As a clinic supervisor overseeing a cluster of clinics in the Nelson Mandela Bay Health District (NMBHD), the researcher observed a number of problems with the implementation of the re-engineering of the primary health care (RPHC) programme. The problems observed include inadequate supervision of RPHC staff, poor communication and conflict between clinic and RPHC staff, failure to filter RPHC statistics into clinic statistics and the incorrect management of patients by RPHC staff. Therefore, the purpose of this study is to explore and describe the experiences of professional nurses regarding the implementation of the RPHC programme in the NMBHD and to make recommendations the district manager could use to address the research findings. The study used a qualitative, exploratory, descriptive and contextual design. The research population consisted of professional nurses who are implementing the RPHC programme in the NMBHD, and the sampling technique was a non-probability, purposive technique for the selection of the research sample. Semi-structured interviews were used to collect the data and Tesch’s model respectively. The researcher adhered to ethical considerations throughout the study and ensured trustworthiness of the data by using the criteria of credibility, transferability, dependability and conformability. Three themes were identified; namely; the professional nurses expression of their concerns regarding poor working conditions; issues regarding the community health workers and their positive experiences associated with the RPHC programme. The study concludes with recommendations made to the District manager with regard to nursing practice, as well as recommendations to nursing education and research.

Human Immunodeficiency Virus (HIV) positive patients are at increased risk for developing mental health problems when compared with the general population. The identification and management of symptoms of mental illness in HIV-positive patients is thus crucial in reducing the risk to developing severe mental illness. The severe mental illness may lead to poor adherence to anti retro-viral drugs resulting in increased morbidity and mortality. The primary health care nurses are largely responsible for managing the treatment of HIV-positive patients as they spend the greatest degree of their time with these patients as compared to other health care professionals. Consequently it is important for primary health care nurses to identify symptoms of mental illness. However, it was unclear to the researcher, a professional psychiatric nurse, as to the level of knowledge among primary health care nurses concerning symptoms of mental illness in HIV-positive patients. Therefore, the aim of this study was to determine the knowledge of primary health care nurses regarding symptoms of mental illness in HIV-positive patients attending primary health care services. In addition, recommendations were developed for primary health care nurses for the purpose of improving their competence in the identification of symptoms of mental illness in HIV-positive patients attending primary health care services. The researcher has utilised quantitative, explorative, descriptive and contextual design. Bloom’s Taxonomy was used as a theoretical lens, to explore the primary health care nurse’s knowledge regarding symptoms of mental illness in HIV-positive patients. The study was conducted in the primary health care services situated in the Nelson Mandela Metropolitan area. The research population consisted of the primary health care nurses working with HIV-positive patients in these primary health care services. The researcher utilised census survey to recruit participants. A structured questionnaire, with 3 sections was used in this study. The necessary principles of reliability and validity were exercised to ensure research of the highest quality. The data was analysed by using descriptive and inferential statistics. All ethical considerations pertaining to beneficence, maleficence, justice, autonomy and obtaining permission from relevant structures to conduct the study were strictly adhered to.

The study aimed to explore and describe factors which impacted on the satisfaction of patients using the curative component of primary health care in the Ekurhuleni Metropolitan area. A qualitative, explorative and contextual design was followed in this study. Focus group interviews were used to collect data from clients, nurse clinicians and community health committee members. Findings indicated that there was lack of facilities, resources and supplies, lack of safety and security measures, negative attitudes of nurse clinicians, lack of community involvement and lack of clinic management involvement. Suggestions were made by the groups on how to improve the curative primary health care service and intervention strategies were identified from the suggestions made. The implementation of these strategies will help with the improvement of the service delivery at the clinic for primary health care. / Health Studies / (M.A. (Health Studies)

The South African government has initiated the transformation of health services in the country towards primary health care (PHC) in order to provide comprehensive care to individuals and families. The move to PHC involves an increased need for collaboration between health professionals. It is proposed that for effective team-work to take place, an understanding of the roles and functions of team members is imperative in providing quality mental health care. This study explored health professionals’ perceptions of the role and function of clinical psychologists working as part of a health care team in a community context. Three focus groups and three individual interviews were conducted with social workers, nurses and doctors. The data was then processed and analysed using a grounded theory method. The research highlighted the importance of knowledge, and how this affects referrals, perceptions, inter-professional relations and the perceived usefulness of clinical psychology and clinical psychologists. What is of significance is the potential power that the health professionals have as gatekeepers between the general public and clinical psychologists.

Despite a number of research studies showing the correlation between higher nurse staffing levels and improved outcomes, RCN members continues to report lower nurse-to-patient ratios than what research results suggests (RCN, 2011:1). This reflected a general concern within the nursing profession. The operating room requires appropriate staffing which is critical to the safety of surgical patients and quality of patient care. The research study was motivated by the researcher’s own experiences while working in an OR in a private hospital where continuous discussions were held with management about the shortage of skilled staff; and where a shortage of OR nurses resulted in the use of Central Sterilizing Department (CSD) staff to do OR duties. The objective of the study was to explore and describe the perceptions of nurses regarding staffing in the operating rooms of a private hospital in the Nelson Mandela Bay Health District. The researcher used qualitative methods and designs to explore and described the perception of nurses regarding staffing in the operating room (OR) of a private hospital in the Nelson Mandela Bay Health District. The research population of the study included all the nurses working in the OR of a private hospital. The total number of 20 OR nurses was individually interviewed by means of semi-structured interviews. Three main themes emerged that includes nurses ‘perceptions with regard to the implications of inadequate staffing in the OR; nurses experiences towards top management with regard to staffing in the OR and recommendations from participants to improve staffing in the OR. Research findings concluded that nurses have a perception that shortage of OR nurses causes lack of communication, physical, emotional and psychological strain. They also perceived OR nurses to work under unrealistic conditions and to receive added responsibilities due to staff shortages, which affect the overall delivery of quality patient care. Comments included failure of management to attend to staff complaints and the perception of high staff turnover due to a lack of recognition and acknowledgement of overworked staff.

Human Immunodeficiency Virus (HIV) positive patients are at increased risk for developing mental health problems when compared with the general population. The identification and management of symptoms of mental illness in HIV-positive patients is thus crucial in reducing the risk to developing severe mental illness. The severe mental illness may lead to poor adherence to anti retro-viral drugs resulting in increased morbidity and mortality. The primary health care nurses are largely responsible for managing the treatment of HIV-positive patients as they spend the greatest degree of their time with these patients as compared to other health care professionals. Consequently it is important for primary health care nurses to identify symptoms of mental illness. However, it was unclear to the researcher, a professional psychiatric nurse, as to the level of knowledge among primary health care nurses concerning symptoms of mental illness in HIV-positive patients. Therefore, the aim of this study was to determine the knowledge of primary health care nurses regarding symptoms of mental illness in HIV-positive patients attending primary health care services. In addition, recommendations were developed for primary health care nurses for the purpose of improving their competence in the identification of symptoms of mental illness in HIV-positive patients attending primary health care services. The researcher has utilised quantitative, explorative, descriptive and contextual design. Bloom’s Taxonomy was used as a theoretical lens, to explore the primary health care nurse’s knowledge regarding symptoms of mental illness in HIV-positive patients. The study was conducted in the primary health care services situated in the Nelson Mandela Metropolitan area. The research population consisted of the primary health care nurses working with HIV-positive patients in these primary health care services. The researcher utilised census survey to recruit participants. A structured questionnaire, with 3 sections was used in this study. The necessary principles of reliability and validity were exercised to ensure research of the highest quality. The data was analysed by using descriptive and inferential statistics. All ethical considerations pertaining to beneficence, maleficence, justice, autonomy and obtaining permission from relevant structures to conduct the study were strictly adhered to.

Thesis (MPH.) -- University of Limpopo, 2015 / Background: The revised Infant and Young Child Feeding Policy (IYCFP) 2013 encourages HIV-positive mothers to also exclusively breastfeed for six months, and to continue breastfeeding for a year with introduction of appropriate complementary feeding, while their children receive antiretroviral treatment. The aim of this study was to determine knowledge and practices of the Primary Health Care Workers (PHCWs) related to the implementation of the revised IYCFP 2013 in the Blouberg Municipality of Capricorn District, Limpopo Province. Methods: A quantitative descriptive study was conducted on 103 PHCWs. The questionnaire was closed ended. The questionnaire was developed based on the contents of the revised IYCFP 2013. A simple random sampling technique was used to sample nurses irrespective of the category. Data were analyzed through SPSS Software v23.0. Results: Most participants were females (91.3%), category were Professional Nurses (44.7%), aged between 31 and 40 years (44.7%) and also mostly worked for >10 years (56.3%). The results revealed that 97.1% of the participants have good knowledge about infant and young child feeding, 68% of participants were not trained on the revised IYCFP 2013, resulting to only 32% of participants having a good practice of this policy. Also 44.7% of the participants reported that they were not aware if clinics had a copy of this policy. The results further revealed that 92.2% of the participants reported that clinics still receive, keep and issue infant formula to HIV positive mothers, which maybe the reason the dieticians still receive requests for Infant Formulas to be delivered to HIV-positive mothers. Conclusion: There is a need for monitoring and evaluation to ensure availability and vi implementation of the revised IYCFP 2013; and also the need for in-service training on this policy in order to improve the capacity to implement the revised IYCFP 2013. Key Concepts Revised IYCFP 2013; knowledge; practice; implementation; PHCWs; infant and young child feeding.

Thesis (MPH.) -- University of Limpopo, 2015 / Background: The revised Infant and Young Child Feeding Policy (IYCFP) 2013 encourages HIV-positive mothers to also exclusively breastfeed for six months, and to continue breastfeeding for a year with introduction of appropriate complementary feeding, while their children receive antiretroviral treatment. The aim of this study was to determine knowledge and practices of the Primary Health Care Workers (PHCWs) related to the implementation of the revised IYCFP 2013 in the Blouberg Municipality of Capricorn District, Limpopo Province. Methods: A quantitative descriptive study was conducted on 103 PHCWs. The questionnaire was closed ended. The questionnaire was developed based on the contents of the revised IYCFP 2013. A simple random sampling technique was used to sample nurses irrespective of the category. Data were analyzed through SPSS Software v23.0. Results: Most participants were females (91.3%), category were Professional Nurses (44.7%), aged between 31 and 40 years (44.7%) and also mostly worked for >10 years (56.3%). The results revealed that 97.1% of the participants have good knowledge about infant and young child feeding, 68% of participants were not trained on the revised IYCFP 2013, resulting to only 32% of participants having a good practice of this policy. Also 44.7% of the participants reported that they were not aware if clinics had a copy of this policy. The results further revealed that 92.2% of the participants reported that clinics still receive, keep and issue infant formula to HIV positive mothers, which maybe the reason the dieticians still receive requests for Infant Formulas to be delivered to HIV-positive mothers. Conclusion: There is a need for monitoring and evaluation to ensure availability and vi implementation of the revised IYCFP 2013; and also the need for in-service training on this policy in order to improve the capacity to implement the revised IYCFP 2013. Key Concepts Revised IYCFP 2013; knowledge; practice; implementation; PHCWs; infant and young child feeding.

MPM / Oliver Tambo Institute of Governance and Policy Studies

Thesis (MPH.) -- University of Limpopo, 2021 / Background: Late antenatal care (ANC) booking delays treatment and management of high-risk pregnancies, which may result to maternal deaths. Early ANC booking has been found to be effective in most of the pregnancy related risk factors that can be detected and managed at early stages of pregnancy. Aim: The aim of the study was to investigate the prevalence and factors contributing to late ANC booking amongst pregnant women in primary health care facilities at Dikgale-Mamabolo local area. Methods: Quantitative cross-sectional research approach was used. The study was conducted at Dikgale-Mamabolo local area, which consists of seven clinics at Polokwane, Limpopo province in South Africa. Only three clinics were purposefully selected for the study. The population of the study included pregnant women who were 18 years and above. The sample size consisted of 238 pregnant women who came for ANC services in primary health care facilities during the period of the study. Convenience sampling method was used to select pregnant women from the population. Data was collected using an adapted questionnaire. Data was analysed using Statistical Package for Social Sciences (SPPS) version 25. Results: The results indicated that 86% of pregnant women booked antenatal care before five months gestational age and 14% booked after five months gestational age. Factors contributing to late ANC booking amongst pregnant women were marital status, educational level, employment status, mode of transport to clinic, lack of information, cultural beliefs, long distance to the clinic, long waiting time in the clinic and clinic operating hours. Conclusion: Late ANC booking remains a major public health issue. The study showed that lack of information and cultural beliefs are major contributing factors to late ANC booking. It is recommended that awareness campaigns should be conducted in the community and schools to empower women with knowledge about ANC services.