Ntsieni S. Mashau

Self-reported impact of caregiving on voluntary home-based caregivers in Mutale Municipality, South Africa.

Background The establishment of home-based care (HBC) programmes in developing countries has resulted in a shift of burden from hospitals to communities where palliative care is provided by voluntary home-based caregivers. Aim The study investigated the impact of caregiving on voluntary home-based caregivers. Setting The study was conducted at HBC organisations located in Mutale Municipality of Limpopo Province, South Africa. Methods A quantitative cross-sectional descriptive survey design was applied to investigate the impact of caregiving on voluntary home-based caregivers. The sample was comprised of (N = 190) home-based caregivers. Home-based caregivers provide care to people in need of care in their homes, such as orphans, the elderly and those suffering from chronic illnesses such as tuberculosis, HIV and/or AIDS, cancer and stroke. Self-administered questionnaires were used to collect data which were analysed descriptively using the Statistical Package for the Social Sciences software, Version 20. Results The results showed that 101 (53.2%) participants were worried about their financial security because they were not registered as workers, whilst 74 (39.0%) participants were always worried about getting infection from their clients because they often do not have protective equipment. Conclusion Voluntary home-based caregivers have an important role in the provision of palliative care to people in their own homes, and therefore, the negative caregiving impact on the lives of caregivers may compromise the provision of quality palliative care.

Factors contributing to the low uptake of medical male circumcision in Mutare Rural District, Zimbabwe

Background Medical male circumcision (MMC) has become a significant dimension of HIV prevention interventions, after the results of three randomised controlled trials in Uganda, South Africa and Kenya demonstrated that circumcision has a protective effect against contracting HIV of up to 60%. Following recommendations by the World Health Organization, Zimbabwe in 2009 adopted voluntary MMC as an additional HIV prevention strategy to the existing ABC behaviour change model. Purpose The purpose of this study is thus to investigate the factors contributing to the low uptake of MMC. Methods The study was a quantitative cross-sectional survey conducted in Mutare rural district, Zimbabwe. Questionnaires with open- and closed-ended questions were administered to the eligible respondents. The target population were male participants aged 15–29 who met the inclusion criteria. The households were systematically selected with a sample size of 234. Statistical Package for the Social Sciences was used to analyse the data. Results Socioculturally, circumcised men are viewed as worthless (37%), shameful (30%) and are tainted as promiscuous (20%), psychological factors reported were infection and delayed healing (39%), being ashamed and dehumanised (58%), stigmatised and discriminated (40.2%) and fear of having an erection during treatment period (89.7%) whilst socio-economic factors were not having time, as it will take their time from work (58%) and complications may arise leading to spending money on treatment (84%). Conclusion Knowledge deficits regarding male medical circumcision lead to low uptake, education on male medical circumcision and its benefits. Comprehensive sexual health education should target men and dispel negative attitudes related to the use of health services.

Voluntary Home-Based Caregivers’ Perceived Needs for Support: A Study in the Mutale Municipality in South Africa

Abstract Voluntary home-based caregivers have become the backbone of home-based care programmes in Southern Africa where the public health care system is under severe strain. In this paper, a cross-sectional descriptive design was used to investigate home-based caregivers’ perceptions of their need for support. A total of 77 randomly selected home-based caregivers were recruited. Self-administered questionnaires were used to collect data, which was analysed using descriptive statistics. The results revealed that 47 (61%) of the participants agreed that they were trained as home-based caregivers, whereas 62 (80.5%) indicated that they were not satisfied with the training they received. The results showed that 56 (72.7%) of voluntary home-based caregivers did not know where to get help when they felt stressed, whilst 39 (50.6%) voluntary home-based caregivers indicated that they get emotional support from their colleagues. Voluntary home-based caregivers are playing a critical role in providing care to people in their homes in rural areas and therefore it is essential that all stakeholders should participate in addressing their needs.

Views of professional nurses regarding low tuberculosis cure rate in Greater Giyani Municipality, Limpopo Province

BACKGROUND Management of patients suffering from tuberculosis (TB) after discharge from hospital plays a critical role in the cure rate of TB. Despite interventions developed by the World Health Organization (WHO) to improve the cure rate, TB remains a worldwide health problem. OBJECTIVE The purpose of the study was to explore and describe the views of professional nurses regarding the low TB cure rate in primary healthcare facilities of Greater Giyani Municipality in Limpopo Province, South Africa, with the aim of determining strategies that can be used to improve this low rate. METHOD This study was qualitative, exploratory, descriptive and contextual in nature. The population consisted of professional nurses working in primary healthcare facilities within Greater Giyani Municipality, which has a TB cure rate below the national target of 85%. Data gathering was through individual face-to-face interviews using an interview guide. Open-coding was used to analyse the data in this study. RESULTS The theme that emerged from data was ‘factors contributing to low TB cure rate’. This theme was supported by the following sub-themes: poor referral system, lack of knowledge about TB and its treatment, stigma attached to TB, and cultural and religious beliefs. The professional nurses suggested counselling of TB patients upon diagnosis, advice about patients’ responsibilities and the involvement of family members. CONCLUSION The involvement of community stakeholders in TB prevention, health promotion and education activities devoted to disease spread and cure is vital so that the stigma attached to TB can be eliminated. TB education and awareness programmes should be included in the curriculum of primary schools.

Availability of and Access to Health and HIV/ AIDS Prevention Services for Youths in Rural Secondary Schools in South Africa

Abstract The study assessed the accessibility and availability of health and HIV prevention services for rural secondary learners in Malelane Sub-district of South Africa. A cross-sectional descriptive survey design was adopted. Self-report questionnaires were used to collect data from a total of 242 randomly selected learners aged 15 to 22 years yielding 69.1 percent response rate. On the question of access to health facilities, 93.7 percent and 85.5 percent reported accessing the clinic and the hospital respectively. Whilst almost 3 in 4 respondents reported receiving HIV information, only a quarter took part in the HIV/AIDS awareness programme. Though most (98.3%) of the respondents in the study reported being aware of the availability of free condoms, 57.1 percent indicated that they were too scared or afraid to access condoms. The study also established significant differences between gender and participation in promotion of condom use (p=0.03) and awareness of family planning services (p=0.02). Though the findings indicated that health and HIV/AIDS prevention services were available and accessible in terms of physical location of health facilities, utilization of such services was a challenge. To promote and enhance effective utilization of such services, there is the need for the creation of a permissive and conducive youth-friendly climate around health facilities through appropriate HIV/AIDS health education and promotion.

Home-based carers' perceptions of health promotion on sexual health communication in Vhembe District

Background The introduction of home-based care in rural communities in the 1980s contributed immensely toward the upliftment of the personal and environmental health of communities. Women’s groups provided health promotion skills and health education to communities and made a difference in health-related behaviour change. Objective The purpose of the study was to explore and describe the home-based carers’ perception regarding health promotion concerning sexual health communication in Vhembe district, in the context of HIV, amongst communities still rooted in their culture. Method A qualitative, explorative and descriptive design was used in order to understand home-based carers’ perceptions regarding health promotion on sexual health communication amongst rural communities which may adversely impact on health promotion practices. The population were home-based organisations in Vhembe. The sample was purposive and randomly selected and data were gathered through semi-structured face-to-face interviews and focus groups which determined data saturation. Open coding was used for analysis of data. Results The results indicated that sexual communication was absent in most relationships and was not seen as necessary amongst married couples. Socioeconomic conditions, power inequity and emotional dependence had a negative impact on decision making and sexual communication. Conclusion This study, therefore, recommends that educational and outreach efforts should focus on motivating change by improving the knowledge base of home-based carers. Since they are health promoters, they should be able to change the perceptions of the communities toward sexually-transmitted infections and HIV by promoting sexual health communication.