Theses and Dissertations

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Knowledge, attitudes, and perceptions of young adolescents regarding traditional male circumcision: An investigation at Clarkebury High School, Eastern Cape Province.
(University of Fort Hare, 2025-05) Salityi, Tabo; Mashau, F.; Ndawule, L.
Background Traditional Male Circumcision (TMC) can be traced back to the 24th Century (2345 BC) through depictions on Egyptian tombs and is probably one of the oldest surgical procedures known (El-Hout & Khauli, 2007). Male circumcision is performed chiefly for religious, cultural, or prophylactic health reasons, with a global prevalence of 38.7% (Morris et al., 2016) and for that reason is culturally referred as initiation schools. The study aimed to explore grade eight male learners’ knowledge, attitude, and perceptions regarding traditional male circumcision. Methodology The study used a qualitative approach, an exploratory design, to explore the knowledge, attitude, and perceptions regarding traditional male circumcision among grade eight learners in Clarkebury High School in Engcobo, Eastern Cape Province, South Africa. Open-ended questions and focus group discussions were used to collect the data. Descriptive statistics have been presented. Results and discussion The findings of this study showed that most participants had positive attitude towards the traditional male circumcision. Only 33% participants were aware of the morbidity and mortality associated with traditional initiation schools. Most were aware of the stigma associated with a failed traditional initiation and medical male circumcision with 67%. Conclusion There are benefits of Traditional Male Circumcision. Lack of knowledge among the teenagers and the complications associated with the TMC is worth to look at by the relevant stakeholders in a form of School Health Promotion Programme.
Professional nurses’ perceptions of the dispensing of chronic medicines through the Central Chronic Medicines Dispensing and Distribution (CCMDD) program in the Amatole Health District, Eastern Cape
(University of Fort Hare, 2021-11-03) Mjekula, Vatiswa Monica; Pinkoane, M.G.
Central Chronic Medicine Dispensing and Distribution is an outsourced, public dispensing service that has been operating in the Eastern Cape Province since 2014. The program was created for stable chronic patients with the goal of reducing waiting times, decongesting Primary Health Care facilities in the sector and increasing chronic medicine accessibility to all South Africans. It is designed to operate in three models, the Fast Lane, Adherence Clubs and External Pick-Up Points. This research study aims to explore perceptions of professional nurses of the dispensing of chronic medicines through the CCMDD program in the Amatole Health District, to establish what the contributory factors are around its effectiveness or its ineffectiveness. The researcher has employed a mixed method approach, using both qualitative and quantitative designs. Creswell (2013) describes mixed methods research as both a method and methodology for conducting research. It involves collecting, analyzing and integrating quantitative and qualitative research in a single study or in a process of inquiry. In combination, it provides a better understanding of a research problem. According to Polit and Beck (2017: 15), explorative studies are undertaken when a new area is being investigated or when little is known about the area of interest. The purpose of this approach is to give full understanding of research problem. Participants were identified by means of non-probability purposive convenience sampling method. Participants were selected based on the fact that they have knowledge of the phenomenon and were already implementing CCMDD program in their facilities. Study population is the group of 62 in total and only 50 professional nurses working in Primary Health Care facilities of Amatole, Eastern Cape that are implementing CCMDD program were interviewed. Data was collected by means a semi structure interview guide with open ended questions for participants to respond in writing, as well as a tape recorder for quality assurance. This was complemented by writing field notes Data analysis was achieved by translation and transcription of both the interview schedule and the tape-recorded information. Content analysis was carried out using the combined methods of content analysis described by Tesch (in Creswell, 2013). A method of content analysis was employed where the researcher analysed the data independently of the co-coder, who was employed to validate the analysed the transcriptions. After independent analysis, the researcher and the co-coder met to compare their findings and to reach consensus. A demographic data was analysed quantitatively and this was going to help the managers in terms of anticipating how many that need to trained in computer and in program management. The results and findings of the study show that the CCMDD program reduces the clinical workload in the congested health care facilities. It also reduces the waiting time for patients before receiving their medication and, furthermore, it encourages adherence to treatment.
Utilization of Public- Private Partnership to improve quality of healthcare services: Mangaung Metro, Free State
(University of Fort Hare, 2025) Jumba, Nwabisa; Thakhathi, D.R.
Introduction: In both developed and developing nations, the cost of providing healthcare has been rising exponentially in recent years. Governments all across the world are looking for new ways to cut costs and expand the capacity of social programmes while making substantial infrastructure investments. Public-private partnerships (PPPs) have gained popularity throughout the world as a means of enhancing the delivery of health care services. Aim: This research aimed to find out how the Free State Department of Health is using public-private partnerships to improve health care quality, and whether partnerships have the potential to improve access, quality, and efficiency in health care. The study focused on exploring and describing the utilization of Public-Private Partnership in improving the quality of health care services in the Free State Province, using the Universitas-Pelonomi PPP projects. Methodology: An explorative qualitative study was conducted using an open-ended interview, semistructured interviews. 18 participants were sampled using snowball sampling was used to sample participants from government and private sector with experience in the UniversitasPelonomi PPP project. Thematic analysis was used to analyse the collected data. Findings: Three themes with six sub-themes were identified. The study findings revealed that PPP have the potential of increasing access to quality health service provision, to close the gap in the public sector. Furthermore, PPP led to attraction and retention of skilled professionals. PPP in healthcare could be enhanced by strengthening contract management, having a dedicated unit for evaluating and accountability, as well as enhancing governance structures. PPP should have a dedicated line item in the budget for effective rollout. The issue of having a legal team to cater for the needs of the government during contract formulation was highlighted as well. Inadequate specific contract management, governance and evaluation systems were identified as identified as the major challenges followed in the Universitas-Pelonomi PPP project. The study recommended that FSDoH should develop the PPPH unit to have the capacity of carrying out the enormous task of conceiving, engaging, implementing and monitoring partnership projects. Other provinces wishing utilise PPP to improve on health care service delivery should use the lessons from the Universitas-Pelonomi PPP to effectively implement this partnership.
Knowledge, attitude and behaviour of secondary school learners towards hypertension and its risks in Burgersfort, Limpopo, South Africa.
(University of Fort Hare, 2025) Aboje, Samson Benjamin; Mtise, T.
Hypertension is a growing global health concern affecting both adults and adolescents. Secondary school learners who are a major subgroup of adolescents are particularly vulnerable due to limited awareness and the formation of long-term health behaviours during this developmental stage. Without timely intervention, early risk may lead to the onset of hypertension and associated complications in adulthood. This study employed a quantitative research approach and descriptive design to assess the knowledge, attitudes, and behaviours related to hypertension among secondary school learners in Burgersfort, Limpopo Province, South Africa. A total of 366 learners were randomly selected from three public secondary schools. Data was collected using a self-developed, structured online questionnaire. A pilot study confirmed the reliability of the instrument, yielding acceptable Cronbach’s alpha values for all sections. Study results revealed significant gaps in secondary school learners' knowledge of hypertension and its risks. Only a small proportion demonstrated accurate understanding of the condition. Attitudes towards hypertension reflected moderate concern, while behavioural practices were generally insufficient to prevent the onset of hypertension. The data suggests disconnection between awareness and health promoting actions among the secondary school learners. In conclusion, the study underscores the need for comprehensive, school-based health education interventions aimed at improving knowledge, fostering positive attitudes, and encouraging preventive behaviours related to hypertension. Such efforts are essential to decrease the early onset of hypertension and reduce long-term health risks in the secondary school learners’ population.
Perceptions of mothers regarding exclusive breastfeeding at Buffalo City Health District in the Eastern Cape.
(University of Fort Hare, 2022-07) Sobuza, Ntombizethu; Murray, D.
The research study aimed to explore and describe the perceptions of mothers with infants 0-6 months of age regarding exclusive breastfeeding. Breastfeeding is the most convenient way of feeding infants as it strengthens the bond between the mother and baby. The study also compiled recommendations to improve breastfeeding practices and ensure that mothers choose exclusive breastfeeding. A qualitative, descriptive. exploratory, and contextual design was employed for this research study to achieve the research objectives. A non-probability convenience sampling method was used. Mothers with babies 0-6 months of age attending well baby clinic for their routine growth and development during their appointment dates in 13 clinics at Buffalo City Metro Health District in the Eastern Cape Province were targeted because they met the criteria. Thirteen participants were Interviewed regarding exclusive breast feeding. An audio recorder was used to record the interviews with the participants consent and was later transcribed by the researcher. Ethical principles were maintained during interviews and concepts of trustworthiness were applied throughout this study. Data analysis was done using Thematic analysis for the study. A total of four themes and nine sub-themes were identified during the analysis of the data and were discussed in detail. All the mothers acknowledged the importance of exclusive breast-feeding during the 1st 6 months of life in new-born babies. The participants that were interviewed even understood the full benefits of exclusive breastfeeding and had a clear understanding of how to deal with challenges regarding exclusive breastfeeding. In conclusion, training of healthcare workers on exclusive breastfeeding seems important and need continuous attention so that they can acquire effective counselling skills that will support and encourage breastfeeding practices. Mothers should be always encouraged regarding exclusive breastfeeding.
Prevalence and risk factors of hearing loss in Grade R learners in Qumbu District.
(University of Fort Hare, 2025) Pierce, Antonette; Stemela-Zali, U.
Experiences of condom usage among female sex workers in Mangaung Metropolitan, South Africa.
(University of Fort Hare, 2023-05) Phetlho, Mpabi Agnes; Murray, D.
This study aimed to achieve two main objectives. Firstly, it aimed to investigate the experiences of female sex workers in actively using condoms to reduce HIV infection during their work. Secondly, it sought to identify the support systems available to increase female sex workers’ use of condoms particularly for those operating on the streets of Mangaung Metropolitan Municipality. The issue at hand does not only affect individuals engaged in the sex industry but also impacts their families and clients. Furthermore, it influences South Africa in its entirety. Both female sex workers and their clients face a heightened risk of contracting HIV and other sexually transmitted infections (STIs). The rising cases of newly reported HIV infections may be attributed to the inadequate utilisation of condoms among female sex workers. As a result, it is essential that those who are involved in the sex work to collectively shoulder the responsibility of ensuring consistent and effective condom usage, thus preventing the widespread prevalence of HIV infections, despite the ample distribution of condoms. Methodology The study adopted research qualitative, descriptive, explorative, and contextual design to explore experiences of female sex workers’ condom usage during sex work. Semi-structured individual interviews with fourteen participants were conducted and these interviews were recorded and later transcribed verbatim. In addition, it implemented a non-probability sampling method, which relied on effective snowball sampling techniques. This research occurred in Mangaung district, within the province of Free State in South Africa; more specifically, it focused on Bloemfontein, the province’s capital, which is currently known as Mangaung. The study encompassed primary healthcare facilities and community health centres close to participants for their convenience. These settings were approved via the Free State Department of Health (FSDOH) authority . Based on the study’s aim and relevant research questions, data were collected and analysed to identify various themes and sub-themes using Tesch’s method. Furthermore, it adhered diligently to ethical principles to ensure its findings were trustworthy. Findings Female sex workers in Mangaung Metropolitan, South Africa, reported positive experiences related to condom usage when they negotiated condom use with their clients. In this regard, some reported adverse experiences with clients, including violence, verbal abuse, and physical abuse. As a result, several participants had become reluctant to use condoms and had subsequently contracted HIV infection and STIs. Participants also highlighted the challenges associated with health professionals, such as harassment at healthcare facilities and victimisation by law enforcement officers. Respondents also reported on the availability of support systems from NGOs, churches, and doctors. Some respondents reported that sex work was their only means of survival amid high unemployment. All participants made suggestions for support systems to address sex workers' needs. Conclusion Sex work has become the only employment option for most participants. Therefore, the government and other stakeholders must collaborate to create employment and to continuously bring awareness of condom use to curb the spreading of HIV and other Sexually transmitted infections.
A retrospective analysis of drug-resistant tuberculosis trends and causal factors in the period between 2016 and 2020 in the Sarah Baartman District of the Eastern Cape province, South Africa.
(University of Fort Hare, 2025-03-12) Petrus, Salmoné Jordania; Maluleke, T.X.; Mashau, F.
Introduction Resistance to anti-tuberculosis (TB) medication is a challenge that TB control practitioners have seen increasing in recent years. Drug-resistant (DR) TB can be caused by many factors, among them non-adherence to medication, substandard medication, inadequate patient care and airborne transmission. The prevalence of DRTB was high, and there was a significant spike in the number of Rifampicin-resistant cases in the Sarah Baartman district. This study aimed to conduct a retrospective analysis of trends and causal factors to Drug-Resistant Tuberculosis in the Sarah Baartman district from 2016 to 2020 using EDR-web, the Drug-resistant Tuberculosis Register. Methods A retrospective, descriptive and quantitative study design was used. Data were collected from files of 100 TB adult patients’ records who had been treated and admitted at the Margery Parkes TB Hospital in Graaf-Reinet. A data extraction tool was used to collect data from the EDR-web register, which was later captured onto a Microsoft Excel® spreadsheet for further analysis. Results Almost two-thirds of the patients in the study were males (60%) and had an average age of 40.8 years. Of the 100 participants, 54% were infected with HIV, and they had a mean CD4 count of 226 with a 95% confidence interval of (161.8 290.2). Sixty-six percent had previously been treated for TB, and 59.1% had been cured. In relation to the current DR-TB diagnosis, 49% had RR-TB, 46% had MDR-TB, and 5% had preXDR. The time taken to initiate patients on treatment was around 15 days, and the treatment duration was an average of 10.8 months. The treatment used was consistent with the WHO guidelines. Most of the patients were on Pyrazinamide PZA (100%), High dose Isoniazid at 89%, Bedaquiline at 82%, Ethambutol at 79%, Clofazimine at 78%, and Levofloxacin at 74%. Thirteen per cent of the participants reported side effects due to the treatment. Concerning treatment outcome, a 60% treatment success rate was achieved and 19% of the participants died. Conclusion The prevalence of DR-TB was found to be high, and an alarming spike in the number of Rifampicin-resistant cases was observed. DR-TB and TB, in general, are more common in males and affect the economically active age group. People living with HIV are at a higher risk of contracting DR-TB because of their weakened immune systems. Treatment compliance will positively affect CD4 count and treatment outcomes. There is a high risk of developing DR-TB or Pre-XDR-TB, without having been previously exposed to TB or TB treatment. RR-TB is emerging fast and is more prevalent than MDR-TB. DR-TB has a high mortality rate when treatment is delayed. Community mobilisation and patient education aimed at improving health-seeking behaviour and basic household infection control mechanisms would be recommended as interventions to curb the spread of DR-TB.
Knowledge, attitudes and behaviours of females requesting termination of pregnancy in Nelson Mandela Bay regarding emergency contraceptives
(University of Fort Hare, 2024-05) Nyangeni, Chwayita; Rala, N.M.
Background Unintended pregnancies leading to termination of pregnancy (TOP) continue to increase regardless of the availability of emergency contraceptives (ECs). The increase in uptake of TOP services suggests underutilisation of ECs. This could be due to insufficient knowledge, negative attitudes, and non-conforming behaviour towards ECs. Objectives This study investigated the knowledge, attitudes, and behaviours of women regarding emergency contraceptive use in Nelson Mandela Bay. Methods A total of 390 women participated in this cross-sectional survey and a structured selfadministered questionnaire was used for data collection. The data were summarised using frequency distribution tables and associations between participant characteristics and KAB were carried out using the chi-square test. Results Participants knew that condom rupture (70.3%) and forced intercourse/rape (64.9%) were circumstances under which ECs may be used. Women from informal settlements were less likely to be aware of the usefulness of ECs in preventing pregnancy (OR=0.3; 95%CI (0.16; 0.59)) compared to township and urban women and so were those with less than university education (OR=0.2; 95%CI (0.07;0.39)). Women from informal settlements and those with high school education were more likely to be neutral than to agree with effectiveness of ECs compared to township women (OR=2.3; 95%CI(1.14;4.69)) and those with university education (OR=2.6; 95%CI (1.38; 4.88)), respectively. Rural women were less likely to have previously used ECs compared to township women (OR=0.2; 95%CI (0.06;0.86)), so were those with high school education compared to university graduates (OR=0.4; 95%CI (0.19;0.74)). Conclusion Emergency contraception knowledge, attitudes, and behaviours were found to be related to the residential type and educational level. This study recommends strengthening awareness campaigns on ECs to women whose messaging considers residential type and education level.
Personality and interpersonal competence skills of newly qualified midwives and psychosocial challenges affecting competence: A descriptive study
(University of Fort Hare, 2024-08) Mzuku, Nozuko Faith; Nikodem, V.C.; Mtise, T.
Transitioning from a student nurse to a newly qualified professional midwife can be a challenging experience. Newly qualified midwives often need to prepare to meet all professional expectations. While clinical competence is commonly measured and discussed in the literature, information on personality and interpersonal competence skills is seldom reported. These skills, including emotional intelligence, teamwork, empathy, integrity, and social boldness, are crucial for effective practice but are often overlooked. Objectives The objectives of this study were to: 1. Measure and describe personality competence skills using the 16-item PF psychometric test. 2. Measure and describe interpersonal competence skills (such as emotional intelligence, teamwork, empathy, integrity, and social boldness) using the open-resource Psychometric 50-Item Interpersonal Skills Questionnaire. 3. Identify psychosocial challenges in the workplace that may impede newly qualified midwives’ acquisition of personality and interpersonal competence skills. Methodology The study employed a quantitative technique and a descriptive, non-experimental design to achieve these objectives. Results A total of 21 newly qualified midwives participated in the study. Most participants reported isiXhosa as their home language and had completed a bachelor’s degree in nursing. Interestingly, the mean age of participants was 32, older than typical newly graduated students, and most reported being single. Personality competence skills varied among participants. The mean score on the interpersonal competency skills assessment indicated that most newly qualified midwives effectively utilised their own emotions and those of others. The results suggested that participants were more adept at working individually than in teams, although teamwork was noted to enhance their performance. Participants were generally more aware of others’ emotions and more cognizant of their emotional states than the average person. The group scored highly on integrity, showing a strong alignment between their actions and personal principles. Social boldness scores indicated that participants were likelier to demonstrate courage and assertiveness in social interactions. Psychosocial challenges identified included staff burnout, low morale, and insufficient recognition from senior midwives. Participants expressed a need for more informal teaching and orientation as newly qualified staff. Additionally, a shortage of staff and a lack of resources or equipment were significant obstacles in the workplace. Conclusions and Recommendations The study underscored the importance of systematically measuring personality and interpersonal competence skills to integrate newly qualified midwives into clinical settings better. Senior midwives are recommended to create a supportive environment to foster the development of these skills. Persistent challenges, such as inadequate resources and support, continue to hinder the effective transition of newly qualified midwives into the workforce. Improving the performance and preparedness of recently qualified midwives depends on resolving these problems.
Delays of breast cancer diagnosis among women in St. Elizabeth Regional Hospital, Eastern Cape, South Africa
(University of Fort Hare, 2025-03-12) Mthinjwa, Mzameleni; Nkutu, N.; Mashau, F.
Introduction: Breast cancer is the most frequently diagnosed cancer among females worldwide. Breast cancer has the highest incidence among all cancers and is the leading cause of cancer death for women worldwide. Noticeably there are women diagnosed with breast cancer at the late stages., and those women have a low survival rate. Delayed diagnosis from the time a breast abnormality is detected to the time of definitive diagnosis; either by the patient or by a healthcare provider may contribute to the negative outcomes, as well as expensive treatment options and higher recurrence rates. The same problem has been identified at St. Elizabeth Regional Hospital in Lusikisiki, in the Eastern Cape Province. The aim and objectives: To assess factors contributing to delays of breast cancer diagnosis among women at St. Elizabeth Regional Hospital, Lusikisiki in the Eastern Cape Province, South Africa. To describe the strategies for the reduction of time to breast cancer diagnosis among women in St. Elizabeth Regional Hospital in Lusikisiki in the Eastern Cape Province, South Africa. Methods: A qualitative approach was used for this study. The study used an explorative, descriptive and contextual design to identify the reasons for delay in breast cancer diagnosis, among women in St. Elizabeth Regional Hospital in Eastern Cape Province, South Africa. A non- probability purposive sampling technique was used. Ethical clearance was received from the University of Fort Hare Research Ethics Committee. Permission was then obtained from the Provincial Department of Health, and St. Elizabeth’s Regional Hospital to continue with the study. The researcher obtained necessary permission from all participants after they had been thoroughly informed about the purpose of the interview. The researcher obtained consent from the participants to tape record the interview for accurate data collection purpose and permission for data analysis. The data was collected from 11 women with confirmed breast cancer diagnosis seen at St. Elizabeth Regional Hospital in Lusikisiki, Eastern Cape Province. A qualitative data was collected using a self-designed semi-structured interview guide by the researcher. Face-to face interview questions were administered by the researcher, probing was done until saturation was reached on 11 participants. Data analysis: The qualitative data was analysed using thematic analysis. To organize the data into themes that identify factors associated with delays in breast cancer diagnosis among women, the researcher utilized the eight steps of Tesch established in Creswell (2014). Results: The main factors contributing to delays of breast cancer diagnosis among women in St Elizabeth Hospital include financial difficulties, lack of knowledge, lack of presentation to the health facility for consultation, fear of breast cancer and surgery, unreasonable turnaround time for investigation results, lack of oncology skills, and lack of referral to other institution for further investigation and management. Conclusion: There should be oncology capacity building in regional hospitals receiving breast cancer patients from clinics and district hospitals, and continuous breast cancer awareness to reduce delays of breast cancer diagnosis.
Experiences of emergency care technicians with regards to inter-facility transfers of critical patients in Mangaung Metro, Free State
(University of Fort Hare, 2023-06) Mohoto, Nokwanda Teddy-Bear; Nkuthu, N.T.
Background: Over the years, the increase in the number of inter-facility transfers of critically ill or injured patients has placed a burden on the healthcare system. Critically ill or injured patients are transferred to higher level facilities/hospitals so that they can receive specialist care. The inter-facility transfers require a multi-disciplinary healthcare system which includes the referring physician/nurses, emergency medical services and the receiving physician/nurses. The nature of these critical transfers has placed great emphasis on the high quality treatment and management required from emergency services. This has pushed emergency services to introducing new qualifications with better capabilities of treating and managing critically ill or injured patients. In Mangaung Metro, Free State, EMS personnel with the required capabilities have not been employed within operations post 2011. This has left personnel (ECT) with lower qualifications and capabilities employed within operations to be the ones undertaking inter-facility transfers of critically patients. The purpose of the study was to explore the current operational ECT’s experiences on inter-facility transfers of critically ill or injured patients. Objectives were to explore the ECT’s experiences on inter-facility transfers of critical patients in Mangaung; to describe the challenges encountered by ECTs concerning inter-facility transfers of the critical patients in Mangaung and to describe the strategies that can be implemented to improve the experiences of ECTs during inter-facility transfer of critically ill patients. Methods: A qualitative approach with a exploratory design was used throughout the research to explore the ECT’s experiences with regards to inter-facility transfers of critically ill or injured patients. Interviews were held with 9 consenting ECT’s under strict COVID-19 protocols. The ECT’s/participants were coded. An interview guide was used to explore the ECT’s experiences, challenges and strategies to enhance outcomes. A tape recorder was used to record the interviews. The interviews were then transcribed verbatim and sent to a co-coder for verification and analysis. Results: Four themes emerged: 1) Experiences of ECT’s conducting inter-facility transfers of critical patients, 2) lack of knowledge regarding inter-facility transfers of critical patients, 3) challenges experienced by ECT’s regarding inter-facility tranfers of xii critical patients and 4) strategies required to enhance safe inter-facility transfer of critical patients. Majority of the participants expressed negative experiences with regards to interfacilility transfers. These negative experiences were due to a lack of proper equipment to undertake critical tranfers, poor management, lack of capabilies or limited scope of practice, poor pre-hospital and in-hospital relationships and communication, amongst other things. The study revealed that critical patients required highly qualified EMS personnel with a broader scope of practice and capabilities to undertake inter-facility transfers of critical patients. Conclusion: ECT’s revealed how overwhelmed they felt undertaking inter-facility transfers of critical patients and expressed the need for more highly qualified personnel to be employed operationally. More focus should also be put on training/refreshing the ECT’s to current protocols. Communication between the multidisciplinary system needs to be improved. The Department of Health needs to procure more and better equipment for ECT’s to be able to perform their duties as well as invest in proper managerial strategies.
The relationship between clinician compliance with national TB drug sensitive tuberculosis management guidelines and treatment outcomes at Mdantsane Correctional Centre, Eastern Cape
(University of Fort Hare, 2023-08-07) Mjijelwa, Vuyolwethu; Giyose, P.; Mandeya, A.
Tuberculosis (TB) is an inflammatory infectious disease caused by Mycobacterium tuberculosis which affects any tissue of the body. The most common site of disease is the lungs (World Health Organisation, 2023). WHO developed guidelines for managing this disease and South Africa developed its own context specific guidelines. However, compliance with these guidelines is not always possible for various reasons, especially in sub-Saharan Africa. This study was conceptualised with the intention of assessing TB management practices in correctional centres and determining how those practices may be related to treatment outcomes. The main objectives were to determine the compliance of correctional centre clinicians with TB management guidelines and to see if there is a relationship between compliance with guidelines and treatment outcomes. A cross sectional study design was used and data was extracted from 106 patient files. Frequency distributions were used to determine the extent of compliance and the chisquare test was used to test for relationships between different compliance aspects and treatment outcomes. Odds ratios and 95% confidence intervals were used to measure the strength and direction of detected relationships. While there was high compliance in most of the aspects of TB management as per the guidelines, there was lack of justification of deviations, whenever they occurred. The patients who were more likely to have positive treatment outcomes were those whose baseline smear results were known (OR=4.8; 95%CI (1.22;22.59)), whose weight was monitored (OR=1.5; 95%CI (1.27;1.71)) and whose treatment duration was known (OR=6.1; 95%CI (1.39;26.81)). The Department of Correctional Services health management should develop a comprehensive capacitation plan that will include mentoring and monitoring of compliance with TB guidelines. An effective linkage to the care system within correctional services and DOH facilities must be developed to ensure continuity of care and improve treatment outcomes. Tuberculosis case-finding and contact tracing require more research to understand the trends of infection and inform comprehensive infection control policies.
Investigation of the Covid-19 pandemic impact on Child Health and Nutrition Services in Primary Health Care facilities, Mnquma Local Municipality: A retrospective study
(University of Fort Hare, 2023-08-31) Mdingi-Buqa, Namhla Linda; Murray, D.; Mayeye, F.
Introduction The Coronavirus-19 (COVID-19) pandemic, a global phenomenon with multiple waves of infection, significantly disrupted livelihoods and health services worldwide. While evidence suggested children were less susceptible to severe illness and death from the virus itself, the pandemic’s indirect effects put them at risk. many countries including South Africa, responded by declaring a state of disaster and implementing movement restrictions to control the spread of the virus. This study investigated the impact of these measures on child health and nutrition services in the Mnquma subdistrict of the Amathole District, South Africa. Methods This study employed an explanatory sequential mixed method of quantitative and qualitative designs. In terms of quantitative data, retrospective data was analysed in two parts. Firstly, Part One involved reviewing twenty health patient records from 2019/20 to 2020/21 period. Part Two (2) focussed on twelve child health and nutrition indicators for children aged two years old, extracted from the District Health Information Management System (DHIS). This allowed for a comparison of trends in service utilisation between pre-pandemic and pandemic periods. On the other hand, qualitative research explored factors contributing to reduced access to health care and disruptions in services. The researcher used purposive sampling to select the five clinics for convenience and proximity. During data collection at each clinic, caregivers were recruited and interviewed until data saturation was reached. Results The study revealed the negative consequence of the COVID-19 pandemic on child health service utilisation. Data from the District Health Information System (DHIS) for 2019/20 showed generally lower immunisation rates in 2020 compared to 2019 except for the first dose Diphtheria, Tetanus, and Pertussis (DTaP) vaccine. Interestingly the variations in proportions between the two years for DTaP (first dose), DTaP (third vi dose), and measles vaccination were statistically significant (chi -square=3668.5, pvalue<0.0001). Analysis of the data also indicated a decline in the number of children fully immunised. These decreases ranged from 1.9% to 4.4% in Mpukane, Nqancule, and Zazulwana clinics. Conversely, Hebe-Hebe and Ndabakazi clinics reported increases of 4.8% and 1.6% respectively. Reviews of children’s medical records revealed coughs as the most prevalent illness affecting 50% of children’s visits. Vomiting was a less frequent issue accounting for15% of consultations for this symptom. Notably, the study found no significant changes in the nutritional status during the pandemic. Caregiver interviews identified challenges during the pandemic that likely hindered access to child health and nutrition services. These challenges included movement restrictions due to COVID-19 regulations, temporary clinic closures, fear of contracting COVID-19, and clinic staff shortages that further strained the services. Additionally, the high cost of private health care made it difficult for some caregivers to access necessary care for their children. Conclusion This study concluded that the COVID-19 pandemic significantly disrupted access to and utilisation of child health and nutrition services in the Mnquma sub-district, South Africa. Children primarily presented with COVID-19-related symptoms like cough, gastroenteritis, and eye/ear infections. Several factors hindered service utilisation, including movement restrictions due to lockdown, clinic closures, and caregiver fear of contracting the virus. Furthermore, the reported hunger, household food insecurity, school closures, and long queues at grocery stores negatively impacted the nutritional status of children.
Psychological, emotional and social wellbeing of adolescents in urban and semi-urban communities of Centurion, Gauteng
(University of Fort Hare, 2025-03-12) Matukane, Alucia Nkateko; Mashau, F.; Wagner, J-D.
Background: Adolescents in developing countries seem to be experiencing significant behavioural changes, with mental health being the leading cause. This study aims to describe and compare the psychological, emotional, and social wellbeing of adolescentsliving in urban and semi-urban areas. Methods: A cross-sectional study was conducted among 414 adolescents (aged between 10 to 19 years), using Keyes’s MENTAL HEALTH CONTINUUM SHORT FORM in both urban and semi-urban communities. Descriptive and inferential statistical analysis were used to compare the differences with significance set at p<0.05. Results: Based on Keyes (2009) Mental Health Continuum model, the descriptive statistics using Pivot Tables more than two-thirds of the participants were classified as being moderately mentally health (185,58%) with the remainder being classified along the continuum as flourishing (98,31%) and languishing (37,11%). Two samples t-test analysis results have shown a high significance level on emotional wellbeing (p=0.0000), a low significance level on social wellbeing (p=0.0570) and no significance in the psychological wellbeing (p=9949) of the adolescents from the two communities. Further analysis using the Chi-square test revealed a statistically significant difference in five of the MHC-SF 14 items. Items 1 to 3 (p<0.001) and items 4 - 5 (p=0.015, p=0.003). There was no statistically significant difference in items 6 to 14 of MHC-SF. Conclusion: The majority of the adolescents who took part in this study had moderate mental health, followed by those who were flourishing, as evidenced by positive functioning symptoms. Adolescent mental health problems are linked to their general wellbeing. Interventions for mental health issues vary depending on what is causing them. This study can be used to determine the need for policies and programs that can support adolescents' mental health resilience in changing social determinants of health situations, as adolescent mental health becomes a more important issue.
The role of community-based organisations and ward-based outreach teams in the implementation of the 90-90-90 Human Immunodeficiency Virus Treatment Strategy in the Amathole District
(University of Fort Hare, 2023) Makeleni, Ntombekhaya Phyllis; Goon, D.T.
Community-based services are vital to the achievement of goals set for ending HIV as a public health threat. Amathole Health District has not produced the desired results towards the achievement of the 90-90-90 HIV treatment strategy. The aim of this study was to assess the role of community-based organisations and wardbased outreach teams (WBOTs) in the implementation of the 90-90-90 HIV treatment strategy in Amathole in the Eastern Cape, South Africa. A qualitative design was followed by conducting face-to-face interviews with purposively selected ward-based outreach team leaders and managers of community-based organisations. Focus group discussions were held using an interview guide. Individual interviews included four ward-based outreach team leaders and five managers of communitybased organisations. Focus group discussions were inclusive of four groups of community health workers from ward-based outreach teams (WBOTs) and five groups of community care givers from community-based organisations (CBOs). The findings of the study were five common themes included: case finding where home visits and counselling were provided; linkage to care where referral of clients and tracing of defaulters was done; retention to care which included conducting follow-up visits and client monitoring; collaboration between CBOs, WBOTs, and health facilities and success achieved in the implementation of the 90-90-90 human immunodeficiency virus (HIV) treatment strategy which included viral suppression, decreased deaths, and tracing of defaulters. It is concluded that the continuum of HIV care requires more efforts towards ensuring that there is synergy between community-based workers and public health institutions for the achievement of the 90-90-90 targets.
A programme for promoting the uptake of organ donation among Xhosa Community in the Eastern Cape Province
(University of Fort Hare, 2024-11) Mtise, Tobeka; Seekoe, E.; Goon, D.T.
Currently, there exists a global shortage of viable organs that meet the high transplantation demands as treatment options. While there is an increasing need for organ transplantation, people are dying on a daily basis because they are not receiving the life-saving organs they require. Furthermore, while many South Africans rely on life-saving organ transplants, convincing rural black communities to donate organs is an arduous task because of their prevailing cultural beliefs. Considering the above, the overall aim of this study was to develop a programme promoting the uptake of organ donation among the Xhosa community in the Eastern Cape Province by empowering them with the necessary knowledge and understanding of organ donation. Moreover, it sought to promote community discussion of and participation in organ donation. The researcher anticipated that by equipping communities and individuals with truth-based facts, more people would be willing to become organ donors, thereby addressing the severe shortage thereof.
A Retrospective analysis of maternal death in the Nelson Mandela Academy Hospital in Eastern Cape Province, South Africa from 2013 to 2017
(University of Fort Hare, 2023-05) Majiki, Nosipho Sharon; Maluleke, T.X.
Background: Globally thousands of women die each year from preventable causes during pregnancy and childbirth. It is considered the key indicator of a country's progress in improving the health status of their communities these deaths of women could be prevented through the provision of the skilled birth attendance, emergency obstetric and neonatal care services and increase use of contraceptives. However, many poor countries cannot manage to provide these to pregnant women. It is unfortunate that the deaths of women in a family and community bring along many psychological and emotional factors in families and health services, because it leads to a long-term social and economic breakdown, both for the immediate family and the wider community. Furthermore, the cost of the maternal death to families, living children, and other dependents are widespread, affecting future generations and economic progress of the country. The study was conducted using patients’ records women classified as maternal deaths at Nelson Mandela Academic Hospital in the 2013 to 2017.The aim of the study was to conduct a descriptive retrospective review maternal death causes, trends and contributory factors of maternal death in Nelson Mandela Academic Hospital in the year 2013 to 2017. Methodology: It was a retrospective analysis, quantitative and descriptive study where 202 maternal death patients whose age was between 18 and 45 years old and were admitted in NMAH. Two hundred patient’s files were reviewed and analysed over. Only record files of patient’s that were admitted and died in Nelson Mandela Academic Hospital in Umtata due to pregnancy related conditions. Data were collected over a period of twelve weeks and analysed using descriptive statistics. Results: The main primary causes of maternal deaths at NMAH were non-pregnancy-related, infections and avoidable factors that included lack of appropriately trained specialist and health personnel; delay in initiating care or delay of referrals; lack of blood products; managing patients at an inappropriate level of care; problem recognition; and sub-standard care in the referral hospitals. The patient related contributory factors were unbooked patients, delay in seeking help and patients’ refusal of medication or surgery or advice for religious reasons.
The study of self-esteem among patients diagnosed with schizophrenia attending theout-patient department od Cecilia Makiwani Hospital in East London area.
(University of Fort Hare, 2009) Durrheim, Ricarda Janet; Magadla, N.I.N.
The objective of the current study was to determine the self-esteem of people who suffer from schizophrenia. The study was aimed at gaining information about the self-esteem of the schizophrenic person living in the East-London area and seen by the psychiatrist at Cecilia Makiwane hospital during the year 2008.
Knowledge and attitudes of professional nurses towards HIV and AIDS patients at the Libode District health services in the Eastern Cape Province.
(University of Fort Hare, 2011-12-08) Gedu, Grace Nontutuzelo; Tshotsho, N.
This study was conducted at the Libode District Health Services amongst professional nurses who render services to HIV and AIDS patients. Generally, caring for HIV positive patients, nurses need to be knowledgeable about the transmission of the HIV virus, in order to render quality care to the patients. They also need to be sensitive and to demonstrate positive attitudes towards the patients. It was unknown whether the professional_ nurses at the Libode District Health Services are knowledgeable or not regarding HIV and AIDS. Their attitudes towards the HIV positive patients, were also unknown. Not knowing the knowledge and attitude of professional nurses regarding HIV and AIDS has the potential to compromise the quality of nursing care rendered to the patients. The purpose of the study was to explore and describe the level of knowledge of professional nurses regarding HIV and AIDS well as their attitudes towards the HIV-positive patients so as to make recommendations for quality patient-care based on the results.

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