Safe handling, storage, and management of vaccines at selected primary health care facilities in Buffalo City Metropolitan, Eastern Cape Province
- Mazwembe-Hoho, Andiswa Zimkitha
- Authors: Mazwembe-Hoho, Andiswa Zimkitha
- Date: 2022-04
- Subjects: Vaccines , Pharmaceutical policy
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/27942 , vital:70902
- Description: Background The World Health Organization has a standardized tool for assessing vaccine handling and management. South Africa has adopted WHO tools to suit its own conditions of supply and storage of vaccines, the WHO tool is a guideline for managing vaccines. Importantly, every person handling or supervising handling of vaccines should own this manual (s) and use it as a reference for the handling, storage, and management of vaccines and related items. Aim The aim of this study was to examine safe handling, storage, and management of vaccines by health care workers in PHC facilities of BCM Municipality. Methodology A quantitative research approach and descriptive design was used to assess the safe handling, storage, and management of vaccines in PHC facilities in BCM in EC. Results The results showed that safe handling, storage, and management of vaccines in PHC facilities in BCM does not comply fully on safe handling, storage, and management of vaccines. The overall compliance rate was 86%, and this indicated that healthcare workers have knowledge of what is required to be compliant with safe handling, storage, and management of vaccines. Conclusion Safe handling, storage, and management ovaccines in PHC facilities in BCM is conditionally compliant as the healthcare workers have moderate-to-satisfactory knowledge. , Thesis (MPH) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-04
- Authors: Mazwembe-Hoho, Andiswa Zimkitha
- Date: 2022-04
- Subjects: Vaccines , Pharmaceutical policy
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/27942 , vital:70902
- Description: Background The World Health Organization has a standardized tool for assessing vaccine handling and management. South Africa has adopted WHO tools to suit its own conditions of supply and storage of vaccines, the WHO tool is a guideline for managing vaccines. Importantly, every person handling or supervising handling of vaccines should own this manual (s) and use it as a reference for the handling, storage, and management of vaccines and related items. Aim The aim of this study was to examine safe handling, storage, and management of vaccines by health care workers in PHC facilities of BCM Municipality. Methodology A quantitative research approach and descriptive design was used to assess the safe handling, storage, and management of vaccines in PHC facilities in BCM in EC. Results The results showed that safe handling, storage, and management of vaccines in PHC facilities in BCM does not comply fully on safe handling, storage, and management of vaccines. The overall compliance rate was 86%, and this indicated that healthcare workers have knowledge of what is required to be compliant with safe handling, storage, and management of vaccines. Conclusion Safe handling, storage, and management ovaccines in PHC facilities in BCM is conditionally compliant as the healthcare workers have moderate-to-satisfactory knowledge. , Thesis (MPH) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-04
Status of physical activity and physical fitness among intermediate-phase schoolchildren from marginalised communities in Port Elizabeth
- Authors: Ncanywa, Sesethu
- Date: 2022-04
- Subjects: Child development -- South Africa -- Eastern Cape , Children -- Physiology
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/55833 , vital:53905
- Description: The purpose of the study was to investigate the current status of physical activity (PA) and physical fitness (PF) of intermediate-phase schoolchildren from marginalised communities in Port Elizabeth. A total of 985 schoolchildren (n=505 boys, n=474 girls) aged 8 to 16 years, from eight quintile 3 government schools participated in this study. These schools included four schools from the Township area and four from the Northern areas in Port Elizabeth. The tests included in the study were PA (Actigraph accelerometer), PF (20 m shuttle run test and grip strength), and body composition (body mass index and body fat percentage). Results showed that girls had higher body mass index (BMI) and body fat percentage (BF%), lower VO2max, less time spent on average per day on moderate to vigorous physical activity (MVPA) and lower grip strength (GS) as compared to boys (p0.05). No significant differences were found between the two geographic areas with regards to VO2max, GS, BMI and BF% (p>0.05). However, when confounding variables were considered, there was a significant difference in the BMI (p=0.0007), BF% (p=0.0003) and GS (p=0.0004) of the children from the two geographic areas. A negative correlation was found between VO2max and BMI A positive correlation was found between VO2max and MVPA . Overall, girls seem to be more at risk than boys for future non communicable diseases. These findings highlight the importance of promoting PA and monitored PF in children, and particularly in girls from marginalised communities. , Thesis (MA) -- Faculty of Health Sciences, School of lifestyle Sciences, 2022
- Full Text:
- Date Issued: 2022-04
- Authors: Ncanywa, Sesethu
- Date: 2022-04
- Subjects: Child development -- South Africa -- Eastern Cape , Children -- Physiology
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/55833 , vital:53905
- Description: The purpose of the study was to investigate the current status of physical activity (PA) and physical fitness (PF) of intermediate-phase schoolchildren from marginalised communities in Port Elizabeth. A total of 985 schoolchildren (n=505 boys, n=474 girls) aged 8 to 16 years, from eight quintile 3 government schools participated in this study. These schools included four schools from the Township area and four from the Northern areas in Port Elizabeth. The tests included in the study were PA (Actigraph accelerometer), PF (20 m shuttle run test and grip strength), and body composition (body mass index and body fat percentage). Results showed that girls had higher body mass index (BMI) and body fat percentage (BF%), lower VO2max, less time spent on average per day on moderate to vigorous physical activity (MVPA) and lower grip strength (GS) as compared to boys (p0.05). No significant differences were found between the two geographic areas with regards to VO2max, GS, BMI and BF% (p>0.05). However, when confounding variables were considered, there was a significant difference in the BMI (p=0.0007), BF% (p=0.0003) and GS (p=0.0004) of the children from the two geographic areas. A negative correlation was found between VO2max and BMI A positive correlation was found between VO2max and MVPA . Overall, girls seem to be more at risk than boys for future non communicable diseases. These findings highlight the importance of promoting PA and monitored PF in children, and particularly in girls from marginalised communities. , Thesis (MA) -- Faculty of Health Sciences, School of lifestyle Sciences, 2022
- Full Text:
- Date Issued: 2022-04
The Concept of Sexual Consent and Male Views on Rape: An Integrative Synthesis
- Authors: Zokoza, Babalwa
- Date: 2022-04
- Subjects: Sexual Consent , Rape -- Public opinion
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/58972 , vital:60252
- Description: Sexual violence affects countries globally and statistics show the prevalence of sexual violence is on the rise. The rationale for the study linked the prevalence of sexual violence in South Africa, therefore the study explores two aspects: 1. the construct of ‘sexual consent; 2. how men perceive sexual consent and rape in existing literature. A qualitative integrative synthesis was utilised as a research design. The data used in the study was sourced from various databases and content analysis was employed to analyse the data. This research thesis reviewed the conceptualisation of consent and male views on rape. In legal terms consent is defined as an agreement that includes choice, and freedom and capacity to make this choice; consent is also vitiated under certain circumstances. Civilians recognise consent as a mutual willingness that can be revoked and lacks resistance both verbally and nonverbally. Academic literature on male perceptions yielded four themes: Tacit knowledge, Ambiguity, Masculinity and Alcohol consumption. The analysis found that men understand the concepts of consent; their worldviews however contribute to them considering whether sexual interactions are consensual or non-consensual. The literature suggests that, considering the influence of patriarchy in South African society, the men referred hold high rape myth acceptance beliefs and have a sense of entitlement to female bodies. , Thesis (MA) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-04
- Authors: Zokoza, Babalwa
- Date: 2022-04
- Subjects: Sexual Consent , Rape -- Public opinion
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/58972 , vital:60252
- Description: Sexual violence affects countries globally and statistics show the prevalence of sexual violence is on the rise. The rationale for the study linked the prevalence of sexual violence in South Africa, therefore the study explores two aspects: 1. the construct of ‘sexual consent; 2. how men perceive sexual consent and rape in existing literature. A qualitative integrative synthesis was utilised as a research design. The data used in the study was sourced from various databases and content analysis was employed to analyse the data. This research thesis reviewed the conceptualisation of consent and male views on rape. In legal terms consent is defined as an agreement that includes choice, and freedom and capacity to make this choice; consent is also vitiated under certain circumstances. Civilians recognise consent as a mutual willingness that can be revoked and lacks resistance both verbally and nonverbally. Academic literature on male perceptions yielded four themes: Tacit knowledge, Ambiguity, Masculinity and Alcohol consumption. The analysis found that men understand the concepts of consent; their worldviews however contribute to them considering whether sexual interactions are consensual or non-consensual. The literature suggests that, considering the influence of patriarchy in South African society, the men referred hold high rape myth acceptance beliefs and have a sense of entitlement to female bodies. , Thesis (MA) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-04
The role of environmental health practitioners in the prevention and management of legionnaires’ disease
- Authors: Mhlonyane, Gcobisa
- Date: 2022-04
- Subjects: Environmental health personnel , Legionnaires' disease
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/58915 , vital:60247
- Description: Environmental Health Practitioners (EHPs) play a vital role in providing and facilitating comprehensive proactive environmental health-related services to promote a safe, healthy and clean environment and prevent diseases. The National Environmental Health Policy (South Africa. Department of Health, 2013) referred to environmental health services as critical preventative health services that require adequate financial, human and material resources to significantly contribute to addressing the development goals. South Africa currently faces a quadruple Burden of Diseases (BoD), consisting of HIV and AIDS and TB, High Maternal and Child Mortality, Non-Communicable Diseases and Violence and Injuries, and, more recently, the COVID-19 pandemic. The contributing factors to environmental-related diseases in South Africa include poor hygiene and sanitation practices due to lack of adequate sanitation facilities, poor management of waste, pollution of water and contaminated ambient air. The National Environmental Health Policy, 2013, described the importance of Environmental Health practice in the prevention and reduction of the incidence of diseases emanating from environmental factors, with a strong focus being on communicable diseases. The aim of the study was to examine the role played by EHPs in the epidemiological surveillance of diseases, in particular the prevention and management of Legionnaires’ disease, in one of the municipalities in the Eastern Cape Province. The study, which followed a mixed methods approach, was divided into two phases- phase 1 and phase 2. Phase 1 of the study employed a quantitative method of data collection where EHPs from the Municipality participated in a questionnaire survey, while phase 2 of the study followed a qualitative method of data collection where members of the Outbreak Response Committee from the District H participated in the focus group interviews. EHPs are represented in the Outbreak Response Committee of District H where they play a significant role in the prevention and management of diseases. Data from the questionnaire survey was analysed using the Statistica software programme where descriptive statistics and Spearman’s correlation test were performed. ix Focus group interviews were transcribed verbatim and an independent coder was used to analyse quantitative data from which three themes emerged. The study revealed the unavailability of programmes for prevention and management of Legionnaires’ disease in the Municipality. EHPs and members of the Outbreak Response Committee were found to have uncertainties related to their role in the prevention and management of Legionnaires’ disease. The study further depicted that the involvement of participants in both phase 1 and phase 2 in managing Legionnaires’ disease in their respective areas, is influenced by external factors such as the unavailability of programmes and systems to monitor, prevent and manage Legionnaires’ disease, shortages of staff, financial implications and capacity building. Lastly, the challenges encountered by the EHPs and members of the Outbreak Response Committees should be addressed by their respective managers to improve their response towards prevention and management of Legionnaires’ disease. , Thesis (MA) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-04
- Authors: Mhlonyane, Gcobisa
- Date: 2022-04
- Subjects: Environmental health personnel , Legionnaires' disease
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/58915 , vital:60247
- Description: Environmental Health Practitioners (EHPs) play a vital role in providing and facilitating comprehensive proactive environmental health-related services to promote a safe, healthy and clean environment and prevent diseases. The National Environmental Health Policy (South Africa. Department of Health, 2013) referred to environmental health services as critical preventative health services that require adequate financial, human and material resources to significantly contribute to addressing the development goals. South Africa currently faces a quadruple Burden of Diseases (BoD), consisting of HIV and AIDS and TB, High Maternal and Child Mortality, Non-Communicable Diseases and Violence and Injuries, and, more recently, the COVID-19 pandemic. The contributing factors to environmental-related diseases in South Africa include poor hygiene and sanitation practices due to lack of adequate sanitation facilities, poor management of waste, pollution of water and contaminated ambient air. The National Environmental Health Policy, 2013, described the importance of Environmental Health practice in the prevention and reduction of the incidence of diseases emanating from environmental factors, with a strong focus being on communicable diseases. The aim of the study was to examine the role played by EHPs in the epidemiological surveillance of diseases, in particular the prevention and management of Legionnaires’ disease, in one of the municipalities in the Eastern Cape Province. The study, which followed a mixed methods approach, was divided into two phases- phase 1 and phase 2. Phase 1 of the study employed a quantitative method of data collection where EHPs from the Municipality participated in a questionnaire survey, while phase 2 of the study followed a qualitative method of data collection where members of the Outbreak Response Committee from the District H participated in the focus group interviews. EHPs are represented in the Outbreak Response Committee of District H where they play a significant role in the prevention and management of diseases. Data from the questionnaire survey was analysed using the Statistica software programme where descriptive statistics and Spearman’s correlation test were performed. ix Focus group interviews were transcribed verbatim and an independent coder was used to analyse quantitative data from which three themes emerged. The study revealed the unavailability of programmes for prevention and management of Legionnaires’ disease in the Municipality. EHPs and members of the Outbreak Response Committee were found to have uncertainties related to their role in the prevention and management of Legionnaires’ disease. The study further depicted that the involvement of participants in both phase 1 and phase 2 in managing Legionnaires’ disease in their respective areas, is influenced by external factors such as the unavailability of programmes and systems to monitor, prevent and manage Legionnaires’ disease, shortages of staff, financial implications and capacity building. Lastly, the challenges encountered by the EHPs and members of the Outbreak Response Committees should be addressed by their respective managers to improve their response towards prevention and management of Legionnaires’ disease. , Thesis (MA) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-04
Water quality monitoring: a correlation Between the bacteriological quality of drinking water and Diarrhoeal prevalence within the Koukamma local municipality
- Authors: Jacobs, Nathan Elmar
- Date: 2022-04
- Subjects: Water quality monitoring stations -- Koukamma local municipality , Water quality management
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/58882 , vital:60244
- Description: Background: Various studies have linked water quality and the prevalence of diarrhoeal cases within developing countries globally. The Emanti water quality monitoring system (eWQMS), representing the Kou-Kamma Local Municipality (Eastern Cape, South Africa), has often yielded non-complaint microbiological drinking water quality results retrospectively. This study investigated the relationship between the bacteriological quality of drinking water and diarrhoeal prevalence in children under five years of age within the Kou-Kamma Local Municipality from 2012 to 2016. Methods: A quantitative, descriptive, and ecological study design was employed retrospectively within the Kou-Kamma Local Municipality. Retrospective data collected from the Emanti Water Quality Monitoring System (eWQMS) represented the bacteriological quality of drinking water within the study area from 2012 to 2016. Concurrently, secondary data from the District Health Information Management System of the Eastern Cape Department of Health: Kouga Local service area was collected. The data represented cases of diarrhoea with dehydration in children under five years of age, reported at public health facilities within the study area retrospectively (from 2012 to 2016). Statistical analyses (Spearman's Rank Correlation) determined the relationship between the bacteriological quality of drinking water and the prevalence of diarrhoea in children under five years as per the retrospective period. Water samples were also collected for 2017 and 2018 to determine the presence of enteric pathogens in the municipal drinking water supply. Results: The study found that the Kou-Kamma Local Municipality had an overall noncompliance rate of 47% for the municipal drinking water supplied to the community from 2012 to 2016 (retrospective period). The difference in failure proportion (noncompliance) of water samples for the four climatic seasons where statistically significant (p=0.004). A significant difference was observed between autumn and winter (p=0.003) and autumn and spring (p=0.025). The failure proportion of water samples for autumn was significantly higher (mean = 0.603231, sd = 0.19528237) compared to winter (mean = 0.316675, sd = 0.19649776) and spring (mean = 0.374495, sd = 0.20626332). No significant difference was observed for the failure proportion of water samples between the various years of the retrospective period xvi (p=0.416). Children under the age of five accounted for n=460 cases of diarrhoea with dehydration at the public health facilities for the retrospective period. The Kareedouw area (n=196) and Joubertina area (n=134) recorded the highest diarrhoeal cases reported for the study period. These two areas both had hospitals that operated 24 hours a day; however, the differences in cases reported between the two areas was not statistically significant (p=0.179). Diarrhoeal case data reported between the various years within the study period were significantly different (p<0.001). The observed differences were between 2012 and 2014 (p=0.008) and 2012 and 2015 (p=0.001). The differences in the cases of diarrhoea with dehydration, in children under five years of age, were not statistically significant for the four climatic seasons (p=0.121). The relationship between the failure proportion of water samples and the prevalence of diarrhoea with dehydration in children under five years of age was statistically significant (p=0.001). The results revealed a moderate positive relationship (rs=0.434) between the bacteriological quality of drinking water and the prevalence of cases of diarrhoea with dehydration. Water samples were collected at various sampling points for July 2017 and November 2018 and analysed for enteric pathogens. Vibrio cholerae, Salmonella sp. and Shigella sp. were detected in such water samples collected. The relationship between the failure proportion of water samples and the presence of enteric pathogens was not statistically significant (rs=0.56723, p=0.240). Conclusion: The overall bacteriological quality of drinking water within the municipality was poor and likely posed a potential health risk to consumers. The study further revealed a steep rise of diarrhoeal with dehydration prevalence in children under five years of age during 2013, which decreased slowly during the years to follow. A moderate, positive relationship existed between the failure proportion of water samples and diarrhoea with dehydration prevalence in children under five years of age (rs=0.434, p=0.001 ). Therefore, municipalities should improve their bulk water infrastructure and drinking water disinfecting methods while realising the need for increased awareness of water-borne disease prevention. , Thesis (MA) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-04
- Authors: Jacobs, Nathan Elmar
- Date: 2022-04
- Subjects: Water quality monitoring stations -- Koukamma local municipality , Water quality management
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/58882 , vital:60244
- Description: Background: Various studies have linked water quality and the prevalence of diarrhoeal cases within developing countries globally. The Emanti water quality monitoring system (eWQMS), representing the Kou-Kamma Local Municipality (Eastern Cape, South Africa), has often yielded non-complaint microbiological drinking water quality results retrospectively. This study investigated the relationship between the bacteriological quality of drinking water and diarrhoeal prevalence in children under five years of age within the Kou-Kamma Local Municipality from 2012 to 2016. Methods: A quantitative, descriptive, and ecological study design was employed retrospectively within the Kou-Kamma Local Municipality. Retrospective data collected from the Emanti Water Quality Monitoring System (eWQMS) represented the bacteriological quality of drinking water within the study area from 2012 to 2016. Concurrently, secondary data from the District Health Information Management System of the Eastern Cape Department of Health: Kouga Local service area was collected. The data represented cases of diarrhoea with dehydration in children under five years of age, reported at public health facilities within the study area retrospectively (from 2012 to 2016). Statistical analyses (Spearman's Rank Correlation) determined the relationship between the bacteriological quality of drinking water and the prevalence of diarrhoea in children under five years as per the retrospective period. Water samples were also collected for 2017 and 2018 to determine the presence of enteric pathogens in the municipal drinking water supply. Results: The study found that the Kou-Kamma Local Municipality had an overall noncompliance rate of 47% for the municipal drinking water supplied to the community from 2012 to 2016 (retrospective period). The difference in failure proportion (noncompliance) of water samples for the four climatic seasons where statistically significant (p=0.004). A significant difference was observed between autumn and winter (p=0.003) and autumn and spring (p=0.025). The failure proportion of water samples for autumn was significantly higher (mean = 0.603231, sd = 0.19528237) compared to winter (mean = 0.316675, sd = 0.19649776) and spring (mean = 0.374495, sd = 0.20626332). No significant difference was observed for the failure proportion of water samples between the various years of the retrospective period xvi (p=0.416). Children under the age of five accounted for n=460 cases of diarrhoea with dehydration at the public health facilities for the retrospective period. The Kareedouw area (n=196) and Joubertina area (n=134) recorded the highest diarrhoeal cases reported for the study period. These two areas both had hospitals that operated 24 hours a day; however, the differences in cases reported between the two areas was not statistically significant (p=0.179). Diarrhoeal case data reported between the various years within the study period were significantly different (p<0.001). The observed differences were between 2012 and 2014 (p=0.008) and 2012 and 2015 (p=0.001). The differences in the cases of diarrhoea with dehydration, in children under five years of age, were not statistically significant for the four climatic seasons (p=0.121). The relationship between the failure proportion of water samples and the prevalence of diarrhoea with dehydration in children under five years of age was statistically significant (p=0.001). The results revealed a moderate positive relationship (rs=0.434) between the bacteriological quality of drinking water and the prevalence of cases of diarrhoea with dehydration. Water samples were collected at various sampling points for July 2017 and November 2018 and analysed for enteric pathogens. Vibrio cholerae, Salmonella sp. and Shigella sp. were detected in such water samples collected. The relationship between the failure proportion of water samples and the presence of enteric pathogens was not statistically significant (rs=0.56723, p=0.240). Conclusion: The overall bacteriological quality of drinking water within the municipality was poor and likely posed a potential health risk to consumers. The study further revealed a steep rise of diarrhoeal with dehydration prevalence in children under five years of age during 2013, which decreased slowly during the years to follow. A moderate, positive relationship existed between the failure proportion of water samples and diarrhoea with dehydration prevalence in children under five years of age (rs=0.434, p=0.001 ). Therefore, municipalities should improve their bulk water infrastructure and drinking water disinfecting methods while realising the need for increased awareness of water-borne disease prevention. , Thesis (MA) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-04
An appraisal of strategies to mitigate related to non-communicable diseases of the eye: a case study of Michael Mapongwane Health Clinic in Khayelitsha, Western Cape Metro District
- Authors: Ngcebetsha, Avela Ayanda
- Date: 2022-03
- Subjects: Chronically ill--Care , Ophthalmic nursing
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/22908 , vital:53186
- Description: Preventive and curative eye-care services are a critical component of care for patients diagnosed with chronic diseases. The South African constitution guarantees health as a fundamental human right of all citizens. While most chronically ill patients are managed at the primary health care centers, eye care services are currently contracted to private service providers. The extent to which people, especially the chronically ill patients, have access to eye-care service under the current structure is less understood. The study aims to establish the effectiveness and sustainability of the eye-care service delivery model at the Michael Mapongwane CHC, with specific reference to access to eye-care services. Specifically, the study examined the rate and determinants of eye-care service utilisation, assess user’s satisfaction and perspectives of primary health workers and private service providers regarding the current structure of eye-care services. The study adopted a descriptive and explanatory design, which involved a survey and semi-structured interviews. The survey was conducted among 423 patients attending the two primary health centers selected for this study. Patients with chronic illness were recruited over a period of one month. Overall, 365 patients with chronic illness and 58 patients without chronic illness took part in the study. Descriptive and inferential statistics were used to analyse the quantitative date. Purposive sampling was used to select nine health workers and 10 private eye-care service providers for the semi-structured interviews. The data obtained were transcribed and coded. Thematic content analysis was performed on the qualitative data. The results show that less than half of the respondents (n=168) had ever had an eye test, and an even lower proportion (n=115) had had an eye test in the past two years. Age, female sex, formal rural dwelling, marital status, and income were significantly associated with ever having an eye test done. The results reveal a gross inequality in access to eye care test. Only 19.2% of patients diagnosed with hypertension had had their eyes examined. Even fewer proportions of the patients (8.5%) had had their eyes examined during or after diagnosis for hypertension. Likewise, only one in three patients diagnosed with diabetes has had their eyes examined before or after they were diagnosed with diabetes. The majority of patients who had used the services affirmed that it was easy to access eye care services. While most respondents agreed that waiting time to make an appointment was not too long, over half of them affirmed that waiting to see an eye doctor was too long. Most users were reasonably satisfied with the eye care services received. Primary health care providers highlighted challenges such as work overload, poor infrastructure, and patient’s forgetfulness of the appointment dates as factors affecting access to eye care services in their clinic. The primary challenges the private eye-care service providers experienced were small rooms or inappropriate clinic rooms, language barrier and inadequate support from the clinics. In conclusion, this study has shown that access to preventive and curative health care services was among patients attending primary health care centres, and especially those with chronic illness. The current structure of eye care services makes it difficult for patients to access care and for providers to provide quality care. , Thesis (MPH) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-03
- Authors: Ngcebetsha, Avela Ayanda
- Date: 2022-03
- Subjects: Chronically ill--Care , Ophthalmic nursing
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/22908 , vital:53186
- Description: Preventive and curative eye-care services are a critical component of care for patients diagnosed with chronic diseases. The South African constitution guarantees health as a fundamental human right of all citizens. While most chronically ill patients are managed at the primary health care centers, eye care services are currently contracted to private service providers. The extent to which people, especially the chronically ill patients, have access to eye-care service under the current structure is less understood. The study aims to establish the effectiveness and sustainability of the eye-care service delivery model at the Michael Mapongwane CHC, with specific reference to access to eye-care services. Specifically, the study examined the rate and determinants of eye-care service utilisation, assess user’s satisfaction and perspectives of primary health workers and private service providers regarding the current structure of eye-care services. The study adopted a descriptive and explanatory design, which involved a survey and semi-structured interviews. The survey was conducted among 423 patients attending the two primary health centers selected for this study. Patients with chronic illness were recruited over a period of one month. Overall, 365 patients with chronic illness and 58 patients without chronic illness took part in the study. Descriptive and inferential statistics were used to analyse the quantitative date. Purposive sampling was used to select nine health workers and 10 private eye-care service providers for the semi-structured interviews. The data obtained were transcribed and coded. Thematic content analysis was performed on the qualitative data. The results show that less than half of the respondents (n=168) had ever had an eye test, and an even lower proportion (n=115) had had an eye test in the past two years. Age, female sex, formal rural dwelling, marital status, and income were significantly associated with ever having an eye test done. The results reveal a gross inequality in access to eye care test. Only 19.2% of patients diagnosed with hypertension had had their eyes examined. Even fewer proportions of the patients (8.5%) had had their eyes examined during or after diagnosis for hypertension. Likewise, only one in three patients diagnosed with diabetes has had their eyes examined before or after they were diagnosed with diabetes. The majority of patients who had used the services affirmed that it was easy to access eye care services. While most respondents agreed that waiting time to make an appointment was not too long, over half of them affirmed that waiting to see an eye doctor was too long. Most users were reasonably satisfied with the eye care services received. Primary health care providers highlighted challenges such as work overload, poor infrastructure, and patient’s forgetfulness of the appointment dates as factors affecting access to eye care services in their clinic. The primary challenges the private eye-care service providers experienced were small rooms or inappropriate clinic rooms, language barrier and inadequate support from the clinics. In conclusion, this study has shown that access to preventive and curative health care services was among patients attending primary health care centres, and especially those with chronic illness. The current structure of eye care services makes it difficult for patients to access care and for providers to provide quality care. , Thesis (MPH) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-03
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
Experiences of midwives regarding the use of pharmacological and non-pharmacological labour pain interventions in Lejweleputswa District in Free State
- Parkies, Limakatso Elizabeth
- Authors: Parkies, Limakatso Elizabeth
- Date: 2022-03
- Subjects: Pharmacology , Anesthesia in obstetrics
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/23567 , vital:58166
- Description: Due to the disabling effects of severe labour pains, labour pain management remains an important topic in midwifery and needs to be reviewed more often. According to studies, various pain relief options, both pharmacological and non-pharmacological, are available to help women cope with pain, but midwives did not employ these techniques adequately because of various experiences. Studies further indicate that, though the limited number of these techniques were employed they were not effective on some women. Thus, the purpose of this research study was to explore and describe midwives’ experiences on pharmacological and non-pharmacological labour pain management in the Lejweleputswa District of the Free State Province. This study employed a qualitative, descriptive, explorative, and contextual design. A purposive sampling technique was used to select the participants. The target population was midwives who work in the maternity wards of the institutions under study with three to five years’ experience in midwifery. Individual, face-face, semi-structured interviews were conducted; these were recorded for the researcher’s reference purposes, so as not to overlook important information. In addition, the researcher made use of field notes, recording in them what was heard, observed, felt, experienced, and thought during the interview. Ethical principles and trustworthiness were maintained throughout this study. Data analysis was done using Tesch’s approach to open coding in qualitative research. Confidentiality and anonymity were ensured throughout the interviews. The nine themes and 19 sub-themes that emerged during data analysis were discussed comprehensively. The findings indicate that midwives use both pharmacological and non-pharmacological methods in managing labour pain. Some methods are effective in relieving pain for certain mothers, while other methods proved ineffective. Midwives administer Pethidine and Phenergan as per doctors’ prescription; non-pharmacological methods, such as back massage, deep breathing exercises, mobilisation, and warm baths or showers are also employed. Midwives provide pharmacological methods to all women in labour, and routinely employ non- pharmacological methods. Although the midwives are willing to manage patients’ pain, they face certain challenges, such as shortage of staff, increased workload, as well as inadequate resources. This leads to inadequate provision of non-pharmacological care. In conclusion, the midwives’ experiences were that both pharmacological and non-pharmacological techniques were used for all labouring women and they had relaxing and calming effects on some women, resulting to them giving birth with ease, although for some they were not effective. In addition, the pharmacological interventions caused drowsiness to some women and babies. The findings will provide evidence-based information to the Free State Department of Health in order to assist policymakers and stakeholders in initiating and developing appropriate policies, guidelines, and interventions that can improve labour pain management. The Free State Department of Health should consider using other opioids and non-opioids in managing labour pain to broaden the scope of pain relief methods available to the midwives. , Thesis (MPH) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-03
- Authors: Parkies, Limakatso Elizabeth
- Date: 2022-03
- Subjects: Pharmacology , Anesthesia in obstetrics
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/23567 , vital:58166
- Description: Due to the disabling effects of severe labour pains, labour pain management remains an important topic in midwifery and needs to be reviewed more often. According to studies, various pain relief options, both pharmacological and non-pharmacological, are available to help women cope with pain, but midwives did not employ these techniques adequately because of various experiences. Studies further indicate that, though the limited number of these techniques were employed they were not effective on some women. Thus, the purpose of this research study was to explore and describe midwives’ experiences on pharmacological and non-pharmacological labour pain management in the Lejweleputswa District of the Free State Province. This study employed a qualitative, descriptive, explorative, and contextual design. A purposive sampling technique was used to select the participants. The target population was midwives who work in the maternity wards of the institutions under study with three to five years’ experience in midwifery. Individual, face-face, semi-structured interviews were conducted; these were recorded for the researcher’s reference purposes, so as not to overlook important information. In addition, the researcher made use of field notes, recording in them what was heard, observed, felt, experienced, and thought during the interview. Ethical principles and trustworthiness were maintained throughout this study. Data analysis was done using Tesch’s approach to open coding in qualitative research. Confidentiality and anonymity were ensured throughout the interviews. The nine themes and 19 sub-themes that emerged during data analysis were discussed comprehensively. The findings indicate that midwives use both pharmacological and non-pharmacological methods in managing labour pain. Some methods are effective in relieving pain for certain mothers, while other methods proved ineffective. Midwives administer Pethidine and Phenergan as per doctors’ prescription; non-pharmacological methods, such as back massage, deep breathing exercises, mobilisation, and warm baths or showers are also employed. Midwives provide pharmacological methods to all women in labour, and routinely employ non- pharmacological methods. Although the midwives are willing to manage patients’ pain, they face certain challenges, such as shortage of staff, increased workload, as well as inadequate resources. This leads to inadequate provision of non-pharmacological care. In conclusion, the midwives’ experiences were that both pharmacological and non-pharmacological techniques were used for all labouring women and they had relaxing and calming effects on some women, resulting to them giving birth with ease, although for some they were not effective. In addition, the pharmacological interventions caused drowsiness to some women and babies. The findings will provide evidence-based information to the Free State Department of Health in order to assist policymakers and stakeholders in initiating and developing appropriate policies, guidelines, and interventions that can improve labour pain management. The Free State Department of Health should consider using other opioids and non-opioids in managing labour pain to broaden the scope of pain relief methods available to the midwives. , Thesis (MPH) -- 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
The contribution of efficient financial management on public health service delivery at King Cetshwayo District in KwaZulu Natal
- Authors: Msane, Sihlesabambo Londiwe
- Date: 2022-03
- Subjects: Public health -- Finance
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/21882 , vital:51839
- Description: The aim of this research is to develop strategies that the DOH could put into place to improve its internal controls in financial management in order to contribute towards service delivery at Ngwelezane, Queen Nandi and Eshowe hospitals within King Cetshwayo District. The study used a mix of qualitative and quantitative study methods, however using one research instrument to collect both qualitative and quantitative data from 37 financial managers in these three hospitals. Data analysis using content analysis (of qualitative data) and percentage frequency analysis (of quantitative date) yielded study findings. This study found that financial managers are fairly competent regarding ‘effective communication’, ‘team work’, and ‘financial leadership’; the study results did not show respondents’ clear comprehension of Auditor General findings and processes followed to implement the recommendations in order to assess internal controls; and findings also indicate that financial managers meet objectives of financial management through cash flow, budget forecasts and expenditure. Developing a framework that will guide and monitor the application of financial strategies with the aim of improving service delivery will involve enhancing financial managers’ knowledge of District and Institution Service Delivery Plans, allocating resources properly and efficiently during the budgeting exercise, establishing internal strategies to maximise accountability and transparency, having fraud prevention strategies in these institution, and putting measures in place to be able to forecast budgetary adverse. It is recommended that the Executive Management facilitates strategic break-away sessions for the financial managers to workshop them on practical ways to improve the efficiency of financial management on public health service delivery, as outlined in this study. , Thesis (MPH) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-03
- Authors: Msane, Sihlesabambo Londiwe
- Date: 2022-03
- Subjects: Public health -- Finance
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/21882 , vital:51839
- Description: The aim of this research is to develop strategies that the DOH could put into place to improve its internal controls in financial management in order to contribute towards service delivery at Ngwelezane, Queen Nandi and Eshowe hospitals within King Cetshwayo District. The study used a mix of qualitative and quantitative study methods, however using one research instrument to collect both qualitative and quantitative data from 37 financial managers in these three hospitals. Data analysis using content analysis (of qualitative data) and percentage frequency analysis (of quantitative date) yielded study findings. This study found that financial managers are fairly competent regarding ‘effective communication’, ‘team work’, and ‘financial leadership’; the study results did not show respondents’ clear comprehension of Auditor General findings and processes followed to implement the recommendations in order to assess internal controls; and findings also indicate that financial managers meet objectives of financial management through cash flow, budget forecasts and expenditure. Developing a framework that will guide and monitor the application of financial strategies with the aim of improving service delivery will involve enhancing financial managers’ knowledge of District and Institution Service Delivery Plans, allocating resources properly and efficiently during the budgeting exercise, establishing internal strategies to maximise accountability and transparency, having fraud prevention strategies in these institution, and putting measures in place to be able to forecast budgetary adverse. It is recommended that the Executive Management facilitates strategic break-away sessions for the financial managers to workshop them on practical ways to improve the efficiency of financial management on public health service delivery, as outlined in this study. , Thesis (MPH) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-03
Causes of high staff-turnover amongst professional nurses at selected health facilities in Kwazulu-Natal Province
- Mabaso, Sindisiwe Carol Catherine
- Authors: Mabaso, Sindisiwe Carol Catherine
- Date: 2022-02
- Subjects: Primary health care -- South Africa -- KwaZulu-Natal , Labor turnover -- South Africa -- KwaZulu-Natal
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/21838 , vital:51822
- Description: BACKGROUND: Staff turnover, defined as the total separations from employment, is expensive, can result in lost capacity, and can limit local health departments’ ability to respond to public health needs. Despite the importance of workforce capacity in public health, little is known about workforce turnover in local health departments. This study sought to determine the causes of high staff-turnover amongst professional nurses at selected health facilities in KwaZulu-Natal province and to identify corrective measures. Professional nurses are a critical staff category in any health organisation and make up the backbone of health care system. It is thus vital to ensure that this category is retained for the benefit of health services and its ultimate beneficiary, the patient. Furthermore, Personnel and Salaries System (PERSAL) statistics have shown that the hospitals selected for this study viz., Nkandla Local Municipality (LM) has more that two times (28%) the turnover rates (TORs) for PNs when compared to the district target of 11%, thus the decision to conduct this study at this particular municipality. METHODOLOGY: This research adopted a mixed methods retrospective study where both quantitative and qualitative approach was used to analyse data. The primary data source was the Exit Interview forms completed when a staff member resigns. It consists of three sections viz., section one contained demographics of each respondent with variables such as name PERSAL number, gender, rank, appointment and termination dates; section two contained closed ended statements on potential causes of termination where the respondent answered yes or no to statements such as offered senior position; and section three which was mostly qualitative information where respondents stated own additional views and comments regarding other causes of termination and recommended solutions. Both sections one and two were analysed using quantitative analysis while section three was analysed using qualitative analysis. Qualitative data from comments sections of the exit interview forms was thematically presented and analysed. These results were grouped into five themes namely; Career Progression, Management, Unacceptable or Poor Conditions of Service, Remuneration and Personal Issues. These previously completed exit interview forms were manually analysed in order to determine the causes of high staff-turnover amongst professional nurses at selected health facilities in KwaZulu-Natal province, during the period 2015-2016. Exit interview forms, previously completed by professional nurses for the period 2015 to 2016, were collected from both Nkandla LM district hospitals namely Ekombe and Nkandla. A self-designed spread sheet was used to collate the quantitative data from the exit interview forms which contained personal and demographic data (names, gender, PERSAL numbers, appointment and termination dates, rank, etc.), type of exit, and causes of exit, comments and proposed changes, following which it was manually analysed. RESULTS: A total of 54 participants completed the exit interview forms and selected the causes of service termination which were relevant to them. Ekombe Hospital participants were twelve (12) and Nkandla Hospital participants were forty two (42). Not all professional nurses who exited the service during the study period completed the exit interview form. The exit interview form completion rate was 78% (54/69). Twenty-four percent (13/54) of participants did not complete the exit interview form in full. The quantitative analysis revealed that the gender distribution of participants was mostly female, making 80% (43/54). The majority of participants, 30% (16/54), had 21-25 years’ service prior to exiting. On qualitative data analysis, the majority of participants selected unacceptable or poor conditions of service as the cause of service termination 65% (35/54) participants. This trend was also similar when each hospital participants’ selections were examined. In Ekombe Hospital 83% (10/12) participants’ selected unacceptable or poor conditions of service as the cause of service termination and in Nkandla Hospital this was 60% (25/42) participants. The majority of participants, 78% (42/54), stated that they still intended to re-join the department, and most were seeking employment in the public service. Furthermore, 70% (38/54), of the participants stated they would have stayed had their expectations been met. Further examination of themes and sub-themes derived from the qualitative data of the exit interview forms, the majority of comments, (20 comments), were related to Unacceptable or Poor Conditions of Service as the cause of termination. Sub themes analysis further identified resource shortages as the most common comments related to this determination. CONCLUSION: The leading causes of high staff-turnover amongst professional nurses at selected health facilities in KwaZulu-Natal province was determined to be unacceptable or poor conditions of service. On thematic analysis of qualitative data that emerged from the exit interview forms, the key areas that contributed to this determination included mainly resource constraints issues such as shortage of staff, shortage of equipment, shortage of funds, as well as poor infrastructure. Recommendations for staff retention and improvements in service conditions have been proposed. , Thesis (MPH) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-02
- Authors: Mabaso, Sindisiwe Carol Catherine
- Date: 2022-02
- Subjects: Primary health care -- South Africa -- KwaZulu-Natal , Labor turnover -- South Africa -- KwaZulu-Natal
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/21838 , vital:51822
- Description: BACKGROUND: Staff turnover, defined as the total separations from employment, is expensive, can result in lost capacity, and can limit local health departments’ ability to respond to public health needs. Despite the importance of workforce capacity in public health, little is known about workforce turnover in local health departments. This study sought to determine the causes of high staff-turnover amongst professional nurses at selected health facilities in KwaZulu-Natal province and to identify corrective measures. Professional nurses are a critical staff category in any health organisation and make up the backbone of health care system. It is thus vital to ensure that this category is retained for the benefit of health services and its ultimate beneficiary, the patient. Furthermore, Personnel and Salaries System (PERSAL) statistics have shown that the hospitals selected for this study viz., Nkandla Local Municipality (LM) has more that two times (28%) the turnover rates (TORs) for PNs when compared to the district target of 11%, thus the decision to conduct this study at this particular municipality. METHODOLOGY: This research adopted a mixed methods retrospective study where both quantitative and qualitative approach was used to analyse data. The primary data source was the Exit Interview forms completed when a staff member resigns. It consists of three sections viz., section one contained demographics of each respondent with variables such as name PERSAL number, gender, rank, appointment and termination dates; section two contained closed ended statements on potential causes of termination where the respondent answered yes or no to statements such as offered senior position; and section three which was mostly qualitative information where respondents stated own additional views and comments regarding other causes of termination and recommended solutions. Both sections one and two were analysed using quantitative analysis while section three was analysed using qualitative analysis. Qualitative data from comments sections of the exit interview forms was thematically presented and analysed. These results were grouped into five themes namely; Career Progression, Management, Unacceptable or Poor Conditions of Service, Remuneration and Personal Issues. These previously completed exit interview forms were manually analysed in order to determine the causes of high staff-turnover amongst professional nurses at selected health facilities in KwaZulu-Natal province, during the period 2015-2016. Exit interview forms, previously completed by professional nurses for the period 2015 to 2016, were collected from both Nkandla LM district hospitals namely Ekombe and Nkandla. A self-designed spread sheet was used to collate the quantitative data from the exit interview forms which contained personal and demographic data (names, gender, PERSAL numbers, appointment and termination dates, rank, etc.), type of exit, and causes of exit, comments and proposed changes, following which it was manually analysed. RESULTS: A total of 54 participants completed the exit interview forms and selected the causes of service termination which were relevant to them. Ekombe Hospital participants were twelve (12) and Nkandla Hospital participants were forty two (42). Not all professional nurses who exited the service during the study period completed the exit interview form. The exit interview form completion rate was 78% (54/69). Twenty-four percent (13/54) of participants did not complete the exit interview form in full. The quantitative analysis revealed that the gender distribution of participants was mostly female, making 80% (43/54). The majority of participants, 30% (16/54), had 21-25 years’ service prior to exiting. On qualitative data analysis, the majority of participants selected unacceptable or poor conditions of service as the cause of service termination 65% (35/54) participants. This trend was also similar when each hospital participants’ selections were examined. In Ekombe Hospital 83% (10/12) participants’ selected unacceptable or poor conditions of service as the cause of service termination and in Nkandla Hospital this was 60% (25/42) participants. The majority of participants, 78% (42/54), stated that they still intended to re-join the department, and most were seeking employment in the public service. Furthermore, 70% (38/54), of the participants stated they would have stayed had their expectations been met. Further examination of themes and sub-themes derived from the qualitative data of the exit interview forms, the majority of comments, (20 comments), were related to Unacceptable or Poor Conditions of Service as the cause of termination. Sub themes analysis further identified resource shortages as the most common comments related to this determination. CONCLUSION: The leading causes of high staff-turnover amongst professional nurses at selected health facilities in KwaZulu-Natal province was determined to be unacceptable or poor conditions of service. On thematic analysis of qualitative data that emerged from the exit interview forms, the key areas that contributed to this determination included mainly resource constraints issues such as shortage of staff, shortage of equipment, shortage of funds, as well as poor infrastructure. Recommendations for staff retention and improvements in service conditions have been proposed. , Thesis (MPH) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-02
Exploring socio-economic factors influencing incidences and outcome of multidrug resistance tuberculosis among patients and facility staffs in Makana Sub-District, Eastern Cape
- Cannon, Lesley-Ann https://orcid.org/0000-0002-7635-277X
- Authors: Cannon, Lesley-Ann https://orcid.org/0000-0002-7635-277X
- Date: 2022-02
- Subjects: Multidrug resistance , Tuberculosis
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/26706 , vital:65958
- Description: Background Drug-resistant Tuberculosis (DR-TB) is one of the main causes of global public health crisis, due to the morbidity and mortality rates associated with the disease. This DR TB is a complex illness having direct and indirect impact on finances, social functioning, and quality of life of infected individuals. Major research advances have been made in the diagnosis and treatment of DR-TB. However, minimal information exists on the socio-economic factors influencing the incidence and outcomes. This study aims to fill the gap by exploring the socio-economic factors from both the health care professional and patient perspective in particular settings to gain insights into developing context-specific strategies against the burden of DR-TB. Methodology The study applied a qualitative method to explore the socio-economic factors influencing MDR-TB through key-in-depth interviews (KIIs) and focus group discussions (FGDs). The study enrolled a total of thirty-two (32) consenting participants. The KIIs was conducted for ten (10) healthcare workers and nine (9) MDR-TB patients. Two focus group discussions were done involving seven (7) MDR TB patients and six (6) MDR-TB patients, respectively. The study targeted healthcare workers working in the MDR-TB field and TB patients with the following: GeneXpert Rifampicin resistance and patient confirmed as MDR TB. Eligible participants were selected using a purposive sampling technique from the hospitals` routine data electronic records (EDR-WEB database) and hardcopy registers (drug-resistant TB register) on MDR-TB patients enrolled in care at the study site. Informed consent was obtained from all study participants after thoroughly explaining the purpose. No personal information of participants was used. All responses from respondents were coded during analysis for autonomy and the respondents were not identifiable in any published or unpublished work following this research. The interviews were transcribed, some translated into English, where necessary, and analysed until saturation was reached. Data was coded and analysed using both thematic and content analysis technique. Results There were 3 main themes identified in the study: social factors, economic factors, and other contributing factors. 7 sub- themes were recorded under social factors and 2 subthemes under economic factors. Two independent factors that were also considered to impact MDR-TB were the attitude of healthcare workers, as well as the current COVID-19 pandemic. Conclusion MDR-TB is a major public health concern in the Makana Sub-district of the Eastern Cape. The findings of this study highlight the impact of socio- economic factors on the incidence, spread, defaulter rate and outcomes of MDR-TB. The social areas highlighted by the study participants as affecting the incidence and outcomes of MDR TB were housing and relocation, decreased immunity, stigma, patients’ attitude and lack of support, alcohol and other substance usage and prison/ incarceration. The economic factors identified by the participants were unemployment and job loss and health related expenses. Other factors are those factors contributing to the increased incidence and possible poor outcomes of MDR TB. Healthcare workers impact and attitude and the effects of the covid-19 pandemic were highlighted as additional factors influencing the incidence and outcomes of MDR TB. The management of MDR-TB requires rigorous efforts that should be directed at addressing the socio-economic factors. Therefore, future quantitative studies and important programmatic strategies should be considered to tackle the socio-economic challenges that contribute to the burden of MDR-TB infection in the Makana community. , Thesis (MPA) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-02
- Authors: Cannon, Lesley-Ann https://orcid.org/0000-0002-7635-277X
- Date: 2022-02
- Subjects: Multidrug resistance , Tuberculosis
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/26706 , vital:65958
- Description: Background Drug-resistant Tuberculosis (DR-TB) is one of the main causes of global public health crisis, due to the morbidity and mortality rates associated with the disease. This DR TB is a complex illness having direct and indirect impact on finances, social functioning, and quality of life of infected individuals. Major research advances have been made in the diagnosis and treatment of DR-TB. However, minimal information exists on the socio-economic factors influencing the incidence and outcomes. This study aims to fill the gap by exploring the socio-economic factors from both the health care professional and patient perspective in particular settings to gain insights into developing context-specific strategies against the burden of DR-TB. Methodology The study applied a qualitative method to explore the socio-economic factors influencing MDR-TB through key-in-depth interviews (KIIs) and focus group discussions (FGDs). The study enrolled a total of thirty-two (32) consenting participants. The KIIs was conducted for ten (10) healthcare workers and nine (9) MDR-TB patients. Two focus group discussions were done involving seven (7) MDR TB patients and six (6) MDR-TB patients, respectively. The study targeted healthcare workers working in the MDR-TB field and TB patients with the following: GeneXpert Rifampicin resistance and patient confirmed as MDR TB. Eligible participants were selected using a purposive sampling technique from the hospitals` routine data electronic records (EDR-WEB database) and hardcopy registers (drug-resistant TB register) on MDR-TB patients enrolled in care at the study site. Informed consent was obtained from all study participants after thoroughly explaining the purpose. No personal information of participants was used. All responses from respondents were coded during analysis for autonomy and the respondents were not identifiable in any published or unpublished work following this research. The interviews were transcribed, some translated into English, where necessary, and analysed until saturation was reached. Data was coded and analysed using both thematic and content analysis technique. Results There were 3 main themes identified in the study: social factors, economic factors, and other contributing factors. 7 sub- themes were recorded under social factors and 2 subthemes under economic factors. Two independent factors that were also considered to impact MDR-TB were the attitude of healthcare workers, as well as the current COVID-19 pandemic. Conclusion MDR-TB is a major public health concern in the Makana Sub-district of the Eastern Cape. The findings of this study highlight the impact of socio- economic factors on the incidence, spread, defaulter rate and outcomes of MDR-TB. The social areas highlighted by the study participants as affecting the incidence and outcomes of MDR TB were housing and relocation, decreased immunity, stigma, patients’ attitude and lack of support, alcohol and other substance usage and prison/ incarceration. The economic factors identified by the participants were unemployment and job loss and health related expenses. Other factors are those factors contributing to the increased incidence and possible poor outcomes of MDR TB. Healthcare workers impact and attitude and the effects of the covid-19 pandemic were highlighted as additional factors influencing the incidence and outcomes of MDR TB. The management of MDR-TB requires rigorous efforts that should be directed at addressing the socio-economic factors. Therefore, future quantitative studies and important programmatic strategies should be considered to tackle the socio-economic challenges that contribute to the burden of MDR-TB infection in the Makana community. , Thesis (MPA) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-02
Exploring socio-economic factors influencing incidences and outcome of multidrug resistance tuberculosis among patients and facility staffs in Makana Sub-District, Eastern Cape
- Authors: Cannon, Lesley-Ann Lynnath
- Date: 2022-02
- Subjects: Multidrug resistance , Multidrug-resistant -- tuberculosis
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/23471 , vital:57896
- Description: Drug-resistant Tuberculosis (DR-TB) is one of the main causes of global public health crisis, due to the morbidity and mortality rates associated with the disease. This DR-TB is a complex illness having direct and indirect impact on finances, social functioning, and quality of life of infected individuals. Major research advances have been made in the diagnosis and treatment of DR-TB. However, minimal information exists on the socio-economic factors influencing the incidence and outcomes. This study aims to fill the gap by exploring the socio-economic factors from both the health care professional and patient perspective in particular settings to gain insights into developing context-specific strategies against the burden of DR-TB. The study applied a qualitative method to explore the socio-economic factors influencing MDR-TB through key-in-depth interviews (KIIs) and focus group discussions (FGDs). The study enrolled a total of thirty-two (32) consenting participants. The KIIs was conducted for ten (10) healthcare workers and nine (9) MDR-TB patients. Two focus group discussions were done involving seven (7) MDR-TB patients and six (6) MDR-TB patients, respectively. The study targeted healthcare workers working in the MDR-TB field and TB patients with the following: GeneXpert Rifampicin resistance and patient confirmed as MDR TB. Eligible participants were selected using a purposive sampling technique from the hospitals` routine data electronic records (EDR-WEB database) and hardcopy registers (drug-resistant TB register) on MDR-TB patients enrolled in care at the study site. Informed consent was obtained from all study participants after thoroughly explaining the purpose. No personal information of participants was used. All responses from respondents were coded during analysis for autonomy and the respondents were not identifiable in any published or unpublished work following this research. The interviews were transcribed, some translated into English, where necessary, and analysed until saturation was reached. Data was coded and analysed using both thematic and content analysis technique. There were 3 main themes identified in the study: social factors, economic factors, and other contributing factors. 7 sub- themes were recorded under social factors and 2 subthemes under economic factors. Two independent factors that were also considered to impact MDR-TB were the attitude of healthcare workers, as well as the current COVID-19 pandemic. MDR-TB is a major public health concern in the Makana Sub-district of the Eastern Cape. The findings of this study highlight the impact of socio- economic factors on the incidence, spread, defaulter rate and outcomes of MDR-TB. The social areas highlighted by the study participants as affecting the incidence and outcomes of MDR TB were housing and relocation, decreased immunity, stigma, patients’ attitude and lack of support, alcohol and other substance usage and prison/ incarceration. The economic factors identified by the participants were unemployment and job loss and health related expenses. Other factors are those factors contributing to the increased incidence and possible poor outcomes of MDR TB. Healthcare workers impact and attitude and the effects of the covid-19 pandemic were highlighted as additional factors influencing the incidence and outcomes of MDR TB. The management of MDR-TB requires rigorous efforts that should be directed at addressing the socio-economic factors. Therefore, future quantitative studies and important programmatic strategies should be considered to tackle the socio-economic challenges that contribute to the burden of MDR-TB infection in the Makana community. , Thesis (MPA) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-02
- Authors: Cannon, Lesley-Ann Lynnath
- Date: 2022-02
- Subjects: Multidrug resistance , Multidrug-resistant -- tuberculosis
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/23471 , vital:57896
- Description: Drug-resistant Tuberculosis (DR-TB) is one of the main causes of global public health crisis, due to the morbidity and mortality rates associated with the disease. This DR-TB is a complex illness having direct and indirect impact on finances, social functioning, and quality of life of infected individuals. Major research advances have been made in the diagnosis and treatment of DR-TB. However, minimal information exists on the socio-economic factors influencing the incidence and outcomes. This study aims to fill the gap by exploring the socio-economic factors from both the health care professional and patient perspective in particular settings to gain insights into developing context-specific strategies against the burden of DR-TB. The study applied a qualitative method to explore the socio-economic factors influencing MDR-TB through key-in-depth interviews (KIIs) and focus group discussions (FGDs). The study enrolled a total of thirty-two (32) consenting participants. The KIIs was conducted for ten (10) healthcare workers and nine (9) MDR-TB patients. Two focus group discussions were done involving seven (7) MDR-TB patients and six (6) MDR-TB patients, respectively. The study targeted healthcare workers working in the MDR-TB field and TB patients with the following: GeneXpert Rifampicin resistance and patient confirmed as MDR TB. Eligible participants were selected using a purposive sampling technique from the hospitals` routine data electronic records (EDR-WEB database) and hardcopy registers (drug-resistant TB register) on MDR-TB patients enrolled in care at the study site. Informed consent was obtained from all study participants after thoroughly explaining the purpose. No personal information of participants was used. All responses from respondents were coded during analysis for autonomy and the respondents were not identifiable in any published or unpublished work following this research. The interviews were transcribed, some translated into English, where necessary, and analysed until saturation was reached. Data was coded and analysed using both thematic and content analysis technique. There were 3 main themes identified in the study: social factors, economic factors, and other contributing factors. 7 sub- themes were recorded under social factors and 2 subthemes under economic factors. Two independent factors that were also considered to impact MDR-TB were the attitude of healthcare workers, as well as the current COVID-19 pandemic. MDR-TB is a major public health concern in the Makana Sub-district of the Eastern Cape. The findings of this study highlight the impact of socio- economic factors on the incidence, spread, defaulter rate and outcomes of MDR-TB. The social areas highlighted by the study participants as affecting the incidence and outcomes of MDR TB were housing and relocation, decreased immunity, stigma, patients’ attitude and lack of support, alcohol and other substance usage and prison/ incarceration. The economic factors identified by the participants were unemployment and job loss and health related expenses. Other factors are those factors contributing to the increased incidence and possible poor outcomes of MDR TB. Healthcare workers impact and attitude and the effects of the covid-19 pandemic were highlighted as additional factors influencing the incidence and outcomes of MDR TB. The management of MDR-TB requires rigorous efforts that should be directed at addressing the socio-economic factors. Therefore, future quantitative studies and important programmatic strategies should be considered to tackle the socio-economic challenges that contribute to the burden of MDR-TB infection in the Makana community. , Thesis (MPA) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-02
Factors associated with infant mortality in Sarah Baartman District, Eastern Cape Province, South Africa
- Authors: Muavha, Mukondeleli Selina
- Date: 2022-02
- Subjects: Infants--Mortality
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/22067 , vital:51980
- Description: This study aimed to investigate the factors associated with infant mortality in Sarah Baartman District hospitals. A quantitative descriptive case-control design was used to investigate and describe the association between maternal socio-demographic, infant, environmental factors, and infant mortality. A data abstraction instrument was used to identify cases and their controls, and to retrieve information related to antenatal and obstetric care for the mothers of both cases and controls, as well as some information related to perinatal care for both mother and infant, from the registers in the district hospitals in Sarah Baartman district for the financial years 2015/2016 to 2017/2018. This was followed by structured questionnaires which were hand-delivered, to the mothers of the cases and controls. This study showed that seven maternal socio-demographic factors (educational level, mother’s source of income, religion, where mother took sick child to, frequency of visits by a health care worker within the last one year, number of alive siblings, and history of intrauterine death) were significantly related to infant mortality among the study participants. Among the environmental factors, the type of house, availability of tap and type of toilet were significantly related to infant mortality among the study participants. The study recommends public policies concerning maternal health through targeting mothers for food supplementation and prenatal care to reduce infant mortality rates. Infant mortality in the study area can also be reduced by improving mother’s education because women’s education has spill over effects on fertility and maternal health care behaviour. , Thesis (MPH) -- Faculty of Health Sciences, Public Health, 2021
- Full Text:
- Date Issued: 2022-02
- Authors: Muavha, Mukondeleli Selina
- Date: 2022-02
- Subjects: Infants--Mortality
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/22067 , vital:51980
- Description: This study aimed to investigate the factors associated with infant mortality in Sarah Baartman District hospitals. A quantitative descriptive case-control design was used to investigate and describe the association between maternal socio-demographic, infant, environmental factors, and infant mortality. A data abstraction instrument was used to identify cases and their controls, and to retrieve information related to antenatal and obstetric care for the mothers of both cases and controls, as well as some information related to perinatal care for both mother and infant, from the registers in the district hospitals in Sarah Baartman district for the financial years 2015/2016 to 2017/2018. This was followed by structured questionnaires which were hand-delivered, to the mothers of the cases and controls. This study showed that seven maternal socio-demographic factors (educational level, mother’s source of income, religion, where mother took sick child to, frequency of visits by a health care worker within the last one year, number of alive siblings, and history of intrauterine death) were significantly related to infant mortality among the study participants. Among the environmental factors, the type of house, availability of tap and type of toilet were significantly related to infant mortality among the study participants. The study recommends public policies concerning maternal health through targeting mothers for food supplementation and prenatal care to reduce infant mortality rates. Infant mortality in the study area can also be reduced by improving mother’s education because women’s education has spill over effects on fertility and maternal health care behaviour. , Thesis (MPH) -- Faculty of Health Sciences, Public Health, 2021
- Full Text:
- Date Issued: 2022-02
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
Factors influencing the performance of staff members in a tertiary hospital
- Combrink, Cornelius Johannes
- Authors: Combrink, Cornelius Johannes
- Date: 2021-12
- Subjects: Community health services
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/21642 , vital:51737
- Description: Healthcare services within a hospital setting are the basic aspects for the success of service delivery and staff performance in this regard. The paramount component of human resources makes a positive contribution to a healthcare system. Recently, it has been recognised that the performance of healthcare personnel ought to be a key factor for a sustainable performance system. Nevertheless, it is generally known that healthcare workers fail to accomplish the anticipated outcomes of health interventions. This concept leads to the research question: Why is the public sector known for poor service delivery and poor performance? This study aims to determine the factors that impact on the health worker’s performance in a tertiary hospital in South-Africa. A framework will be carefully constructed and cautiously implemented to improve and develop the performance of healthcare workers in this hospital. The vast scope and population involved in this study make a quantitative research approach most suitable, along with a non-probability purposive sampling method. A survey method using an electronic questionnaire that was circulated via a web survey, and a paper-based questionnaire that was distributed within the hospital were used to obtain a diverse perception of the healthcare workers. Data analysis included determining factors, group differences and correlations using the SPSS-27 program. The target population included all healthcare workers in the tertiary hospital – from junior employees to senior management level staff. Statistical data analysis collected for this study revealed four major factors (politics-related resources, resource, training and socioeconomic) that play a major role in the trends of performance culture at the selected tertiary hospital. These results lead to the understanding that the hospital is currently experiencing inadequate human resources management components such as recognition of employees who perform above expectations; execution of a performance appraisal system; lack in implementing the annual salary increase; unfavourable working conditions (lack of resources); troublesome management skills, and insufficient feedback on performance outcomes. These features are directly associated with the quality and degree of the performance of healthcare personnel. Based on the results, a management framework was proposed. The framework consists of activities that will improve the healthcare profession; strengthen expertise and knowledge; develop management skills; enhance knowledge through research and, ultimately, upgrade the performance of healthcare personnel. , Thesis (MPH) -- Faculty of Health Sciences, Public Health, 2021
- Full Text:
- Date Issued: 2021-12
- Authors: Combrink, Cornelius Johannes
- Date: 2021-12
- Subjects: Community health services
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/21642 , vital:51737
- Description: Healthcare services within a hospital setting are the basic aspects for the success of service delivery and staff performance in this regard. The paramount component of human resources makes a positive contribution to a healthcare system. Recently, it has been recognised that the performance of healthcare personnel ought to be a key factor for a sustainable performance system. Nevertheless, it is generally known that healthcare workers fail to accomplish the anticipated outcomes of health interventions. This concept leads to the research question: Why is the public sector known for poor service delivery and poor performance? This study aims to determine the factors that impact on the health worker’s performance in a tertiary hospital in South-Africa. A framework will be carefully constructed and cautiously implemented to improve and develop the performance of healthcare workers in this hospital. The vast scope and population involved in this study make a quantitative research approach most suitable, along with a non-probability purposive sampling method. A survey method using an electronic questionnaire that was circulated via a web survey, and a paper-based questionnaire that was distributed within the hospital were used to obtain a diverse perception of the healthcare workers. Data analysis included determining factors, group differences and correlations using the SPSS-27 program. The target population included all healthcare workers in the tertiary hospital – from junior employees to senior management level staff. Statistical data analysis collected for this study revealed four major factors (politics-related resources, resource, training and socioeconomic) that play a major role in the trends of performance culture at the selected tertiary hospital. These results lead to the understanding that the hospital is currently experiencing inadequate human resources management components such as recognition of employees who perform above expectations; execution of a performance appraisal system; lack in implementing the annual salary increase; unfavourable working conditions (lack of resources); troublesome management skills, and insufficient feedback on performance outcomes. These features are directly associated with the quality and degree of the performance of healthcare personnel. Based on the results, a management framework was proposed. The framework consists of activities that will improve the healthcare profession; strengthen expertise and knowledge; develop management skills; enhance knowledge through research and, ultimately, upgrade the performance of healthcare personnel. , Thesis (MPH) -- Faculty of Health Sciences, Public Health, 2021
- Full Text:
- Date Issued: 2021-12
The impact of COVID-19 on depression, anxiety, and post-traumatic stress levels in doctors and nurses at a South African health facility
- Authors: Finger-Motsepe, Kelebogile
- Date: 2021-12
- Subjects: COVID-19 (Disease) , Mental health
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/27920 , vital:70880
- Description: Introduction: The emergence of the coronavirus disease of 2019 (Covid-19) has wrought profound and enduring transformations in global health, economic dynamics, and social interactions. However, the comprehensive quantification of the psychological repercussions of the Covid-19 pandemic remains elusive and is poised to compound the preexisting burden of mental health disorders within the general populace. Elevated transmission rates, rapid disease progression within vulnerable demographics, and the absence of definitive curative or preventive measures have collectively contributed to a heightened worldwide state of stress and anxiety. Extensive research has demonstrated that the apprehension and stress associated with Covid-19 are markedly pronounced among healthcare professionals, commonly referred to as front-line workers, in comparison to the general population. The Covid-19-related psychological distress is anticipated to act as a catalyst, exacerbating mental health conditions within high-risk groups. Aims and Objectives: This study endeavours to ascertain the prevalence and severity of depression, anxiety, and post-traumatic stress disorder (PTSD) among medical doctors and nurses employed at a regional hospital in South Africa. Methodology: A cross-sectional investigation was conducted to evaluate the presence of anxiety, depression, and stress symptoms among medical doctors and nurses working at a Regional Hospital situated in the Free State Province of South Africa. A purposive sample of 200 participants, comprising all willing doctors and nurses employed at the study site, was enrolled in the study. Findings: The participants exhibited an average age of 42 years and an average tenure of approximately 72 months at the hospital. The majority of participants were of African descent, with a male-to-female ratio of 1:2.3. Female healthcare workers reported significantly higher instances of PTSD than their male counterparts. In the aggregate, 71.4percent of doctors reported symptoms indicative of depression, 73.2percent reported anxiety-related symptoms, and 19.6percent reported PTSD-related symptoms. Among nurses, 72percent displayed clinically significant symptoms of depression, 81percent exhibited anxiety-related symptoms, and 27.7percent manifested symptoms suggestive of PTSD. A moderately robust positive correlation was discerned between PTSD and Anxiety (p = .000; r = .466) as well as PTSD and Depression (p = .000; r = .315). Additionally, a strong positive correlation was identified between Anxiety and Depression (p = .000; r = .631). A statistically significant disparity (p = .030) in anxiety levels was observed among workers in different risk-prone areas. Nurses reported substantially higher levels of anxiety (p = .039; M = 10.63, sd = 4.03) compared to doctors (M = 9.01, sd = 3.80) and administrators (M = 10.50, sd = 4.32). Moreover, both nurses (M = 27.06, sd = 13.61) and administrators (M = 33.33, sd = 14.44) exhibited significantly higher instances of PTSD (p = .003) than doctors (M = 19.96, sd = 15.03). Conclusions: The healthcare workers under scrutiny reported elevated levels of anxiety and depression attributable to the Covid-19 pandemic, although the prevalence of posttraumatic stress symptoms was comparatively lower within the hospital setting. Furthermore, this study illuminates that depressive, anxiety, and post-traumatic stress symptoms were more prevalent among nurses than doctors. Additionally, healthcare professionals operating in high-risk Covid-19 environments, such as the Covid-19 ward, demonstrated heightened levels of anxiety when juxtaposed with their counterparts stationed in low-risk Covid-19 areas within the healthcare facility. , Thesis (MPH) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2021-12
- Authors: Finger-Motsepe, Kelebogile
- Date: 2021-12
- Subjects: COVID-19 (Disease) , Mental health
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/27920 , vital:70880
- Description: Introduction: The emergence of the coronavirus disease of 2019 (Covid-19) has wrought profound and enduring transformations in global health, economic dynamics, and social interactions. However, the comprehensive quantification of the psychological repercussions of the Covid-19 pandemic remains elusive and is poised to compound the preexisting burden of mental health disorders within the general populace. Elevated transmission rates, rapid disease progression within vulnerable demographics, and the absence of definitive curative or preventive measures have collectively contributed to a heightened worldwide state of stress and anxiety. Extensive research has demonstrated that the apprehension and stress associated with Covid-19 are markedly pronounced among healthcare professionals, commonly referred to as front-line workers, in comparison to the general population. The Covid-19-related psychological distress is anticipated to act as a catalyst, exacerbating mental health conditions within high-risk groups. Aims and Objectives: This study endeavours to ascertain the prevalence and severity of depression, anxiety, and post-traumatic stress disorder (PTSD) among medical doctors and nurses employed at a regional hospital in South Africa. Methodology: A cross-sectional investigation was conducted to evaluate the presence of anxiety, depression, and stress symptoms among medical doctors and nurses working at a Regional Hospital situated in the Free State Province of South Africa. A purposive sample of 200 participants, comprising all willing doctors and nurses employed at the study site, was enrolled in the study. Findings: The participants exhibited an average age of 42 years and an average tenure of approximately 72 months at the hospital. The majority of participants were of African descent, with a male-to-female ratio of 1:2.3. Female healthcare workers reported significantly higher instances of PTSD than their male counterparts. In the aggregate, 71.4percent of doctors reported symptoms indicative of depression, 73.2percent reported anxiety-related symptoms, and 19.6percent reported PTSD-related symptoms. Among nurses, 72percent displayed clinically significant symptoms of depression, 81percent exhibited anxiety-related symptoms, and 27.7percent manifested symptoms suggestive of PTSD. A moderately robust positive correlation was discerned between PTSD and Anxiety (p = .000; r = .466) as well as PTSD and Depression (p = .000; r = .315). Additionally, a strong positive correlation was identified between Anxiety and Depression (p = .000; r = .631). A statistically significant disparity (p = .030) in anxiety levels was observed among workers in different risk-prone areas. Nurses reported substantially higher levels of anxiety (p = .039; M = 10.63, sd = 4.03) compared to doctors (M = 9.01, sd = 3.80) and administrators (M = 10.50, sd = 4.32). Moreover, both nurses (M = 27.06, sd = 13.61) and administrators (M = 33.33, sd = 14.44) exhibited significantly higher instances of PTSD (p = .003) than doctors (M = 19.96, sd = 15.03). Conclusions: The healthcare workers under scrutiny reported elevated levels of anxiety and depression attributable to the Covid-19 pandemic, although the prevalence of posttraumatic stress symptoms was comparatively lower within the hospital setting. Furthermore, this study illuminates that depressive, anxiety, and post-traumatic stress symptoms were more prevalent among nurses than doctors. Additionally, healthcare professionals operating in high-risk Covid-19 environments, such as the Covid-19 ward, demonstrated heightened levels of anxiety when juxtaposed with their counterparts stationed in low-risk Covid-19 areas within the healthcare facility. , Thesis (MPH) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2021-12
Assessment of compliance to the maintenance procedure of medical equipment in a selected hospital, Oliver Reginald Tambo District, Eastern Cape Province
- Authors: Mbangata, Mzuyanda
- Date: 2021-11
- Subjects: Equipment health monitoring , Maintenance--Equipment and supplies
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/21871 , vital:51838
- Description: Background Medical equipment assumes a major part in diagnosis, prevention and treatment of diseases as well as illness and rehabilitation of patients. The maintenance of medical equipment is one of the most vital components in quality health care service delivery and it should not be ignored in the hospital. Therefore, it is critical that medical equipment must be maintained, and be in good working condition to ensure it completes its life cycle, also to prevent possible injuries to the patients and clinicians/end-users. Proper maintenance of medical equipment needs compliance with the manufacturer’s recommendations. Inappropriate maintenance of medical equipment leads to medical equipment malfunctioning, decreases the level of medical equipment performance, and wastes money and other resources. The equipment downtime makes health care services not accessible to patients. Maintenance includes the following activities, medical equipment acceptance, preventive maintenance, inspection, calibration and repair following the manufacturer’s recommendations. Aim of the study The purpose of the study was to assess compliance to the maintenance procedures of medical equipment in a selected hospital in Oliver Reginald Tambo District, Eastern Cape Province. Methodology A qualitative descriptive design was used to access information regarding compliance with the maintenance of medical equipment in a selected hospital, in Oliver Reginald Tambo District, Eastern Cape. The compliance was accessed at the selected hospital that has eight departments. The research objectives gave a framework for how the research was to be conducted. The data was collected through semi-structured interviews until data saturation. An open coding Tesch’s qualitative method was used for data analysis. A purposive sampling technique was used to select participants who were knowledgeable and responsible for management of medical equipment maintenance. The participants were experienced clinicians and technicians answerable for medical equipment maintenance and management. The researcher adhered to ethical and trustworthiness principles. Findings The following themes and their related categories emerged as compliance procedures adhered to/applied: i) Determinants of applied procedures; ii) Compliance with maintenance that is facilitate frequent checks, daily regular testing of equipment; iii) Report faulty equipment; iv) Send equipment for repairs; v) Do follow up on repairs; and vi) Keep machines working all the time. Contributory factors to non-compliance included: Unavailability of funds; technical staff shortage; lack of technical training; non-compliance in performance of quality checks; lack of training of end users; lack of set of maintenance plans; and long procurement process. Complications aligned with non-compliance: Inappropriate referral patients; inaccessibility of health care services; and misdiagnosing patients. Recommendations The strengthening of clinical engineering department with human resources (technical staff), finance (funds for spare parts) and physical resources (workspace, testing equipment and tools, service manuals etc.) Prioritise medical equipment maintenance also improvement of maintenance budget allocation and utilization. Provision of training for end users and technical staff. Establishment and implementation of maintenance plan and improvement of procurement processes. Conclusion The selected hospital is partially compliant with the maintenance of medical equipment because the hospital performs only reactive maintenance. It evidently appeared that affected service delivery is initiated by the shortage of technical staff and equipment availability and reliability. The hospital needs to focus and improve on the above mentioned factors affecting medical equipment maintenance. The results showed that improper maintenance of medical equipment contributes to the overcrowding of tertiary hospitals through unnecessary referrals due to medical equipment malfunctioning. The study contributes to improving the maintenance management of medical equipment. , Thesis (MPH) -- Faculty of Health Sciences, 2021
- Full Text:
- Date Issued: 2021-11
- Authors: Mbangata, Mzuyanda
- Date: 2021-11
- Subjects: Equipment health monitoring , Maintenance--Equipment and supplies
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/21871 , vital:51838
- Description: Background Medical equipment assumes a major part in diagnosis, prevention and treatment of diseases as well as illness and rehabilitation of patients. The maintenance of medical equipment is one of the most vital components in quality health care service delivery and it should not be ignored in the hospital. Therefore, it is critical that medical equipment must be maintained, and be in good working condition to ensure it completes its life cycle, also to prevent possible injuries to the patients and clinicians/end-users. Proper maintenance of medical equipment needs compliance with the manufacturer’s recommendations. Inappropriate maintenance of medical equipment leads to medical equipment malfunctioning, decreases the level of medical equipment performance, and wastes money and other resources. The equipment downtime makes health care services not accessible to patients. Maintenance includes the following activities, medical equipment acceptance, preventive maintenance, inspection, calibration and repair following the manufacturer’s recommendations. Aim of the study The purpose of the study was to assess compliance to the maintenance procedures of medical equipment in a selected hospital in Oliver Reginald Tambo District, Eastern Cape Province. Methodology A qualitative descriptive design was used to access information regarding compliance with the maintenance of medical equipment in a selected hospital, in Oliver Reginald Tambo District, Eastern Cape. The compliance was accessed at the selected hospital that has eight departments. The research objectives gave a framework for how the research was to be conducted. The data was collected through semi-structured interviews until data saturation. An open coding Tesch’s qualitative method was used for data analysis. A purposive sampling technique was used to select participants who were knowledgeable and responsible for management of medical equipment maintenance. The participants were experienced clinicians and technicians answerable for medical equipment maintenance and management. The researcher adhered to ethical and trustworthiness principles. Findings The following themes and their related categories emerged as compliance procedures adhered to/applied: i) Determinants of applied procedures; ii) Compliance with maintenance that is facilitate frequent checks, daily regular testing of equipment; iii) Report faulty equipment; iv) Send equipment for repairs; v) Do follow up on repairs; and vi) Keep machines working all the time. Contributory factors to non-compliance included: Unavailability of funds; technical staff shortage; lack of technical training; non-compliance in performance of quality checks; lack of training of end users; lack of set of maintenance plans; and long procurement process. Complications aligned with non-compliance: Inappropriate referral patients; inaccessibility of health care services; and misdiagnosing patients. Recommendations The strengthening of clinical engineering department with human resources (technical staff), finance (funds for spare parts) and physical resources (workspace, testing equipment and tools, service manuals etc.) Prioritise medical equipment maintenance also improvement of maintenance budget allocation and utilization. Provision of training for end users and technical staff. Establishment and implementation of maintenance plan and improvement of procurement processes. Conclusion The selected hospital is partially compliant with the maintenance of medical equipment because the hospital performs only reactive maintenance. It evidently appeared that affected service delivery is initiated by the shortage of technical staff and equipment availability and reliability. The hospital needs to focus and improve on the above mentioned factors affecting medical equipment maintenance. The results showed that improper maintenance of medical equipment contributes to the overcrowding of tertiary hospitals through unnecessary referrals due to medical equipment malfunctioning. The study contributes to improving the maintenance management of medical equipment. , Thesis (MPH) -- Faculty of Health Sciences, 2021
- Full Text:
- Date Issued: 2021-11
Knowledge, attitudes, and practices of the treatment options for dental caries among the adult patients for dental caries in Buffalo City Metropolitan Municipality, in East London, Eastern Cape, South Africa
- Authors: Veleekizhakethil, Legy
- Date: 2021-11
- Subjects: Dental caries , Periodontics
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/22968 , vital:53257
- Description: Dentistry offers several caries-preventive measures, some of which emphasise not only patient’s responsibility to manage their disease, but also how dental professionals should manage it. Consequently, this study aimed to examine the knowledge, attitudes, and practices of adult patients towards treatment options relating to dental caries in the geographical context of Buffalo City Metropolitan Municipality, situated in the Eastern Cape Province of South Africa. Purpose Firstly, this quantitative study set out to assess the existing oral health knowledge, attitudes, and practices among an adult population visiting dental health facilities in Buffalo City Metropolitan Municipality, in East London, Eastern Cape, South Africa. Secondly, it aimed to examine the prevalence of dental caries, periodontal diseases and tooth associated diseases in this specific setting. Furthermore, the study sought to provide baseline data in order to organise a successful dental prevention programme. The data obtained will determine the layout of policies to be put forward to the Department of Health. Methodology The researcher took a quantitative approach and conducted descriptive surveys from November 2019 to March 2020. A close-ended, structured questionnaire for data collection was designed based on the aspects of knowledge, attitudes, practices and behaviour pertaining to the area of dental caries. A clinical examination of dental status was performed using dental probes, dental mirrors and tooth air-drying. All decay, and missing, filled or restored teeth due to dental caries, along with the presence of calculus, gingival, and periodontal lesions were recorded. Results Participants had an average knowledge score of 80percent with a 95percent confidence interval of (76percent; 84percent). The majority knew the importance of cleaning their teeth (88.9percent), were aware of the effects of sugary diets (80.7percent), avoided sugary foods (64.6percent), and lastly were aware of the causes of dental caries (71.3percent). However it is concerning that most had never visited a dentist, as reflected by 69.1percent of participants agreeing or strongly agreeing. At least 70percent of those who responded were satisfied with their dentists in that they ( the dentists) freely share ideas and opinions and provide advice on options for dental care. The study revealed a high prevalence of dental caries with a ratio of 6.23. Conclusions The majority of the participants affirmed the importance of visiting the dentist for a routine dental examination. In addition, the majority are aware that sugary diets are associated with dental caries. However, there is a high prevalence of dental caries among participants in this setting. Therefore, dentists should provide preventive measures, along with professional restorative and plaque removal, to curb the burden of dental caries and periodontal diseases. The type and extent of preventive measures must be adjusted according to the patient’s individual needs. Dental health professionals must collaborate with other health-care providers to promote preventive dental health. , Thesis (MPH) -- Faculty of Health Sciences, 2021
- Full Text:
- Date Issued: 2021-11
- Authors: Veleekizhakethil, Legy
- Date: 2021-11
- Subjects: Dental caries , Periodontics
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/22968 , vital:53257
- Description: Dentistry offers several caries-preventive measures, some of which emphasise not only patient’s responsibility to manage their disease, but also how dental professionals should manage it. Consequently, this study aimed to examine the knowledge, attitudes, and practices of adult patients towards treatment options relating to dental caries in the geographical context of Buffalo City Metropolitan Municipality, situated in the Eastern Cape Province of South Africa. Purpose Firstly, this quantitative study set out to assess the existing oral health knowledge, attitudes, and practices among an adult population visiting dental health facilities in Buffalo City Metropolitan Municipality, in East London, Eastern Cape, South Africa. Secondly, it aimed to examine the prevalence of dental caries, periodontal diseases and tooth associated diseases in this specific setting. Furthermore, the study sought to provide baseline data in order to organise a successful dental prevention programme. The data obtained will determine the layout of policies to be put forward to the Department of Health. Methodology The researcher took a quantitative approach and conducted descriptive surveys from November 2019 to March 2020. A close-ended, structured questionnaire for data collection was designed based on the aspects of knowledge, attitudes, practices and behaviour pertaining to the area of dental caries. A clinical examination of dental status was performed using dental probes, dental mirrors and tooth air-drying. All decay, and missing, filled or restored teeth due to dental caries, along with the presence of calculus, gingival, and periodontal lesions were recorded. Results Participants had an average knowledge score of 80percent with a 95percent confidence interval of (76percent; 84percent). The majority knew the importance of cleaning their teeth (88.9percent), were aware of the effects of sugary diets (80.7percent), avoided sugary foods (64.6percent), and lastly were aware of the causes of dental caries (71.3percent). However it is concerning that most had never visited a dentist, as reflected by 69.1percent of participants agreeing or strongly agreeing. At least 70percent of those who responded were satisfied with their dentists in that they ( the dentists) freely share ideas and opinions and provide advice on options for dental care. The study revealed a high prevalence of dental caries with a ratio of 6.23. Conclusions The majority of the participants affirmed the importance of visiting the dentist for a routine dental examination. In addition, the majority are aware that sugary diets are associated with dental caries. However, there is a high prevalence of dental caries among participants in this setting. Therefore, dentists should provide preventive measures, along with professional restorative and plaque removal, to curb the burden of dental caries and periodontal diseases. The type and extent of preventive measures must be adjusted according to the patient’s individual needs. Dental health professionals must collaborate with other health-care providers to promote preventive dental health. , Thesis (MPH) -- Faculty of Health Sciences, 2021
- Full Text:
- Date Issued: 2021-11
Low uptake and early removal of Implanon NXT among women of reproductive age in Limpopo
- Magomani, Nandu Victoria https://orcid.org/ 0000-0001-5473-9984
- Authors: Magomani, Nandu Victoria https://orcid.org/ 0000-0001-5473-9984
- Date: 2021-11
- Subjects: Contraceptive drug implants
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/21849 , vital:51829
- Description: Implanon NXT also referred to as subdermal Implant, is a long-acting subdermal contraceptive method available in the South African public health care system since 2014. The implant was introduced to broaden the choice for women of childbearing age to delay or prevent unwanted pregnancies. Following a surge in popularity, reports of early removals and frequent adverse effects led to a significant decrease in its uptake in the country. Insufficient knowledge on Implanon, poor management of side effects, poor counseling by health care workers, and lack of partner support were the main themes that were picked from the interview, influencing uptake or early removals of the Implanon. The major concerning side effect reported was uncontrolled and irregular heavy bleeding The purpose of the study was to explore the factors associated with low uptake and early removals of Implanon NXT among women of reproductive age in one district in Limpopo province. A qualitative research design was used, primarily as exploratory and descriptive in nature. Participants were identified using non-probable, purposeful voluntary sampling. Data collection was achieved using open-ended structured interviews with sixteen (16) women aged from18-49. Data was analysed using thematic method of organizing data into categories, followed by coding and sorting the data to identify patterns and interpret the meanings and responses. An independent consultant was involved to confirm the thematic areas identified after which consensus discussions took place to finalize the analysed data. From the results, it appeared that there was a need that Implanon should be marketed by use of digital platforms and print media for information sharing. These platforms should be utilized by DOH from the National, provincial, district, facility and community levels. There should be clear protocol on how to manage different kinds of side effects, and this information should be rolled out to the implementation level. Health Care workers should provide client education and counselling services to the clients about the effectiveness of the method. Male partner involvement is crucial to provide support for women on contraceptives and to support their contraceptive choices. Mentorship will help providers to attain their proficiency in Implanon counselling, insertions, and removals. Lastly, availing adequate and effective youth-friendly services to enable young people to open up more about challenges and options that can be explored. For the adolescents and youth, these services should be provided by trained providers not at the general unit, where there is a mixture of adult population and the elderly, but at youth zones to enhance the uptake of Implanon NXT. Recommendations are for clinical practice area, for generic student education as well as for further research. The conclusions confirm that the government need to revitalise the Implanon program, to drive the uptake and reduce early removals. Training of health workers and mentorship should emphasize more comprehensive counselling, provide adequate information on what is to be expected and more importantly, how to treat and manage the side effects. That early removals due to side effects become the last option as information need to be widely available to all users utilising the traditional methods and modern methods such as digital platforms to spread the correct information and create demand for the Implanon. The functional service-provision-based youth-friendly services which will cater for the needs of young women and adolescents is highlighted as it provides a comfortable and conducive environment to provide and receive a comprehensive sexual reproductive health and rights services. , Thesis (MPH) -- Faculty of Health Sciences, 2021
- Full Text:
- Date Issued: 2021-11
- Authors: Magomani, Nandu Victoria https://orcid.org/ 0000-0001-5473-9984
- Date: 2021-11
- Subjects: Contraceptive drug implants
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/21849 , vital:51829
- Description: Implanon NXT also referred to as subdermal Implant, is a long-acting subdermal contraceptive method available in the South African public health care system since 2014. The implant was introduced to broaden the choice for women of childbearing age to delay or prevent unwanted pregnancies. Following a surge in popularity, reports of early removals and frequent adverse effects led to a significant decrease in its uptake in the country. Insufficient knowledge on Implanon, poor management of side effects, poor counseling by health care workers, and lack of partner support were the main themes that were picked from the interview, influencing uptake or early removals of the Implanon. The major concerning side effect reported was uncontrolled and irregular heavy bleeding The purpose of the study was to explore the factors associated with low uptake and early removals of Implanon NXT among women of reproductive age in one district in Limpopo province. A qualitative research design was used, primarily as exploratory and descriptive in nature. Participants were identified using non-probable, purposeful voluntary sampling. Data collection was achieved using open-ended structured interviews with sixteen (16) women aged from18-49. Data was analysed using thematic method of organizing data into categories, followed by coding and sorting the data to identify patterns and interpret the meanings and responses. An independent consultant was involved to confirm the thematic areas identified after which consensus discussions took place to finalize the analysed data. From the results, it appeared that there was a need that Implanon should be marketed by use of digital platforms and print media for information sharing. These platforms should be utilized by DOH from the National, provincial, district, facility and community levels. There should be clear protocol on how to manage different kinds of side effects, and this information should be rolled out to the implementation level. Health Care workers should provide client education and counselling services to the clients about the effectiveness of the method. Male partner involvement is crucial to provide support for women on contraceptives and to support their contraceptive choices. Mentorship will help providers to attain their proficiency in Implanon counselling, insertions, and removals. Lastly, availing adequate and effective youth-friendly services to enable young people to open up more about challenges and options that can be explored. For the adolescents and youth, these services should be provided by trained providers not at the general unit, where there is a mixture of adult population and the elderly, but at youth zones to enhance the uptake of Implanon NXT. Recommendations are for clinical practice area, for generic student education as well as for further research. The conclusions confirm that the government need to revitalise the Implanon program, to drive the uptake and reduce early removals. Training of health workers and mentorship should emphasize more comprehensive counselling, provide adequate information on what is to be expected and more importantly, how to treat and manage the side effects. That early removals due to side effects become the last option as information need to be widely available to all users utilising the traditional methods and modern methods such as digital platforms to spread the correct information and create demand for the Implanon. The functional service-provision-based youth-friendly services which will cater for the needs of young women and adolescents is highlighted as it provides a comfortable and conducive environment to provide and receive a comprehensive sexual reproductive health and rights services. , Thesis (MPH) -- Faculty of Health Sciences, 2021
- Full Text:
- Date Issued: 2021-11