Theses and Dissertations

Permanent URI for this collection

http://hdl.handle.net/20.500.11837/251

Browse

Now showing 1 - 20 of 26

Analysis of early-phase contact tracing during the coronavirus disease 2019 outbreak in Mangaung Metro, Free State
(University of Fort Hare, 2022-09) Monyobo, Priscilla Kesaletseng; Goon, D T
Background and Aim Contact tracing is a critical public health measure for controlling and preventing the spread of infectious diseases. Although the principles underlying this strategy are not novel, understanding the changes in infectiousness of COVID-19 is indeed novel. As are the capacity and operating procedures required to support disease investigation in Mangang Metro during the SARS-CoV-2 (COVID-19) pandemic. On 16 March 2020, the first coronavirus disease case in the area, which led to a larger outbreak, occurred in Mangaung Metro, Free State province, South Africa. To date, Mangaung Metro remains the epicentre of the COVID-19 pandemic and the primary driver of the caseload in the Free State province. The aim of this study was to analyse contact tracing data in Mangaung Metro during the early phase of the COVID-19 outbreak (16 March 2020 – 30 June 2020) in order to measure the viral transmissibility of COVID-19 in the early stages of the outbreak, specifically in the context of Mangaung Metro. Methods A descriptive systematic analysis of index COVID-19 cases and their contacts in Mangaung Metro was conducted. The review period ran from 16 March to 30 June 2020, during which there was a total of 1 001 cases in Mangaung Metro. Data was captured on an Excel spreadsheet using the contact line list variables from the established National Institute of Communicable Disease contact line list framework. The inferential statistics were based on a time series analysis to compare the impact of contact tracing stratified by symptomatology and the root cause of the cases to the overall cases in Mangaung Metro. The study determined whether isolation, quarantine, and contact tracing were able to control outbreaks in the early phase using characteristics of disease transmission and parameters particularised to the COVID- 19 pathogen. Results As of 30 June 2020, the Free State province had a total of 2 072 COVID-19 cases. Mangaung Metro contributed 1 001 cases (48 percent) of the total number of cases in the study period. Between March and June 2020, 3 553 contacts were traced in Mangaung Metro. This number translates to at least three investigated and traced contacts per index or laboratory confirmed positive case. From the traced contacts, 1 080 samples were collected and sent for laboratory testing. In April 2020, the greatest number of samples were collected. This high rate in sample collection is posited to be the result of the high rate of contacts traced, as well as the initial clinical guidelines followed for contact tracing. Most positive contacts were discovered in March 2020. One of the possible reasons for the high detection of COVID-19 confirmed positive contacts during the early stages of the outbreak was the focus and importance of contact tracing while the caseload remained relatively low. However, as the outbreak progressed in the Mangaung Metro context, the number and relative percentage of positive cases detected through contact tracing decreased. In total, the positive contacts recorded in March 2020 amounted to 92 (51.3 percent), 18 in April (10.5 percent), 41 in May (22.9percent), and 28 in June (15.6 percent). The March 2020 tracking rate was the highest at 73.2percent, with an average contact tracing rate of 15.5 percent by the end of June 2020. Of all the contacts traced, 7.9 percent involved healthcare workers in the Free State. Conclusion The study’s findings show that contact tracing was an effective control measure during the early stages of the COVID-19 outbreak in Mangung Metro district. Furthermore, the impact was greatest when the caseload was low and the burden on the healthcare system less severe. Mangaung Metro demonstrated the capability of tracing more contacts in the early-early phase of the outbreak; however, as the outbreak progressed to the latent early phase, the caseload increased and fewer contacts were traced. The consequence of contact tracing not being as effective during the latent early phase relates to the increase in both exposed and untraceable contacts, which in turn fueled the increase of new cases. This further impacted the at-risk and vulnerable population, especially the elderly, who were at an increased risk if not traced in a timely manner, possibly resulting in mortality.,Thesis (MPA) -- Faculty of Health Sciences, 2022
An approach to National Health Workforce Planning for health service delivery in South Africa
(University of Fort Hare, 2009-12) Mahlathi, Malixole Percival; Thakhathi, D. R.
Although South Africa educates and trains many health professionals of various categories, it continues to experience relative and critical shortages of these professionals especially at its rural health facilities. It boasts more than 15 Faculties of Health Sciences which train a variety of health professionals. In addition to training for its own purposes, it also offers training for several countries in the Southern African Development Community. The burden of disease is considered to be high and increasing, complicated by the HIV and AIDS epidemic. In the light of these challenges it is necessary that South Africa engages in careful health workforce planning as a long term approach to solve shortage of health professionals and improving the delivery of health services. This study examines the health workforce planning approaches by the various Provincial Departments of Health and the student planning approaches by the Faculties of Health Sciences of the Higher Education Institutions that train health professionals.,Thesis (PhD) -- Faculty of Health Sciences, 2009
Backpack carriage and musculoskeletal pain among primary school learners in King Williams Town, South Africa
(University of Fort Hare, 2022) Moni, Busisiwe; Goon, D T
BACKGROUND: There is rising concern that kids are walking to school with too much weight on their backs. The weight of schoolchildren's backpacks is a persistent and divisive topic in the fields of education and health. Children who carry heavy backpacks are more likely to have back discomfort and musculoskeletal pain, which raises their risk of developing chronic back pain as adults. There is little research on this topic among South African school-age youngsters. The goal of the study was to find out how common low back and other musculoskeletal complaints were among primary school students who used a school bag. RESEARCH AIM: The purpose of the study was to identify the prevalence and location of musculoskeletal discomfort in primary school students in King William's Town, South Africa, and describe their link with backpack use. METHOD: In King Williams Town, Eastern Cape, South Africa, a descriptive cross-sectional survey was conducted among elementary school students between the ages of 9 and 14 years old. A systematic questionnaire and the Cornell Musculoskeletal Questionnaire were used to gather the data (body chart). Age, gender, and schoolbag details (style of backpack, carrying technique, and carrying time) were collected. The learner's waist, hip, and bag circumferences were all measured. On the data, descriptive and interferential statistics were used. FINDINGS: The study's conclusions showed that students' musculoskeletal pain was brought on by the weight of their backpacks or school bags. The majority of the students (89.8percent) complain about the difficulty they experience when lugging their heavy backpacks to class. In addition, 83.4percent of the students had bags that weighed more than 10percent of their body weight. Additionally, a sizable percentage of students (89.8percent) carry a hefty bag to school every day and report feeling fatigued while doing so (90.8percent). 90percent of the students reported feeling discomfort before, during, or after carrying their schoolbags. This pain is related with carrying a schoolbag. The majority of students (53.5percent) felt that their daily pain interferes with their ability to study. In order of severity, the majority of students report having discomfort in their shoulders (82.7percent), lower back (59.9percent), neck (47.0percent), upper back (40.7percent), and upper arm (16.4percent). CONCLUSION: According to the study, there is a link between students' musculoskeletal pain and carrying hefty backpacks or school bags. The shoulders are where musculoskeletal discomfort is most frequently felt. The study supported the findings of the majority of studies cited in the literature that most schoolchildren suffer from musculoskeletal pain because the weight of their backpacks is excessive compared to their size, weight, and age. RECOMMENDATIONS: The study produced a number of recommendations, including that the Department of Basic Education inform teachers, students, parents, guardians, and other key stakeholders about the effects of heavy backpacks or schoolbags on students' musculoskeletal pain. For students' convenience and to lighten the load on their school bags, locker rooms should be available. Teachers, parents, and guardians should also pay attention to the school bags that students are using to make sure that the weight is appropriate for their age and body size.,Thesis (MPA) -- Faculty of Health Sciences, 2022
Barriers to exclusive breastfeeding for mothers in the Tswelopele Municipality
(University of Fort Hare, 2020-03) Quebu, Simthandile Rebecca; Murray, Daphne
The purpose of the study was to assess the barriers to exclusive breastfeeding (EBF) of mothers in the Tswelopele Municipality. The South Africa Demographic and Health survey reported the country’s EBF rates among children below six months of age to be at 32percent for the year 2016. The World Health Organisation endorses the promotion and protection of the practice of EBF throughout the first six months of life, and the addition of complementary foods at six months coupled with breastfeeding up to two years of age. This feeding practise is recommended as the most efficient feeding practice to save infants from various illnesses and mortality across the globe, irrespective of their mother’s HIV status and economic class. A qualitative, contextual, explorative and descriptive research design was employed for this study to achieve the research objectives. The researcher incorporated both purposive and convenience sampling in this study. Purposive sampling was used to select the clinics, and convenience sampling was used to select the participants. Mothers who had infants 6-12 months old who were accessing infant and child health services in the three public health care facilities in the Tswelopele Municipality were a target population. Individual semi-structured interviews were administered, and an audio recorder was utilized to record the interviews with the participants' consent. The researcher throughout this study verbatim transcribed the interview audio tapes, and ethical principles and trustworthiness standards were adhered to. The University of Fort Hare (Ref # 2021=06=12 QuebuS) granted ethical clearance and all participants gave formal consent to voluntarily participate in this research. Tesch's approach for data analysis to open coding in qualitative research was used to analyse the data. Sixteen (16) participants in total took part in this study and the research study was conducted during the whole month of October 2021.During the data analysis, four main themes and thirteen sub-themes emerged, all of which were thoroughly examined. The findings suggest that maternal factors such as extreme pain in the breast, maternal sickness, belief that milk supply is insufficient, lack of EBF knowledge and cultural influences are the key contributors to the success or failure of EBF practice. When mothers have difficulties with breastfeeding, their difficulties can become barriers to EBF. Furthermore, a noteworthy finding is that some participants in this study were eager to breastfeed their babies and maintain EBF for six months; however, their infants had problems that prohibited them from doing so. These issues primarily included infants who refused to breastfeed and breast milk not being tolerated by some infants, as seen by baby vomiting after feeds. It was recommended that breastfeeding education and counselling should be available to mothers and their families from prenatal to postnatal so that they have enough time to make informed infant feeding decisions. Furthermore, an open dialogue with mothers and their families on a realistic understanding of what to expect when they first breastfeed, as well as the exploration of myths, inaccurate information, and concerns can be addressed during the counselling sessions. In conclusion, health professionals should also take into account the culture of mothers, respect cultural customs linked with breastfeeding, and respectfully educate them and their families about traditions that may affect breast-feeding.,Thesis (MPH) -- Faculty of Health Sciences, 2020
Barriers to utilisation of antenatal care services in Bloemfontein, sub-district of Mangaung Metro, Free State, South Africa
(University of Fort Hare, 2022-11) Montshiwa, Kgalalelo Christine; Maluleke, X T
Background: Maternal and child mortality remain a global health problem, regardless of preventative measures put in place. Antenatal care is crucial to decrease maternal and child morbidity and mortality. However, in Bloemfontein, the sub-district of Mangaung Metro in the Free State, it has been identified that women utilise this kind of service sub-optimally. The study aimed to explore and describe barriers to the utilisation of antenatal care by pregnant women in the Bloemfontein sub-district of Mangaung Metro. Methodology: This study was qualitative and used an explorative, descriptive design. Qualitative data was collected by using focus group discussions and key informants’ interviews. Three focus group discussions with twenty-five pregnant and lactating mothers, aged between 18 and 49 years, were conducted. Participants took part in one focus group discussion at each healthcare facility. Four key informant interviews were conducted with four facility managers and one professional midwife who conducted ANC at the clinic at the time of the study in the three healthcare facilities. A thematic analysis process was used to analyse the collected qualitative data under each identified barrier. The STATA version 15 was used in the analysis of the demographic characteristics of the participants. Results: Most of the participants indicated that they are aware of the importance of attending ANC appointments however, they have voiced that the delayed waiting times and staff attitudes contribute to how they feel about visiting a clinic early. Some of the participants mentioned that they have cultural barriers as they still believe that a traditional pregnant woman should not reveal her pregnancy in the early days but must rather wait until her stomach has grown significantly for her to visit the clinic. Two participants indicated that they had unplanned pregnancies and wanted to do an abortion, but their religious beliefs prevented them to choose to terminate their pregnancies. Economically, not all participants complained about their financial situation though the majority were unemployed and single. Participants from the Bloemspruit facility complained of transport as they stay far from the clinic and they are sometimes forced to walk alone which makes it difficult to attend all their booked sessions with their midwives. The results of the study revealed that there are several factors contributing to late antenatal care attendance namely provider and personal factors contributing to late antenatal care attendance in the Bloemfontein sub-district of Mangaung Metro. Personal factors that were found to be contributing to late antenatal care booking were lack of transport, especially for Bloemspruit participants, unwanted pregnancy, lack of financial support, lack of partner support, cultural and religious beliefs, and lack of knowledge. Provider factors that were found to be contributing to late booking were lack of resources like tools of the trade, long waiting times, poor infrastructure, human resources, and midwives’ attitudes. Recommendations. To deploy qualified midwives to conduct antenatal care clinics, to extend the service over the weekends as participants mentioned that they struggle to get time off from work during the week. Health promotion and community awareness campaigns on the importance of antenatal care may increase the utilisation of antenatal care services.,Thesis (MPA) -- Faculty of Health Sciences, 2023
Challenges faced by healthcare professionals in reporting near miss incidents in a hospital, at the Amathole District, Eastern Cape Province, South Africa
(University of Fort Hare, 2022-12) Ntlanganiso, Lindiwe; Du Plessis, D W
Background Recording and investigation of NMIs can provide valuable information on monitoring and enhancing patient safety in the healthcare facilities. This in turn, can reduce the likelihood of medico-legal claims. Regardless of attempts to establish efficient incident reporting systems across the entire healthcare industry, underreporting of errors persists worldwide. Therefore, not only do near miss incidents serve as early warning signs of impending potential failure in the healthcare system, but they also provide a chance for patient safety improvement. With that in mind, this study was undertaken to investigate challenges faced by health care professionals in reporting near miss incidents at a hospital in the Amathole District, in the Eastern Cape province of South Africa. Aim The aim of the study was to develop recommendations for healthcare management and healthcare professionals on how to better manage NMIs, and by identifying the challenges faced by health care professionals and the impact they have on the quality of care at one state-funded district hospital. Setting The study was conducted with healthcare professionals at a district hospital in the Amathole District, Eastern Cape Province, South Africa. Methods This study used a mixed method study design. Purposive and convenience sampling were used for participants’ selection for the study. Quantitative data was collected using the WHO Near-Miss Approach while individual and focus group interviews with healthcare professionals were carried out for collecting qualitative data. The maternity and neonatal intensive care units were identified as the two high-risk areas from which most medical negligence claims are lodged. The number of complications that occurred in each month of the year 2019 was determined by using components of the WHO near miss approach. The researcher adopted this approach to serve as a baseline assessment. Data was analysed using both Nvivo Version 10 and SPSS Version 20. Findings The challenges that healthcare professionals face in reporting near miss incidents at the study site included lack of knowledge about the reporting tool and system, inability to identify a near miss incident and healthcare professional attitudes and practices. The document review revealed that the NMIs are existent but not reported on the prescribed reporting system, a total of 210 actual incidents had occurred in the maternity and neonatal units of the hospital, which accounts for 62% of the 357 deliveries in the year 2019. Conclusion Based on the study result and findings, the healthcare system should shift towards a proactive rather than a reactive approach to medical and clinical errors. Continuously reducing the incidence of all patient safety incidents requires improved prevention strategies and effective strategies for recovery from possible medico-legal claims. The study further suggests that additional focus should be placed on NMI reporting and investigation so that operative improvement plans can be developed, implemented, monitored and evaluated. In essence, these improvement plans should be designed to progress patient care, reduce avoidable PSIs and reduce medico-legal claims.,Thesis (MCur) -- Faculty of Health Sciences, 2022
Challenges hindering the implementation of quality supervision in primary health care facilities in Oliver Reginald Tambo District, Eastern Cape Province
(University of Fort Hare, 2018) Zamxaka, Nontlantla Caroline; Mupindu, W
The study investigated the factors that prevent quality supervision in primary health care(PHC) facilities in Oliver Reginald Tambo (O.R. Tambo) district of the Eastern Cape Province of South Africa. The motivation for this study was a concern regarding consistently poor performance by PHC facilities in the province despite regular supervisory visits. The objectives of the study were to explore practices of PHC supervisors in implementing supervision, and to assess perceptions, opinions, and attitudes of PHC supervisors and PHC operational managers with regards to PHC supervisory visits. On search methodology, qualitative approach was predominating whilst quantitative data was supplementing the study. A purposive sample of PHC supervisors and operational managers was drawn from PHC facilities which had a consistent, 100% rate of supervisory visits. The data was analysed thematically. The results revealed systemic and structural challenges that affect the implementation of quality supervision, rendering supervisory visits inefficient. These were: a high workload resulting from inconsistency in the allocation of facilities, as well as the many other responsibilities which supervisors have; a lack of knowledge and experience in supervisors; a lack of health service resources including transport; a high turnover of nurses; lack of support from the district and sub-district leadership and management; lack of collaboration, coordination and integration of activities; and delayed procurement processes resulting in a recurring lack of equipment and medical supplies. The findings of the study brought an understanding of the systemic and structural requirements that need to be made for a functioning quality supervisory system. Successful interventions require strengthening of leadership and governance, and the diligent application of the systems approach to solving problems at facility, district and provincial level. An improvement in leadership and governance should include innovative strategies to utilise the limited resources available without compromising the key objective of quality health care.,Thesis (MPH) -- Faculty of Health Sciences, 2018
Clinicians knowledge and perceptions of point of care testing (poct) in selected hospitals in the free state, South Africa
(University of Fort Hare, 2022-08) Watkins, Edgar Jeffrey; Oladimeji, Elizabeth Kelechi; Last name, First name
Point of care testing (POCT) improves access and equity to health diagnostic services in resource-limited settings like South Africa, where some health facilities do not have on-site laboratories. With recent technological advancements, most traditional laboratory tests can now be conducted on-site at primary health clinics (PHC), hospital wards and clinics. One advantage of the POCT device is that it can be used by a non-medical laboratory expert at the patient’s bed side during hospitalizations or near the patient in the doctor’s consultation rooms. This results in a shorter turnaround time for the availability of test results when compared to that from a specimen sent to a traditional clinical laboratory. Despite the benefits of POCT, many clinicians (doctors and nurses) avoid utilizing POCT for quality assurance reasons. Clinicians believe the results from a POCT device may not be as reliable as the results from tests performed by a medical laboratory scientist in the traditional clinical laboratory. This study used a concurrent mixed method research design to explore clinicians' POCT knowledge and attitudes in a subset of hospitals in the Free state of South Africa. The study population comprised of consenting medical professionals from the ten (10) selected Free State district hospitals (study sites). The findings demonstrated that hospitals in urban areas have easier access to laboratory services. There were two (2) urban study sites that had on-site laboratories which achieved faster Turn-Around-Time (TAT). The participants indicate that they are aware of POCT and routinely use it, but there are far fewer POCT tests available than laboratory tests. When diagnostic options are scarce, point-of-care testing (POCT) can provide a more accurate diagnosis than traditional methods. The improved health care provision and reduced incidence of health complications is the end result. According to the participants, having access to POCT diagnostic services has shown promise in addressing challenges that sometimes present with laboratory-based methods, particularly in settings with limited access to hospitals or when laboratories cannot be accessed. Further, clinicians argue that errors in the usage of POCT may occur due to the quality of these POCTs and improper documentation of the test results by the clinicians. Therefore, poor utilization of POCT by clinicians can be improved if implemented with pre-set strict selection goals and processes to ensure that the right POCT is selected for the right purpose that would reduce resource expenditure by the hospitals and improve patient experiences and health outcomes.,Thesis (MPH) -- Faculty of Health Sciences, 2022
Colistin utilisation and clinical outcomes at a public hospital in Bloemfontein, South Africa
(University of Fort Hare, 2022-07) Matshediso, Gaalebale Prudence; Adeniyi, O V
Background Colistin is an antibiotic used as the last resort in the treatment of multi-drug resistant Gram-negative bacteria. Its use started in the 1950s but was decreased in the 1980s owing to its nephrotoxic side effects. The re-emergence of Colistin utilisation in 2012 in South Africa followed the emergence of multi-drug resistant Gram-negative bacteria. There is a dearth of information on the rationale use of Colistin in South Africa. Aim To describe the use of Colistin and its clinical outcomes at a tertiary hospital in Bloemfontein, South Africa. Methodology A retrospective cross-sectional study was conducted at a tertiary hospital in Bloemfontein between 2015 and 2019. Relevant data was extracted from the medical records of patients treated with Colistin. Stratified random sampling was used in selecting 50percent of the eligible medical records of patients treated with Colistin per stratum. Data was analysed using simple descriptive and inferential statistics. Results Of the total sample (N=69), the majority were neonates (43.5percent), while children constituted the lowest number of patients (18.8percent). The highest contributor to the top diagnosis, septicaemia, were neonates (44.2percent). Adherence to policy and Colistin treatment guidelines was suboptimal, more so in neonates (45.3percent) than in adults (73.7percent) and children (72.3percent). Colistin was used as a last resort in 68.1percent of the participants. Cure was achieved in 26.9percent, 46.2percent and 80percent of adults, children and neonates, respectively. The highest rate of nephrotoxicity was seen in adults (57.7percent). In the multivariate logistic regression model analysis, both adults [adjusted odds ratio (AOR)=25.54, 95percent confidence interval (CI) 2.73-238.65] and children (AOR=8.56, 95percentCI 1.06 – 69.10) had a higher risk of death than neonates. However, there was no significant difference in the odds for mortality by gender, co-morbidities, illness duration prior to admission and adherence to treatmen Conclusions This study found a suboptimal level of compliance with policy and recommended guidelines on the use of Colistin in a South African public sector tertiary hospital. In addition, there were variations in the level of compliance by age categories, with lower levels of compliance in neonates than in children and adults. The odds for mortality by gender, co-morbidities, illness duration prior to admission and adherence to treatment guidelines and policies were found to be insignificant, and age was the only predictor of mortality found in the study. The findings of the study highlight the need for improved clinical governance on antibiotic stewardship and monitoring of use of Colistin across all categories of patients in the hospital. Future studies should examine the contributing factors for suboptimal compliance, with evidence-based recommendations on the use of Colistin in the study setting as well as factors contributing to high mortality in adults.,Thesis (MPA) -- Faculty of Health Sciences, 2022
Data management and dispensary: missing link contributing to antiretroviral loss to follow-Up in Lejweleputswa District
(University of Fort Hare, 2022-09) Moatlhodi, Charlotte Motshele; Goon, D T
Background and aim: The widespread use and access to Anti-Retro Viral Treatment (ART) world-wide has contributed to full preventive and therapeutic benefits. An estimated amount of 68percent of HIV positive people received ART in South Africa (SA) as of 2018. However, reports from TIER.Net and DHIS (District Health Information System), indicate that the retention of patients on ART (specifically first line triple combination therapy Tenofovir Emtricitabine Efavirenz (TEE)) continues to decline. Meanwhile, data on TEE dispensed from the dispensary shows increasing quantities patients across the Free State province on a monthly basis. The aim of this study is to determine factors contributing to the discrepancy between Fixed Dose Combination (FDC) TEE dispensing data and patients on FDC TEE captured on TIER.Net and Health Patient Registration System (HPRS), as a means of improving identification and monitoring of patients that carry the potential risk of being lost to subsequent follow-ups (ART collection / clinical visits). Methods: A retrospective, quantitative, and descriptive record review of 382 medical records of HIV positive patients, along with TIER.Net and Health Patient Registration System (HPRS) reports, was conducted at five primary healthcare (PHC) facilities, each representing the five sub-districts found in Lejweleputswa district using a self-designed data collection tool. Descriptive statistics was used to summarise and present data. Results: Sixty five percent the TEE collected from the dispensary was captured on TIER. Net. It could not be determined on none of the medical records whether or not the administrative clerk captured dispensed TEE on the same date of collection from the dispensary on TIER.Net. Subsequently, the actual date of capturing the TEE dispenses on TIER.Net following collection of the treatment from the dispensary could also not be determined. The overall data on TEE dispensed/collected from the dispensary the same was not the same as the data captured on TIER.Net. Thirty five percent of patients were reported to have collected their ART according to dispensary data than that reported on TIER.Net. Eighty percent of the TEE collected from the dispensary was captured on HPRS. Eighty percent of facilities had an area and computer dedicated for HPRS and TIER.Net but none had a backup computer in cases of theft/breakage. None of the facilities had access to back up connectivity, a manual capturing process in the form of paper-based head count registers was instead utilised as back-up. Conclusion: The following factors were found to contribute to the discrepancy between the TEE dispensing data, TIER.net and HPRS: Poor records keeping, unauthorised dispensing of prescriptions, poor data management, delays and non-capturing of ART medical records and infrastructural and human resource challenges that exist in the data management of the patient medical records. There is a need to address these gaps in order to improve reliability of dispensary data, as well as reports from TIER.Net and HPRS, in order to streamline the identification and monitoring of patients at risk of becoming lost to follow-up.,Thesis (MPA) -- Faculty of Health Sciences
Dietary preference and perceptions of the health implications: A qualitative study on perspectives from outpatients and health care providers at Nontyatyambo Community Health Centre, Eastern Cape, South Africa
(University of Fort Hare, 2022-08) Chocko, Ronnie J A V; Oladimeji, Kelechi Elizabeth
Introduction and background. Poor dietary choices are resulting in an increase of mortality and morbidity rates globally. Epidemiological studies reveal that diets high in animal-sourced foods (ASF) lead to an increased risk of developing cardio-metabolic diseases (CMD). On the other hand, plant-based foods (PBF) have been shown to reduce this risk. Making well informed dietary choices plays an important role in reducing the burden of these diseases. To this end, this study further explores the role that diet plays in maintaining good health by exploring current dietary preferences, perceptions of the health implications of these dietary choices and perceptions of the benefits of PBFs vs ASFs of people in a local South African context. Methodology. This qualitative study was conducted at Nontyatyambo Community Health Centre, Mdantansane, Buffalo City Metropolitan district in the Eastern Cape province of South Africa. A sample of 42 participants was enrolled for the study. A question/interview guide was used to collect data through key-in-depth interviews and focus group discussions. Two audio recorders were used to record the verbal responses of participants. The recorded interviews were transcribed and translated to English. The transcribed data was systematically and thematically analyzed. Results. It was found that all participants in this study were following an omnivorous dietary pattern. A number of participants expressed that they did not like vegetables. In this study, most participants felt that PBFs were healthier than ASFs. Even though they felt PBFs were healthier, none followed exclusively plant-based diet. Conclusion. Transforming dietary patterns to contain more plant-based foods may be a critical factor in reversing harmful effects on public health and the environment. This calls for urgent public health intervention to improve nutritional uptake as a strategy to reduce potential CMD.,Thesis (MPA) -- Faculty of Health Sciences, 2022
Experiences of midwives regarding the use of pharmacological and non-pharmacological labour pain interventions in Lejweleputswa district in Free State
(University of Fort Hare, 2019) Parkies, Limakatso Elizabeth; Murray, Daphne
Due to the disabling effects of severe labour pains, labour pain management remains an important topic in midwifery and needs to be reviewed more often. According to studies, various pain relief options, both pharmacological and non-pharmacological, are available to help women cope with pain, but midwives did not employ these techniques adequately because of various experiences. Studies further indicate that, though the limited number of these techniques were employed they were not effective on some women. Thus, the purpose of this research study was to explore and describe midwives’ experiences on pharmacological and non-pharmacological labour pain management in the Lejweleputswa District of the Free State Province. This study employed a qualitative, descriptive, explorative, and contextual design. A purposive sampling technique was used to select the participants. The target population was midwives who work in the maternity wards of the institutions under study with three to five years’ experience in midwifery. Individual, face-face, semi-structured interviews were conducted; these were recorded for the researcher’s reference purposes, so as not to overlook important information. In addition, the researcher made use of field notes, recording in them what was heard, observed, felt, experienced, and thought during the interview. Ethical principles and trustworthiness were maintained throughout this study. Data analysis was done using Tesch’s approach to open coding in qualitative research. Confidentiality and anonymity were ensured throughout the interviews. The nine themes and 19 sub-themes that emerged during data analysis were discussed comprehensively. The findings indicate that midwives use both pharmacological and non-pharmacological methods in managing labour pain. Some methods are effective in relieving pain for certain mothers, while other methods proved ineffective. Midwives administer Pethidine and Phenergan as per doctors’ prescription; non-pharmacological methods, such as back massage, deep breathing exercises, mobilisation, and warm baths or showers are also employed. Midwives provide pharmacological methods to all women in labour, and routinely employ non-pharmacological methods. Although the midwives are willing to manage patients’ pain, they face certain challenges, such as shortage of staff, increased workload, as well as inadequate resources. This leads to inadequate provision of non-pharmacological care. In conclusion, the midwives’ experiences were that both pharmacological and non-pharmacological techniques were used for all labouring women and they had relaxing and calming effects on some women, resulting to them giving birth with ease, although for some they were not effective. In addition, the pharmacological interventions caused drowsiness to some women and babies. The findings will provide evidence-based information to the Free State Department of Health in order to assist policymakers and stakeholders in initiating and developing appropriate policies, guidelines, and interventions that can improve labour pain management. The Free State Department of Health should consider using other opioids and non-opioids in managing labour pain to broaden the scope of pain relief methods available to the midwives.,Thesis (MPH) -- Faculty of Health Sciences, 2019
Experiences of patients with cancer regarding decentralization of oncology services at a selected tertiary hospital in the Eastern Cape
(University of Fort Hare, 2021-09) Jojo, Lumkile; Nkutu, N T
Background: Cancer burden is a global public health concern. It is associated with high morbidities and mortalities worldwide. Over the past decade, there has been a constant increase in the incidence of cancer cases affecting mostly low-income countries and middle- income countries. South Africa as a middle-income country is also affected by this cancer rise. The limited access to oncology services contributed to the late presentation and late diagnosis. In the Eastern Cape, oncology services were previously offered in Port Elizabeth and East London only. Oncology unit was recently opened in Mthatha to decentralize oncology services in the province. The purpose of the study was to explore the experiences of patients with cancer regarding decentralization of oncology services at a public tertiary hospital in the Eastern Cape province of South Africa. Objectives were to describe experiences of patients with cancer regarding decentralization of oncology services at a public tertiary hospital in the Eastern Cape, and to describe the quality of oncology services provided by a public tertiary hospital in the Eastern Cape. Methods: a qualitative research approach with a descriptive, explorative, and contextual design was undertaken in this study, to get the perspective of the oncology healthcare service recipients on the decentralization of oncology services at a public tertiary hospital. An interview guide was used to get experiences of the cancer patients attending oncology clinic. Interviews were conducted to 19 participants on a one-to-one basis. With ethical consideration, all COVID-19 protocols were observed. All interviews were transcribed carefully against their audio-recordings. Field notes were also taken by the researcher on what was heard, observed, thought and experienced during the interview process. The concept of trustworthiness was used to ensure rigour throughout this study. Data was analysed by means of thematic analysis. Data was organized into themes using the Tesch’s approach to open coding in qualitative research. Results: seven themes emerged: 1) experience related to a high level of satisfaction with services provided and desired expectations, 2) waiting time, 3) availability of human and material resources, 4) attitude of health care workers, 5) appropriate treatment and care, 6) access to services, and 7) need for improved infrastructural facilities Many patients had positive experiences about decentralization of oncology services in the province. Most patients were happy about travelling short distances, a smaller number of days, using less money and the time it takes to see a doctor. They also expressed their satisfaction on the quality of oncology services rendered in the unit. The waiting times were acceptable, medicines available and staff had positive attitudes towards the patients. The study revealed that, there were complaints about infrastructure, poor hospital record keeping, and lack of resources. The themes which emanated from the recordings of the study showed that patients with cancer, attending oncology clinic at a public tertiary hospital had positive experiences in this decentralized oncology unit. The services rendered at the facility were of acceptable quality. Staff had positive attitude towards their patients. All patients were seen by the doctors within acceptable waiting time, and they all got their prescribed medication. Access to services was much improved in terms of distance, number of days travelled by patients to access the service and time taken to see the doctor for appointments. Conclusion: The hospital must improve its infrastructure, record keeping, security, and expand the services. Put more focus on cancer awareness programs.,Thesis (MPA) -- Faculty of Health Sciences, 2021
Exploring knowledge, attitudes and psychosocial experiences of health care workers regarding covid-19 in Bufalo City Municipality
(University of Fort Hare, 2020-03) Notununu, Zintle; Murray, D
The purpose of this study was to explore and describe the knowledge, attitude and psychosocial experiences of health care workers regarding Covid-19 in Buffalo City Municipality. Covid-19 is a disease that attacks the respiratory system and functions. It is a highly infectious disease with a lengthy 5-6 sometimes even 14-day incubation period. It is very serious condition and has killed a lot of people including the Health Care Workers A qualitative descriptive explorative contextual design was employed in this research study. The design was relevant for this study to explore and describe the knowledge, attitude, and psychosocial experiences of health workers regarding Covid-19 in Buffalo City Municipality. The non-probability sampling method was used and a convenient sampling technique was used to select the participants. Professional nurses who met the criteria and who were on duty on the day of data collection were included in the study. The researcher interviewed 15 professional nurses and stopped as the data was saturated. A semi-structured Interview guide was used as an instrument to collect data containing open-ended questions. The researcher maintained ethical principles throughout the study. Concepts of trustworthiness of the study were applied throughout the research. Tech’s eight steps approach was used to guide the data analysis process. The findings of this study indicate that health care workers have a high level of knowledge about Covid-19. They know what Covid-19 is, how it started, its signs and symptoms, how to protect themselves from it and its complications. Negative attitudes, fears were noticed from the HCWs and thus the need for psychological support was identified. Feelings of neglect and lack of motivation were also identified. Psychological support for health care workers must be provided to prevent staff burnout. Personal Protective Equipment used in the hospital premises must be left and washed in the hospital laundry to prevent the spread of infection to the families of the HCWs. It was indicated that there are health care workers who experienced chronic illnesses after being diagnosed with Covid-19. These chronic illnesses include diabetes and high blood pressure. It was brought to light that myths circulating on the social media about Covid-19 vaccines are delaying the end of Covid-19 epidemic by putting the health care workers at risk of being infected with it as they will be expected to treat patients diagnosed with Covid-19; therefore, government should develop a policy that will limit people from spreading things that they are not true and cannot prove. In conclusion, community awareness and forced vaccination are recommended to end the Covid-19 virus. Monitory incentives should be provided to motivate health care workers. Their overtime that they have worked during Covid-19 must be paid. The Department of Health and hospital managers must make sure that working conditions are improved. This includes the availability of machines to test for Covid-19. More research needs to be done to find out why some people who were diagnosed with Covid-19 end up having chronic illnesses that they never had previously.,Thesis (MPH) -- Faculty of Health Sciences, 2020
Exploring socio-economic factors influencing incidences and outcome of multidrug resistance tuberculosis among patients and facility staffs in Makana Sub-District, Eastern Cape
(University of Fort Hare, 2022-02) Cannon, Lesley-Ann ; Oladimeji, K E
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
The impact of COVID-19 on depression, anxiety, and post-traumatic stress levels in doctors and nurses at a South African health facility
(University of Fort Hare, 2021-12) Finger-Motsepe, Kelebogile; Van Niekerk, Rudolph Leon; Last name, First name
Introduction: The emergence of the coronavirus disease of 2019 (Covid-19) has wrought profound and enduring transformations in global health, economic dynamics, and social interactions. However, the comprehensive quantification of the psychological repercussions of the Covid-19 pandemic remains elusive and is poised to compound the preexisting burden of mental health disorders within the general populace. Elevated transmission rates, rapid disease progression within vulnerable demographics, and the absence of definitive curative or preventive measures have collectively contributed to a heightened worldwide state of stress and anxiety. Extensive research has demonstrated that the apprehension and stress associated with Covid-19 are markedly pronounced among healthcare professionals, commonly referred to as front-line workers, in comparison to the general population. The Covid-19-related psychological distress is anticipated to act as a catalyst, exacerbating mental health conditions within high-risk groups. Aims and Objectives: This study endeavours to ascertain the prevalence and severity of depression, anxiety, and post-traumatic stress disorder (PTSD) among medical doctors and nurses employed at a regional hospital in South Africa. Methodology: A cross-sectional investigation was conducted to evaluate the presence of anxiety, depression, and stress symptoms among medical doctors and nurses working at a Regional Hospital situated in the Free State Province of South Africa. A purposive sample of 200 participants, comprising all willing doctors and nurses employed at the study site, was enrolled in the study. Findings: The participants exhibited an average age of 42 years and an average tenure of approximately 72 months at the hospital. The majority of participants were of African descent, with a male-to-female ratio of 1:2.3. Female healthcare workers reported significantly higher instances of PTSD than their male counterparts. In the aggregate, 71.4percent of doctors reported symptoms indicative of depression, 73.2percent reported anxiety-related symptoms, and 19.6percent reported PTSD-related symptoms. Among nurses, 72percent displayed clinically significant symptoms of depression, 81percent exhibited anxiety-related symptoms, and 27.7percent manifested symptoms suggestive of PTSD. A moderately robust positive correlation was discerned between PTSD and Anxiety (p = .000; r = .466) as well as PTSD and Depression (p = .000; r = .315). Additionally, a strong positive correlation was identified between Anxiety and Depression (p = .000; r = .631). A statistically significant disparity (p = .030) in anxiety levels was observed among workers in different risk-prone areas. Nurses reported substantially higher levels of anxiety (p = .039; M = 10.63, sd = 4.03) compared to doctors (M = 9.01, sd = 3.80) and administrators (M = 10.50, sd = 4.32). Moreover, both nurses (M = 27.06, sd = 13.61) and administrators (M = 33.33, sd = 14.44) exhibited significantly higher instances of PTSD (p = .003) than doctors (M = 19.96, sd = 15.03). Conclusions: The healthcare workers under scrutiny reported elevated levels of anxiety and depression attributable to the Covid-19 pandemic, although the prevalence of posttraumatic stress symptoms was comparatively lower within the hospital setting. Furthermore, this study illuminates that depressive, anxiety, and post-traumatic stress symptoms were more prevalent among nurses than doctors. Additionally, healthcare professionals operating in high-risk Covid-19 environments, such as the Covid-19 ward, demonstrated heightened levels of anxiety when juxtaposed with their counterparts stationed in low-risk Covid-19 areas within the healthcare facility.,Thesis (MPH) -- Faculty of Health Sciences, 2022
Infant feeding knowledge, attitudes and practices of mothers in private health facilities in Alice Town, Eastern Cape, South Africa
(University of Fort Hare, 2022-07) Oyeniran, Aderonke Adepeju; Goon, D T
Background and aim of the study: Within the global field of health education, it is generally accepted that the topic of breast-feeding is a crucial discussion due to its maternal, infant, and communal benefits. However, certain African countries, such as South Africa, experience certain challenges related to both predictive factors and maternal attitudes to breast-feeding. To improve public awareness and promote the implementation of breast-feeding, these factors should be investigated to highlight the importance of this practice among young mothers. Method: The study utilised a cross-sectional survey by means of a self-administered questionnaire, which was completed by the carefully chosen participants. The collected data were then analysed using a statistical package for social sciences (SPSS) (frequency, percentages, mean and standard deviation) and inferential statistics (logistic regression). The level of significance for the inferential statistics was set at 0.05. Results: A total of 377 infant mothers participated in the study with median age of 30. Most infant mothers that participated in the study were well educated with infant mother 189 having a bachelor’s degree. The findings revealed that mothers of 40 years above are 1.51 times more likely not to breastfeed exclusively compared to mothers of less than 40 years of age (95percent CI, 0.75-2.25). The odds ratio of the incidence of decision in breastfeeding for participants with breastfeeding and formula milk was 1.66 (95percent CI, 0.87-2.53). In term of family support, mothers who don’t receive family support were 3.43 times more likely no to breastfeed. The result also revealed that mothers with breast pain were 0.98 more likely not to breastfeed. Conclusion: This study concludes that infant mothers are well informed about breastfeeding. This study also revealed that factors such as infant mothers’ knowledge about breastfeeding, medical health of both mother and infant and cultural norms can go a long way in influencing the decision of mothers to breastfeeding their infant or not.,Thesis (MPH) -- Faculty of Health Sciences, 2022
Investigation of risky sexual behaviour amongst HIV/AIDS positive individuals on antiretroviral treatment in Buffalo City Metropolitan Municipality Eastern Cape Province, South Africa
(University of Fort Hare, 2022-07) Pere, Mzukisi Ernest; Mayeye, B F
Background: Human immunodeficiency virus (HIV)/ acquired immune deficiency syndrome (AIDS) is one of the major public health concerns. Antiretroviral treatments (ART) is available immediately for HIV-positive individuals but sexually transmitted infections are on the rise. The majority of HIV positive patients on ART are engaging in unsafe sexual practices. Purpose: The aim of this study was to investigate risky sexual behaviour of people on antiretroviral treatment regarding prevention. The study was conducted on adult clients in the Buffalo City Metropolitan Municipality. Methods: A quantitative and descriptive cross-sectional design was conducted whereby 304 patients who visited Nontyatyambo Health Centre were randomly selected. Data was entered and analyzed using Statistical Package for the Social Sciences (SPSS) 24. Simple descriptive statistics such as numbers, percentages and tables were used to characterise variables. A chi-square test was used to explore associations between dependent and independent variables. Test significance, confidence intervals and p-values of all the causes and contributory factors were set at 0.05. Results: Thirty two percent reported having sex with multiple sexual partners while 19percent reported never using a condom. Forty eight percent reported having had sexually transmitted infections since starting on ART. The median age (36 years (IQR: 31, 45) vs. 35 years (IQR: 26, 40)) of those who reported STIs was higher than the median age of those who did not report STI (p=0.012). Males (57percent, p=0.049), those who were employed (55percent, p=0.048), and those who were cohabitating (68percent, 0.030) were more likely to report STI. Similarly, those who had unprotected sex with a casual partner (62percent, p<0.001), and those who did not use a condom because a partner did not like it (71percent, p=0.001) were more likely to report STIs. A significant number of 32percent of the participants reported engaging in risky sexual practices while 48percent had reported an STI. Recommendations include educational outreach programmes and capacitation of health care workers with appropriate skills and tools.,Thesis (MPH) -- Faculty of Health Sciences, 2022
Knowledge, attitude and perception of uninitiated adolescents towards customary male initiation practices in selected schools in Buffalo City Municipality, Eastern Cape
(University of Fort Hare, 2022-07) Igaba, Nelson Kibiribiri; Oladimeji, K E; Goon, D T
Background: Based on evidence that Voluntary Medical Male Circumcision (VMMC) significantly reduces the risk of human immunodeficiency virus- HIV transmission by 60percent, the World Health Organization (WHO) recommends implementing VMMC programs in countries with a high HIV prevalence, considering the unique sociocultural and economic dynamics of each setting. However, in South Africa (SA), multiple tribes including the AmaXhosa in the Eastern Cape (EC) province practice Customary Male Initiation (CMI) also known as Ulwaluko as a rite of passage of males from boyhood to manhood, and this involves circumcision. In recent years, this practice has been riddled with deaths of initiates, admissions to hospital, amputation of penis, assaults, drug and alcohol, and crime. Hence, this study aimed at understanding the knowledge, attitude, and perceptions of uninitiated adolescents towards the CMI practice in Buffalo City Municipality (BCM), EC to aid in developing strategies to solve current challenges. Methods: Between June and December 2021, this cross-sectional descriptive study was conducted in selected schools within BCM, in the EC, using a quantitative research approach. The study population included adolescent males aged 15 to 19 years who had not attended CMI. Applying a multistage random sampling technique, three (3)BCM towns (Bhisho, King William Town-KWT and East London-EL) and the Mdantsane township (MT) were selected and further the schools from which consenting pupils were enrolled into the study. Data was collected using a validated self-administered questionnaire which was captured on excel and analysed using STATA version 16.1. Categorical variables were summarized using percentages. Bivariate and multivariate regression was used to determine factors associated with a level of knowledge, attitude, and perception towards CMI and VMMC. The odds ratio with a 95percent confidence interval was calculated. A p–value of <0.05 was considered statistically significant. Results: Among 297 participants that responded 251 (84.51percent) were between the ages of 15-19 years and had not undergone circumcision or CMI. These were included in this analysis. Majority of participants 181 (72.11percent, 95percent CI 66.21-77.33) lacked knowledge on whether circumcision reduces risk of HIV acquisition. More than three quarters of participants 195 (77.69percent, 95percent CI 72.09-83.87) showed absence of knowledge on whether circumcision reduces risk of STIs. Close to all participants 244 (97.21percent, 95percent CI 94.25-98.67) indicated that they would choose CMI over VMMC due to cultural reason. More than three quarters of participants 193 (76.89percent, 95percent CI 71.24-81.72) agreed that CMI/Ulwaluko proves manhood. The presence of knowledge on the benefits of VMMC was positively dependent on the location where a participants lived (uOR 2.32, 95percent CI 1.09-4.97, p-value 0.029) and access to internet more than once a week (uOR 3.44, 95percent CI 1.14-10.43, p-value 0.029. The choice for CMI over VMMC was positively associated with participants living in Mdantsane Township than those living in urban areas (Coef. 1.55, 95percent CI 0.77-2.33, p-value 0.001). Conclusion: This study found lack of knowledge on benefits of VMMC, laws governing and on risks associated with CMI/Ulwaluko practices among uninitiated adolescents. The study further found that CMI/Ulwaluko was still highly regarded despite current challenges and most adolescents would choose CMI/Ulwaluko over VMMC. There is urgent need to integrate VMMC services into CMI/Ulwaluko to include health education on benefits of VMMC, infection prevention and control, male circumcision by trained medical personnel and education on laws governing CMI/Ulwaluko. These interventions should also target uninitiated adolescents.,Thesis (MPA) -- Faculty of Health Sciences, 2022
Knowledge, attitude and perceptions of pre-hospital emergency care providers concerning pre-hospital clinical practice guidelines in the Mangaung Metropolitan area, Free State, South Africa
(University of Fort Hare, 2022-12) Ramoshaba, Mapule Petronella; Nkutu, N T; Last name, First name
Background and Introduction. Pre-hospital emergency care provided in a timeous and efficient manner is a pivotal component in improved patient prognosis, after a life altering situation has occurred. This management of patients is rendered prior to arrival at a medical facility. This service is provided by pre-hospital emergency care providers who apply life saving techniques and knowledge within their scopes of practice and then transporting patients to appropriate medical facilities for definitive care. Pre-hospital emergency care providers of all levels of care, namely: Basic life support, Intermediate life support and Advanced life support render emergency care services to patients with a main goal of seeing patients return back to normal life living. For this to be achieved, the providers must be empowered with the best knowledge, appropriate skills and adequate equipment at their disposal. Clinical practice guidelines are recommendations that are based on evidence in order to support beneficial clinical practices. These were introduced in the pre-hospital setting in South Africa in 2018 to review the scopes of practice of all levels of care, and make appropriate changes and additions for the betterment of the patient and the upskilling of pre-hospital emergency care providers. Since the providers are the end users of these guidelines, and are expected to apply them on patients, they are the best candidates to provide clarity on their perceptions, experiences and challenges which leads to the research questions being: What are the perceptions of the Pre-hospital Emergency Care Providers on the Pre-hospital Clinical Practice in the Guidelines? And What are the challenges experienced by the Pre-hospital Emergency Care Providers with regards to the implementation of the Pre-hospital Clinical Practice Guidelines in the application of Pre-hospital emergency medicine? The aim of the study was to explore the perceptions of the Pre-hospital Emergency Care Providers using the implemented Pre-hospital Clinical Practice Guidelines. Methods The study adopted a qualitative research approach with a purposive sampling method used to select the participants. This type of non-probability technique was suitable in the study as it is based on the researcher’s judgement of the participants being knowledgeable on the questions asked. An interview guide was utilised to collect data through semi-structured one on one interviews during which participants perceptions on the Clinical practice guidelines were shared. The data analysis process brought forth themes and sub themes that were aligned to the research findings which yielded the results. Results/findings The results encompassed the participants’ perceptions about pre-hospital clinical Practice Guidelines, as well as their knowledge, attitude, challenges, suggestions and recommendations. These results unearthed some of the reasons for the pre-hospital emergency care providers perceptions towards the guidelines. The majority of PECPS have a positive attitude towards the pre-hospital clinical practice guidelines, but have challenges with the availability of equipment and drugs which is caused by the lack of due diligence in complying with the implementation of the guidelines. Conclusion The recommendations and suggestions from the participants and researcher come with divisive strategies to the implementation of the guidelines and activities to be applied for the smooth implementation of the pre-hospital clinical practice guidelines. The basis for these recommendations and suggestions were the results as per the research findings.,Thesis (MPH) -- Faculty of Health Sciences, 2022

Browse

Browsing Theses and Dissertations by Title

Results Per Page

Sort Options