Analysis of the role of unions in health services delivery at Uitenhage district hospital
- Authors: Tshamase, Nozibele Yvonne
- Date: 2018
- Subjects: Public health Health services accessibility Labor unions
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: http://hdl.handle.net/10353/12348 , vital:39255
- Description: Purpose: According to Khan and Khan (2011:56), a trade union is an organization of employee tasked with activities which include negotiating on behalf of their members for “pay and conditions of employment”. Several authors have purported that these roles extend beyond ensuring not only that the rights of workers are not violated and that their working environment complies with health and safety standards, but also that unions may have an effect on management practices, generally and specifically, on efficiencies and performance (Zulu, 2009; McGuire, 2011; & Dhliwayo, 2012). Health care workers including professionals are organised by the unions in a bid to influence social and economic reforms in the South African democracy. The main aim of this study was to examine the role of public sector unions and how they exercise their functions in delivery of health services Method: A qualitative research method based on phenomenological and case approaches was applied. Semi-structured interviews with open ended questions were used to prompt discussions. Documents were used to obtain complementary data. Senior managers, middle managers, union/employee representatives and employees who are members of the unions in the district hospital of Nelson Mandela Bay health district constituted the target population. Purposive non-probability sampling, which was the preferred method for this study, yielded 16 participants. Results Analysis followed Creswell’s thematic analysis involving coding responses categorising them and identifying themes. This followed repeated and thorough listening to the recorded interviews and transcribing. Themes identified were organisational functioning in line with the service delivery context; worker’s rights protection; negotiating better service conditions; implementing legislation, policies and resolutions; union-management interaction; engaging in strikes and impact on services delivery. Conclusion and Recommendations: The study found that the presence of unions in health care services was necessary because there are various categories of employees – working class – whose interests must be served. The role of the unions leaned heavily towards protection of the rights of the workers. As far as the observation of legislation is concerned, the unions demonstrated knowledge of the legislation applicable to the health care personnel, that is, the BCEA, the LRA and the PSA. The study found that unions were a hindrance to health services delivery in their quest to exercise voice monopoly. The unions tended to exert undue influence on management resulting in lack of discipline and dereliction of duty. The strike actions compromised quality of health care and the rights of citizens to access health care. There was no active participation nor positive contributions in committees where advancement of service delivery standards were deliberated and promoted. Recommendations included training of shop stewards; capacitation and training of managers, and development and communication of departmental labour relations policies.
- Full Text:
- Date Issued: 2018
- Authors: Tshamase, Nozibele Yvonne
- Date: 2018
- Subjects: Public health Health services accessibility Labor unions
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: http://hdl.handle.net/10353/12348 , vital:39255
- Description: Purpose: According to Khan and Khan (2011:56), a trade union is an organization of employee tasked with activities which include negotiating on behalf of their members for “pay and conditions of employment”. Several authors have purported that these roles extend beyond ensuring not only that the rights of workers are not violated and that their working environment complies with health and safety standards, but also that unions may have an effect on management practices, generally and specifically, on efficiencies and performance (Zulu, 2009; McGuire, 2011; & Dhliwayo, 2012). Health care workers including professionals are organised by the unions in a bid to influence social and economic reforms in the South African democracy. The main aim of this study was to examine the role of public sector unions and how they exercise their functions in delivery of health services Method: A qualitative research method based on phenomenological and case approaches was applied. Semi-structured interviews with open ended questions were used to prompt discussions. Documents were used to obtain complementary data. Senior managers, middle managers, union/employee representatives and employees who are members of the unions in the district hospital of Nelson Mandela Bay health district constituted the target population. Purposive non-probability sampling, which was the preferred method for this study, yielded 16 participants. Results Analysis followed Creswell’s thematic analysis involving coding responses categorising them and identifying themes. This followed repeated and thorough listening to the recorded interviews and transcribing. Themes identified were organisational functioning in line with the service delivery context; worker’s rights protection; negotiating better service conditions; implementing legislation, policies and resolutions; union-management interaction; engaging in strikes and impact on services delivery. Conclusion and Recommendations: The study found that the presence of unions in health care services was necessary because there are various categories of employees – working class – whose interests must be served. The role of the unions leaned heavily towards protection of the rights of the workers. As far as the observation of legislation is concerned, the unions demonstrated knowledge of the legislation applicable to the health care personnel, that is, the BCEA, the LRA and the PSA. The study found that unions were a hindrance to health services delivery in their quest to exercise voice monopoly. The unions tended to exert undue influence on management resulting in lack of discipline and dereliction of duty. The strike actions compromised quality of health care and the rights of citizens to access health care. There was no active participation nor positive contributions in committees where advancement of service delivery standards were deliberated and promoted. Recommendations included training of shop stewards; capacitation and training of managers, and development and communication of departmental labour relations policies.
- Full Text:
- Date Issued: 2018
Assessment of the integrated HIV/AIDS curriculum at a university in the Eastern Cape: views of students and educators
- Terblanche, Delcia Jill Nora
- Authors: Terblanche, Delcia Jill Nora
- Date: 2018
- Subjects: AIDS (Disease) -- Study and teaching , AIDS (Disease) -- Prevention , Universities and colleges
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10353/12359 , vital:39256
- Description: Background: HIV/AIDS is a major global public health problem. The higher education sector too, is affected by the scourge of HIV/AIDS. Universities are considered to be high- risks areas for HIV infection because many students indulged in high risky behaviour link to HIV infection; therefore developing ways to prevent students for acquiring HIV and as well reducing HIV prevalence rates through training and teaching about HIV/AIDS will contribute to change in behaviour of students. Anecdotal evidence suggests that the majority of the students at Fort Hare lack the general awareness and education in HIV/AIDS due to lack of information coupled with their general disadvantaged background with the ultimate result being threatened by high infection rates. The University of Fort Hare (UFH), in a bid to capacitate the academic staff in respect of the laudable initiative to integrate HIV/AIDS in curricula, decided to embark on a pilot study that is anticipated to form fundamental strategies to sustainable HIV/AIDS curricula integration across all faculties, at least by the end of 2030. The university has planned to engage in the curriculum integration process by implementing a two year cycle pilot study during the grant period. Aim: The main aim of the study was to assess the challenges faced by students and educators concerning the integration and implementation of HIV/AIDS curriculum at the University of Fort Hare. Methods: The study adopted a quantitative, explorative descriptive design to examine the challenges associated with the Integrated HIV/AIDS curriculum at the University of Fort Hare. The target population was the educators and students who had training and teaching in the Integrated HIV/AIDS curriculum. A purposive sampling was used to select 487 students and 23 educators from across three departments: Nursing Science, LKA (Life, Knowledge and Action) and Law involved in the HIV/AIDS Curriculum Integration programme at the university. A self-design questionnaire was used for data collection focusing on the demographic profiles of the participants, the teaching strategies and methodologies adopted in the Integrated HIV/AIDS curriculum, the usefulness and relevance of the newly integrated HIV/AIDS curriculum content in addressing the needs of the students and the community, and the challenges faced by the educators and students in the Integrated HIV/AIDS curriculum. Ethical approved was obtained from the Research Ethics Committee of the University of Fort Hare. Permission was obtained from the participants through written consent forms. The data was analysed using descriptive statistics (frequency counts, percentage, means and standard deviations (SD)). The Chi-square test was used to examine the relationship between the variables of interest across the departments. A p-value of 0.05 was set for statistical significant testing. Results: The majority of the participants have adequate knowledge of HIV transmission, as 93.2 percent indicated HIV can be contracted through unprotected sex, sharing of needles (92.1 percent), receiving a blood transfusion that has not been screened for HIV (83.9 percent), sharing razor blades that has not been disinfected (83.0 percent), and having more than one sexual partner (86 percent). Age, gender, race and department were significantly associated with knowledge of route of HIV transmission. The present study indicated that the participants experienced several challenges during the teaching of the Integrated HIV/AIDS curriculum. Time allocated was the biggest challenge (58.3 percent), followed by undated materials, and curriculum overloading and teaching. The study indicated that majority of the students would like to compile a portfolio of evidence in the teaching of HIV, followed by creative arts, DVD/movies, and internet research. The majority of the lecturers preferred to teach HIV/AIDS through expressive arts, followed by role play, and formal lectures. The majority of the participants stated that HIV/AIDS information would be useful to them to apply in their communities and in their profession (97 percent), emphasizing that such knowledge and information will empower them to participate in roadshows and voluntary work at HIV/AIDS Shelters. The findings of this study pertaining to the challenges faced by educators during the implementation of the Integrated HIV/AIDS curriculum revealed that the majority of the participants stated that the HIV information was not updated, heavy workload, and adequate training. The lecturers expressed that they would prefer to teach HIV/AIDS curriculum by expressive art through drawing and creating art that expresses HIV and the relevance in the students’ community. Conclusions: Majority of the students received teaching of HIV as part of a course, and HIV teaching as an integrated component in a subject, while few received it as a stand-alone subject offered by a lecturer/facilitator. The present study indicated that the participants experienced several challenges during the teaching of the Integrated HIV/AIDS curriculum. Time allocated was the biggest challenge (58.3percent), followed by undated materials, and curriculum overloading and teaching. The majority of students preferred HIV/AIDS to be taught by their peers experience in HIV, by face-to face by a person who is HIV/AIDS infected or affected. The majority of the lecturers preferred to teach HIV/AIDS through expressive arts, followed by role play, and formal lectures. The majority of the participants affirmed the relevancy of HIV information taught. They further indicated that the information and knowledge gain would able them to make informed decisions on sexual behaviour. The majority of the participants stated that the HIV information was not updated, heavy workload, and adequate training. Most of the educators used formal lectures, followed by compilation of a portfolio of evidence, storytelling, DVD and movies, and experiential learning in hospitals and clinics in teaching HIV/AIDS integrated curriculum. The lecturers expressed that they would prefer to teach HIV/AIDS curriculum by expressive art through drawing and creating art that expresses HIV and the relevance in the students’ community. It is recommended that student’s involvement in the decision making processes of the integrated HIV/AIDS curriculum at the University of Fort Hare would make the programme more successful. HIV/AIDS resource materials need to be updated regularly and relevant to provide educators with specialized knowledge to be able to teach HIV/AIDS.
- Full Text:
- Date Issued: 2018
- Authors: Terblanche, Delcia Jill Nora
- Date: 2018
- Subjects: AIDS (Disease) -- Study and teaching , AIDS (Disease) -- Prevention , Universities and colleges
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10353/12359 , vital:39256
- Description: Background: HIV/AIDS is a major global public health problem. The higher education sector too, is affected by the scourge of HIV/AIDS. Universities are considered to be high- risks areas for HIV infection because many students indulged in high risky behaviour link to HIV infection; therefore developing ways to prevent students for acquiring HIV and as well reducing HIV prevalence rates through training and teaching about HIV/AIDS will contribute to change in behaviour of students. Anecdotal evidence suggests that the majority of the students at Fort Hare lack the general awareness and education in HIV/AIDS due to lack of information coupled with their general disadvantaged background with the ultimate result being threatened by high infection rates. The University of Fort Hare (UFH), in a bid to capacitate the academic staff in respect of the laudable initiative to integrate HIV/AIDS in curricula, decided to embark on a pilot study that is anticipated to form fundamental strategies to sustainable HIV/AIDS curricula integration across all faculties, at least by the end of 2030. The university has planned to engage in the curriculum integration process by implementing a two year cycle pilot study during the grant period. Aim: The main aim of the study was to assess the challenges faced by students and educators concerning the integration and implementation of HIV/AIDS curriculum at the University of Fort Hare. Methods: The study adopted a quantitative, explorative descriptive design to examine the challenges associated with the Integrated HIV/AIDS curriculum at the University of Fort Hare. The target population was the educators and students who had training and teaching in the Integrated HIV/AIDS curriculum. A purposive sampling was used to select 487 students and 23 educators from across three departments: Nursing Science, LKA (Life, Knowledge and Action) and Law involved in the HIV/AIDS Curriculum Integration programme at the university. A self-design questionnaire was used for data collection focusing on the demographic profiles of the participants, the teaching strategies and methodologies adopted in the Integrated HIV/AIDS curriculum, the usefulness and relevance of the newly integrated HIV/AIDS curriculum content in addressing the needs of the students and the community, and the challenges faced by the educators and students in the Integrated HIV/AIDS curriculum. Ethical approved was obtained from the Research Ethics Committee of the University of Fort Hare. Permission was obtained from the participants through written consent forms. The data was analysed using descriptive statistics (frequency counts, percentage, means and standard deviations (SD)). The Chi-square test was used to examine the relationship between the variables of interest across the departments. A p-value of 0.05 was set for statistical significant testing. Results: The majority of the participants have adequate knowledge of HIV transmission, as 93.2 percent indicated HIV can be contracted through unprotected sex, sharing of needles (92.1 percent), receiving a blood transfusion that has not been screened for HIV (83.9 percent), sharing razor blades that has not been disinfected (83.0 percent), and having more than one sexual partner (86 percent). Age, gender, race and department were significantly associated with knowledge of route of HIV transmission. The present study indicated that the participants experienced several challenges during the teaching of the Integrated HIV/AIDS curriculum. Time allocated was the biggest challenge (58.3 percent), followed by undated materials, and curriculum overloading and teaching. The study indicated that majority of the students would like to compile a portfolio of evidence in the teaching of HIV, followed by creative arts, DVD/movies, and internet research. The majority of the lecturers preferred to teach HIV/AIDS through expressive arts, followed by role play, and formal lectures. The majority of the participants stated that HIV/AIDS information would be useful to them to apply in their communities and in their profession (97 percent), emphasizing that such knowledge and information will empower them to participate in roadshows and voluntary work at HIV/AIDS Shelters. The findings of this study pertaining to the challenges faced by educators during the implementation of the Integrated HIV/AIDS curriculum revealed that the majority of the participants stated that the HIV information was not updated, heavy workload, and adequate training. The lecturers expressed that they would prefer to teach HIV/AIDS curriculum by expressive art through drawing and creating art that expresses HIV and the relevance in the students’ community. Conclusions: Majority of the students received teaching of HIV as part of a course, and HIV teaching as an integrated component in a subject, while few received it as a stand-alone subject offered by a lecturer/facilitator. The present study indicated that the participants experienced several challenges during the teaching of the Integrated HIV/AIDS curriculum. Time allocated was the biggest challenge (58.3percent), followed by undated materials, and curriculum overloading and teaching. The majority of students preferred HIV/AIDS to be taught by their peers experience in HIV, by face-to face by a person who is HIV/AIDS infected or affected. The majority of the lecturers preferred to teach HIV/AIDS through expressive arts, followed by role play, and formal lectures. The majority of the participants affirmed the relevancy of HIV information taught. They further indicated that the information and knowledge gain would able them to make informed decisions on sexual behaviour. The majority of the participants stated that the HIV information was not updated, heavy workload, and adequate training. Most of the educators used formal lectures, followed by compilation of a portfolio of evidence, storytelling, DVD and movies, and experiential learning in hospitals and clinics in teaching HIV/AIDS integrated curriculum. The lecturers expressed that they would prefer to teach HIV/AIDS curriculum by expressive art through drawing and creating art that expresses HIV and the relevance in the students’ community. It is recommended that student’s involvement in the decision making processes of the integrated HIV/AIDS curriculum at the University of Fort Hare would make the programme more successful. HIV/AIDS resource materials need to be updated regularly and relevant to provide educators with specialized knowledge to be able to teach HIV/AIDS.
- Full Text:
- Date Issued: 2018
Isolation and characterization of E. coli and Campylobacter spp. from diarrhoeal samples collected from selected hospitals in Amathole District Municipality, Eastern Cape, South Africa
- Authors: Omolajaiye, Sunday Abraham
- Date: 2018
- Subjects: Escherichia coli infections Campylobacter infections Diarrhea
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: http://hdl.handle.net/10353/6213 , vital:29515
- Description: Approximately 2-4 billion cases of infectious diarrhoea occur every year, with the highest numbers recorded in sub-Saharan Africa. It remains the most common public health issue among children in developing nations. The purpose of this research was to unfold the prevalence of diarrhoeagenic E. coli and Campylobacter pathotypes as well as elucidate their antibiogram characteristics in diarrhoeal stool samples collected in some medical facilities in Eastern Cape Province, South Africa. Two hundred stool samples were collected from both inpatients and outpatients from male and females of all age groups attending selected medical facilities in the study area. Isolation and characterization of both organisms were done using culture based and molecular methods. Antibiotic susceptibility patterns of identified isolates were determined against a panel of 12 antimicrobial agents. One hundred and twenty presumptive E. coli isolates and 42 presumptive isolates of Campylobacter spp. Were isolated. Eighty-two percent (82 percent) of the presumptive E. coli isolates were confirmed as E. coli while 46.3 percent belonged to Campylobacter spp. Pathotyping of the diarrhoeagenic E. coli isolates by Polymerase chain reaction (PCR) showed the following prevalences: DAEC 43 (32 percent), EHEC 18 (17 percent), EIEC 11 (10 percent) and EPEC 18 (17 percent). EAEC and ETEC were not detected, while for Campylobacter spp. 37 (88 percent) were C. jejuni, and C. coli was not detected. A total of 12 (32.4 percent) of the confirmed Campylobacter jejuni isolates were found to possess the fliM gene, 9 (24.3 percent) possessed the flhA gene and only 6 (16.2 percent) harboured the gene flgE2. None were positive for the flaA, flab and flhB genes.The antibiotic resistance patterns observed among the E. coli isolates were high against ampicillin (98.1 percent), chloramphenicol (94.3 percent) and tetracycline (90.6 percent). For Campylobacter spp., resistance observed were: chloramphenicol (91.6 percent), tetracycline (25.2 percent), erythromycin (49.6 percent) and gentamycin (56.4 percent). A lesser resistance against imipenem (35.9 percent) and quinolone (ciprofloxacin) (45.5 percent) were exhibited by the E.coli isolates. 10.8 percent and 20.3 percent of the Campylobacter isolates were resistant to imipenem and ciprofloxacin respectively. The presence of chloramphenicol (CatA1) and tetracycline (tetA) resistance genes were detected in 94 percent and 89 percent of E. coli isolates respectively while 98 percent of Campylobacter spp. Harboured the catA1 resistance gene. It could be deduced from this study that E. coli and Campylobacter spp. are predomiant enteric pathogens as the etiologic agents of diarrhoea in the study community, and that their antimicrobial resistance is high in the study location. The need to develop strategies to prevent infection and control resistant organisms is evident.
- Full Text:
- Date Issued: 2018
- Authors: Omolajaiye, Sunday Abraham
- Date: 2018
- Subjects: Escherichia coli infections Campylobacter infections Diarrhea
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: http://hdl.handle.net/10353/6213 , vital:29515
- Description: Approximately 2-4 billion cases of infectious diarrhoea occur every year, with the highest numbers recorded in sub-Saharan Africa. It remains the most common public health issue among children in developing nations. The purpose of this research was to unfold the prevalence of diarrhoeagenic E. coli and Campylobacter pathotypes as well as elucidate their antibiogram characteristics in diarrhoeal stool samples collected in some medical facilities in Eastern Cape Province, South Africa. Two hundred stool samples were collected from both inpatients and outpatients from male and females of all age groups attending selected medical facilities in the study area. Isolation and characterization of both organisms were done using culture based and molecular methods. Antibiotic susceptibility patterns of identified isolates were determined against a panel of 12 antimicrobial agents. One hundred and twenty presumptive E. coli isolates and 42 presumptive isolates of Campylobacter spp. Were isolated. Eighty-two percent (82 percent) of the presumptive E. coli isolates were confirmed as E. coli while 46.3 percent belonged to Campylobacter spp. Pathotyping of the diarrhoeagenic E. coli isolates by Polymerase chain reaction (PCR) showed the following prevalences: DAEC 43 (32 percent), EHEC 18 (17 percent), EIEC 11 (10 percent) and EPEC 18 (17 percent). EAEC and ETEC were not detected, while for Campylobacter spp. 37 (88 percent) were C. jejuni, and C. coli was not detected. A total of 12 (32.4 percent) of the confirmed Campylobacter jejuni isolates were found to possess the fliM gene, 9 (24.3 percent) possessed the flhA gene and only 6 (16.2 percent) harboured the gene flgE2. None were positive for the flaA, flab and flhB genes.The antibiotic resistance patterns observed among the E. coli isolates were high against ampicillin (98.1 percent), chloramphenicol (94.3 percent) and tetracycline (90.6 percent). For Campylobacter spp., resistance observed were: chloramphenicol (91.6 percent), tetracycline (25.2 percent), erythromycin (49.6 percent) and gentamycin (56.4 percent). A lesser resistance against imipenem (35.9 percent) and quinolone (ciprofloxacin) (45.5 percent) were exhibited by the E.coli isolates. 10.8 percent and 20.3 percent of the Campylobacter isolates were resistant to imipenem and ciprofloxacin respectively. The presence of chloramphenicol (CatA1) and tetracycline (tetA) resistance genes were detected in 94 percent and 89 percent of E. coli isolates respectively while 98 percent of Campylobacter spp. Harboured the catA1 resistance gene. It could be deduced from this study that E. coli and Campylobacter spp. are predomiant enteric pathogens as the etiologic agents of diarrhoea in the study community, and that their antimicrobial resistance is high in the study location. The need to develop strategies to prevent infection and control resistant organisms is evident.
- Full Text:
- Date Issued: 2018
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