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.

scholarly journals Nurses perceptions about their behavioural counselling for HIV/AIDS, STIs and TB in eThekwini Municipality clinics KwAZulu-Natal, South Africa

2017 ◽  
Vol 22 ◽  
Author(s):  
Margaret N. Mntlangula ◽  
Nelisiwe Khuzwayo ◽  
Myra Taylor
Keyword(s):  
South Africa ◽  
Cross Sectional Study ◽  
Hiv And Aids ◽  
Cross Sectional ◽  
Sexually Transmitted ◽  
Potential Barriers ◽  
Kwazulu Natal ◽  
Negative Perceptions ◽  
Nurses Perceptions ◽  
Quantitative Descriptive

Background: HIV and AIDS, sexually transmitted infections (STIs) and tuberculosis (TB) are common co-infections in South Africa, and constitute major public health problems. Nurses have frequent contact with HIV positive and TB co-infected patients, their counselling behaviour being influenced by knowledge about counselling as well as their beliefs, attitudes and perceptions about barriers to counselling.Purpose: The purpose of the survey was to assess the knowledge, attitude and beliefs of nurses about behavioural counselling for HIV and AIDS, STIs and TB (HAST) in three areas of the eThekwini Municipality.Results: This was a quantitative descriptive cross sectional study, with stratified sampling being used to select 87 nurses from 24 PHC facilities who completed self-administered questionnaires. The most significant factors associated with the knowledge, attitude and beliefs of nurses about counselling behaviour were their age and level of education. Nurses were well informed about counselling behaviour (mean scores 4.1/5). However, the potential barriers to implementing effective counselling behaviour included their negative perceptions about counselling in HAST.Conclusion: There is an urgent need for further studies to explore barriers to counselling behaviour and how these can be addressed by the nurses and their managers.

scholarly journals Factors Influencing Palliative Care Utilisation Among Patients With Cancer In Kwazulu-Natal, South Africa: A Cross-Sectional Study

2020 ◽  
Author(s):  
Minenhle S. Dlamini ◽  
Khumbulani W. Hlongwana ◽  
Siyabonga B. Dlamini ◽  
Themba G. Ginindza
Keyword(s):  
South Africa ◽  
Palliative Care ◽  
Cancer Patients ◽  
Cross Sectional ◽  
Middle Income ◽  
Middle Income Countries ◽  
Patients With Cancer ◽  
Awareness Campaigns ◽  
Factors Influencing ◽  
Kwazulu Natal

Abstract Background: Cancer remains a public health challenge in low-and-middle income countries (LMICs). Over 30% of those in need of palliative care (PC) worldwide suffer from cancer and 80% of patients with cancer in LMICs are diagnosed at advanced stages, by which time they can only benefit from PC services. The aim of this study was to determine factors influencing PC utilisation among patients with cancer in KwaZulu-Natal (KZN). Methods: A study was conducted among patients who had been diagnosed with different cancers and attending Inkosi Albert Luthuli Central Hospital, Addington Hospital, Pietermaritzburg Grey’s hospital, Msunduzi Hospice and Chatsworth Hospice, using cross-sectional mixed methods. A systematic random sampling technique was used to select the participants. Semi-structured questionnaires were administered to a total of 394 patients with cancer. The questionnaire included two open-ended questions and 59 closed-ended questions. Data from open-ended questions were manually coded and converted into themes, while the closed ended-questions were entered into the REDCap (v.8.11.7) and exported to Stata for analysis. Results: The mean (+SD) age of the 394 participants was 51.89 (+14.67) years and about 22.9% were within the 41–50 years age-group. The majority of participants were females (77.7%) and were unmarried (60.6%). Most of the participants’ racial classification was black (81.5%) and 64.5% had primary education. More than four-fifths (82.7%) were unemployed, 55.8% lived in urban areas and 24.6% had cervical cancer. The analysis of the two open-ended questions incorporated into the questionnaire revealed five major barriers preventing cancer patients from seeking PC services. These themes included lack of cancer knowledge, pursuit of alternative treatment options and long waiting periods at healthcare institutions. In addition, stigma and discrimination, lack of screening and diagnostic equipment and socio-economic barriers, contributed to the underutilisation of PC services by patients with cancer. Participants recommended that cancer awareness campaigns, healthcare services and continuous professional development (CPD) be improved.Conclusion: Cancer patients in low-to middle-income countries, such as South Africa, are still facing barriers to pursuing PC. Better education of the public could contribute to increased knowledge and awareness on cancer and PC services. Utilisation of PC could be maximised, thereby providing a better quality of life for the sufferers and their families until the end of life’s journey. The study also provides information that can be used to strengthen and/or to develop PC guidelines for addressing PC issues.

scholarly journals Health system challenges affecting HIV and tuberculosis integration at primary healthcare clinics in Durban, South Africa

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Dishiki Kalonji ◽  
Ozayr H. Mahomed
Keyword(s):  
South Africa ◽  
Primary Healthcare ◽  
Health Workers ◽  
Health Service Delivery ◽  
Cross Sectional Study ◽  
Integrated Model ◽  
Site Location ◽  
Cross Sectional ◽  
Staffing Ratios ◽  
Primary Healthcare Clinics

Background: Tuberculosis (TB) is the most common presenting illness among people living with human immunodeficiency virus (HIV), with co-infection occurring in up to 60% of cases in South Africa. In line with international guidelines, South Africa has adopted an integrated model at primary healthcare level to provide HIV and TB services by the same healthcare provider at the same visit.Aim: The aim of the study was to conduct a rapid appraisal of integration of HIV and TB services at primary healthcare level in eThekwini District in 2015.Setting: The study was conducted in 10 provincial primary healthcare clinics in the eThekwini Metropolitan Health District in KwaZulu-Natal Province.Methods: An observational, cross-sectional study was conducted. Key informant interviews with operational managers and community health workers were conducted, as well as a review of registers and electronic databases for the period of January to March 2015.Results: Two clinics complied with the mandated integrated model. Three clinics were partially integrated; while five clinics maintained the stand-alone model. Possible constraints included reorganisation of on-site location of services, drug provision, TB infection control and inadequate capacity building, while potential enablers comprised structural infrastructure, staffing ratios and stakeholder engagement.Conclusion: HIV and TB integration is suboptimal and will need to be improved by addressing the systemic challenges affecting health service delivery, including strengthening supervision, training and the implementation of a change management programme.

scholarly journals An assessment of nutritional status in children of rural, northern KwaZulu-Natal province

2020 ◽  
Vol 62 (1) ◽  
Author(s):  
Kelly R. Gate ◽  
Nompumelelo G. Mfeka-Nkabinde ◽  
Kantharuben Naidoo
Keyword(s):  
South Africa ◽  
Nutritional Status ◽  
Primary Healthcare ◽  
Metabolic Diseases ◽  
Cross Sectional Study ◽  
World Health ◽  
Cross Sectional ◽  
Healthcare Facilities ◽  
Childhood Malnutrition ◽  
Kwazulu Natal

Background: Childhood malnutrition in South Africa is largely perceived as one of undernutrition, with the opposite end of the spectrum (overnutrition) being evidenced in the increasing prevalence of childhood obesity, demonstrated to be associated with chronic metabolic diseases in adulthood. Targeting childhood malnutrition is a potential interventional strategy to prevent non-communicable diseases amongst adults. As the prevalence of malnutrition (undernutrition and overnutrition) in rural, northern KwaZulu-Natal province, South Africa, is largely unknown, this study aimed to determine the baseline nutritional status of children attending primary healthcare facilities within the Bethesda Hospital catchment area.Methods: This quantitative, cross-sectional study included children aged 6 weeks to 19 years, attending any primary healthcare clinics for over a 3 months period. Anthropometric measurements were obtained to categorise the children according to the World Health Organisation’s (WHO) nutritional classifications.Results: Stunting in children aged less than 5 years was found to be lower (14%) than nationally representative studies (27%); however, 14.4% of the infants aged 6 weeks to 5 months were overweight, increasing to 32.3% in those aged 14–19 years. Males in the 6-weeks to 5-month age group were more likely to be overweight/obese and stunted than females in the same age group.Conclusion: Undernutrition is showing a downward trend, which is a testament to initiatives to reduce food insecurity amongst the poor. However, the emerging upward trend of overweight/obesity in children of all ages, indicates the need to have a national discussion on over- and undernutrition, its causes and implications.

scholarly journals Factors Influencing Rapid Antiretroviral Therapy Initiation at Four eThekwini Clinics, KwaZulu-Natal, South Africa

2021 ◽  
Author(s):  
Sabina M. Govere ◽  
Chester Kalinda ◽  
Moses J. Chimbari
Keyword(s):  
South Africa ◽  
Antiretroviral Therapy ◽  
Cross Sectional Study ◽  
Hiv Diagnosis ◽  
Cross Sectional ◽  
Art Initiation ◽  
Factors Influencing ◽  
Universal Test And Treat ◽  
Kwazulu Natal ◽  
Major Factors

AbstractTimely uptake of Antiretroviral therapy considerably improves the health of people living with the Human Immunodeficiency virus. We conducted a cross-sectional study of newly HIV diagnosed individuals in four clinics in eThekwini municipality, KwaZulu-Natal. Data was collected between June 2020 and December 2020. Participants completed an interviewer-administered questionnaire after HIV testing, on the day of HIV diagnosis. We evaluated factors influencing uptake of same-day ART initiation in eThekwini clinics, KwaZulu Natal, South Africa. Demographic information, health status, sexual behaviour, knowledge of universal test and treat (UTT), ART initiation uptake, and disclosure data was collected. Among the 403 participants, same-day initiation (SDI) was 69.2% (n = 279). We observed the number of sexual partners (aOR 0.35; 95% CI 0.15–0.81), HIV status of the partner (aOR 5.03; 95% CI 2.74–9.26) and knowledge of UTT (aOR 1.97; 95% CI 1.34–2.90) were identified as major factors influencing uptake of same-day ART initiation. More strategies are needed to achieve the SDI uptake within the framework of UTT.

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.

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