Fhumulani Mavis Mulaudzi

Indigenous beliefs and practices that influence the delayed attendance of antenatal clinics by women in the Bohlabelo district in Limpopo, South Africa

OBJECTIVE To explore and describe the indigenous beliefs and practices that influence the attendance of antenatal clinics by women in the Bohlabelo district in Limpopo, South Africa RESEARCH DESIGN AND METHODS A qualitative design was used to enable participants to share their beliefs and practices in their own words. Purposive sampling was used. SETTING Women who were attending antenatal clinics for the first time were targeted. Data were collected via unstructured in-depth interviews. Twelve women were interviewed. FINDINGS The findings were grouped into six main categories: pregnancy is a honour; pregnancy needs to be preserved; the unborn infant is protected; the knowledge that clients have; trust in indigenous perinatal practices; and perceptions regarding clinic or hospital services. It became clear that the indigenous beliefs and practices of pregnant women have an influence on their attendance of antenatal clinics. For example, factors such as fear of bewitchment cause delayed attendance of antenatal clinics. Women use herbs to preserve and protect their unborn infants from harm. They also trust the knowledge of traditional birth attendants, and prefer their care and expertise to the harsh treatment that they receive from midwives in hospitals and clinics who look down on their indigenous beliefs and practices. CONCLUSIONS It is recommended that indigenous beliefs and practices should be incorporated into the midwifery curriculum, so that the health sector is able to meet the needs of all members of the community.

Toward decolonizing nursing: the colonization of nursing and strategies for increasing the counter‐narrative

Although there are notable exceptions, examination of nursings participation in colonizing processes and practices has not taken hold in nursings consciousness or political agenda. Critical analyses, based on the examination of politics and power of the structural determinants of health, continue to be marginalized in the profession. The goals of this discussion article are to underscore the urgent need to further articulate postcolonial theory in nursing and to contribute to nursing knowledge about paths to work toward decolonizing the profession. The authors begin with a description of unifying themes in postcolonial theory, with an emphasis on colonized subjectivities and imperialism; the application of a critical social science perspective, including postcolonial feminist theory; and the project of working toward decolonization. Processes involved in the colonization of nursing are described in detail, including colonization of nursings intellectual development and the white privilege and racism that sustain colonizing thinking and action in nursing. The authors conclude with strategies to increase the counter-narrative to continued colonization, with a focus on critical social justice, human rights and the structural determinants of health.

Suggestions for creating a welcoming nursing community : Ubuntu, cultural diplomacy, and mentoring

Although there is historical evidence that nursing has been a profession that nurtures and affirms young nurses, some have observed recently that senior nurses “eat their young” and that there is a lack of student nurse socialization, creating poor role identification. Some young nurses are leaving the profession. This paper suggests that senior nurses consider the implementation of the African community-building philosophy of ubuntu to guide their interactions with young nurses. Cultural diplomacy and mentoring are discussed as means of implementing ubuntu philosophy in the creation of a welcoming nursing community.

The experiences of nurses in caring for circumcised initiates admitted to hospital with complications.

The circumcision of males is a ritual that is performed in the veld, out of the public eye. Traditionally, it has to be attended by circumcised men only; no one is allowed to see the initiates before they are officially released or discharged. In recent times, initiates have been admitted to hospitals following complications during the circumcision process. In the hospitals, they are cared for by nurses. Hospitalisation of initiates creates problems for the elders who accompany the initiates as well as the nurses who are expected to care for them. The purpose of the study was to explore and describe the experiences of nurses who care for initiates who have been admitted into hospital with medical and physical complications. A qualitative approach was adopted for this study, and the data was collected by means of unstructured interviews. A purposively selected sample of nurses of different categories from a rural hospital in the Nkangala district in Mpumalanga Province, South Africa, participated in the study. The data was analysed, and five major categories were developed. The major categories were: conflicting cultural practices, emotions, common complications, ethical issues and possible solutions. Based on the findings of the study, it is recommended that traditional circumcision should be regulated to avoid complications that lead to the admission of initiates into hospitals. Also, a collaborative partnership should be established between the health institutions and the traditional surgeons and healers in caring for initiates.Abstract The circumcision of males is a ritual that is performed in the veld, out of the public eye. Traditionally, it has to be attended by circumcised men only; no one is allowed to see the initiates before they are officially released or discharged. In recent times, initiates have been admitted to hospitals following complications during the circumcision process. In the hospitals, they are cared for by nurses. Hospitalisation of initiates creates problems for the elders who accompany the initiates as well as the nurses who are expected to care for them. The purpose of the study was to explore and describe the experiences of nurses who care for initiates who have been admitted into hospital with medical and physical complications. A qualitative approach was adopted for this study, and the data was collected by means of unstructured interviews. A purposively selected sample of nurses of different categories from a rural hospital in the Nkangala district in Mpumalanga Province, South Africa, participated in the study. The data was analysed, and five major categories were developed. The major categories were: conflicting cultural practices, emotions, common complications, ethical issues and possible solutions. Based on the findings of the study, it is recommended that traditional circumcision should be regulated to avoid complications that lead to the admission of initiates into hospitals. Also, a collaborative partnership should be established between the health institutions and the traditional surgeons and healers in caring for initiates.

Experiences and challenges of an interprofessional community of practice in HIV and AIDS in Tshwane district, South Africa

Abstract Collaboration amongst stakeholders remains a central tenet to achieving goals in planning, implementation, monitoring and evaluation of HIV and AIDS prevention and care strategies. This paper describes the experiences of members of a health care team who joined efforts to collaborate and form a community of practice (CoP) in HIV and AIDS. Qualitative, exploratory case study methods were used. Twenty-six participants were interviewed. Transcripts from the interviews were subjected to the thematic framework of data analysis. Based on the analysis, three themes emerged as impacting on collaboration and these were: the understanding and expectations of being a CoP member; professionalism and ethics within the CoP and collaboration in HIV and AIDS care. The key findings were that the understanding and expectations from the CoP varied. Ethical principles including respect, trust and confidentiality were identified as key tenets of collaboration and were expressed in various ways. The expectations of being a CoP member, the ethical principles within the CoP all impacted in differing ways on how they collaborated. The implication of this study suggests that consultation during inception and throughout the process, clarification of roles, transparency and respect are cardinal points in professional relationships.

Collaborative HIV care in primary health care: nurses' views.

BACKGROUND Collaborative HIV care between the nurses and traditional health practitioners is an important strategy to improve health care of people living with HIV. AIM To explore and describe the views of nurses regarding collaborative HIV care in primary healthcare services in the City of Tshwane, South Africa. METHOD A qualitative, descriptive design was used to explore and describe the views of nurses who met the studys inclusion criteria. In-depth individual interviews were conducted to collect data from purposively selected nurses. Content analysis was used to analyse data. RESULTS Two main categories were developed during the data analysis stage. The views of nurses and health system challenges regarding collaborative HIV care. DISCUSSION The study findings revealed that there was inadequate collaborative HIV care between the nurses and the traditional health practitioners. CONCLUSION It is evident that there is inadequate policy implementation, monitoring and evaluation regarding collaboration in HIV care. The study findings might influence policymakers to consider the importance of collaborative HIV care, and improve the quality of care by strengthening the referral system and follow-up of people living with HIV and AIDS, as a result the health outcomes as implied in the Sustainable Development Goals 2030 might be improved. IMPLICATIONS FOR NURSING AND HEALTH POLICY Training and involvement of traditional health practitioners in the nursing and health policy should be considered to enhance and build a trustworthy working relationship between the nurses and the traditional health practitioners in HIV care.

Challenges experienced by South Africa in attaining Millennium Development Goals 4, 5 and 6

BACKGROUND Despite progress made by other countries worldwide in achieving Millennium Development Goals (MDGs) 4, 5 and 6, South Africa is experiencing a challenge in attaining positive outcomes for these goals. OBJECTIVE AND SETTING To describe the challenges experienced by South Africa regarding the successful implementation of MDGs 4, 5 and 6. METHODS An integrative literature review was used to identify and synthesise various streams of literature on the challenges experienced by South Africa in attaining MDGs 4, 5 and 6. RESULTS The integrative review revealed the following themes: (1) interventions related to child mortality reduction, (2) implementation of maternal mortality reduction strategies, and (3) identified barriers to zero HIV and TB infections and management. CONCLUSION It is recommended that poverty relief mechanisms be intensified to improve the socio-economic status of women. There is a need for sectoral planning towards maternal health, and training of healthcare workers should emphasise the reduction of maternal deaths. Programmes addressing the reduction of maternal and child mortality rates, HIV, STIs and TB need to be put in place.

The perceptions of African women regarding natural menopause in Mamelodi, Tshwane district

Background The majority of South African aging population are women, who spend late adulthood experiencing natural menopause. Despite the government spending billions of rand on different services for ageing women, menopausal challenges to African women still receive little attention. Objectives The aim of the study was to explore and describe the perceptions of African women regarding natural menopause, in order to propose recommendations for health and social support systems for women in Mamelodi, Tshwane district. Method A qualitative, exploratory, descriptive and contextual design was used to conduct the study. The population of the study consisted of menopausal women, between the ages 45 and 60 years or more, visiting the clinics for collection of chronic medication and other health assessment. Individual face-to-face interviews were conducted, using a semi-structured interview guide to collect data. Tesch’s method of qualitative data analysis was used in the study. Results The main theme that emerged from the study was ‘attitude toward menopause’, which was supported by cultural beliefs and experience. The African menopausal women expressed the importance of health support systems that will meet their needs within their context. Conclusion Women’s health programs and educational health information at facilities should include menopausal education to promote and improve health of all African menopausal women during their adulthood. There is a need to establish a women’s health support group network within communities to share menopausal experiences with peers. The training and education curriculum of healthcare providers should include detailed menopause in order to provide comprehensive, congruent care.

Comparison between indigenous and Western postnatal care practices in Mopani District, Limpopo Province, South Africa

Abstract Background Postnatal care begins immediately after the expulsion of the placenta and continues for six to eight weeks post-delivery. High standard of care is required during the postnatal period because mothers and babies are at risk and vulnerable to complications related to postpartum haemorrhage and infections. Midwives and traditional birth attendants are responsible for the provision of postnatal care in different settings, such as clinics and hospitals, and homes. Methods A qualitative, exploratory, descriptive and contextual research approach was followed in this study. Unstructured interviews were conducted with the traditional birth attendants. An integrated literature review was conducted to identify the Western postnatal care practices. Teschs process was followed during data analysis. Findings The following main categories were identified: similarities between indigenous and Western postnatal care practices, and differences between indigenous and Western postnatal care practices. Based on these findings, training of midwives and traditional birth attendants was recommended in order to empower them with knowledge and skills regarding the indigenous and Western postnatal care practices. Conclusions It is evident that some indigenous postnatal care practices have adverse effects on the health of postnatal women and their newborn infants, but these are unknown to the traditional birth attendants. The employment of indigenous postnatal care practices by the traditional birth attendants is also influenced by their cultural beliefs, norms, values and attitudes. Therefore, there is an urgent need to train midwives and traditional birth attendants regarding the indigenous and Western postnatal care to improve the health of postnatal women and their babies.

Healthcare workers’ experiences of HIV testing in Tshwane, South Africa

BACKGROUND In an era when antiretroviral (ARV) therapy has become part of the Human Immunodeficiency Virus (HIV) prevention strategy, early testing and introduction to ARVs iscritical for improving public health outcomes in general and, in particular, the lives of people living with HIV. South Africa has the highest number of people living with HIV as compared with the rest of the world. Initiated voluntary HIV counselling and testing and provider initiated counselling and testing (PICT) are required in order to increase the uptake of HIV testing. OBJECTIVES To explore and describe the experiences of healthcare workers who are themselves in need of HIV testing. METHOD A descriptive, exploratory design was used. In-depth interviews were conducted with the 26 healthcare workers who were involved in HIV testing in the Tshwane district of South Africa. The participants were sampled purposively from two healthcare settings. A thematic framework was used for data analysis. RESULTS There was a complication with regard to PICT as healthcare workers felt they could not initiate HIV testing for themselves and or their work colleagues without their confidentiality being compromised. This was complicated further by both the perceived and actual fear of stigmatisation and discrimination. It was difficult for qualified staff to support and encourage the uptake of HIV testing by students nurses as this was seen, albeit incorrectly, as targeting the students in a negative manner. CONCLUSION There is a need for accessible HIV testing policies for healthcare workers in order to increase access to HIV testing and prevent the progression of the disease.