Transformation of service delivery in the Westcoast winelands region's hospitals: challenges and prospects

M.Cur. (Psychiatric Nursing) / There is an increase in the readmission rate of African psychiatric patients to psychiatric hospitals as determined by the records. This to a large extent involves those diagnosed as being psychotic of one category to another forming eighty percent of all patients in the admission wards for both the male and the female patients ...

The aim of this study is to explore the introduction of IsiXhosa (iintsomi) as an alternative method in the maternal health education in rural Primary Health Care in the Eastern Cape. An informal preliminary observation of a maternal health lesson by the researcher indicated a further need for maternal health educators to introduce storytelling into the health content themes. To re-inforce the maternal health educator lesson on the causes of teenage pregnancy, lifestyles for pregnant women, causes of miscarriage and termination of pregnancy, the Community Health Workers can undoubtedly use isiXhosa iintsomi in selected clinics and maternal waiting homes. As a readily available resource that cuts across all literacy barriers, iintsomi (isiXhosa) fosters a cross-cultural consultation which enables the healthcare worker to convey messages that make sense to the rural women. While the conventional methods of teaching have a tendency to create tension and lack of participation, use of folktale (iintsomi) have huge potential to bring lesson enjoyment; a meaningful interaction and story sharing by the maternal health educator, the pregnant women and greater community; access to important health messages; and strengthened utilisation of Primary Health Care. The study therefore suggests that there is a place for isiXhosa iintsomi: From the Fireplace into the Workplace.

The Home and Community Based Care (HCBC) and Support programme has been established as a cost effective response for communities to tackle HIV and AIDS and many other chronic conditions and vulnerabilities which are faced by individuals, families and communities. In terms of the Framework for Home and Community Based Care and Support Programme (2012: 4) HCBCs create an enabling platform for “individuals, families and communities to have access to holistic and comprehensive services nearest to home, which encourages participations by people, responds to the needs of the people, encourages traditional community life and strengthens mutual support opportunity and social responsibility”. Victor Khanye Local Municipality, IDP (2010-2011: 116) states that VKLM is faced with: a high incidence of HIV and AIDS due to poverty, ignorance and a lack of proper entertainment facilities; shortage of clinics and professional staff members, which makes it difficult for patients to access treatment and maximum care and support; and an increase in the number of OVCs which results in a lack of parental care and guidance, poverty, illiteracy, lack of access to medical care, school drop-outs and ultimately an increase in criminal activity and the further spread of HIV and AIDS. The research will assess the effectiveness of Home Community Based Care programmes (HCBCs) on orphaned and vulnerable children with specific reference to the Victor Khanye sub-district in Nkangala District, Mpumalanga Province. The research was conducted in Delmas and its surrounding farming areas. Victor Khanye sub-District has nine wards, most of which are predominantly farming rural areas. The field research took place during June and August 2013 and represents observations recorded at the field interviews, the local AIDS committee and one-on-one interviews with beneficiaries The study is concluded with conclusions drawn from the field study and recommendations.

The general health status of pregnant women depends largely on the quality of the antenatal services available to them. The provision of good antenatal services ensures early detection and prompt management of any complication or disease that may adversely affect pregnancy outcome. In order to ensure high quality care, antenatal services need to be evaluated at regular intervals, both from provider and client perspective, to ensure their effectiveness in improving the health status of pregnant women. The midwife, as the first contact person for most pregnant women attending antenatal clinics in South Africa, has the potential to play a major role in improving the health status of these women. However, for the midwife to be effective in achieving this, antenatal services need to be effectively utilized by women. One of the factors that affect utilization of any service is client satisfaction with the service being rendered. This study, therefore, explores the perceptions that pregnant women have of the care that they receive from midwives at the selected antenatal clinics. The objectives of the study are to: {u100083} Explore and describe the perceptions and experiences of pregnant women attending antenatal clinic regarding the care they receive from midwives. {u100083} Make recommendations to assist registered midwives in optimizing the accompaniment of women during the antenatal period. A qualitative, descriptive, exploratory and contextual design was used for the study. The sample was chosen from the target population by means of purposive sampling and data was collected through unstructured interviews with the participants. Before data collection, permission was obtained from the Eastern Cape Department of Health and the Nursing Service Manager of the Gateway clinic, in the district hospital where the research was conducted. The Nursing Service Manager was acting as a Medical Superintendent at the time of the study. Written, informed consent was obtained from all participants before conducting interviews. Trustworthiness was ensured by means of Guba’s model throughout the study, and the aspects of truth value, applicability, consistency and neutrality were considered. Tesch’s eight steps of data analysis were used to analyze the data collected, and four main themes were identified namely: • Women perceive midwives as considerate and knowledgeable • Women perceive midwives as lazy and rude • Women experience mixed emotions about the care they receive from midwives • Though their experiences, women identified certain needs in the services and care they received at the clinic. Conclusions were drawn and recommendations for midwifery practice made based on the results of the study, with the aim of improving antenatal services rendered to pregnant women.

South Africa has a complex healthcare system. The provision and financing of health care in South Africa occur within two fundamentally different systems: the public healthcare sector and non-governmental not-for-profit organisations, on the one hand, and the private healthcare system, on the other hand. The socioeconomic status of an individual in South Africa is the primary determinant of the system through which he or she will receive access to healthcare. The healthcare services provided by the public and private sectors are perceived to be unequal. The introduction of healthcare reforms by the South African government through the National Health Insurance (NHI) aims to address these disparities. The primary objective of this study was to contribute to the successful implementation of the proposed South African NHI by identifying critical success factors that would impact such implementation. A sample of managerial representatives of the following healthcare institutions in the Nelson Mandela Bay Municipality (NMBM) was drawn: Large private hospitals groups; Eastern Cape Department of Health; Independent medical practitioners groups; South African Dental Association; Pharmacy Association of South Africa; Optometrist Association of South Africa. A total of 250 questionnaires were distributed among these institutions and approximately 233 usable questionnaires were returned (response rate 93.2 percent). A literature review was conducted to identify the various viewpoints (critical success factors, as well as positive and negative perceptions) on NHIs in other countries, as well as the proposed one in South Africa. About 43 of such viewpoints were identified. The 233 respondents were surveyed on these 43 viewpoints. The empirical results revealed the following three critical success factors for the successful implementation of the South African NHI: The projected benefits for stakeholders, with specific reference to medical aid schemes; the projected benefits to the private healthcare sector in servicing the public sector; and strategic leadership. The empirical results also showed that the healthcare managers, who serve the poor versus the affluent geographical areas of the NMBM, differ with regard to their projected success of the NHI. Finally, the study highlighted these health managers’ general perceptions about the envisaged benefits and shortcomings of the NHI.

M.Cur. / It is evident that the current political changes presently taking place in South Africa need to be accompanied by a dramatic transformation to accommodate the economic, social, technological and health changes amongst others. The nursing discipline is no exception. For a change to be felt by nursing staff and by health consumers, effective management strategies need to be developed to accommodate transformation guidelines as outlined by the Reconstruction and Development Programme, the National Health Plan and the Constitution which all emphasize the right to health, hence this study. This study focuses on a primary health care clinics. This is a qualitative, contextual, exploratory and descriptive study with the overall aim of exploring and describing a nursing service strategy for change in Soweto Primary Health clinics where the researcher is employed. To accomplish this aim, the following objectives were formulated: to explore and describe the expectations of the managers and the functional nurses concerning the required nursing service strategy for change within Soweto Primary Health Clinics; to explore and describe the expectations of health consumers concerning the required nursing service strategy for change in Soweto Primary Health Clinics; to describe the required nursing service strategy for Soweto Primary Health Clinics. Through purposive sampling, three focus groups were selected from the role players within Soweto who represent the nursing managers, the functional nurses' and the health consumers in order to infer the required change strategy for the nursing service. i. Data was collected through these focus groups interviews using semi-structured questions. Data management and data analysis was done using the methods of content analysis according to Kerlinger (1986: 480). An research expert, was utilised as a reliability measure to identify and categorise themes separately from the researcher. The categories that emerged were subsequently refined through consensus discussions between the researcher and the independent researcher. Woods and Catanzaro' s measures (1988: 136) to ensure validity and reliability were applied in this study.

Thesis(MPH.) -- University of Limpopo, 2019 / Background: Community service health professionals working in rural areas experience challenges such poor accommodation, poor supervision, unavailability of equipment and medication. The majority of studies focussed on doctors, with a few including dentists and pharmacists. This study intended to establish the experiences of community service health professionals in all professions. Objective(s): The objectives of the study were to describe and explore the experiences of community service health professionals. Methods: A qualitative, exploratory and descriptive study was conducted. Purposive sampling was used to select community service health professionals for the study. Face to face interviews with community service health professionals were conducted to collect data. Community service health professionals were interviewed until data saturation was reached. The Tesch‘s eight steps were used to analyze data. Results: The study findings indicated that community service health professionals experienced challenges relating to accommodation, supervision and unavailability of equipment and medication. Conclusions: Community service health professionals are experiencing challenges regarding working in Limpopo province rural hospitals. It is recommended that the government should allocate more funds to health care services to address the challenges faced by community service health professionals

Thesis (M. A. (Nursing Science)) -- University of Limpopo, 2016. / Perinatal morbidity is a public health indicator of the level of equality in a country. Its prevention has major medical, social and economic costs. The aim of this study was to describe factors contributing to high perinatal morbidity rates in Mankweng-Polokwane Complex of the Capricorn district, Limpopo Province, South Africa. A quantitative, descriptive cross-sectional research method was used to describe factors contributing to high perinatal morbidity. The study population comprised 80 registered midwives. Simple random sampling was used to select the 66 respondents. Data were collected using a self-developed questionnaire. Questionnaires were completed and returned, and only one questionnaire was not returned, and two were spoiled as they were incomplete, then 63 questionnaires were analysed. Ethical clearance was obtained from Medunsa Research and Ethics Committee, Limpopo Province Department of Health Ethics Committee and Hospital management. The Statistical Package for Social Sciences (SPSS, version 22) was used for data analysis. Descriptive statistics were used to analyse and describe and summarise data whereby the findings were presented in the form of distribution tables and graphs. Inferential statistics were used based on probability and allowed judgement to be made about the variables. The study revealed that shortage of staff, absenteeism, resignation, bad staff-patient ratio and overcrowding of patients, long waiting periods for caesarean sections, long waiting period for babies operation, work overload of staff, lack of equipment and supplies, congenital anomalies, perinatal asphyxia, prematurity and neonatal sepsis were contributory factors to high perinatal morbidity rates. The study recommended that all staff should be able to resuscitate newborn babies, be able to use Partograph effectively, further research on factors contributing to high perinatal morbidity and education training on speciality qualifications. Key-words: Factors, High, Perinatal, Morbidity rates

PURPOSE Explore the competencies required by the child nurse practitioners in the child nursing practice in order to refine the current competencies in a programme for Child Nursing Science presented at a Nursing Education Institution in Gauteng. DESIGN AND METHOD A quantitative, non-experimental, descriptive, exploratory and applied research design was used. A structured self reported questionnaire was constructed based on the competencies derived from the current programme for Child Nursing Science used at the Nursing Education Institution, the Specialist Paediatric and Child Health Nurse by the Australian Confederation of Paediatric and Child Health Nurses and the World Health Organization Children’s Nursing Curriculum. The structured self reported questionnaire was distributed to 110 child nurse practitioners working in child nursing practices in Gauteng and a total of 82 responded. FINDINGS All competencies were regarded as important, except for competencies related to research, family-centred child care, complementary and traditional child care practices, evidence-based practice, mentoring and play activities. CONCLUSION Findings were used to refine the current competencies in a programme for Child Nursing Science / Health Studies / M.A. (Health Studies)