Exploring the Correlation of Two Field Tests with Match-Related Performance in Female Premier League Hockey Players
- Authors: Knott-Craig, Hannah Sue
- Date: 2022-04
- Subjects: Women hockey players
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/58892 , vital:60245
- Description: Background: Field hockey is a stick and ball team sport which is comprised of technical and tactical components and requires elevated physical conditioning. Due to the intermittent and complex nature of field hockey, it has become increasingly difficult for coaches to accurately measure the players hockey specific fitness levels. For this reason, various fitness tests have been developed over the years. However, some of the fitness tests utilised to this day do not incorporate movements similar to match situations, and therefore, do not stress the same energy systems in a similar manner to match-play. Hence, the INTER test and Dynamic Yo-Yo test are being utilised in the current study as they incorporate similar movements seen in match-play, and they incorporate varying rest periods. The INTER test is a test that incorporates shuttles, maximal sprints and agility movements. Whereas the Dynamic Yo-Yo test only incorporates shuttles running with differing changes in angles. However, both of these tests have previously only been used in a soccer context, therefore, the results obtained were compared to soccer specific data. Match-related data was compared to current field hockey data. Aim and Objectives: The main aim of the research study was to determine whether the INTER test and the Dynamic Yo-Yo test correlate with match-related physiological demands and physical performance. There were three main objectives of the study. First, to determine and describe the physical and physiological responses in selected cohort off hockey players during match-play, the INTER test and the Dynamic Yo-Yo test. Second, to run correlations between the two field tests and match-play to identify relationships. Third was to identify the differences between the two field tests. Methods: Using a combination of purposive and convenience sampling, a total of 20 field hockey players from the Eastern Cape Premier Hockey League voluntarily participated in the study (age: 22.25 ± 3.16 years; height: 167.3 ± 2.61cm; weight: 59.4 ± 3.87). The participants were monitored during the INTER test, Dynamic Yo-Yo test and the field hockey matches. The following physiological and physical variables were monitored: heart rate, breathing rate, distance and speed. The participants were given a minimum of 24 hours recovery time between field tests and matches to ensure fatigue did not impact results. The monitoring during the field tests and match-play was done by all participants wearing the Zephyr BioHarness and QStarz global positioning system. VI Results: The mean distance achieved in the INTER test and the Dynamic Yo-Yo test both produced a statistically strong relationship to the mean distance achieved in the matches (r=0.82, p=0.000). The time spent in the INTER test and the Dynamic Yo-Yo test compared to the time spent in match-play showed a very weak correlation (r=0.19; r=-0.08). Both the mean breathing rate for the INTER test and the Dynamic Yo-Yo test resulted in a very strong correlations (r=0.8) which was statistically significant (p=0.000). Participants spend on average 72% of match-play at >85% HRpeak compared to the 52% and 78% spent at >85% HRpeak during the INTER test and the Dynamic Yo-Yo test respectively. The INTER test produced a greater number of statistically significant correlations with the combined matches compared to the Dynamic Yo-Yo test. When identifying the differences between the variables measured in the INTER test and the Dynamic Yo-Yo test, it was identified that there were many significant differences. Conclusions: Both the Dynamic Yo-Yo and the INTER test can be used by hockey coaches. However, the researcher would recommend the utilisation of the INTER test, because it displayed stronger, more significant correlations to match-play. The set-up of the INTER test is also more convenient as it can be conducted on the astro turf. While, both tests did have some correlations to match-play, additional tests would need to be included in a testing battery to provide coaches with complete profiles of the players in order to assist in team selections. , Thesis (MA) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-04
- Authors: Knott-Craig, Hannah Sue
- Date: 2022-04
- Subjects: Women hockey players
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/58892 , vital:60245
- Description: Background: Field hockey is a stick and ball team sport which is comprised of technical and tactical components and requires elevated physical conditioning. Due to the intermittent and complex nature of field hockey, it has become increasingly difficult for coaches to accurately measure the players hockey specific fitness levels. For this reason, various fitness tests have been developed over the years. However, some of the fitness tests utilised to this day do not incorporate movements similar to match situations, and therefore, do not stress the same energy systems in a similar manner to match-play. Hence, the INTER test and Dynamic Yo-Yo test are being utilised in the current study as they incorporate similar movements seen in match-play, and they incorporate varying rest periods. The INTER test is a test that incorporates shuttles, maximal sprints and agility movements. Whereas the Dynamic Yo-Yo test only incorporates shuttles running with differing changes in angles. However, both of these tests have previously only been used in a soccer context, therefore, the results obtained were compared to soccer specific data. Match-related data was compared to current field hockey data. Aim and Objectives: The main aim of the research study was to determine whether the INTER test and the Dynamic Yo-Yo test correlate with match-related physiological demands and physical performance. There were three main objectives of the study. First, to determine and describe the physical and physiological responses in selected cohort off hockey players during match-play, the INTER test and the Dynamic Yo-Yo test. Second, to run correlations between the two field tests and match-play to identify relationships. Third was to identify the differences between the two field tests. Methods: Using a combination of purposive and convenience sampling, a total of 20 field hockey players from the Eastern Cape Premier Hockey League voluntarily participated in the study (age: 22.25 ± 3.16 years; height: 167.3 ± 2.61cm; weight: 59.4 ± 3.87). The participants were monitored during the INTER test, Dynamic Yo-Yo test and the field hockey matches. The following physiological and physical variables were monitored: heart rate, breathing rate, distance and speed. The participants were given a minimum of 24 hours recovery time between field tests and matches to ensure fatigue did not impact results. The monitoring during the field tests and match-play was done by all participants wearing the Zephyr BioHarness and QStarz global positioning system. VI Results: The mean distance achieved in the INTER test and the Dynamic Yo-Yo test both produced a statistically strong relationship to the mean distance achieved in the matches (r=0.82, p=0.000). The time spent in the INTER test and the Dynamic Yo-Yo test compared to the time spent in match-play showed a very weak correlation (r=0.19; r=-0.08). Both the mean breathing rate for the INTER test and the Dynamic Yo-Yo test resulted in a very strong correlations (r=0.8) which was statistically significant (p=0.000). Participants spend on average 72% of match-play at >85% HRpeak compared to the 52% and 78% spent at >85% HRpeak during the INTER test and the Dynamic Yo-Yo test respectively. The INTER test produced a greater number of statistically significant correlations with the combined matches compared to the Dynamic Yo-Yo test. When identifying the differences between the variables measured in the INTER test and the Dynamic Yo-Yo test, it was identified that there were many significant differences. Conclusions: Both the Dynamic Yo-Yo and the INTER test can be used by hockey coaches. However, the researcher would recommend the utilisation of the INTER test, because it displayed stronger, more significant correlations to match-play. The set-up of the INTER test is also more convenient as it can be conducted on the astro turf. While, both tests did have some correlations to match-play, additional tests would need to be included in a testing battery to provide coaches with complete profiles of the players in order to assist in team selections. , Thesis (MA) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-04
Hook, Line, and Sinker: Fishing in the Online Relationship Realm, an Exploration of Addictiveness in Online Romantic Relationships
- Authors: Froneman, Carmen Michelle
- Date: 2022-04
- Subjects: Online dating , Relationship addiction
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/58871 , vital:60229
- Description: In an online space where individuals are meeting and creating relationships, it is important to explore and understand the nuanced, complex psychological phenomena that occur. Current psychological research into the phenomena of online addictiveness has gained traction with international studies exploring and expanding on this phenomena. Definitions of internet addiction differ widely, but research indicates that addicts expend large amounts of time online and that using the internet becomes a significant part of their everyday lives. Consequently, exploring individual’s experiences of online addiction within a romantic context becomes more relevant. The aim of this study was to explore and describe adults lived experiences of addictiveness in the context of online romantic relationships by expanding on the previous data of Froneman’s (2016) study. The present study utilised a qualitative approach and was exploratory and descriptive in design. The sample size of the present study was seven adult participants and semi-structured interviews were utilised as the method of data collection. Themes including motivation for using online dating, spending time online and the Biopsychosocial dynamics were identified through the participant’s narratives. These findings ultimately can be used for future research. , Thesis (MA) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-04
- Authors: Froneman, Carmen Michelle
- Date: 2022-04
- Subjects: Online dating , Relationship addiction
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/58871 , vital:60229
- Description: In an online space where individuals are meeting and creating relationships, it is important to explore and understand the nuanced, complex psychological phenomena that occur. Current psychological research into the phenomena of online addictiveness has gained traction with international studies exploring and expanding on this phenomena. Definitions of internet addiction differ widely, but research indicates that addicts expend large amounts of time online and that using the internet becomes a significant part of their everyday lives. Consequently, exploring individual’s experiences of online addiction within a romantic context becomes more relevant. The aim of this study was to explore and describe adults lived experiences of addictiveness in the context of online romantic relationships by expanding on the previous data of Froneman’s (2016) study. The present study utilised a qualitative approach and was exploratory and descriptive in design. The sample size of the present study was seven adult participants and semi-structured interviews were utilised as the method of data collection. Themes including motivation for using online dating, spending time online and the Biopsychosocial dynamics were identified through the participant’s narratives. These findings ultimately can be used for future research. , Thesis (MA) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-04
Invasive radiological procedures: patients’ satisfaction with radiographers’ care in public hospitals in Ghana and South Africa
- Authors: Denteh, Derrick Kofi
- Date: 2022-04
- Subjects: Hospitals -- Radiological services , Patient satisfaction -- Africa
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/58772 , vital:60097
- Description: There has been a steady increase in invasive radiological procedures throughout the world. The situation is no different in Ghana and South Africa where the governments have sought to increase the equipment available for such procedures in public hospitals. However, complaints by patients and radiographers at the two public hospitals in Ghana and South Africa suggested that not all patients are satisfied with the radiographers’ care provided during invasive radiological procedures. The study aimed to investigate patients’ satisfaction with radiographers’ care during invasive radiological procedures at two public hospitals in Ghana and South Africa, and thereafter to do a comparison of the two hospitals. The study utilised a quantitative, comparative descriptive design. The theoretical framework that guided this study was Cox’s Interaction Model of Client Health Behaviour. The research population consisted of participants who had undergone various invasive radiological procedures. The data were collected by means of a structured self-administered questionnaire. The reliability and validity of the data collection instrument was enhanced by conducting a pilot study as well as through peer review and the guidance of a statistician. Descriptive and inferential statistical analyses were undertaken and presented in the form of tables and graphs. The study was conducted in an ethical manner by adhering to the principles of beneficence, justice and respect for persons. Overall, there was greater patient satisfaction with radiographers’ care in Ghana than in South Africa. Regarding patient satisfaction and health information, a statistically significant difference was observed between both countries (t = 10.02, df = 218, p = 0.000 and d = 1.36). Concerning patient satisfaction and affective support, a statistically significant difference was observed with a medium effect size (t = -4.34, df = 22, p = 0.000, d = 0.59). Patient satisfaction and decisional control was shown to have a statistically significant difference between the two countries (t = 20.27, df = 218, p = 0.000 and d = 2.73). Regarding professional/technical competencies, a statistically significant difference was observed with large size effect between the two countries (t = -6.77, df = 22, p = 0.000 and d = 0.91). In conclusion, the two countries were shown to differ regarding patient satisfaction in relation to Cox’s domains of health information, decisional control, affective support v and professional/technical competencies. In Ghana, there was greater patient satisfaction in relation to health information and decisional control than in South Africa. Conversely, in South Africa patient satisfaction in relation to affective support and professional/technical competencies was higher than in Ghana. As such, patient satisfaction could be improved if radiography management seeks to find ways to address these aspects in the hospitals under study in Ghana and South Africa. , Thesis (MA) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-04
- Authors: Denteh, Derrick Kofi
- Date: 2022-04
- Subjects: Hospitals -- Radiological services , Patient satisfaction -- Africa
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/58772 , vital:60097
- Description: There has been a steady increase in invasive radiological procedures throughout the world. The situation is no different in Ghana and South Africa where the governments have sought to increase the equipment available for such procedures in public hospitals. However, complaints by patients and radiographers at the two public hospitals in Ghana and South Africa suggested that not all patients are satisfied with the radiographers’ care provided during invasive radiological procedures. The study aimed to investigate patients’ satisfaction with radiographers’ care during invasive radiological procedures at two public hospitals in Ghana and South Africa, and thereafter to do a comparison of the two hospitals. The study utilised a quantitative, comparative descriptive design. The theoretical framework that guided this study was Cox’s Interaction Model of Client Health Behaviour. The research population consisted of participants who had undergone various invasive radiological procedures. The data were collected by means of a structured self-administered questionnaire. The reliability and validity of the data collection instrument was enhanced by conducting a pilot study as well as through peer review and the guidance of a statistician. Descriptive and inferential statistical analyses were undertaken and presented in the form of tables and graphs. The study was conducted in an ethical manner by adhering to the principles of beneficence, justice and respect for persons. Overall, there was greater patient satisfaction with radiographers’ care in Ghana than in South Africa. Regarding patient satisfaction and health information, a statistically significant difference was observed between both countries (t = 10.02, df = 218, p = 0.000 and d = 1.36). Concerning patient satisfaction and affective support, a statistically significant difference was observed with a medium effect size (t = -4.34, df = 22, p = 0.000, d = 0.59). Patient satisfaction and decisional control was shown to have a statistically significant difference between the two countries (t = 20.27, df = 218, p = 0.000 and d = 2.73). Regarding professional/technical competencies, a statistically significant difference was observed with large size effect between the two countries (t = -6.77, df = 22, p = 0.000 and d = 0.91). In conclusion, the two countries were shown to differ regarding patient satisfaction in relation to Cox’s domains of health information, decisional control, affective support v and professional/technical competencies. In Ghana, there was greater patient satisfaction in relation to health information and decisional control than in South Africa. Conversely, in South Africa patient satisfaction in relation to affective support and professional/technical competencies was higher than in Ghana. As such, patient satisfaction could be improved if radiography management seeks to find ways to address these aspects in the hospitals under study in Ghana and South Africa. , Thesis (MA) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-04
Linkage to care of HIV clients following diagnosis in Engcobo Sub-district, Eastern Cape
- Authors: Mthini, Sandiso
- Date: 2022-04
- Subjects: Primary care (Medicine) , HIV infections AIDS (Disease) -- South Africa
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/27017 , vital:66223
- Description: Background: “Linkage to care” is an essential strategy in place for the retention of HIV diagnosed clients on treatment. It is vital throughout the management and care of an HIV client. Aim of the study was to explore the effectiveness of “linkage to care” of HIV clients following the diagnosis in the Engcobo sub-district, Eastern cape. Methodology: Qualitative, explorative, descriptive study design was used to explore and describe the effectiveness of “linkage to care” of HIV clients following diagnosis in the Engcobo sub-district. The population for the study were all healthcare workers, who are involved in the program of “linkage to care” of HIV positive clients. Purposive Sampling was used to select professional nurses, Community healthcare workers, Lay counsellors, linkage officers who are involved in the linkage of HIV positive patients and the facility managers whom their facilities provide HIV care services. Interview guide was used to collect data and Tesch’s method was used to analyse data. Findings: Themes that emerged from the study were flexible time to “linkage to care”; use of different policies; administration; team activities and “linkage to care” benefits. Recommendations: Training on “linkage to care”; case management model; TIER.NET system upgrade/ linkage App development, patient information packs; standardised extended hours; transport assistance/outreach mobile services. Conclusion “Linkage to care” is a team effort, it needs collaboration and knowledge. Despite the implementation of a linkage program, there are challenges that the department of health needs to act on as addressed on researcher’s recommendations. , Thesis (MPA) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-04
- Authors: Mthini, Sandiso
- Date: 2022-04
- Subjects: Primary care (Medicine) , HIV infections AIDS (Disease) -- South Africa
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/27017 , vital:66223
- Description: Background: “Linkage to care” is an essential strategy in place for the retention of HIV diagnosed clients on treatment. It is vital throughout the management and care of an HIV client. Aim of the study was to explore the effectiveness of “linkage to care” of HIV clients following the diagnosis in the Engcobo sub-district, Eastern cape. Methodology: Qualitative, explorative, descriptive study design was used to explore and describe the effectiveness of “linkage to care” of HIV clients following diagnosis in the Engcobo sub-district. The population for the study were all healthcare workers, who are involved in the program of “linkage to care” of HIV positive clients. Purposive Sampling was used to select professional nurses, Community healthcare workers, Lay counsellors, linkage officers who are involved in the linkage of HIV positive patients and the facility managers whom their facilities provide HIV care services. Interview guide was used to collect data and Tesch’s method was used to analyse data. Findings: Themes that emerged from the study were flexible time to “linkage to care”; use of different policies; administration; team activities and “linkage to care” benefits. Recommendations: Training on “linkage to care”; case management model; TIER.NET system upgrade/ linkage App development, patient information packs; standardised extended hours; transport assistance/outreach mobile services. Conclusion “Linkage to care” is a team effort, it needs collaboration and knowledge. Despite the implementation of a linkage program, there are challenges that the department of health needs to act on as addressed on researcher’s recommendations. , Thesis (MPA) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-04
Lived Experiences of Repeat Sex Offenders in a Zimbabwean Juvenile Prison Regarding Secondary Desistance
- Authors: Chingozho, Johnson
- Date: 2022-04
- Subjects: Sex Offender -- Zimbabwe , Prison violence
- Language: English
- Type: Doctoral's theses , text
- Identifier: http://hdl.handle.net/10948/58750 , vital:60084
- Description: Juvenile sex offending is a serious crime that represents a social dysfunction for the offender, an injury to the community and a traumatic experience for the victim. Sex offending is generally perceived to be a conscious and intentional decision. Adolescent sex offending may be attributed to emotional immaturity and faulty thinking patterns. While interventions have been developed in Western settings, it appears they have failed to reduce reoffending among juvenile sex offenders in Zimbabwe. This is attributed to a lack of a culturally responsive psychological programme developed for the Zimbabwean adolescent sex offender. The study employed a phenomenological qualitative research approach that is exploratory, descriptive and theory generative in design. The Integrated Theory of Desistance from Sex Offending (ITDSO) underpinned the research study. The ITDSO’s three temporal dimensions namely: decisive momentum, rehabilitation and reentry were instrumental in the framing of the interview questions used in fieldwork and the development of the Zimbabwe Adolescent Sex Offender Psychoeducational Programme (ZASOPP). The research study took place in four phases. Phase 1 of the study constituted an integrative literature review utilising Whittemore and Knafl’s framework. Synthesis of the literature was conducted and analysed in terms of the themes that emerged that were relevant to juvenile sex offending and desistance. Phase 2 employed a qualitative phenomenological approach to understand the lived experiences of repeat juvenile sex offenders regarding secondary desistance in a Zimbabwean juvenile prison. The data collection process involved in-depth semi-structured interviews with 11 male repeat juvenile sex offenders between the ages of 17 and 21 years. The interviews were conducted in the Shona language. The data collected from the semi-structured interviews were transcribed verbatim, coded, and analysed by the researcher vii utilising the Colaizzi method. Phase 2 revealed a lack of parental guidance, minimisation, poor social skills, poor academic achievement, alcohol, and drug misuse as perceived factors influencing sex reoffending among juvenile sex offenders. The fear of prison, hopelessness, and challenges in adapting to the new reality in prison contributed to pains of imprisonment. Predictably, the study findings further revealed a lack of an appropriate psychological rehabilitation programme targeted at intervention among juvenile sex offenders. Phase 3 of the research study involved the development of a conceptual framework from the synthesis of findings from the integrative literature review, fieldwork and six concepts of the survey list of the Dickoff, James and Wiedenbach theory. The conceptual framework was used as a basis for the development of a psychoeducational programme. Phase 4 of the research study involved the development of a Zimbabwe Adolescent Sex Offender Psychoeducational Programme as informed by the conceptual framework developed in Phase 3 for clinical assessment and intervention among juvenile sex offenders in prison. The formulated programme would be used to intervene among juvenile sex offenders in a Zimbabwean juvenile prison to assist them to have psychological, mental well-being and to enhance secondary desistance. , Thesis (PhD) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-04
- Authors: Chingozho, Johnson
- Date: 2022-04
- Subjects: Sex Offender -- Zimbabwe , Prison violence
- Language: English
- Type: Doctoral's theses , text
- Identifier: http://hdl.handle.net/10948/58750 , vital:60084
- Description: Juvenile sex offending is a serious crime that represents a social dysfunction for the offender, an injury to the community and a traumatic experience for the victim. Sex offending is generally perceived to be a conscious and intentional decision. Adolescent sex offending may be attributed to emotional immaturity and faulty thinking patterns. While interventions have been developed in Western settings, it appears they have failed to reduce reoffending among juvenile sex offenders in Zimbabwe. This is attributed to a lack of a culturally responsive psychological programme developed for the Zimbabwean adolescent sex offender. The study employed a phenomenological qualitative research approach that is exploratory, descriptive and theory generative in design. The Integrated Theory of Desistance from Sex Offending (ITDSO) underpinned the research study. The ITDSO’s three temporal dimensions namely: decisive momentum, rehabilitation and reentry were instrumental in the framing of the interview questions used in fieldwork and the development of the Zimbabwe Adolescent Sex Offender Psychoeducational Programme (ZASOPP). The research study took place in four phases. Phase 1 of the study constituted an integrative literature review utilising Whittemore and Knafl’s framework. Synthesis of the literature was conducted and analysed in terms of the themes that emerged that were relevant to juvenile sex offending and desistance. Phase 2 employed a qualitative phenomenological approach to understand the lived experiences of repeat juvenile sex offenders regarding secondary desistance in a Zimbabwean juvenile prison. The data collection process involved in-depth semi-structured interviews with 11 male repeat juvenile sex offenders between the ages of 17 and 21 years. The interviews were conducted in the Shona language. The data collected from the semi-structured interviews were transcribed verbatim, coded, and analysed by the researcher vii utilising the Colaizzi method. Phase 2 revealed a lack of parental guidance, minimisation, poor social skills, poor academic achievement, alcohol, and drug misuse as perceived factors influencing sex reoffending among juvenile sex offenders. The fear of prison, hopelessness, and challenges in adapting to the new reality in prison contributed to pains of imprisonment. Predictably, the study findings further revealed a lack of an appropriate psychological rehabilitation programme targeted at intervention among juvenile sex offenders. Phase 3 of the research study involved the development of a conceptual framework from the synthesis of findings from the integrative literature review, fieldwork and six concepts of the survey list of the Dickoff, James and Wiedenbach theory. The conceptual framework was used as a basis for the development of a psychoeducational programme. Phase 4 of the research study involved the development of a Zimbabwe Adolescent Sex Offender Psychoeducational Programme as informed by the conceptual framework developed in Phase 3 for clinical assessment and intervention among juvenile sex offenders in prison. The formulated programme would be used to intervene among juvenile sex offenders in a Zimbabwean juvenile prison to assist them to have psychological, mental well-being and to enhance secondary desistance. , Thesis (PhD) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-04
Perceptions of Role Players in the Pharmaceutical Manufacturing Sector in South Africa Regarding the Proposal of a National Health Insurance System
- Authors: Essex, Laycan
- Date: 2022-04
- Subjects: Pharmaceutical industry -- South Africa , National Health Insurance
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/58849 , vital:60218
- Description: The proposed implementation of National Health Insurance (NHI) is attracting considerable interest among healthcare workers, as observed in the large quantity of available literary evidence. The available research is mainly focused on the perceptions of healthcare workers, working under the proposed NHI reform. Based on a literature gap observed in recently published articles on perceptions of healthcare professionals regarding the implementation of NHI, the researcher aimed to assess the opinions of key stakeholders in the pharmaceutical manufacturing sector in South Africa. This study employed a qualitative approach, using semi-structured interviews with key stakeholders employed in the pharmaceutical manufacturing sector. Their perceptions regarding the NHI were analysed and interpreted through thematic analysis in order to determine whether they have a positive or a negative perception towards the introduction of the NHI reform in South Africa. The majority of role players are in full support of NHI and there was a consensus amongst the participants that there will be great opportunities for the pharmaceutical manufacturing sector. Regarding the capabilities relating to capacity to supply, participants felt that South Africa’s pharmaceutical manufacturing sector has sufficient infrastructure to support the roll out of the NHI. Furthermore, participants felt positive about increased accessibility to pharmaceutical care by all South Africans, regardless of race, social and economic status. , Thesis (MA) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-04
- Authors: Essex, Laycan
- Date: 2022-04
- Subjects: Pharmaceutical industry -- South Africa , National Health Insurance
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/58849 , vital:60218
- Description: The proposed implementation of National Health Insurance (NHI) is attracting considerable interest among healthcare workers, as observed in the large quantity of available literary evidence. The available research is mainly focused on the perceptions of healthcare workers, working under the proposed NHI reform. Based on a literature gap observed in recently published articles on perceptions of healthcare professionals regarding the implementation of NHI, the researcher aimed to assess the opinions of key stakeholders in the pharmaceutical manufacturing sector in South Africa. This study employed a qualitative approach, using semi-structured interviews with key stakeholders employed in the pharmaceutical manufacturing sector. Their perceptions regarding the NHI were analysed and interpreted through thematic analysis in order to determine whether they have a positive or a negative perception towards the introduction of the NHI reform in South Africa. The majority of role players are in full support of NHI and there was a consensus amongst the participants that there will be great opportunities for the pharmaceutical manufacturing sector. Regarding the capabilities relating to capacity to supply, participants felt that South Africa’s pharmaceutical manufacturing sector has sufficient infrastructure to support the roll out of the NHI. Furthermore, participants felt positive about increased accessibility to pharmaceutical care by all South Africans, regardless of race, social and economic status. , Thesis (MA) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-04
Risk Factors Associated with Premature Birth at a District Hospital in Bisho, Eastern Cape
- Pullen, Stacey-Leigh Lillian
- Authors: Pullen, Stacey-Leigh Lillian
- Date: 2022-04
- Subjects: Premature infants -- Eastern Cape
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/58947 , vital:60250
- Description: Introduction and background: It is estimated that as many as 12.4 of every 1 000 live births in South Africa, are premature births. Prematurity is the leading cause of death in children under five years old. Furthermore, preterm infants have an increased risk of life-long morbidities. Globally at least 2.5 million premature infants die annually due to complications or lack of proper healthcare. Prematurity and the outcomes of its complications have raised concerns globally, as greater disparity is being seen between rich and poor countries. Lack of resources, poorly skilled health care professionals and poor management of small and pre-term babies, are areas of great concern in especially in poorer countries. Identifying the causes of prematurity will consequently not only help reduce the prevalence but more so the morbidity and mortality rates caused by preterm labour. It is therefore important to highlight and understand the consequences of such a high incidence in preterm births, when identifying these risk factors. Aims and objectives: The aim of the study was to identify which risk factors are associated with the cause of prematurity at Bisho Hospital, a district hospital in central Eastern Cape, South Africa. The objectives of the study were to identify which risk factors between the full-term and pre-term group were more prevalent and therefore associated with prematurity as well as identifying which risk factors could be prevented or even treated at Bisho Hospital. Methodology: A descriptive quantitative correlation study design was used, where premature as well as full-term infants were included in the study. Data was collected by means of a questionnaire. All accessible medical notes of both the mother and infant were used as well. The questionnaire was used to establish which risk factors were most prevalent during the pregnancies of women in each group and whether these risk factors were significant contributors to prematurity. Results: A sample of fifty mothers, with prematurely born babies were included in the study, along with eighty mothers who delivered full-term babies. The four main risk factors associated with pre-term birth within this study population was: a positive 6 HIV status (p=0.022), a poor maternal nutritional status (p=0.031), mothers living far distances from their local clinic (0.041-0.024) and mothers having previously delivered a pre-term baby (p=0.009). Discussion: The four major risk factors identified in this study have shown to have significant effects on pregnancy outcomes in other studies too. Modifiable risk factors such as a poor nutritional status can be identified and addressed as a preventative measurement for prematurity. While the other three risk factors are non-modifiable, mothers who are HIV positive, have previously had a premature baby and those who live farther than 5km (or a walk of 15-30 minutes long) away from their closest clinic, should be identified as a high risk for pre-term births in current pregnancies. While addressing these risk factors is important in attempting to reduce the prevalence of prematurity, improved care of small and premature babies could help combat the growing problem of early infant deaths within this same group. Recommendation: Financial investment and analysis of current policies in the prevention and management of premature delivery should be a priority. Ensuring health care workers are regularly trained as well as equipping nurseries with the basic resources to manage a pre-term baby, can help reduce mortality and morbidity associated with prematurity. , Thesis (MA) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-04
- Authors: Pullen, Stacey-Leigh Lillian
- Date: 2022-04
- Subjects: Premature infants -- Eastern Cape
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/58947 , vital:60250
- Description: Introduction and background: It is estimated that as many as 12.4 of every 1 000 live births in South Africa, are premature births. Prematurity is the leading cause of death in children under five years old. Furthermore, preterm infants have an increased risk of life-long morbidities. Globally at least 2.5 million premature infants die annually due to complications or lack of proper healthcare. Prematurity and the outcomes of its complications have raised concerns globally, as greater disparity is being seen between rich and poor countries. Lack of resources, poorly skilled health care professionals and poor management of small and pre-term babies, are areas of great concern in especially in poorer countries. Identifying the causes of prematurity will consequently not only help reduce the prevalence but more so the morbidity and mortality rates caused by preterm labour. It is therefore important to highlight and understand the consequences of such a high incidence in preterm births, when identifying these risk factors. Aims and objectives: The aim of the study was to identify which risk factors are associated with the cause of prematurity at Bisho Hospital, a district hospital in central Eastern Cape, South Africa. The objectives of the study were to identify which risk factors between the full-term and pre-term group were more prevalent and therefore associated with prematurity as well as identifying which risk factors could be prevented or even treated at Bisho Hospital. Methodology: A descriptive quantitative correlation study design was used, where premature as well as full-term infants were included in the study. Data was collected by means of a questionnaire. All accessible medical notes of both the mother and infant were used as well. The questionnaire was used to establish which risk factors were most prevalent during the pregnancies of women in each group and whether these risk factors were significant contributors to prematurity. Results: A sample of fifty mothers, with prematurely born babies were included in the study, along with eighty mothers who delivered full-term babies. The four main risk factors associated with pre-term birth within this study population was: a positive 6 HIV status (p=0.022), a poor maternal nutritional status (p=0.031), mothers living far distances from their local clinic (0.041-0.024) and mothers having previously delivered a pre-term baby (p=0.009). Discussion: The four major risk factors identified in this study have shown to have significant effects on pregnancy outcomes in other studies too. Modifiable risk factors such as a poor nutritional status can be identified and addressed as a preventative measurement for prematurity. While the other three risk factors are non-modifiable, mothers who are HIV positive, have previously had a premature baby and those who live farther than 5km (or a walk of 15-30 minutes long) away from their closest clinic, should be identified as a high risk for pre-term births in current pregnancies. While addressing these risk factors is important in attempting to reduce the prevalence of prematurity, improved care of small and premature babies could help combat the growing problem of early infant deaths within this same group. Recommendation: Financial investment and analysis of current policies in the prevention and management of premature delivery should be a priority. Ensuring health care workers are regularly trained as well as equipping nurseries with the basic resources to manage a pre-term baby, can help reduce mortality and morbidity associated with prematurity. , Thesis (MA) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-04
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