scholarly journals Exploring the mechanism through which a child-friendly storybook addresses barriers to child-participation during HIV care in primary healthcare settings in KwaZulu-Natal, South Africa

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chipo Mutambo ◽  
Kemist Shumba ◽  
Khumbulani W. Hlongwana
Keyword(s):  
South Africa ◽  
Primary Healthcare ◽  
Hiv Care ◽  
Care Process ◽  
Analysis Method ◽  
Child Participation ◽  
Job Aids ◽  
Effective Manner ◽  
Kwazulu Natal ◽  
Depth Interviews

Abstract Background Healthcare workers (HCWs) in South Africa widely use job-aids as practical tools to enhance the provision of HIV services, thereby improving patient-provider interactions during the care process. Job-aids are visual support materials that provide appropriate information using graphics and words in a simple and yet effective manner. We explored the mechanism through the KidzAlive Talk tool storybook (Talk tool), a child-centred job-aid for HCWs that facilitates child-participation during HIV consultations in primary healthcare (PHC) clinics implementing the KidzAlive model. Methods The study was conducted in PHC clinics across four districts; namely: uMkhanyakude, Zululand, uMgungundlovu, and eThekwini in KwaZulu-Natal (KZN), South Africa. We conducted in-depth interviews with children (n = 30), their primary caregivers (PCGs) (n = 30), and KidzAlive trained and mentored HCWs (n = 20). Data were collected in both English and isiZulu languages through user-specific, structured in-depth interviews. All the interviews were audio-recorded (with participants’ assent and consent, respectively). Data were transcribed verbatim, prior to translating the isiZulu transcripts to English. Translations were done by a member of the research team competent in both languages. Electronic data were imported to NVivo 10 for analysis and subsequently analysed using a thematic analysis method followed by a constant comparative and modified grounded theory analysis method. Results The findings identified the following barriers to child-participation: Primary caregiver limiting the child’s involvement due to fear of traumatising them; HCWs’ limited knowledge and skills to deliver child-centred HIV care; childhood developmental stage-related limitations and healthcare institutional paternalism. The Talk tool addresses the above barriers by using simple language and terminology to cater for children at various stages of development; alleviating HCWs’ and PCGs’ fear of possible psychological harm to the child; using storytelling and colourful cartoon illustrations for child edutainment; Being versatile by allowing for multiple utility and tackling institutional paternalism that limit child-involvement in the process of care. Conclusions This study provided evidence on how the Talk tool storybook addresses barriers to child-participation in the HIV care process. The evidence generated from this study is compelling enough to recommend the scale-up of this innovation in low-resource settings.

scholarly journals Social and Demographic Factors Associated with Postnatal Depression Symptoms among HIV-Positive Women in Primary Healthcare Facilities, South Africa

Healthcare ◽  
2021 ◽  
Vol 9 (1) ◽  
pp. 65
Author(s):  
Kebogile Elizabeth Mokwena ◽  
Nontokozo Lilian Mbatha
Keyword(s):  
South Africa ◽  
Primary Healthcare ◽  
Postnatal Depression ◽  
Hiv Positive ◽  
P Value ◽  
Depression Symptoms ◽  
Healthcare Facilities ◽  
Factors Associated ◽  
Hiv Positive Women ◽  
Kwazulu Natal

Background: Mothers living with HIV are at risk for mental health problems, which may have a negative impact on the management of their HIV condition and care of their children. Although South Africa has a high prevalence of HIV, there is a dearth of studies on sociodemographic predictors of postnatal depression (PND) among HIV-positive women in South Africa, even in KwaZulu Natal, a province with the highest prevalence of HIV in the country. Objective: The objective of the study was to determine sociodemographic factors associated with the prevalence of postnatal depression symptoms among a sample of HIV-positive women attending health services from primary healthcare facilities in Umhlathuze District, KwaZulu Natal. Methods: A quantitative cross-sectional survey was used to collect data from 386 HIV-positive women who had infants aged between 1 and 12 weeks. The Edinburgh Postnatal Depression Scale (EPNDS), to which sociodemographic questions were added, was used to collect data. Results: The prevalence of PND symptoms among this sample of 386 HIV-positive women was 42.5%. The age of the mothers ranged from 16 to 42 years, with a mean of 29 years. The majority of the mothers were single or never married (85.5%; n = 330), living in a rural setting (81.9%; n = 316%), with a household income of less than R 2000 (estimated 125 USD) per month (64.9%; n = 120). The government child support grant was the main source of income for most of the mothers (53%; n = 183). PND symptoms were significantly associated with the participant’s partner having other sexual partners (p-value < 0.001), adverse life events (p-value = 0.001), low monthly income (p-value = 0.015), and being financially dependent on others (p-value = 0.023). Conclusion: The prevalence of PND symptoms among the sample is high, with a number of social and demographic factors found to be significantly associated with PND. This requires the consideration of sociodemographic information in the overall management of both HIV and postnatal depression. Addressing the impact of these factors can positively influence the health outcomes of both the mother and the baby.

scholarly journals High incidence and persistence of hepatitis B virus infection in individuals receiving HIV care in KwaZulu-Natal, South Africa

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Nokukhanya Msomi ◽  
Kogieleum Naidoo ◽  
Nonhlanhla Yende-Zuma ◽  
Nesri Padayatchi ◽  
Kerusha Govender ◽  
...  
Keyword(s):  
South Africa ◽  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Hbv Infection ◽  
Hiv Care ◽  
Care Provision ◽  
Hbsag Positivity ◽  
Kwazulu Natal ◽  
B Virus ◽  
Clinical Records

Abstract Background Hepatitis B virus (HBV), Human Immunodeficiency virus (HIV) and Tuberculosis (TB) are common infections in South Africa. We utilized the opportunity of care provision for HIV-TB co-infected patients to better understand the relationship between these coinfections, determine the magnitude of the problem, and identify risk factors for HBV infection in HIV infected patients with and without TB in KwaZulu-Natal, South Africa. Methods This retrospective cohort analysis was undertaken in 2018. In-care HIV infected patients were included in the analysis. Results from clinical records were analysed to determine the prevalence, incidence, persistence and factors associated with HBsAg positivity in HIV-infected patients with or without TB co-infection. Results A total of 4292 HIV-infected patients with a mean age of 34.7 years (SD: 8.8) were included. Based on HBsAg positivity, the prevalence of HBV was 8.5% (363/4292) [95% confidence interval (CI): 7.7–9.3] at baseline and 9.4% (95%CI: 8.6–10.3%) at end of follow-up. The HBV incidence rate was 2.1/100 person-years (p-y). Risk of incident HBV infection was two-fold higher among male patients (HR 2.11; 95% CI: 1.14–3.92), while severe immunosuppression was associated with a greater than two-fold higher risk of persistent infection (adjusted risk ratio (RR) 2.54; 95% CI 1.06–6.14; p = 0.004. Additionally, active TB at enrolment was associated with a two-fold higher risk of incident HBV infection (aHR 2.38; 95% CI: 0.77–7.35). Conclusion The provision of HIV care and treatment in high HBV burden settings provide a missed opportunity for HBV screening, immunization and care provision.

scholarly journals The perceived role of ward-based primary healthcare outreach teams in rural KwaZulu-Natal, South Africa

2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Landiwe S. Khuzwayo ◽  
Mosa Moshabela
Keyword(s):  
South Africa ◽  
Primary Healthcare ◽  
Sampling Technique ◽  
Limited Information ◽  
Chronic Patients ◽  
Group Discussions ◽  
Healthcare Facilities ◽  
User Perceptions ◽  
Kwazulu Natal

Background: The aim of ward-based outreach teams (WBOTs) is to improve access to primary healthcare (PHC) services including health promotion and disease prevention in South Africa. Limited information is available in South Africa on user perceptions of services provided by WBOTs in rural households.Aim: The study aimed to explore community awareness and perception of WBOTs, as well people’s motivation to engage and use WBOT services.Setting: The study was conducted between July and September 2015 in iLembe district, KwaZulu-Natal.Methods: This was exploratory-descriptive qualitative research. Purposive sampling technique was used in this study. A total of 16 key informant interviews and 4 focus group discussions were conducted. The voice recordings were transcribed in isiZulu and translated into English.Results: Four themes emerged from the data analysis, namely bringing services closer, organising services, expanding services and forming bridges. Respondents demonstrated insightful knowledge and understanding of services provided by WBOTs. They expressed an appreciation of the way WBOT services brought healthcare closer to people and serve to bridge the gap between the community and local healthcare facilities. Respondents identified unclear WBOT work schedules and the failure to carry medication other than vitamin A as the main challenges. However, WBOTs did deliver medication for controlled chronic patients in their households.Conclusion: The study suggests that WBOTs provide a commendable service, but need to expand their service package to further increase access to PHC services and cater for community health needs.

Continuum in HIV care from entry to ART initiation in rural KwaZulu-Natal, South Africa

2014 ◽  
Vol 19 (6) ◽  
pp. 680-689 ◽  
Author(s):  
Mélanie Plazy ◽  
Rosemary Dray-Spira ◽  
Joanna Orne-Gliemann ◽  
François Dabis ◽  
Marie-Louise Newell
Keyword(s):  
South Africa ◽  
Hiv Care ◽  
Art Initiation ◽  
Kwazulu Natal

scholarly journals A semiotic investigation of the graphic imagery by pioneer tattoo artists in KwaZulu-Natal with special reference to the Ramesar brothers

2018 ◽  
Author(s):  
◽  
Rory Van As
Keyword(s):  
South Africa ◽  
Literature Review ◽  
Special Reference ◽  
Empirical Data ◽  
Visual Semiotics ◽  
Kwazulu Natal ◽  
Personal Experiences ◽  
History Of ◽  
Communication Practices ◽  
Depth Interviews

This study focuses on the graphic imagery of tattoo artists in KwaZulu-­‐Natal with special reference to the Ramesar brothers. Various visual communication practices and theories are drawn upon to explain the imagery created by them. The literature review chapters of this study cover a brief history of primarily Western tattooing practices, as well as a discussion of the meaning of tattoos from a visual semiotics perspective. The fieldwork component of the study involved conducting and analysing a series of qualitative in-­‐depth interviews with interviewees who were either tattooed by, or are family members of, the Ramesar brothers. The purpose of the interviews was to explore the personal experiences and motivations that contributed to the work of these tattoo artists. The study contributes to visual studies in South Africa in the sense that the empirical data confirm the pioneer status of the Ramesar brothers as graphic artists.

scholarly journals Obstetric outcomes and antenatal access among adolescent pregnancies in Kwazulu-Natal, South Africa

2018 ◽  
Vol 60 (1) ◽  
pp. 45
Author(s):  
Trishka Govender ◽  
P Reddy ◽  
S Ghuman
Keyword(s):  
South Africa ◽  
Low Birthweight ◽  
District Hospital ◽  
Qualitative Interviews ◽  
North Coast ◽  
Obstetric Outcomes ◽  
Financial Barriers ◽  
Kwazulu Natal ◽  
Adolescent Pregnancies ◽  
Depth Interviews

Background: Pregnancy among adolescents in South Africa is a growing concern as it may be associated with adverse socioeconomic and health impacts. Timeous initiation and optimal utilisation of antenatal care (ANC) services is imperative to ensure positive pregnancy outcomes. However, this is not always possible owing to various challenges. Methods: A multi-method study design using both retrospective record review and qualitative interviews was undertaken at a district hospital on the North Coast of KwaZulu-Natal, South Africa. Data on ANC attendance trends and obstetric/perinatal outcomes for all recorded adolescent pregnancies (13–16 years) at the district hospital under study was collected over 3 years (2011–2013) (n = 314). Qualitative interviews with randomly selected pregnant adolescents were conducted to assess experiences of ANC access and utilisation. Results: Late ANC booking and reduced ANC visits were common for adolescent pregnancies. Under-utilisation of ANC (i.e. less than 4 visits) was significantly associated with lower gestational age (< 37 weeks) (OR = 2.64; 95% CI = 1.04; 6.74; p < 0.05). Low birthweight, low Apgar scores as well as the incidence of maternal anaemia and pregnancy-induced hypertension (PIH) were found to be related to late ANC booking. In-depth interviews suggested that teenagers suffered emotional vulnerability linked to family, partner and financial support. They discussed various barriers linked with accessing ANC while acknowledging perceived benefits. Conclusion: Adolescent pregnancy was associated with late booking and reduced ANC visits, which was a risk for adverse maternal health outcomes. In-depth interviews suggested numerous challenges associated with ANC access including; financial barriers, attitude of healthcare workers (HCWs), long queues, distance travelled to access ANC services, human immunodeficiency virus (HIV) status and a lack of knowledge. (Full text of the research articles are available online at www.medpharm.tandfonline.com/ojfp) S Afr Fam Pract 2017; DOI: 10.1080/20786190.2017.133378

scholarly journals Factors Influencing Patient Experience in Primary Healthcare Clinics within the eThekwini Municipality in KwaZulu-Natal

2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Hope Padayachee ◽  
Emmanuel Mutambara
Keyword(s):  
South Africa ◽  
Patient Experience ◽  
Primary Healthcare ◽  
Cross Sectional ◽  
Factors Influencing ◽  
Healthcare Evaluation ◽  
Kwazulu Natal ◽  
Experience Education ◽  
Quantitative Descriptive ◽  
Primary Healthcare Clinics

Patient experience is seen as a fundamental measure for healthcare evaluation, which fuels the debate regarding the most relevant factors influencing patient experience. Limited empirical knowledge exists concerning the factors that influence patient experience from the users’ perspective in South Africa. This study addresses the research gap by determining the factors influencing patient experience among primary healthcare users in Waterloo, Grove-End and Stonebridge communities in the eThekwini Municipality of KwaZulu-Natal. The study is quantitative, descriptive and cross-sectional, and utilises a self-administered questionnaire that was distributed among 280 primary healthcare users. They strongly agreed (> 90%) that all the factors presented in the study are contributors to their patient experience. The factor analysis determined the relevance of the factors as perceived by the respondents. It was found that the doctor’s role (0.970), clinic cleanliness (0.943), coordination and continuity of care (0.943), and waiting time (0.914) are the most significant influencers of patient experience. Education (0.898), nurses (0.882), medication (0.854) and the quality of care (0.853) serve as moderate influencers. Access (0.745), family/friend involvement (0.722) and the physical state of the infrastructure (0.714) are mild influencers of patient experience. Patient-centred care (0.639), management effectiveness (0.637), communication (0.596) and information (0.443) were non-influencers of patient experience. User experience is multifaceted and each factor represents a varying level of influence. It is recommended that a patient-experience framework should be developed that can be linked to improvement initiatives within South Africa in an effort to support quality improvement.

Sign in / Sign up

Export Citation Format

Share Document