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The extent of cervical cancer screening in Mamelodi Provincial ClinicsLetebele-Hartell, Keneilwe Elsa 12 May 2010 (has links)
BACKGROUND : Cervical cancer is the second most common malignancy in women worldwide, and the leading cause of mortality among women. It affects approximately 500 000 women each year with about 270 000 deaths. Almost 80% of the mortalities occur in developing countries. The National Department of Health in South Africa introduced a cervical cancer screening policy in the year 2000. The aim of the policy was to screen more that 70% of the women aged 30 – 59 by the end of 10 years. Women aged 30 – 59 years are offered 3 Pap smears per life time, with an interval of 10 years between the smears. AIM: The aim of the study was to determine the uptake of cervical cancer screening among eligible women (age 30 – 59 years), their practice, knowledge and attitude, as well as the capacity of the facility and the service providers to offer cervical cancer screening service. METHODS: A health systems descriptive study. A two stage sampling technique was done. Purposeful sampling of the healthcare facilities in the defined area was done, targeting the Provincial Health clinics. Records were reviewed at the facility to determine the percent of women aged 30 – 39 years, who used the facility and had Pap smears over the period: August 2003 to July 2007. Facility managers at the Holani clinic and Stanza Bopape Community Health Center were interviewed. Self administered questionnaires were distributed to doctors and professional nurses at both facilities. Questionnaires were also distributed to the women aged 30 – 59 years who visited the facilities during data collection to determine the knowledge, attitude and practice of these women concerning Pap smear. Data entry was done using Epi-Info and Microsoft Excel. Data was analyzed using STATA version 9. Methods applied were frequencies, percentages and cross tabulations. Differences between groups were examined using Fisher’s exact test and Chi-square test. Results were presented in tables and graphs. RESULTS : Record review at Holani clinic indicated that the percent of women aged 30 – 59 years who had undergone Pap smears while attending clinic from January 2004 to July 2007 was 8%. Stanza Bopape had incomplete records. Only about 50% of the women interviewed had undergone Pap smear. Socio-demographic factors like age, education and employment did not have a significant effect on the knowledge, attitude and practice of cervical cancer screening by the targeted service users. Women of lower parity had undergone more Pap smears than those of higher parity. Women of lower parity had more knowledge about Pap smear (p-value=0.05). The knowledge and practice of Pap smear among women aged 30 – 59 years who attended the clinics were significantly associated with getting information from the nurse (p=0.01). Knowledge of the National Cervical Cancer Screening Policy by the service providers was limited. Both facilities had adequate resources for performing the procedure. The number of trained staff per facility was adequate for the performance of the procedure. There was enough privacy to do the procedure. Specimen transportation was adequate, and turn around time was acceptable. CONCLUSION : The extent of Pap smear investigation at the facilities is inadequate. The Service Providers need to calculate the minimum number of Pap smears needed per day to reach the required targets. Nurses at the primary healthcare setting play a major role in improving the uptake of cervical cancer screening. There is a need to actively recruit women to come for Pap smear, while at the same time strengthening health education. Copyright / Dissertation (MMed)--University of Pretoria, 2010. / School of Health Systems and Public Health (SHSPH) / Unrestricted
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A critical performance evaluation of the South African Health Facilities Infrastructure Management Programme of 2011/12 /D.P. van der Westhuijzen.Van der Westhuijzen, David Pieter January 2013 (has links)
The Health Facilities Infrastructure Management Programme in South Africa aims to ensure an appropriate and sustainable platform for the delivery of health services. Since 1994, the average number of hospital beds has decreased from 4.4 beds per 1 000 people to 2.4 beds per 1 000 people. During the same period, there was no significant reduction in the 1 372 clinic backlog.
The evaluation of the performance of the Health Facilities Infrastructure Management Programme was based on a systems approach. This performance evaluation was conducted across four dimensions, with 12 assessment instruments and within 134 assessment parameters. Several of these instruments were developed as part of this study.
Actual performance, per assessment parameter, was expressed in terms of a four level project management maturity scale. About one third of the parameters indicated a low level of project management maturity, one third indicating a medium-low level of maturity, with less than 10% judged to have reached maturity.
It was found that the Infrastructure Unit in the National Department of Health is solely responsible for addressing more than half of the performance areas described by the assessment parameters. The proposed prioritisation model indicated that 50% of the performance areas needed to be addressed as a matter of urgency.
The study concludes with 10 system transformation recommendations aimed at maturity growth in the Infrastructure Unit in the National Department of Health, as well as maturity growth in the Health Facilities Infrastructure Management Programme as a whole.
The following key terms are relevant:
• Health Facilities Infrastructure Management Programme
• Performance evaluation
• Infrastructure Unit
• National Department of Health of South Africa
• Project management maturity
• Assessment instruments
• Assessment parameters
• Prioritisation model / Thesis (MArt et Scien (Urban and Regional Planning))--North-West University, Potchefstroom Campus, 2013.
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A critical performance evaluation of the South African Health Facilities Infrastructure Management Programme of 2011/12 /D.P. van der Westhuijzen.Van der Westhuijzen, David Pieter January 2013 (has links)
The Health Facilities Infrastructure Management Programme in South Africa aims to ensure an appropriate and sustainable platform for the delivery of health services. Since 1994, the average number of hospital beds has decreased from 4.4 beds per 1 000 people to 2.4 beds per 1 000 people. During the same period, there was no significant reduction in the 1 372 clinic backlog.
The evaluation of the performance of the Health Facilities Infrastructure Management Programme was based on a systems approach. This performance evaluation was conducted across four dimensions, with 12 assessment instruments and within 134 assessment parameters. Several of these instruments were developed as part of this study.
Actual performance, per assessment parameter, was expressed in terms of a four level project management maturity scale. About one third of the parameters indicated a low level of project management maturity, one third indicating a medium-low level of maturity, with less than 10% judged to have reached maturity.
It was found that the Infrastructure Unit in the National Department of Health is solely responsible for addressing more than half of the performance areas described by the assessment parameters. The proposed prioritisation model indicated that 50% of the performance areas needed to be addressed as a matter of urgency.
The study concludes with 10 system transformation recommendations aimed at maturity growth in the Infrastructure Unit in the National Department of Health, as well as maturity growth in the Health Facilities Infrastructure Management Programme as a whole.
The following key terms are relevant:
• Health Facilities Infrastructure Management Programme
• Performance evaluation
• Infrastructure Unit
• National Department of Health of South Africa
• Project management maturity
• Assessment instruments
• Assessment parameters
• Prioritisation model / Thesis (MArt et Scien (Urban and Regional Planning))--North-West University, Potchefstroom Campus, 2013.
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