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Globally, the most crucial element of development strategies is a decrease in maternal mortality. Every 2 minutes, a pregnant woman dies from complications related to pregnancy or childbirth. According to studies, the majority of pregnancy and delivery difficulties are mostly influenced by sociocultural and health system factors. PUBMED, Google Scholar, National EDT, EBSCOHost, and Science Direct databases were used to find relevant articles. The process for choosing relevant and qualified articles was based on a PRISMA flowchart. The standard of the accepted articles was evaluated using the Critical Appraisal Skill Program (CASP) checklists. This study employed a thematic analysis, and in the articles on sociocultural and healthcare system factors influencing maternal mortality, six themes and 23 subthemes were found. It was determined that most women choose to consult traditional experts during pregnancy or childbirth rather than health facilities, and that there is little interaction between societal expectations and the healthcare system, which further contributes to problems and maternal mortality. This study found that social, cultural, and health system factors may directly and indirectly contribute to maternal mortality. It is also recommended that cultural norms and health system norms collaborate together to reduce maternal mortality.

Purpose: The purpose of this scoping literature review is to explore the breadth of the available literature, and identify knowledge gaps to inform future research through the use of Rodgers evolutionary concept analysis framework. The literature review also seeks to describe the key child indices developed and their characteristics so as to guide the development of a GMP index for improved child health in Zimbabwe. Methods: The keywords growth monitoring and promotion, community health workers, caregivers of children under five years, child health indices, and index development were used to search for relevant literature from Science Direct, Google Scholar, EBSCO, and PUBMED databases in English. The initial electronic database search yielded 535 research articles, and 316 were further assessed for their relevance to the study. An additional 140 articles were excluded from the search as they did not contain adequate evidence as per the Rodgers Evolutionary Framework. After the full-text review, 80 articles out of 220 articles met the inclusion criteria. Those found to be suitable were 25 articles and were thus included in the final analysis. Results: Key Antecedents: distance and socio-cultural constraints, CHW activeness, participation of fathers in GMP activities, poor understanding and interpretation of growth charts, poor communication between caregivers and CHWs, full vaccination status and complacency; Attributes: education status of parents, knowledge, attitude, and practices of caregivers and Consequences: timely health interventions, improved child health outcomes, a platform to promote optimal child health practices of GMP activities were identified. Conclusion: More research needs to be explored to form indices that incorporate behaviour change metrics. This will lead to an increased evidence base to guide the health system, funders, and policy makers conclusively.

Inadequate knowledge and poor attitudes about prostate cancer (PC) negatively affect early screening practices among males. The PC mortality rate is increasing due to late reporting, screening, and treatment. This study explored the awareness, attitudes, and PC screening behaviours among males in the Limpopo, Thulamela municipality. This descriptive cross-sectional study involved 245 males that were randomly selected. A structured questionnaire was used to collect data. Fisher’s exact tests and logistic regression analysis were used to examine the association between sociodemographic variables, awareness, and attitudes towards PC. Our findings revealed that 64.1% demonstrated inadequate awareness about PC. The overall score (84.9%) showed a positive attitude towards PC. However, 87.4% had a negative attitude towards the effectiveness of treatment for PC. The majority (96.7%) of respondents had never undergone a PSA test, although 53.1% were willing to undergo a PSA test. There was a significant positive correlation between awareness of prostate cancer and attitudes toward prostate cancer (r = 0.280, p < 0.001). Health status predicted awareness about PC, while age and health status predicted attitudes towards PC among men. Rural community-based programmes and heightened awareness campaigns are needed to conscientize men about the risk factors, symptoms, diagnosis, and treatment of PC in rural areas of Limpopo.

Background: Health Systems Strategies play a key role in determining Adolescent Sexual Health outcomes. This study aims to review the literature on the relationship between Health Systems Strategies and Adolescent Sexual Health issues guided by Rodger's evolutionary concept analysis framework. The study further develops a Conceptual Framework that would guide a study that seeks to “Develop strategies to facilitate safe sexual practices in adolescents through Integrated Health Systems in selected Districts in Zimbabwe.” Methods: Adolescents, Health Systems, Sexual Health, and Strategies were used to search for published literature (in English) on Google Scholar, PUBMED, EBSCO, Cochran Library, and Science Direct. A total of 142 Articles and 11 reports were obtained, and the content was screened for relevance. This led to 42 articles and 03 reports being found suitable and relevant, and thus, the content was reviewed. Thematic analysis was done to identify attributes, antecedents, and consequences of Health Systems Strategies on Adolescent Sexual Health. These findings were then used to inform the development of the Conceptual Framework. Results: Key attributes, antecedents and consequences of Health System Strategies on Adolescent Sexual Health were identified. Strategies to Improve Adolescent Sexual Health outcomes were also identified. Conclusions: Different contextual factors influence policy changes and the consequences are mixed, with both positive and negative outcomes.

Task shifting of nurse-initiated management of antiretroviral therapy (NIMART) rather than doctors is crucial to meet the increasing demand for antiretroviral therapy (ART) in primary health care in low and middle-income countries with limited healthcare resources. This chapter will furnish cooperation between the NIMART conceptual framework, National Department of Health policies and guidelines, and empirical findings regarding the management of ART and tuberculosis (TB) in South Africa and globally through pre-service and in-service training and continuous professional development (CPD). It will also include regulations and WHO guidelines on task shifting, application in a healthcare setting, the HIV continuum of care use in identifying gaps, and the development of appropriate interventions to improve patients and population health outcomes. The training and health care systems or structural challenges or barriers and strategies or enablers to enhance effective training and implementation, including the role and responsibilities of NIMART nurses, will be explored and discussed in detail. The focus will mostly be on the primary health care (PHC) setting as the first level of care and entry into the healthcare system to decentralize healthcare services and facilitate access to HIV services by the community.

The lack of a conceptual framework that can be utilized to manage rape survivors diagnosed with Post-Traumatic Stress Disorders presents a challenge in the North-West province. The study aims to provide a conceptual framework for managing rape survivors with PTSD in the province of the North-West using Practice-Oriented Theory and Donabedian’s Structure Process Outcome Model Features. The research was conducted using an explanatory, sequential and mixed-methods approach. Additionally, used was the descriptive and explorative programme evaluation design. The results of the study demonstrated the significance of PTSD assessment before management interventions for rape survivors. The study findings outlined and designed a framework to assess and manage PTSD among rape survivors consulting at Thuthuzela Care Centre and those referred to hospitals for further management. The Practice-Oriented theory by Dickoff, James and Wiedenbach, and the Structure Process Outcome model by Donabedian served as points of reference for the development of the conceptual framework. The study is limited to North-West provincial healthcare facilities and Thuthuzela care centres (TCCs), however, it highlights the lack of a conceptual framework pertaining to the psychological management of PTSD rape survivors in the province and South Africa.

Background: Quality has increasingly become a critical part of life in every aspect. Patients are today continuously looking for good quality services from health professionals. Professional nurses are expected to render quality care to fulfil the patients’ healthcare needs. Poor nursing care has led to several litigations and the loss of patients’ lives. It is essential to explore professional nurses’ viewpoints regarding quality nursing care.Objectives: To explore and describe the understanding of professional nurses regarding quality care rendered to patients in the selected hospitals of Limpopo Province.Method: This study utilised a qualitative, exploratory-descriptive design. Individual semi-structured interviews were conducted for data collection. Participants comprised 35 professional nurses who were purposely selected. Data collected were audio-recorded and transcribed verbatim. Data were analysed using Tech’s eight-step data coding process, which led to the emergence of themes and sub-themes. Trustworthiness was ensured through credibility, confirmability, dependability, and transferability.Results: Three themes emerged: professional nurses’ descriptions, meanings, and expectations of quality nursing care. The findings highlight that quality nursing care means meeting patients’ needs through advocacy, empathy, fulfilment of patients’ needs, good interpersonal relationships and teamwork. Challenges experienced included the lack of resources and staff shortage.Conclusion: Hospital management needs to develop effective ways to support professional nurses in delivering quality nursing care. In discussion with the Department of Health (DoH), hospitals should be fully equipped with resources to render quality care to patients. Evaluation of service quality and patient satisfaction should be ongoing for improving the quality of patient care.Contribution: The study reveals that professional nurses perceive quality nursing care differently. Moreover, it emphasises the importance of maintaining and promoting quality nursing care as the cornerstone of healthcare.

Rape is very high in South Africa. It predisposes rape survivors to many health care problems, including the risk of contracting human immunodeficiency virus, sexually transmitted infections, falling pregnant, and long mental health effects. PTSD and depression are regarded as the most common mental health effects diagnosed among rape survivors, and they require long term mental health care management. In the current era, follow-up care management for rape survivors is mostly done at Thuthuzela Care Centres. However, rape survivors do not often go for follow-up care, because these centres are mostly far from them. Thus, this problem can be addressed by integrating the management of these long-term disorders within the primary health care settings in South Africa, because most people have access to their nearby clinics. This chapter aims to describe ways of integrating follow-up care management for continuous assessment and management of rape survivors diagnosed with PTSD and depression through task-shifting these duties to nurses working within the primary health care settings in South Africa. The chapter focuses on the mental health care status of rape survivors diagnosed with PTSD and depression. Training of nurses is essential to manage rape survivors diagnosed with PTSD and depression in primary health care.

Background: Cultural norms bring substantial weight in women’s decision-making, especially concerning the choice of the birth location. Cultural and religious practices may influence how pregnant women respond to Antenatal Care (ANC) services, feel confident about which questions to ask, or participate in the discussions about their care plan or birth options. Purpose: The study aimed to explore and describe the influence of cultural practices on the management of pregnancy in the Mbombela Municipality of Mpumalanga Province. Methods: Using a qualitative approach, pregnant women who failed to completely attend ANC services were purposively sampled, and individual unstructured in-depth interviews were employed to collect data. The study consisted of a sample size of 18 pregnant women, and data saturation was reached. Tech’s method of analysis was followed for data analysis. Results: Study findings revealed a significant theme: cultural practices and pregnancy management, encompassing three sub-themes: cultural practices in pregnancy, cultural medication taken by pregnant women, and the effects of cultural practices on pregnancy management. Conclusion: It is recommended that women should be given health education concerning ANC services every day while they wait in primary health care clinics. Accordingly, the healthcare professionals should encourage the active involvement of all pregnant women in health promotion gatherings and offer chances for clarity seeking. Despite the availability of free maternal healthcare services in primary healthcare clinics, women still consult traditional healers during pregnancy and believe in cultural practices. It is therefore important that programs developed for maternal services be congruent to the cultural practices of women to be serviced.

Background: Worldwide, adolescents have had limited access to reproductive health services due to several factors. The nature of communities and their organisations play a significant role in shaping adolescent sexual behaviours and practices. This study sought to explore the extent of the influence of community environmental factors in moulding adolescent sexual behaviours in Mberengwa and Umguza districts. Methods: A quantitative cross-sectional survey was conducted on 370 and 360 systematically selected adolescents in Mberengwa and Umguza districts, respectively, using a pre-tested researcher-administered questionnaire. The collected data was captured in Excel and imported to STATA Version 13 Standard Edition for analysis. Different statistical methods (both descriptive and inferential) were utilised to interrogate collected data and inferences made. Results: Most respondents were female and were between 13-17 years. Most of the respondents were literate. Umguza district had a significantly higher prevalence of pregnancies, Sexually Transmitted Infections, and a higher number of adolescents engaging in sexual activities. Predictors of Sexually Transmitted Infections and pregnancies were the sex of the respondent, tribe, sexual encounters, age, and religion. Conclusion: Adolescents are at risk of contracting Sexually Transmitted Infections and impregnation as they engage in risky sexual behaviours, as evidenced by the findings. The two districts have a significantly higher prevalence of having sex than the national average.

Epilepsy is a neglected noncommunicable condition in this era. Therefore, it is imperative that practical approaches to enhance the management of epilepsy for the success of people living with epilepsy (PLWE) be analyzed and described. The chapter will encompass the challenges faced by people living with epilepsy, their needs, the PLWE resilience and coping strategies, epileptic seizure first-aid management, and support for people living with epilepsy. The issues aforementioned can potentially shape the future of the people living with epilepsy if attended to effectively. It is high time that epilepsy and people living with epilepsy are given the attention they require to reduce the stigma attached, misconceptions, maltreatment, mismanagement, and negative cultural and religious beliefs, as this will encourage the people living with epilepsy to accept themselves and partake in the family, community, school, and societal engagements without any fear.

Depression and anxiety among the youth are serious mental health problems leading to suicide and causing unmeasurable negative long-term impacts, not only for the individual but also for family and friends. This chapter aims to unpack current perspectives on overcoming depression and anxiety to enhance educational success among the youth. A literature review was conducted to thoroughly address relevant content to bring forth short and long-term practical steps that might enhance educational success among youth who are continuously dealing with depression and anxiety. Given the magnitude of depression and anxiety among youth, the current trends of depression among the youth, and factors leading to anxiety and depression were unpacked. In addition, the perspectives on how family members, friends, and community members can identify signs and symptoms of anxiety and depression, guidelines about overcoming anxiety and depression, tailor-made practical guidelines to enhance educational success, and recommendations were explained. In conclusion, it is clear that in rural areas, there is a knowledge gap about mental illness in general. It is, therefore, recommended that the government focus must be on educating the community to provide knowledge and understanding. Consequently, families and friends will better identify depression and anxiety and consequently provide the necessary support.

Caring for Mental Health Care Users (MHCUs) diagnosed with Substance User Disorders (SUDs) is challenging and demanding as nurses reported that these users are untrustworthy. This leaves the nurses emotionally and physically drained. Some of these MHCUs are violent, aggressive, suicidal or homicidal. However, there is no literature found on the nurses’ coping strategies when caring for MHCUs diagnosed with SUDS. The purpose of this chapter was to explore and describe the current literature on the nurses’ coping strategies when caring for MHCUs diagnosed with SUDs. A narrative literature review was used in this chapter. JSTOR, Google Scholar, Sabinet Online, African Journals and Science Direct databases were used to search relevant and current literature using the following keywords: coping, coping strategies, nurses, care, caring, mental health care users, psychiatric patients, substance abuse, substance-related disorders and substance use disorders. Six themes emerged in this chapter namely nurses’ resilience, peer support, management support, strengthening the multidisciplinary team (MDT) approach, open-door policy as well as education and training. The findings and recommendations of this chapter may assist nurses of all categories to provide quality care, treatment and rehabilitation services when caring for MHCUs who are diagnosed with SUDs.

This study sought to explore correctional rehabilitation effectiveness in a South African setting. Using a phenomenological approach, we interviewed ten parole recidivists who have been convicted m...

Background: Postpartum haemorrhage is one of the causes of the rise in maternal mortality. Midwives’ experiences related to postpartum haemorrhage (PPH) management remain unexplored, especially in Limpopo. The purpose of the study was to explore the challenges experienced by midwives in the management of women with PPH. Methods: Qualitative research was conducted to explore the challenges experienced by midwives in the management of women with PPH. Midwives were sampled purposefully. Unstructured interviews were conducted on 18 midwives working at primary health care facilities. Data were analysed after data saturation. Results: After data analysis, one theme emerged “challenges experienced by midwives managing women with PPH” and five subthemes, including: “difficulty experienced resulting in feelings of frustrations and confusion and lack of time and shortage of human resource inhibits guidelines consultation”. Conclusion: The study findings revealed that midwives experienced difficulty when managing women with postpartum haemorrhage. For successful implementation of maternal health care guidelines, midwives should be capacitated through training, supported and supervised in order to execute PPH management with ease. Keywords: Midwifery in South Africa; implementation of maternal guidelines; postpartum haemorrhage; maternal mortality.

Background: Epilepsy misconceptions are widespread; these influence the quality of life of people living with epilepsy (50 million people worldwide) and their families. Objective: The review’s objective was to highlight the public knowledge and awareness of epilepsy with an emphasis on its impact, gaps, and available guidelines for public awareness. Methods: The search databases included PubMed, EBSCOhost, Google Scholar using keywords, index terms as well as the Boolean search. Twenty-seven studies were included, which yielded three themes and six sub-themes. Results: Three themes emerged from the data: knowledge, beliefs, and awareness of epilepsy, the impact of epilepsy, and epilepsy awareness guide. From these themes, six sub-themes were established. Implications: Generally, people in Africa continue to hold misconceptions about epilepsy. This study shows that there is a need for further research examining the level of knowledge and awareness held in different contexts to develop a means to educate the general public as it has been revealed that there is generally inadequate knowledge and awareness of epilepsy. Furthermore, this study gathers knowledge that is now accessible as a threshold to much-needed research on epilepsy education, awareness and knowledge in Africa.

Background: Pregnant woman’s personal experience of antenatal care services can either be positive or negative; however, knowledge and experience appear to be of paramount importance in shaping their attitudes towards any healthcare-related services. This implies that women's experience of antenatal care services may affect their decision for seeking antenatal care in their present pregnancy, which can lead them to delay seeking care. Purpose: This study sought to explore the attitudes of pregnant women towards antenatal care services provided in primary health care facilities of Mbombela Municipality, Mpumalanga Province, South Africa. Methods: A qualitative exploratory descriptive study design was used for this study. Purposive sampling technique was used to sample pregnant women who fail to attend antenatal services as expected. Data were collected through face to face unstructured in-depth interview. A total of eighteen pregnant women participated in the study until data saturation. Data were analysed using Tech’s method of analysis. Results: Results revealed the following theme and sub-themes: Attitudes of pregnant women related to individual perceptions, perceived barriers to utilizing antenatal care services,’ attitudes of healthcare providers, long waiting times in healthcare facilities, lack privacy and confidentiality in healthcare facilities and attitudes of pregnant women related to attendance of antenatal services. Conclusion: Attitudes of pregnant women about antenatal care are shaped by their knowledge and previous encounters with the health care services that they had previously received. It is therefore important to provide women-friendly services. It is recommended that health education regarding the importance of antenatal care services must be given to all women daily in the waiting areas of each primary health care facilities, thus, the healthcare providers should promote the active participation of pregnant women during the health education sessions and provide opportunities to ask questions.

Occupational exposure to human immunodeficiency virus (HIV) among nurses had been reported to be a major challenge in South African and broader African context. There seems to be an increase in the level of exposure and uptake of post-exposure prophylaxis (PEP) in Africa. This had warranted the need to establish a systematic review on the level of knowledge among nurses regarding PEP in the African continent. The search engines used included: EBSco Host (North-West University [NWU] library), Sabinet, Google Scholar, ScienceDirect, and PubMed. The search was limited to the current decade (2008-2018), including articles that are in English. Keywords used were: ‘knowledge’, ‘post-exposure prophylaxis/PEP’, ‘HIV’, and ‘nurs*’. Thematic evaluation to pick out commonalities of the applications covered in this review have been achieved. The themes identified from the review were: poor knowledge regarding PEP, receiving training on PEP for HIV, immediate steps to take after exposure to infected blood, exposure to HIV, and not taking PEP. There is a strong need to increase the awareness and knowledge regarding PEP as well as to implement training programs to train nurses on the process of PEP in healthcare settings, to increase knowledge on PEP, and thereby decrease seroconversion of HIV. y.

Background: The high rate of malaria in the province has negatively impacted the department financially since medicines for malaria treatment are scarce and expensive. Many of the families live near the streams, and they are uninformed about malaria’s clinical manifestations and preventive measures. Aims: This study aimed to assess caregivers’ knowledge about malaria in children of selected villages within the Limpopo province of South Africa. Methods: Using a cross-sectional study design, this study was conducted in villages surrounding the Vhembe district of Limpopo province. A structured self-administered questionnaire was used to collect data. The data were analysed using descriptive statistics. This study included 80 caregivers of children under 12 years of age. Results: It was found that approximately 85% of caregivers knew about malaria’s clinical manifestations and prevention measures. Conclusion: Community health care workers can improve the knowledge of caregivers by strengthening health education and preventive campaigns.

Background: Adolescent Sexual Health strategies developed and implemented in different country settings need to be contextualised through validation to align with the populace's needs. This study sought to validate developed strategies meant to facilitate the integration of Indigenous Health System and Modern Health System for improved Adolescent Sexual Health outcomes. Methods: The Delphi Technique was used to validate the strategies by recruiting fifteen experts in Indigenous Health systems, Health Systems and Policies, Adolescent Sexual Health and Program, Guideline, and Strategy Development to evaluate the developed strategies and assess their feasibility. Furthermore, 100 key stakeholders in Umguza and Mberengwa responded to a semi-structured checklist to express their opinions on the developed strategies and their feedback used to refine the strategies. Results: Experts suggested minor changes to one strategy and agreed with the other four strategies. Most key stakeholders (97%) endorsed the proposed strategies. The strategies were, therefore, refined and presented as per the suggestions of these consulted actors. Conclusion: Therefore, it is imperative that these strategies be piloted and implemented in the two districts and the progress monitored and evaluated. Suppose they are yielding positive results in as far as Adolescent Sexual health-related issues are concerned. In that case, an implementation must be expanded and rolled out in other districts that have a similar setup.

The Prevention-of-Mother-To-Child Transmission (PMTCT) program was introduced to prevent vertical transmission of HIV from a mother to her infant through pregnancy, labor, and breastfeeding. Therefore, it is critical for the program to be accessible in primary health care facilities across the globe to increase treatment uptake and to eliminate child and maternal mortality rates caused by HIV infections. However, barriers are still being experienced by some nurses while implementing PMTCT around Moretele sub-district in the North West Province (NWP). Hence, this qualitative study explored and described the factors influencing the implementation of PMTCT. A qualitative, exploratory-descriptive design was followed. Ten participants were selected purposively, and each participant was interviewed individually using WhatsApp video calling. All participants were made aware of their voices being recorded; data saturation was reached on the eighth participant as no new information evolved. Data were analyzed using Tesch’s method of qualitative data analysis. The findings revealed that factors that influenced PMTCT implementation were due to patient, management, and staff-related factors. Moreover, these factors impacted the provision of effective patient care. The findings of this study show that much still needs to be done to achieve and sustain the PMTCT implementation goal. Therefore, the training of nurses should be of paramount importance. They should be provided and equipped with the necessary resources, support, and encouragement to offer and ensure quality health care. Furthermore, the government should ensure that policies and guidelines are regularly monitored and evaluated.

We aimed to characterise practices of rape care management centres in a South African setting. Participants were rape survivors consulted in Thuthuzela care centres of the North West Province. They...

This exploratory systematic literature review aimed to characterise the current evidence on psychological management intervention guidelines for use with rape survivors with post-traumatic stress d...

Background: Strategies to improve sexual health outcomes have evolved over the years due to technology’s evolution to ensure that they are relevant. Challenges have been noticed in different systems that run parallel, particularly in Low-Income Countries where the majority utilise Indigenous Health Systems. Optimisation of resources and minimisation of conflicts could be realised through integrated health systems in the management of adolescents’ sexual health issues. This study sought to develop strategies to facilitate Indigenous Health System and Modern Health System integration to improve the management of Adolescent Sexual Health issues, leveraging results from 3 papers. Methods: A multi-stage approach was utilised, with Phase 1 focussing on a preliminary assessment through merging findings from the 4 papers. The Strengths, Weaknesses, Opportunities, and Threats analyses were then used, followed by the Basic Logic Model to identify critical aspects that needed to be considered in building the strategies. The second phase used the Build, Overcome, Eliminate and Minimise framework to build the strategies. Results: A total of 5 strategies were proposed to facilitate this integration, and these included revival of committees that were inclusive of all stakeholders; allocating Indigenous Health System space in clinics to work in; establishing adolescent-friendly clinics; intensifying information dissemination on sexual health-related issues, and developing clear Terms of Reference and procedures to govern this integration and ensure it is a success. Conclusions: Implementing these strategies could facilitate this integration and ensure that programs are planned and implemented in a complementary manner, thereby reducing conflicts between the 2 systems and ensuring collaborative efforts towards shared goals that would transform to better Sexual Health Outcomes for adolescents.

Introduction: integrated management of Human Immunodeficiency virus and Non communicable diseases is essential to improve clinical outcomes of patients living with HIV. there is poor implementation of integrated management of HIV and NCDs in Primary health care facilities in most of African countries. The aim of the study was to conduct the strengths, weaknesses, opportunities and threats (SWOT) analysis of the Vhembe district to determine the implementation of integrated management of HIV and NCDs among NIMART nurses in Limpopo Province ,South Africa .Material and Methods: A descriptive quantitative study was employed using checkilist and SWOT framework. We used 25 PHC facilities to collect facility data, NIMART nurses data and patients data to complete the four checklists. The collected data was analysed using SPSS version 26. the analysed data was further analysed and segregated into the SWOT framework.Results: From the total of 25 PHC facilities we found that 147(100%) were NIMART trained ,109 (74.1%) were not trained on Adult primary care guidelines. All 100% of facilities did not have the updated adult primary care guideline 2016/17. In all 25 (100%) despite the evidence of implementation integrated management of HIV and NCDs , patients were not screened for diabetes as per the guidelines.Conclusion: The SWOT analysis allowed the researchers to identify the areas which can be sustained , strengthened and addressed for successful implementation of integration of HIV and NCDs to improve patient clinical outcomes in PHC facilities. The results of the study may be applied to any context and maybe used by decision makers, managers, professionals and other relevant stakeholders to develop more policies or frameworks on the integrated management of HIV and NCDs.

Different stakeholders play varying roles in shaping up adolescent sexual behaviours that, in turn, influence their sexual experiences. In Zimbabwe, it has been reported that adolescents from cultural districts exhibit poor sexual health outcomes as compared to other districts. Therefore, this study sought to explore the role of different key community stakeholders in the indigenous health system and how it impacts on adolescent sexual health issues. The study further explored how the indigenous health system could be integrated into the modern health system. A qualitative cross-sectional survey was conducted on purposively and snowballed respondents in Umguza and Mberengwa districts. Interviews and focus group discussions were used to gather and record data from participants. The recorded data were transcribed verbatim, translated to English, coded and thematically analysed on MAXQDA Analytics Pro 2020. Four superordinate and 12 subordinate themes emerged from the data during analysis. Stakeholders play varied roles in adolescents’ upbringing and support though there are contradicting teachings from the indigenous health system and modern health system. It is possible to integrate these two systems though there were foreseen logistical challenges and clashes in the values and belief systems. Participants made suggestions on how these challenges could be overcome. There is a window of opportunity to pursue the suggested ways of integrating indigenous health systems and modern health systems for improved adolescent sexual health outcomes.

Background Globally, the burden of tuberculosis or human immunodeficiency virus (TB/HIV) is at 24% and this alarming rate compelled the World Health Organization (WHO) to declare the African region as a critical workforce shortage area. To facilitate adherence to treatment guidelines, WHO recommended a strategy of task shifting for countries with high health workforce shortages. The strategy aimed at the redistribution of health care tasks to available workers. The study aimed to determine the factors facilitating nurse-initiated management of antiretroviral therapy (NIMART) trained nurses’ adherence to TB/HIV treatment guidelines. Methods The study employed an exploratory-descriptive design. The study was conducted in Ugu and Ngaka Modiri Molema Districts of KwaZulu-Natal (KZN) and North West (NW) Provinces of South Africa. The population comprised of 24 participants who were purposively selected. The in-depth focus group discussions were conducted and ATLAS T.I. was used for data analysis following the basic steps of notice-collect-think (NCT) analysis. Trustworthiness and adherence to ethics were ensured. Results The singular theme of factors facilitating NIMART trained nurses’ adherence to treatment guidelines which included positive attitudinal needs and positive behavioural change emerged from raw data. Conclusion Continuous training, support supervision, and improved relationships with colleagues need to be enhanced to enable NIMART trained nurses to adhere to treatment guidelines.

Isoniazid preventive therapy (IPT) is a strategy that has been proposed by the National Department of Health of South Africa and the World Health Organization for people living with HIV (PLWH) to prevent latent tuberculosis (TB) progressing to active TB. This research focused on exploring and describing experiences of PLWH regarding IPT provision in the Ngaka Modiri Molema district in the North West province of South Africa. A qualitative, exploratory, contextual and descriptive research design was used for this study. Semi-structured individual interviews were conducted to collect data from PLWH. The sample size consisted of 14 participants and data saturation was reached at participant 11. A thematic data analysis was employed in this study. The study consisted of 10 female participants and 4 male participants. Three main themes emerged during interviews, namely factors that facilitate IPT provision and uptake, factors that inhibit the adherence of patients to IPT, and strategies to improve provision or adherence. The provision of IPT at a community health centre in Ngaka Modiri Molema district municipality was reported to be satisfactorily although challenges were also marked. IPT must be available at all times to ensure the promotion of PLWH adherence, continuity of care and retention in HIV care. In addition, screening of PLWH for active TB disease before they can be initiated should be a priority. PLWH should be supported and followed up through the directly observed treatment, short-course strategy to promote adherence and this can also be facilitated through adherence social clubs.

Background Nurse-Initiated Management of Antiretroviral Therapy ( NIMART) training was introduced with the purpose of improving the knowledge, skills and competence of nurses in providing comprehensive quality care to people living with HIV (PLWH) and facilitating World Health Organisation task-shifting where nurses initiate antiretroviral therapy (ART) rather than doctors to meet the increasing demand of ART drugs. The aim of this review was to identify evidence of training strategies that can improve the implementation and deals with challenges that hinder quality. Methods A measurement tool to assess systematic reviews methodological systematic review tool was used to critically assess selected studies. Studies were sought using multiple databases including CINAHL (EBSCO), Google Scholar, ProQuest, academic journals, SA publications, electronic resources and OAISTER published from January 2012 to February 2017. The initial review of studies yielded 535 results excluding duplications. The screening of full-text articles was conducted, and 33 articles met the eligibility criteria and were included for quality assessment. The rest were excluded. The quality assessment research instrument was used to analyse and synthesise selected full-text articles (n=33). Results The studies indicate that NIMART or HIV training is used interchangeably and has the potential to empower nurses with knowledge and skills. It also has a positive impact on increasing ART uptake; however, nurses still lack confidence and competence to provide comprehensive quality patient-centred care. Studies suggest that a shift from the traditional didactics of lectures or slide presentation methods during training to the use of interactive training strategies that stimulate critical thinking in making decisions about HIV care, followed by mentoring and continuous professional development. Conclusion and recommendation This study reveals that the use of effective training techniques during NIMART training has a positive impact on the learning outcomes, implementation and performance of HIV programmes. The health care system should focus on dealing with barriers that negatively influence NIMART implementation. Given the lack of a framework or model related to NIMART or HIV training, the study recommends the development of a conceptual framework to strengthens the implementation of NIMART training.

Background Sexual and reproductive health are sensitive topics that may not be easily discussed among different age groups in most cultures. Most parents are uncomfortable to communicate with their children about sexual and reproductive health. The rate of teenage pregnancy and sexually transmitted infections continues to rise as parents shift the responsibility of discussing sexual health to other members of the family or teachers. Many sexual and reproductive ill-health exists among teenagers as a result of poor communication with parents or elders. The aim of the study was to explore the views of parents/guardians regarding t the discussion of sexual and reproductive health issues with teenagers. Methods The study was conducted in Capricorn and Mopani Districts of Limpopo Province where teenage pregnancy rates were reported to be very high. A qualitative explanatory approach was used. The population comprised of parents/guardians to teenagers who were pregnant or having children. Data were collected through individual face to face interview guided by one central question. Data were analysed using Tesch's method. Measures to ensure trustworthiness and ethical issues were ensured. Results Two themes emerged from the study: Views regarding discussing sexual and reproductive-related topics between parents and teenagers and Relationship of parents/guardians and their teenagers as an influence of discussions about SRH matters. Conclusion Parents/guardians still view discussing sexual and reproductive health issues with teenagers as taboo and difficult. However, discussing sexual and reproductive health issues with teenagers is seen as a beneficial practise as it might influence them positively and may decrease unwanted sexual risks such as teenage pregnancies and HIV infections.

Background: The implementation of nurse-initiated management of antiretroviral therapy (NIMART) management training is a challenge in the primary health care (PHC). It is evident from the literature reviewed and the data obtained from the North West province that gaps still exist. There is no conceptual framework providing guidance to NIMART training and implementation. Aim: Therefore, the aim of this study was to develop a conceptual framework to strengthen NIMART training and implementation in the North West province to improve patients and human immunodeficiency virus (HIV) programme outcomes. Setting: The study was conducted in the North West Province, South Africa. Methods: A pragmatic, explanatory, sequential, mixed-methods research design was followed. A descriptive and explorative programme evaluation design was used. Data were collected from two sources: antiretroviral therapy (ART) statistics from District Health Information System (DHIS) & Tier.net of 10 PHC facilities to evaluate and determine the impact of NIMART on the HIV programme and five focus group discussions conducted amongst 28 NIMART nurses and three HIV programme managers to describe challenges influencing NIMART training and implementation. Results: The study revealed that there was low ART initiation compared to the number of clients who tested HIV-positive. There was poor monitoring of patients on ART, which was evident in the low viral load collection and suppression, high loss to follow-up and deaths related to HIV. Challenges exist and this was confirmed by the qualitative findings, including human resource ratios, training and mentoring and the entire absence of a conceptual framework or model that guides training and implementation. Conclusion: The study findings were conceptualised to describe and develop a framework needed to facilitate and influence NIMART training and implementation to improve the HIV programme and patient outcomes. Dickoff, James and Wiedenbach’s practice-oriented theory and Donabedian’s structure process outcomes model provided a starting point in the ultimate development of the framework. Although the study was limited to the North West province’s PHC clinics and community health centres and did not include hospitals, it is of high significance as there is no such conceptual framework in the province or in even South Africa.

This study aimed to describe factors associated with the experience of Post-Traumatic Stress Disorder (PTSD) among rape survivors. Participants were female survivors attending a treatment centre in...

Background: Health Systems Strategies have been key in determining Adolescent Sexual Health outcomes. This study therefore aims to review literature on relationship between Health Systems Strategies and Adolescent Sexual Health issues guided by Rodgers evolutionary concept analysis framework. The study further develops a Conceptual Framework that would guide a study that seeks to “develop strategies to facilitate safe sexual practices in adolescents through Integrated Health Systems in selected Districts in Zimbabwe”.Methods: The words Adolescents, Health Systems, Sexual Health and Strategies were used to search for published literature (in English) on Google Scholar, PUBMED, EBSCO and Science Direct. 111 Articles and 04 reports were obtained and their content screened for relevance and 32 articles 01 report were found suitable and relevant and thus were reviewed. Thematic analysis to identify attributes, antecedents and consequences of Health Systems Strategies on Adolescent Sexual Health was done. These findings were then used to inform the development of the Conceptual Framework.Results: Identified attributes were: contextual, dynamic, engaging and advocating, and inefficient Health Systems in addressing Adolescent Sexual Health. Identified antecedents of these Health System Strategies on Adolescent Sexual Health included; adolescent sexual rights, lack of understanding of what sexual health is, need for integrated Adolescent Sexual Health systems, available resources and type of society. Consequences of these Health Systems Strategies on Adolescent Sexual Health were identified to be; weak Adolescent Sexual Health programs, parallel and fragmented Health Systems, vulnerability and heightened risks for poor health outcomes and challenges in interacting with different ethnic groups and gender.Conclusions: Adolescents are very vulnerable and need to be protected at all costs. There is need to have comprehensive Health Systems Strategies that would positively influence Adolescent Sexual Health.

South Africa has consistently had high reports on the prevalence of rape, and post-traumatic stress disorder (PTSD) is the most common mental healthcare problem associated with rape. However, it seems that the provision of mental healthcare services for rape survivors is an acute challenge in the North West province and South Africa in general. Thuthuzela care centres provide care for rape survivors and these centres are located in public hospitals that mostly have mental health institutions that are well equipped with mental healthcare practitioners to assist rape survivors. This study explored and described the perceptions of mental healthcare practitioners regarding the psychological management of rape survivors suffering from PTSD in the North West province in South Africa. The study used a qualitative exploratory, descriptive and contextual research design to explore and describe the perceptions of mental healthcare practitioners regarding the psychological management of rape survivors suffering from PTSD. Data were collected using the purposive sampling method among mental healthcare practitioners through focus group discussions. Tesch’s method was used to analyse perceptions obtained from the participants. Five themes emerged: barriers to the psychological management of PTSD, assessments confirming diagnosis of PTSD, the use of various psychotherapeutic interventions, psychopharmacological management, and the involvement of various stakeholders. Therefore, recommendation is made for the implementation of effective psychotherapies such as debriefing, supportive counselling, trauma-focused cognitive behavioural therapy, the provision of selective serotonin reuptake inhibitors, and brain working recursive therapy for the management of PTSD from post-rape experiences. Recommendations for the development of psychological management guidelines for rape survivors suffering from PTSD are also made for future research.

The challenges of caring for people living with HIV (PLWH) in a low-resource setting has had a negative impact on the nursing profession, resulting in a shortage of skilled nurses. In response to this shortage and perceived negative impact, we conducted a descriptive, cross-sectional study to describe the level of knowledge and psychosocial wellbeing of nurses caring for PLWH at a regional hospital in Limpopo Province, South Africa. A total of 233 nurses, the majority being female, participated and were stratified into professional nurses (n =108), enrolled nurses (n = 58) and enrolled nursing auxiliaries (n = 66). Data were collected using HIV/AIDS knowledge questionnaire, Maslach Burnout Inventory; AIDS Impact Scale and Beck's Depression Inventory. The total knowledge score obtained by all the participants ranged from 2 to 16, with an average of 12.93 (SD = 1.92) on HIV/AIDS knowledge. Depersonalization (D) (83.7%) and emotional exhaustion (EE) (53.2%) were reported among participating nurses caring for PLWH. Burnout was higher among professional nurses as compared to both enrolled nurses and enrolled nursing auxiliaries. There was a moderate negative significant correlation between HIV knowledge with the nurses' emotional exhaustion (r = 0.592), depression (r = 0.584) and stigma and discrimination (r = 0.637). A moderate to high level of burnout was evident among all levels of nurses. These findings lead to the recommendations for support of nurses caring for PLWH that include structured nursing educational support, organisational support with respect to employee wellness programmes that address depression and work burnout, as well as social support. The provision of these support mechanisms has the potential of creating a positive practice environment for nurses in the Vhembe District of the Limpopo Province in particular, and South Africa in general, and in improved care for PLWH.

Nursing is an occupation that is subjected to a high degree of stress. Stress had been seen as a predictor of the nature of care provided by nurses caring for people living with Human Immunodeficiency Virus (HIV) (PLWH). The purpose was to develop a conceptual model for establishment of Nurse-Environment-Patient Relationship in hospital setting. A descriptive, cross-sectional paper was conducted. The Maslach Burnout (MBI) and Beck’s Depression Inventories (BDI), and Acquired Immunodeficiency Syndrome (AIDS) impact scale was used to assess the impact of caring for PLWH among nurses. The paper adopted the assumptions of cognitivism and cognitive appraisal theory. Majority of nurses reported to suffer grief and loss and identification with their patients. A moderate to high level of burnout was marked. A conceptual model of psychosocial impact of caring for PLWH is a comprehensive model that projects the impact of caring for PLWH among nurses and a link between nurses, their working environment and p...

Report on Conference

Report on Conference

Nurses are faced with challenges regarding inadequate precautionary resources and the lack of support for occupational health practices still experienced in the clinical setting which expose them to the risk of contracting TB and HIV. Hence this study sought to investigate TB/HIV exposure among nursing students in the clinical practice environment. A cross-sectional descriptive design was used in this study. The study sample included nursing students from first to fourth year level from the School of Nursing Sciences at the North-West University who were purposively selected. A high percentage of nursing students reported that they have experienced a situation where they were afraid that they might have been infected with both TB and HIV. Awareness about post-exposure prophylaxis (PEP) was marked among the majority of nursing students. The uptake of PEP differed across junior and senior levels of nursing students. The results revealed that the higher the level of study, the greater the exposure. The lack of sufficient clinical support from nursing staff and preceptors had equally contributed to the exposure of nursing students to both HIV and TB, therefore, more support must be provided to nursing students.