey by means of a self-administered questionnaire, which was completed by the carefully chosen participants. The collected data were then analysed using a statistical package for social sciences (SPSS) (frequency, percentages, mean and standard deviation) and inferential statistics (logistic regression). The level of significance for the inferential statistics was set at 0.05. Results: A total of 377 infant mothers participated in the study with median age of 30. Most infant mothers that participated in the study were well educated with infant mother 189 having a bachelor’s degree. The findings revealed that mothers of 40 years above are 1.51 times more likely not to breastfeed exclusively compared to mothers of less than 40 years of age (95percent CI, 0.75-2.25). The odds ratio of the incidence of decision in breastfeeding for participants with breastfeeding and formula milk was 1.66 (95percent CI, 0.87-2.53). In term of family support, mothers who don’t receive family support were 3.43 times more likely no to breastfeed. The result also revealed that mothers with breast pain were 0.98 more likely not to breastfeed. Conclusion: This study concludes that infant mothers are well informed about breastfeeding. This study also revealed that factors such as infant mothers’ knowledge about breastfeeding, medical health of both mother and infant and cultural norms can go a long way in influencing the decision of mothers to breastfeeding their infant or not. , Thesis (MPH) -- Faculty of Health Sciences, 2022
- Full Text:
- Authors: Oyeniran, Aderonke Adepeju
- Date: 2022-07
- Subjects: Infants -- Nutrition , Baby foods , Breastfeeding
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/27139 , vital:66315
- Description: Background and aim of the study: Within the global field of health education, it is generally accepted that the topic of breast-feeding is a crucial discussion due to its maternal, infant, and communal benefits. However, certain African countries, such as South Africa, experience certain challenges related to both predictive factors and maternal attitudes to breast-feeding. To improve public awareness and promote the implementation of breast-feeding, these factors should be investigated to highlight the importance of this practice among young mothers. Method: The study utilised a cross-sectional survey by means of a self-administered questionnaire, which was completed by the carefully chosen participants. The collected data were then analysed using a statistical package for social sciences (SPSS) (frequency, percentages, mean and standard deviation) and inferential statistics (logistic regression). The level of significance for the inferential statistics was set at 0.05. Results: A total of 377 infant mothers participated in the study with median age of 30. Most infant mothers that participated in the study were well educated with infant mother 189 having a bachelor’s degree. The findings revealed that mothers of 40 years above are 1.51 times more likely not to breastfeed exclusively compared to mothers of less than 40 years of age (95percent CI, 0.75-2.25). The odds ratio of the incidence of decision in breastfeeding for participants with breastfeeding and formula milk was 1.66 (95percent CI, 0.87-2.53). In term of family support, mothers who don’t receive family support were 3.43 times more likely no to breastfeed. The result also revealed that mothers with breast pain were 0.98 more likely not to breastfeed. Conclusion: This study concludes that infant mothers are well informed about breastfeeding. This study also revealed that factors such as infant mothers’ knowledge about breastfeeding, medical health of both mother and infant and cultural norms can go a long way in influencing the decision of mothers to breastfeeding their infant or not. , Thesis (MPH) -- Faculty of Health Sciences, 2022
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Investigation of risky sexual behaviour amongst HIV/AIDS positive individuals on antiretroviral treatment in Buffalo City Metropolitan Municipality Eastern Cape Province, South Africa
- Authors: Pere, Mzukisi Ernest
- Date: 2022-07
- Subjects: Sexual behaviour -- South Africa -- Eastern Cape , Youth Sexual behaviour
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/23578 , vital:58190
- Description: Background: Human immunodeficiency virus (HIV)/ acquired immune deficiency syndrome (AIDS) is one of the major public health concerns. Antiretroviral treatments (ART) is available immediately for HIV-positive individuals but sexually transmitted infections are on the rise. The majority of HIV positive patients on ART are engaging in unsafe sexual practices. Purpose: The aim of this study was to investigate risky sexual behaviour of people on antiretroviral treatment regarding prevention. The study was conducted on adult clients in the Buffalo City Metropolitan Municipality. Methods: A quantitative and descriptive cross-sectional design was conducted whereby 304 patients who visited Nontyatyambo Health Centre were randomly selected. Data was entered and analyzed using Statistical Package for the Social Sciences (SPSS) 24. Simple descriptive statistics such as numbers, percentages and tables were used to characterise variables. A chi-square test was used to explore associations between dependent and independent variables. Test significance, confidence intervals and p-values of all the causes and contributory factors were set at 0.05. Results: Thirty two percent reported having sex with multiple sexual partners while 19percent reported never using a condom. Forty eight percent reported having had sexually transmitted infections since starting on ART. The median age (36 years (IQR: 31, 45) vs. 35 years (IQR: 26, 40)) of those who reported STIs was higher than the median age of those who did not report STI (p=0.012). Males (57percent, p=0.049), those who were employed (55percent, p=0.048), and those who were cohabitating (68percent, 0.030) were more likely to report STI. Similarly, those who had unprotected sex with a casual partner (62percent, p<0.001), and those who did not use a condom because a partner did not like it (71percent, p=0.001) were more likely to report STIs. A significant number of 32percent of the participants reported engaging in risky sexual practices while 48percent had reported an STI. Recommendations include educational outreach programmes and capacitation of health care workers with appropriate skills and tools. , Thesis (MPH) -- Faculty of Health Sciences, 2022
- Full Text:
- Authors: Pere, Mzukisi Ernest
- Date: 2022-07
- Subjects: Sexual behaviour -- South Africa -- Eastern Cape , Youth Sexual behaviour
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/23578 , vital:58190
- Description: Background: Human immunodeficiency virus (HIV)/ acquired immune deficiency syndrome (AIDS) is one of the major public health concerns. Antiretroviral treatments (ART) is available immediately for HIV-positive individuals but sexually transmitted infections are on the rise. The majority of HIV positive patients on ART are engaging in unsafe sexual practices. Purpose: The aim of this study was to investigate risky sexual behaviour of people on antiretroviral treatment regarding prevention. The study was conducted on adult clients in the Buffalo City Metropolitan Municipality. Methods: A quantitative and descriptive cross-sectional design was conducted whereby 304 patients who visited Nontyatyambo Health Centre were randomly selected. Data was entered and analyzed using Statistical Package for the Social Sciences (SPSS) 24. Simple descriptive statistics such as numbers, percentages and tables were used to characterise variables. A chi-square test was used to explore associations between dependent and independent variables. Test significance, confidence intervals and p-values of all the causes and contributory factors were set at 0.05. Results: Thirty two percent reported having sex with multiple sexual partners while 19percent reported never using a condom. Forty eight percent reported having had sexually transmitted infections since starting on ART. The median age (36 years (IQR: 31, 45) vs. 35 years (IQR: 26, 40)) of those who reported STIs was higher than the median age of those who did not report STI (p=0.012). Males (57percent, p=0.049), those who were employed (55percent, p=0.048), and those who were cohabitating (68percent, 0.030) were more likely to report STI. Similarly, those who had unprotected sex with a casual partner (62percent, p<0.001), and those who did not use a condom because a partner did not like it (71percent, p=0.001) were more likely to report STIs. A significant number of 32percent of the participants reported engaging in risky sexual practices while 48percent had reported an STI. Recommendations include educational outreach programmes and capacitation of health care workers with appropriate skills and tools. , Thesis (MPH) -- Faculty of Health Sciences, 2022
- Full Text:
Investigation of risky sexual behaviour amongst HIV/AIDS positive individuals on antiretroviral treatment in Buffalo City Metropolitan Municipality Eastern Cape Province, South Africa
- Authors: Pere, Mzukisi Ernest
- Date: 2022-07
- Subjects: HIV-positive persons , Sexually transmitted diseases , AIDS (Disease) -- Prevention
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/27198 , vital:66395
- Description: Background: Human immunodeficiency virus (HIV)/ acquired immune deficiency syndrome (AIDS) is one of the major public health concerns. Antiretroviral treatments (ART) is available immediately for HIV-positive individuals but sexually transmitted infections are on the rise. The majority of HIV positive patients on ART are engaging in unsafe sexual practices. Purpose: The aim of this study was to investigate risky sexual behaviour of people on antiretroviral treatment regarding prevention. The study was conducted on adult clients in the Buffalo City Metropolitan Municipality. Methods: A quantitative and descriptive cross-sectional design was conducted whereby 304 patients who visited Nontyatyambo Health Centre were randomly selected. Data was entered and analyzed using Statistical Package for the Social Sciences (SPSS) 24. Simple descriptive statistics such as numbers, percentages and tables were used to characterise variables. A chi-square test was used to explore associations between dependent and independent variables. Test significance, confidence intervals and p-values of all the causes and contributory factors were set at 0.05. Results: Thirty two percent reported having sex with multiple sexual partners while 19percent reported never using a condom. Forty eight percent reported having had sexually transmitted infections since starting on ART. The median age (36 years (IQR: 31, 45) vs. 35 years (IQR: 26, 40)) of those who reported STIs was higher than the median age of those who did not report STI (p=0.012). Males (57percent, p=0.049), those who were employed (55percent, p=0.048), and those who were cohabitating (68percent, 0.030) were more likely to report STI. Similarly, those who had unprotected sex with a casual partner (62percent, p<0.001), and those who did not use a condom because a partner did not like it (71percent, p=0.001) were more likely to report STIs. A significant number of 32percent of the participants reported engaging in risky sexual practices while 48percent had reported an STI. Recommendations include educational outreach programmes and capacitation of health care workers with appropriate skills and tools. , Thesis (MPH) -- Faculty of Health Sciences, 2022
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- Authors: Pere, Mzukisi Ernest
- Date: 2022-07
- Subjects: HIV-positive persons , Sexually transmitted diseases , AIDS (Disease) -- Prevention
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/27198 , vital:66395
- Description: Background: Human immunodeficiency virus (HIV)/ acquired immune deficiency syndrome (AIDS) is one of the major public health concerns. Antiretroviral treatments (ART) is available immediately for HIV-positive individuals but sexually transmitted infections are on the rise. The majority of HIV positive patients on ART are engaging in unsafe sexual practices. Purpose: The aim of this study was to investigate risky sexual behaviour of people on antiretroviral treatment regarding prevention. The study was conducted on adult clients in the Buffalo City Metropolitan Municipality. Methods: A quantitative and descriptive cross-sectional design was conducted whereby 304 patients who visited Nontyatyambo Health Centre were randomly selected. Data was entered and analyzed using Statistical Package for the Social Sciences (SPSS) 24. Simple descriptive statistics such as numbers, percentages and tables were used to characterise variables. A chi-square test was used to explore associations between dependent and independent variables. Test significance, confidence intervals and p-values of all the causes and contributory factors were set at 0.05. Results: Thirty two percent reported having sex with multiple sexual partners while 19percent reported never using a condom. Forty eight percent reported having had sexually transmitted infections since starting on ART. The median age (36 years (IQR: 31, 45) vs. 35 years (IQR: 26, 40)) of those who reported STIs was higher than the median age of those who did not report STI (p=0.012). Males (57percent, p=0.049), those who were employed (55percent, p=0.048), and those who were cohabitating (68percent, 0.030) were more likely to report STI. Similarly, those who had unprotected sex with a casual partner (62percent, p<0.001), and those who did not use a condom because a partner did not like it (71percent, p=0.001) were more likely to report STIs. A significant number of 32percent of the participants reported engaging in risky sexual practices while 48percent had reported an STI. Recommendations include educational outreach programmes and capacitation of health care workers with appropriate skills and tools. , Thesis (MPH) -- Faculty of Health Sciences, 2022
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Knowledge, attitude and perception of uninitiated adolescents towards customary male initiation practices in selected schools in Buffalo City Municipality, Eastern Cape
- Authors: Igaba, Nelson Kibiribiri
- Date: 2022-07
- Subjects: Circumcision , HIV infections -- Prevention , Initiation rites
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/26896 , vital:66061
- Description: Background: Based on evidence that Voluntary Medical Male Circumcision (VMMC) significantly reduces the risk of human immunodeficiency virus- HIV transmission by 60percent, the World Health Organization (WHO) recommends implementing VMMC programs in countries with a high HIV prevalence, considering the unique sociocultural and economic dynamics of each setting. However, in South Africa (SA), multiple tribes including the AmaXhosa in the Eastern Cape (EC) province practice Customary Male Initiation (CMI) also known as Ulwaluko as a rite of passage of males from boyhood to manhood, and this involves circumcision. In recent years, this practice has been riddled with deaths of initiates, admissions to hospital, amputation of penis, assaults, drug and alcohol, and crime. Hence, this study aimed at understanding the knowledge, attitude, and perceptions of uninitiated adolescents towards the CMI practice in Buffalo City Municipality (BCM), EC to aid in developing strategies to solve current challenges. Methods: Between June and December 2021, this cross-sectional descriptive study was conducted in selected schools within BCM, in the EC, using a quantitative research approach. The study population included adolescent males aged 15 to 19 years who had not attended CMI. Applying a multistage random sampling technique, three (3)BCM towns (Bhisho, King William Town-KWT and East London-EL) and the Mdantsane township (MT) were selected and further the schools from which consenting pupils were enrolled into the study. Data was collected using a validated self-administered questionnaire which was captured on excel and analysed using STATA version 16.1. Categorical variables were summarized using percentages. Bivariate and multivariate regression was used to determine factors associated with a level of knowledge, attitude, and perception towards CMI and VMMC. The odds ratio with a 95percent confidence interval was calculated. A p–value of <0.05 was considered statistically significant. Results: Among 297 participants that responded 251 (84.51percent) were between the ages of 15-19 years and had not undergone circumcision or CMI. These were included in this analysis. Majority of participants 181 (72.11percent, 95percent CI 66.21-77.33) lacked knowledge on whether circumcision reduces risk of HIV acquisition. More than three quarters of participants 195 (77.69percent, 95percent CI 72.09-83.87) showed absence of knowledge on whether circumcision reduces risk of STIs. Close to all participants 244 (97.21percent, 95percent CI 94.25-98.67) indicated that they would choose CMI over VMMC due to cultural reason. More than three quarters of participants 193 (76.89percent, 95percent CI 71.24-81.72) agreed that CMI/Ulwaluko proves manhood. The presence of knowledge on the benefits of VMMC was positively dependent on the location where a participants lived (uOR 2.32, 95percent CI 1.09-4.97, p-value 0.029) and access to internet more than once a week (uOR 3.44, 95percent CI 1.14-10.43, p-value 0.029. The choice for CMI over VMMC was positively associated with participants living in Mdantsane Township than those living in urban areas (Coef. 1.55, 95percent CI 0.77-2.33, p-value 0.001). Conclusion: This study found lack of knowledge on benefits of VMMC, laws governing and on risks associated with CMI/Ulwaluko practices among uninitiated adolescents. The study further found that CMI/Ulwaluko was still highly regarded despite current challenges and most adolescents would choose CMI/Ulwaluko over VMMC. There is urgent need to integrate VMMC services into CMI/Ulwaluko to include health education on benefits of VMMC, infection prevention and control, male circumcision by trained medical personnel and education on laws governing CMI/Ulwaluko. These interventions should also target uninitiated adolescents. , Thesis (MPA) -- Faculty of Health Sciences, 2022
- Full Text:
- Authors: Igaba, Nelson Kibiribiri
- Date: 2022-07
- Subjects: Circumcision , HIV infections -- Prevention , Initiation rites
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/26896 , vital:66061
- Description: Background: Based on evidence that Voluntary Medical Male Circumcision (VMMC) significantly reduces the risk of human immunodeficiency virus- HIV transmission by 60percent, the World Health Organization (WHO) recommends implementing VMMC programs in countries with a high HIV prevalence, considering the unique sociocultural and economic dynamics of each setting. However, in South Africa (SA), multiple tribes including the AmaXhosa in the Eastern Cape (EC) province practice Customary Male Initiation (CMI) also known as Ulwaluko as a rite of passage of males from boyhood to manhood, and this involves circumcision. In recent years, this practice has been riddled with deaths of initiates, admissions to hospital, amputation of penis, assaults, drug and alcohol, and crime. Hence, this study aimed at understanding the knowledge, attitude, and perceptions of uninitiated adolescents towards the CMI practice in Buffalo City Municipality (BCM), EC to aid in developing strategies to solve current challenges. Methods: Between June and December 2021, this cross-sectional descriptive study was conducted in selected schools within BCM, in the EC, using a quantitative research approach. The study population included adolescent males aged 15 to 19 years who had not attended CMI. Applying a multistage random sampling technique, three (3)BCM towns (Bhisho, King William Town-KWT and East London-EL) and the Mdantsane township (MT) were selected and further the schools from which consenting pupils were enrolled into the study. Data was collected using a validated self-administered questionnaire which was captured on excel and analysed using STATA version 16.1. Categorical variables were summarized using percentages. Bivariate and multivariate regression was used to determine factors associated with a level of knowledge, attitude, and perception towards CMI and VMMC. The odds ratio with a 95percent confidence interval was calculated. A p–value of <0.05 was considered statistically significant. Results: Among 297 participants that responded 251 (84.51percent) were between the ages of 15-19 years and had not undergone circumcision or CMI. These were included in this analysis. Majority of participants 181 (72.11percent, 95percent CI 66.21-77.33) lacked knowledge on whether circumcision reduces risk of HIV acquisition. More than three quarters of participants 195 (77.69percent, 95percent CI 72.09-83.87) showed absence of knowledge on whether circumcision reduces risk of STIs. Close to all participants 244 (97.21percent, 95percent CI 94.25-98.67) indicated that they would choose CMI over VMMC due to cultural reason. More than three quarters of participants 193 (76.89percent, 95percent CI 71.24-81.72) agreed that CMI/Ulwaluko proves manhood. The presence of knowledge on the benefits of VMMC was positively dependent on the location where a participants lived (uOR 2.32, 95percent CI 1.09-4.97, p-value 0.029) and access to internet more than once a week (uOR 3.44, 95percent CI 1.14-10.43, p-value 0.029. The choice for CMI over VMMC was positively associated with participants living in Mdantsane Township than those living in urban areas (Coef. 1.55, 95percent CI 0.77-2.33, p-value 0.001). Conclusion: This study found lack of knowledge on benefits of VMMC, laws governing and on risks associated with CMI/Ulwaluko practices among uninitiated adolescents. The study further found that CMI/Ulwaluko was still highly regarded despite current challenges and most adolescents would choose CMI/Ulwaluko over VMMC. There is urgent need to integrate VMMC services into CMI/Ulwaluko to include health education on benefits of VMMC, infection prevention and control, male circumcision by trained medical personnel and education on laws governing CMI/Ulwaluko. These interventions should also target uninitiated adolescents. , Thesis (MPA) -- Faculty of Health Sciences, 2022
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Linkage to care of HIV clients following diagnosis in Engcobo Sub-district, Eastern Cape
- Authors: Mthini, Sandiso
- Date: 2022-04
- Subjects: Primary care (Medicine) , HIV infections AIDS (Disease) -- South Africa
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/27017 , vital:66223
- Description: Background: “Linkage to care” is an essential strategy in place for the retention of HIV diagnosed clients on treatment. It is vital throughout the management and care of an HIV client. Aim of the study was to explore the effectiveness of “linkage to care” of HIV clients following the diagnosis in the Engcobo sub-district, Eastern cape. Methodology: Qualitative, explorative, descriptive study design was used to explore and describe the effectiveness of “linkage to care” of HIV clients following diagnosis in the Engcobo sub-district. The population for the study were all healthcare workers, who are involved in the program of “linkage to care” of HIV positive clients. Purposive Sampling was used to select professional nurses, Community healthcare workers, Lay counsellors, linkage officers who are involved in the linkage of HIV positive patients and the facility managers whom their facilities provide HIV care services. Interview guide was used to collect data and Tesch’s method was used to analyse data. Findings: Themes that emerged from the study were flexible time to “linkage to care”; use of different policies; administration; team activities and “linkage to care” benefits. Recommendations: Training on “linkage to care”; case management model; TIER.NET system upgrade/ linkage App development, patient information packs; standardised extended hours; transport assistance/outreach mobile services. Conclusion “Linkage to care” is a team effort, it needs collaboration and knowledge. Despite the implementation of a linkage program, there are challenges that the department of health needs to act on as addressed on researcher’s recommendations. , Thesis (MPA) -- Faculty of Health Sciences, 2022
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- Authors: Mthini, Sandiso
- Date: 2022-04
- Subjects: Primary care (Medicine) , HIV infections AIDS (Disease) -- South Africa
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/27017 , vital:66223
- Description: Background: “Linkage to care” is an essential strategy in place for the retention of HIV diagnosed clients on treatment. It is vital throughout the management and care of an HIV client. Aim of the study was to explore the effectiveness of “linkage to care” of HIV clients following the diagnosis in the Engcobo sub-district, Eastern cape. Methodology: Qualitative, explorative, descriptive study design was used to explore and describe the effectiveness of “linkage to care” of HIV clients following diagnosis in the Engcobo sub-district. The population for the study were all healthcare workers, who are involved in the program of “linkage to care” of HIV positive clients. Purposive Sampling was used to select professional nurses, Community healthcare workers, Lay counsellors, linkage officers who are involved in the linkage of HIV positive patients and the facility managers whom their facilities provide HIV care services. Interview guide was used to collect data and Tesch’s method was used to analyse data. Findings: Themes that emerged from the study were flexible time to “linkage to care”; use of different policies; administration; team activities and “linkage to care” benefits. Recommendations: Training on “linkage to care”; case management model; TIER.NET system upgrade/ linkage App development, patient information packs; standardised extended hours; transport assistance/outreach mobile services. Conclusion “Linkage to care” is a team effort, it needs collaboration and knowledge. Despite the implementation of a linkage program, there are challenges that the department of health needs to act on as addressed on researcher’s recommendations. , Thesis (MPA) -- Faculty of Health Sciences, 2022
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Safe handling, storage, and management of vaccines at selected primary health care facilities in Buffalo City Metropolitan, Eastern Cape Province
- Mazwembe-Hoho, Andiswa Zimkitha
- Authors: Mazwembe-Hoho, Andiswa Zimkitha
- Date: 2022-04
- Subjects: Vaccines , Pharmaceutical policy
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/27942 , vital:70902
- Description: Background The World Health Organization has a standardized tool for assessing vaccine handling and management. South Africa has adopted WHO tools to suit its own conditions of supply and storage of vaccines, the WHO tool is a guideline for managing vaccines. Importantly, every person handling or supervising handling of vaccines should own this manual (s) and use it as a reference for the handling, storage, and management of vaccines and related items. Aim The aim of this study was to examine safe handling, storage, and management of vaccines by health care workers in PHC facilities of BCM Municipality. Methodology A quantitative research approach and descriptive design was used to assess the safe handling, storage, and management of vaccines in PHC facilities in BCM in EC. Results The results showed that safe handling, storage, and management of vaccines in PHC facilities in BCM does not comply fully on safe handling, storage, and management of vaccines. The overall compliance rate was 86%, and this indicated that healthcare workers have knowledge of what is required to be compliant with safe handling, storage, and management of vaccines. Conclusion Safe handling, storage, and management ovaccines in PHC facilities in BCM is conditionally compliant as the healthcare workers have moderate-to-satisfactory knowledge. , Thesis (MPH) -- Faculty of Health Sciences, 2022
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- Authors: Mazwembe-Hoho, Andiswa Zimkitha
- Date: 2022-04
- Subjects: Vaccines , Pharmaceutical policy
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/27942 , vital:70902
- Description: Background The World Health Organization has a standardized tool for assessing vaccine handling and management. South Africa has adopted WHO tools to suit its own conditions of supply and storage of vaccines, the WHO tool is a guideline for managing vaccines. Importantly, every person handling or supervising handling of vaccines should own this manual (s) and use it as a reference for the handling, storage, and management of vaccines and related items. Aim The aim of this study was to examine safe handling, storage, and management of vaccines by health care workers in PHC facilities of BCM Municipality. Methodology A quantitative research approach and descriptive design was used to assess the safe handling, storage, and management of vaccines in PHC facilities in BCM in EC. Results The results showed that safe handling, storage, and management of vaccines in PHC facilities in BCM does not comply fully on safe handling, storage, and management of vaccines. The overall compliance rate was 86%, and this indicated that healthcare workers have knowledge of what is required to be compliant with safe handling, storage, and management of vaccines. Conclusion Safe handling, storage, and management ovaccines in PHC facilities in BCM is conditionally compliant as the healthcare workers have moderate-to-satisfactory knowledge. , Thesis (MPH) -- Faculty of Health Sciences, 2022
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An appraisal of strategies to mitigate related to non-communicable diseases of the eye: a case study of Michael Mapongwane Health Clinic in Khayelitsha, Western Cape Metro District
- Authors: Ngcebetsha, Avela Ayanda
- Date: 2022-03
- Subjects: Chronically ill--Care , Ophthalmic nursing
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/22908 , vital:53186
- Description: Preventive and curative eye-care services are a critical component of care for patients diagnosed with chronic diseases. The South African constitution guarantees health as a fundamental human right of all citizens. While most chronically ill patients are managed at the primary health care centers, eye care services are currently contracted to private service providers. The extent to which people, especially the chronically ill patients, have access to eye-care service under the current structure is less understood. The study aims to establish the effectiveness and sustainability of the eye-care service delivery model at the Michael Mapongwane CHC, with specific reference to access to eye-care services. Specifically, the study examined the rate and determinants of eye-care service utilisation, assess user’s satisfaction and perspectives of primary health workers and private service providers regarding the current structure of eye-care services. The study adopted a descriptive and explanatory design, which involved a survey and semi-structured interviews. The survey was conducted among 423 patients attending the two primary health centers selected for this study. Patients with chronic illness were recruited over a period of one month. Overall, 365 patients with chronic illness and 58 patients without chronic illness took part in the study. Descriptive and inferential statistics were used to analyse the quantitative date. Purposive sampling was used to select nine health workers and 10 private eye-care service providers for the semi-structured interviews. The data obtained were transcribed and coded. Thematic content analysis was performed on the qualitative data. The results show that less than half of the respondents (n=168) had ever had an eye test, and an even lower proportion (n=115) had had an eye test in the past two years. Age, female sex, formal rural dwelling, marital status, and income were significantly associated with ever having an eye test done. The results reveal a gross inequality in access to eye care test. Only 19.2% of patients diagnosed with hypertension had had their eyes examined. Even fewer proportions of the patients (8.5%) had had their eyes examined during or after diagnosis for hypertension. Likewise, only one in three patients diagnosed with diabetes has had their eyes examined before or after they were diagnosed with diabetes. The majority of patients who had used the services affirmed that it was easy to access eye care services. While most respondents agreed that waiting time to make an appointment was not too long, over half of them affirmed that waiting to see an eye doctor was too long. Most users were reasonably satisfied with the eye care services received. Primary health care providers highlighted challenges such as work overload, poor infrastructure, and patient’s forgetfulness of the appointment dates as factors affecting access to eye care services in their clinic. The primary challenges the private eye-care service providers experienced were small rooms or inappropriate clinic rooms, language barrier and inadequate support from the clinics. In conclusion, this study has shown that access to preventive and curative health care services was among patients attending primary health care centres, and especially those with chronic illness. The current structure of eye care services makes it difficult for patients to access care and for providers to provide quality care. , Thesis (MPH) -- Faculty of Health Sciences, 2022
- Full Text:
- Authors: Ngcebetsha, Avela Ayanda
- Date: 2022-03
- Subjects: Chronically ill--Care , Ophthalmic nursing
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/22908 , vital:53186
- Description: Preventive and curative eye-care services are a critical component of care for patients diagnosed with chronic diseases. The South African constitution guarantees health as a fundamental human right of all citizens. While most chronically ill patients are managed at the primary health care centers, eye care services are currently contracted to private service providers. The extent to which people, especially the chronically ill patients, have access to eye-care service under the current structure is less understood. The study aims to establish the effectiveness and sustainability of the eye-care service delivery model at the Michael Mapongwane CHC, with specific reference to access to eye-care services. Specifically, the study examined the rate and determinants of eye-care service utilisation, assess user’s satisfaction and perspectives of primary health workers and private service providers regarding the current structure of eye-care services. The study adopted a descriptive and explanatory design, which involved a survey and semi-structured interviews. The survey was conducted among 423 patients attending the two primary health centers selected for this study. Patients with chronic illness were recruited over a period of one month. Overall, 365 patients with chronic illness and 58 patients without chronic illness took part in the study. Descriptive and inferential statistics were used to analyse the quantitative date. Purposive sampling was used to select nine health workers and 10 private eye-care service providers for the semi-structured interviews. The data obtained were transcribed and coded. Thematic content analysis was performed on the qualitative data. The results show that less than half of the respondents (n=168) had ever had an eye test, and an even lower proportion (n=115) had had an eye test in the past two years. Age, female sex, formal rural dwelling, marital status, and income were significantly associated with ever having an eye test done. The results reveal a gross inequality in access to eye care test. Only 19.2% of patients diagnosed with hypertension had had their eyes examined. Even fewer proportions of the patients (8.5%) had had their eyes examined during or after diagnosis for hypertension. Likewise, only one in three patients diagnosed with diabetes has had their eyes examined before or after they were diagnosed with diabetes. The majority of patients who had used the services affirmed that it was easy to access eye care services. While most respondents agreed that waiting time to make an appointment was not too long, over half of them affirmed that waiting to see an eye doctor was too long. Most users were reasonably satisfied with the eye care services received. Primary health care providers highlighted challenges such as work overload, poor infrastructure, and patient’s forgetfulness of the appointment dates as factors affecting access to eye care services in their clinic. The primary challenges the private eye-care service providers experienced were small rooms or inappropriate clinic rooms, language barrier and inadequate support from the clinics. In conclusion, this study has shown that access to preventive and curative health care services was among patients attending primary health care centres, and especially those with chronic illness. The current structure of eye care services makes it difficult for patients to access care and for providers to provide quality care. , Thesis (MPH) -- Faculty of Health Sciences, 2022
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