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Background: Theatre involves expressing meaning in a collaborative art using words, movements, and visual elements. However, theatre remains poorly used as a viable teaching strategy or a method for communicating health messages. Instead, it is relegated to solemnly transmitting indigenous knowledge. Aim: To explore and describe communication of educational health messages through theatre using an appreciative inquiry approach. Setting: The study was conducted among the Ubuntu theatre group from a rural province in South Africa. The group is famous for using theatre to communicate educational health messages through the lens of Ubuntu philosophy. Methods: A qualitative exploratory descriptive design was followed. A non-probability purposive sampling was used to select thirteen members of the Ubuntu theatre group. Data were collected by two moderators from the two focus group discussions through conference calls. Deductive thematic content data analysis was used to describe the 4-Ds of appreciative inquiry. Results: Theatre is a playful pedagogy that can cut through language and cultural barriers when used to communicate educational health messages. There is a need to formalise it as an alternative pedagogy within the health care sciences curriculum. Furthermore, the sustainability of theatre as an educational tool is dependent on expanding educational practices, documenting its success stories and periodical in-service training. Conclusion: Using Ubuntu innovation to communicate complex educational health messages through theatre can maximise learning. This study recommends that Ubuntu-infused health messages be conveyed using theatre. Contribution: The study adds to the body of knowledge by presenting Ubuntu innovation in communicating health messages through theatre.

Abstract Background South Africa is reporting higher rates of adolescent pregnancy as compared to other countries. There are different types of interventions that are in place to address teenage pregnancy. However, these interventions were developed using top-down strategy without the inclusion of different stakeholders and adolescents which makes it hard to implement those interventions particularly in countries like South Africa. Hence, this study aimed to develop strategies to enhance sexual health education for prevention of teenage pregnancy in Vhembe District, Limpopo Province of South Africa. Methods The research design of this study will be Co-operative Inquiry.The study will take place in Vhembe District in Limpopo province of South Africa through collaborating with a Non-governmental Organisation (NGO). The study population will be the teenagers and all the different stakeholders caring for teenagers in their areas of specialization. Purposive sampling will be used to sample the targeted participants of the study. The data collection method will be done in phases and focus group discussions will be used to collect data. Content analysis will be used to analyse data. Discussion This study will add to the body of knowledge regarding the strategies that maybe used to enhance sexual health education for prevention of teenage pregnancy.

Background: Participation of male partners in antenatal care (ANC) is a complicated process that involves social and behavioural transformation. It necessitates that males take a more active part in reproductive health. Men’s participation in prenatal care has been linked to beneficial health outcomes such as enhanced maternal health outcomes across the world. However, culture has been identified as a barrier to male partners’ participation in prenatal care. Aim: The aim of the study was to explore and describe the cultural barriers to male partner involvement in ANC. Setting: The study focussed on selected clinics and hospitals under Vhembe District, Limpopo province. Methods: Qualitative, exploratory, descriptive, and contextual research design was used in this study. Qualitative data were collected through individual semi-structured interviews and Focus Group Discussions (FGDs). A thematic analysis approach was used to analyse the collected data from semi-structured interviews and FGDs. Results: The findings revealed three themes: cultural beliefs and practices that affect male partners’ involvement in ANC; gender-related barriers that affect male partners’ involvement in ANC; and socioeconomic barriers to male partners’ involvement in ANC. Conclusion: The study’s findings revealed that certain cultural beliefs and practices are a stumbling block to male partners’ involvement in antenatal healthcare. Contribution: Culturally based developed strategy might help in improving the knowledge and practices of male partners in ANC.

Ubuntu is an ancient concept and a way of life among most African cultures. It describes the fundamental principles of living for African communities and is rooted in the values of reciprocal sharing. Ubuntu encompasses the whole community in contrast to the Western ideology of individualism and hence the need to sustain and transmit these values from one generation to the next. The study focused on exploring the experiences of high school learners regarding Ubuntu education and training in South Africa. The study was conducted in two selected high schools in the Greater Giyani Municipality of the Limpopo Province. A qualitative research approach and an exploratory, descriptive design were applied. A purposive sampling method was used to identify 15 learners from the two selected high schools for the Boot Camp. Focus group discussions (FGDs) were conducted as a data collection method among the grade 10 and 11 learners. Trustworthiness and ethical consideration were ensured. The findings from the study revealed that learners shared different experiences during the Boot Camp. One of the experiences shared by the learners is the knowledge gained on applying the concept of the theology of the body to Ubuntu values. Internalisation of Ubuntu values forms an essential landmark in the individual’s life, significantly young people growing up within African communities rooted in African culture. Contribution: This study’s findings will help educate young people about Ubuntu’s philosophies and encourage them to disseminate information regarding Ubuntu within their respective schools and communities.

Background: Traditional health practitioners (THPs) play an important role in communities by providing necessary health services for a variety of health problems. Possessing complementary biomedical knowledge and skills is vital in saving lives of patients. However, less is known about biomedical knowledge and skills among THPs. Aim: This study aimed to explore and describe the training needs of THPs on biomedical knowledge and skills in urban townships in South Africa. Setting: The study was conducted in a township in the City of Tshwane Metropolitan Municipality of Gauteng province, South Africa. Methods: A qualitative, explorative, descriptive design with 18 THPs was employed through snowballing sampling. Data were collected through a lekgotla group discussion and thematic content analysis undertaken. Results: Themes that emanated include knowledge of the basic physiological functioning of the human body; biomedical knowledge and skills required for the assessment of patients; managing emergency health conditions and understanding diagnostic concepts used in traditional health practice versus biomedical systems. Conclusion: Traditional health practitioners have demonstrated interest in being trained on certain skills used within the biomedical system to care for patients. Performing the necessary first-aid skills by THPs will assist patients in the communities while waiting for emergency services or referrals. Provision of training programmes for THPs on first aid interventions during emergencies is therefore recommended. Contribution: The study revealed that capacitating THPs with biomedical knowledge and skills can improve their ability to promote healthy living and prevent health problems in communities where access to resources is limited.

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Introduction Younger professional nurses are the future of the nursing profession and they receive the baton from older and retired nurses to continue the profession in good light. Ubuntu is an African philosophy that is embedded in caring ethics and it is viewed as a core value of the nursing profession and is highly valued by older nurses. Objective We explored the perceptions of retired nurses on factors that prevent younger professional nurses from applying the ethos of Ubuntu in professional care. Methods In this study, we explored the factors that prevent younger professional nurses from applying the ethos of Ubuntu in professional care. In this qualitative explorative study, data were collected during focus group discussions in a workshop held with 40 retired nurses in a province in South Africa. The transcripts were analyzed following the six steps outlined by Braun and Clarke (2006). Results Based on the perceptions of the retired nurses two main themes emerged as factors that prevent the younger professional nurses from applying the ethos of Ubuntu in their professional practice; 1) Motivation to practice Ubuntu in nursing, 2) Lack of political will to recognize nursing. Conclusion Retired nurses felt that Ubuntu could be applied in nursing care if these factors are addressed by both nurses and stakeholders.

Background: Caregivers are offered health information on neonatal care before they are discharged from the healthcare facilities after giving birth. However, they continue to feed and bath neonates in ways that are informed by indigenous traditions. Notably, these ways include the provision of supplementary feeds before 6 months and bathing the neonate as early as possible, which are practices that contradict the World Health Organization (WHO) recommendations of neonatal care. Objectives: This study aimed to explore and describe the indigenous neonatal feeding and bathing practices of caregivers in Vhembe District, Limpopo province. Setting: This study was conducted in Limpopo province at Vhembe District, Makhado Municipality. Methodology: A qualitative, explorative and descriptive enquiry was used to conduct 18 semi-structured individual interviews to explore and describe their indigenous neonatal feeding and bathing practices. Purposive and snowball sampling methods were used to select participants. Creswell’s method of data analysis was used to analyse data. Ethical principles were maintained. Results: Two themes with sub-themes resulted from data analysis presenting indigenous neonatal feeding practices and indigenous neonatal bathing practices. Conclusion: This study revealed that caregivers use indigenous neonatal feeding and bathing practices across age groups and social standing. Younger mothers receive guidance from older women in their families or community. Midwives should know the indigenous neonatal feeding and bathing practices of the communities they serve to offer relevant culture-sensitive health education. Contributions: This study contributes to the creation of knowledge about indigenous neonatal care practices amongst mothers and caregivers.

Background: South African maternity care guidelines stipulate that post-natal patients can be discharged within 6 h after delivery, provided that the condition of mothers and neonates do not require medical, surgical or obstetric attention. Hence in many instances post-natal care is rendered at home by traditional birth attendants (TBAs). Traditional birth attendants play a crucial role in the care of women during pregnancy, birth and puerperium within communities. Aim: To explore and describe the experiences of TBAs during the provision of post-natal care to mothers and their neonates in order to make recommendations to improve the quality of post-natal care delivered at home. Setting: The community hall of a selected rural traditional community was used as a setting for data collection. Methods: A qualitative, exploratory and descriptive design was used. Three focus groups were held with 26 TBAs whom were purposively selected. Data were analysed using qualitative content analysis. Results: The study confirmed two categories that included: lack of supportive working relationships between TBAs and midwives and lack of respect of TBAs, by post-natal women. Conclusion: It is evident that the TBAs experienced negative experiences. Therefore, initiation of teamwork, empowerment and confidence development are crucial to improve the working experiences of TBAs during the provision of post-natal care. Quality post-natal care might reduce maternal and neonatal morbidity and mortality rates. Teamwork between TBAs and midwives might be initiated. Continuity of care for post-natal women might be improved.

Background: South Africa was caught off guard by the student unrest in 2015 and 2016. This unrest was named the #fees must fall campaign. During this campaign, students raised the issue of decolonisation of the curriculum, challenging the higher education fraternity and the academic community. This was based on the fact that the existing curriculum has inadequate content on African traditional indigenous knowledge (ATIK), and continues to use the Western approach to address the needs of a multicultural, multiracial and multi-ethnic societies. Institutions responded by initiating dialogues regarding decolonisation of the curriculum in senates, scholars and between different health professional bodies. Aim: This article aimed to explore and describe the perspectives of nursing students regarding incorporating ATIK into the curriculum. Methods: Using a participatory transformative approach, researchers and participants worked collaboratively to inform social change. Participants comprised nursing students. The academics, traditional health practitioners, indigenous knowledge holders and primary health care nurses formed the panellists. Data were collected through one communal dialogue workshop, which lasted for 8 hours, tea and lunch included. Data were analysed thematically. Results: Students’ perspectives emerged strongly as four themes, namely, politics of identity, displacement and distortion, curriculum content and institutional resistance. Students expressed that the current education system results in an identity crisis. The existing curriculum does not adequately convey an understanding of ATIK; it is displaced and distorted. Conclusion: Nursing science has great potential to incorporate the wealth of ATIK into its curriculum. In spite of a vibrant and rich cultural heritage, the ATIK specific to nursing sciences still needs to be incorporated into the existing curriculum in a responsive and relevant manner.

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.

Background: Despite progress made by other countries worldwide in achieving Millennium Development Goals (MDGs) 4, 5 and 6, South Africa is experiencing a challenge in attaining positive outcomes for these goals. Objective and setting: To describe the challenges experienced by South Africa regarding the successful implementation of MDGs 4, 5 and 6. Methods: An integrative literature review was used to identify and synthesise various streams of literature on the challenges experienced by South Africa in attaining MDGs 4, 5 and 6. Results: The integrative review revealed the following themes: (1) interventions related to child mortality reduction, (2) implementation of maternal mortality reduction strategies, and (3) identified barriers to zero HIV and TB infections and management. Conclusion: It is recommended that poverty relief mechanisms be intensified to improve the socio-economic status of women. There is a need for sectoral planning towards maternal health, and training of healthcare workers should emphasise the reduction of maternal deaths. Programmes addressing the reduction of maternal and child mortality rates, HIV, STIs and TB need to be put in place. Keywords: Millennium Development Goals; maternal and child morbidity and mortality; HIV and AIDS; STI and TB

Background: The majority of South African aging population are women, who spend late adulthood experiencing natural menopause. Despite the government spending billions of rand on different services for ageing women, menopausal challenges to African women still receive little attention. Objectives: The aim of the study was to explore and describe the perceptions of African women regarding natural menopause, in order to propose recommendations for health and social support systems for women in Mamelodi, Tshwane district. Method: A qualitative, exploratory, descriptive and contextual design was used to conduct the study. The population of the study consisted of menopausal women, between the ages 45 and 60 years or more, visiting the clinics for collection of chronic medication and othe rhealth assessment. Individual face-to-face interviews were conducted, using a semi-structured interview guide to collect data. Tesch’s method of qualitative data analysis was used in the study. Results: The main theme that emerged from the study was ‘attitude toward menopause’, which was supported by cultural beliefs and experience. The African menopausal women expressed the importance of health support systems that will meet their needs within their context. Conclusion: Women’s health programs and educational health information at facilities should include menopausal education to promote and improve health of all African menopausal women during their adulthood. There is a need to establish a women’s health support group network within communities to share menopausal experiences with peers. The training and education curriculum of healthcare providers should include detailed menopause in order to provide comprehensive, congruent care.

Background: Proverbs and idioms represent cultural and societal beliefs and values inherited from the forefathers. An example is lebitla la mosadi ke bogadi. Over many decades African people have used such ancient instructions to counsel women to be resilient in their marriages thus impacting on their mental health. Objective: The purpose of this article was to explore and describe that proverb and its impact on women’s mental health. Method: Hermeneutic phenomenology was used to explore and describe the prover band its impact on indigenous women’s mental health. The population included married, divorced, widowed and single women who were attending social clubs or networks in the cities of Tshwane and Johannesburg. Snowball and purposive sampling was used to select 57 participants. Five face-to-face interviews and eight focus groups interviews were conducted. Colaizzi’s data analysis method was used to analyse data. Results: Oppression and stigmatisation of women and their families and harmful effects that may result in death were identified as having an impact on women’s mental health. Some women shared that they were oppressed in many ways. In addition, they feared stigmatisation should they wish to divorce. They constantly lived in fear of being harmed or killed by their spouses. Conclusion: There was a need for nurses to develop awareness regarding cultural issues so that women are better served in primary healthcare settings. Women who are suspected of experiencing abuse, should be screened for abuse so that they can be assisted accordingly.

The aim of this study was to explore and describe the perceptions of nurses regarding the implementation of the occupation-specific dispensation (OSD) in a selected nursing college in Limpopo province. A qualitative approach was used with a purposive sampling method for the selection of 12 voluntary participants who had worked for more than five years and been subjected to the implementation of OSD. In-depth interviews were conducted and data analysed according to Tesch's method. The perceptions of nurse educators were shared through participants' responses to a central research question. Participants expressed different responses, both positive and negative. The findings of this study demonstrated: high expectations, unfair treatment in relation to the implementation, and reactions to introduction of OSD. Participants also identified envisaged ways of improving the situation through the identification of ways to correct the problems. This study recommended that management ensure that nurse educators' remuneration packages are competitive with those of similar professions in the clinical setting. Recognition of nurse educators' additional qualifications, long-service experiences and rural allowance reviews in nursing education should be taken into consideration urgently.

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 postnatalcare practices. Tesch’s 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.

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

Background: Child-rearing remains a concern within our communities, especially because families of today lack primary parents due to multifaceted challenges such as working mothers, diseases and violence. Health-promoting school initiatives are necessary because they allow a multifaceted approach to child-rearing. They further provide a conducive environment for continued schoolchild-rearing moving from home to school.Objectives: This study promotes an integrated approach to school care using the African concept of Ubuntu – solidarity and sense of community – as a point of departure. The socio-ecological model was used, which includes the work of the school healthcare nurse in contributing to holistic health services.Method: An integrative review was conducted in January 2013, which included methodology studies, a theory review and a variety of studies related to school health. The studies were categorised according to school health, Ubuntu and the socio-ecological model.Findings: The role of school healthcare nurses entails acting as a liaison officer between a variety of stakeholders who work together to shape the future of children.Conclusion: Ubuntu, together with the socio-ecological model, can assist us to involve an entire community to raise children. This knowledge serves as a background to the planning of a school health programme. The role of the nurse in school health can also assist in collaborative efforts to formulate the programme and develop the competencies that will inform school health nurse training curricula.