Infant and Young Child Feeding Policy: do primary health care nurses adhere to the HIV breastfeeding recommendations in Limpopo province?

Background: The HIV and Infant and Young Child Feeding (IYCF) guidelines in the revised IYCF policy of 2013 encouraged HIV-positive mothers to breastfeed exclusively for six months. In the case of HIV, the 2013 recommendation was that breastfeeding should continue for a year with the introduction of appropriate complementary feeding at six months while children receive antiretroviral treatment. The aim of this study was to determine the knowledge and practices of primary health care (PHC) nurses related to the implementation of the revised IYCF policy, with a specific focus on HIV breastfeeding recommendations, in Blouberg Municipality, Limpopo province. Methods: A quantitative, descriptive study design was conducted and included 103 conveniently selected PHC nurses. Data were collected using a questionnaire with closed ended questions. Data were analysed using SPSS® software v23.0, and using both descriptive and inferential statistical analysis. Results: Some 97.1% (n = 100) of the participants displayed good knowledge of IYCF recommendations in the context of HIV. In all, 68% (n = 70) of participants were not trained on the HIV and IYCF guidelines in the revised IYCF policy of 2013, resulting in only 32% (n = 33) of participants correctly implementing these guidelines. Also, 44.7% (n = 46) of the participants reported that they were not aware whether clinics had a copy of this policy. The results further revealed that 92.2% (n = 95) of the participants reported that clinics still received, kept and issued infant formula to HIV-positive mothers, which may be the reason why dietitians still received requests for infant formulas to be delivered to HIV-positive mothers. Conclusion: PHC nurses need to be trained, monitored and evaluated when updated HIV and IYCF guidelines are issued in order to ensure their correct implementation

Obesity and health problems among South African healthcare workers: do healthcare workers take care of themselves?

Background: Obesity has reached epidemic proportions globally. In South Africa, 56% of white men, 49% of black men and 75% of black women have been reported to be overweight or obese. The focus of this study is on South African healthcare workers (HCW), because they are considered role models for health for patients and their communities. Objectives: The objective was to determine the prevalence of obesity and obesity-related health problems among HCW and to compare these variables between medical and nonmedical staff at one selected public hospital in South Africa. Methods: A questionnaire was distributed to 200 respondents from a balanced pool of randomly selected HCW (100 medical staff and 100 nonmedical staff). Self-reported body mass index (BMI), obesity-related health problems and perceptions about body weight were assessed. Results: Seventy-three per cent of the HCW were overweight or obese, and half of them had never tried to lose weight. Females and older HCW were more obese than men and younger counterparts. There was no difference in BMI distribution between medical and nonmedical staff. About one-third of HCW reported that they suffered from obesity-related noncommunicable diseases (NCDs; hypertension 20% and diabetes 10%) and stress (32.5%). The majority of HCW had an inaccurate perception of their own weight. Conclusion: South African HCW have a high prevalence of obesity-related NCDs. A health promotion programme targeting HCW is urgently needed to encourage weight control, urge the prevention of obesity-related NCDs and change selfperceptions of body weight, in order to improve their own health and make them better role models for the general public. Keywords: obesity, obesity-related diseases, health problems, noncommunicable diseases, healthcare workers, self-perception, hospita

Mental health and HIV sexual risk behaviour among University of Limpopo students

Background. Little attention has been paid to the role of poor mental health among young people with regard to HIV risk behaviour and HIV prevention in Africa. Objective. To determine the association between mental health, substance use and HIV sexual risk behaviour among a sample of university students in South Africa. Methods. A cross-sectional survey was conducted among undergraduate students who were recruited conveniently from public campus venues at the University of Limpopo Medical University of Southern Africa (Medunsa) campus. The sample included 722 university students (57.6% men and 42.4% women) with a mean age of 21.7 years (standard deviation ±8.8). Results. Of the 722 students, 39.5% reported depression, 23.4% screened positive for post-traumatic stress disorder (PTSD), 22% reported hazardous or harmful alcohol use, 33% reported ≥2 sexual partners in the past 12 months, 50% reported inconsistent condom use, 46% reported unknown HIV status of a sexual partner and 20% reported alcohol use in the context of sex in the past 3 months. In multivariate analysis, HIV risk behaviour was associated with, among men, hazardous or harmful alcohol use and having screened positive for PTSD, and among women, being in the 4th or more year of study and current cannabis use. Conclusion. Poor mental health, including substance use, was found to be associated with HIV risk behaviour. Co-ordinated mental health and sexual and reproductive health services that meet the needs of university students would be desirable

Perceptions of healthcare professionals regarding their own body weight in selected public hospitals in Mpumalanga Province, South Africa

Background. Obesity has been cited as a public health problem in both developing and developed countries. There is evidence that rates of obesity have increased among healthcare workers (HCWs) in South Africa (SA), especially those who do night shifts, with a negative effect on health. Perceptions of body weight contribute significantly to the desire to lose weight or not to do so.Objective. To determine perceptions of HCWs regarding their own body weight in selected public hospitals in Mpumalanga Province, SA.Methods. The study design was a cross-sectional survey. A total of 210 HCWs were sampled. Data were collected using self-administered questionnaires. Anthropometric measurements such as weight and height were objectively measured and body mass indices (BMIs) were calculated.Results. Of the sample of HCWs 82.4% were females, with a mean age of 37.8 years. About half (51.9%) were obese and 21.4% were overweight. They tended to misperceive their body weight compared with actual BMI classification, with the majority of obese and overweight individuals considering themselves to be of normal weight.Conclusions. The results indicate that HCWs misclassify their own body weight, which is a risk factor for obesity. It is important to focus on the health of this group of workers, on whom the health of South Africans depends and who should be the drivers of healthy living for all. Correct classification of their own body weight will encourage people to take action in a bid to combat their own and others’ obesity.

Processes of change used by healthcare workers to participate in physical activity: What motivates healthcare workers to exercise?

The Transtheoretical Model (TTM) of the stages and processes of change describes five different stages of motivational readiness, which is common, tomost behaviour change processes. The aim of this study was to identify processes of change that healthcare workers (HCWs) use to progress from one stage of physical activity (PA) to another. This was a retrospective quantitative descriptive design involving 163 HCWs who were previously exposed to different education and motivation to exercise for a period of 6 months. Data were collected using self-administered questionnaires, and anthropometric measures were taken pre and post interventions. Data were analysed using SPSS version 18.0 for descriptive statistical analysis. Chi-square was used to draw the inferential associations.The results showed that all the ten processes of change influenced the exercise behaviour of HCWs. However, the most utilized construct was behavioural processes by HCWs at action stage compared to those at pre-action stages who mainly used cognitive processes. The least utilized constructs were helping relationships (54%) and stimulus control (64%) by all HCWs. Medical staff significantly used conscious raising as compared to nonmedical staff (p=0.038), and males used less dramatic relief process (53.67%) as compared to females (79%). Results show that precontemplators only utilized two processes of change. This demonstrated the extent of their resistance to change despite the efforts made to increase their exposure levels to PA interventions. Helping relationships and stimulus control were the least utilized processes. Hence, it is essential to incorporate both cognitive and behavioural processes as motivation to persuade HCWs to exercise.Keywords: Transtheoretical Model, processes of change, healthcare workers, physical activity

Factors influencing healthcare worker’s participation in physical activity in one public hospital in South Africa: Do healthcare workers have barriers to exercise?

The purpose of this study was to determine factors influencing healthcare workers‟ participation in physical activity (PA) in South Africa. This was a quantitative, cross-sectional study, with a sample size of 200 healthcare workers (HCWs)(100 Medical, 100 nonmedical staff) from one public tertiary hospital in Pretoria, South Africa. Data were collected using two methods: self-administered questionnaires (demographic characteristics; level of PA; and barriers to exercise) and anthropometric measures (Body weight, height and fitness level). Data were analyzed using SPSS 17.0. A descriptive statistical method was used to analyze frequencies and chi square test was used to determine level of significance of correlations between different variables and between medical and nonmedical staff. Binary logistic regression was used to determine the association between barriers, attitude, knowledge and PA stages. The majority of staff (73.5%) were overweight/ obese, with females being significantly overweight and obese (p<.05) compared to males. Seventy five percent (75%)of staff were at pre-action stages with more nonmedical staff at pre-action stages compared to medical staff (p<.05) and 81.5% had low fitness level. Eighty three percent (83%) of staff cited lack of motivationand57% of obese participants misclassified their bodyweight as normal weight. Both barriers and attitude were significant predictors of PA stages of staff (p=0.019 and 0.022; Odds ratios of 0.424 and 2.800 respectively) whereas knowledge was not a significant predictor (p=0.270; OR = 2.062). However, medical staff had generally good knowledge compared to nonmedical staff (p<.05) but both medical and nonmedical staff had positive attitude towards PA (p>.05). There is high prevalence of obesity and physical inactivity and many barriers exist among healthcare workers which influence their level of physical activity, irrespective of their gender, job categories and age. Employers should seek to eliminate the barriers that discourage use of worksite to increase level of PA.Keywords: Participation in physical activity, barriers; healthcare workers

The prevalence of urinary incontinence and its impact on quality of life among the university female staff in South Africa

Background: Urinary incontinence (UI) is a common problem among females and has been associated with significant decreased quality of  life. Few  women  seek  help  for  this  condition  with  only  a  few  who consult physiotherapy treatment.Purpose: To determine the prevalence of urinary incontinence and its impact on quality of life among the university women in South Africa.Method:  A  quantitative  cross-sectional  study design  with  145  women  ran-domly selected from the university. A questionnaire was used to determine UI Diagnosis; Impact on Qol and treatment seeking tendencies. BMI was meas-ured objectively. ethical clearance was obtained from University. Data was analysed using SPSS 17.0Results:  Forty  six(32%)  women  reported  to  having  UI.  Risk  factors  associated  with  UI  included  age,  race,  and  obesity. UI had a significant negative impact on quality of life and only 4.4% of participants with UI consulted physio-therapy for this condition.Conclusion: There is a high prevalence of UI among the women at this university with a significant impact on quality of life.The role of Physiotherapy in management of UI has been demonstrated and there is therefore a need to empower women with non-invasive treatment options, like physiotherapy

Physical activity, fitness level and health problems of healthcare workers in South Africa: The transtheoretical model as an explanatory framework

The aim of this study was to determine the level of physical activity of healthcare workers using the transtheoretical model (TTM) as a framework and to identify barriers to exercise. A self-administered questionnaire was distributed to 200 randomly selected hospital staff members in South Africa. The weight and height of the participants were measured, and fitness level was measured using a step test. The results were analysed using SPSS version 17.0. Approximately 10% of the male and 65% of the female hospital staff were found to be obese or severely obese. Furthermore, 55% of the older staff members were obese compared with 32% of the younger staff members and 44% of the medical staff met the criteria for obesity, which was somewhat less than the 50% of the non-medical staff who were obese. With approximately 25% of the hospital staff reporting that they engaged in regular exercise and/or physical activity, the majority of the staff were found not to engage in regular physical activity. Of those who claimed to engage in regular exercise, the majority were male members of the medical staff who were under 40 years of age and of normal weight. The barriers to exercise ranged from a lack of motivation (>80%), no support at work (>80%), lack of family support (> 50%), and lack of facilities at home (45%). The majority of the staff were at the pre-action stages for exercise and displayed low levels of physical fitness, irrespective of their job category. There is, therefore, a need for worksite intervention to improve the level of physical activity of healthcare workers in South Africa. The use of the TTM to identify the appropriate stage of physical activity for healthcare workers will enable health promoters to design programmes specific to the individual‘s stage of exercise readiness.Keywords: Obesity, health problems, healthcare workers, self-perception, hospital, transtheoretical model

Infant and Young Child Feeding Policy: do primary health care nurses adhere to the HIV breastfeeding recommendations in Limpopo province?

Background: The HIV and Infant and Young Child Feeding (IYCF) guidelines in the revised IYCF policy of 2013 encouraged HIV-positive mothers to breastfeed exclusively for six months. In the case of HIV, the 2013 recommendation was that breastfeeding should continue for a year with the introduction of appropriate complementary feeding at six months while children receive antiretroviral treatment. The aim of this study was to determine the knowledge and practices of primary health care (PHC) nurses related to the implementation of the revised IYCF policy, with a specific focus on HIV breastfeeding recommendations, in Blouberg Municipality, Limpopo province. Methods: A quantitative, descriptive study design was conducted and included 103 conveniently selected PHC nurses. Data were collected using a questionnaire with closed ended questions. Data were analysed using SPSS® software v23.0, and using both descriptive and inferential statistical analysis. Results: Some 97.1% (n = 100) of the participants displayed good knowledge of IYCF recommendations in the context of HIV. In all, 68% (n = 70) of participants were not trained on the HIV and IYCF guidelines in the revised IYCF policy of 2013, resulting in only 32% (n = 33) of participants correctly implementing these guidelines. Also, 44.7% (n = 46) of the participants reported that they were not aware whether clinics had a copy of this policy. The results further revealed that 92.2% (n = 95) of the participants reported that clinics still received, kept and issued infant formula to HIV-positive mothers, which may be the reason why dietitians still received requests for infant formulas to be delivered to HIV-positive mothers. Conclusion: PHC nurses need to be trained, monitored and evaluated when updated HIV and IYCF guidelines are issued in order to ensure their correct implementation