A trend analysis of perinatal mortalities in Barberton Hospital between 2002 and 2016
- Authors: Modupe, Oluwarotimi Folorunsho
- Date: 2018
- Subjects: Newborn infants -- Mortality Perinatology
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: http://hdl.handle.net/10353/11254 , vital:37630
- Description: Background and aim: There is no doubt that the quantification of data on the new born is imperative towards the design of effective public health policy interventions. However, the trend in under-five mortality rates in Barberton Hospital is not recognised as no empirical investigation has been undertaken to ascertain its position in this regard. A trend analysis of infant and maternal deaths in will therefore shed light on possible factors influencing this trend. The specific objectives of this study were to examine the trend and causes of perinatal mortality in Barberton Hospital from 2002-2016. It was hypothesized that there would be a downward trend in the infant and maternal mortality rates in Barberton Hospital from 2002-2016, possibly as a result of improved medical care. Methods: This retrospective study was conducted in Barberton Hospital, located in the Umjindi sub-district in Mpumalanga Province. The data was drawn from the Perinatal Problem Identification Programme (PPIP) database. Pregnancy related deaths of women, and of children from birth to one year in Barberton Hospital from 1999-2014 were extracted. The population study consists of a record review of all infant and maternal deaths in Barberton Hospital from 2002-2016 and captured in the data on the PPIP. The University of Fort Hare ethical review committee approved the study protocol. In addition, permission to use the data was granted by the Mpumalanga Department of Health after applying for approval for use of the data for academic purposes. The data was then exported into an Excel format document and fed to Statistical Package for Social Sciences (SPSS) program to allow for a more detailed analysis. Results: Over the period under review (2002-2016), a total of 21151 babies were delivered, 20593 babies were alive at discharge, 221 babies died in the first 28 days of delivery, and 337 babies were stillbirths. 18577 were normal weight (≥2500gram), 1581 weighed 2000-2499 grams, 568 weighed 1500-1999grams, 286 weighed 1000-1499 and 139 weighed below 1000grams. All the women who gave birth over the period under review, 27.3percent tested positive to HIV, 40.3 percent tested negative. Of all women that tested positive, 80.2percent received any form of ART. For over half of women that received ART (n=2981), the type of ART they received is unknown. Most women whose baby died were young. One in five women did not have their age captured in the database indicating an important gap that need to be addressed in order to ensure integrity of the database. Of all the 558 perinatal mortality, 75.3 weighed below 2500 grams. Low birth weight is major risk factor for child mortality. Babies weighing less than 2,500 grams are 20 times more likely to die than heavier babies. For all the perinatal deaths, the majority of their mothers received antenatal care services. About 86.6percent were delivered at Barberton Hospital and only 1 child was delivered in transit to the hospital. Of all the 558 deaths, only 7.5 percent was multiple births. Of the 558 babies that died, only 39.6percent were born alive, 37.1percent was macerated stillbirths. The syphilis serology test indicated that most mothers tested negative. The HIV serology test indicated that 28percent of mothers tested positive. The hospital recorded a total of 337 stillbirths between 2002 and 2016. This accounts for 60.2percent of all perinatal mortality over the period. Of all stillbirths, 61.6percent was macerated stillbirths. Yearly analysis of stillbirth rate did not clearly indicate whether stillbirth rate is increasing or declining. Not less than 56 primary obstetric causes of perinatal deaths were identified in this study. Many perinatal deaths were unexplainable due to lack of post-mortem. Idiopathic preterm labour was the main primary obstetric cause of early (34.5percent) and late neonatal (38.9percent) deaths, and the next was labour related intrapartum asphyxia. Labour related intrapartum asphyxia also accounts for 6.8percent of all stillbirths. The main known primary obstetric cause of stillbirth in the Hospital was Proteinuric hypertension/hypertension disorders. Over 60percent of perinatal mortality in Barberton Hospital was due to associated maternal conditions. Only 10.9percent was due to fetal related conditions and 26.4percent was unexplained. Few deaths were due to health system failure and domestic violence. Spontaneous preterm labour (18.4percent), abnormal labour or uterine rupture (14.5percent), maternal hypertension (12.4percent), antepartum haemorrhage (10.2percent) were the main associated maternal conditions causes of perinatal mortality in Barberton Hospital. Similarly, Fetal abnormality and infections were the main associated fetal condition causes of perinatal mortality. Of all the babies that were alive at birth, 85.2percent died due to maternal related conditions. Most neonates died due to spontaneous preterm labour (43.5percent) and abnormal labour or uterine rupture (23.1percent). Maternal HIV, diabetics and syphilis only accounted for a few neonatal deaths. For stillbirth babies that were alive at admission, abnormal labour or uterine rupture (33.1percent) and antepartum haemorrhage (19.7percent) were the main causes of their death. Over 60percent of all of macerated deaths have unexplained causes. Maternal hypertension is the main known cause of macerated stillbirth. For stillbirths that were dead on admission, maternal hypertension (13.1percent), antepartum haemorrhage (26.2percent) and abnormal labour or uterine rupture were the main causes of deaths. The majority of perinatal deaths in the hospital were caused by intrauterine deaths (58.8percent). Extreme multi-organ immaturity (13.1percent), Hyaline membrane disease (7.2percent) and Hypoxic ischaemic encephalopathy (5.2percent) were among the main final causes of perinatal deaths. The main behavioural factor causing perinatal mortality in Mpumalanga province was non-use of antenatal care services. The majority of perinatal mortality (60.4percent) was due to health system related causes. Most perinatal deaths were due to poor management of cases and delayed referral. Conclusion: The findings indicate that while stillbirths have slightly declined, neonatal deaths have not declined over the period. Perinatal have slightly declined in the hospital. The findings of this study also indicate that the majority of perinatal deaths in the hospital were caused by idiopathic preterm labour, unexplained intrauterine deaths, hypertension, and intrapartum asphyxia. Patient and health system related factors contributed significantly to perinatal deaths in the hospital. There is a need for yearly analysis of PPIP data to track progress and identify area for continuous improvement in provision of quality obstetric services. A greater community awareness of risk factors for perinatal deaths and importance of early and regular take up antenatal care services is needed.
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- Date Issued: 2018
School principals' leadership behaviours in relation to teacher job dissatisfaction : a case of three rural schools in the Butterworth Education District
- Authors: Nohako, Siphumle
- Date: 2018
- Subjects: School principals Teacher-administrator relationships Teachers -- Job satisfaction
- Language: English
- Type: Thesis , Masters , MEd.
- Identifier: http://hdl.handle.net/10353/11216 , vital:37320
- Description: There is an increasing dissatisfaction among teachers in South Africa. Teacher job dissatisfaction has been found to have negative impact on how teachers perform their jobs, is likely to influence teachers to leaving the teaching profession and impact negatively on learner achievement. Finding ways to combat the problems is of utmost importance. Leadership behaviours of school principals have been found to be one of the key factors that positively affect teacher job dissatisfaction. This qualitative study sought to understand leadership behaviours employed by rural school principals in relation to teacher job dissatisfaction. This was a case study of three schools in the Butterworth Education District in the Eastern Cape Province. A total of three principals and twelve teachers participated in the study. Semi-structured interviews and documentary analysis were data collection instruments utilised in this study. House’s Path Goal Theory was identified as the relevant theory for understanding school principals’ leadership behaviours in relation to teacher job dissatisfaction. Findings revealed that, school principals are aware of the manifestations of teacher job dissatisfaction at their schools. However, teacher job satisfaction does not feature as an agenda item in both staff and school management meetings. Moreover school principals were found to be employing various leadership behaviours to respond to different manifestations of teacher job dissatisfaction. Leadership behaviours like participative and transformational were found to have a positive impact on teacher job dissatisfaction. Directive and laissez-faire were found not suitable in improving teacher job dissatisfaction. Findings also unearthed tensions between school principals’ leadership behaviours and teachers’ expectations on how principals should lead in relation to teacher job dissatisfaction. This study proposes that, as leaders school principals should act in both formal and informal ways to build teacher commitment in their organizations and influence teachers to achieve the goals and objectives of the school. School principals should create platforms where teacher job dissatisfaction is discussed and strategies to improve it are explored. This would help them to be aware of how their leadership behaviours impact on teacher job satisfaction and thereby make conscientious decisions to improve the level of teacher job dissatisfaction.
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- Date Issued: 2018
The impact of social cash transfers on children's wellbeing : a case study of the Harmonized Social Cash Transfer Scheme in selected households in the Epworth District of Zimbabwe
- Authors: Chawatama, Christopher Taurai
- Date: 2018
- Subjects: Child welfare Social work with children Family social work
- Language: English
- Type: Thesis , Masters , MSoc
- Identifier: http://hdl.handle.net/10353/11298 , vital:39054
- Description: This study investigated the impact of the Harmonized Social Cash Transfer Scheme (HSCT) on the children’s wellbeing specifically on their education, health, food consumption and nutrition as well as on child labour practices. The study area was Epworth District where the study sample, respondents and participants were drawn. Semi structured in-depth interviews and survey questionnaires were used to collect data. What was problematized in the study was that although social cash transfers have gained traction as a poverty alleviation tool used by many governments, their authenticity, sensitiveness and impact on child wellbeing is still being questioned. The study yielded that the HSCT generally led to the improvement of the beneficiary children’s wellbeing. In terms of education the HSCT contributed positively towards children school enrolment, school attendance, school performance and also significantly reduced school absenteeism. Furthermore, the HSCT also removed underlying impediments such as transport costs and consultation fees that prevented the poor from accessing health care facilities. However poor service delivery by government health facilities has threatened to derail initiatives and milestones achieved by the HSCT in improving the health of children. It emerged from the study that the HSCT led to the improvement of the children’s food consumption particularly in terms of quantity. However in terms of quality not much success was recorded because of the small value of the transfer money and also escalating food prices. In addition, the HSCT also led to the reduction of child labour practices as children were enrolled and kept in school hence making them unavailable for work. Money availability also saw external labour being hired to work instead of children. The study noted that the small value of the HSCT is an impediment to the full realisation of child wellbeing. Not much success was recorded in enhancing the nutritional composition of the meals because of the small equitable access to health care was not achieved since private health facilities charge exorbitant fees. Additionally child labour practices could not be totally eliminated because additional income was still needed. The study recommends that for maximum results to be reaped on child wellbeing social cash transfers need to be supplemented and complemented by interventions that strengthens the livelihoods of household. It is also vital to reinforce the goods and services supply infrastructure. This entails the government’s action in strengthening schools, government health facilities and enhancing overall food security in the communities.
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- Date Issued: 2018
Applicability of putative probiotic bacteria to replace antibiotics as growth promoters in commercial and indigenous piglets
- Authors: Dlamini, Ziyanda Confidence
- Date: 2017
- Subjects: Antibiotics , Dietary supplements , Piglets
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: http://hdl.handle.net/10353/11428 , vital:39071
- Description: Antibiotic use in pig production contributes to development of antimicrobial resistance in food animals and risk of antibiotic residues in animal food products. The use of probiotics appears to be the potential alternative to antibiotics. This work is designed to validate the applicability of administered direct-fed putative probiotic strains of Lactobacillus reuteri ZJ625, Lactobacillus reuteri VB4, Lactobacillus salivarius ZJ614 and Streptococcus salivarius NBCR 13956 on growth performance, hematological parameters, and antibody stimulation in weaned commercial and indigenous pigs. Forty-five weaned piglets were divided into five treatment experimental groups as follows: Diet with: antibiotic (PC), No antibiotic and no probiotic (NC), Probiotic (P1) (P2) combination of probiotics (P3). Piglets’ performance were monitored during the trial. Faecal and ileum samples were collected for microbial count analysis. Blood samples were collected from the sacrificed piglets at the end of the trial, for the hematological and biochemical analysis and probiotics ability to stimulate immunoglobulin G (IgG). Four probiotic strains were tested for cell surface hydrophobicity against xylene, chloroform and ethyl acetate. The strains were also tested for auto-aggregation and co-aggregation abilities. Enterococcus faecalis ATCC 29212 was used as a control pathogen in the co-aggregation ability test. The probiotic strains were also screened for presence of virulence and resistance genes. DNA was extracted from all the four probiotic strains using ZR Fungal/Bacterial DNA MiniPepTM (Zymo Research, USA) following manufacturer’s instructions. The DNA samples were later amplified in PCR reactions with specific primers to detect virulence genes of adhesion collagen protein (ace), aggregation substances (agg and asa); antibiotic resistance genes of: Vancomycin vanA, Vancomycin vanC1 and Vancomycin vanC2/3. The data was analyzed by one-way ANOVA using SAS statistics software (SAS 9.3) (2003). Results from the study revealed that supplementation of probiotics had no effect on feed intake (FI) in all of the experimental groups. However, supplementation of probiotics in P3 treatment resulted in greater average daily gain (ADG) and improved feed conversion ratio (FCR) of weaned piglets (p < 0.05). Microbial count of fecal samples from all the treatment groups did not differ while ileum samples had lower enteric bacteria in P3 group as compared to other treatments. Concentration of albumin, globulin, neutrophils and basophils were high in NC treatment compared to other treatments. (p < 0.05). IgG concentration was highest in P3 compared to other treatment (p < 0.05). All probiotics strains showed high hydrophobicity to all solvents used in the test. Cell Surface Hydrophobic was highest in xylene (78percent – 84percent), followed by chloroform (68percent – 75percent) and lowest in ethyl acetate (52percent - 60percent). All of the test strains showed high auto-aggregation ability after 4 hr of incubation. L .reuteri VB4 exhibited highest auto-aggregation ability of 70percent, while the least auto-aggregation ability of 60percent was observed for L. salivarius ZJ614. In the co-aggregation assays, all probiotic bacterial strains exhibited a strong co-aggregation of 45percent to 56percent after 4 hr of incubation at 37 °C. L. reuteri VB4 exhibited highest co-aggregation ability while L. salivarius ZJ614 exhibited the lowest co-aggregation ability. No presence of virulence genes ace and asa was detected in all of the putative probiotic strains, but agg virulence gene was detected in L. reuteri VB4 strains. L. reuteri VB4 and S. salivarius NBRC13956 had resistance genes vanC 2/3 and vanC1, respectively. Overall, the results from this study, suggest that the candidate probiotics strains have enhanced the growth and measured blood parameters of the weaned piglets used in these experiments, and also, the probiotic strains have the abilities to initiate the stimulation of IgG. Probiotics could be used as a novel alternative to antibiotics in the animal nutrition and production, with the abilities to confer health benefits and promote growth. The outcome of the research advocates that these probiotics will be beneficial to pig production, and might outcompete the current antibiotics in use as growth promoters. One of the major advantages of probiotics to pig industry is the production of antibiotic free and good quality pork meat to local and international consumers, thus, enhancing South African Pork industry.
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- Date Issued: 2017
Factors that influence the career success of women managers at a historically black institution in South Africa
- Authors: Chikuya, Albeter Fungai
- Date: 2017
- Subjects: Women executives -- South Africa Universities and colleges -- South Africa Career development -- South Africa
- Language: English
- Type: Thesis , Masters , MCom
- Identifier: http://hdl.handle.net/10353/11275 , vital:39052
- Description: Orientation: The government of South Africa is making efforts to facilitate the inclusion of women in the workplace, even though they still encounter various career barriers that inhibit their career success. Research purpose: The main purpose of the study was to investigate the factors influencing the career success of women managers at a historically black institution. Motivation: Most studies that focused on career success opted for a positivist research paradigm, but this study is amongst the few that has employed the interpretivism paradigm to enable the researcher to understand subjectively the occupational challenges women experience. Research approach, design, methodology: The study was conducted to ascertain the factors that influence the career success of women managers. A sample of 20 participants was selected, and one on one semi-structured interviews were conducted with women managers who are currently working at the University of Fort Hare. A qualitative approach was suitable for the study because the challenges of the participants were expressed from their lived experiences. The interviews were analysed using Braun and Clarke's six steps of data analysis. Main findings: The study revealed that women experience similar career challenges as they go up their career ladder. Such challenges include gender discrimination, resistance, the glass ceiling and work-life balance dilemma; hence, all these above affect the career success of women. Various themes emerged from the study, namely, the quests for further professional development and improvements, the heightened prioritisation of objective rewards and subjective rewards, negotiation between work and personal space as affecting career development and the resolution tactic: flee or fight. Practical/ managerial implications: An intervention is needed to ensure that organisations are more sensitive to the issues of women representation to top positions to enhance their career success. The study will be useful to both organisations and academics to design policies that will facilitate the career success of women. Contribution: The study is amongst the few that adopted the qualitative paradigm in investigating the factors influencing the career success of women managers, by understanding from their lived experiences. The implications of these findings for policy, practice and career counselling are suggested.
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- Date Issued: 2017
The implementation of leadership development strategic plan : a case study of the department of education in the Eastern Cape province
- Authors: Dom, Khanyiswa
- Date: 2017
- Subjects: Development leadership Strategic planning Performance
- Language: English
- Type: Thesis , Masters , MPA
- Identifier: http://hdl.handle.net/10353/11288 , vital:39053
- Description: The study used qualitative methodology to investigate and evaluate the implementation of leadership development strategic plan in the Eastern Cape Provincial Department of Education. The study sought to establish what does the Department‘s policy of leadership development entail to Human Resource Management and Development and what challenges are there in the implementation of the policy and what interventions are necessary to improve the implementation of the leadership policy. The study established that given the need for a transformed public service in line with the post-apartheid democratic dispensation, fundamental reforms to the administration, governance and the funding of education in general had to be given maximum attention hence the need for the adoption and implementation of the leadership development strategic plan in the Provincial Department of Education of the Eastern Cape. The study revealed that the nature of challenges that the department is facing speaks a lot the need for leadership development at the provincial level. However, the implementation of the strategic plan is marred by the challenges that include resources constraints and lack of funding among others. The study therefore came up with some recommendation that can help to improve the implementation of the leadership development plan in the public service sector especially as it relates to the Eastern Cape Provincial Department of Education.
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- Date Issued: 2017