Do the primary health care nurses in Gazankulu provide second class cheap care to the poor?

Primary health care nurses, Gazankul

Patient-perceived factors contributing to low tuberculosis cure rate at Greater Giyani healthcare facilities

Background: Compliance with tuberculosis (TB) treatment is unpredictable. Most patients do not comply because they do not see the importance of doing so, which is usually influenced by lack of knowledge. Objectives: The purpose of the study was to explore and describe the factors contributing to low TB cure rates in Greater Giyani Municipality, as viewed by patients. Method: The study was conducted in the Greater Giyani Municipality in Limpopo Province which had a TB cure rate ranging from 14% to 94%. The research design in this study was qualitative, exploratory, descriptive and contextual in nature. The population consisted of all TB patients diagnosed and referred for treatment and care in Primary Health Care (PHC) facilities. Non-probability purposive sampling was used to select TB patients and health facilities which had a cure rate lower than the national target of 85%. One patient was sampled from each PHC facility. An in-depth face-to-face interview was used to collect data using an interview guide. Results: The findings showed that most of the TB patients come from poor families, which makes it difficult for them to obtain financial and food security. The health facilities often run out of food supplements and TB medicine. Cultural beliefs about TB also lead to TB patients seeking assistance from traditional health practitioners and faith-based healers. Conclusion: There is a need to have a policy regarding how discharged tuberculosis patients on treatment are supervised when at home. Healthcare facilities should also ensure that there is enough medication for these patients as lack of medication can lead them to default.   Agtergrond: Dit is onmoontlik om te bepaal of pasiënte by hulle tuberkulosebehandeling gaan hou. Die meeste pasiënte hou nie daarby nie omdat hulle nie die belangrikheid daarvan insien nie. Doelwitte: Die doel van die studie was om die faktore wat in die Groter Giyani Munisipaliteit tot lae genesingskoerse onder TB-pasiënte lei, te ondersoek en te beskryf, soos deur pasiënte gesien. Metode: Die studie is in die Groter Giyani Munisipaliteit in die Limpopo Provinsie gehou, waar die genesingskoers vir TB tussen 14% en 94% is. Die navorsing in hierdie studie was kwalitatief, verkennend, beskrywend en kontekstueel van aard. Die populasie het bestaan uit alle gediagnoseerde TB-pasiënte wat vir behandeling en sorg na primêre gesondheidsorgfasiliteite verwys is. Nie-waarskynlikheid, doelgerigte steekproefneming is gebruik om TB-pasiënte en gesondheidsfasiliteite te kies wat ’n laer genesingskoers as die nasionale doelwit van 85% het. Een pasiënt uit elke primêre gesondheidsorgfasiliteit is by die steekproef ingesluit. ‘n Diepgaande persoonlike onderhoud is gebruik om data met behulp van ‘n onderhoudgids in te samel. Resultate: Die bevindinge toon dat die meeste van die TB-pasiënte uit arm gesinne kom, wat dit vir hulle moeilik maak om finansiële en voedselsekerheid te hê. Die gesondheidsfasiliteite se voedselaanvullings en TB-medisyne raak dikwels op. Kulturele oortuigings oor TB lei ook daartoe dat TB-pasiënte by tradisionele gesondheidsorgpraktisyns en geloofsgebaseerde genesers hulp soek. Gevolgtrekking: Dit is nodig dat ‘n beleid oor toesig oor die behandeling van ontslaande TB-pasiënte wat tuis aansterk, opgestel word. Gesondheidsorgfasiliteite behoort ook seker te maak dat daar genoeg medisyne vir hierdie pasiënte is, aangesien ‘n gebrek aan medisyne daartoe kan lei dat die pasiënte ophou om hulle medikasie te gebruik

Views of professional nurses regarding low tuberculosis cure rate in Greater Giyani Municipality, Limpopo Province

Background: Management of patients suffering from tuberculosis (TB) after discharge from hospital plays a critical role in the cure rate of TB. Despite interventions developed by the World Health Organization (WHO) to improve the cure rate, TB remains a worldwide health problem. Objective: The purpose of the study was to explore and describe the views of professional nurses regarding the low TB cure rate in primary healthcare facilities of Greater Giyani Municipality in Limpopo Province, South Africa, with the aim of determining strategies that can be used to improve this low rate. Method: This study was qualitative, exploratory, descriptive and contextual in nature. The population consisted of professional nurses working in primary healthcare facilities within Greater Giyani Municipality, which has a TB cure rate below the national target of 85 %. Data gathering was through individual face-to-face interviews using an interview guide. Open-coding was used to analyse the data in this study. Results: The theme that emerged from data was ‘factors contributing to low TB cure rate’. This theme was supported by the following sub-themes: poor referral system, lack of knowledge about TB and its treatment, stigma attached to TB, and cultural and religious beliefs. The professional nurses suggested counselling of TB patients upon diagnosis, advice about patients’ responsibilities and the involvement of family members. Conclusion: The involvement of community stakeholders in TB prevention, health promotion and education activities devoted to disease spread and cure is vital so that the stigma attached to TB can be eliminated. TB education and awareness programmes should be included in the curriculum of primary schools