Challenges faced by professional nurses when implementing the Expanded Programme on Immunisation at rural clinics in Capricorn District, Limpopo

Background: Immunisation is the cornerstone of primary healthcare. Apart from the provision of safe water, immunisation remains the most cost-effective public health intervention currently available. Immunisation prevents infectious conditions that are debilitating, fatal and have the potential to cause huge public health burdens, both financially and socially, in South Africa. Aim: To determine the challenges faced by professional nurses when implementing the Expanded Programme on Immunisation (EPI) at rural clinics in Capricorn District, Limpopo Province, South Africa. Setting: The study was conducted in selected primary healthcare clinics of Capricorn District, Limpopo Province. Methods: A qualitative explorative descriptive contextual research design was used to gather data related to the challenges faced by professional nurses when implementing EPI at rural clinics in Capricorn District. Results: The findings revealed that professional nurses had knowledge of the programme, but that they experienced several challenges during implementation of EPI that included staff shortages and problems related to maintenance of the vaccines’ potency. Conclusions: The Department of Health as well as the nursing administration should monitor policies and guidelines, and especially maintenance of a cold chain for vaccines, to ensure that they are practised throughout Limpopo Province. The problem of staff shortages also needs to be addressed so that the EPI can achieve its targeted objectives. Keywords: Professional nurse, knowledge, EPI-SA, immunisatio

Social support experiences of adolescents living with perinatal HIV in rural Limpopo, South Africa

Background: Adolescents with perinatal HIV (APHIV) experience emotional turmoil, which is worsened by real or perceived negative impacts on the adolescents’ relationships, aspirations for their careers, and aspirations for their families. Objectives: To explore the experiences of APHIV with regard to social support on their mental health and general well-being in the Vhembe District of Limpopo province. Method: A mixed-methods sequential exploratory design was employed to conduct in-depth one-on-one interviews in the Vhembe District of the Limpopo province of South Africa. The interviews were conducted in selected community health centres and clinics over a period of four months (April 2019 - July 2019). This study included APHIV between the ages of 10 years and 19 years who had been initiated on antiretroviral therapy before the age of 10 years. Results: Two major themes emerged. Theme 1 – Experiences within the family – included the sub-themes experience of positive social support within the family, and lack of support in the family. Theme 2 – Experiences outside the family – included the sub-themes experiences at the clinic, experiences at community level, and experiences at school and with friends. Conclusion: Adolescents with perinatal HIV are in need of social support from their loved ones as well as the community. Expansion of household programmes and intervention through integration of services by the multidisciplinary team might assist with alleviating the social support needs which will improve their mental health and adherence to treatment

Record-keeping: Challenges experienced by nurses in selected public hospitals

Background: Patients’ records provide a trace of care processes that have occurred and are further used as communication amongst nurses for continued management of patients. Nurses have the responsibility to ensure that records are accurate and complete in order to effectively manage their patients. In hospitals, nurses have to record a wide range of information in the patient’s records and this leads to increased workload on the part of nurses that compromises accurate record-keeping. Objectives: The purpose of this study was to explore and describe the challenges experienced by nurses with regard to record-keeping at selected public hospitals in the Vhembe district, Limpopo Province, South Africa. Method: A qualitative, explorative and descriptive research design was used. Nurses working in selected public hospitals were purposively selected and semi-structured interviews were conducted until data saturation was reached. Data were analysed using the Tesch’s open-coding method. Results: Nurses working in public hospitals experience record-keeping as a challenging activity owing to a variety of challenges which include lack of time to complete the records, increased patients’ admission and shortage of recording material. Conclusion: Record-keeping is not done properly which is problematic, and it is recommended that there should be continuous training, monitoring and evaluation of nurses on record-keeping issues, supply of adequate recording materials and proper time management amongst nurses to improve record-keeping challenges. The need for comprehensive record-keeping remains fundamental in public hospitals in order to improve patient care

The effects of absenteeism on nurses remaining on duty at a tertiary hospital of Limpopo province

Background: Absenteeism is a global problem in the working force and this is no exception in the nursing profession. Much attention has been drawn to factors that contribute to absenteeism; however, little attention has been placed on the effects of absenteeism on nurses remaining on duty by their colleagues. Nurses absent themselves leaving behind their colleagues to execute their part of work. Objectives: To investigate the effects of absenteeism on nurses who remained on duty at a tertiary hospital in Limpopo province. Method: A quantitative descriptive research approach was chosen to enable the researchers to achieve the research aim. Data collected using structured questionnaires were analysed by descriptive statistics. Results: The findings indicated that absenteeism has an effect on both the nurses’ psychological and professional well-being, as well as the quality of patient care provided as a result of psychological stress, low morale of nurses and increased workload. The study further revealed the provision of substandard care to patients by those nurses who are remaining on duty, resulting in risk of medical errors that could jeopardise their professional credibility. Therefore, absenteeism creates an unhealthy working environment for nurses remaining on duty. Conclusion: Nurse managers should provide platforms to address psychological and professional problems experienced by nurses remaining on duty. The study further recommends the introduction of policies that would address absenteeism in the workplace and how nurses who remain on duty could be assisted with the workload of colleagues who continuously absent themselves

Factors contributing to teenage pregnancy in the Capricorn district of the Limpopo Province

Teenage pregnancy refers to pregnancy of a woman of less than 19 years. It is found commonly amongst young people who have been disadvantaged and have poor expectations with regard to either their education or job market. Adolescents may lack knowledge of access to conventional methods of preventing pregnancy, as they may be afraid to seek such information. The study purpose was to identify factors contributing to teenage pregnancy in one village in the Capricorn District of the Limpopo Province.<p>A quantitative descriptive research approach was chosen. Population consisted of all pregnant teenagers attending antenatal care during June to August 2007 at one clinic in the Capricorn District of the Limpopo Province. Simple random probability sampling was used to include 100 pregnant teenagers who satisfied the inclusion criteria. Data were collected through structured self-administered questionnaires. Descriptive statistical data analysis was used. Ethical considerations were ensured.</p><p>Findings were classified as demographic data where 24% of the respondents were aged between 15–16 years and 76% were aged between 17–19 years. Findings further revealed that 60% of the respondents started to engage in sex at 13–15 years; 48% of the teenagers’ partners were 21 years and above, 44% depended on a single parents’ income; 20% father’s income, 16% received a social grant and 8% lived on the pension fund of the grandparents.</p><p>Pregnancy prevention strategies were recommended based on the results. The strategies focused on reproductive health services, male involvement and adult-teenager communication programmes.</p

Prevalence of overweight and obesity amongst patients with diabetes and their non-diabetic family members in Senwabarwana, Limpopo province, South Africa

Background: Diabetes remains a public health concern and the second cause of mortality in South Africa. Family history of diabetes increases risk of developing diabetes. Obesity amongst patients is associated with comorbidity, whilst amongst non-diabetic family members it is associated with developing diabetes. This study aimed at determining prevalence of overweight and obesity amongst patients with diabetes and non-diabetic family members.Methods: A quantitative, cross-sectional descriptive study was conducted on 200 patients and 200 non-diabetic family members were selected using systematic random sampling from rural clinics of Senwabarwana. Data were collected using close-ended questionnaires and anthropometric measurements. Body mass index (BMI) and waist circumference were measured and interpreted according to World Health Organization guidelines. Data were analysed using Statistical Package for Social Sciences, using both descriptive and inferential statistics. Chi-square test was used to calculate associations at 95% confidence interval where a p-value of 0.05 was considered statistically significant.Results: Most patients (75.5%) had comorbidities and hypertension was most prevalent (89.0%). Over half of the patients (57.0%) and 38.0% of family members were obese. Most patients (75.0%) and 58.0% of family members had abdominal obesity.Conclusion: Patients with diabetes suffer from comorbidities are overweight and obese whilst evidence from various studies suggest that non-diabetic family members are at added risk of developing diabetes because of higher BMI and abdominal obesity. There is an urgent need to create a conducive environment that discourages sedentary behaviours through lifestyle modifications using the family centred approach, and involve family members in the care of patients

Indigenous practices of pregnant women at Dilokong hospital in Limpopo province, South Africa

Background: Indigenous practices (IPs) are experiences generated by people who are living in a specific regional context and cultural group. IPs are shaped by cultural traits that are passed from one generation to the next. IPs practices are rooted and embedded in society and, therefore, the practices become part of the people’s lifestyle. It is difficult to try and change these practices as people have adhered to them throughout their entire lives. The believe system plays a major role in health care seeking behaviour of individuals because they are informed by the IPs that are observed in their environment. Objectives: To explore and describe the IPs of pregnant women at Dilokong hospital in Limpopo province. Method: A qualitative, descriptive, explorative and contextual research design was used for the participants to describe the IPs used by pregnant women. Data were collected through unstructured one-on-one interviews. Results: The following four themes with sub-themes emerged from the data: IPs based on ancestral knowledge; IPs based on spiritual diviners versus church principles; restricted practices versus instructions followed during pregnancy; and labour and IPs during labour and delivery. Conclusion: IPs are regarded as an honourable health intervention by traditional health practitioners (THPs), families and pregnant women. IPs like cords around women’s waists are still observed during physical examinations. However, there is a reduction of prescribed indigenous oral medication used to accelerate labour because of their potential toxicity

Turnover of professional nurses at Mokopane Hospital in the Limpopo Province, South Africa: Experiences of nursing unit managers

Background: Staff turnover of professional nurses remains a concern for public and private hospitals management because it has an impact on the morale of nurses and it may also lead to poor patient care. Objectives: The objectives of this study were to explore and describe the experiences of nursing unit managers with regard to the turnover of professional nurses who were under their supervision. Method: A qualitative, explorative, descriptive research design was used to determine the experiences of nursing unit managers related to the turnover of professional nurses. Data collection was done by using semi-structured one-to-one interviews with professional nurses .Two groups of participants were interviewed: Those working day duty (n = 9) and those working night duty (n = 3) who were at work on the anticipated days for data collection. Results: The findings revealed that every unit was experiencing a shortage of professional nurses, which caused other nurses to work overtime with an inevitable increase in workload. That led to tiredness, conflict amongst professional nurses, job dissatisfaction, and absenteeism which compromised nursing care. This resulted in patient dissatisfaction and sometimes led to deaths that could have been prevented. Conclusion: It is recommended that staff turnover should be addressed by the hospital top management implementing several strategies. For example, top management could ensure that staff members work in a healthy environment with resources that they need during the provision of care, address the effects of the staff turnover, support the staff members and refrain from putting pressure on nursing unit managers whilst they are attending to problems

Adherence to antiretroviral therapy among HIV and AIDS patients at the Kwa-Thema clinic in Gauteng Province, South Africa

Background: Introduction of antiretroviral therapy (ART) has shown reduction in HIV-related mortality and morbidity in people living with HIV and AIDS. Since high levels of adherence of more than 95.0% is required to achieve effective suppression of viral load, researchers found it important to establish whether people are pursuing what is expected of them. Aim and setting: The study was aimed at determining adherence to ART among HIV and AIDS patients at the Kwa-Thema clinic in Gauteng Province. Methods: Quantitative cross-sectional descriptive design was used. Ethical clearance was sort from MEDUNSA Research Ethics Committee. Validity and reliability were maintained throughout the study. A non-probability systematic sampling was used. Data were collected using administered structured questionnaire, and a total of 290 respondents were involved. Data were analysed using SPSS software version 22. Results: The findings indicated that the adherence to ART was 77.0%. Factors that were significantly associated with adherence were gender ( χ2 = 3.78, df = 1, p < 0.05), level of education ( χ2 = 3.52, df = 3, p = 0.032), co-treatment of HIV and other infections ( χ2 = 5.46, df = 4, p = 0.019), ability to follow ART ( χ2 = 12.82, df = 1, p = 0.000 < 0.05), and types of antiretroviral drugs. Recommendation: The study recommends intensification of health education campaign against stigma and gender discrimination. Providing feedback to patients regarding benefits of ART is important. Conclusion: The study concluded that adherence to ART at the Kwa-Thema clinic was suboptimal (less than 95%) at 77%, but comparable with the adherence levels in other developing countries

Measures to Enhance Student Learning and Well-Being during the COVID-19 Pandemic: Perspectives of Students from a Historically Disadvantaged University

Since December 2019, the world population has been battling with the SARS-CoV-2 disease (COVID-2019) pandemic. The pandemic has continued to impact negatively on people’s livelihoods and also on student’s education. This qualitative study established from students in a previously disadvantaged university, their challenges and needs pursuant to the COVID-19 nationwide lockdown in South Africa. A total of 312 (male = 141; female = 171) registered students were conveniently sampled and completed an online survey questionnaire. Thematically analysed data revealed that student education and health have been impacted since the COVID-19 nationwide lockdown. Participants went on to recommend several measures which, if implemented, could improve their well-being and access to education. Study findings imply that students from previously disadvantaged universities, who in their majority are from impoverished rural communities, have been struggling to access remote learning due to amongst others, the lack of information and communication technology (ICT) devices and network connectivity problems. It, therefore, requires rural-based universities to work together with the government and the private sector and join hands in addressing student challenges and needs during the on-going lockdown in the country. This would be one way of ensuring that in spite of students’ socioeconomic status, cultural location or background, their right to education is protected