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:
- Date Issued: 2022-09
- 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:
- Date Issued: 2022-09
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:
- Date Issued: 2022-09
- 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:
- Date Issued: 2022-09
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:
- Date Issued: 2022-09
- 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:
- Date Issued: 2022-09
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:
- Date Issued: 2022-07
- 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:
- Date Issued: 2022-07
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:
- Date Issued: 2022-07
- 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:
- Date Issued: 2022-07
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:
- Date Issued: 2022-07
- 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:
- Date Issued: 2022-07
Development of a strategy to promote prenatal physical activity participation among women in Buffalo City Municipality, South Africa
- Okafor, Uchenna Benedine https://orcid.org/0000-0002-0435-2041
- Authors: Okafor, Uchenna Benedine https://orcid.org/0000-0002-0435-2041
- Date: 2022-03
- Subjects: Prenatal care , Exercise for pregnant women
- Language: English
- Type: Doctoral theses , text
- Identifier: http://hdl.handle.net/10353/22919 , vital:53218
- Description: Research has proven that prenatal physical activity practice is associated with multiple health benefits; however, most women in South Africa rarely participate in prenatal physical activity. In contrast to more developed countries, there is dearth of research focusing specifically on prenatal physical activity and exercise among South African women. Nevertheless, in order to effectively, and strategically promote such prenatal activity, such information is important to plan for an intervention strategy. The main aim of this study was to assess the level, patterns, and associated factors of prenatal physical activity; beliefs, knowledge, attitudes, perceived benefits, and sources of information women received during pregnancy; and, furthermore, to develop an effective and relevant intervention strategy to facilitate the participation in this particular activity in Buffalo City Municipality, Eastern Cape, South Africa. Methods The study was a mixed-method, cross-sectional study design with both quantitative and qualitative data collection and analyses. The sequential explanatory design was adopted to merge and mix different datasets to be collected and analysed. The quantitative data involved a convenient sample of 1082 pregnant women in 12 randomly selected primary healthcare clinics offering antenatal health services in Buffalo City, Eastern Cape. The Pregnancy Physical Activity Questionnaire was interviewer-administered to women at each antenatal health clinic on pre-specified days, in a designated room allocated to the primary researcher by the health facility manager. The descriptive statistics were frequency distribution, percentages, mean and standard deviation. Furthermore, the bivariate and multivariate analyses were performed on two categories of participants, namely inactive or active, to determine the factors affecting prenatal physical activity behaviour. Furthermore, multiple logistic regression analyses were used to assess associations between physical activity and the predictor variables during pregnancy. Adjusted odds ratios with 95% confidence interval were applied to estimate factors associated with physical activity levels, and the associations between prenatal physical activity levels and socio-demographic, lifestyle, and obstetrics characteristics were determined using a chi-squared analyses. The significance level was set at p = 0.05. In addition, a qualitative descriptive approach was applied, using semi-structured face-to-face interviews with 15 purposively selected pregnant women, as well as 17 midwives offering antenatal health-care services to pregnant women in the 12 selected healthcare clinics. Qualitative data were analysed using a thematic content analysis. To develop the physical activity strategy for the promotion of prenatal physical activity practice, three frameworks were applied, namely the Strength, Weakness, Opportunity and Threat (SWOT), the Political, Economic Growth, Socio-Cultural, Technological, Laws and Environmental (PESTLE), and, lastly, the Build, Overcome, Explore and Minimise (BOEM) analytical frameworks. To facilitate the validation of the strategy, the findings were additionally analysed, after which, appropriate intervention strategies promoting prenatal physical activity were developed by again using the SWOT and PESTLE analytical strategic frameworks. This process involved a purposive sampling of seven experts with knowledge of and a proven academic and scholarly background in prenatal physical activity and maternal health. Next, the developed physical activity strategy was presented to various stakeholders, which included six primary healthcare managers, two midwives, and pregnant women purposively selected in each of the 12 chosen antenatal health clinics for the validation process. The stakeholders discussed, deliberated on, and provided comments and opinions of the feasibility and implementation of the developed prenatal physical activity for promotion of physical activity practices in the Eastern Cape Province. Results The findings of this particular study demonstrated low levels of prenatal physical activity among pregnant women, and, further indicated that the most preferred form of activity was light-intensity and household activities. Only 278 of the women (25.7%) met recommendations for prenatal activity (≥150 min moderate intensity exercise per week). The average time spent in moderate–vigorous physical activity was 151.6 min (95% CI: 147.2– 156.0). Most of the women participated in light exercises with a mean of 65.9% (95% CI: 64.8–67.0), and 47.6% (95% CI: 46.3–48.9) participated in household activities. The majority of the women did not receive physical activity advice during prenatal care sessions (64.7%). Lower age (<19 years) (adjusted odd ratio (AOR) = 0.3; CI: 0.16–0.76), semi-urban residence (AOR = 0.8; CI: 0.55–1.03), lower educational level (AOR = 0.5; CI: 0.20–0.71), unemployment (AOR = 0.5; CI: 0.29–0.77) and nulliparity (AOR = 0.6; CI: 0.28–1.31) were negatively associated with prenatal physical activity, while prenatal physical activity was positively associated with starting physical activity in the first trimester (AOR = 1.9; CI: 1.06–3.31) compared to other trimesters. In addition, the pregnant women were aware of the safety (88.2%) and benefits of physical activity for both mother and baby (79.6%), improved labour and delivery (93.1%), promote energy (89.0%), and should be discontinued when tired (76.6%). However, they also held the contradictory belief that pregnancy is “a time to rest” (56.5%). Furthermore, the most common sources of information about prenatal physical activity were the media, television, the radio and Internet-based websites (70.2%). Most women affirmed that prenatal physical activity reduced infant weight (61.4%), lessen moodiness (90.4), decreased risk of gestational diabetes mellitus (92.9%), pregnancy-induced hypertension (92.5%), and complications at birth (97.8%), while common negative perceptions included musculoskeletal discomfort (82.7%), and back pain (85.7%). The majority of women indicated that prenatal physical activity improved self-image (95.7%), sleep patterns (94.2%), and respiratory function (95.8%). The results from the quantitative data revealed that the major modifiable barriers to prenatal physical activity were tiredness (73.3%), lack of advice from healthcare professionals (nurses/midwives) (64.7%), low energy (64.5%), and non-accessibility to physical activity facilities (63.0%). The results were confirmed in the qualitative data, based on the Ecological Model, in which women also mentioned tiredness, work and household responsibilities, a lack of motivation, and the lack of physical activity advice and information on the relevant recommendations and guidelines. Overall, 62.4% women had high knowledge regarding prenatal physical activity; and half of the women showed a positive attitude toward it (50.1%). Whilst participants had knowledge of other types of antenatal exercises, 80.9% of the women had no knowledge of swimming exercise. Negative attitudes towards physical activity included the feeling of tiredness (67.7%), lack of interest (64.8%), and inadequate information on physical activity (59.5%). In addition, the study highlighted that midwives rarely educate and counsel pregnant women about prenatal physical activity during scheduled antenatal visits, which was attributed largely to the shortage of midwives handling many responsibilities at clinics. Nevertheless, the midwives did express a willingness to provide effective physical activity education and counselling on prenatal physical activity, if supported by relevant training and workshops. Furthermore, they further recommended the use of the Mom Connect application, which is a technological device designed by the National Department of Health, to distribute relevant information about maternal and child health. The prenatal physical activity strategies developed to address the above-mentioned and other barriers associated with prenatal physical activity include the use of scientific and technological innovations to provide basic information on prenatal physical activity to pregnant women by means of Mom Connect, and, by collaborating with the various cellphone and network companies in South Africa. Another strategy was to integrate prenatal physical activity training into the curricula of the existing higher institutions of learning that provide teaching of maternal health in the Eastern Cape Province. Additional strategies included the documentation and subsequent clarification of misconceptions about the safety concerns often associated with prenatal physical activity by making the documents accessible to all women at the clinics in the form of a small pamphlet or booklet. Lastly, stakeholders suggested that the government offer periodic prenatal physical activity campaigns, which should be presented in local community town halls and clinics and by other stakeholders to address the current lack of awareness and effectively eliminate misrepresentations and falsehoods around the safety of prenatal physical activity within geographical setting of the Eastern Cape Province. Conclusion Despite the advantages of prenatal physical activity practices, most pregnant women in South Africa do not participate in moderate-intensity physical activity. Notably, while women perceive prenatal physical activity as beneficial to both mother and baby, such theoretical knowledge is not easily translatable into practice. The predominant sources of information on prenatal physical activity are the television, the radio, and other media, which may be potentially misleading or contradictory to evidence-based physical activity practice. Furthermore, tiredness, a lack of time, work and household responsibilities, and a lack of motivation were major modifiable barriers to prenatal physical activity by the women. In addition, pregnant women rarely receive information on prenatal physical activity. Consequently, to address the needs of the pregnant women as highlighted in this study, a prenatal physical activity intervention strategy was developed and validated by key stakeholders to promote prenatal physical activity and exercise practice among women, taken in account the local context. , Thesis (PhD) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-03
- Authors: Okafor, Uchenna Benedine https://orcid.org/0000-0002-0435-2041
- Date: 2022-03
- Subjects: Prenatal care , Exercise for pregnant women
- Language: English
- Type: Doctoral theses , text
- Identifier: http://hdl.handle.net/10353/22919 , vital:53218
- Description: Research has proven that prenatal physical activity practice is associated with multiple health benefits; however, most women in South Africa rarely participate in prenatal physical activity. In contrast to more developed countries, there is dearth of research focusing specifically on prenatal physical activity and exercise among South African women. Nevertheless, in order to effectively, and strategically promote such prenatal activity, such information is important to plan for an intervention strategy. The main aim of this study was to assess the level, patterns, and associated factors of prenatal physical activity; beliefs, knowledge, attitudes, perceived benefits, and sources of information women received during pregnancy; and, furthermore, to develop an effective and relevant intervention strategy to facilitate the participation in this particular activity in Buffalo City Municipality, Eastern Cape, South Africa. Methods The study was a mixed-method, cross-sectional study design with both quantitative and qualitative data collection and analyses. The sequential explanatory design was adopted to merge and mix different datasets to be collected and analysed. The quantitative data involved a convenient sample of 1082 pregnant women in 12 randomly selected primary healthcare clinics offering antenatal health services in Buffalo City, Eastern Cape. The Pregnancy Physical Activity Questionnaire was interviewer-administered to women at each antenatal health clinic on pre-specified days, in a designated room allocated to the primary researcher by the health facility manager. The descriptive statistics were frequency distribution, percentages, mean and standard deviation. Furthermore, the bivariate and multivariate analyses were performed on two categories of participants, namely inactive or active, to determine the factors affecting prenatal physical activity behaviour. Furthermore, multiple logistic regression analyses were used to assess associations between physical activity and the predictor variables during pregnancy. Adjusted odds ratios with 95% confidence interval were applied to estimate factors associated with physical activity levels, and the associations between prenatal physical activity levels and socio-demographic, lifestyle, and obstetrics characteristics were determined using a chi-squared analyses. The significance level was set at p = 0.05. In addition, a qualitative descriptive approach was applied, using semi-structured face-to-face interviews with 15 purposively selected pregnant women, as well as 17 midwives offering antenatal health-care services to pregnant women in the 12 selected healthcare clinics. Qualitative data were analysed using a thematic content analysis. To develop the physical activity strategy for the promotion of prenatal physical activity practice, three frameworks were applied, namely the Strength, Weakness, Opportunity and Threat (SWOT), the Political, Economic Growth, Socio-Cultural, Technological, Laws and Environmental (PESTLE), and, lastly, the Build, Overcome, Explore and Minimise (BOEM) analytical frameworks. To facilitate the validation of the strategy, the findings were additionally analysed, after which, appropriate intervention strategies promoting prenatal physical activity were developed by again using the SWOT and PESTLE analytical strategic frameworks. This process involved a purposive sampling of seven experts with knowledge of and a proven academic and scholarly background in prenatal physical activity and maternal health. Next, the developed physical activity strategy was presented to various stakeholders, which included six primary healthcare managers, two midwives, and pregnant women purposively selected in each of the 12 chosen antenatal health clinics for the validation process. The stakeholders discussed, deliberated on, and provided comments and opinions of the feasibility and implementation of the developed prenatal physical activity for promotion of physical activity practices in the Eastern Cape Province. Results The findings of this particular study demonstrated low levels of prenatal physical activity among pregnant women, and, further indicated that the most preferred form of activity was light-intensity and household activities. Only 278 of the women (25.7%) met recommendations for prenatal activity (≥150 min moderate intensity exercise per week). The average time spent in moderate–vigorous physical activity was 151.6 min (95% CI: 147.2– 156.0). Most of the women participated in light exercises with a mean of 65.9% (95% CI: 64.8–67.0), and 47.6% (95% CI: 46.3–48.9) participated in household activities. The majority of the women did not receive physical activity advice during prenatal care sessions (64.7%). Lower age (<19 years) (adjusted odd ratio (AOR) = 0.3; CI: 0.16–0.76), semi-urban residence (AOR = 0.8; CI: 0.55–1.03), lower educational level (AOR = 0.5; CI: 0.20–0.71), unemployment (AOR = 0.5; CI: 0.29–0.77) and nulliparity (AOR = 0.6; CI: 0.28–1.31) were negatively associated with prenatal physical activity, while prenatal physical activity was positively associated with starting physical activity in the first trimester (AOR = 1.9; CI: 1.06–3.31) compared to other trimesters. In addition, the pregnant women were aware of the safety (88.2%) and benefits of physical activity for both mother and baby (79.6%), improved labour and delivery (93.1%), promote energy (89.0%), and should be discontinued when tired (76.6%). However, they also held the contradictory belief that pregnancy is “a time to rest” (56.5%). Furthermore, the most common sources of information about prenatal physical activity were the media, television, the radio and Internet-based websites (70.2%). Most women affirmed that prenatal physical activity reduced infant weight (61.4%), lessen moodiness (90.4), decreased risk of gestational diabetes mellitus (92.9%), pregnancy-induced hypertension (92.5%), and complications at birth (97.8%), while common negative perceptions included musculoskeletal discomfort (82.7%), and back pain (85.7%). The majority of women indicated that prenatal physical activity improved self-image (95.7%), sleep patterns (94.2%), and respiratory function (95.8%). The results from the quantitative data revealed that the major modifiable barriers to prenatal physical activity were tiredness (73.3%), lack of advice from healthcare professionals (nurses/midwives) (64.7%), low energy (64.5%), and non-accessibility to physical activity facilities (63.0%). The results were confirmed in the qualitative data, based on the Ecological Model, in which women also mentioned tiredness, work and household responsibilities, a lack of motivation, and the lack of physical activity advice and information on the relevant recommendations and guidelines. Overall, 62.4% women had high knowledge regarding prenatal physical activity; and half of the women showed a positive attitude toward it (50.1%). Whilst participants had knowledge of other types of antenatal exercises, 80.9% of the women had no knowledge of swimming exercise. Negative attitudes towards physical activity included the feeling of tiredness (67.7%), lack of interest (64.8%), and inadequate information on physical activity (59.5%). In addition, the study highlighted that midwives rarely educate and counsel pregnant women about prenatal physical activity during scheduled antenatal visits, which was attributed largely to the shortage of midwives handling many responsibilities at clinics. Nevertheless, the midwives did express a willingness to provide effective physical activity education and counselling on prenatal physical activity, if supported by relevant training and workshops. Furthermore, they further recommended the use of the Mom Connect application, which is a technological device designed by the National Department of Health, to distribute relevant information about maternal and child health. The prenatal physical activity strategies developed to address the above-mentioned and other barriers associated with prenatal physical activity include the use of scientific and technological innovations to provide basic information on prenatal physical activity to pregnant women by means of Mom Connect, and, by collaborating with the various cellphone and network companies in South Africa. Another strategy was to integrate prenatal physical activity training into the curricula of the existing higher institutions of learning that provide teaching of maternal health in the Eastern Cape Province. Additional strategies included the documentation and subsequent clarification of misconceptions about the safety concerns often associated with prenatal physical activity by making the documents accessible to all women at the clinics in the form of a small pamphlet or booklet. Lastly, stakeholders suggested that the government offer periodic prenatal physical activity campaigns, which should be presented in local community town halls and clinics and by other stakeholders to address the current lack of awareness and effectively eliminate misrepresentations and falsehoods around the safety of prenatal physical activity within geographical setting of the Eastern Cape Province. Conclusion Despite the advantages of prenatal physical activity practices, most pregnant women in South Africa do not participate in moderate-intensity physical activity. Notably, while women perceive prenatal physical activity as beneficial to both mother and baby, such theoretical knowledge is not easily translatable into practice. The predominant sources of information on prenatal physical activity are the television, the radio, and other media, which may be potentially misleading or contradictory to evidence-based physical activity practice. Furthermore, tiredness, a lack of time, work and household responsibilities, and a lack of motivation were major modifiable barriers to prenatal physical activity by the women. In addition, pregnant women rarely receive information on prenatal physical activity. Consequently, to address the needs of the pregnant women as highlighted in this study, a prenatal physical activity intervention strategy was developed and validated by key stakeholders to promote prenatal physical activity and exercise practice among women, taken in account the local context. , Thesis (PhD) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-03
Exploration of the factors influencing the upscaling of medical male circumcision targets in selected hospitals in eThekwini District, South Africa
- Authors: Tshabalala, Sandile Clement
- Date: 2022-03
- Subjects: Circumcision
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/22005 , vital:51930
- Description: Medical male circumcision has been shown to reduce female to male HIV transmission. This study was designed to examine the underlying factors responsible for, or influencing, the inability of the health care system to achieve the MMC targets in selected hospitals in KZN. The objective of this study to was explore the challenges that lead to failure of the government to meet set targets, regarding the implementation of the MMC programme in the province of KZN, as perceived by the health care workers. Methodology A mixed quantitative and qualitative study where 150 questionnaires were used and in-depth open-ended interviews were conducted. Participants were from Clairwood and Wentworth hospitals in the district of eThekwini, KwaZulu-Natal. Eighteen healthcare workers (nurse managers, doctors, nurses and counsellors) were purposively selected from the two hospitals. Results Findings showed that poor marketing of MMC, in line with the cultural and religious inclination of the catchment populations, had an effect on the targets. The fear of pain by the male clients came out as the biggest factor followed by the fear of having an HIV test done. The six weeks healing period before indulgence in sexual intercourse had a part to play in the reluctance of clients to do MMC. Some clients feared losing the ability to have an erection post MMC and would therefore not come for MMC. Other contributory factors for failure to reach targets included shortage of staff, poor mobilisation by the staff due to lack of training on how to mobilise and how to market MMC, lack of availability of mobilisation and marketing resources, inadequate and inequitable allocated of resources. Other factors include, lack of incentives for staff to stay in the programme or even within the Department, lack of training, cultural and religious beliefs in the community. The staff also felt that the MMC targets were too high. Notwithstanding, the staff members were willing to learn how to market MMC and to mobilise clients. Clients and community education on the importance of MMC and the combination of this process with good sexual behaviour would improve MMC uptake and reduce HIV prevalence and the incidence. Conclusions The fear of pain, fear to do HIV test and the fear to loose erection were the most prominent reasons why the males would not come for MMC procedure. , Thesis (MPH) -- Faculty of Health Sciences, Public Health, 2022
- Full Text:
- Date Issued: 2022-03
- Authors: Tshabalala, Sandile Clement
- Date: 2022-03
- Subjects: Circumcision
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/22005 , vital:51930
- Description: Medical male circumcision has been shown to reduce female to male HIV transmission. This study was designed to examine the underlying factors responsible for, or influencing, the inability of the health care system to achieve the MMC targets in selected hospitals in KZN. The objective of this study to was explore the challenges that lead to failure of the government to meet set targets, regarding the implementation of the MMC programme in the province of KZN, as perceived by the health care workers. Methodology A mixed quantitative and qualitative study where 150 questionnaires were used and in-depth open-ended interviews were conducted. Participants were from Clairwood and Wentworth hospitals in the district of eThekwini, KwaZulu-Natal. Eighteen healthcare workers (nurse managers, doctors, nurses and counsellors) were purposively selected from the two hospitals. Results Findings showed that poor marketing of MMC, in line with the cultural and religious inclination of the catchment populations, had an effect on the targets. The fear of pain by the male clients came out as the biggest factor followed by the fear of having an HIV test done. The six weeks healing period before indulgence in sexual intercourse had a part to play in the reluctance of clients to do MMC. Some clients feared losing the ability to have an erection post MMC and would therefore not come for MMC. Other contributory factors for failure to reach targets included shortage of staff, poor mobilisation by the staff due to lack of training on how to mobilise and how to market MMC, lack of availability of mobilisation and marketing resources, inadequate and inequitable allocated of resources. Other factors include, lack of incentives for staff to stay in the programme or even within the Department, lack of training, cultural and religious beliefs in the community. The staff also felt that the MMC targets were too high. Notwithstanding, the staff members were willing to learn how to market MMC and to mobilise clients. Clients and community education on the importance of MMC and the combination of this process with good sexual behaviour would improve MMC uptake and reduce HIV prevalence and the incidence. Conclusions The fear of pain, fear to do HIV test and the fear to loose erection were the most prominent reasons why the males would not come for MMC procedure. , Thesis (MPH) -- Faculty of Health Sciences, Public Health, 2022
- Full Text:
- Date Issued: 2022-03
Backpack carriage and musculoskeletal pain among primary school learners in King Williams Town, South Africa
- Authors: Moni, Busisiwe
- Date: 2022
- Subjects: Backache -- Prevention , Pediatric rheumatology , Pain -- Treatment
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/26984 , vital:66208
- Description: BACKGROUND: There is rising concern that kids are walking to school with too much weight on their backs. The weight of schoolchildren's backpacks is a persistent and divisive topic in the fields of education and health. Children who carry heavy backpacks are more likely to have back discomfort and musculoskeletal pain, which raises their risk of developing chronic back pain as adults. There is little research on this topic among South African school-age youngsters. The goal of the study was to find out how common low back and other musculoskeletal complaints were among primary school students who used a school bag. RESEARCH AIM: The purpose of the study was to identify the prevalence and location of musculoskeletal discomfort in primary school students in King William's Town, South Africa, and describe their link with backpack use. METHOD: In King Williams Town, Eastern Cape, South Africa, a descriptive cross-sectional survey was conducted among elementary school students between the ages of 9 and 14 years old. A systematic questionnaire and the Cornell Musculoskeletal Questionnaire were used to gather the data (body chart). Age, gender, and schoolbag details (style of backpack, carrying technique, and carrying time) were collected. The learner's waist, hip, and bag circumferences were all measured. On the data, descriptive and interferential statistics were used. FINDINGS: The study's conclusions showed that students' musculoskeletal pain was brought on by the weight of their backpacks or school bags. The majority of the students (89.8percent) complain about the difficulty they experience when lugging their heavy backpacks to class. In addition, 83.4percent of the students had bags that weighed more than 10percent of their body weight. Additionally, a sizable percentage of students (89.8percent) carry a hefty bag to school every day and report feeling fatigued while doing so (90.8percent). 90percent of the students reported feeling discomfort before, during, or after carrying their schoolbags. This pain is related with carrying a schoolbag. The majority of students (53.5percent) felt that their daily pain interferes with their ability to study. In order of severity, the majority of students report having discomfort in their shoulders (82.7percent), lower back (59.9percent), neck (47.0percent), upper back (40.7percent), and upper arm (16.4percent). CONCLUSION: According to the study, there is a link between students' musculoskeletal pain and carrying hefty backpacks or school bags. The shoulders are where musculoskeletal discomfort is most frequently felt. The study supported the findings of the majority of studies cited in the literature that most schoolchildren suffer from musculoskeletal pain because the weight of their backpacks is excessive compared to their size, weight, and age. RECOMMENDATIONS: The study produced a number of recommendations, including that the Department of Basic Education inform teachers, students, parents, guardians, and other key stakeholders about the effects of heavy backpacks or schoolbags on students' musculoskeletal pain. For students' convenience and to lighten the load on their school bags, locker rooms should be available. Teachers, parents, and guardians should also pay attention to the school bags that students are using to make sure that the weight is appropriate for their age and body size. , Thesis (MPA) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022
- Authors: Moni, Busisiwe
- Date: 2022
- Subjects: Backache -- Prevention , Pediatric rheumatology , Pain -- Treatment
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/26984 , vital:66208
- Description: BACKGROUND: There is rising concern that kids are walking to school with too much weight on their backs. The weight of schoolchildren's backpacks is a persistent and divisive topic in the fields of education and health. Children who carry heavy backpacks are more likely to have back discomfort and musculoskeletal pain, which raises their risk of developing chronic back pain as adults. There is little research on this topic among South African school-age youngsters. The goal of the study was to find out how common low back and other musculoskeletal complaints were among primary school students who used a school bag. RESEARCH AIM: The purpose of the study was to identify the prevalence and location of musculoskeletal discomfort in primary school students in King William's Town, South Africa, and describe their link with backpack use. METHOD: In King Williams Town, Eastern Cape, South Africa, a descriptive cross-sectional survey was conducted among elementary school students between the ages of 9 and 14 years old. A systematic questionnaire and the Cornell Musculoskeletal Questionnaire were used to gather the data (body chart). Age, gender, and schoolbag details (style of backpack, carrying technique, and carrying time) were collected. The learner's waist, hip, and bag circumferences were all measured. On the data, descriptive and interferential statistics were used. FINDINGS: The study's conclusions showed that students' musculoskeletal pain was brought on by the weight of their backpacks or school bags. The majority of the students (89.8percent) complain about the difficulty they experience when lugging their heavy backpacks to class. In addition, 83.4percent of the students had bags that weighed more than 10percent of their body weight. Additionally, a sizable percentage of students (89.8percent) carry a hefty bag to school every day and report feeling fatigued while doing so (90.8percent). 90percent of the students reported feeling discomfort before, during, or after carrying their schoolbags. This pain is related with carrying a schoolbag. The majority of students (53.5percent) felt that their daily pain interferes with their ability to study. In order of severity, the majority of students report having discomfort in their shoulders (82.7percent), lower back (59.9percent), neck (47.0percent), upper back (40.7percent), and upper arm (16.4percent). CONCLUSION: According to the study, there is a link between students' musculoskeletal pain and carrying hefty backpacks or school bags. The shoulders are where musculoskeletal discomfort is most frequently felt. The study supported the findings of the majority of studies cited in the literature that most schoolchildren suffer from musculoskeletal pain because the weight of their backpacks is excessive compared to their size, weight, and age. RECOMMENDATIONS: The study produced a number of recommendations, including that the Department of Basic Education inform teachers, students, parents, guardians, and other key stakeholders about the effects of heavy backpacks or schoolbags on students' musculoskeletal pain. For students' convenience and to lighten the load on their school bags, locker rooms should be available. Teachers, parents, and guardians should also pay attention to the school bags that students are using to make sure that the weight is appropriate for their age and body size. , Thesis (MPA) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022
Retrospective analysis of factors contributing to parasuicide among youth in Buffalo City Metropolitan Municipality, Eastern Cape, South Africa
- Authors: Nganto, Yanga
- Date: 2021-11
- Subjects: Parasuicide -- South Africa
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/22897 , vital:53181
- Description: Parasuicide is a problem that affects the youth locally and globally. Parasuicide has negative psychological impacts on youth. This study was designed to assess elements of parasuicide in the Buffalo City Metropolitan Municipality of South Africa, using records of patients admitted to Frere and Cecilia Makiwane hospitals between 2016 and 2020. The purpose of the study was to conduct a descriptive retrospective review of parasuicide among youth to determine trends, causes, and contributing factors of committing parasuicide. Methods A retrospective, quantitative and descriptive study was conducted with 200 files of patients aged between 18 and 35 years conveniently sampled. These patients diagnosed as committed parasuicide and were admitted at Frere and Cecilia Makiwane hospitals over a period of four years from 1 April 2016 to 31 March 202. Only record files of patients’ residing in East London and Mdantsane catchment area were selected. Raw data was collected for a period of twelve weeks using a developed data collection tool developed in Ms Excel spreadsheet. Results In this sample, the large number of the patients were under 26 years (60.5%), female (57%), single (92.5%), and Black (99.5%). Furthermore, majority of the patients had attained secondary education (89.5%), were unemployed (83%) and living with their families (59%). There were different methods and agents used by participants to commit parasuicide and reasons differed from person to person. Among patients who reported a suicide attempt, organophosphates were most commonly used agent for self-poisoning (47%, n=94), followed by substances such as use of drugs and alcohol (n=57, 28.5%), violence (n=27, 13.5%), corrosive agents including bleach and Jik (n=11, 5.5%), and hydrogen peroxide including acidic sub-stances like battery acid (n=11, 5.5%). The common reason found in the study and indicates participants had psychiatric disorder (34.5%). Conclusion Limiting access to organophosphate agents and other lethal means is an effective strategy that should be adopted to prevent parasuicide among youth. Timely identification of risks or warning signs, social prevention and immediate intervention at the state level will play an important role in controlling parasuicide among youth. Moreover, improving health care services with psychotherapy support would empower youth with skills that would enhance their self-confidence, self-worth and resilience. Consequently, attainment of these attributes would result in the prevention and control of parasuicide amongst youth. , Thesis (MPH) -- Faculty of Health Sciences, 2021
- Full Text:
- Date Issued: 2021-11
- Authors: Nganto, Yanga
- Date: 2021-11
- Subjects: Parasuicide -- South Africa
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/22897 , vital:53181
- Description: Parasuicide is a problem that affects the youth locally and globally. Parasuicide has negative psychological impacts on youth. This study was designed to assess elements of parasuicide in the Buffalo City Metropolitan Municipality of South Africa, using records of patients admitted to Frere and Cecilia Makiwane hospitals between 2016 and 2020. The purpose of the study was to conduct a descriptive retrospective review of parasuicide among youth to determine trends, causes, and contributing factors of committing parasuicide. Methods A retrospective, quantitative and descriptive study was conducted with 200 files of patients aged between 18 and 35 years conveniently sampled. These patients diagnosed as committed parasuicide and were admitted at Frere and Cecilia Makiwane hospitals over a period of four years from 1 April 2016 to 31 March 202. Only record files of patients’ residing in East London and Mdantsane catchment area were selected. Raw data was collected for a period of twelve weeks using a developed data collection tool developed in Ms Excel spreadsheet. Results In this sample, the large number of the patients were under 26 years (60.5%), female (57%), single (92.5%), and Black (99.5%). Furthermore, majority of the patients had attained secondary education (89.5%), were unemployed (83%) and living with their families (59%). There were different methods and agents used by participants to commit parasuicide and reasons differed from person to person. Among patients who reported a suicide attempt, organophosphates were most commonly used agent for self-poisoning (47%, n=94), followed by substances such as use of drugs and alcohol (n=57, 28.5%), violence (n=27, 13.5%), corrosive agents including bleach and Jik (n=11, 5.5%), and hydrogen peroxide including acidic sub-stances like battery acid (n=11, 5.5%). The common reason found in the study and indicates participants had psychiatric disorder (34.5%). Conclusion Limiting access to organophosphate agents and other lethal means is an effective strategy that should be adopted to prevent parasuicide among youth. Timely identification of risks or warning signs, social prevention and immediate intervention at the state level will play an important role in controlling parasuicide among youth. Moreover, improving health care services with psychotherapy support would empower youth with skills that would enhance their self-confidence, self-worth and resilience. Consequently, attainment of these attributes would result in the prevention and control of parasuicide amongst youth. , Thesis (MPH) -- Faculty of Health Sciences, 2021
- Full Text:
- Date Issued: 2021-11
Knowledge, attitude and behaviors of pregnant women towards pregnancy induced hypertension in Mdantsane Township Buffalo City Health District
- Authors: Peter, Bulelwa Beatrice
- Date: 2020-07
- Subjects: Hypotension in pregnancy , Pregnancy--Complications
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/22930 , vital:53221
- Description: The prevalence of pregnancy-induced hypertension (PIH) deaths is high in the Eastern Cape. Anecdotal evidence indicates that most women fall pregnant because of attitudes towards contraceptives and are seemingly unaware of pregnancy-related complications. Hence, the objective of this study was to examine the knowledge, attitudes and behaviour of pregnant women concerning pregnancyinduced hypertension in the Buffalo City Metropolitan Municipality. Methods: This was a cross-sectional survey involving 200 pregnant women attending antenatal healthcare clinics in Mdantsane, Buffalo City Metropolitan Municipality. A self-administered questionnaire was used for data collection. Collected data were managed and analysed using statistical package for social sciences (SPSS) version 24. Data analysis involved both descriptive (count, frequency, mean and standard deviation) and inferential statistics (Chi-square and logistics regression). For the inferential statistics, the level of significance was set at 0.05. Results: It was observed that the married women were more likely to be aware of PIH compared to single women (OR=2.4 95%CI (1.17; 4.90)). Of the 45 married women, 73.3% were aware of PIH compared to single women. Out of the women who participated in the study, 43.8% showed attitudes indicating they were not aware of this condition and associated complications from high-pressure during pregnancy. Compared to those in their first pregnancy, those who had previous pregnancy were more likely to be aware of PIH (OR=17.1 95 % CI (9.09; 32.15)). Of the 140 previously pregnant women, 83.6 % were aware of PIH compared to those during their first pregnancy. Conclusion: The results of the study indicate that sociodemographic factors play a role in pregnant women 's understanding of PIH. Improving knowledge of PIH among pregnant women requires context-specific strategies. During an antenatal visit, health care providers should implement focussed health education programmes. , Thesis (MA) -- Faculty of Health Sciences, 2020
- Full Text:
- Date Issued: 2020-07
- Authors: Peter, Bulelwa Beatrice
- Date: 2020-07
- Subjects: Hypotension in pregnancy , Pregnancy--Complications
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/22930 , vital:53221
- Description: The prevalence of pregnancy-induced hypertension (PIH) deaths is high in the Eastern Cape. Anecdotal evidence indicates that most women fall pregnant because of attitudes towards contraceptives and are seemingly unaware of pregnancy-related complications. Hence, the objective of this study was to examine the knowledge, attitudes and behaviour of pregnant women concerning pregnancyinduced hypertension in the Buffalo City Metropolitan Municipality. Methods: This was a cross-sectional survey involving 200 pregnant women attending antenatal healthcare clinics in Mdantsane, Buffalo City Metropolitan Municipality. A self-administered questionnaire was used for data collection. Collected data were managed and analysed using statistical package for social sciences (SPSS) version 24. Data analysis involved both descriptive (count, frequency, mean and standard deviation) and inferential statistics (Chi-square and logistics regression). For the inferential statistics, the level of significance was set at 0.05. Results: It was observed that the married women were more likely to be aware of PIH compared to single women (OR=2.4 95%CI (1.17; 4.90)). Of the 45 married women, 73.3% were aware of PIH compared to single women. Out of the women who participated in the study, 43.8% showed attitudes indicating they were not aware of this condition and associated complications from high-pressure during pregnancy. Compared to those in their first pregnancy, those who had previous pregnancy were more likely to be aware of PIH (OR=17.1 95 % CI (9.09; 32.15)). Of the 140 previously pregnant women, 83.6 % were aware of PIH compared to those during their first pregnancy. Conclusion: The results of the study indicate that sociodemographic factors play a role in pregnant women 's understanding of PIH. Improving knowledge of PIH among pregnant women requires context-specific strategies. During an antenatal visit, health care providers should implement focussed health education programmes. , Thesis (MA) -- Faculty of Health Sciences, 2020
- Full Text:
- Date Issued: 2020-07
Adult circumcision practices of traditional surgeons and nurses in relation to the initiates’ health outcomes/morbidity in the Eastern Cape
- Authors: Dalasa, Siyamthemba
- Date: 2019
- Subjects: Circumcision -- Social aspects
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10353/17029 , vital:40834
- Description: BACKGROUND Despite the adverse outcomes associated with traditional male circumcision, the practice remains prevalent, especially in the Eastern Cape, South, Africa. This study seeks to assess the practices of traditional surgeons and nurses in relation to the prevention and control of infections and their understanding of human physiological mechanisms during circumcision processes. METHOD This study has adopted a qualitative design, which involved conducting 115 semistructured interviews among traditional surgeons, traditional nurses and traditionally circumcised men, and one focus group discussion among traditional nurses. The data generated were transcribed and subjected to thematic content analysis. RESULTS The analysis revealed that both traditional surgeons and nurses demonstrated both poor aseptic techniques and a lack of knowledge of how the human body functions. Their lack of knowledge of basic human physiology meant that they trivialised sepsis in the penile wound. In addition, the seclusion lodges for circumcision and initiates living were unclean and uninhabitable. CONCLUSION The poor aseptic techniques of traditional surgeons and nurses, as well as the uncleanliness of their environment during traditional male circumcision procedures, could expose initiates to infections and morbidity. Environmental health officers should regularly supervise traditional surgeons and nurses in order to prevent the adverse health outcomes associated with the traditional male circumcision practice.
- Full Text:
- Date Issued: 2019
- Authors: Dalasa, Siyamthemba
- Date: 2019
- Subjects: Circumcision -- Social aspects
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10353/17029 , vital:40834
- Description: BACKGROUND Despite the adverse outcomes associated with traditional male circumcision, the practice remains prevalent, especially in the Eastern Cape, South, Africa. This study seeks to assess the practices of traditional surgeons and nurses in relation to the prevention and control of infections and their understanding of human physiological mechanisms during circumcision processes. METHOD This study has adopted a qualitative design, which involved conducting 115 semistructured interviews among traditional surgeons, traditional nurses and traditionally circumcised men, and one focus group discussion among traditional nurses. The data generated were transcribed and subjected to thematic content analysis. RESULTS The analysis revealed that both traditional surgeons and nurses demonstrated both poor aseptic techniques and a lack of knowledge of how the human body functions. Their lack of knowledge of basic human physiology meant that they trivialised sepsis in the penile wound. In addition, the seclusion lodges for circumcision and initiates living were unclean and uninhabitable. CONCLUSION The poor aseptic techniques of traditional surgeons and nurses, as well as the uncleanliness of their environment during traditional male circumcision procedures, could expose initiates to infections and morbidity. Environmental health officers should regularly supervise traditional surgeons and nurses in order to prevent the adverse health outcomes associated with the traditional male circumcision practice.
- Full Text:
- Date Issued: 2019
A trend analysis of perinatal mortalities in Barberton Hospital between 2002 and 2016
- Modupe, Oluwarotimi Folorunsho
- Authors: Modupe, Oluwarotimi Folorunsho
- Date: 2018
- Subjects: Newborn infants -- Mortality Perinatology
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: http://hdl.handle.net/10353/11254 , vital:37630
- Description: Background and aim: There is no doubt that the quantification of data on the new born is imperative towards the design of effective public health policy interventions. However, the trend in under-five mortality rates in Barberton Hospital is not recognised as no empirical investigation has been undertaken to ascertain its position in this regard. A trend analysis of infant and maternal deaths in will therefore shed light on possible factors influencing this trend. The specific objectives of this study were to examine the trend and causes of perinatal mortality in Barberton Hospital from 2002-2016. It was hypothesized that there would be a downward trend in the infant and maternal mortality rates in Barberton Hospital from 2002-2016, possibly as a result of improved medical care. Methods: This retrospective study was conducted in Barberton Hospital, located in the Umjindi sub-district in Mpumalanga Province. The data was drawn from the Perinatal Problem Identification Programme (PPIP) database. Pregnancy related deaths of women, and of children from birth to one year in Barberton Hospital from 1999-2014 were extracted. The population study consists of a record review of all infant and maternal deaths in Barberton Hospital from 2002-2016 and captured in the data on the PPIP. The University of Fort Hare ethical review committee approved the study protocol. In addition, permission to use the data was granted by the Mpumalanga Department of Health after applying for approval for use of the data for academic purposes. The data was then exported into an Excel format document and fed to Statistical Package for Social Sciences (SPSS) program to allow for a more detailed analysis. Results: Over the period under review (2002-2016), a total of 21151 babies were delivered, 20593 babies were alive at discharge, 221 babies died in the first 28 days of delivery, and 337 babies were stillbirths. 18577 were normal weight (≥2500gram), 1581 weighed 2000-2499 grams, 568 weighed 1500-1999grams, 286 weighed 1000-1499 and 139 weighed below 1000grams. All the women who gave birth over the period under review, 27.3percent tested positive to HIV, 40.3 percent tested negative. Of all women that tested positive, 80.2percent received any form of ART. For over half of women that received ART (n=2981), the type of ART they received is unknown. Most women whose baby died were young. One in five women did not have their age captured in the database indicating an important gap that need to be addressed in order to ensure integrity of the database. Of all the 558 perinatal mortality, 75.3 weighed below 2500 grams. Low birth weight is major risk factor for child mortality. Babies weighing less than 2,500 grams are 20 times more likely to die than heavier babies. For all the perinatal deaths, the majority of their mothers received antenatal care services. About 86.6percent were delivered at Barberton Hospital and only 1 child was delivered in transit to the hospital. Of all the 558 deaths, only 7.5 percent was multiple births. Of the 558 babies that died, only 39.6percent were born alive, 37.1percent was macerated stillbirths. The syphilis serology test indicated that most mothers tested negative. The HIV serology test indicated that 28percent of mothers tested positive. The hospital recorded a total of 337 stillbirths between 2002 and 2016. This accounts for 60.2percent of all perinatal mortality over the period. Of all stillbirths, 61.6percent was macerated stillbirths. Yearly analysis of stillbirth rate did not clearly indicate whether stillbirth rate is increasing or declining. Not less than 56 primary obstetric causes of perinatal deaths were identified in this study. Many perinatal deaths were unexplainable due to lack of post-mortem. Idiopathic preterm labour was the main primary obstetric cause of early (34.5percent) and late neonatal (38.9percent) deaths, and the next was labour related intrapartum asphyxia. Labour related intrapartum asphyxia also accounts for 6.8percent of all stillbirths. The main known primary obstetric cause of stillbirth in the Hospital was Proteinuric hypertension/hypertension disorders. Over 60percent of perinatal mortality in Barberton Hospital was due to associated maternal conditions. Only 10.9percent was due to fetal related conditions and 26.4percent was unexplained. Few deaths were due to health system failure and domestic violence. Spontaneous preterm labour (18.4percent), abnormal labour or uterine rupture (14.5percent), maternal hypertension (12.4percent), antepartum haemorrhage (10.2percent) were the main associated maternal conditions causes of perinatal mortality in Barberton Hospital. Similarly, Fetal abnormality and infections were the main associated fetal condition causes of perinatal mortality. Of all the babies that were alive at birth, 85.2percent died due to maternal related conditions. Most neonates died due to spontaneous preterm labour (43.5percent) and abnormal labour or uterine rupture (23.1percent). Maternal HIV, diabetics and syphilis only accounted for a few neonatal deaths. For stillbirth babies that were alive at admission, abnormal labour or uterine rupture (33.1percent) and antepartum haemorrhage (19.7percent) were the main causes of their death. Over 60percent of all of macerated deaths have unexplained causes. Maternal hypertension is the main known cause of macerated stillbirth. For stillbirths that were dead on admission, maternal hypertension (13.1percent), antepartum haemorrhage (26.2percent) and abnormal labour or uterine rupture were the main causes of deaths. The majority of perinatal deaths in the hospital were caused by intrauterine deaths (58.8percent). Extreme multi-organ immaturity (13.1percent), Hyaline membrane disease (7.2percent) and Hypoxic ischaemic encephalopathy (5.2percent) were among the main final causes of perinatal deaths. The main behavioural factor causing perinatal mortality in Mpumalanga province was non-use of antenatal care services. The majority of perinatal mortality (60.4percent) was due to health system related causes. Most perinatal deaths were due to poor management of cases and delayed referral. Conclusion: The findings indicate that while stillbirths have slightly declined, neonatal deaths have not declined over the period. Perinatal have slightly declined in the hospital. The findings of this study also indicate that the majority of perinatal deaths in the hospital were caused by idiopathic preterm labour, unexplained intrauterine deaths, hypertension, and intrapartum asphyxia. Patient and health system related factors contributed significantly to perinatal deaths in the hospital. There is a need for yearly analysis of PPIP data to track progress and identify area for continuous improvement in provision of quality obstetric services. A greater community awareness of risk factors for perinatal deaths and importance of early and regular take up antenatal care services is needed.
- Full Text:
- Date Issued: 2018
- Authors: Modupe, Oluwarotimi Folorunsho
- Date: 2018
- Subjects: Newborn infants -- Mortality Perinatology
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: http://hdl.handle.net/10353/11254 , vital:37630
- Description: Background and aim: There is no doubt that the quantification of data on the new born is imperative towards the design of effective public health policy interventions. However, the trend in under-five mortality rates in Barberton Hospital is not recognised as no empirical investigation has been undertaken to ascertain its position in this regard. A trend analysis of infant and maternal deaths in will therefore shed light on possible factors influencing this trend. The specific objectives of this study were to examine the trend and causes of perinatal mortality in Barberton Hospital from 2002-2016. It was hypothesized that there would be a downward trend in the infant and maternal mortality rates in Barberton Hospital from 2002-2016, possibly as a result of improved medical care. Methods: This retrospective study was conducted in Barberton Hospital, located in the Umjindi sub-district in Mpumalanga Province. The data was drawn from the Perinatal Problem Identification Programme (PPIP) database. Pregnancy related deaths of women, and of children from birth to one year in Barberton Hospital from 1999-2014 were extracted. The population study consists of a record review of all infant and maternal deaths in Barberton Hospital from 2002-2016 and captured in the data on the PPIP. The University of Fort Hare ethical review committee approved the study protocol. In addition, permission to use the data was granted by the Mpumalanga Department of Health after applying for approval for use of the data for academic purposes. The data was then exported into an Excel format document and fed to Statistical Package for Social Sciences (SPSS) program to allow for a more detailed analysis. Results: Over the period under review (2002-2016), a total of 21151 babies were delivered, 20593 babies were alive at discharge, 221 babies died in the first 28 days of delivery, and 337 babies were stillbirths. 18577 were normal weight (≥2500gram), 1581 weighed 2000-2499 grams, 568 weighed 1500-1999grams, 286 weighed 1000-1499 and 139 weighed below 1000grams. All the women who gave birth over the period under review, 27.3percent tested positive to HIV, 40.3 percent tested negative. Of all women that tested positive, 80.2percent received any form of ART. For over half of women that received ART (n=2981), the type of ART they received is unknown. Most women whose baby died were young. One in five women did not have their age captured in the database indicating an important gap that need to be addressed in order to ensure integrity of the database. Of all the 558 perinatal mortality, 75.3 weighed below 2500 grams. Low birth weight is major risk factor for child mortality. Babies weighing less than 2,500 grams are 20 times more likely to die than heavier babies. For all the perinatal deaths, the majority of their mothers received antenatal care services. About 86.6percent were delivered at Barberton Hospital and only 1 child was delivered in transit to the hospital. Of all the 558 deaths, only 7.5 percent was multiple births. Of the 558 babies that died, only 39.6percent were born alive, 37.1percent was macerated stillbirths. The syphilis serology test indicated that most mothers tested negative. The HIV serology test indicated that 28percent of mothers tested positive. The hospital recorded a total of 337 stillbirths between 2002 and 2016. This accounts for 60.2percent of all perinatal mortality over the period. Of all stillbirths, 61.6percent was macerated stillbirths. Yearly analysis of stillbirth rate did not clearly indicate whether stillbirth rate is increasing or declining. Not less than 56 primary obstetric causes of perinatal deaths were identified in this study. Many perinatal deaths were unexplainable due to lack of post-mortem. Idiopathic preterm labour was the main primary obstetric cause of early (34.5percent) and late neonatal (38.9percent) deaths, and the next was labour related intrapartum asphyxia. Labour related intrapartum asphyxia also accounts for 6.8percent of all stillbirths. The main known primary obstetric cause of stillbirth in the Hospital was Proteinuric hypertension/hypertension disorders. Over 60percent of perinatal mortality in Barberton Hospital was due to associated maternal conditions. Only 10.9percent was due to fetal related conditions and 26.4percent was unexplained. Few deaths were due to health system failure and domestic violence. Spontaneous preterm labour (18.4percent), abnormal labour or uterine rupture (14.5percent), maternal hypertension (12.4percent), antepartum haemorrhage (10.2percent) were the main associated maternal conditions causes of perinatal mortality in Barberton Hospital. Similarly, Fetal abnormality and infections were the main associated fetal condition causes of perinatal mortality. Of all the babies that were alive at birth, 85.2percent died due to maternal related conditions. Most neonates died due to spontaneous preterm labour (43.5percent) and abnormal labour or uterine rupture (23.1percent). Maternal HIV, diabetics and syphilis only accounted for a few neonatal deaths. For stillbirth babies that were alive at admission, abnormal labour or uterine rupture (33.1percent) and antepartum haemorrhage (19.7percent) were the main causes of their death. Over 60percent of all of macerated deaths have unexplained causes. Maternal hypertension is the main known cause of macerated stillbirth. For stillbirths that were dead on admission, maternal hypertension (13.1percent), antepartum haemorrhage (26.2percent) and abnormal labour or uterine rupture were the main causes of deaths. The majority of perinatal deaths in the hospital were caused by intrauterine deaths (58.8percent). Extreme multi-organ immaturity (13.1percent), Hyaline membrane disease (7.2percent) and Hypoxic ischaemic encephalopathy (5.2percent) were among the main final causes of perinatal deaths. The main behavioural factor causing perinatal mortality in Mpumalanga province was non-use of antenatal care services. The majority of perinatal mortality (60.4percent) was due to health system related causes. Most perinatal deaths were due to poor management of cases and delayed referral. Conclusion: The findings indicate that while stillbirths have slightly declined, neonatal deaths have not declined over the period. Perinatal have slightly declined in the hospital. The findings of this study also indicate that the majority of perinatal deaths in the hospital were caused by idiopathic preterm labour, unexplained intrauterine deaths, hypertension, and intrapartum asphyxia. Patient and health system related factors contributed significantly to perinatal deaths in the hospital. There is a need for yearly analysis of PPIP data to track progress and identify area for continuous improvement in provision of quality obstetric services. A greater community awareness of risk factors for perinatal deaths and importance of early and regular take up antenatal care services is needed.
- Full Text:
- Date Issued: 2018
Assessment of the integrated HIV/AIDS curriculum at a university in the Eastern Cape: views of students and educators
- Terblanche, Delcia Jill Nora
- Authors: Terblanche, Delcia Jill Nora
- Date: 2018
- Subjects: AIDS (Disease) -- Study and teaching , AIDS (Disease) -- Prevention , Universities and colleges
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10353/12359 , vital:39256
- Description: Background: HIV/AIDS is a major global public health problem. The higher education sector too, is affected by the scourge of HIV/AIDS. Universities are considered to be high- risks areas for HIV infection because many students indulged in high risky behaviour link to HIV infection; therefore developing ways to prevent students for acquiring HIV and as well reducing HIV prevalence rates through training and teaching about HIV/AIDS will contribute to change in behaviour of students. Anecdotal evidence suggests that the majority of the students at Fort Hare lack the general awareness and education in HIV/AIDS due to lack of information coupled with their general disadvantaged background with the ultimate result being threatened by high infection rates. The University of Fort Hare (UFH), in a bid to capacitate the academic staff in respect of the laudable initiative to integrate HIV/AIDS in curricula, decided to embark on a pilot study that is anticipated to form fundamental strategies to sustainable HIV/AIDS curricula integration across all faculties, at least by the end of 2030. The university has planned to engage in the curriculum integration process by implementing a two year cycle pilot study during the grant period. Aim: The main aim of the study was to assess the challenges faced by students and educators concerning the integration and implementation of HIV/AIDS curriculum at the University of Fort Hare. Methods: The study adopted a quantitative, explorative descriptive design to examine the challenges associated with the Integrated HIV/AIDS curriculum at the University of Fort Hare. The target population was the educators and students who had training and teaching in the Integrated HIV/AIDS curriculum. A purposive sampling was used to select 487 students and 23 educators from across three departments: Nursing Science, LKA (Life, Knowledge and Action) and Law involved in the HIV/AIDS Curriculum Integration programme at the university. A self-design questionnaire was used for data collection focusing on the demographic profiles of the participants, the teaching strategies and methodologies adopted in the Integrated HIV/AIDS curriculum, the usefulness and relevance of the newly integrated HIV/AIDS curriculum content in addressing the needs of the students and the community, and the challenges faced by the educators and students in the Integrated HIV/AIDS curriculum. Ethical approved was obtained from the Research Ethics Committee of the University of Fort Hare. Permission was obtained from the participants through written consent forms. The data was analysed using descriptive statistics (frequency counts, percentage, means and standard deviations (SD)). The Chi-square test was used to examine the relationship between the variables of interest across the departments. A p-value of 0.05 was set for statistical significant testing. Results: The majority of the participants have adequate knowledge of HIV transmission, as 93.2 percent indicated HIV can be contracted through unprotected sex, sharing of needles (92.1 percent), receiving a blood transfusion that has not been screened for HIV (83.9 percent), sharing razor blades that has not been disinfected (83.0 percent), and having more than one sexual partner (86 percent). Age, gender, race and department were significantly associated with knowledge of route of HIV transmission. The present study indicated that the participants experienced several challenges during the teaching of the Integrated HIV/AIDS curriculum. Time allocated was the biggest challenge (58.3 percent), followed by undated materials, and curriculum overloading and teaching. The study indicated that majority of the students would like to compile a portfolio of evidence in the teaching of HIV, followed by creative arts, DVD/movies, and internet research. The majority of the lecturers preferred to teach HIV/AIDS through expressive arts, followed by role play, and formal lectures. The majority of the participants stated that HIV/AIDS information would be useful to them to apply in their communities and in their profession (97 percent), emphasizing that such knowledge and information will empower them to participate in roadshows and voluntary work at HIV/AIDS Shelters. The findings of this study pertaining to the challenges faced by educators during the implementation of the Integrated HIV/AIDS curriculum revealed that the majority of the participants stated that the HIV information was not updated, heavy workload, and adequate training. The lecturers expressed that they would prefer to teach HIV/AIDS curriculum by expressive art through drawing and creating art that expresses HIV and the relevance in the students’ community. Conclusions: Majority of the students received teaching of HIV as part of a course, and HIV teaching as an integrated component in a subject, while few received it as a stand-alone subject offered by a lecturer/facilitator. The present study indicated that the participants experienced several challenges during the teaching of the Integrated HIV/AIDS curriculum. Time allocated was the biggest challenge (58.3percent), followed by undated materials, and curriculum overloading and teaching. The majority of students preferred HIV/AIDS to be taught by their peers experience in HIV, by face-to face by a person who is HIV/AIDS infected or affected. The majority of the lecturers preferred to teach HIV/AIDS through expressive arts, followed by role play, and formal lectures. The majority of the participants affirmed the relevancy of HIV information taught. They further indicated that the information and knowledge gain would able them to make informed decisions on sexual behaviour. The majority of the participants stated that the HIV information was not updated, heavy workload, and adequate training. Most of the educators used formal lectures, followed by compilation of a portfolio of evidence, storytelling, DVD and movies, and experiential learning in hospitals and clinics in teaching HIV/AIDS integrated curriculum. The lecturers expressed that they would prefer to teach HIV/AIDS curriculum by expressive art through drawing and creating art that expresses HIV and the relevance in the students’ community. It is recommended that student’s involvement in the decision making processes of the integrated HIV/AIDS curriculum at the University of Fort Hare would make the programme more successful. HIV/AIDS resource materials need to be updated regularly and relevant to provide educators with specialized knowledge to be able to teach HIV/AIDS.
- Full Text:
- Date Issued: 2018
- Authors: Terblanche, Delcia Jill Nora
- Date: 2018
- Subjects: AIDS (Disease) -- Study and teaching , AIDS (Disease) -- Prevention , Universities and colleges
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10353/12359 , vital:39256
- Description: Background: HIV/AIDS is a major global public health problem. The higher education sector too, is affected by the scourge of HIV/AIDS. Universities are considered to be high- risks areas for HIV infection because many students indulged in high risky behaviour link to HIV infection; therefore developing ways to prevent students for acquiring HIV and as well reducing HIV prevalence rates through training and teaching about HIV/AIDS will contribute to change in behaviour of students. Anecdotal evidence suggests that the majority of the students at Fort Hare lack the general awareness and education in HIV/AIDS due to lack of information coupled with their general disadvantaged background with the ultimate result being threatened by high infection rates. The University of Fort Hare (UFH), in a bid to capacitate the academic staff in respect of the laudable initiative to integrate HIV/AIDS in curricula, decided to embark on a pilot study that is anticipated to form fundamental strategies to sustainable HIV/AIDS curricula integration across all faculties, at least by the end of 2030. The university has planned to engage in the curriculum integration process by implementing a two year cycle pilot study during the grant period. Aim: The main aim of the study was to assess the challenges faced by students and educators concerning the integration and implementation of HIV/AIDS curriculum at the University of Fort Hare. Methods: The study adopted a quantitative, explorative descriptive design to examine the challenges associated with the Integrated HIV/AIDS curriculum at the University of Fort Hare. The target population was the educators and students who had training and teaching in the Integrated HIV/AIDS curriculum. A purposive sampling was used to select 487 students and 23 educators from across three departments: Nursing Science, LKA (Life, Knowledge and Action) and Law involved in the HIV/AIDS Curriculum Integration programme at the university. A self-design questionnaire was used for data collection focusing on the demographic profiles of the participants, the teaching strategies and methodologies adopted in the Integrated HIV/AIDS curriculum, the usefulness and relevance of the newly integrated HIV/AIDS curriculum content in addressing the needs of the students and the community, and the challenges faced by the educators and students in the Integrated HIV/AIDS curriculum. Ethical approved was obtained from the Research Ethics Committee of the University of Fort Hare. Permission was obtained from the participants through written consent forms. The data was analysed using descriptive statistics (frequency counts, percentage, means and standard deviations (SD)). The Chi-square test was used to examine the relationship between the variables of interest across the departments. A p-value of 0.05 was set for statistical significant testing. Results: The majority of the participants have adequate knowledge of HIV transmission, as 93.2 percent indicated HIV can be contracted through unprotected sex, sharing of needles (92.1 percent), receiving a blood transfusion that has not been screened for HIV (83.9 percent), sharing razor blades that has not been disinfected (83.0 percent), and having more than one sexual partner (86 percent). Age, gender, race and department were significantly associated with knowledge of route of HIV transmission. The present study indicated that the participants experienced several challenges during the teaching of the Integrated HIV/AIDS curriculum. Time allocated was the biggest challenge (58.3 percent), followed by undated materials, and curriculum overloading and teaching. The study indicated that majority of the students would like to compile a portfolio of evidence in the teaching of HIV, followed by creative arts, DVD/movies, and internet research. The majority of the lecturers preferred to teach HIV/AIDS through expressive arts, followed by role play, and formal lectures. The majority of the participants stated that HIV/AIDS information would be useful to them to apply in their communities and in their profession (97 percent), emphasizing that such knowledge and information will empower them to participate in roadshows and voluntary work at HIV/AIDS Shelters. The findings of this study pertaining to the challenges faced by educators during the implementation of the Integrated HIV/AIDS curriculum revealed that the majority of the participants stated that the HIV information was not updated, heavy workload, and adequate training. The lecturers expressed that they would prefer to teach HIV/AIDS curriculum by expressive art through drawing and creating art that expresses HIV and the relevance in the students’ community. Conclusions: Majority of the students received teaching of HIV as part of a course, and HIV teaching as an integrated component in a subject, while few received it as a stand-alone subject offered by a lecturer/facilitator. The present study indicated that the participants experienced several challenges during the teaching of the Integrated HIV/AIDS curriculum. Time allocated was the biggest challenge (58.3percent), followed by undated materials, and curriculum overloading and teaching. The majority of students preferred HIV/AIDS to be taught by their peers experience in HIV, by face-to face by a person who is HIV/AIDS infected or affected. The majority of the lecturers preferred to teach HIV/AIDS through expressive arts, followed by role play, and formal lectures. The majority of the participants affirmed the relevancy of HIV information taught. They further indicated that the information and knowledge gain would able them to make informed decisions on sexual behaviour. The majority of the participants stated that the HIV information was not updated, heavy workload, and adequate training. Most of the educators used formal lectures, followed by compilation of a portfolio of evidence, storytelling, DVD and movies, and experiential learning in hospitals and clinics in teaching HIV/AIDS integrated curriculum. The lecturers expressed that they would prefer to teach HIV/AIDS curriculum by expressive art through drawing and creating art that expresses HIV and the relevance in the students’ community. It is recommended that student’s involvement in the decision making processes of the integrated HIV/AIDS curriculum at the University of Fort Hare would make the programme more successful. HIV/AIDS resource materials need to be updated regularly and relevant to provide educators with specialized knowledge to be able to teach HIV/AIDS.
- Full Text:
- Date Issued: 2018
Factors contributing to non-adherence in HIV positive patients on antiretroviral treatment in primary health care facilities, East London, Eastern Cape
- Authors: Petse, Siphokazi
- Date: 2018
- Subjects: Antiretroviral therapy -- Eastern Cape -- South Africa , Patient compliance , HIV-positive persons -- South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10353/9734 , vital:34905
- Description: Aim: South Africa is faced with the major challenge of ensuring and sustaining the quality of services, including preventing and managing side- effects, and improving drug adherence, which are all critical, for the success of a comprehensive HIV programme. The aim of this study was to examine the underlying contributing factors to antiretroviral treatment adherence among HIV positive patients attending primary health care facilities in East London. Methods: This was a descriptive cross-sectional study involving 371 HIV positive patients on antiretroviral treatment in xx primary health care facilities in East London, South Africa. The study utilized a self- designed structured questionnaire with both open- ended and closed ended questions, divided into socio-demographic, socio- economic, level of understanding and knowledge on HIV, quality of care and waiting times. Results: About 64 percent of the participants had a good knowledge of HIV, 25 percent had an average knowledge with few participants having poor knowledge of HIV (11 percent). Majority (92.2 percent) were counselled before starting ARVs treatment. Majority of participants (70.7 percent) do have money for transport to come to the clinic, while 53.1 percent experienced side effects. The majority (70 percent) of the participants were non-adherents. Concerning viral load distribution, 52 percent were undetectable, 26 percent unsuppressed and 22 percent suppressed. Marital status (married) (p=0.005), having no formal education (p=0.035), being Christian (p=0.007), alcohol consumption (p= 0.021) and viral load suppression had significant association with non-adherence to ARV treatment among participants. After adjusting for confounders, only non-Christians and unsuppressed viral loads were the independent predictors of non-adherence. Conclusion: The main contributing factors to ART non-adherence among participants on ARVs were marital status, level of education, religion, and Christians were more adherent to the treatment than non-Christians. Alcohol consumption also contributed to non-adherence and viral load. Adherence counseling should be done on each and every visit to remind the participants on the importance of taking their treatment. These factors need to be addressed to improve adherence to the treatment, decrease the virus in the blood (viral load) and improve their health in general.
- Full Text:
- Date Issued: 2018
- Authors: Petse, Siphokazi
- Date: 2018
- Subjects: Antiretroviral therapy -- Eastern Cape -- South Africa , Patient compliance , HIV-positive persons -- South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10353/9734 , vital:34905
- Description: Aim: South Africa is faced with the major challenge of ensuring and sustaining the quality of services, including preventing and managing side- effects, and improving drug adherence, which are all critical, for the success of a comprehensive HIV programme. The aim of this study was to examine the underlying contributing factors to antiretroviral treatment adherence among HIV positive patients attending primary health care facilities in East London. Methods: This was a descriptive cross-sectional study involving 371 HIV positive patients on antiretroviral treatment in xx primary health care facilities in East London, South Africa. The study utilized a self- designed structured questionnaire with both open- ended and closed ended questions, divided into socio-demographic, socio- economic, level of understanding and knowledge on HIV, quality of care and waiting times. Results: About 64 percent of the participants had a good knowledge of HIV, 25 percent had an average knowledge with few participants having poor knowledge of HIV (11 percent). Majority (92.2 percent) were counselled before starting ARVs treatment. Majority of participants (70.7 percent) do have money for transport to come to the clinic, while 53.1 percent experienced side effects. The majority (70 percent) of the participants were non-adherents. Concerning viral load distribution, 52 percent were undetectable, 26 percent unsuppressed and 22 percent suppressed. Marital status (married) (p=0.005), having no formal education (p=0.035), being Christian (p=0.007), alcohol consumption (p= 0.021) and viral load suppression had significant association with non-adherence to ARV treatment among participants. After adjusting for confounders, only non-Christians and unsuppressed viral loads were the independent predictors of non-adherence. Conclusion: The main contributing factors to ART non-adherence among participants on ARVs were marital status, level of education, religion, and Christians were more adherent to the treatment than non-Christians. Alcohol consumption also contributed to non-adherence and viral load. Adherence counseling should be done on each and every visit to remind the participants on the importance of taking their treatment. These factors need to be addressed to improve adherence to the treatment, decrease the virus in the blood (viral load) and improve their health in general.
- Full Text:
- Date Issued: 2018
Knowledge, attitudes and practice of professional nurses regarding organ donation in critical care units of public and private hospitals in Eastern Cape Province
- Authors: Green, Bukelwa
- Date: 2018
- Subjects: Organ donors--Supply and demand Donation of organs, tissues, etc Transplantation of organs, tissues
- Language: English
- Type: Thesis , Masters , Magister Curationis
- Identifier: http://hdl.handle.net/10353/11116 , vital:37138
- Description: Globally there is an overwhelming increase in the number of patients waiting for donated organs for transplantation, with a gross shortage of available organs. There are many contributing factors to this dearth of donated organs, including level of knowledge, cultural beliefs, lack of clear practice and the attitudes of health care providers, as the gatekeepers of the health system. This non-experimental research study assessed the attitudes, level of knowledge, and practices of professional nurses working in critical care units in public and private hospitals in Eastern Cape Province regarding organ donation. The study was conducted in both private and public hospital intensive care and renal care units. The targeted population in the study was professional nurses working in intensive and renal care units, trained in critical care or nephrology, as well as those who were not trained but working in these specialised areas. The non-probability, purposive sampling method was employed and total population was 187 professional nurses working in public and private critical care units but only 108 managed to yield data for this study. Data was collected with anonymous, self - developed questionnaires. The questionnaire was submitted to supervisors and statistician for validity. Reliability was established by conducting pretest of the instrument, which yielded positive results because all questionnaires were correctly completed.Data captured and analysed using the Statistical Package for Social Sciences (SPSS) software for Windows version 22 and is presented by means of percentages and tables. Results: The findings were that, there is insufficient knowledge on the topic of organ donation, with subsequent inadequate practice, which derives from lack of pre-registration training and ongoing in-service education regarding the topic. The unavailability of full organ transplantation services in the province is viewed as a hindrance in the practice of organ donation. There was generally a positive attitude towards organ donation, particularly among Christian nurses. The knowledge deficit and limited practice seem not to have affected the attitudes of the participants, who supported the idea of organ donation. However, despite the positive attitudes, only 13 participants (12.0 percent) agreed to be registered as organ donors. 50 percent of participants lacked knowledge about availability and contact details of the provincial organ donation foundation, which may indicate inadequate marketing on the part of the foundation. There was no significant difference in knowledge, attitudes and practice between nurses in the private and public sectors. Rather differences were noted between the different levels of health care services, i.e. between the secondary and tertiary level. The tertiary level outperformed the secondary level institutions. It is recommended that organ donation be incorporated into the syllabi of health sciences courses both in universities and colleges, and that awareness campaigns be strengthened.
- Full Text:
- Date Issued: 2018
- Authors: Green, Bukelwa
- Date: 2018
- Subjects: Organ donors--Supply and demand Donation of organs, tissues, etc Transplantation of organs, tissues
- Language: English
- Type: Thesis , Masters , Magister Curationis
- Identifier: http://hdl.handle.net/10353/11116 , vital:37138
- Description: Globally there is an overwhelming increase in the number of patients waiting for donated organs for transplantation, with a gross shortage of available organs. There are many contributing factors to this dearth of donated organs, including level of knowledge, cultural beliefs, lack of clear practice and the attitudes of health care providers, as the gatekeepers of the health system. This non-experimental research study assessed the attitudes, level of knowledge, and practices of professional nurses working in critical care units in public and private hospitals in Eastern Cape Province regarding organ donation. The study was conducted in both private and public hospital intensive care and renal care units. The targeted population in the study was professional nurses working in intensive and renal care units, trained in critical care or nephrology, as well as those who were not trained but working in these specialised areas. The non-probability, purposive sampling method was employed and total population was 187 professional nurses working in public and private critical care units but only 108 managed to yield data for this study. Data was collected with anonymous, self - developed questionnaires. The questionnaire was submitted to supervisors and statistician for validity. Reliability was established by conducting pretest of the instrument, which yielded positive results because all questionnaires were correctly completed.Data captured and analysed using the Statistical Package for Social Sciences (SPSS) software for Windows version 22 and is presented by means of percentages and tables. Results: The findings were that, there is insufficient knowledge on the topic of organ donation, with subsequent inadequate practice, which derives from lack of pre-registration training and ongoing in-service education regarding the topic. The unavailability of full organ transplantation services in the province is viewed as a hindrance in the practice of organ donation. There was generally a positive attitude towards organ donation, particularly among Christian nurses. The knowledge deficit and limited practice seem not to have affected the attitudes of the participants, who supported the idea of organ donation. However, despite the positive attitudes, only 13 participants (12.0 percent) agreed to be registered as organ donors. 50 percent of participants lacked knowledge about availability and contact details of the provincial organ donation foundation, which may indicate inadequate marketing on the part of the foundation. There was no significant difference in knowledge, attitudes and practice between nurses in the private and public sectors. Rather differences were noted between the different levels of health care services, i.e. between the secondary and tertiary level. The tertiary level outperformed the secondary level institutions. It is recommended that organ donation be incorporated into the syllabi of health sciences courses both in universities and colleges, and that awareness campaigns be strengthened.
- Full Text:
- Date Issued: 2018
Relationship between alcohol use patterns and knowledge of alcohol-attributable health conditions among undergraduate students' at a university in the Eastern Cape
- Authors: Mandeya, Andrew
- Date: 2018
- Subjects: Drinking of alcoholic beverages College students--Alcohol use
- Language: English
- Type: Thesis , Masters , Public Health
- Identifier: http://hdl.handle.net/10353/11128 , vital:37173
- Description: Background: Alcohol use prevalence has been found to be higher than 50 percent at some universities in South Africa. It is against this background that this study aimed to establish the relationship between alcohol use, knowledge of alcohol-attributable health conditions and biographical characteristics. Literature review: The study was based on a review of literature on prevalence and patterns of alcohol use among university students, knowledge of alcohol-attributable chronic diseases, foetal alcohol syndrome, sexual and reproductive health and alcohol use measurement. Methodology: Data were collected from 213 undergraduate students enrolled for the Statistics service courses on two campuses of the same university. The Mann-Whitney normal approximation and the Kruskal-Wallis tests were used to compare health knowledge across levels of alcohol use and biographical characteristics. The chi-squared test and multiple logistic regression analysis were used to determine the significance and patterns of associations between alcohol use and health knowledge and biographical characteristics. Results: The prevalence rates of alcohol use and risky alcohol use were found to be 58.2 percent and 42.7 percent, respectively. The mean health knowledge was 42.9 percent, which, is rather low. Males [OR=0.3; 95 percentCI (0.18; 0.68)], returning students [OR=0.5; 95 percentCI (0.25; 0.94)] and those with employed fathers [OR=2.3; 95 percentCI (1.19; 4.47)] were found to be at a higher risk of alcohol use. Health knowledge was significantly higher among alcohol users (Z=-2.7; p=0.0074) and those whose fathers had a post matric education (𝜒2=6.4; p=0.0410) and/or employment (Z=-2.7; p=0.0064). Conclusion: While prevalence rates of alcohol use and risky alcohol were high, health knowledge was disappointingly low. This suggests need for interventions designed to minimise alcohol use while at the same time increasing health knowledge.
- Full Text:
- Date Issued: 2018
- Authors: Mandeya, Andrew
- Date: 2018
- Subjects: Drinking of alcoholic beverages College students--Alcohol use
- Language: English
- Type: Thesis , Masters , Public Health
- Identifier: http://hdl.handle.net/10353/11128 , vital:37173
- Description: Background: Alcohol use prevalence has been found to be higher than 50 percent at some universities in South Africa. It is against this background that this study aimed to establish the relationship between alcohol use, knowledge of alcohol-attributable health conditions and biographical characteristics. Literature review: The study was based on a review of literature on prevalence and patterns of alcohol use among university students, knowledge of alcohol-attributable chronic diseases, foetal alcohol syndrome, sexual and reproductive health and alcohol use measurement. Methodology: Data were collected from 213 undergraduate students enrolled for the Statistics service courses on two campuses of the same university. The Mann-Whitney normal approximation and the Kruskal-Wallis tests were used to compare health knowledge across levels of alcohol use and biographical characteristics. The chi-squared test and multiple logistic regression analysis were used to determine the significance and patterns of associations between alcohol use and health knowledge and biographical characteristics. Results: The prevalence rates of alcohol use and risky alcohol use were found to be 58.2 percent and 42.7 percent, respectively. The mean health knowledge was 42.9 percent, which, is rather low. Males [OR=0.3; 95 percentCI (0.18; 0.68)], returning students [OR=0.5; 95 percentCI (0.25; 0.94)] and those with employed fathers [OR=2.3; 95 percentCI (1.19; 4.47)] were found to be at a higher risk of alcohol use. Health knowledge was significantly higher among alcohol users (Z=-2.7; p=0.0074) and those whose fathers had a post matric education (𝜒2=6.4; p=0.0410) and/or employment (Z=-2.7; p=0.0064). Conclusion: While prevalence rates of alcohol use and risky alcohol were high, health knowledge was disappointingly low. This suggests need for interventions designed to minimise alcohol use while at the same time increasing health knowledge.
- Full Text:
- Date Issued: 2018
Risk factors of cardio-metabolic diseases among student nurses at Lilitha College of Nursing, East London, South Africa
- Authors: Mkanzi, Noluthando
- Date: 2018
- Subjects: Risk assessment Cardiovascular system -- Diseases Human physiology
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10353/12924 , vital:39404
- Description: Background: Non-communicable diseases are a growing public health concern and its prevalence is escalating exponentially, with a high frequency of morbidity, premature mortality, disability and loss of productivity. Since health education has become an important part of medical care, student nurses are potentially well suited to assist with the combat of these diseases. Early identification and treatment of modifiable risk factors among young adults would reduce the risk of developing cardio-metabolic diseases, thus, promoting health, prolonging life as well as saving costs related to healthcare. Objective: This study aimed to investigate the prevalence of cardio-metabolic risk factors among student nurses. Method: This was a descriptive cross sectional study, involving a convenience sample of 228 students during the educational year of 2017-2018 at Lilitha Collegeof Nursing in East London, South Africa. The WHO STEPwise standardized questionnaire was used to collect information on socio-demographic data (age, gender, year of study) and behavioural characteristics (smoking, alcohol consumption, physical inactivity, and dietary intake) of the participants. Anthropometric screening included measurement of height, weight and waist circumference. The biochemical screening included measurement of blood pressure and determination of fasting blood glucose concentration. Only students with complete data set were included in the data analysis. Statistical Package for Social Science (SPSS) version 23.0 was employed for descriptive and inferential analysis. Results: About half (41.7 percent) of the study participants were between the ages of 21 to 25 years and majority were females (67.5 percent).The prevalence of overweight and obesity were found to be 33 percent and 44 percent respectively. The prevalence of overweight was higher in males (44.6 percent), while females (53.9 percent) had higher prevalence of obesity. Female gender and increasing age are the only independent predictors of obesity. Results on blood pressure measurement showed that 25 percent of the participants had elevated blood pressure, and 22 percent were on stage 1 of hypertension while 2 percent were on stage 2. According to Joint National Committee on hypertension (JNC)’s criteria for defining hypertension, 44 percent of the participants had pre hypertension and 11percent had hypertension, diabetes and vegetables consumption were statistically associated with hypertension. The prevalence of pre-diabetes and diabetes was 6 percent and 7 percent respectively. Only abdominal obesity measured by waistto- hip ratio had a significant relationship with diabetes. Just 4.8 percent of the participants smoked daily and 33.3 percent consumed alcohol. Regarding physical activity, males were more active (60.8 percent) compared to females (54.8 percent). Conclusion: A high burden of overweight, obesity, and physical inactivity was observed among student nurses in East London. Screening for cardio-metabolic risk factors (CMRFs) among nursing students and implementation of intervention programs are recommended. Programs to raise awareness about CMRFs, encourage young adult students to adopt a healthy dietary behaviour and promote physical exercise should be initiated.
- Full Text:
- Date Issued: 2018
- Authors: Mkanzi, Noluthando
- Date: 2018
- Subjects: Risk assessment Cardiovascular system -- Diseases Human physiology
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10353/12924 , vital:39404
- Description: Background: Non-communicable diseases are a growing public health concern and its prevalence is escalating exponentially, with a high frequency of morbidity, premature mortality, disability and loss of productivity. Since health education has become an important part of medical care, student nurses are potentially well suited to assist with the combat of these diseases. Early identification and treatment of modifiable risk factors among young adults would reduce the risk of developing cardio-metabolic diseases, thus, promoting health, prolonging life as well as saving costs related to healthcare. Objective: This study aimed to investigate the prevalence of cardio-metabolic risk factors among student nurses. Method: This was a descriptive cross sectional study, involving a convenience sample of 228 students during the educational year of 2017-2018 at Lilitha Collegeof Nursing in East London, South Africa. The WHO STEPwise standardized questionnaire was used to collect information on socio-demographic data (age, gender, year of study) and behavioural characteristics (smoking, alcohol consumption, physical inactivity, and dietary intake) of the participants. Anthropometric screening included measurement of height, weight and waist circumference. The biochemical screening included measurement of blood pressure and determination of fasting blood glucose concentration. Only students with complete data set were included in the data analysis. Statistical Package for Social Science (SPSS) version 23.0 was employed for descriptive and inferential analysis. Results: About half (41.7 percent) of the study participants were between the ages of 21 to 25 years and majority were females (67.5 percent).The prevalence of overweight and obesity were found to be 33 percent and 44 percent respectively. The prevalence of overweight was higher in males (44.6 percent), while females (53.9 percent) had higher prevalence of obesity. Female gender and increasing age are the only independent predictors of obesity. Results on blood pressure measurement showed that 25 percent of the participants had elevated blood pressure, and 22 percent were on stage 1 of hypertension while 2 percent were on stage 2. According to Joint National Committee on hypertension (JNC)’s criteria for defining hypertension, 44 percent of the participants had pre hypertension and 11percent had hypertension, diabetes and vegetables consumption were statistically associated with hypertension. The prevalence of pre-diabetes and diabetes was 6 percent and 7 percent respectively. Only abdominal obesity measured by waistto- hip ratio had a significant relationship with diabetes. Just 4.8 percent of the participants smoked daily and 33.3 percent consumed alcohol. Regarding physical activity, males were more active (60.8 percent) compared to females (54.8 percent). Conclusion: A high burden of overweight, obesity, and physical inactivity was observed among student nurses in East London. Screening for cardio-metabolic risk factors (CMRFs) among nursing students and implementation of intervention programs are recommended. Programs to raise awareness about CMRFs, encourage young adult students to adopt a healthy dietary behaviour and promote physical exercise should be initiated.
- Full Text:
- Date Issued: 2018
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.
- Full Text:
- Date Issued: 2018
- 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.
- Full Text:
- Date Issued: 2018
Evaluation of self-efficacy in clinical performance of nurses initiate and management of anti-retroviral therapy by South African professional nurses
- Authors: Mangi, Nozuko Glenrose
- Date: 2017
- Subjects: Nursing assessment -- South Africa -- Eastern Cape Self-efficacy Nursing -- South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: http://hdl.handle.net/10353/4492 , vital:28344
- Description: Self-efficacy in clinical performance is a very important aspect in quality of health care, because it is the ability of the person to produce the desired outcomes. The aim of the study was to evaluate self-efficacy in clinical performance of NIMART programme by professional nurses in Buffalo City Metropolitan in Eastern Cape Province South Africa. A quantitative, descriptive survey design was used to examine self-efficacy in clinical performance during implementation of NIMART programme. A purposive sample of 358 NIMART programme trained professional nurses was included in the study. Analysis of the finding was done using SPSS version 21.0. Descriptive statistics (frequencies, percentage, mean and standard deviations) were used to analyse categorical variables. To reduce data volume, factor analysis was used to identify six variable clusters: Evaluation; planning, assessment, implementation, and patient care mentoring. Factor 1 (evaluation) was highly loaded on patient driven results (0.63); nursing interventions (0.70); breakdown point location (0.80); prognosis based care decisions (0.79); prognosis based outcome monitoring (0.70); and prognosis based settings adjustment (0.70). These items collectively define evaluation of self-efficacy clinical performance of the participants. Factor 2 (planning) was termed planning of patient care in a clinical setting was significantly loaded on these items: data driven nursing diagnosis (0.51); patient driven nursing diagnosis (0.52); settings based nursing diagnosis (0.49); overall care plan formulation (0.52); short-term patients care formulation (0.58); long-term patient care formulation (0.66); goal based measurable outcomes (0.80); goal based daily patient care plan (0.79); settings based daily patient care plan (0.73). Factor 3 (assessment) which was termed assessment in clinical performance was not significantly loaded in some of the items: physical assessment (0.64); patient history (0.65); energy restoration (0.56); time management (0.71); objective patient health data (0.61); subjective patient health data (0.49); data collection documentation (0.44). Factor 4 (implementation) data source correlation; patient health data analysis (0.45); patient strength (0.46); nurse-patient/family communication (0.55); nurse patient collaboration (0.64); Experience driven decision making (0.58). Factor 5 (patient care) patient care plan adherence (0.65); setting based overall patient care (0.74); resource based overall patient care (0.59). Factor 6 (mentoring) patient’s concerns identification (0.48); patient problems prioritisation (0.46); mentor/colleague advice (0.43); mentor/colleague feedback use (0.61); patient discharge strategies (0.71); continuous reporting/documenting (0.63). The mean scores produced by the Kruskal-Wallis test showed the lowest scoring pattern as follows: 20122013201120142010. This order was the same for all the variables, confirming that the 2010 group scored significantly higher than any other group on all the variables. The overall results of the study revealed that professional nurses have high self-efficacy in clinical performance in implementation of NIMART programme, except in evaluation aspect of self-efficacy where they scored lessor. Professional nurses trained by FPD scored higher in the aspects of self-efficacy in clinical performance compared to RTC trained; but scored lower in evaluative ability of self-efficacy in both institutions (FPD and RTC). The findings of this study showed that the overall self-efficacy of the professional nurses trained on NIMART programme performed clinically satisfactorily. It is recommended that in-service education or continuous professional development for professional nurses working in PHC’s should not only concentrate on updating clinical skills, but also create opportunity for reflection and strengthening of professional nurses’ self-efficacy in clinical performance. Also, further study on other processes of goal realisation will aid our understanding of self-efficacy in achieving the desirable goals of the professional nurses for patient quality care. Further research is also needed to evaluate clients’ satisfaction during care based on the NIMART intervention programme.
- Full Text:
- Date Issued: 2017
- Authors: Mangi, Nozuko Glenrose
- Date: 2017
- Subjects: Nursing assessment -- South Africa -- Eastern Cape Self-efficacy Nursing -- South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: http://hdl.handle.net/10353/4492 , vital:28344
- Description: Self-efficacy in clinical performance is a very important aspect in quality of health care, because it is the ability of the person to produce the desired outcomes. The aim of the study was to evaluate self-efficacy in clinical performance of NIMART programme by professional nurses in Buffalo City Metropolitan in Eastern Cape Province South Africa. A quantitative, descriptive survey design was used to examine self-efficacy in clinical performance during implementation of NIMART programme. A purposive sample of 358 NIMART programme trained professional nurses was included in the study. Analysis of the finding was done using SPSS version 21.0. Descriptive statistics (frequencies, percentage, mean and standard deviations) were used to analyse categorical variables. To reduce data volume, factor analysis was used to identify six variable clusters: Evaluation; planning, assessment, implementation, and patient care mentoring. Factor 1 (evaluation) was highly loaded on patient driven results (0.63); nursing interventions (0.70); breakdown point location (0.80); prognosis based care decisions (0.79); prognosis based outcome monitoring (0.70); and prognosis based settings adjustment (0.70). These items collectively define evaluation of self-efficacy clinical performance of the participants. Factor 2 (planning) was termed planning of patient care in a clinical setting was significantly loaded on these items: data driven nursing diagnosis (0.51); patient driven nursing diagnosis (0.52); settings based nursing diagnosis (0.49); overall care plan formulation (0.52); short-term patients care formulation (0.58); long-term patient care formulation (0.66); goal based measurable outcomes (0.80); goal based daily patient care plan (0.79); settings based daily patient care plan (0.73). Factor 3 (assessment) which was termed assessment in clinical performance was not significantly loaded in some of the items: physical assessment (0.64); patient history (0.65); energy restoration (0.56); time management (0.71); objective patient health data (0.61); subjective patient health data (0.49); data collection documentation (0.44). Factor 4 (implementation) data source correlation; patient health data analysis (0.45); patient strength (0.46); nurse-patient/family communication (0.55); nurse patient collaboration (0.64); Experience driven decision making (0.58). Factor 5 (patient care) patient care plan adherence (0.65); setting based overall patient care (0.74); resource based overall patient care (0.59). Factor 6 (mentoring) patient’s concerns identification (0.48); patient problems prioritisation (0.46); mentor/colleague advice (0.43); mentor/colleague feedback use (0.61); patient discharge strategies (0.71); continuous reporting/documenting (0.63). The mean scores produced by the Kruskal-Wallis test showed the lowest scoring pattern as follows: 20122013201120142010. This order was the same for all the variables, confirming that the 2010 group scored significantly higher than any other group on all the variables. The overall results of the study revealed that professional nurses have high self-efficacy in clinical performance in implementation of NIMART programme, except in evaluation aspect of self-efficacy where they scored lessor. Professional nurses trained by FPD scored higher in the aspects of self-efficacy in clinical performance compared to RTC trained; but scored lower in evaluative ability of self-efficacy in both institutions (FPD and RTC). The findings of this study showed that the overall self-efficacy of the professional nurses trained on NIMART programme performed clinically satisfactorily. It is recommended that in-service education or continuous professional development for professional nurses working in PHC’s should not only concentrate on updating clinical skills, but also create opportunity for reflection and strengthening of professional nurses’ self-efficacy in clinical performance. Also, further study on other processes of goal realisation will aid our understanding of self-efficacy in achieving the desirable goals of the professional nurses for patient quality care. Further research is also needed to evaluate clients’ satisfaction during care based on the NIMART intervention programme.
- Full Text:
- Date Issued: 2017