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: 2019
- Subjects: Anesthesia in obstetrics , Labor (Obstetrics) , Pain -- Treatment
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/27187 , vital:66387
- 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, 2019
- Full Text:
- Date Issued: 2019
- Authors: Parkies, Limakatso Elizabeth
- Date: 2019
- Subjects: Anesthesia in obstetrics , Labor (Obstetrics) , Pain -- Treatment
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/27187 , vital:66387
- 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, 2019
- Full Text:
- Date Issued: 2019
Factors to improve data quality of electronic medical records
- Authors: Makeleni, Noloyiso Anele
- Date: 2019
- Subjects: Electronic records , Medical records -- Management , Medical records -- Data processing
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/19881 , vital:43618
- Description: Electronic Medical Record (EMR) systems have been identified as having the potential to improve health care and allow the health care sector to reap a number of benefits when implemented successfully. These benefits include enabling quick and easy access to patient files and also reducing the problem of misplaced or lost patient files. Such EMRs allow for patient records to be up to date, provided that health care practitioners capture standard and consistent data in the relevant fields. In Africa, there are only a few countries that have successfully implemented EMR systems due to social and technological challenges. Social factors include lack of computer skilled health workers, lack of adequate training, physician’s resistance to shift from using paper records to electronic records, either due to complex systems or the fear of being replaced by the systems. On the other hand, the technological factors include lack of Information Technology (IT) and clinical resources, lack of internet access, financial barriers to purchase the necessary technological hardware and implementation costs. A few South African health care institutions have implemented EMR systems, however, most of the public health care facilities still make use of a manual system to capture patient information. In the case where public health care facilities do have an EMR system implemented, there are problems with the consistency of the data that is captured. The inconsistency is caused by the different understandings that the health care professionals have regarding the importance of capturing the necessary information that is collected at various points in health care institutions, thus affecting data quality. For the successful implementation and use of EMR systems, everything within the health care organisation should be integrated. In other words, the steering committee and workgroup, the equipment, the product, the processes, the system and the facility design and construction should be incorporated to work together. The common problems identified in literature regarding data quality in EMRs include misspelled words, inconsistent word strings, inaccurate information entered on the record and incompleteness of the record. These problems lead to poor quality information, lack of accessibility of the record, poorly organised notes and inaccurate information about the patient. The South African strategy aims to implement a National Health Insurance (NHI) which will provide citizens with equitable access to health care. For the successful implementation of the NHI strategy, South African health care sectors should address the barriers which were identified and learn from other African countries that have successfully implemented EMR systems and had positive outcomes. Therefore, this study investigates how data quality can be improved on electronic medical records in public health care in South Africa? The qualitative research methodology approach was used for this study. Interviews were conducted with eight health care professionals at Klerksdorp, in the North West province to obtain data regarding the factors they would deem important for the improvement of data quality in EMRs. The Data Quality Framework (DQF) was applied in this study and six dimensions were identified as the factors to improve data quality. These dimensions include completeness, accuracy, consistency, conformity, timeliness, and integrity. From the analysis of the interview responses, it was discovered that there were, in fact, data quality issues experienced at the public health care facilities of South Africa. A need was identified for the use of data quality assessment tools and solutions to address the data quality issues or challenges that health care practitioners are faced with during their daily jobs. Seven barriers were also identified as having an impact on the successful implementation of EMRs at health care institutions. These barriers, together with the data quality issues, influence the successful use of EMRs and should not be overlooked. From these barriers the study developed seven Critical Success Factors which can be used by the National Department of Health to improve the quality of EMRs. , Thesis (MCom) -- Faculty of Management and Commerce, 2019
- Full Text:
- Date Issued: 2019
- Authors: Makeleni, Noloyiso Anele
- Date: 2019
- Subjects: Electronic records , Medical records -- Management , Medical records -- Data processing
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/19881 , vital:43618
- Description: Electronic Medical Record (EMR) systems have been identified as having the potential to improve health care and allow the health care sector to reap a number of benefits when implemented successfully. These benefits include enabling quick and easy access to patient files and also reducing the problem of misplaced or lost patient files. Such EMRs allow for patient records to be up to date, provided that health care practitioners capture standard and consistent data in the relevant fields. In Africa, there are only a few countries that have successfully implemented EMR systems due to social and technological challenges. Social factors include lack of computer skilled health workers, lack of adequate training, physician’s resistance to shift from using paper records to electronic records, either due to complex systems or the fear of being replaced by the systems. On the other hand, the technological factors include lack of Information Technology (IT) and clinical resources, lack of internet access, financial barriers to purchase the necessary technological hardware and implementation costs. A few South African health care institutions have implemented EMR systems, however, most of the public health care facilities still make use of a manual system to capture patient information. In the case where public health care facilities do have an EMR system implemented, there are problems with the consistency of the data that is captured. The inconsistency is caused by the different understandings that the health care professionals have regarding the importance of capturing the necessary information that is collected at various points in health care institutions, thus affecting data quality. For the successful implementation and use of EMR systems, everything within the health care organisation should be integrated. In other words, the steering committee and workgroup, the equipment, the product, the processes, the system and the facility design and construction should be incorporated to work together. The common problems identified in literature regarding data quality in EMRs include misspelled words, inconsistent word strings, inaccurate information entered on the record and incompleteness of the record. These problems lead to poor quality information, lack of accessibility of the record, poorly organised notes and inaccurate information about the patient. The South African strategy aims to implement a National Health Insurance (NHI) which will provide citizens with equitable access to health care. For the successful implementation of the NHI strategy, South African health care sectors should address the barriers which were identified and learn from other African countries that have successfully implemented EMR systems and had positive outcomes. Therefore, this study investigates how data quality can be improved on electronic medical records in public health care in South Africa? The qualitative research methodology approach was used for this study. Interviews were conducted with eight health care professionals at Klerksdorp, in the North West province to obtain data regarding the factors they would deem important for the improvement of data quality in EMRs. The Data Quality Framework (DQF) was applied in this study and six dimensions were identified as the factors to improve data quality. These dimensions include completeness, accuracy, consistency, conformity, timeliness, and integrity. From the analysis of the interview responses, it was discovered that there were, in fact, data quality issues experienced at the public health care facilities of South Africa. A need was identified for the use of data quality assessment tools and solutions to address the data quality issues or challenges that health care practitioners are faced with during their daily jobs. Seven barriers were also identified as having an impact on the successful implementation of EMRs at health care institutions. These barriers, together with the data quality issues, influence the successful use of EMRs and should not be overlooked. From these barriers the study developed seven Critical Success Factors which can be used by the National Department of Health to improve the quality of EMRs. , Thesis (MCom) -- Faculty of Management and Commerce, 2019
- Full Text:
- Date Issued: 2019
Indigenisation and participatory development in Zimbabwe: the case of the indigenisation and empowerment policy
- Musasa, Gabriel https://orcid.org/0000-0003-1906-5624
- Authors: Musasa, Gabriel https://orcid.org/0000-0003-1906-5624
- Date: 2019
- Subjects: Community development -- Zimbabwe , Zimbabwe -- Economic conditions
- Language: English
- Type: Doctoral theses , text
- Identifier: http://hdl.handle.net/10353/20359 , vital:45657
- Description: The study analysed the Indigenisation and Economic Empowerment Programme (IEEP) with regard to majority participation and its implementation, given the unfriendly macroeconomic and international environment the country is currently facing. The IEEP is claimed to be addressing poverty and seeking to promote economic participation of indigenous Zimbabweans, particularly targeting women, youth and disabled sections of society. The main aim of the study was to analyse the outcomes of the IEEP with regard to creating space for participation and to promote social justice of Zimbabwean nationals in the main economic sectors of the country, which are agriculture, manufacturing, mining and tourism. Using a qualitative approach, this study analysed the perspectives of government, non-governmental organisations, academics and the marginalised groups of women, disabled and youth in Zimbabwe through interviews and focus group discussions. The data from the fieldwork was analysed using the thematic approach. The findings revealed that a new elite of black entrepreneurs has emerged and foreign capital is diminishing, with limited success being attributed to policy outputs, particularly the community share ownership schemes and employee share ownership scheme. However, the policy did not produce positive outcomes as expected, owing to lack of policy clarity, heavy politicisation and political manoeuvring, as well as lack of information, education and training. Further problems were corruption, lack of support for beneficiaries, lack of funding, the unfavourable macro-economic environment, the liquidity crisis, limited access to credit facilities, broken internal politics and exclusion, lack of monitoring and evaluation, economic sanctions and international isolation. The programme fell victim to improper association and some institutional inertia. Participation in the IEEP, as implied in the social justice approach, does not fully embrace attainment of basic liberties and equality of opportunity, mainly because of the patterns of accumulation, dispossession, economic structures and social relations that are politicised. Elite capture, ethnic and regional segregation, the macro-economic environment and the narrow focus on the formal sector that led to the collapse of industry are the major hurdles to participation. Efforts to facilitate equality of opportunity for women and people with disabilities are heavily subdued by the lack of good institutional support that may enable meaningful participation and possibly yield better outcomes for the worst off in society. The IEEP has failed to redress the inequalities inherent in Zimbabwean economy, with evidence from the findings that the majority cannot take the opportunities that are offered by the programme. The study identified a way forward on how participation can be incorporated in the comprehensive framework for socio-economic development in Zimbabwe through a menu of intervention, giving direction to what needs to be done for individuals and communities to participate in the IEEP in a meaningful way. In particular, this will involve land entitlement, promoting innovation in global value chains, a hybridised two-pathway model of indigenisation, a disability intervention model, and a sustainable model of community share ownership schemes. These interventions are ideal for bringing about the desired aspiration of transformation in a sustainable way in Zimbabwe, as well as fostering social justice for people with disabilities. , Thesis (DPhil) -- Faculty of Management and Commerce, 2020
- Full Text:
- Date Issued: 2019
- Authors: Musasa, Gabriel https://orcid.org/0000-0003-1906-5624
- Date: 2019
- Subjects: Community development -- Zimbabwe , Zimbabwe -- Economic conditions
- Language: English
- Type: Doctoral theses , text
- Identifier: http://hdl.handle.net/10353/20359 , vital:45657
- Description: The study analysed the Indigenisation and Economic Empowerment Programme (IEEP) with regard to majority participation and its implementation, given the unfriendly macroeconomic and international environment the country is currently facing. The IEEP is claimed to be addressing poverty and seeking to promote economic participation of indigenous Zimbabweans, particularly targeting women, youth and disabled sections of society. The main aim of the study was to analyse the outcomes of the IEEP with regard to creating space for participation and to promote social justice of Zimbabwean nationals in the main economic sectors of the country, which are agriculture, manufacturing, mining and tourism. Using a qualitative approach, this study analysed the perspectives of government, non-governmental organisations, academics and the marginalised groups of women, disabled and youth in Zimbabwe through interviews and focus group discussions. The data from the fieldwork was analysed using the thematic approach. The findings revealed that a new elite of black entrepreneurs has emerged and foreign capital is diminishing, with limited success being attributed to policy outputs, particularly the community share ownership schemes and employee share ownership scheme. However, the policy did not produce positive outcomes as expected, owing to lack of policy clarity, heavy politicisation and political manoeuvring, as well as lack of information, education and training. Further problems were corruption, lack of support for beneficiaries, lack of funding, the unfavourable macro-economic environment, the liquidity crisis, limited access to credit facilities, broken internal politics and exclusion, lack of monitoring and evaluation, economic sanctions and international isolation. The programme fell victim to improper association and some institutional inertia. Participation in the IEEP, as implied in the social justice approach, does not fully embrace attainment of basic liberties and equality of opportunity, mainly because of the patterns of accumulation, dispossession, economic structures and social relations that are politicised. Elite capture, ethnic and regional segregation, the macro-economic environment and the narrow focus on the formal sector that led to the collapse of industry are the major hurdles to participation. Efforts to facilitate equality of opportunity for women and people with disabilities are heavily subdued by the lack of good institutional support that may enable meaningful participation and possibly yield better outcomes for the worst off in society. The IEEP has failed to redress the inequalities inherent in Zimbabwean economy, with evidence from the findings that the majority cannot take the opportunities that are offered by the programme. The study identified a way forward on how participation can be incorporated in the comprehensive framework for socio-economic development in Zimbabwe through a menu of intervention, giving direction to what needs to be done for individuals and communities to participate in the IEEP in a meaningful way. In particular, this will involve land entitlement, promoting innovation in global value chains, a hybridised two-pathway model of indigenisation, a disability intervention model, and a sustainable model of community share ownership schemes. These interventions are ideal for bringing about the desired aspiration of transformation in a sustainable way in Zimbabwe, as well as fostering social justice for people with disabilities. , Thesis (DPhil) -- Faculty of Management and Commerce, 2020
- Full Text:
- Date Issued: 2019
The role of local economic development in the empowerment of women in rural areas : the case of Makana Municipality
- Authors: Hani, Nomkita Octavia
- Date: 2019
- Subjects: Economic development , Women in development
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/19772 , vital:43237
- Description: The aim of the study was to explore the role of Local economic development (LED) in empowering rural women in Makana Municipally. The researcher intended to achieve the following objectives (i) to assess the role of LED among the rural women of Makana Municipality in strengthening economic development ii) to explore the LED challenges confronted by the community and the municipality in the implementation of economic empowerment programs that will create economic opportunities for rural women iii) to identify the way forward in enhancing the LED strategy to empower rural women to enable them participate in economic programs of the local Municipality that will benefit them and the community. The study adopted a qualitative approach and purposive sampling methods which were used to select samples for the study. Open ended questions were used in face to face interviews and focus groups to collect data in Makana Municipality. The study findings indicated that while women are part LED activities in the Makana municipality, the benefits that accrue to them are still minimal and trickling down to very few of them because of egoism and nepotism, corruption and crime, favouritism and poor communication. There is a great need for interventions requiring regular visits from LED officials and provision of educational programs in the local language, to enable the women to have a clear understanding of the benefits that accrue to them from LED projects, notwithstanding the opportunities open to them for participation. The study then proposed recommendations to empower women which include making resources available for their empowerment, such as, the provision of skill development programs, knowledge and information distribution, reviewing of the LED policy, infrastructure development and access to markets. , Thesis (MCom) -- Faculty of Management and Commerce, 2019
- Full Text:
- Date Issued: 2019
- Authors: Hani, Nomkita Octavia
- Date: 2019
- Subjects: Economic development , Women in development
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/19772 , vital:43237
- Description: The aim of the study was to explore the role of Local economic development (LED) in empowering rural women in Makana Municipally. The researcher intended to achieve the following objectives (i) to assess the role of LED among the rural women of Makana Municipality in strengthening economic development ii) to explore the LED challenges confronted by the community and the municipality in the implementation of economic empowerment programs that will create economic opportunities for rural women iii) to identify the way forward in enhancing the LED strategy to empower rural women to enable them participate in economic programs of the local Municipality that will benefit them and the community. The study adopted a qualitative approach and purposive sampling methods which were used to select samples for the study. Open ended questions were used in face to face interviews and focus groups to collect data in Makana Municipality. The study findings indicated that while women are part LED activities in the Makana municipality, the benefits that accrue to them are still minimal and trickling down to very few of them because of egoism and nepotism, corruption and crime, favouritism and poor communication. There is a great need for interventions requiring regular visits from LED officials and provision of educational programs in the local language, to enable the women to have a clear understanding of the benefits that accrue to them from LED projects, notwithstanding the opportunities open to them for participation. The study then proposed recommendations to empower women which include making resources available for their empowerment, such as, the provision of skill development programs, knowledge and information distribution, reviewing of the LED policy, infrastructure development and access to markets. , Thesis (MCom) -- Faculty of Management and Commerce, 2019
- Full Text:
- Date Issued: 2019
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