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An investigation into total volatile organic compound exposure levels in homes and classrooms of asthmatic children in selected sites in Durban.Maharaj, Santosh Kumar. January 2008 (has links)
Indoor air quality has become an important health concern due to the number of indoor pollutants and the realization that even minimal exposures to volatile organic compounds may produce direct or indirect adverse health outcomes. Young people are most vulnerable to these poisonous chemicals as they spend much of their times indoors at homes, schools, nurseries and in day care centers. Exposure to volatile organic compounds indoors has been related to asthma and other respiratory symptoms. The adverse effects of air pollution on respiratory health in South Durban have been described in a number of studies. In 2000, a study in the South Durban Basin at Settlers Primary School demonstrated both a high prevalence of respiratory diseases amongst schoolchildren as well as an association between ambient air pollutants and other adverse health outcomes. The South Durban Health Study subsequently undertook a health risk assessment and an epidemiological study investigating this association further on behalf of the eThekwini Municipality. The study highlighted that relatively moderate ambient concentration of N02, NO, PMIO and S02 were strongly and significantly associated with a reduction in lung function among children with persistent asthma. Moreover, attending primary school in South Durban was significantly associated with increased risk from persistent asthma when compared to schools in North Durban. METHODS The descriptive study measured the total volatile organic compound levels within selected homes and schools of asthmatic children in South and North Durban. Recommendations for reducing or mitigating indoor total volatile organic compound exposures were made. The study involved a secondary analysis of data obtained from the South Durban Health Study. The monitoring for total volatile organic compounds within homes and classrooms was undertaken using passive samplers during a 72-hour period and analyzed using a gaschromatography/ mass spectrometry method. Temperature and humidity was assessed using temperature and humidity sensors. Statistical analysis was performed using SPSS version 13. The dataset comprised 140 total volatile organic compound samples from homes and 14 from classrooms. Total volatile organic compounds were measured in microgram per cubic meter (g/m3), temperature in degrees Celsius and relative humidity in percentage of moisture. RESULTS Total volatile organic compounds with levels in households ranging from 17g/m3 to 1440g/m3 and in classrooms ranging from 48g/m3 to 5292g/m3 were measured. The mean levels detected were significantly different in homes and classrooms / Thesis (MMed.)-University of KwaZulu-Natal, Durban, 2008.
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Pre-treatment preparation and loss-to-care of adults living with HIV from an antiretroviral therapy clinic in Durban, KwaZulu-Natal.Nixon, Krystal-Lee. January 2011 (has links)
Introduction. The demand for comprehensive Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS) services is greater than the available supply, particularly for the provision of antiretroviral therapy. The resulting bottleneck in service delivery has considerable implications for people living with HIV and for resource management. Aim. The purpose of this research was to investigate loss-to-care and associated variables of adult HIV-infected people who were eligible for antiretroviral therapy, from July 2004 to December 2007 at Sinikithemba HIV Clinic in Durban, KwaZulu-Natal. Methods. An observational descriptive and analytic cohort study design was used. Secondary data sourced from Sinikithemba were collated. All HIV-infected adults, 15 years and older when registered on the TrakCare database, who were eligible for antiretroviral therapy were included in the study. Data were extracted to describe the preparation of HIV infected adults who were eligible for antiretroviral therapy. Variables were first summarised and described before the confirmatory analytic steps were taken to measure associations at the p<0.05 significance level. Results. Of the 10 424 HIV-infected adults registered at Sinikithemba, 5470 (52%) were eligible for antiretroviral therapy from July 2004 to December 2007 and 2979 (54%) of these were lost to care prior to initiating antiretroviral therapy. Six exposure variables were significantly associated with this loss-to-care, (gender, baseline CD4 count, pre-eligibility care, antiretroviral therapy delay, preparation step and waiting time). These variables remained significantly associated with loss-to-care even after controlling for confounding with logistic regression. Discussion and Recommendations. With the rapid scale-up of antiretroviral therapy programmes, the outcome of those people living with HIV lost to care before commencing therapy have not been adequately documented. This large cohort enrolled over three-and-a-half years demonstrates that the loss-to-care prior to initiation of antiretroviral therapy is a significant problem that needs to be further investigated. Focusing retention strategies at the pre-antiretroviral therapy stage of HIV care will improve overall programme outcomes. / Thesis (M.Med.)-University of KwaZulu-Natal, Durban, 2011.
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Level of hospitals' preparedness for a mass disaster during the 2010 FIFA World Cup Soccer in the eThekwini District of KwaZulu-Natal.Singh, Nirvadha. January 2010 (has links)
International mass sports gatherings like the FIFA (Federation Internationale de Football Association) World Cup Soccer and Olympics can cause great challenges to local healthcare systems and emergency medical services. History has shown that disasters do occur during these events, whether on a small or large scale. Disaster Management Practitioners from the public health perspective widely recognize that poor planning and a range of other underlying factors, create conditions of vulnerability. These result in insufficient capacity or measures to reduce hazards’ potentially negative consequences. The eThekwini District has to be prepared in the event of a mass disaster. Pre-empting and planning for disasters will lead to the safety and security of our citizens. The aim of this study was to undertake a baseline survey (in a total number of eleven public sector hospitals) to assess the state of hospital readiness, medical preparedness, and emergency care in preparation for the 2010 FIFA World Cup Soccer in the eThekwini District. A general assessment tool in the form of a standard questionnaire, and a walkthrough visit with a checklist, was used to collect data. There is no previous study conducted at the eThekwini District to assess requirements for an international event in terms of a mass disaster. South Africa is a developing country, and this was the first time any developing country had hosted a sporting event on such a large magnitude thus there are no international standards on sports disaster management by any other developing countries to generalise to eThekwini District. The current disaster management operational plan that is being used for the World Cup is based on a United Kingdom integrated management philosophy tool. The study herein adopted a public health approach and incorporates the Yokohama Strategy within its tool along with the use of HMIMMS and MIMMS in the assessment of the clinical criteria. The perceived minimum requirements suggested by the hospitals and a Provincial Task Team, from the Provincial Health Disaster Management office, was used as a guideline. The study showed that although disaster plans and policies are in situ, there still exists a need for resources to be directed toward skills training, attraction and retention of healthcare professionals, revitalisation of emergency and theatre areas and the commissioning of more isolation units. The results of the study would enable the District Office to note any shortcomings and lack of resources in public sector hospitals. The study outcome would be important for the implementation of any strategic planning to aid the hospitals in preparation for mass disasters that may occur during the 2010 FIFA World Cup Soccer. / Thesis (M.Med.)-University of KwaZulu-Natal, Durban, 2010.
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Epidemiological and clinical status of South African primary school children : investing in the future.Jinabhai, Champaklal Chhaganlal. January 2001 (has links)
The physical, psychological and social development of school children has been
neglected - partly because they were seen as healthy "survivors" of the ravages of
childhood illnesses, and partly because of the way in which health services are
organized (such as the traditional under-five maternal and child health (MCH)
services and the curative PHC clinic services). From the age of five years children
undergo rapid and profound bio-psycho-social development, to emerge in
adolescence as the next generation of leaders and workers. Securing their future
growth and development is vital for any society to be economically and socially
productive.
A substantial body of national and intemational literature has recognised the
detrimental impact of helminthic infections and micronutrient deficiencies on the
physical and psychological health and development of school children; which
requires appropriate nutritional interventions. Concern has been expressed that
these adverse biological, physical and social deprivations have a cumulative
impact on several dimensions of children's growth. Most important, apart from
stunting physical growth, is the inhibition of educational development of school
children. Recent evidence strongly suggests a powerful interaction between
physical and psychosocial growth and development of children. Inhibition of either
component of a child's well-being has adverse implications. Conversely,
investments in the physical and psychological development of children are likely to
generate substantial health and educational benefits and are a worthy investment
to secure a healthy future generation.
In summary, there are a number of reasons for, and benefits of, investing in
school-based health and nutrition interventions. They are likely to improve
learning at school and enhance educational outcomes; create new opportunities to
meet unfulfilled needs; redress inequity; build on investments in early child
development and promote and protect youth and adolescent development. Health
and nutrition interventions such as school feeding programmes, micronutrient
supplementation and deworming aim to improve primary outcomes of macro and
micro-nutrient deficiencies, parasitic and cognitive status; as well as secondary
outcomes of developing integrated comprehensive school health policies and
programmes. This rationale served as the conceptual framework for this study. This
theoretical framework views improvements of the health, nutritional, cognitive and
scholastic development status of school children as the primary focus of policies,
strategies and programmes in the health and education sector. This focus constitutes
the central core of this thesis. Optimum social development requires investments in
both the health and educational development of school children, so as to maximise
the synergies inherent in each sector and to operationalise national and international
strategies and programmes.
As part of the larger RCT study a comprehensive nutritional, health and
psychological profile of rural school children was established through a
community-based cross-sectional study. Eleven schools were randomly selected
from the Vulamehlo Magisterial District in southern KwaZulu-Natal (KZN). Within
each school, all Standard 1 pupils, aged between 8 - 10 years, were selected
giving a final study sample of 579 children. Some of the observed prevalence's
were stunting (7.3%), wasting (0.7%), anaemia (16.5%) (as measured by
haemoglobin below 12 g/dl), vitamin A deficiency (34.7%) (as measured by serum
retinol below 20 ug/dl) and serum ferritin below 12ng/ml (28.1%). This study
established that micronutrient deficiency, parasitic infestations and stunting remain
significant public health problems among school-aged children in South Africa.
Combining micronutrient supplementation and deworming are likely to produce
significant health and educational gains.
To determine the impact of single and combined interventions (anthelminthic
treatment and micronutrient supplements) on nutritional status and scholastic and
cognitive performance of school children, a double-blind randomised placebo
controlled trial was undertaken among 579 children 8-10 years of age. There was
a significant treatment effect of vitamin A on serum retinol (P<0.01), and the
suggestion of an additive effect between vitamin A fortification and deworming.
Vitamin A and iron fortification also produced a significant treatment effect on
transferrin saturation (P<0.05). Among the dewormed group, anthelminthic
treatment produced a significant decrease in the prevalence of helminthic
infections (P<0.02), but with no significant between-group treatment effect
(P>0.40). Scholastic and cognitive scores and anthropometric indicators were no
different among the treated or the untreated children. Fortified biscuits improved
micronutrient status among rural primary school children; vitamin A combined with
deworming had a greater impact on micronutrient status than vitamin A fortification
on its own; while anthelminthic treatment produced a significant reduction in the
overall prevalence of parasite infection.
The prevalence's of Ascaris lumbricoides, Trichuris trichiura and Schistosoma
haematobium declined significantly sixteen weeks post-treatment. The levels of
both prevalence and intensity in the untreated group remained constant. The cure
rates over the first two weeks of the study were 94.4% for Ascaris lumbricoides,
40% for Trichuris trichiura, and 72.2% for Schistosoma haematobium. The benefits
of targeted school-based treatment in reducing the prevalence and intensity of
infection supports the South African government's focus of using school-based
interventions as part of an integrated parasite control programme. These
strategies and programmes were found to be consistent with the
recommendations of WHO and UNICEF.
The nutritional transition facing developing and middle-income countries also has
important implications for preventive strategies to control chronic degenerative
diseases (Popkin B, 1994; WHO 1998; Monyeki KO, 1999). This descriptive study,
comparing BMI data of school children over three time periods, found a rising
prevalence of overweight and obesity among South African school children.
Obesity as a public health problem requires to be addressed from a population or
community perspective for its prevention and management.
Environmental risk factors such as exposure to atmospheric pollution remain
significant hazards for children. Lead poisoning is a significant, preventable risk
factor affecting cognitive and scholastic development among children. The
prevalence of elevated blood lead (PbB) levels in rural and semi-urban areas of
KwaZulu-Natal (KZN) as well as the risk factors for elevation of PbB among
children in informal settlements were examined. This study investigated over 1200
rural and urban children in two age groups: 3-5 and 8-10 years old. Average PbB
level in peri-urban Besters, an informal settlement in the Durban metropolitan
region, was 10 ug/dl with 5% of the children showing PbB level of greater than 25
ug/dl. By comparison, average PbB value in Vulamehlo, a rural area located
90-120 km from Durban, was 3.8 ug/dl and 2% of the children's PbB levels were
greater than 10 ug/dl.
Since the cognitive and scholastic performance of school children was a primary
outcome measure in this study, it was important to explore other factors that
influenced this variable. The performance scores of all four tests in the battery,
among the cohort of a thousand rural and urban children, were in the lower range.
The educational deficit identified in this test battery clearly indicates the impact of
the inferior "Bantu" educational system that African children have experienced in
South Africa.
Aspects of the School Health Services that were investigated in this descriptive
study included the services provided and their distribution; assessment of health
inspection; health education and referral processes undertaken by the School
Health Teams; perceptions of managers, providers and recipients of the service;
as well as the costs of the provision of the service in KwaZulu-Natal. In KwaZulu-Natal,
there were School Health Teams In all the 8 health and education regions in
the province. In total, there were 95 teams in the province, consisting of nearly 300
staff members. The School Health Teams were involved in a wide range of
activities - 74% of all teams were involved in health inspection and 80% were
involved in health education. The total annual cost of delivering School Health
Services in the province in 1995 was estimated to be approximately R8 750 000.
Given the rise of HIV and AIDS in the province, School Health Services need to
play a central role not only in prevention, but also in assisting with the acceptance
of HIV-positive children within schools. It is recommended that the current and
future draft SHS policy guidelines be approved by the relevant authorities for
immediate implementation. Districts should consider developing "Health Promoting
Schools", with School Health Teams being a central resource.
This thesis has explored several aspects of the epidemiological profile of school
children in rural and urban settings in KwaZulu-Natal. It has established that
school children are exposed to a range of risk factors ranging from nutritional
deficits, parasitic infections, atmospheric lead poisoning and a rising prevalence of
overweight. All of these risk factors may compromise their physical, psychological
and social development. A number of health interventions have been identified, which have the potential to address these problems. Such investments are essential to secure the health of future generations. / Thesis (M.D.)-University of Natal, Durban, 2001.
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Prevalence of multi-drug resistant tuberculosis and the associated risk factors at a tuberculosis outpatient facility in Durban, South Africa.Gajee, Renu. January 2011 (has links)
Introduction
Tuberculosis (TB) is a major cause of death worldwide. Control of Tuberculosis is a
serious challenge to global health. A new and potentially devastating threat to TB
control is the emergence of multi-drug resistant TB (MDR-TB). South Africa was
ranked fourth among the countries with the highest number of confirmed MDR-TB
cases.
Aim
The aim was to investigate the annual MDR-TB prevalence and associated risk
factors for MDR-TB from 2001 to 2007 at the Prince Cyril Zulu Communicable
Disease Centre. To investigate previous TB treatment duration, previous TB
treatment outcome, and duration of previous TB treatment interruption in a subgroup
of patients who were previously treated for TB. To determine the average length of
time from diagnosis of TB to diagnosis of MDR-TB and commencement of MDR-TB
treatment.
Methods
An observational analytic nested case-control study design was used. All patients
who were diagnosed with pulmonary TB and who had a sputum culture performed
between 2001 and 2007 were included in the study. The cases were all MDR-TB
cases diagnosed on sputum culture between 2001 and 2007. The controls were
drug susceptible TB cases which had a sputum culture done at diagnosis, and were
diagnosed in the same month as the MDR-TB case
Results
There were 10 205 sputum cultures performed from 2001 to 2007. MDR-TB was
found in 445 patients. An increase in the prevalence of MDR-TB occurred in 2007,
due to a significant increase in prevalence among new TB cases. The MDR-TB
prevalence was 11.7% among new TB cases and 4.7% among previously treated
TB cases in 2007. There was no significant association between demographic
characteristics and MDR-TB. Previous TB treatment failure and a duration of
previous TB treatment of greater than 32 weeks was found to be significantly
associated with MDR-TB. The median time from TB diagnosis to MDR-TB diagnosis
was 98 day and from MDR-TB diagnosis to MDR-TB treatment 10 days.
Discussion
Delays in the diagnosis of MDR-TB, long waiting times before MDR-TB treatment
commencement and lack of isolation have contributed to the spread of primary
MDR-TB and was most likely responsible for the increase in prevalence of MDR-TB
among new TB cases.
Recommendations
It was suggested that a sputum specimen should be obtained for culture and
sensitivity from all new TB patients in areas which have an MDR-TB prevalence of
greater than 3% among new TB patients.
Ensure patient education on basic infection control measures.
Improve MDR-TB diagnosis and reduce waiting times for MDR-TB treatment. / Thesis (M.Med.Sc.)-University of KwaZulu-Natal, Durban, 2011.
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Developing an implementation strategy for the free health care policy for persons with disabilities at public hospitals in KwaZulu-Natal.Simbeye, Daniel. January 2013 (has links)
ABSTRACT
This study focuses on the implementation strategy of free health care policy for disabled
persons at hospital level in KwaZulu-Natal. Since the introduction nationally, in 2003 of free
health care policy for disabled persons, no evaluation has been conducted in KwaZulu-
Natal to inform health service managers and the KwaZulu-Natal Department of Health on
the implementation of this policy. A provincial implementation strategy is needed for
effective implementation of the policy. To date, no such provincial implementation strategy
is available and the lack of an implementation strategy for this policy motivated this study.
METHODS
An exploratory qualitative study design was implemented to elicit information from health
service providers and representatives of persons with disabilities to inform the development
of an implementation strategy for the free health care policy for disabled persons at public
hospitals in KwaZulu-Natal. Data was collected through interviews and focus group
discussions. Data was analysed by utilising a thematic approach.
RESULTS
Respondents reported a variety of understandings with regard to policy context of the Free
Health Care Policy for disabled persons, policy content in terms of purpose and eligibility,
policy implementers and their roles in implementing the policy, and the implementation
process of this policy at state hospitals of KwaZulu-Natal.
CONCLUSION
There is limited understanding of the Free Health Care Policy among some health service
personnel and some disability groups, and this may have contributed to the erratic and poor
implementation of the policy at public hospitals in KwaZulu-Natal. Factors necessary for
policy implementation such as a communication strategy, guidelines for implementation,
assessment of availability of resources, training of implementers, monitoring and evaluation
strategy are crucial for effective implementation of any policy including the Free Health
Care Policy for disabled persons. / Thesis (M.Med.Sc.)-University of KwaZulu-Natal, Durban, 2013.
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M-PH : knowledge, beliefs and attitudes regarding counselling behaviour for HIV and AIDS, STIs and TB : a survey of eThekwini district primary health care workers.Ntlangula, Margaret N. January 2012 (has links)
Background
HIV infection continues to be a challenge in South Africa with new infections reported
at alarming rates. Health Care Workers (HCWs) who are nurses consequently have
frequent contact with HIV positive and TB co-infected patients. During this contact
their counselling behaviour is influenced by their knowledge, beliefs and attitudes
about HIV and AIDS, STIs and TB (HAST) and may influence provision as well as
the quality of HAST counselling behaviour.
Aim
The aim of the study was to assess eThekwini Municipality Health Care Workers’
knowledge, beliefs and attitudes regarding counselling behaviour for HAST and to
make recommendations based on the findings of this study.
Methods
A descriptive cross sectional study design was used in which data about HAST
counselling behaviour were collected using self administered questionnaires. The
study population was all the nurses working at eThekwini Municipality Health clinics
that were on duty at the time of the study and excluded those nurses who were
absent or on leave during the period of data collection. Informed consent was signed
by each respondent. Data were captured using SPSS version 14 and univariate,
bivariate and multivariate analysis was undertaken. The level of significance was
P<0, 05.
Results
The HCWs were well informed regarding counselling behaviour for HAST. HCWs
with university education scored higher than those with college level of education but
there were no statistically significant differences between the HCWs with the
university education and those with college education. However some HCWs’
attitudes and beliefs about poverty were negative and may not be helpful in
improving a patient’s health. Results showed that some HCWs’ negative attitudes
about HAST counselling resulted from fear of HIV and or TB infection. Age and the
level of education showed statistically significant association with beliefs. Older,
better educated HCWs with a university education scored higher for knowledge for
HAST counselling behaviour. There was no statistical significant difference found
between HCWs who see less than 100 patients per day and those who see more
than 100 patients per day.
Conclusion
The findings of the study show that HCWs were well informed regarding
counselling behaviour for HAST, even though some HCWs have negative
attitudes which are not supportive which need to be addressed.
Recommendations It is recommended that HCWs receive continuous training in order to address the
negative attitudes about counselling behaviour for HAST. / Thesis (M.Med.Sc.)-University of KwaZulu-Natal, Durban, 2012
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Racial differences in willingness to participate in HIV prevention clinical trials amongst university students in KwaZulu-Natal, South Africa.Pillay, Diantha. January 2013 (has links)
Introduction
Willingness to participate in clinical trials is a crucial element in recruitment of
suitable participants for intervention trials. Measurement of willingness to
participate assists in determining community preparedness for clinical trials,
such as HIV vaccine trials. Therefore, researchers have developed a Clinical
Research Involvement Scale (CRIS) to assess willingness to participate
modelled on the Theory of Reasoned Action. The CRIS was tested in the USA
and was noted that it would benefit from additional testing in other populations.
Aim
The purpose of this study is to determine whether racial differences exist in
willingness to participate and explore potential factors associated with
willingness to participate in HIV prevention research.
Methods
A cross sectional analytic study was conducted. The CRIS was administered to
university students aged 18-45 at the University of KwaZulu-Natal in South
Africa. The CRIS was administered online with a demographic questionnaire to
facilitate evaluation of possible associations between willingness to participate
and age, gender, relationship status, parity, religion, education status, student
status, employment status and access to private health care. Participation was
once-off at the time of completing the scale.
Results
The study enrolled 636 participants, two thirds being female. An effective
sample size of 509 was considered for analysis after data was cleaned for
accuracy and completeness. The results indicated that all students across all
race groups were willing to participate in HIV prevention research. However,
when considering factors that affected willingness to participate, statistically
significant differences were noted. Based on the differences amongst these
factors, Black students expressed greater intention to participate compared to
White and Indian students. The CRIS was deemed a reliable instrument in this
population; however in its current structure it did not show strong validity.
Validity improved if the factors of motivation to comply and outcome evaluations
were removed in this population.
Discussion
The study findings are specific to students of the University of KwaZulu-Natal
and cannot be generalized to other populations. The racial differences in factors
that affect willingness to participate indicate differences in risk perception and
seeking access to better quality healthcare.
Recommendations
The CRIS should be used in other student populations to assess its validity.
(350 words) / Thesis (M.Med.Sc.)-University of KwaZulu-Natal, Durban, 2013.
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Assessing nursing students' readiness for e-learning.Coopasami, Marilynne. 28 August 2014 (has links)
Introduction
e-Learning has been integrated and implemented in education and training to the level that it is now a well-established global practice. If used judiciously, e-Learning is a tool that enables active, individual and flexible learning. When integrated into medical education, it offers features that allow lecturers to be not merely content distributors, but also facilitators of learning.
Aim
The aim of this study was to assess the readiness of students to make the shift from traditional learning, to the technological culture of e-Learning.
Methods
An observational, cross-sectional, analytical study design was used and data was collected using a validated questionnaire. The sample comprised of all students enrolled in the first year nursing programme at the Durban University of Technology registered for anatomy and physiology in 2013. Informed consent was obtained from each participant prior to conducting the study.
Results
Three quarters (77/101 76%) of the participants were females. The psychological readiness score was noted to be high in the “could be worse” category (pre-72%, post- 64%). The technological readiness score was noted to be in the “dig deeper” category (pre- 58%, post- 65%) whilst the equipment readiness score fell in the e-Learning “not ready category” (pre- and post- 68%).
Discussion
The Chapnick Readiness Score Guide was used to analyse psychological, technological and equipment readiness. e-Learning has been identified as a multi-disciplinary field,
which is dominated by information technology. Technological and equipment readiness factors of e-Learning are easier to resolve than the psychological readiness factor.
Recommendations Although e-Learning could be a key tool in nursing education, a few factors require attention before it can be effectively implemented in this tertiary level education facility. / Thesis (M.Med.Sc.)-University of KwaZulu-Natal, Durban, 2014.
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The assessment of knowledge and attitudes of health legislation (HL) among private family practitioners (FP) working in a defined geographical area.Mahomed, Mahomed Faruk. January 2011 (has links)
Introduction
Since the 1994 change in power in South Africa, there have been many necessary changes in health legislation (HL), in accordance with the principles enshrined in the Constitution, Such changes have been recognized as being both complex and fraught with stakeholder interests. There is a perception that private family practitioners (FP) generally harbour negative attitudes towards HL that has been brought into effect in recent years. It is also possible that FP, in general, lack knowledge regarding HL. The aim of the study was to assess the knowledge and attitudes of private family practitioners (FP) to health legislation (HL) within a localized geographical area of the eThekweni Metro, KwaZulu-Natal Province. The specific objectives were:
To determine family practitioners’ knowledge of health legislation.
To determine family practitioners’ attitudes towards health legislation.
To assess the correlation between family practitioners’ knowledge and attitudes.
To compare the self-reported knowledge of health legislation with the objective assessment of knowledge and attitudes.
To establish practitioners’ perceptions of the future of the profession, and of family practice in particular.
Methods
A cross-sectional descriptive and analytical study was performed, using a pre-tested, validated, structured questionnaire. This instrument was personally hand-delivered to each of a group of private family practitioners practising within a confined geographical area. The sample comprised of 101 family practitioners. Data were analysed using SPSS version 15.0 (SPSS Inc., Chicago, Illinois).
Results
The study revealed that private FP possess limited knowledge about HL and have a negative attitude in general towards HL. The mean knowledge score was 55% (standard deviation 12.2%). The mean score for attitudes towards health legislation was 46,3% (standard deviation 4.2%). The correlation coefficient between knowledge and attitudes was 0.244 (p=0.022). Therefore, there was a weak positive, but statistically significant, correlation between knowledge and attitudes. Thus, in general, as knowledge increased, so did attitudes improve and become more positive. The self reported knowledge and attitudes of FPs seemed to show some unexpected though non-statistically significant anomaly, in that FPs who considered themselves “well aware” of certain parts of HL, together with those who were “not aware”, reporting a more negative attitude towards HL than those who considered themselves to be “aware”. FPs’ perceptions of the future of the profession, and of family practice in particular, were generally reported as being reasonable to poor. Financial viability and sustainability of FP, in particular, were reported as being reasonable to poor. The attractiveness of the profession to the youth of today was reported as being poorer than in the past. However, the majority of FP held the perception that medicine as a profession was distinct as it responds to a calling to serve society at large, giving this aspect of the question a ranking of “reasonable to good”.
Conclusion and Recommendations
The study revealed that this group of FPs attained an overall mean knowledge score of 55% with respect to HL. FPs’ knowledge of HL requires improvement, which can be achieved through effective education and training programmes. Private FPs need to embrace the change process, but also need to be more pro-active in vocalizing their opinions. The Health Ministry and relevant authorities and policymakers need to play a greater role in creating an atmosphere that embraces and facilitates change by involving iii
relevant stakeholders. Lastly, it is recommended that this study serve as a template for a broader research project involving larger numbers of participants and a wider geographical area. In addition, an intervention tool should be devised. Such a tool could take the form of a structured education programme on HL, with an associated monitoring and evaluation aspect, which would enable an assessment of the intervention programme in terms of its value and the influence it has on improving knowledge and attitudes. / Thesis (M.Med.Sc.)-University of KwaZulu-Natal, Durban, 2011.
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