An investigation into births before arrival in healthcare facilities in uThungulu Health District during a period of 1 April 2014 to 31 March 2015
- Mkhwanazi, Cynthia Nqobile Nokuthula
- Authors: Mkhwanazi, Cynthia Nqobile Nokuthula
- Date: 2018
- Subjects: Childbirth Childbirth at home
- Language: English
- Type: Thesis , Masters , Public Health
- Identifier: http://hdl.handle.net/10353/11161 , vital:37198
- Description: Births Before Arrival (BBAs) in healthcare facilities is a worldwide health challenge. These births results with diverse obstetric and neonatal complications which could be avoided should delivery took place in an accredited environment. Delivery in health facility rate and Births Before Arrival is one of the vital measures used to monitor access as well as quality of Maternal and Child health services. A birth before arrival in health institutions happens accidentally and unattended by skilled health professionals outside the healthcare facilities (Lazic & Takač, 2011). It is found in both developed and developing countries with various adverse outcomes ranging from haemorrhage to death. Important strides had been taken to improve maternal and child health globally but the healthcare facilities are still experiencing an overwhelming number of births before arrival in healthcare facilities. This is a public health concern. The purpose of the study was to identify factors associated with Births before Arrival in UThungulu Health District facilities and determine the prevalence of BBAs and the neonatal and maternal morbidity and mortality associated with it. A retrospective quantitative research design was used. Maternity clinical records Reviews of 238 Births Before Arrival (BBA) in healthcare facilities that occurred between 1 April 2014 to 31 March 2015 were conducted in the six hospitals in UThungulu Health District. The births before arrival data was analysed using SPSS (Statistical Package for Social Science) version 23, for Windows and used for descriptive and inferential analysis. The reasons for BBA included poor ante natal education of mothers on early signs of labour, lack of transport, poor use of maternity waiting areas and some clinics do not conduct deliveries. The majority of study participants were single (unmarried) and this accentuates the importance of strengthening family planning coverage in this area. Poor reporting of early neonatal deaths and stillbirths was one of the significant observations made during the study. Deceased babies were left at home and buried without being registered at home affairs. Taking cognizance of diverse risks and health needs of expectant women would assist the Health department in planning for adequate coverage for provision of suitable pregnancy care that would improve the health of women and their babies.
- Full Text:
- Date Issued: 2018
- Authors: Mkhwanazi, Cynthia Nqobile Nokuthula
- Date: 2018
- Subjects: Childbirth Childbirth at home
- Language: English
- Type: Thesis , Masters , Public Health
- Identifier: http://hdl.handle.net/10353/11161 , vital:37198
- Description: Births Before Arrival (BBAs) in healthcare facilities is a worldwide health challenge. These births results with diverse obstetric and neonatal complications which could be avoided should delivery took place in an accredited environment. Delivery in health facility rate and Births Before Arrival is one of the vital measures used to monitor access as well as quality of Maternal and Child health services. A birth before arrival in health institutions happens accidentally and unattended by skilled health professionals outside the healthcare facilities (Lazic & Takač, 2011). It is found in both developed and developing countries with various adverse outcomes ranging from haemorrhage to death. Important strides had been taken to improve maternal and child health globally but the healthcare facilities are still experiencing an overwhelming number of births before arrival in healthcare facilities. This is a public health concern. The purpose of the study was to identify factors associated with Births before Arrival in UThungulu Health District facilities and determine the prevalence of BBAs and the neonatal and maternal morbidity and mortality associated with it. A retrospective quantitative research design was used. Maternity clinical records Reviews of 238 Births Before Arrival (BBA) in healthcare facilities that occurred between 1 April 2014 to 31 March 2015 were conducted in the six hospitals in UThungulu Health District. The births before arrival data was analysed using SPSS (Statistical Package for Social Science) version 23, for Windows and used for descriptive and inferential analysis. The reasons for BBA included poor ante natal education of mothers on early signs of labour, lack of transport, poor use of maternity waiting areas and some clinics do not conduct deliveries. The majority of study participants were single (unmarried) and this accentuates the importance of strengthening family planning coverage in this area. Poor reporting of early neonatal deaths and stillbirths was one of the significant observations made during the study. Deceased babies were left at home and buried without being registered at home affairs. Taking cognizance of diverse risks and health needs of expectant women would assist the Health department in planning for adequate coverage for provision of suitable pregnancy care that would improve the health of women and their babies.
- Full Text:
- Date Issued: 2018
Assessing factors influencing professional nurses' attrition in South Africa : a case study of private hospitals in Johannesburg
- Authors: Mbobo, Angelina Pretty
- Date: 2018
- Subjects: Intensive care nursing
- Language: English
- Type: Thesis , Masters , Public Health Leadership
- Identifier: http://hdl.handle.net/10353/11181 , vital:37200
- Description: South Africa faces an immense shortage of healthcare professionals, especially trained and experienced critical care nurses. This thesis assesses factors influencing professional nurses ‘attrition in two selected private hospitals. This results in an HR risk; loss of skills, task shifting and the use of less skilled nurses, and not limited to the high workloads in intensive care units together with the job dissatisfaction consequently. To confirm this, a case study making use of a qualitative approach, follows the definition of a social constructivism framework. The study assessed 40 trained and experienced critical care nurses in focus groups of 5, with which a stratified purposive sampling technique was used and the focus group interviews were 90 minutes Seven structured interviews were undertaken, (using a narrative summary) with hospital operational managers working directly with the critical care nurses. Audio-recorded data were analysed by thematic content analysis using Creswell’s steps content analysis method. Multiple reasons, as given by nurses, to discontinue their services in private hospitals emerged. These were: Heavy workloads, shortage of trained staff, medico-legal risks; lack of supervision, support and teamwork, physical and emotional exhaustion, fatigue, stress and burnout, differential salary scales, non-competitive retirement packages role ambiguity, inadequate equipment, unresolved conflict with colleagues or management, personal financial crisis, lack of recognition and Lack of career development or promotion. These factors make use of themes, which include issues related to line management, administration, subjective and uncertainty of roles. Operational managers confirmed such reasons for the discontinuation of services offered by critical care nurses in private hospitals. Management views to the attrition of critical care nurses were that: (a) The staffing crisis was a serious matter of concern, (b) the use of less skilled staff resulted in negative effects on patient care and (c) the low number of critical care nursing staff negatively affected organisational goals.
- Full Text:
- Date Issued: 2018
- Authors: Mbobo, Angelina Pretty
- Date: 2018
- Subjects: Intensive care nursing
- Language: English
- Type: Thesis , Masters , Public Health Leadership
- Identifier: http://hdl.handle.net/10353/11181 , vital:37200
- Description: South Africa faces an immense shortage of healthcare professionals, especially trained and experienced critical care nurses. This thesis assesses factors influencing professional nurses ‘attrition in two selected private hospitals. This results in an HR risk; loss of skills, task shifting and the use of less skilled nurses, and not limited to the high workloads in intensive care units together with the job dissatisfaction consequently. To confirm this, a case study making use of a qualitative approach, follows the definition of a social constructivism framework. The study assessed 40 trained and experienced critical care nurses in focus groups of 5, with which a stratified purposive sampling technique was used and the focus group interviews were 90 minutes Seven structured interviews were undertaken, (using a narrative summary) with hospital operational managers working directly with the critical care nurses. Audio-recorded data were analysed by thematic content analysis using Creswell’s steps content analysis method. Multiple reasons, as given by nurses, to discontinue their services in private hospitals emerged. These were: Heavy workloads, shortage of trained staff, medico-legal risks; lack of supervision, support and teamwork, physical and emotional exhaustion, fatigue, stress and burnout, differential salary scales, non-competitive retirement packages role ambiguity, inadequate equipment, unresolved conflict with colleagues or management, personal financial crisis, lack of recognition and Lack of career development or promotion. These factors make use of themes, which include issues related to line management, administration, subjective and uncertainty of roles. Operational managers confirmed such reasons for the discontinuation of services offered by critical care nurses in private hospitals. Management views to the attrition of critical care nurses were that: (a) The staffing crisis was a serious matter of concern, (b) the use of less skilled staff resulted in negative effects on patient care and (c) the low number of critical care nursing staff negatively affected organisational goals.
- Full Text:
- Date Issued: 2018
Towards the development of a conceptual framework for hospital performance assessment of a South African public hospital in the Eastern Cape province
- Authors: Wagner, Rolene Margaret
- Date: 2018
- Subjects: Public hospitals Hospital care Hospitals -- Administration
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: http://hdl.handle.net/10353/12249 , vital:39223
- Description: An integrated conceptual framework for measuring and comparing the performance of a South African teaching hospital in the Eastern Cape Province with other hospitals, is not available. The aim of this study was therefore to contribute to the development of a conceptual framework for assessing the performance of a SA public hospital in the Eastern Cape Province. The systematic literature review included all black and grey literature that relate to one of the two main themes- the purpose of measuring hospital performance and the methodology of assessing hospital performance. Relevant studies were identified through a Google search using the following descriptors: “Hospital Performance”, and “Hospital Performance Assessment”. There were 369 scholarly articles with the exact descriptors anywhere in the article with 59 articles released during the period 2012 to 2016. Ultimately, 7 articles met all the inclusionary criteria and described enterprise wide assessments of hospital performance. Other relevant articles, inclusive of grey literature, are included. Two of the studies in Morocco and Costa Rica were systematic reviews of hospital performance and covered the period 2000-2011. The Botswana case study assessed the use of the WHO PATH tool to measure the performance of its public hospitals. The Iranian, United States and Malaysian studies reflected on single aspect measures of hospital performance such as efficiency; the effect of weighting hospital performance indicators for patient harm on hospital profiles and payment; and Bed Occupancy rates, respectively. The review of the challenges associated with developing a hospital performance assessment framework was not found to be as useful as the other articles. The WHO PATH tool provides a high level integrated conceptual framework for measuring and comparing the performance of a South African teaching hospital in the Eastern Cape Province with other hospitals. This, however, needs to be adapted to the South African context with specific indicators being selected by local stakeholders that will promote best possible patient outcomes and a positive experience of patient-centred care at effective and efficient public health facilities. Lessons can be drawn from other countries’ experiences that have implemented hospital performance assessments and tested specific performance indicators.
- Full Text:
- Date Issued: 2018
- Authors: Wagner, Rolene Margaret
- Date: 2018
- Subjects: Public hospitals Hospital care Hospitals -- Administration
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: http://hdl.handle.net/10353/12249 , vital:39223
- Description: An integrated conceptual framework for measuring and comparing the performance of a South African teaching hospital in the Eastern Cape Province with other hospitals, is not available. The aim of this study was therefore to contribute to the development of a conceptual framework for assessing the performance of a SA public hospital in the Eastern Cape Province. The systematic literature review included all black and grey literature that relate to one of the two main themes- the purpose of measuring hospital performance and the methodology of assessing hospital performance. Relevant studies were identified through a Google search using the following descriptors: “Hospital Performance”, and “Hospital Performance Assessment”. There were 369 scholarly articles with the exact descriptors anywhere in the article with 59 articles released during the period 2012 to 2016. Ultimately, 7 articles met all the inclusionary criteria and described enterprise wide assessments of hospital performance. Other relevant articles, inclusive of grey literature, are included. Two of the studies in Morocco and Costa Rica were systematic reviews of hospital performance and covered the period 2000-2011. The Botswana case study assessed the use of the WHO PATH tool to measure the performance of its public hospitals. The Iranian, United States and Malaysian studies reflected on single aspect measures of hospital performance such as efficiency; the effect of weighting hospital performance indicators for patient harm on hospital profiles and payment; and Bed Occupancy rates, respectively. The review of the challenges associated with developing a hospital performance assessment framework was not found to be as useful as the other articles. The WHO PATH tool provides a high level integrated conceptual framework for measuring and comparing the performance of a South African teaching hospital in the Eastern Cape Province with other hospitals. This, however, needs to be adapted to the South African context with specific indicators being selected by local stakeholders that will promote best possible patient outcomes and a positive experience of patient-centred care at effective and efficient public health facilities. Lessons can be drawn from other countries’ experiences that have implemented hospital performance assessments and tested specific performance indicators.
- Full Text:
- Date Issued: 2018
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