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Faculty of Health Sciences

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    Health seeking behaviour among married women in northern Nigeria : a framework to promote autonomy
    (2023-05) Paul, Mary Kakamission; Ngxongo, Thembelihle Sylvia Patience; Naidoo, V.
    Introduction and background Morbidity and mortality rates (MMR) continue to be a major health care problem in developing countries such as Botswana, Cameroon, Chad, Congo, Guyana, Lesotho, Namibia, Somalia, Swaziland, Zimbabwe, Nigeria, South Africa and many others. The majority of deaths are often as a result of disparities that prevail in health care delivery, especially in rural areas such as inaccessibility, unavailability of health care facilities, inadequate material, lack of human resources, poor road infrastructure to facilitate the utilisation of ante natal care, and difficult access to health care providers by pregnant women. The cultural and social beliefs of the community cannot be overlooked due to their influence on the decision to utilise health care services. Autonomy to seek healthcare among married women (MW) is a major challenge in most developing countries, including Nigeria. Autonomy is the ability to make your own decisions without being controlled by anyone else, or the right of an organisation, country or region to be independent and govern itself. Cultural and religious beliefs affect the MW from Nigeria, many of whom face the possibility of dying due to the lack of autonomy to seek healthcare early. Globally, men often control decisions about the health of their wives and children, including the family’s use of healthcare services. Aim of the study: The study aimed to develop a framework to promote healthcare decisionmaking autonomy amongst MW in northern Nigeria. Objectives of the study: The objectives of the study were to explore the process of healthcare decision-making and autonomy practices among married men (MM) and women in northern Nigeria, then develop a framework to facilitate healthcare decision-making and autonomy practices among MW in that region. Method: A qualitative descriptive research design was employed whereby data were gathered from both the MM and MW from the Lemu community in Gbako Local Government Area of Niger State Nigeria through semi-structured interviews and focus group discussions. Findings: The current study was guided by Andersen’s Health Belief Model and findings from the study confirmed poor health seeking behaviours due to lack of autonomy for health seeking decisions for MW from the Lemu rural community in northen Nigeria. Recomendations from the study focused mainly on strategies to ensure awareness of MM and other community members regarding the importance of autonomy for MWs to be able to make decisions to visit healthcare centres. This study also found that strengthening collaboration and partnerships between healthcare workers and the community was a means to create a platform where critical information regarding healthcare related issues could be discussed. A tailored practice framework to facilitate healthcare decision-making and autonomy practices among MW in northern Nigeria was developed. Conclusion: The findings from the study confirm that although autonomy for MW for making health-seeking decisions is one of the critical factors that influence health seeking behaviour, several socio-demographic and socio-economic factors are also responsible for health-seeking behaviour.
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    Lived experiences of post-penectomy for patients receiving healthcare from a public hospital in KwaZulu-Natal : a phenomenological study
    (2023-05-31) Ndlovu, Virginia Vuyokazi; Sokhela, Dudu Gloria; Sibanda, M.
    Penile cancer is a rare malignancy with prevalence higher in areas of high Human Papilloma Virus (HPV) such as Africa, Asia and South America. In middle- and low income countries where circumcision is not routinely practiced, the rate of penile cancer could be ten times higher. A penectomy refers to a procedure which all or parts of the penis are surgically removed. Total penectomy involves the removal of the entire penis. During this procedure, a new opening is created in the perineum through which urine can pass. In some cases, the testicles, scrotum and lymph nodes may be removed. A partial penectomy involves the removal of part of the penis and typically leaves the shaft intact. Surgical treatment is inevitably mutilating. Despite its therapeutic effectiveness, total penectomy leads to mutilations that affect the ability of patients to void urine while upright. It also affects the patient’s corporal image, genital sensibility, and self-esteem. Purpose: The purpose of the study was to explore the lived experiences of post penectomy patients receiving care in a Public Hospital in KwaZulu-Natal. Methodology This was a qualitative study based on Edmund Husserl’s descriptive phenomenology which is described as the science of the essence of consciousness or inquiry into the consciousness of the patient. Purposeful sampling was used for the study. Data was collected using face-to-face in-depth interviews with patients who had penectomy surgery and were receiving follow-up health care in the selected public hospital. These patients were a year or more post-surgery therefore had sufficient experience to provide rich data. Participants were met and told about the study when they came to the hospital’s outpatient department for their follow up visits, and interviews were conducted where they are most comfortable such as at their homes. Results The data was analysed by means of content analysis and raw data was coded and sorted into sub-categories and categories. Sub-categories were: feeling severe pain, beliefs about causation of illness, feelings of loss of life, sense of self care, coping mechanisms, support system, loss of self-esteem, fear of people knowing about the surgery performed, bodily discomfort from disfigurement, being able to have sexual satisfaction, and use of sexual gadgets. The underlying meaning of categories were formulated into themes which were: thought processes before penectomy surgery, psychological effects of penectomy surgery, difficulty in urination, and sexual function post penectomy surgery. All participants had penile cancer. Pain was the main reason for these participants to make a decision to have the penectomy surgery; participants had severe sores around their penile area and these sores were not healing. Other reasons during their thought processes before making a decision for the penectomy surgery was the penile cancer itself, with participants being worried that if they delay or they do not agree to the surgery the cancer would spread to other organs of the body Conclusion Even though penectomy surgery is a debilitating procedure and inevitably mutilating despite its therapeutic effectiveness, the pain and the illness that the participants were going through led them to take the decision to have the surgery. Outcomes were the relief of pain and healing from penile cancer. No recurrence of cancer was verbalised by the participants after the surgery.
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    A survey of patient satisfaction of the DUT Homoeopathic Community Health Centre (DUT HCHC)
    (2022-05-13) Adandé, Adhiéman Sihle; Couchman, Ingrid; Brijnath, Shraddha
    Background Patient satisfaction is a vital area of research concerning the quality of healthcare. Satisfied patients are more likely to benefit from their healthcare, keep their appointments and comply with medical regimes such as proper medication upon given instructions from their healthcare practitioner (Hills and Kitchen, 2007: 243). Herr (2008) conducted a similar study on patient satisfaction at the Homoeopathic Community Health Centre (HCHC) at Durban University of Technology (DUT). Although there has been renovation at the community health since then, more than five years have passed without any evaluation. Patient satisfaction is a patient-focused indicator of healthcare services. Therefore, evaluating patient satisfaction is a good criterion for analysing the quality and relationship between patients and healthcare practitioners. Therefore, patient dissatisfaction is a significant factor for changing healthcare services or complaints against a healthcare practitioner (Miri, Nejad and Soltani, 2016: 89). Thus, continuous improvement in healthcare quality is a daily goal for all healthcare services, such as clinics and professionals who work in healthcare. To thrive in a competitive marketplace, it is essential for healthcare organisations and their practitioners to recognise that viewing patients as customers and improving customer satisfaction has direct implications on healthcare quality (Harding and Taylor 2010: 928; Stavins 2006:29). This study evaluated patient’s feedback to create a patient satisfaction survey for use at the HCHC at DUT continually. Aim The aim of this study was to conduct a patient’s satisfaction of the service provided at the DUT HCHC, with the purpose to identify shortfalls/gaps such as to improve every aspect of patient satisfaction, which positively contributes to the overall treatment and service being provided at the DUT HCHC. Methodology The sample group of the first 70 patients that consulted at the DUT HCHC between July 2020 and March 2021, that voluntarily participated in this study were included in the study by means of convenience sampling. The use of a self-administered questionnaire to establish patient satisfaction was applied. No names were required and all data has been kept strictly confidential. This information will subsequently be used to improve the quality of the service provided at this facility and increase the degree of patient satisfaction experienced. Results In this study there was generally a high degree of satisfaction with the healthcare and services provided. Areas of particularly high satisfaction were, Patient’s arrival at the community health centre where they were both promptly and politely greeted, as well as the overall interaction between the student Homoeopath, Administrative staff as well as the Clinician on duty and the patient. Areas that demonstrated lower degree of satisfaction were advertising by media and signage, signage, toilet accessibility for disabled patients and parking. Conclusion The feedback from the patient satisfaction survey will subsequently serve to improve the quality of the service provided at the DUT HCHC and increase the degree of patient satisfaction experience.