Janetta Hendrika Roos

Factors affecting the performance of professional nurses in Namibia

BACKGROUND Professional nurses play a vital role in the provision of health care globally. The performance of health care workers, including professional nurses, link closely to the productivity and quality of care provision within health care organisations. It was important to identify factors influencing the performance of professional nurses if the quality of health care delivery was to improved. OBJECTIVES The aim of the present study was to identify factors affecting the performance of professional nurses in Namibia. METHOD A quantitative, descriptive survey was used to collect data by means of a questionnaire. A random sample of 180 professional nurses was selected from six hospitals in three regions of Namibia. RESULTS Factors affecting the performance of nurses negatively were identified such as: lack of recognition of employees who are performing well, quality performance outcomes and an absence of a formal performance appraisal system and poor working conditions. Various factors contribute to both the positive and negative performance of professional nurses in Namibia. Strategies were developed for addressing the negative factors that could positively affect the performance of professional nurses in Namibia. CONCLUSIONS This study emphasises the importance of developing strategies to promote the performance of nurses; build knowledge and expertise; develop mechanisms for improving the performance of nurses; expand leadership and management capacity; and generate information and knowledge through research.

A descriptive study on health workforce performance after decentralisation of health services in Uganda

BackgroundUganda, like many developing countries, is committed to achieving the Millennium Development Goals (MDGs) by 2015. However, serious challenges prove to hamper the attainment of these goals, particularly the health related MDGs. A major challenge relates to the human resources for health. The health system in Uganda was decentralised in the 1990s. Despite the health sector reforms, the services have remained significantly deficient and performance of health workers is thought to be one of the contributing factors. The purpose of this study was, therefore, to investigate the performance of health workers after decentralisation of the health services in Uganda in order to identify and suggest possible areas for improvement.MethodsA cross-sectional descriptive survey, using quantitative research methods was utilised. A structured self-administered questionnaire was used to collect quantitative data from 276 health workers in the districts of Kumi, Mbale, Sironko and Tororo in Eastern Uganda. The health workers included doctors, clinical officers, professional nurses and midwives. The sample was selected using stratified random sampling. The data was analysed using SPSS version 18.0 and included both univariate and bivariate analysis. The results were presented in tabular and text forms.ResultsThe study revealed that even though the health workers are generally responsive to the needs of their clients, the services they provide are often not timely. The health workers take initiatives to ensure that they are available for work, although low staffing levels undermine these efforts. While the study shows that the health workers are productive, over half (50.4%) of them reported that their organisations do not have indicators to measure their individual performance. The findings indicate that the health workers are skilled and competent to perform their duties. In general, the results show that health workers are proficient, adaptive, proactive and client-oriented.ConclusionAlthough Uganda is faced with a number of challenges as regards human resources for health, the findings show that the health workers that are currently working in the health facilities are enthusiastic to perform. This may serve as a motivator for the health workers to improve their performance and that of the health sector.

Communication satisfaction of professional nurses working in public hospitals

AIM This study aimed to establish and describe the level of communication satisfaction that professional nurses experience in selected public hospitals in the City of Johannesburg, South Africa. BACKGROUND The success of any organisation depends on the effectiveness of its communication systems and the interaction between staff members. METHOD Data were collected by means of questionnaires, based on the Communication Satisfaction Questionnaire (CSQ), from a sample of 265 professional nurses from different categories, chosen using a disproportionate random stratified sampling method. RESULTS The results indicated poor personal feedback between nurse managers (operational managers) and professional nurses, as well as dissatisfaction among nurse managers and professional nurses with regard to informal communication channels. A lack of information pertaining to policies, change, financial standing and achievements of hospitals was identified. CONCLUSION Nurse managers should play a leadership role in bringing staff of different departments together by creating interactive communication forums for the sharing of ideas. IMPLICATIONS FOR NURSING MANAGEMENT The results emphasise the need for nurse managers to improve communication satisfaction at all levels of the hospital services in order to enhance staff satisfaction and create a positive working environment for staff members.

Assessing the implementation of performance management of health care workers in Uganda

BackgroundThe performance management concept is relatively new to the Ugandan health sector. Uganda has been implementing health sector reforms for nearly two decades. The reforms included the introduction of the results-oriented management in the public sector and the decentralisation of the management of health care workers from central to local governments. This study examined the implementation of performance management of health care workers in order to propose strategies for improvement.MethodsThe study was a descriptive survey carried out in the Kumi, Mbale, Sironko and Tororo districts and utilising mixed research methodology. A self-administered questionnaire was used to collect quantitative data from the health care workers. A semi-structured interview guide was used to collect qualitative data from the health service managers. The sample for the quantitative method was selected using stratified random sampling. Purposive sampling was used to select health service managers. Quantitative data were analysed using Statistical Package for Social Sciences (version 18.0). Qualitative data were categorised according to the themes and analysed manually.ResultsThe findings show that to some extent performance management is implemented in the health sector; however, there were loopholes in its implementation. There were inadequacies in setting performance targets and performance management planning was hardly done. Although many health care workers had job descriptions, the performance indicators and standards were not clearly defined and known to all workers and managers. Additionally the schedules for performance assessments were not always adhered to. There were limited prospects for career progression, inadequate performance feedback and poor rewarding mechanisms.ConclusionsPerformance management of health care workers is inadequately done in the districts. Performance management is a key component of attempts to improve health sector outcomes. As a result of this study, suggestions to enhance health sector performance management in the districts have been put forward. The authors are optimistic that if these suggestions are implemented, the performance of health care workers is likely to improve.

Infant feeding practices implemented by HIV-positive mothers in South Africa

Infant feeding is a critical part of the prevention of vertical transmission of HIV process [1], especially in resource poor countries. Thus the infant feeding options selected by HIVpositive mothers influence their babies’ risk of HIV infection. Exclusive breastfeeding for the first six months has a limited risk of vertical transmission of HIV. Although exclusive formula feeding carries no such risk, formula feeding might be inaccessible to some HIV-positive mothers and/or unsafe for some babies. Formula feeding it could increase infant mortality rates due to diarrhoea and malnutrition in resource-limited countries [1, 2]. Mixing breastfeeding with formula feeds increases the babies’ risk of HIV infection. Giving solid foods to babies younger than six months of age could also increase this risk.

A quantitative study on factors influencing enrolment of dairy farmers in a community health insurance scheme

BackgroundAccess to affordable and effective health care is a challenge in low- and middle- income countries. Out-of-pocket expenditure for health care is a major cause of impoverishment. One way to facilitate access and overcome catastrophic expenditure is through a health insurance mechanism, whereby risks are shared and financial inputs pooled by way of contributions. This study examined factors that influenced the enrolment status of dairy farmers in Western Kenya to a community health insurance (CHI) scheme.MethodsQuantitative, cross-sectional research was used to describe factors influencing the enrolment in the CHI scheme. Quota and convenience sampling was used, recruiting a sample of 135 farmers who supply milk to a dairy cooperation. Data were collected using a structured interview schedule and analysed using Stata SE, Data Analysis and Statistical Software, Version 12.ResultsFactors influencing non-enrolment were identified as affordability (40%; n = 47), unfamiliarity with the management of the scheme (37%; n = 44) and a lack of understanding about the scheme (41%; n = 48). An exploratory factor analysis was used to reduce the variables to two factors: information provision and understanding community health insurance (CHI). Logistic regression identified factors associated with enrolment in the Tanykina Community Healthcare Plan (TCHP). Supplies of less than six litres of milk per day (OR: 0.22; 95% CI: 0.06–0.84) and information provision (OR: 8.77; 95% CI: 2.25–34.16) were significantly associated with enrolment in the TCHP.Nearly 30% (29.6%; n = 40) of the respondents remarked that TCHP is expensive and 17% (n = 23) asked for more education on CHI and TCHP in an open-ended question.ConclusionRecommendations related to marketing strategies, financial approach, information provision and further research were outlined to be made to the management of the TCHP as well as to those involved in public health.

The experiences of women who undergo termination of pregnancy in Mpumalanga province, South Africa

The Choice of Termination of Pregnancy Act, 92 of 1996 (South Africa 1996) is aimed at improving the lives of all women, stipulating that every woman has the right to make choices about her own body, including being pregnant. This act was welcomed by many health professionals as it was seen as a way to increase access to safe abortion services and thus prevent morbidity and mortality associated with unsafe and illegal ‘back street’ abortions. The purpose of the study was to explore and describe the experiences of women who undergo termination of pregnancy (TOP) at TOP services in the Mpumalanga Province, South Africa. A qualitative, descriptive, explorative and contextual research design was utilised. Participants were included in the sample through convenience sampling. Data was collected from nine individuals using semi-structured interviews. Tesch’s method of data analysis was used to analyse the qualitative data. Measures to ensure trustworthiness were applied throughout the research and ethical considerations in the conduct of research adhered to. The findings revealed that health care consumers in Mpumalanga Province experienced emotional, physical and psychological discomfort in the TOP services received. Recommendations include community education for the support of the TOP programme, better integration of the TOP programme into other medical and social services and timely counselling, control and pain management for women who undergo TOP.