Factors contributing to tuberculosis mortality among new tuberculosis patients in Zululand Health District
- Authors: Dlamini, Khulekani Zakheleni
- Date: 2018
- Subjects: Mortality Tuberculosis -- Mortality Tuberculosis -- Patients
- Language: English
- Type: Thesis , Masters , Public Health
- Identifier: http://hdl.handle.net/10353/10667 , vital:35657
- Description: During the period ranging from 2011 to 2013, Zululand Health District reported tuberculosis (TB) related mortality cases above the WHO’s norm of 10 percent. This raised concerns because TB is curable even if the person is HIV positive. The overall performance of TB programme in South Africa concealed the actual problem of TB related mortality in the country and most particularly in Zululand Health District. The aim of the study was to examine factors contributing to TB mortality, and the extent of TB related mortality in Zululand Health District. A retrospective, descriptive study was conducted to review records of data on the electronic TB register at the district level in order to ascertain the relationship between TB mortality and the contributory factors associated with TB mortality. The TB data was analysed using descriptive and inferential statistics to test the null hypothesis at the significance level of p< 0.05. The study was limited to only new patients enrolled between the periods from the 1st January 2012 to the 31 December 2013. The study found that TB/HIV comorbidity was a main factor contributing to mortality among new TB patients. Eighty percent (80%) of all patients who died were HIV positive. Poor CD4 monitoring, delays or failure to initiate TB/HIV comorbid patients was one of the factors associated with mortality (p < 0.0001, OR 0.51) among this cohort of patients. Poor DOT support system significantly (p< 0.0008, OR 0.81) contributed to mortality in this district. The study also found significant association between mortality and failure to initiate comorbid patient on co-trimoxazole prophylaxis (Chi-square =9.1; df=1; p=0.0025). Tuberculosis and HIV comorbidity, and delays or failure to providing antiretroviral therapy to HIV positive patients were the main factors responsible for TB mortality in Zululand Health District. The whole phenomenon was attributable to health worker related factors. Good TB/HIV clinical management guidelines and protocols developed by the Department of Health, and distributed to all health facilities did not alleviate the problem. Support and supervision could translate policies and protocols to action.
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Perceptions, knowledge and attitudes of women towards maternal deaths at Qaukeni Sub-district in OR Tambo Health District in Eastern Cape Province, South Africa
- Authors: Mayekiso, Nomahlubi Dorcas
- Date: 2018
- Subjects: Maternal health services--South Africa--Eastern Cape Mothers--Mortality
- Language: English
- Type: Thesis , Masters , Public Health
- Identifier: http://hdl.handle.net/10353/11194 , vital:37203
- Description: BACKGROUND AND AIM: Maternal mortality is a global problem, with the risk of deathever present during pregnancy, labour and postnatal, particularly in developing countries. The purpose of the study was to explore the perceptions, knowledge and attitudes of women of child-bearing age concerning maternal deaths in Qaukeni Sub-District, Eastern Cape Province, South Africa. METHODS: A descriptive, contextual, exploratory research design was used to explore the perceptions, knowledge and attitudes of child-bearing-age women. Interviews were conducted with 21 purposively selected multiparous pregnant women. FINDINGS: Some of the participants knew signs and symptoms of pregnancy as well as danger signs during pregnancy such as haemorrhage, sepsis, high blood pressure and complications of unsupervised home deliveries; while others had little knowledge about these signs and symptoms. Some participants knew about the causes of maternal deaths and a number of them had beliefs that can be construed as myths. The use of herbal medications in pregnancy, such as gwarugwaru and mbelekisane, were highlighted as a problem in maternal health, with serious complications that can lead to maternal deaths. The participants have negative attitudes towards the clinics and hospitals due to the ill treatment they received from health professionals in labour wards, which may have led to the loss of lives of women and children. Lack of resources, unskilled traditional birth attendants, lack of accountability and responsibility by health professionals were contributory factors towards maternal deaths. CONCLUSIONS: Lack of resources, unskilled traditional birth attendants, lack of accountability and the irresponsibility of professional nurses and doctors were all pointed out by participants as either direct or indirect causes of maternal deaths. The recommendations include frequent in-service training for unskilled birth attendants, and the provisions of more professional nurses and doctors. Campaigns also need to be held to highlight the risks that women are exposed to during pregnancy, and the importance of early interventions.
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Secrets that kill : reflections on violation of cultural rights enshrined in the constitution and human rights through traditional circumcision
- Authors: Mlisa, Lily Rose Nomfundo
- Date: 2018
- Subjects: Human rights--South Africa Circumcision Circumcision--Law and legislation
- Language: English
- Type: Thesis , Masters , Public Health
- Identifier: http://hdl.handle.net/10353/11150 , vital:37176
- Description: The study was based on four research objectives: (1) to identify philosophy, psychology, cultural reasons behind the harsh and traumatic experiences of young Xhosa boys and their mothers during ukwaluka (male circumcision) as a mark for transition to manhood; (2) to review perceptions concerning the role of mothers during the male circumcision (MC) process (3) identify cultural and psycho-social construction and meaning of MC and (4) to explore recommended possible strategies on managing MC-related traumas and deaths in the Sub-Saharan region and Eastern Cape Province in particular. Desktop literature review methodology was followed. An in depth literature review was conducted on diverse website search engines using a set of inclusion criteria. Published articles from 1995 to 2015 were selected. Thematic content analysis was used to categorise and interpret emerging themes from the reviewed articles as aligned to set research objectives. Results revealed diverse philosophical and cultural perceptions around MC, its construction and meaning among different cultures whether circumcising or non-circumcising cultures. In addition, various reasons are laid out for the harsh treatment given to initiates in different settings. Results also indicated that the MC is no longer a secret due to social media profuse publications about it. The impact of education and health care benefits around medical male circumcision (MMC) has influenced women from both non-circumcising and circumcising cultures to accept it. It is recommended that MC should continue under strict observation of prescribed protocols to lessen or prevent malpractices in the process. MMC is also highly recommended. In addition, the government and traditional leaders have to continue to conduct capacity building of traditional surgeons, prospective initiates and initiates including nurses and family members about crucial protocols and health matters around MC. Finally, results recommend best practices that could be learnt from other circumcising cultures to restore the respect of MC in the Eastern Cape, as well as inclusion of women in the MC process management.
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The effectiveness of employee assistance programme and its contribution in the improvement of employee productivity in the Department of Health, OR Tambo District : a case study of forensic pathology laboratory
- Authors: Siyangaphi, Thembinkosi
- Date: 2018
- Subjects: Employee assistance programs -- South Africa -- Eastern Cape Labor productivity Employee motivation -- South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Masters , Public Health
- Identifier: http://hdl.handle.net/10353/10542 , vital:35603
- Description: The Employee Assistance Programme (EAP) is a programme used by organizations to address problems related to drug addiction, stress and family problems, aimed at enhancing both work productivity and promoting high morale among the workers. The employees in the Department of Health (DoH) are faced with many challenges which affect them, personally, and their output at work. The OR Tambo District is currently faced with high levels of absenteeism, stress, low morale amongst health staff members, resulting in most employees resigning from the service. Others die due to ill health caused by high levels of stress and depression. Some employees are being dismissed for unethical behaviour, which include, among other things, alcohol and drug abuse and abuse of state resources, non-performance and absenteeism. Furthermore, due to the shortage of staff which results in a very high workload for the incumbents, some employees experience burnout, stress, depression and exhaustion. The main objective of the study was to assess the effectiveness of the Employee Assistance Programme among OR Tambo health workers in order to improve their work productivity and performance. The study applied a descriptive, quantitative design. The target population were all employees in the Forensic Pathology Laboratory in OR Tambo District and the sample included Managers, FPOs, Supervisors and General Assistants. The questionnaire was used to collect data. The major findings of the study demonstrated that most workers are dissatisfied with their personal growth and development in the organization. Furthermore, the results indicate that respondents are not satisfied with the decision space in their job functions, salary and benefits. The findings of this study demonstrated that most employees of the Department of Health experienced health, emotional and financial problems relating to alcohol and drug abuse, stress and work overload in their workplace. The study shows that the managers referred their employees for cases related to poor performance, absenteeism, alcohol and drug abuse, tiredness, employee and health problems; changes which were noticeable after referral. One of the major conclusions and recommendations that have been drawn in this study is that EAP is a good programme in terms of its contribution to work productivity of employees, however, it needs to be marketed and services should be utilized effectively.
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