Roinah Nkhensani Ngunyulu

Assessing the use of contraceptives by female undergraduate students in a selected higher educational institution in Gauteng

Background Unplanned pregnancies amongst students at higher education institutions are a major concern worldwide, including South Africa. Apart from various social and psychological challenges, unplanned pregnancies affect students’ objectives of achieving academic success. Research undertaken in the United States of America (USA) indicates that around 80% of female students in institutions of higher education between ages 18 and 24 are sexually active. Objectives To assess and describe the use of contraceptives by undergraduate female students in a selected higher educational institution in Gauteng. Method A cross-sectional, descriptive, quantitative design was used. A total of 400 female undergraduate students were requested to respond to a self-administered questionnaire. Stratified random sampling was used to select the participants. They were selected systematically from two campuses. Data were entered using an excel sheet at the Department of Statistics, and analysed using the Statistical Analysis Software programme, (SAS version 9.3), of the Department of Statistics’ higher educational institutions. Results A total of 74% females indicated they were sexually active, 79% of whom reported using contraceptives. The most common used methods were oral contraceptives at 38%, and 25% for male condoms. The most commonly known methods were condoms at 84%, and the oral contraceptive at 68%. The knowledge of condom use to prevent sexually transmitted diseases was high at 91%. Conclusion Inadequate knowledge and awareness on some contraceptive methods was found. Thus, educational programmes to increase students’ knowledge on the use of all contraceptive methods are urgently needed.

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.

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 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.

Perceptions of the Vhavenda regarding the significance of IKS rituals and customs in women's health : "The other side of the coin"

Abstract The paper aimed to explore and describe the perceptions of the Vhavenda people regarding the significance of indigenous knowledge systems (IKS) rituals and customs in promoting Women’s Health. Indigenous knowledge should be given a platform to add to our understanding of the world and advance philosophies that inform research approaches and interventions that sustain and acknowledge the role played by IKS in promoting women’s health. The HIV epidemic, disproportionately affecting sub-Saharan African women and their families, has put an academic spotlight on African beliefs systems and IKS. Most of the academic studies are based on western approaches, which are built predominantly around individualistic western beliefs and cultures that perceives IKS as the ‘other’ form of knowledge that can pose a threat to African women’s health. A qualitative descriptive study was conducted. In depth interviews were held with key informants who were knowledgeable about Vhavenda cultures. The findings demonstrate that beliefs about polygamy, widow inheritance and initiation schools are more complicated as participants perceived these customs as having benefits and risks to women’s health. The paper recommends adopting the African philosophy of ubuntu to assist in harmonizing the Vhavenda IKS to assist in addressing women, s health challenges.