Background: Globally the burden of tuberculosis or human immunodeficiency virus (TB/HIV) is at 24% with 3% global health workforce and this an alarming rate that World Health Organization (WHO) declared African region as a critical workforce shortage area. To facilitate adherence to treatment guidelines, WHO recommended a strategy of task shifting for these countries with high health workforce shortages. The strategy aimed at the redistribution of health care tasks to available workers. The purpose of the study was to determine factors facilitating trained nurse-initiated management of antiretroviral therapy (NIMART) nurses’ adherence to TB/HIV treatment guidelines in KwaZulu-Natal (KZN) and North West (NW) Provinces of South Africa.Design: The study was qualitative, explorative and descriptive in nature. The population comprised of 24 participants who were purposively selected. The in-depth focus group discussion was conducted. Data analysis was through the used of ATLAS T.I. software program (version 7.0) and followed the basic steps of notice-collect-think (NCT) analysis. Trustworthiness and ethical consideration were ensured.Results: The following one theme namely; marked identified needs to be met to promote adherence to treatment guidelines and sub-themes emerged from raw data: Expected positive attitudinal needs outlined and an outline of a positive behavioural change. Conclusion: Factors such as continuous training, support supervision and improved relationships with colleagues need to be enhanced to enable NIMART nurses to adhere to treatment guideline.

Background: The term ‘menopause’ is derived from the Greek words men (month) and pausis (a cessation, a pause). It is a direct description of the psychological and physical events in women where menstruation ceases to occur. It is the time in a woman’s life when she has experienced her last menstrual bleed. Menopause is not a disease per se but a condition associated with hormonal changes where oestrogen diminishes to a low level, causing aging-related health problems. Objectives: The purpose of this study was to explore perceptions of menopause and aging amongst women in rural villages of Vhembe District in Limpopo Province, South Africa.Method: The study was qualitative and explorative, using phenomenological approach. Purposive sampling was used to select the four villages and to select the focus groups. Sample size was determined by data saturation.Results: The study findings were that participants in the villages associated cessation of menstruation to aging rather than menopause. Once menstruation stopped, one was regarded as old.Conclusion: The conclusions of the study were that (1) menopausal issues should be emphasised and receive priority from puberty at the girls initiation schools, high schools, churches, other community resources and health care services so that when women reach menopause, (2) they should accept and be able to effectively cope with menopause and aging. (3) Emphasis should also be placed on menopause as the aspect of human aging. Agtergrond: Die term ‘menopouse’ is afgelei van die Griekse woorde menos (maand) en pausis (onderbreking/pouse, einde) en is ’n direkte beskrywing van die psigologiese en fisiese gebeure in vroue waar menstruasie ophou voorkom. Dit is die tyd in ’n vrou se lewe wanneer die laaste menstruele bloeding ervaar word. Menopouse is nie ’n siekte per se nie, maar ’n toestand wat geassosieer word met hormonale veranderings waar estrogen afneem tot ’n vlak wat gesondheidsverwante probleme veroorsaak.Doelstelling: Die doel van die studie was om persepsies ten opsigte van menopause en veroudering onder landelike vroue in die Vhembe-distrik in Limpopo Provinsie, Suid-Afrika, te verken.Metode: Die studie was kwalitatief en verkennend, met ’n fenomenologiese benadering. Doelgerigte steekproefneming is gebruik om die vier dorpies en deelnemers van die fokusgroepe te selekteer. Die steekproefgrootte is bepaal deur dataversadiging.Resultate: Die bevindings was dat die deelnemers die einde van menstruasie aan ouderdom, en nie aan menopause nie, toeskryf. Wanneer menstruasie stop, word ’n vrou dus as oud beskou.Gevolgtrekkings: Aanbevelings was dat (1) menopausale onderwerpe reeds beklemtoon behoort te word vanaf puberteit in inisiasieskole, hoërskole, kerke en gemeenskappe en gesondheidsdienste sodat, wanneer menopouse bereik word, (2) vroue dit kan aanvaar en positief ervaar. (3) Klem behoort ook op menopause as ’n menslike aspek van veroudering gelê te word.

Background Zimbabwe has the highest teenage pregnancy rate in Sub Saharan Africa. Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS) prevalence in adolescents that are from tribes that perform cultural initiations and subscribe to certain norms are higher than the national prevalence which is estimated at 12% (18 and 13.6% respectively) in Zimbabwe. Indigenous Health Systems (IHSs) and Modern Health Systems (MHSs) in Zimbabwe run parallel thereby introducing challenges in the management of adolescent sexual health due to conflicts. This study seeks to develop strategies that will facilitate the integration of IHSs and MHS in Mberengwa and Umguza districts. Methods This research will be conducted in two phases. The first phase would utilise a concurrent triangulation mixed methods design with both qualitative and quantitative approaches. The findings from the qualitative and quantitative approaches would be merged through a comparison of findings side by side. The second phase would focus on the development and validation of strategies that would facilitate the integration of IHSs and MHSs. The Strength, Weakness, Opportunity and Threat (SWOT) analysis would be applied on interfaced findings from phase one. The Basic Logic and the Build, Overcome, Explore and Minimise (BOEM) models would then be used to develop strategies based on the SWOT findings. The developed strategies would be validated through the application of Delphi technique and administration of checklist to selected key stakeholders through organised workshops. Discussion There have been no known studies found in the literature that explores the possibility and developed strategies of integrating IHSs and MHSs so as to promote safe sexual practices in adolescents. Most programs on sexual health have ignored the role of IHSs and MHSs in influencing safe sexual practices leading to them failing to attain desired goals. A lot of emphases has been targeted at minimising the spread of Sexually Transmitted Infections (STIs) through advocating for utilisation MHSs rather than focussing on an integrating systems that are meant to manage Adolescent Sexual Health (ASH) related issues. The study protocol was approved by the University of Venda Ethics Committee Registration (SHS/19/PH/17/2608) on the 26th of August 2019.

BackgroundRecording of information on multiple documents increases professional nurses’ responsibilities and workload during working hours. There are multiple registers and books at Primary Health Care (PHC) facilities in which a patient’s information is to be recorded for different services during a visit to a health professional. Antenatal patients coming for the first visit must be recorded in the following documents: tick register; Prevention of Mother-To-Child Transmission (PMTCT) register; consent form for HIV and AIDS testing; HIV Counselling and Testing (HCT) register (if tested positive for HIV and AIDS then this must be recorded in the Antiretroviral Therapy (ART) wellness register); ART file with an accompanying single file, completion of which is time-consuming; tuberculosis (TB) suspects register; blood specimen register; maternity case record book and Basic Antenatal Care (BANC) checklist. Nurses forget to record information in some documents which leads to the omission of important data. Omitting information might lead to mismanagement of patients. Some of the documents have incomplete and inaccurate information. As PHC facilities in Vhembe District render twenty four hour services through a call system, the same nurses are expected to resume duty at 07:00 the following morning. They are expected to work effectively and when tired a nurse may record illegible information which may cause problems when the document is retrieved by the next person for continuity of care.ObjectivesThe objective of this study was to investigate and describe the effects of increased nurses’ workload on quality documentation of patient information at PHC facilities in Vhembe District, Limpopo Province.MethodsThe study was conducted in Vhembe District, Limpopo Province, where the effects of increased nurses’ workload on quality documentation of information is currently experienced. The research design was explorative, descriptive and contextual in nature. The population consisted of all nurses who work at PHC facilities in Vhembe District. Purposive sampling was used to select nurses and three professional nurses were sampled from each PHC facility. An in-depth face-to-face interview was used to collect data using an interview guide.ResultsPHC facilities encountered several effects due to increased nurses’ workload where incomplete patient information is documented. Unavailability of patient information was observed, whilst some documented information was found to be illegible, inaccurate and incomplete.ConclusionDocumentation of information at PHC facilities is an evidence of effective communication amongst professional nurses. There should always be active follow-up and mentoring of the nurses’ documentation to ensure that information is accurately and fully documented in their respective facilities. Nurses find it difficult to cope with the increased workload associated with documenting patient information on the multiple records that are utilized at PHC facilities, leading to incomplete information. The number of nurse...

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BackgroundChildren depend solely on caregivers who can be either parents or guardians for drug administration to enhance adherence to antiretroviral treatment (ART), which might pose any number of challenges.PurposeThe purpose of this study was to explore and describe the challenges faced by caregivers of children on ART at Mutale Municipality, Vhembe District, Limpopo Province.Research design and methodThe research design was qualitative, explorative, descriptive and contextual in nature. The population consisted of 16 caregivers who were 18 years of age and above, and mentally capable, irrespective of educational qualifications, caring for children aged between 0 and 15 years who were on ART between April 2013 and October 2014. Non-probability, purposive sampling was used to select the 16 caregivers. Required permission, approval and ethical clearance were obtained from the University of Venda Higher Degree Committee, Limpopo Provincial Health Department and relevant institutions. An in-depth, individual, unstructured interview method was used to collect data. One central question was asked: ‘What are the challenges you experience when caring for a child on antiretroviral treatment?’ Subsequent questions were based on the participants’ responses to the central question. Qualitative data were analysed by means of Tesch’s open-coding method.ResultsThe findings of this study revealed that participants, that is, caregivers of children on ART, experienced financial burdens because of transport costs needed to comply with follow-up dates and insufficient of money for food, clothing the child in need of care, pocket money for lunch boxes during school hours and time lost while waiting for consultations. Participants reported some level of stigmatisation against children on ART by family members, especially the husbands or in-laws of the secondary caregivers. Many primary and secondary caregivers seemed to have given up seeking support from government and community structures.ConclusionThe conclusions drawn from this research are that caregivers hardly receive any support from family members or the community. Fear of disclosing the HIV-positive status of children resulted in the delay of financial support from the government, thus leading to serious financial burden on the caregivers.

The aim of the study was to determine the factors that influence the uptake of contraception services by adolescents in the Vhembe district of Limpopo Province, South Africa. A qualitative research method which is explorative, descriptive and contextual in nature was used to investigate the phenomenon from the adolescents’ perspective. The target population comprised of adolescents residing in one of the six villages of Vhembe District. Data was collected through six focus group discussions until data saturation was achieved. Data was analysed using an open coding method. The findings revealed that adolescents are aware of the availability of contraceptive services. However, they lack a comprehensive knowledge about contraception and contraceptives, which led to negative attitudes towards using the services. Cultural health beliefs and attitudes were also identified as a barrier to the uptake and use of contraceptives. Recommendations were made on interventions to increase the uptake of contraception services amongst adolescents.Die doel met die studie was om te bepaal watter faktore beïnvloed adolessente in die Vembe distrik van Limpopo Provinsie, Suid Afrika se besluit om voorbehoedmiddels te gebruik. ’n Kwalitatiewe navorsingsmetode wat eksploratief, beskrywend en kontekstueel van aard is, is gebruik om die fenomeen vanuit die perspektief van die adolessent te ondersoek. Data is ingewin deur ses fokusgroepbesprekings todat ’n punt van dataversadiging bereik is. Data is met behulp van oop kodeering geanaliseer. Bevindinge het getoon dat die adolessente wel bewus is van die beskikbaarheid van voorbehoeddienste, alhoewel hulle kennis van voorbehoeding en voorbehoedmiddels gebrekkig is, en dit het tot ’n negatiewe houding jeens die gebruik van die dienste gelei. Kulturele en kulturele gesondheidsgelowe gelowe en houdings is ook geidentifiseer as ’n hindernis tot die gebruik van voorbehoedmiddels. Aanbevelings is gemaak ten opsigte van intervensies om die gebruik van voorbehoeddienste onder adolessente te bevorder.

Aim:Screening for early detection and treatment of cervical cancer is a cornerstone of prevention. The purpose of this study was to assess the awareness in women about the utilization of cervical cancer screening services in Vhembe District, South Africa.Methods:This cross-sectional study involved a random selection of 500 women aged 20-59 years in Vhembe District, Limpopo Province, South Africa. Data was collectedviaa self-structured questionnaire on the demographic variables, provision, utilization and awareness of cervical cancer screening services.Results:The majority of the participants agreed to have cervical cancer screening services in their clinics (79.2%), and never had a Pap smear (58.6%). Most women would not go for cervical cancer screening, mainly because of a lack of facilities (30.0%), fear of pain (24.4%), and embarrassment (15.2%). Most participants indicated that Pap smear test meant scraping the cervix to detect abnormal cancerous cells (39.2%) and 34.2% did not know a Pap smear. Majority of the participants indicated Pap smears should be done every 10 years (65.8%); Pap smears could detect cervical cancer earlier (66.8%), and had heard about cervical cancer (71.6%). The majority of the participants considered cervical cancer as a serious problem to warrant considerable attention (59.4%); and some perceived cervical cancer as transmittable through multiple sexual partners (22.2%). The majority of the participants were aware of a vaccine against cervical cancer for girls at school (69.0%), and it was indicated that government should use health education to encourage women to attend cervical screening services (51.6%).Conclusion:Despite the free availability of cervical cancer screening services and awareness, the utilization of cervical cancer screening services is low. There is a need to intensify cervical screening health talks and campaigns, and to provide alternative accessible options for screening services for women in rural areas.