Understanding student early departure from a Master of Public Health programme in South Africa

Background. Student departure from university without completing a qualification is a major concern in higher education. Higher Education South Africa reported that in undergraduate studies, 35% of students depart after the first year and only 15% of students who enrol complete their degree within the minimum permissible time. At postgraduate level, the departure from Masters programmes in South Africa (SA) ranged from 30% to 67% in 2010. Early departure refers to students who leave an academic programme within the first semester of commencing their studies. At one SA university, there were a total of 109 first-time Master of Public Health (MPH) student registrations in 2013 and 2014. By the end of the first semester in the respective years, a total of 27 students actively deregistered from the programme and 11 students did not sit the first-semester examinations, representing an aggregate 35% rate of early departure. The factors associated with early departure at the University of KwaZulu-Natal are not well understood.Objective. To understand factors associated with early departure in the MPH programme at the University of KwaZulu-Natal.Method. A mixed-methods design was implemented. Students who departed within the first semester of commencing the MPH programme in 2013/2014 were followed up. Data were collected using self-administered questionnaires and in-depth interviews.Results. Failure to balance work and academic obligations with poor time management, stress and academic demands related to the programme, and insufficient academic progress were found to be associated with student early departure from the MPH programme.Conclusion. Student early departure from the MPH programme was influenced by multifaceted factors. Senior students can mentor new students as early as possible in their programme. The orientation block should include development activities such as time management, stress management and effective study skills to assist mature students to cope with the demands of part-time postgraduate studies

Tracking Master of Public Health graduates: Linking higher education and the labour market

Background. Master of Public Health (MPH) students come from a wide range of health professional backgrounds. Graduate programmes in public health should equip alumni with knowledge and skills to analyse and integrate health research findings, and have a practical approach to current public health issues. In South Africa (SA), there is a need for health professionals with an adaptable public health approach who can contribute meaningfully to addressing public health problems and transforming the health sector. The role and relevance of graduate public health training in the SA healthcare system have not yet been reported. Tracking of graduates is important to assess the effectiveness of study programmes, graduates’ worth for the healthcare labour market, and their contribution towards improving the healthcare system.Objective. To describe the professional backgrounds of MPH graduates from the University of KwaZulu-Natal, Durban, SA and the role of their learning in their current public health practice.Methods. An emailed, self-administered questionnaire survey of graduates (N=61) was conducted in 2013.Results. Forty-five (73%) of the 61 contactable public health graduates from the past 10 years returned the completed questionnaire; 28 (63%) areworking in the public sector and 9 (22%) at academic institutions. Graduates reported that research skills, critical analysis, report writing, and leadershipand management were acquired in the MPH programme. Most reported that they were able to integrate the knowledge and skills acquired from the MPH degree in their current workplace.Conclusion. The MPH degree equips graduates with skills that contribute to addressing some of the public health problems in SA

Exploring student persistence to completion in a Master of Public Health programme in South Africa

Background. Student persistence can be defined as the continuation of student enrolment and progression towards the completion of a qualification. Despite the increased number of postgraduate enrolments, attrition from postgraduate programmes is estimated at 40 - 50% in most countries globally. The throughput for Master of Public Health (MPH) programmes in South Africa (SA) ranged from 25% to 60% between 2009 and 2014. MPH students study primarily part-time and reside off campus.Objective. To explore the phenomenon of persistence to completion in an MPH programme in SA.Methods. A constructivist approach was adopted to understand the phenomenon of student persistence among MPH graduates. Data were collected through face-to-face in-depth interviews with graduates who completed the MPH degree between 2006 and 2014. Interviews were conducted from August 2015 to the end of October 2015. Each interview was audio recorded and transcribed verbatim. A thematic analysis was implemented.Results. The findings indicated that personal, social, work and academic characteristics influenced student persistence to completion. Career advancement, the status that comes with an MPH qualification and being a first-generation postgraduate student provide internal and external motivations that have an impact on student persistence. An interplay between self-efficacy and social capital positively influences student persistence to completion.Conclusion. Student persistence to completion is influenced by multifaceted factors. Motivation, self-efficacy and social capital play a vital role in fostering persistence among part-time mature postgraduate students

Perceptions of rehabilitation coordinators on community outreach services in KwaZulu-Natal, South Africa

Community outreach rehabilitation services are a strategy to decentralise hospital-based rehabilitation services to community level. Community outreach rehabilitation services increase the reach of therapy as most rehabilitation professionals are based in regional or tertiary facilities. The coverage of rehabilitation services outside of hospital setting remains unclear. The aim of this study was to establish the settings as well as explore the barriers and facilitating factors in the delivery of community outreach rehabilitation services in KwaZulu-Natal. Guided by a qualitative research design, data were collected through face to face in-depth interviews with five rehabilitation coordinators employed in provincial and district offices of the KwaZulu-Natal’s Department of Health in 2019. The interview data were transcribed and analysed thematically. Community outreach rehabilitation services are delivered in primary care clinics, homes and schools. Stakeholder support, involvement of community health workers, the positive role played by senior therapists and rehabilitation coordinators as well as composition and perceived outcomes of the multidisciplinary approach, were reported as facilitating factors in the success of community outreach rehabilitation services. Barriers identified included human resources constraints, unavailability of transport for community outreach, inadequate infrastructure and limited support from top management. Thus, community outreach rehabilitation services require policy review and planning for better implementation. Keywords: Community outreach rehabilitation services, rehabilitation coordinators, health facilitie

Factors associated with physical activity amongst patients with hypertension in two community health centres in uMgungundlovu health district, KwaZulu-Natal, 2018

Background: Hypertension (HPT) is a global public health challenge. It predisposes to cardiovascular diseases, kidney diseases and disability as well as contributing to high death rates. HPT is increasing tremendously in sub-Saharan Africa with HPT-related mortality risk having increased by 25% in less than 10 years in South Africa. Physical activity is a cost-effective way of reducing, controlling and preventing hypertension. The aim of the study was to establish the level of physical activity, and factors associated with physical activity, amongst patients with hypertension, in two community health centres in uMgungundlovu Health District, KwaZulu-Natal, 2018.Methods: An observational, cross-sectional descriptive study with an analytic component was implemented. Data were collected utilising an interviewer-administered questionnaire. Frequency distribution tables and the chi-square test were used in the analysis of data. A p-value less than 0.05 was deemed statistically significant.Results: A total of 374 questionnaires were administered of which 373 were adequately completed, yielding a response rate of 99.7%. The results showed that 39.1% were highly physical active, 32.4% were moderately physical active and 28.4% had low physical activity. Age, marital status, employment status and level of education were significantly associated with physical activity. Major barriers to physical activity included health problems and having no time to exercise. Health-related reasons were reported to be the major motivator towards physical activity.Conclusion: Over a third of the participants presented with high levels of physical activity. Health education should focus on promoting physical activity for HPT clients

Developing social accountability in 1styear medical students: A case study from the Nelson R Mandela School of Medicine Durban South Africa

Background. Medical schools need to be more socially accountable. The Making a Difference group community service activity (MaD), which is part of the 1st-year medical curriculum at the University of KwaZulu-Natal, Durban, South Africa, aims to make students more responsible, responsive and accountable to community needs. Small groups of students engage with an organisation of their choice that works with a disadvantaged community. They spend 16 hours in appropriate community service, which includes an HIV and AIDS education activity.Objective. To describe and categorise the MaD process of developing social accountability in medical students.Methods. This case study draws on routinely collected administrative and qualitative data obtained from reflective journals kept by each student. Adocument analysis was undertaken of the posters produced by each group that described their reciprocal learning from this experience. Ethical approval for the ongoing evaluation of the undergraduate programme was obtained.Results. The MaD gave students exposure to authentic experiences through socially accountable activities. Enabled by the structured and stepwise MaD approach, groups demonstrated responsibility in identifying and engaging a local community. They developed a simple plan of action that was responsive to community needs. At each stage, they demonstrated accountability to the various stakeholders. Students reflected on the social determinants of health and disease and described MaD as a ‘humbling and huge learning experience’.Conclusion. Through MaD, 1st-year medical students engaged in practical, socially accountable activities with members of disadvantaged communities.They developed some understanding of a population perspective on health and the social determinants that influence health and disease in a community