Assessing the implementation of long-acting reversible contraceptive implant, Implanon NXT, roll out in East London, Eastern Cape, South Africa.
- Authors: Mdingi, Mildred Mandisa
- Date: 2020
- Subjects: Primary health care
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: http://hdl.handle.net/10353/18452 , vital:42267
- Description: Background: In 2014, South African Department of Health (SADOH) initiated use of Implanon NXT, a type of implant in addition to long-acting reversible contraceptives available in the country to expand contraceptives options for women of reproductive age. After its introduction, there were reports on early removals and frequent side effects. It is therefore vital to identify how successful the implementation of this method was in particular in East London area. Objectives: The purpose of this study was to evaluate how successful the implementation of Implanon NXT roll out was in East London, Eastern Cape. Additionally, the study also aimed to understand the views health care providers have of the Implanon NXT. Methods: A retrospective crosssectional design using existing data from family planning registers and distribution of questionnaires to Health Care Providers responsible for insertion and removal of the method (HCP). Results: February 2014 to March 2019, 1238 Implanon NXT insertions were done and only 266 removals in one study site. Out of the 266 participants, 67.7% of the participants removed the Implanon for reasons other than ill health (side effects), while the remaining 32.3% had experienced side effects and opted for early Implanon removal. Bleeding was the most common side effect reported by 44 of 266 (16.5%) participants. The health care providers who completed questionnaires for this study were overall confident in providing the Implanon NXT services. Conclusion: Implementation of a new contraceptive method requires clear standardised policies and guidelines on counselling and management of side effects. Findings of this study are reassuring that Implanon NXT had a role to play in prevention of unintended pregnancies. Implementation and rollout in one site reviewed has been demonstrated to be successful. The respondents in this study possesses knowledge about the Implanon NXT.
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- Date Issued: 2020
Exploring challenges in implementing a health referral system in the Buffalo city metropolitan municipality in the Eastern Cape Province”
- Authors: Matolengwe, Aseza
- Date: 2020
- Subjects: Primary health care
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: http://hdl.handle.net/10353/18441 , vital:42266
- Description: The purpose of the study is to explore and describe challenges experienced by health professionals regarding implementation of the referral system used in Buffalo City Metropolitan Municipality (BCMM) in the Eastern Cape Province. A referral system in health care can be defined as a method whereby a health worker with insufficient skills and less resources in the primary health care setting, who has fewer remedies or options to manage medical conditions, seeks assistance from a more senior practitioner in a tertiary setting with better resources to provide guidance in managing the patient or to take over the management of the patient (Eastern Cape Department of Health, 2007:7). A qualitative descriptive explorative contextual design was used to explore and describe the challenges pertaining to the implementation of a referral system in the public health sector in Buffalo City Metropolitan Municipality (BCMM) in the Eastern Cape. A purposive sampling technique was employed with an inclusion criteria of health care professionals who are doctors, professional nurses, pharmacists and specialists. After obtaining ethical clearance from the respective departments, steps for data collection were implemented. Individual interviews were conducted using an interview guide that was prepared by the researcher. Findings in the study indicate that there are challenges in implementing a referral system in relation to infrastructure, workforce capacity, equipment, transport and drug availability. The participants provided suggestions according to their experiences on what they felt the Department of Health in BCMM could do to strengthen the referral system in place. The researcher then provided recommendations to the Department of Health of BCMM. The health referral system in BCMM needs to be strengthened through provision of adequate infrastructure, improving workforce capacity, and availability of medicines and equipment. A monitoring and evaluation plan must be affected by the Eastern Cape Department of Health. Education and training are needed for the health care workers and the community through their involvement in stakeholder meetings
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- Date Issued: 2020
Knowledge of drowning risks amongst adolescents in the Nelson Mandela Metropole, Eastern Cape Province, South Africa
- Authors: Isaacs, Imeraan
- Date: 2020
- Subjects: Primary health care
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: http://hdl.handle.net/10353/18422 , vital:42264
- Description: The purpose of this research study was to explore and describe the knowledge and the level of awareness of drowning risks amongst adolescents in the Nelson Mandela Metropole, Eastern Cape Province, and South Africa. Drowning is defined as the “process of experiencing respiratory impairment from either submersion or immersion into a water medium” (van Beeck et al 2005:853). Global statistics place drowning as being the third foremost cause of unintentional death worldwide (WHO 2013). The World Health Organization reports that more than 90% of the estimated 370 000 drowning fatalities recorded in 2012 occurred in low and middle income countries (WHO 2014). A qualitative descriptive explorative contextual design was employed in this research study. A non-probability convenience sampling method was used. Adolescents aged 10- 13 years old who attend a public primary school and model C primary school in Nelson Mandela Metropole area in the Eastern Cape Province were the target population who had the specific characteristics of interest and significance to the research phenomenon (Asiamah et al 2017). Four focus group interviews were conducted. The groups consisted of five to ten participants grouped together to discuss the matter. Field notes were also taken by the researcher on what was heard, observed, thought and experienced during the interview process (Streubert & Carpenter 2007). Ethical principles were maintained as well as the concepts of trustworthiness were applied throughout this study.Data analysis was done using Tesch’s approach to open coding in qualitative research. A total of six themes and seven sub-themes arose during the analysis of the data and were completely discussed. The findings suggest that most of the participants are quite aware and knowledgeable of the potential risks that predispose an individual to drowning. The consequences of what happens when a victim is exposed to drowning, however, requires more insight. The risk of being unsupervised as well as not being able to swim was echoed in most of the group interviews. vii A noteworthy finding was the fact that the participants who were involved with some form of water safety programme/s at school were very articulate in their responses to the questions. It was recommended that educational programmes ought to be aligned with current evidence which is reflective of the region’s demographics and dynamics. Even though all researchers do not share the sentiments that swim proficiencies heighten the safety of the individual in and around water, the need for ongoing research initiatives is a significant stimulus that will generate new evidence and inform current preventive strategies. Identification and awareness of drowning risks require a foundation of comprehension in order to better understand and interpret the consequences of these risks. Learn to swim or swim orientation initiatives could potentially assist at primary school level with the safety levels of learners.
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- Date Issued: 2020
Competencies of Qualified Primary Health Care professional nurses in Assessing, Diagnosing and Managing clients in health facilities in Buffalo City Metro”
- Authors: Falati, Patience Yoliswa
- Date: 2019
- Subjects: Primary health care
- Language: English
- Type: Thesis , Masters/Doctoral , MPH
- Identifier: http://hdl.handle.net/10353/16716 , vital:40766
- Description: The study investigated the competencies of qualified PHC professional nurses in assessing, diagnosing and managing clients in the facilities. Aim: The study aimed to explain the competences of qualified PHC professional nurses in assessing, diagnosing and managing clients in the facilities. The research study followed a descriptive and qualitative design. Data was collected from qualified PHC professional nurses in 79 clinics (both urban and rural), 4CHC’s and 4 hospital casualties. A structured questionnaire with closed ended questions was used. Data analysis was done by means of descriptive statistics. The study showed that the overall percentage of 90% denotes that these PHC professional nurses are competent in all the aspects of competences. Assessing competences of qualified PHC professional nurses in assessing, diagnosing and managing clients in the facilities is of vital importance for quality health care/ improving service delivery and client satisfaction. Recommendation were made to influence the implementation of policies and guidelines for quality service delivery
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- Date Issued: 2019
An information privacy model for primary health care facilities
- Authors: Boucher, Duane Eric
- Date: 2013
- Subjects: Data protection , Privacy, Right of , Medical records -- Access control , Primary health care , Medical care , Caregivers , Community health nursing , Confidential communications , Information technology -- Management
- Language: English
- Type: Thesis , Masters , MCom (Information Systems)
- Identifier: vital:11139 , http://hdl.handle.net/10353/d1007181 , Data protection , Privacy, Right of , Medical records -- Access control , Primary health care , Medical care , Caregivers , Community health nursing , Confidential communications , Information technology -- Management
- Description: The revolutionary migration within the health care sector towards the digitisation of medical records for convenience or compliance touches on many concerns with respect to ensuring the security of patient personally identifiable information (PII). Foremost of these is that a patient’s right to privacy is not violated. To this end, it is necessary that health care practitioners have a clear understanding of the various constructs of privacy in order to ensure privacy compliance is maintained. This research project focuses on an investigation of privacy from a multidisciplinary philosophical perspective to highlight the constructs of information privacy. These constructs together with a discussion focused on the confidentiality and accessibility of medical records results in the development of an artefact represented in the format of a model. The formulation of the model is accomplished by making use of the Design Science research guidelines for artefact development. Part of the process required that the artefact be refined through the use of an Expert Review Process. This involved an iterative (three phase) process which required (seven) experts from the fields of privacy, information security, and health care to respond to semi-structured questions administered with an interview guide. The data analysis process utilised the ISO/IEC 29100:2011(E) standard on privacy as a means to assign thematic codes to the responses, which were then analysed. The proposed information privacy model was discussed in relation to the compliance requirements of the South African Protection of Personal Information (PoPI) Bill of 2009 and their application in a primary health care facility. The proposed information privacy model provides a holistic view of privacy management that can residually be used to increase awareness associated with the compliance requirements of using patient PII.
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- Date Issued: 2013
The impact of HIV/AIDS on the delivery of maternal health care services of selected primary health care clinics of Peddie in the Eastern Cape Province
- Authors: Mangi, Nozuko Glenrose https://orcid.org/0000-0001-9158-8820
- Date: 2011
- Subjects: Maternal health services , Primary health care , HIV infections -- Africa
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/24576 , vital:63209
- Description: The aim of this descriptive study was to explore the impact of HIV/AIDS on the maternal health programme at selected Primary Health Care (PHC) clinics in the Peddie sub-district, in the Eastern Cape, South Africa. This study showed that the HIV/AIDS epidemic has had major influences on the rendering of maternal health services in this sub-district. An understanding of the impact of HIV/AIDS on the delivery of the maternal health programme in the Peddie Primary Health Clinics will potentially help the District Health Service office, as well as the clinic managers and professional nurses to formulate strategies to strengthen the maternal health programme. This data will also be helpful when developing plans to cope with the heavy work-load of the clinics offering maternal health services, and to address the attitudes and concerns of the professional nurses working in the PHC clinics in this area. Thirty professional nurses working at 10 clinics responded to the questionnaires which elicited questions pertaining to the impact of HIV/AIDS on the rendering of their services. As part of the data gathering procedures, standardised notice boards at the PHC clinics were used to document the services rendered. The numbers of ANC clients attended to each of the clinics per week were collected in routine attendance tick registers used in the clinics for recording and monitoring statistics in the maternal health programme. The data was analysed to examine the possible impact of HIV/AIDS on maternal health services rendered by registered nurses/midwives working in the PHC clinics. The registered nurses who responded to the questionnaires (Annexure H) made several suggestions. These included the following: (i) encouraged more training (11 nurses), (ii) addition of more staff members, (iii) to have specialized staff for management of maternal HIV. Because of the study limitations such as the sample size of 10 clinics with a total of 30 nurses who were studied, the study may not be generalised to the whole of the Eastern Cape Province. The study however did provide baseline information on the impact of HIV/AIDS on the maternal health programme. The study findings were that HIV/AIDS has had an impact on the delivery of the maternal health programme due to the extra services brought about by the response to the HIV/AIDS pandemic. This study will contribute to a better understanding of the impact of HIV/AIDS on the maternal health programme at the PHC level in Peddie. The research provided insight into issues that are crucial to the delivery of maternal health programmes in rural areas. , Thesis (MCur) -- Faculty of Science and Agriculture, 2011
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- Date Issued: 2011
Nurses' experience of contesting discourses in HIV/AIDS activities in the primary health care setting
- Authors: Tutani, Lumka
- Date: 2001
- Subjects: Primary health care , AIDS (Disease) -- Nursing , AIDS (Disease) -- Patients -- Counseling of
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:3074 , http://hdl.handle.net/10962/d1002583 , Primary health care , AIDS (Disease) -- Nursing , AIDS (Disease) -- Patients -- Counseling of
- Description: This paper explores the experience of nurses who work both as Primary Health Care Providers and counsellors trained in the narrative model of counselling in primary health care settings. Five focus groups were conducted in both Xhosa and English. Discourse analysis was used as a method of analysing the data. Training nurses in the narrative counselling model introduced an alternative discourse, which was experienced as contradicting their usual way of working. Two dominant discourses were the “not knowing” approach, assumed by the narrative model of counselling, and the “knowing” stance, assumed by health education. The institutionalised construction of counselling by doctors and matrons, and their power versus the power of the nurse counsellors was also cited as sources of conflict. Despite the tensions, narrative model of counselling seems to be offering new positions, which may benefit people living with HIV and improve HIV/AIDS activities in the Primary Health Care (PHC) context.
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- Date Issued: 2001