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Safe handling, storage, and management of vaccines at selected primary health care facilities in Buffalo City Metropolitan, Eastern Cape Province
(University of Fort Hare, 2022-04) Mazwembe-Hoho, Andiswa Zimkitha; Mangi, N; Seekoe, E; Last name, First name
Background The World Health Organization has a standardized tool for assessing vaccine handling and management. South Africa has adopted WHO tools to suit its own conditions of supply and storage of vaccines, the WHO tool is a guideline for managing vaccines. Importantly, every person handling or supervising handling of vaccines should own this manual (s) and use it as a reference for the handling, storage, and management of vaccines and related items. Aim The aim of this study was to examine safe handling, storage, and management of vaccines by health care workers in PHC facilities of BCM Municipality. Methodology A quantitative research approach and descriptive design was used to assess the safe handling, storage, and management of vaccines in PHC facilities in BCM in EC. Results The results showed that safe handling, storage, and management of vaccines in PHC facilities in BCM does not comply fully on safe handling, storage, and management of vaccines. The overall compliance rate was 86%, and this indicated that healthcare workers have knowledge of what is required to be compliant with safe handling, storage, and management of vaccines. Conclusion Safe handling, storage, and management ovaccines in PHC facilities in BCM is conditionally compliant as the healthcare workers have moderate-to-satisfactory knowledge.,Thesis (MPH) -- Faculty of Health Sciences, 2022
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; Last name, First name
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
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
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