Mmapheko Doriccah Peu

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.

Role of community nurses in the prevention of tuberculosis in the Tshwane Health District of Gauteng

The objectives of this study were to identify the role of community nurses in the prevention of tuberculosis (TB) and to identify problems experienced by them when fulfilling this role in the Tshwane Health District of Gauteng. A non-experimental, descriptive, quantitative research design method was used to collect data from community nurses. The sample included 59 registered nurses who voluntarily agreed to participate in the study. A questionnaire was used to collect data and quantitative data analysis methods were employed. Various opinions and ideas on the role of community nurses in the prevention of TB and the problems experienced were identified. Based on the results of this research, measures to protect community nurses from contracting TB whilst on duty should be a priority. Government should support TB programmes by providing money to non-governmental organisations and direct observed treatment short course (DOTS) supporters to make follow-up visits to patients possible, thus reducing the number of defaulters. Stringent measures should be taken at all border points to ensure that foreigners are screened for TB, multidrug-resistant TB and extensively drug-resistant TB. This study was limited to community nurses in the Tshwane Health District of Gauteng who were registered with the South African Nursing Council (SANC) and therefore this study could not be generalised to registered nurses in the hospital setting or even to clinics in the rest of South Africa.

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.

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.

The needs of health promoters on a health promotion programme for families with adolescents orphaned by HIV and AIDS

The South African communities has shown to have a challenge in accessing health services especially in rural areas; hence the national strategic objective 1.7 aimed at strengthening community systems to expand access to services using the community-based care programmes (NSP 2012-2016). The programmes enhance access to health services whilst promoting health and educating the community to improve health knowledge and work towards attaining a healthy living (NSP 2012-2016). However, the health promoters from the rural Hammanskraal region in the North West Province of South Africa often found themselves rendering the health promotion services in their communities with limited resources. This study aimed at exploring and describing the challenges faced by health promoters in implementing health promotion programmes for families with adolescents orphaned by HIV and AIDS. The study followed a qualitative design. Data was collected using focus group interviews. Participants were purposely selected by the social worker and the health promotion coordinator working at Hammanskraal. The process of data analysis was adapted from the eight steps of Tesch method of data analysis where categories, sub-categories and themes were isolated. The following categories emerged as the needs of health promoters on health promotion programmes for families with adolescents orphaned by HIV and AIDS, (1) financial needs, (2) resources, (3) basic life needs, (4) educational needs and (5) health promoters needs. It is therefore recommended that equal distribution of resources: including medicine, equipment and finances, should be maintained in order to ensure non-interrupted services.

Health support needs of widows in South Africa : a phenomenological inquiry

Community health care should facilitate effective adaptation to widowhood. In South Africa, the primary health-care nurses, who are the first-line health-care services, seem to miss opportunities for identifying and effectively managing widows experiencing health risks. This study explored the health-support needs of widows. We purposively selected 12 participants, who were widows between 25 and 65 years old residing in an urban area of South Africa. Data were gathered during unstructured individual phenomenological interviews and analyzed using a descriptive phenomenological method. Widowhood is an embodied and intense emotional experience with a cognitive impact. Related to these experiences are widows’ health-support needs. Widows have a need to be listened to and to be understood and cared for; attitudes and skills which require time and availability from primary health-care nurses. Widows expressed a need to engage in support groups, receive home visits, and receive health education from primary health-care nurses.

The experiences of lay counsellors regarding HIV and AIDS care and support in Tshwane clinics

Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) is a major burden disease in South Africa. The pandemic characterises the need for increased counselling and testing due to the availability of antiretroviral therapy (ART). This study describes the experiences of lay counsellors regarding care and support for HIV and AIDS. A qualitative approach was used during focus group interviews at four Tshwane clinics. The purposive sampling method was used to select participants from each facility. Data were collected and data analysis conducted using Tesch’s method. The results highlight that lay counsellors are not recognised as part of the health workers and multidisciplinary team by the Department of Health. It was recommended that the lay counsellors be retained as stipend earning government workers with clearly stipulated and revised conditions of service. On-going support, managerial support and supervision are necessary to improve care and support of HIV and AIDS.

The constraints and concerns regarding the size and/or shape of the second generation female condom : the narratives from the healthcare providers

Background Despite the redesigning of the Reality condom (FC) to a new version of the second generation female condom commonly known as (FC2), the users are persistently constrained and concerned about the size and shape of this new version. Condom use is aligned to the Millennium Development Goals (MDG) 3, 5 and 6, which address gender equality, improving maternal health and preventing HIV and AIDS. Aim To explore and describe the constraints and concerns regarding the size and/or shape of the FC2. Setting The study was conducted at Tshwane health district in Gauteng province. Methods A qualitative exploratory descriptive design was used. Individual in-depth interviews that yielded narratives in a designated health district in South Africa were conducted. Results From the analysis of narratives three specific themes emerged. Firstly, the specific theme was that the size and shape of FC2 is undesirable for the health care providers, which may lead women to contract HIV and AIDS. The second theme was that the size and shape of FC2 and female genitals makes insertion complicated and predisposes women to be vulnerable in sexual relationships. The third was that the size and shape of FC2 results in pain and discomfort during coitus, exposing women to unwanted pregnancies and HIV and AIDS. Conclusions The findings indicated the need for an evocative collaborative, interdisciplinary ‘walk the talk’ sexual health and AIDS education training programme for health care providers in primary health care facilities. Such programmes, if maintained, may assist health care providers to achieve the MDG 3, 5 and 6.

Perceptions of midwives regarding the role of traditional birth attendants during postnatal care in South Africa

The studys objective was to explore and describe the perceptions of midwives regarding the role of traditional birth attendants during postnatal care. The purpose of the study was to improve the standard of postnatal care, and to empower midwives with knowledge and skills regarding indigenous postnatal care practices, in order to meet the cultural care needs of postnatal patients from different cultural backgrounds. South Africa, as a developing country, has midwives who discharge postnatal patients after six hours post-delivery if the condition of both the mother and the baby is satisfactory; therefore, the traditional birth attendants render postnatal care at home. As a result, the midwives are not aware of the indigenous postnatal care practices used by the traditional birth attendants when taking care of postnatal women. Knowledge gained from this study may assist midwives to identify and address indigenous practices that are a threat to the health of women; to improve the standard of postnatal care. A qualitative approach using in-depth face-to-face interviews with midwives was followed. The findings revealed two themes, namely: (1) positive perceptions of midwives regarding the role of traditional birth attendants; and (2) negative perceptions of midwives regarding the role of traditional birth attendants. It is recommended that there should be teamwork between the midwives and the traditional birth attendants in order to strengthen the referral system of postnatal patients between the clinics or hospitals post-delivery and to enhance and maintain continuity of postnatal care.