Faculty of Health Sciences
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Item Experiences of facilitators regarding the extended curriculum programme offered at a higher education institution in the province of KwaZulu-Natal in South Africa(AOSIS, 2018-09-20) Sibiya, Maureen Nokuthula; Mahlanze, Hazel ThokozaniBACKGROUND: Much like the rest of the world, student access and success are primary concerns of the South African higher education institutions, especially in the face of data that suggest that up to 50% of students do not successfully complete their course of study. Despite compulsory and free basic education for all South Africans, and increased government funding for education, there has been little impact on learner performance and the majority of primary schools remain poor. To improve access and success and in keeping with international practice, the Department of Nursing at the selected university of technology in 2013 offered for the first time the extended curriculum programme (ECP). To date, the impact of the programme has never been evaluated. OBJECTIVES: The aim of the study was to explore the experiences of the facilitators regarding ECP in the undergraduate nursing programme. METHOD: Guided by this, the current article describes a qualitative exploration of the experiences of six purposively selected facilitators regarding ECP in the Department of Nursing. In-depth interviews were conducted with the ECP facilitators. Tesch's method was used to analyse the data. RESULTS: Four main themes emerged from the data: stigmatisation and lack of confidence, lack of self-will, additional workload of facilitators and gradual improvement of students' performance. The participants reported that although students displayed and verbalised negative attitude towards the ECP, the performance of students showed gradual improvement and thus a need to continue to offer the programme to increase access and success in higher education institutions. CONCLUSION: It was concluded that ECP should continue to increase access and success in higher education institutions; however, there is a need for additional resources to support ECP students.Item Experiences of facilitators regarding the extended curriculum programme offered at a higher education institution in the province of KwaZulu-Natal in South Africa(AOSIS, 2018-09-20) Sibiya, Maureen Nokuthula; Mahlanze, Hazel ThokozaniMuch like the rest of the world, student access and success are primary concerns of the South African higher education institutions, especially in the face of data that suggest that up to 50% of students do not successfully complete their course of study. Despite compulsory and free basic education for all South Africans, and increased government funding for education, there has been little impact on learner performance and the majority of primary schools remain poor. To improve access and success and in keeping with international practice, the Department of Nursing at the selected university of technology in 2013 offered for the first time the extended curriculum programme (ECP). To date, the impact of the programme has never been evaluated. OBJECTIVES: The aim of the study was to explore the experiences of the facilitators regarding ECP in the undergraduate nursing programme. METHOD: Guided by this, the current article describes a qualitative exploration of the experiences of six purposively selected facilitators regarding ECP in the Department of Nursing. In-depth interviews were conducted with the ECP facilitators. Tesch's method was used to analyse the data. RESULTS: Four main themes emerged from the data: stigmatisation and lack of confidence, lack of self-will, additional workload of facilitators and gradual improvement of students' performance. The participants reported that although students displayed and verbalised negative attitude towards the ECP, the performance of students showed gradual improvement and thus a need to continue to offer the programme to increase access and success in higher education institutions. CONCLUSION: It was concluded that ECP should continue to increase access and success in higher education institutions; however, there is a need for additional resources to support ECP students.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.Item Experiences of midwives regarding nursing practice breakdown in maternity units at a selected public hospital in KwaZulu Natal(UNISA Press, 2016) Mhlongo, Ndumiso Mbonisi; Sibiya, Maureen Nokuthula; Miya, Respect M.Pregnant women have certain expectations about the midwife and their skills. If such expectations are not met, substandard care occurs. Such substandard care has a negative impact on both the pregnant women and the Department of Health. The aim of the study was to explore and describe the experiences of midwives regarding practice breakdown in maternity units at a public hospital in KwaZulu-Natal in order to improve the quality of care in maternity units. A qualitative research study that was exploratory, descriptive and contextual in nature was conducted. Semi-structured interviews were conducted with 13 midwives. Data was transcribed verbatim, then organised into codes. The study revealed that the majority of the participants faced practice breakdown, which mostly starts during ante-natal care visits. Midwives who attended to pregnant women during ante-natal care did not follow set protocols and guidelines and this resulted in complications during delivery. Midwives were of the opinion that the management did not care about their challenges and did not attempt to resolve the challenges. Therefore, strategies of retaining midwives must be put in place by the Department of Health. Midwives must be relieved in all nonnursing- related matters to allow them to focus on the pregnant women.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.Item An assessment of the implementation of the provincial cervical screening programme in selected primary health care clinics in the Ilembe region, KwaZulu-Natal(2002) Sibiya, Maureen Nokuthula; Grainger, Linda D.Cervical cancer is almost completely preventable, yet it is the second most prevalent cancer amongst women in South Africa. KwaZulu-Natal (KZN) in particular has a high mortality rate of cervical cancer and 1:40 women die from cancer of the cervix. Therefore, in 1997 a cervical screening. policyand-. programme was implemented in the province. The KZN Department of Health and the Sub-Directorate Maternal, Child and. Women's Health needed to know what was happening currently in terms of implementation of the cervical screening programme since it was first implemented three years ago. Therefore, the purpose of the study was to evaluate the implementation of the Provincial Cervical Screening Programme in selected Primary Health Care clinics in lIembe Region, KZN. This study took the form of formative evaluation research. The target population consisted of PHC clinics in KZN that have implemented the cervical screening policy and the programme. The accessible population for this study consisted of the clinics in the lIembe Region. A four-stage selection plan was applied to select the sample from the accessible population. The first stage involved a random selection of two clinics from an urban area and two from a rural area. Within each of the selected clinics, three types of evidence for the evaluation of the implementation of the cervical screening programme were sampled. Therefore, the second stage of the plan was the selection of records. A purposive sample of all records of clients who were diagnosed with abnormal smears was assessed. The third stage involved the selection of all Professional Nurses from each of the selected clinics. Lastly, the fourth stage involved the selection of the day for collecting data on the facilities and resources. The sources of evidence that were used to evaluate the implementation of cervical screening programme by the clinics were non-participant observation, which involved clinic audit, a review of abnormal smear records and self-reports from nurses regarding the cervical screening programme. Results indicated that there was a lack of resources needed for implementing the programme in rural clinics compared to urban clinics. However, all clinics in the study had an adequate supply of the drugs needed for the treatment of abnormal smears. The researcher also found that nurses lacked knowledge regarding the indications for taking smears. On reviewing the records, the researcher noted that most of the results indicated that smears had adequate cells needed for analysis. However, the results indicated that there was a problem with follow-up of clients with abnormal smears. There was lack of necessary resources such as telephones needed to do proper follow-up. Feedback to the clinics from the referral hospital regarding the outcome of the visit was inadequate. The results also indicated thatthe mechanisms of record keeping were poor. Nurses were of the opinion that women should have their first Pap smear at the age of 20 and thereafter at intervals of five years, once they start to be sexually active because of the high rate of sexually transmitted infections and HIV/AIDS in KZN. Therefore, the above results indicate that problems exist at the selected PHC clinics that may result in ineffective implementation of the cervical screening programme.Item The use of standard treatment guidelines and essential medicines list by professional nurses at primary healthcare clinics in the uMgungundlovu District in South Africa(Elsevier, 2015) Sooruth, Umritha Raj; Sibiya, Maureen Nokuthula; Sokhela, Dudu GloriaOne of the major challenges for the Department of Health in South Africa today is inequity and the need to provide quality integrated health care for all its citizens. Primary healthcare (PHC) has been declared as the way to achieve this goal, through the District Health System. Standard Treatment Guidelines (STGs) and the Essential Medicines List (EML) have been developed and are used at PHC clinics and hospitals. This study explored the use of STGs and the EML by professional nurses at PHC clinics in the uMgungundlovu District, province of KwaZulu-Natal in South Africa. A quantitative descriptive research design was used. Questionnaires were used to collect data from respondents at the PHC clinics. The researcher also reviewed the professional nurse’s registers retrospectively on the rational use of drugs. The findings of the study revealed that the respondents had a good understanding of the use of the STGs and the EML. There was no evidence of polypharmacy, and medications were prescribed according to the STGs and the EML guidelines. Areas that were suboptimal were related to prescription writing, in writing of schedules and routes of medication as indicated in facility records. The results further showed that training on the use of the STGs and EML were inadequate, which implies the need for strengthening of training programmes.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 PatienceThe 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.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 NokuthulaTuberculosis (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.Item Student nurses’ perceptions about the integrated management of childhood illnesses training received at the KwaZulu-Natal College of Nursing, South Africa(AFAHPER-SD, 2015-10) Jacpasad, Neervani; Sibiya, Maureen Nokuthula; Sokhela, Dudu GloriaIntegrated management of childhood illnesses (IMCI) is the WHO and UNICEF’s strategy developed in the 1990s to reduce child mortality and morbidity globally. This integrated approach guides health care workers and ensures that the child is cared for effectively at a single visit to reduce morbidity and mortality rate of children younger than five years of age. South Africa is one of 12 countries with high child mortality and morbidity rates. The purpose of this descriptive quantitative study was to evaluate the IMCI training of 100 randomly selected student nurses in the KwaZulu-Natal College of Nursing. The objective was to assess teaching methods used to prepare learner nurses for this approach. A self-administered questionnaire designed by Goga and Muhe (2011) was used to collect data. The results indicated that the time allocated for theory was adequate, but for clinical practice and clinical training time was found to be insufficient. It was concluded that the recommended duration of training (11) days was inadequate for the amount of information contained in the IMCI course.