scholarly journals The Consequences of Delaying Telling Children with Perinatal HIV About Their Diagnosis as Perceived by Healthcare Workers in the Eastern Cape; A Qualitative Study

Children ◽  
2020 ◽  
Vol 7 (12) ◽  
pp. 289
Author(s):  
Sphiwe Madiba ◽  
Cynthia Diko
Keyword(s):  
Healthcare Workers ◽  
Psychosocial Health ◽  
Eastern Cape ◽  
Hiv Diagnosis ◽  
Group Discussions ◽  
Perinatal Hiv ◽  
African Health ◽  
Negative Impacts ◽  
Delayed Disclosure ◽  
Main Barrier

Although the benefits of disclosure are considerable, informing children with perinatal HIV of their own HIV status is often delayed to late adolescence. This study examined the social and contextual challenges that influence delaying disclosure to children and assessed the outcomes of delayed disclosure on the psychosocial health of children as perceived by the healthcare workers (HCWs) providing care to these children. Data were collected from HCWs via focus group discussions. Nurses, lay counsellors, social workers, and dieticians were selected from facilities in a rural South African health district. Thematic analysis was performed. The caregivers’ social context was the main barrier against informing children timely about their HIV diagnosis. The extent of the internalised HIV stigma influenced the delay in disclosing to the children. Delaying disclosure contributes to children’s refusing to take their medication, leads to the accidental disclosure of HIV, give rise to anger and resentment towards the caregiver, increase the risk of secondary transmitting of HIV, and poor health outcomes. It is essential to train HCWs to support caregivers and children through the disclosure process to ensure that caregivers realise the benefits of disclosure. Strategies to encourage caregivers to disclose early should be sensitive to their concerns about the negative impacts of disclosure.

scholarly journals Telling Children with Perinatal HIV About Their HIV Serostatus: Healthcare Workers’ Practices and Barriers to Disclosing in a South African Rural Health District

2021 ◽  
Vol 12 ◽  
pp. 215013272098475
Author(s):  
Sphiwe Madiba ◽  
Cynthia Diko
Keyword(s):  
South African ◽  
Healthcare Workers ◽  
Health Facilities ◽  
Health District ◽  
Local Context ◽  
Group Discussions ◽  
Perinatal Hiv ◽  
Qualitative Thematic Analysis ◽  
African Health ◽  
Hiv Serostatus

In South Africa, caregivers and healthcare workers (HCWs) lack confidence and skills to disclose to children with perinatal HIV (PHIV). Moreover, existing disclosure guidelines do not provide strategies on how to approach disclosure. Although the caregiver has been endorsed as a responsible person to disclose to the child, the involvement of HCWs in the process is critical. Yet research suggests that many HCWs are reluctant to perform disclosure. This study examines the involvement in, practices of, and barriers against HCWs’ disclosing to children with PHIV. Methods: We conducted 8 focus group discussions with a total of 51 HCWs comprising nurses, lay counsellors, social workers, and dieticians. The HCWs were selected from 23 health facilities in a rural South African health district by purposive sampling. Data were transcribed verbatim, and data analysis followed qualitative thematic analysis. Results: A high proportion of HCWs had no formal training in pediatric disclosure and some had never disclosed to children. Those who routinely disclosed approached disclosure as an ongoing process that unfolded over time. They ensured caregiver readiness as a necessary step in the disclosure process. The main barriers for HCWs to participate fully in the disclosure process were the lack of relevant disclosure guidelines, inadequate disclosure skills, and a shortage of skilled staff. Inadequate skills affected the confidence of the HCWs to disclose, while a lack of standardized disclosure guidelines and HCWs’ reliance on personal experience during disclosure resulted in confusion and uncertainty among them due to the inconsistencies in their approach to disclosure. Conclusion: This study confirms the urgent need to train HCWs to attain skills and confidence in disclosure. Training HCWs in standardized disclosure counselling would lead to an increase in the rate of disclosure to children. It is essential that the district adapt the disclosure guidelines to the local context for use in health facilities.

scholarly journals Eastern Cape Healthcare Workers Acquisition of SARS-CoV-2 (ECHAS): Cross-Sectional (Nested Cohort) Study Protocol

2021 ◽  
Vol 18 (1) ◽  
pp. 323
Author(s):  
Oladele Vincent Adeniyi ◽  
David Stead ◽  
Mandisa Singata-Madliki ◽  
Joanne Batting ◽  
Leo Hyera ◽  
...  
Keyword(s):  
Cohort Study ◽  
Infection Rate ◽  
Healthcare Workers ◽  
Health Facilities ◽  
Control Measures ◽  
Infection Prevention And Control ◽  
Eastern Cape ◽  
Rt Pcr ◽  
Cross Sectional ◽  
Increased Risk

Healthcare workers (HCWs) are at increased risk of infection by the virulent severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Though data exist on the positivity rate of the SARS-CoV-2 reverse transcription polymerase chain reaction (RT-PCR) test as well as COVID-19-related deaths amongst HCWs in South Africa, the overall infection rate remains underestimated by these indicators. It is also unclear whether the humoral immune response after SARS-CoV-2 infection offers durable protection against reinfection. This study will assess the SARS-CoV-2 seroprevalence amongst HCWs in the Eastern Cape (EC) and examine the longitudinal changes (rate of decay) in the antibody levels after infection in this cohort. Using a multi-stage cluster sampling of healthcare workers in selected health facilities in the EC, a cross-sectional study of 2250 participants will be recruited. In order to assess the community infection rate, 750 antenatal women in the same settings will be recruited. Relevant demographic and clinical characteristics will be obtained by a self-administered questionnaire. A chemiluminescent microparticle immunoassay (CMIA) will be used for the qualitative detection of IgG antibodies against SARS-CoV-2 nucleocapsid protein. A nested cohort study will be conducted by performing eight-weekly antibody assays (X2) from 201 participants who tested positive for both SARS-CoV-2 RT-PCR and serology. Logistic regression models will be fitted to identify the independent risk factors for SARS-CoV-2 infection. The cumulative SARS-CoV-2 infection rate and infection fatality rate among the frontline HCWs will be estimated. In addition, the study will highlight the overall effectiveness of infection prevention and control measures (IPC) per exposure sites/wards at the selected health facilities. Findings will inform the South African Department of Health’s policies on how to protect HCWs better as the country prepares for the second wave of the SARS-CoV pandemic.

scholarly journals The Mentor Mothers Program in the Department of Defense in Nigeria: An Evaluation of Healthcare Workers, Mentor Mothers, and Patients’ Experiences

Healthcare ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. 328
Author(s):  
Josephine Moshe Ibu ◽  
Euphemia Mbali Mhlongo
Keyword(s):  
Department Of Defense ◽  
Healthcare Workers ◽  
Psychosocial Support ◽  
Hiv Infections ◽  
Health Facilities ◽  
World Health ◽  
Group Discussions ◽  
Analysis Technique ◽  
Hiv Awareness ◽  
Health Organization

Nigeria contributes the highest to the global burden of HIV/AIDS and also accounts for the largest proportion of new vertically transmitted HIV infections among children. The Mentor Mothers program in the Nigerian Department of Defense was introduced in accordance with the World Health Organization and its implementing partner guidelines to curb the high incidence of vertically acquired HIV infections. Understanding the experiences of participants could serve as a gateway to evaluating the effectiveness of the program to better provide quality services within targeted health facilities. This qualitative study employed key informant interviews with six healthcare workers as well as two focus group discussions with six mentor mothers and six prevention of mother-to-child transmission (PMTCT) patients in four selected hospitals in the Nigerian Department of Defense to explore their experiences of the Mentor Mothers program. A thematic analysis technique was used to analyze the collated data. As a result, four main themes emerged, with the program perceived by most participants as providing psychosocial support to the patients, a valuable educational resource for raising HIV awareness, a valuable resource for promoting exclusive breastfeeding and mitigating vertical transmission of the virus, and functioning as a link between patients and the healthcare system. The participants reported that the program had effectively decreased HIV infections in children, reduced child and maternal mortality, and supported the livelihood and development of women, families, and communities in and around the Nigerian Department of Defense health facilities.

scholarly journals Perceived Stigma as a Contextual Barrier to Early Uptake of HIV Testing, Treatment Initiation, and Disclosure; The Case of Patients Admitted with AIDS-Related Illness in a Rural Hospital in South Africa

Healthcare ◽  
2021 ◽  
Vol 9 (8) ◽  
pp. 962
Author(s):  
Sphiwe Madiba ◽  
Evelyn Ralebona ◽  
Mygirl Lowane
Keyword(s):  
Adult Patients ◽  
Hiv Status ◽  
Perceived Stigma ◽  
Hospital Data ◽  
Hiv Diagnosis ◽  
Related Stigma ◽  
Enacted Stigma ◽  
Delayed Disclosure ◽  
Selective Disclosure ◽  
Close Family

We explored the extent to which perceived HIV-related stigma influences the disclosure and concealment of HIV status to family among adult patients hospitalised for AIDS-related illness, and described reports of negative responses and enacted stigma following disclosure. We conducted interviews with a purposeful sample of 28 adult patients in a rural South African hospital. Data analysis was deductive and inductive and followed the thematic approach. We found evidence of delayed HIV diagnosis and initiation of treatment. There was delayed and selective disclosure as well as concealment of the HIV-positive status. The disclosure was delayed for months or even years. During that time, there was active concealment of the HIV status to avoid stigma from family, friends, and community. When disclosure occurred, there was selective disclosure to close family members who would keep the secret and respond favorably. Although the participants disclosed mostly to close family, some of their post-disclosure experiences included incidents of enacted stigma and discrimination. The fear of perceived stigma and self-stigma influenced the active concealment of their HIV status from others. Continuous concealment of one’s HIV status and delayed disclosure limit the opportunities for support and care. There is a need to take into consideration the interaction between HIV-related stigma and disclosure to develop disclosure-counselling strategies in primary health care settings.

scholarly journals Maternal Vaccination in Uganda: Exploring Pregnant Women, Community Leaders and Healthcare Workers’ Perceptions

Vaccines ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 552
Author(s):  
Phiona Nalubega ◽  
Emilie Karafillakis ◽  
Lydia Atuhaire ◽  
Pamela Akite ◽  
Flavia Zalwango ◽  
...  
Keyword(s):  
Side Effects ◽  
Pregnant Women ◽  
Healthcare Workers ◽  
Community Leaders ◽  
Community Members ◽  
Group Discussions ◽  
Maternal Vaccination ◽  
Key Informant ◽  
Maternal Immunisation ◽  
The Government

Background: We investigated pregnant women, community leaders, healthcare workers (HCWs) and programme managers’ perceptions of maternal vaccination in Kampala, Uganda. Methods: We conducted focus group discussions, key informant interviews and in-depth discussions with HCWs (3), community leaders (3), pregnant women (8) and programme managers (10) between November 2019 and October 2020. Data were analysed thematically. Results: Pregnant women, community leaders and some HCWs had limited maternal immunisation knowledge. There was confusion over what constitutes a vaccine. Pregnant women may not receive vaccines because of mistrust of government; use of expired vaccines; reliance on traditional medicine; religious beliefs; fear of side effects; HCWs attitudes; and logistical issues. The key facilitators of maternal vaccination were a desire to prevent diseases, positive influences from HCWs and information about vaccine side effects. Community leaders and some pregnant women highlighted that pregnant women do not make decisions about maternal vaccination independently and are influenced by different individuals, including other pregnant women, older people, partners, relatives (parents), community leaders, HCWs and the government. Conclusions: Our results indicate that public health messaging should target all community members, including partners and parents of pregnant women as well as HCWs, to improve knowledge of and confidence in maternal vaccines.

Barriers to Development of Selected Municipalities of Sulu Province

2021 ◽  
Vol 4 (5) ◽  
pp. 444-463
Author(s):  
Abdurahim S. Tahil ◽  
Shernahar K. Tahil
Keyword(s):  
Good Governance ◽  
Perceived Barriers ◽  
Systematic Sampling ◽  
Quantitative Aspect ◽  
The Political ◽  
Group Discussions ◽  
Ecological Aspects ◽  
Main Barrier ◽  
Political Economic ◽  
Qualitative Part

This study was conducted to determine the barrier to the development of selected municipalities of Sulu province.  It aimed to find out the Suluanos’ concept of development in terms of political, economic, socio-cultural, technological, and ecological aspects, including how these perceived barriers affect the development of Sulu. This research utilized the descriptive method where the Quantitative aspect gathered the data from 400 adults of ten big municipalities using a checklist questionnaire. The respondents were selected through systematic sampling.  For the qualitative part, the collected data were from 90 participants through focus group discussions. The statistical tools used were frequency, percentage, mean, standard deviation, and group means. The finding revealed that the Suluanos’ concept of development upheld the development policies which are participatory, equitable, appropriateness, concertizing, and environment friendly and the corresponding functions of development such as the political, economic, socio-cultural, technological, and ecological aspects. Of the five development functions, the economic aspect (2.95) was the main barrier to development.  It is followed by the technological aspect (2.91), the political (2.79), and ecological (2.42) as the fourth rank. On the other hand, the socio-cultural part (2.21) was the least encountered barrier. The perceived barriers that affected the development of Sulu were related to lack of high ethical standards, transparency, accountability, effectiveness, and lack of respect for and commitment to social justice, human rights, environmental life protection, and people's empowerment. Based on the data gathered, the findings made the researcher conclude that the political, economic, technological, socio-cultural, and ecological aspects in Sulu were considered barriers to development.  They were not within the bounds of good governance.   Bureaucracy was weak due to the leaders' personalities, who were neither transactional nor transformational. At the same time, they were not within the context of the alternative model of development. To minimize if not eliminate the barriers to development, the government's efforts should be geared towards accountability to improve the quality of governance and dispensation of justice. Further studies are recommended to determine other predictors that can similarly evaluate the development conditions of Sulu Province.     

scholarly journals Perceptions of professional nurses regarding introduction of the Batho Pele principles in State hospitals

Curationis ◽  
2015 ◽  
Vol 38 (1) ◽  
Author(s):  
Sindiwe James ◽  
Thenjiwe M. Miza
Keyword(s):  
Health Care ◽  
Data Analysis ◽  
Care Delivery ◽  
Health Care Delivery System ◽  
Group Discussions ◽  
State Hospitals ◽  
African Health ◽  
Outpatient Departments ◽  
Field Notes ◽  
Professional Nurses

Background: The South African health care delivery system has shifted focus to primary health care since 1994. For this purpose the Batho Pele principles were introduced. Nurses claim, however, that since the introduction of these principles patients and their families have been making unnecessary and sometimes impossible demands of nursing staff. This article presents the perceptions of the professional nurses regarding the introduction of the Batho Pele principles in their workplace.Objectives: To describe the perceptions of professional nurses regarding introduction of the Batho Pele principles and to recommend guidelines to facilitate measures to realise the objects of these principles.Method: A qualitative, exploratory, descriptive and contexual research design was used. Six audio-taped focus group discussions and field notes were used to collect data from purposively sampled participants who have worked in the outpatient departments of hospitals in thePort Elizabeth Hospital Complex. Guba’s model of trustworthiness was used to confirm integrity of the study, whilst the participants were kept anonymous, protected from harm and participated voluntarily. Data analysis was done using Tesch’s data analysis spiral and with the involvement of an independent-coder.Results: Three themes emerged, revealing that the professional nurses perceived the objectives of the Batho Pele principles as difficult to uphold due to the inadequate planning prior to their implementation. Inadequacy of human and material resources aggravated this perception.Conclusion: Professional nurses are not happy with how things are in terms of introduction of the Batho Pele principles, but are optimistic of a positive change in the near future.

scholarly journals The black hole of dealing with a disability diagnosis: Views of South African rural parents

2021 ◽  
Vol 10 ◽  
Author(s):  
Vuyelwa V. Duma ◽  
Ntombekhaya Tshabalala ◽  
Gubela Mji
Keyword(s):  
South African ◽  
Rural Setting ◽  
Support Needs ◽  
Eastern Cape ◽  
Group Discussions ◽  
Negative Attitudes ◽  
Children With Disability ◽  
Depth Interview ◽  
The Social ◽  
Rural Parents

Background: Lack of support systems in the management of health and rehabilitation related problems, including the stigma of giving birth to a child with disability, results in some parents ignoring the doctor’s prognosis of lifelong disability.Objectives: The study was conducted in the Eastern Cape province (ECP) of South Africa (SA) on parents’ views in caring for children with disability in an area with minimal health facilities in a rural setting.Method: Data was collected using exploratory descriptive qualitative methods. A Xhosa-speaking researcher facilitated six focus group discussions and conducted one individual in-depth interview with 37 parents or caregivers of children with disability residing at Happy home. Only one father was interviewed. Thematic analysis was used in interpreting data obtained from interviews.Results: The findings revealed themes indicating key concerns of parents, which were as follows: challenges with disability diagnosis, negative attitudes of health professionals, health and rehabilitation related problems, and lack of support from families and community.Conclusion: Caring for children with disability in a rural setting where services are minimal or not available to the poorest people who mostly need such services is not easy. Thus, to respond appropriately to the health and support needs of children with disability, it is crucial to understand the social context and needs of their families and caregivers. Due to size of the study, findings cannot be generalised. Recommendations are made for further studies to explore the vital issues affecting parents of children with disabilities.

scholarly journals Merging Artificial Intelligence and Blockchain Technologies to Solve Academic Qualification Forgery Issues

2020 ◽  
Author(s):  
Manju Jose
Keyword(s):  
Artificial Intelligence ◽  
Industrial Revolution ◽  
Emerging Technologies ◽  
Integrated System ◽  
Future Research ◽  
Group Discussions ◽  
Academic Qualification ◽  
Negative Impacts ◽  
Economy And Education ◽  
Academic Qualifications

This paper emphasizes the possibility of merging artificial intelligence and Blockchain technologies to solve academic qualifications forgery issues in the educational sectors. Empirical data is collected through interviews with specialists and technical people who are interested in the emerging technologies of the Fourth Industrial Revolution and focus group discussions in the field, as well as from reports in the reviewed literary articles. Scientific journals have also been accessed to analyse the paper goals and objectives. The findings suggest that emerging technologies can be integrated to become more efficient and effective in detecting fraud and forgery before it occurs. Considerable attention should be given to reducing and combating these issues because they have significant negative impacts on the economy and education. Accordingly, the study makes recommendations based on the results and areas of future research, considering the establishment of a unified and integrated system. Initially it will be applied as a pilot in Sultanate of Oman, then gradually it will be extended to the Gulf Cooperation Council States (GCC) and internationally particularly the affiliated and the recognized educational institutions to avoid the phenomena that affects the reputation and quality of education institutions and academic qualifications. The conclusion considers the impacts of the proposed system in the education and economy as well in general.

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