Women's knowledge and attitudes towards discontinuation of the Long-acting reversible contraceptive (Implanon) in Buffalo City Municipality, South Africa
- Authors: Mrwebi, Khungelwa Patricia
- Date: 2018
- Subjects: Contraceptives Birth control Women's health services
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: http://hdl.handle.net/10353/11206 , vital:37231
- Description: Unintended pregnancy remains a public health concern worldwide despite the availability of many contraceptives options. The South Africa Government introduced Implanon —a Long-acting Reversible Device— with aim to cost effectively prevent unplanned pregnancy. There are concerns that the implementation of this contraceptive option was without prior piloting to test for level of acceptance and attitude towards this contraception. Also, there is paucity of evidence on knowledge of women and their attitude to implanon as well as duration of use and reasons for discontinuation of implanon in South Africa. The present study address this gap by assessing the women’s knowledge of and attitude to implanon as well as reasons for implanon discontinuation in Buffalo City Municipality in South Africa. This prospective observational study administered a pre-validated questionnaire to 189 women who had removed implanon in the reproductive health clinic in one regional hospital and a primary health centre in Buffalo City Municipality. Descriptive statistics were used to analysis the study data. The average duration for implanon use among the participants was 11.2 months. Most participants had poor knowledge of implanon and implanon knowledge was significantly associated was with age. Most participants opined that implanon use is associated with heavy bleeding (60.7), irregular frequent bleeding (84.3percent), and weight gain (67percent). The main reason for implanon discontinuation was its side effects (71.3 percent). Other reasons for discontinuation of implanon are poor or wrong positioning (3.2percent), want to become pregnant (4.3percent). Some participants discontinued implanon because they were on treatment; 24 participants on ARV drug, one on antipsychotic drugs, and one on TB drugs. Experience of heavy bleeding (39.9percent) was the most stated side of implanon leading to implanon discontinuation. The study concluded that women, even though adopted implanon, lack knowledge of implanon mechanism of action and side effects. Poor knowledge of implanon side effects could explain its early discontinuation among women in South Africa. Provider should prioritise comprehensive counselling of clients on implanon side effects and mechanism of action in order to realise the benefit of implanon in this population.
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- Date Issued: 2018
The integration of mental health care services into primary health care system at King Sabata Dalindyebo Municipality Clinics
- Authors: Dlatu, Ntandazo
- Date: 2012
- Subjects: Community mental health services South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: vital:18478 , http://hdl.handle.net/11260/d1008290
- Description: Introduction: Primary Health care refers to care which is based on the needs of population. Mental health care provided within general primary care services is the first level of care within the formal health system. There is no research in King Sabata Dalindyebo, carried out on issues around integration of mental health with primary health care. The present study is initiated to overcome this gap. Aim of the study: The aim of the study was to investigate the level of knowledge, implementation and barriers of integrating mental health care services into primary health care system at King Sabata Dalindyebo clinics, in Mthatha region. Methods: This descriptive cross-sectional study was conducted at King Sabata Dalindyebo Clinics, between January 2010 and December 2011. A 10% random sample of all health professionals from King Sabata Dalindyebo was interviewed concerning their demographic characteristics, education/ qualifications, general and further training in psychiatry, awareness about Mental Health Care Act 17 of 2002 and mental health care services characteristic related to the integration of mental health care services into primary health care system. For data analysis, the means of continuous variables across 2 groups were compared using Student-t test. The proportions (%) of the categorical variable across 2 groups were compared using Chi-square test. Results: A total of 52 health professionals (40.4% males, 59.6 females, 59.6 married, 3 doctors, 49 nurses, mean age 36.9± 8 years range 23 years-52 years), were surveyed. The participants were characterized by low level of qualification in specialization, further training in psychiatry, and by very low awareness about Mental Health Care Act 17 of 2002. Furthermore, there was no implication of expects (Regional psychiatrist, psychologist, social worker) and co-ordination of mental health care services. Working in remote and disadvantaged area, health workers with lower education qualification, absence of a coordinator for mental health care services and absence of workshop on Mental Health Care Act 17 of 2002 were determinants of lower awareness about Mental Health Care Act 17 of 2002. However, there was a good to excellent framework for potential implementation of mental health care services into primary health care system. The government support in infrastructures, drugs availability, transport and equipment was evident. Patients were helped within abroad based ethical, human rights and psycho-social framework. Conclusion: There is a lack of improving human capacity for mental health in terms of continuous training in mental health issues, policies, organisation and development. Globally, the integration of mental health care service in King Sabata Dalindyebo is non-optimal.
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- Date Issued: 2012
Assessing communication challenges between clerks and deaf patients at Nelson Mandela Academic Hospital in Mthatha
- Authors: Stemela, Unati
- Date: 2011
- Subjects: Clerks and deaf patients -- Communication -- Hospital
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: vital:18417 , http://hdl.handle.net/11260/d1006597
- Description: A study on assessing communication challenges between clerks and deaf patients at Nelson Mandela Academic Hospital was conducted in 2010. The aim was to assess the existence of communication challenges, possible reasons and solutions to these. The literature reviewed identified a gap in the knowledge of communication between staff and deaf patients. A health systems’ study was conducted using a descriptive, cross sectional survey. The study population was made up of 33 clerks who worked at the registration and records area and deaf patients who stayed at Efata and received health services from the hospital. All clerks were interviewed and a random sample of 106 deaf patients was estimated using Epidat statistical software. Self administered questionnaires were used for data collection. Results confirmed the existence of communication challenges between the two groups. A majority of clerks were not trained in Sign Language. They used a combination of methods to communicate with deaf patients, and few clerks could use Sign Language. The patients also used a combination of methods due to the frustration of not having a common method of communication with clerks. The findings clearly showed that there are communication challenges between the two groups and Sign Language needed to be introduced to clerks in order to accommodate deaf patients. Further research may be done on all healthcare providers and to all deaf patients in the region served by Nelson Mandela Academic Hospital, and this could have a positive impact on the quality of service offered by the hospital to the deaf community.
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- Date Issued: 2011
Poor attendance for outpatient physiotherapy by patients discharged from Mthatha General Hospital with a stroke in 2007
- Authors: Ntamo, Precious Nomatende
- Date: 2011
- Subjects: Physiotherapy -- Medical care Stroke Mthatha -- South Africa
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: vital:18424 , http://hdl.handle.net/11260/d1006933
- Description: Background: Stroke is a major cause of disability in the world and its long term effects require good adherence to treatment protocols of physiotherapy. This will ensure optimal rehabilitation and reduce the burden of care in the society and the health service. Superficial analysis of existing data from the Physiotherapy Department of Mthatha General Hospital (MGH) revealed that there was poor attendance of outpatient physiotherapy by patients discharged from MGH with stroke and this had negative effects on outcomes and health care costs. Aim: To identify factors that influence poor attendance for outpatient physiotherapy by patients discharged from MGH with a stroke. Methods: Following approval from the Research Ethics Committee to conduct the study, an observational descriptive study design was used. The study population was 139 patients with stroke who attended for physiotherapy in MGH from January 2007 to December 2007. From a sample size of 103 randomly selected patients, 85 patients participated in the study with a response rate of 82%. Data collection was done using structured interviews and SPSS was used for data analysis. Results: The majority (86%) of patients did not attend physiotherapy until discharge from physiotherapy department. The major factors that influenced poor attendance were movement of patients to other areas (36%) and long distance from MGH (29%). Conclusion: The majority of stroke patients who attended for rehabilitation in MGH Physiotherapy Department lived in rural areas which were distant from Mthatha and could not attend physiotherapy at MGH as required by the physiotherapists. Recommendation: Development of a Provincial Rehabilitation Policy to address the unavailability of physiotherapy services at clinics and health care centers and ensure creation and filling of vacant physiotherapy positions at these levels of care.
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- Date Issued: 2011
Teenage pregnancy among high school girls in Mthatha, South Africa
- Authors: Meel, A
- Date: 2011
- Subjects: Teenage pregnancy -- Prevention , Teenage pregnancy -- Social aspects , South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: vital:18428 , http://hdl.handle.net/11260/d1006969
- Description: Teenage pregnancy is an important health and social problem in South Africa. Despite declining trends of fertility rates in last two decades, the pregnancy among school girls remains steadily high in South Africa. Teenage pregnancy had negative impacts on various aspects of socio-economic well being of school girls. Aim: To determine the proportion of teenage pregnancy among high school girls and to identify the possible factors that influence teenage pregnancy in Mthatha region during the year 2009. Materials and Methods: This is an observational cross sectional, analytic study of teenage pregnancy conducted among high school teenage girls in the Mthatha region of South Africa. Result: A total of 1150 teenage girls from 15 to 19 years of ages responded from seven high schools in the Mthatha region of South Africa. In total 113 (10%) of teenage high school girls were currently mothers or had previously been pregnant. The proportions of those who had ever been pregnant increased significantly with age. The risk of falling pregnant among public high school teenage girls had two times higher compared to private high school teenage girls. Condoms were the most common method of contraception whereas the oral pills were the least common in practice. About half of teenage girls who had ever been pregnant had an abortion and of this one-third had had a backstreet/illegal abortion. The frequency of substance use was significantly higher among teenage girls who had ever been pregnant. A significant correlation was found between low socio-economic status, public schools and teenage pregnancy in this study. Conclusion: Teenage pregnancy is common among high school girls from 15 to 19 years of age in the Mthatha Region, South Africa. Poor socio-economic family conditions, lack of contraceptive use, early sexual maturation, risky behaviour, lack of knowledge about sexuality and reproductive health, multiple sexual partners and substance use were the common contributing factors of teenage pregnancy.
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- Date Issued: 2011
Factors contributing to relapse of adult drug users in Buffalo City Municipality Metropolitan, South Africa
- Authors: Charlie, Thobeka V
- Date: 20xx
- Subjects: Substance abuse
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: http://hdl.handle.net/10353/18380 , vital:42258
- Description: According to the WHO [2014], one in every 14 people is regular users of drugs, adding up to a total of 3.74 million people (taken as a percentage of the population as of 2013). While the United Nations Office on Drug Crimes (UNDOC) revealed that in 2015, 167,750 people have died due to direct use of drugs, the patterns of drug use have increased from 1.3% to 9.8% in 2018 (UNDOC, 2018:49-51). The Eastern Cape is one of the poorest provinces of South Africa characterized by a poor primary and secondary education system, a lack of basic facilities, and poor transport infrastructure. It is evident that South Africa in general, and the Eastern Cape in particular, is experiencing a major problem with drug and substance abuse, which is especially common in school-going children. Furthermore, the Eastern Cape have limited access to specialized drug rehabilitative services due to the geographical location of existing services and the cost associated with travelling. Rehabilitation centres are available in both the State-funded and privately-owned institutions, yet the researcher was perplexed as to why, despite the proven effectiveness of the rehabilitation program in the private health care facility, relapse of the drug abusers in the Eastern Cape continues to occur. This study aimed to explore and describe the reasons why adult drug abusers who previously completed a detoxification program at Clinic A in Buffalo City Municipality, relapse after discharge. Understanding the reasons or factors of relapse assisted in the formulation of recommendations to adjust the program and prevent or reduce relapses. In this study, a qualitative, descriptive, contextual and exploratory, qualitative research design was followed to gain insight into and understand the reasons that contributed to the relapse of the adult drug abuser in a private health care facility in the Eastern Cape. 9 The population was defined as the entire group of persons who met the inclusion criteria, who relapsed after successful completion of a drug detoxification program. The sample consisted of 25 relapsed persons who were willing to participate. In Phase 1 of the study, the researcher invited relapsed adult abusers who were readmitted for the detoxification program from January to December 2019 to participate in an individual interview. The data was then reduced into patterns, categories and themes by clustering and coding the data according to Tesch’s steps of analysis. In Phase 2 of the study, the researcher critically analysed the detoxification program currently used in the private health care facility. National and international articles and best-practice standards were also consulted. Finally, a literature control was done to place the findings of the study in the context of what was already known. In the phenomenology, the literature should be reviewed after data collection and analysis so that the information in the literature does not influence the researcher in any way. In phase 3 of the study, the researcher wrote recommendations to improve the detoxification program at Clinic A [BCM].
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- Date Issued: 20xx