Providers' definitions of quality and barriers to providing quality care: a qualitative study in rural Mpumalanga Province, South Africa

Abstract Background: Traditional healers are frequently exposed to hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) through the widespread practice of traditional “injections”, in which the healer performs dozens of subcutaneous incisions using a razor blade to rub herbs directly into bloodied tissue. An average healer in Agincourt, a rural northeastern sub-district in Mpumalanga province, South Africa, experiences approximately 1,500 occupational blood exposures over the course of their lifetime. Healers in Agincourt have an HIV prevalence of 30% compared to 19% in the general population, and healers who report exposure to patient blood have an adjusted 2.4-fold higher odds of being HIV-positive than those with no exposure. Although research on appropriate PPE use has been well documented for allopathic care providers, little is known about the practices of traditional healers. Methods: This qualitative study was conducted with 30 traditional healers who practice in the rural Bushbuckridge sub-district of Mpumalanga province, northeastern South Africa. We elicited traditional healer attitudes towards glove use during traditional treatments – including patient baths, injections, or other treatments that exposed healers to patient blood or open sores. Results: While 90% of healers reported using latex gloves during some treatments, the majority do not use them regularly. Most employ a combination of gloves, plastic shopping bags, bread bags, paper, and sticks to prevent blood exposure. Healers reported plastic bags slipping or breaking during procedures, exposing them to patient blood. Only three healers consistently used gloves, regardless of the cost. Conclusions: Inadequate PPE use and high HIV prevalence make traditional healers particularly susceptible to contracting HIV in rural South Africa. Despite positive attitudes, consistent glove use remains low due to financial constraints and glove availability. Addressing issues of accessibility and cost of gloves for traditional healers could have a significant impact on the adherence to PPE and, in turn, reduce new HIV infections among this high-risk group.

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Patients experiences on the adverse effects associated with antiretroviral treatment in Piet Retief, Mpumalanga Province, South Africa

10.31124/advance.9784547 ◽

2019 ◽

Author(s):

Portia Simelane ◽

Professor Achiampong Yaw Amoateng

Keyword(s):

South Africa ◽

Qualitative Study ◽

Adverse Effects ◽

Antiretroviral Treatment ◽

Primary Data ◽

Mpumalanga Province ◽

Face To Face ◽

Males And Females

<p>This study made use of primary data. This qualitative study draws on 20 individuals, in-depth, face-to-face interviews (individual) with both males and females patients between the ages 15-49 years enrolled at Piet Retief Wellness Centre for antiretroviral treatment (ART) between the period 2010 and 2017 were used to obtain information from patients who have defaulted treatment and those who have not defaulted treatment.</p>

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Providers' Definitions of Quality and Barriers to Providing Care: a Qualitative Study in Rural Mpumalanga Province, South Africa

10.21203/rs.3.rs-52850/v1 ◽

2020 ◽

Author(s):

Rebecca L West ◽

Sheri A Lippman ◽

Rhian Twine ◽

Meriam Maritze ◽

Kathleen Kahn ◽

...

Keyword(s):

South Africa ◽

Primary Care ◽

Health Care ◽

Primary Health Care ◽

Service Providers ◽

Quality Care ◽

Primary Health Care System ◽

Mpumalanga Province ◽

Primary Health ◽

National Quality

Abstract Background: Facing a quadruple burden of disease (infectious disease, non-communicable disease, maternal and child mortality, high levels of violence and injury), South Africa requires high-quality primary health care to retain patients and optimize outcomes. National health policy is focused on strengthening primary care. While prior research has identified implementation challenges within the primary health care system, there is less understanding of how providers define quality, their perceptions of barriers to providing quality care, and how they overcome these barriers. This study assesses provider views on quality at primary care clinics in a rural region of Mpumalanga Province. Methods: We conducted in-depth interviews with providers in Bushbuckridge sub-district in early 2019 on the value of quality metrics for providers and patients, what indicators they would use to assess clinic performance, and barriers and facilitators of delivering care. Interviews were conducted in Shangaan, audio-recorded, translated, and transcribed into English. A deductive approach was used to develop a provisional coding schema based on study questions, which was refined using an inductive approach in response to patterns and themes emerging from the data.Results: 23 providers were interviewed (83% female, 65% professional nurses). Definitions of quality were focused on clinic structure and resources. Few providers identified patient outcomes as indicators of quality. Providers linked deficiencies in infrastructure and support to deficits in care delivery, such as long wait times due to limited staffing, privacy breaches due to insufficient space, and a chronic lack of medication and equipment. Providers identified mitigating strategies including informal coordination across clinics to address medication shortages in individual facilities. Interwoven throughout the providers’ discussion was the poor communication between the district, PHC supervisors, and implementers at the facility level. Conclusion: Providers connected deficits in quality of care to inadequate infrastructure and insufficient support from district and provincial authorities; mitigating strategies across clinics could only partially address these deficits. The existence of a national quality measurement program was not broadly reflected in providers’ views on quality care. These findings underscore the need for effective district and national approaches to support individual facilities, accompanied by feedback methods designed with input from frontline service providers.

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Patients experiences on the adverse effects associated with antiretroviral treatment in Piet Retief, Mpumalanga Province, South Africa

10.31124/advance.9784547.v1 ◽

2019 ◽

Author(s):

Portia Simelane ◽

Professor Achiampong Yaw Amoateng

Keyword(s):

South Africa ◽

Qualitative Study ◽

Adverse Effects ◽

Antiretroviral Treatment ◽

Primary Data ◽

Mpumalanga Province ◽

Face To Face ◽

Males And Females

<p>This study made use of primary data. This qualitative study draws on 20 individuals, in-depth, face-to-face interviews (individual) with both males and females patients between the ages 15-49 years enrolled at Piet Retief Wellness Centre for antiretroviral treatment (ART) between the period 2010 and 2017 were used to obtain information from patients who have defaulted treatment and those who have not defaulted treatment.</p>

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An Exploration of Aftercare Services for Female Drug Users

SOUTHERN AFRICAN JOURNAL OF SOCIAL WORK AND SOCIAL DEVELOPMENT ◽

10.25159/2415-5829/1783 ◽

2018 ◽

Vol 30 (2) ◽

Author(s):

Talent Mhangwa ◽

Madhu Kasiram ◽

Sibonsile Zibane

Keyword(s):

South Africa ◽

Qualitative Study ◽

Drug Users ◽

Service Providers ◽

Service Users ◽

Rehabilitation Centre ◽

Aftercare Services ◽

Data Source ◽

Female Drug Users ◽

Depth Interviews

The number of female drug users has been on the rise in South Africa, with statistics reflecting a rise in the number of women who attend treatment centres annually. This article presents empirical data from a broader qualitative study which aimed to explore perceptions concerning the effectiveness of aftercare programmes for female recovering drug users. The main data source was transcripts of in-depth interviews and focus groups with both service users and service providers from a designated rehabilitation centre in Gauteng, South Africa. Framed within a biopsychosocial-spiritual model, this article explores the perceptions and meanings which the female recovering drug users and the service providers attach to aftercare programmes. The findings of the research outlined the range of factors promoting recovery, alongside noteworthy suggestions for improvement in aftercare services. While acknowledging multiple influences on behaviour, this article highlights the significance of these findings in planning and implementing holistic aftercare programmes.

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YOUTH WELLBEING IN SOUTH AFRICA: WHAT DIMENSIONS SHOULD WE MEASURE?

Commonwealth Youth and Development ◽

10.25159/1727-7140/1154 ◽

2016 ◽

Vol 13 (1) ◽

pp. 1-17 ◽

Cited By ~ 1

Author(s):

Dabesaki Mac-Ikemenjima

Keyword(s):

South Africa ◽

Health Education ◽

Young People ◽

Qualitative Study ◽

South African ◽

Time Use ◽

Economic Relationships ◽

African Cities ◽

South African Cities ◽

Selection Of

There is growing interest in the development of measures and indexes of youth wellbeing. However, there has been a limited discussion on indicators to measure and select them. This paper reports on the results of a qualitative study on the selection of indicators to measure the wellbeing of young people in South Africa, and reflects on the relevance of the content of their values in choosing indicators for measuring their wellbeing. The data used in this analysis is based on telephone (9) and email (6) interviews conducted with 15 young people (male=5, female=10) aged 22 to 32 from five South African cities during July 2010. In the interviews, participants were asked to identify five issues they considered important to their lives, after which they were asked to rank them in order of importance. The issues indicated by the participants are described and discussed in six dimensions: economic, relationships, spiritual and health, education, time use and material. The indicators developed from this study are discussed in terms of their relevance for use in a measure of youth wellbeing in South Africa.

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The Role of Archives on the Incorporation of the Former Kangwane Homeland to Mpumalanga Province

Africanus Journal of Development Studies ◽

10.25159/0304-615x/3069 ◽

2018 ◽

Vol 47 (2) ◽

Author(s):

Nkholedzeni Sidney Netshakhuma

Keyword(s):

South Africa ◽

Qualitative Methodology ◽

Management Policy ◽

Records Management ◽

Record Keeping ◽

Mpumalanga Province ◽

Specific Objective ◽

National Archives ◽

And Control

This study was conceptualised in order to assess the strategies used to incorporate the homeland of KaNgwane into Mpumalanga province after the cessation of apartheid in 1994. The specific objective of the study was to investigate the compliance of records and archives with the National Archives and Records Service of South Africa Act (Act No 43 of 1996), during the incorporation of the homeland of KaNgwane into Mpumalanga. The study adopted a qualitative methodology through document analysis, interviews and observations. The key findings revealed that the archives of the former homeland of Kangwane were not aligned with the requirements of the National Archives and Records Service of South Africa Act (Act No.43 of 1996.) Institutions seem to lack experience when it comes to the challenges of storing records and implementing arrangement and control systems. The frequent lack of a records management policy and few to no staff with record-keeping and archival backgrounds was also a concern. A shortage of space to store records safely was also one of the major issues that the study uncovered. There appears to be no concerted effort to retain important historical records. Many records are stored in several different locations in government buildings. I conclude that archives play an essential role to the nation as the institutional memory.

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