Repository logo
 

Faculty of Health Sciences

Permanent URI for this communityhttp://ir-dev.dut.ac.za/handle/10321/11

Browse

Filters

2011 - 20167

Settings

Author: search.filters.author.Ngxongo, Thembelihle Sylvia Patience

Search Results

Now showing 1 - 7 of 7
  • Thumbnail Image
    Item
    Experiences and views of the pregnant women regarding the Basic Antenatal Care approach to health care services provision in eThekwini district, KwaZulu-Natal
    (Research and Reviews, 2016-12-23) Ngxongo, Thembelihle Sylvia Patience; Sibiya, Maureen Nokuthula; Gwele, Nomthandazo S.
    Purpose: The purpose of the study was to describe the experiences and views of the pregnant women regarding the antenatal care services received in the Primary Health Care clinics that were implementing the Basic Antenatal Care (BANC) approach. The BANC approach is listed as one of the priority interventions for reducing maternal and child mortality in South Africa and is used in the public health institutions to provide health care services to the pregnant women. Methods: A descriptive qualitative design was used to conduct the study in the 12 primary health care clinics that were providing antenatal care services and implementing the BANC approach in eThekwini district, KwaZulu-Natal The study took place seven years following the introduction of the BANC approach. Data were collected using semi-structured interviews conducted with 54 pregnant women from October 2014 to March 2015. Data were analysed using Tesch’s method of data analysis. Findings: Although some participants highlighted how the BANC approach had brought about improvement in the quality of care, other participants were concerned regarding the waiting times, the intervals between antenatal care visits, integration of antenatal care with other primary health care services, limited space at the clinics and attitudes and performance of clinic staff. Conclusion: In the current study, the participants shared their experiences and views regarding the antenatal care services that were provided using the BANC approach. Most of the situations that the participants had encountered and their views regarding Antenatal care services highlighted specific areas of the BANC approach that needed attention. Guided by this, the researchers were able to provide the recommendations from the study that would assist to improve implementation of the BANC approach. These included special emphasis on compliance to service delivery guidelines and protocols by antenatal health care providers, availability of the clinic staff members who had been trained and oriented towards the implementation of the BANC approach, integration of services and reviewing human and material resources for adequacy when new programs are introduced.
  • Thumbnail Image
    Item
    Evidence of application of the Basic Antenatal Care principles of good care and guidelines in pregnant women’s antenatal care records
    (AOSIS Publishing, 2016-05-31) Ngxongo, Thembelihle Sylvia Patience; Sibiya, Maureen Nokuthula; Gwele, Nomthandazo S.
    Background: Basic Antenatal Care (BANC) is an approach that is used in the public health institutions of South Africa to provide health care services to pregnant women. The approach was introduced as a quality improvement strategy based on the belief that good quality Antenatal Care (ANC) could reduce maternal and perinatal mortalities and improve maternal health. Aim: The aim of this study was to analyse pregnant women’s ANC records for evidence suggesting that the BANC principles of good care and guidelines were being applied. Setting: The study was conducted in the 12 primary health care clinics that were providing ANC services using the BANC approach in eThekwini district, KwaZulu-Natal. Methods: A cross-sectional quantitative design was used to conduct the study. Data were collected through retrospective record review of 1200 maternity case records of the pregnant women who had attended for ANC services three or more times and was analysed using Statistical Package for Social Sciences (SPSS) version 21.0. Results: The majority of the processes detailed in the guidelines and principles of good care were evident in the records. However, several were missing or recorded in few reviews. These included the ANC plan, delivery plan, midwives’ counter signatures on the cards, assessment for foetal congenital abnormalities, and consent for HIV testing. Conclusion: The study identified evidence of incomplete application of the BANC principles of good care and guidelines in pregnant women’s antenatal care records which indicated that the BANC approach was not being successfully implemented. Recommendations were made with regards to policy development, institutional management and practise, nursing education, and further research to assist in successful implementation of the BANC approach in line with the guidelines and principles of good care.
  • No Thumbnail Available
    Item
    Assessment of the use of the new maternity case record in improving the quality of ante natal care in eThekwini District, KwaZulu-Natal
    (Elsevier, 2015) Sibiya, Maureen Nokuthula; Cele, Reginah Jabulisile; Ngxongo, Thembelihle Sylvia Patience
    The national guidelines for maternity care in South Africa recommend that a standardised maternity case record be used by all facilities at all levels of care in order to improve the quality of care for pregnant women. This will facilitate continuity and quality of care for women during pregnancy, labour and post-partum. The aim of the study was to assess the use of the maternity case record in improving the quality of the antenatal care for pregnant women. An exploratory, descriptive study using both quantita-tive and qualitative design was used to conduct the study. Data was collected through a retrospective record review using a checklist for the quantitative strand, and from midwives using unstructured inter-views for the qualitative strand. The quantitative data set was analysed using the Statistical Package for the Social Sciences version 21.0 and the qualitative strand was analysed using the Tesch’s method of data analysis. The results of the record review revealed that although the recording was done fairly well, there were a number of activities and interventions that were recorded poorly or not recorded at all in some primary health care clinics. The midwives verbalised that many mistakes and mismanagement of ante-natal care clients emanated from the structure and the design of the new maternity case record.
  • Thumbnail Image
    Item
    Experiences of community care givers caring for clients with tuberculosis in eThekwini district, KwaZulu-Natal Province, South Africa
    (AFAHPER-SD, 2015-10) Mazibuko, Ntombifuthi Norah; Ngxongo, Thembelihle Sylvia Patience; Sibiya, Maureen Nokuthula
    Tuberculosis (TB) is still a leading cause of deaths in low and middle income countries especially Sub-Saharan Africa. It is estimated that around 70% of adult new cases of tuberculosis in South Africa are co-infected with the human immunodeficiency virus (HIV). TB is curable if the clients take a full uninterrupted course of drug therapy. Treatment interruption presents a problem for clients, their families, the community, and the health personnel caring for them. The National Department of Health (NDOH) introduced the community care giver (CCG) programme to assist health professionals with the control and management of TB. The study aimed to explore and describe the experiences of CCGs caring for TB patients and to identify the support systems available for them. A qualitative exploratory descriptive design was used to conduct the study. Purposive sampling, guided by data saturation, was used to select the 24 participants that were included in the study. The experiences of the CCGs included facing several challenges in caring for TB patients in the eThekwini district. The challenges were; insufficient work kits, failure to access protective clothing, exposure to communicable diseases, insufficient stipends, no career paths, poor supervision and support. Negative experiences of CCGs might have contributed to demoralisation and poor performance resulting into poor care given to TB patients in the communities.
  • Thumbnail Image
    Item
    Factors influencing the uptake of the revised expanded immunisation programme at Umlazi Township, KwaZulu-Natal Province, South Africa : maternal and child care
    (AFAHPER-SD, 2015-10) Ngxongo, Thembelihle Sylvia Patience; Chonco, Nomfundo Prudence Hedwig; Sibiya, Maureen Nokuthula
    The Expanded Programme on Immunisation (EPI) is one of the most powerful and cost-effective global public health programmes to improve child survival. In South Africa, the programme remained fragmented because of the system of apartheid until 1995 when the national EPI was formed through the unification of all immunisation services in the country. Since then there have been significant advances in immunisation service delivery in South Africa with numerous revisions in the schedule, last of which was in 2009. The data information system for eThekwini district reflects remarkably low immunisation coverage for children aged 6 to12 years compared to the other age groups from the time the 2009 revision was made. The aim of the study was to investigate the factors that influence the uptake of the revised EPI for children between the ages of 6 to 12 years at Umlazi Township, KwaZulu-Natal (KZN). A descriptive quantitative design was used to conduct the study. All (n=10) primary health care (PHC) clinics from Umlazi Township were included in the study. Data was collected from 1009 child caregivers (CCGs) and all (n=12) health care workers (HCWs) who were involved in EPI services using self-directed questionnaires. The study revealed that although the EPI programme was well-implemented in Umlazi Township, EPI coverage for children between 6 to 12 years old remained low. Several factors that influenced the uptake of the immunisations were identified. The positive factors which could be used to strengthen the programme were mainly in relation to how the EPI programme was implemented and a few other factors in relation to the CCGs and their access to the PHC clinics. The negative factors were in relation to emergency ordering and supply of vaccines and the knowledge of the children care givers regarding the immunisation. These highlighted a need to strengthen how the EPI was implemented.
  • Thumbnail Image
    Item
    Implementation of the basic antenatal care approach : a tailored practice framework for eThekwini district, KwaZulu-Natal
    (2016) Ngxongo, Thembelihle Sylvia Patience; Sibiya, Maureen Nokuthula; Gwele, Nomthandazo S.
    Globally antenatal care is advocated as the cornerstone for reducing children’s deaths and improving maternal health. The World Health Organization designed and tested a Focussed Antenatal Care model for the developing countries to improve their quality of antenatal care services. South Africa has not successfully implemented this approach, referred to by South Africa as the Basic Antenatal Care approach. A convergent parallel mixed methods design was used to assess how the Basic Antenatal Care approach was implemented in the eThekwini district. Data were collected from 12 Primary Health Care clinics using observations, retrospective record reviews and semi-structured interviews conducted with pregnant women. The quantitative data was analysed using version 21.0 of the Statistical Package of Social Services and qualitative data was analysed using Tech’s method of data analysis. The Basic Antenatal Care approach was not being successfully implemented in the Primary Health Care clinics. Several aspects of planning, people, processes and performance were not done according to the Basic Antenatal Care Principles of Good Care and Guidelines. Although good communication was observed between the clinic staff members and the referral institutions, communication problems existed between the Primary Health Care clinics and the Emergency Medical Rescue Services and also with the pregnant women. Antenatal care and delivery plans and the midwives’ counter checking of maternity charts were not recorded. Some pregnant women had positive perceptions about the antenatal care services but others had negative perceptions. Recommendations pertaining to institutional management and practice, nursing education and research were made. A tailored practice framework and an implementation guide were developed based on setting and client-specific factors to facilitate the implementation of the Basic Antenatal Care approach. The framework highlights the importance of cooperation between management and administration, in-service education and skills development departments/units and the operational level. Effective implementation of the Basic Antenatal Care approach could help to reduce South Africa’s high maternal and neonatal mortality rates. Thus the tailored practice framework and implementation guide, developed as part of this study, could help to improve maternal and neonatal health-related outcomes in South Africa.
  • Thumbnail Image
    Item
    Factors influencing successful implementation of basic ante natal care programme in primary health care clinics in eThekwini district, KwaZulu-Natal
    (2011) Ngxongo, Thembelihle Sylvia Patience; Sibiya, Maureen Nokuthula
    Background South Africa is burdened by consistently high maternal and perinatal mortality rates. In a move to alleviate this burden the South African National Department of Health (DoH) instructed the adoption of the Basic Antenatal Care (BANC) approach in all antenatal care (ANC) facilities. Whereas many facilities have begun the implementation of the BANC approach, in the eThekwini district, not all of the facilities have been successful in doing so. The study was conducted in those eThekwini Municipality Primary Health Care (PHC) facilities that have been successful in order to identify the factors influencing their success in implementing BANC. Methods The facilities that had been successful in implementing BANC were identified, followed by a review of the past records of the patients who had completed their ANC and had given birth. This was done in order to establish whether the facilities that were said to be implementing BANC, were in fact, following BANC guidelines. The factors that influenced successful implementation of BANC were identified based on information obtained from the midwives who were working in the ANC facilities that were successfully implementing BANC. The sample size was comprised of 18 PHC facilities that were successfully implementing BANC from which a total of 59 midwives were used as the study participants. Results Several positive factors that influenced successful implementation of BANC were identified. These factors included; availability and accessibility of BANC services: Policies, Guidelines and Protocol; various means of communication; a comprehensive iii package of services and the integration of services; training and in-service education; human and material resources and the support and supervision offered to the midwives by the PHC supervisors. Other factors included BANC programme supervisors’ understanding of the programme and the levels of experience of midwives involved in implementation of BANC. There were, however, certain challenges and negative factors that were identified and these included: shortage of staff; lack of cooperation from referral hospitals; lack of in-service training; problems in transporting specimens to the laboratory; lack of material resources; lack of management support and the unavailability of BANC guidelines.