Epilepsy in rural South Africa: Patient experiences and healthcare challenges.

OBJECTIVE: This study investigates the prevalent issues of healthcare access and the impact of antiseizure treatments among people with epilepsy (PWE) in rural Limpopo and Mpumalanga, South Africa, where healthcare facilities and affordable treatments are often inadequate. METHODS: Using a cross-sectional survey, 162 PWE were selected using multistage sampling across the provinces. Data were collected via a structured questionnaire and analyzed descriptively using SPSS v27. RESULTS: Most of the participants experienced seizures intermittently, with 70.6% in Limpopo and 53.3% in Mpumalanga reporting occasional episodes, whereas a significant minority in both regions-20.6% and 40%, respectively-suffered from frequent seizures. A notable portion of PWE also reported recurring side effects from antiseizure drugs, which led to consequential life disruptions, including educational dropout and unemployment. SIGNIFICANCE: The findings underscore an urgent need for enhanced educational programs and increased awareness to improve the understanding and management of epilepsy in these underserved areas. Optimizing care for PWE requires a multifaceted approach, including evaluating healthcare accessibility, affordability, and societal beliefs influencing treatment adherence. The study advocates for government and policy interventions to mitigate the quality of life deterioration caused by epilepsy and its treatment in rural communities. PLAIN LANGUAGE SUMMARY: In Limpopo and Mpumalanga, many individuals with epilepsy experience seizures occasionally, while a significant minority have them frequently. Numerous people also suffer recurring side effects from antiseizure medications, impacting their lives severely by causing school dropouts and job losses. This underscores the urgent need for improved education and awareness programs to manage epilepsy in these provinces effectively. The study urges government action and policy reforms to enhance care and support for people with epilepsy in rural areas, aiming to improve their quality of life.

Exploring the Barriers and Facilitators in the Management of Childhood Trauma and Violence Exposure Intervention in the Vhembe District of the Limpopo Province, South Africa.

Research has shown that barriers and facilitators in psychotherapy exhibit similarities. The authors of this study are of the view that to effectively address the difficulties encountered in psychotherapy for children and adolescents, it is crucial to consider the points of view of professionals who have firsthand encounters with children. The purpose of this study was to effectively explore barriers and facilitators in the treatment of children exposed to trauma and violence. Exploratory and descriptive methods, as components of a qualitative research design, were employed to investigate and articulate the barriers and facilitators involved in managing childhood trauma. An advertisement was used to recruit participants. It was developed and distributed to psychologists and social workers recommended by the Thohoyandou Victim Empowerment Programme. Seventeen professionals were individually interviewed using semi-structured interview schedules. The interviews were recorded, transcribed verbatim, and analysed using interpretative phenomenological analysis (IPA). The findings of the study indicated a lack of commitment from parents in honouring appointments, financial challenges, a fear of perpetrators associated with the poor reporting of incidences, professional boundaries, and referral route challenges. Familiar facilitators in the management of childhood trauma included continuous training and workshops for all people working with childhood trauma and violence, the employment of more victim advocates, and awareness campaigns. Additionally, the referral pathway for traumatised children presents logistical, psychological, and educational hurdles, underscoring the complex nature of meeting the needs of these vulnerable populations within the healthcare system. In conclusion, even while the currently available research supports the barriers and facilitators for this population, more investigation is required to examine how these factors affect treatment outcomes, particularly in community-based settings.

Development and validation of an intervention for childhood trauma and exposure to violence in Vhembe District, South Africa.

Most strategies are implemented; however, South Africa needs to evaluate and develop trauma interventions. The study aims to develop, test and validate childhood trauma exposure intervention in the Vhembe district, Limpopo province. Donabedian's structure-process-outcome model will guide the study. The study will employ multiphase mixed methods with five phases. Phase 1 will be a thorough systematic evaluation of literature on childhood trauma and exposure to violence interventions to describe existing interventions. Phase 2, stage 1: Will explore the experiences of children exposed to trauma and violence regarding their experiences of the treatment they received, using semi-structured qualitative interviews. Non-probability purposeful sampling techniques will be used to select participants. The Thoyondou Victim Empowerment's database will select participants. The researchers will conduct semi-structured and unstructured interviews with youngsters exposed to violence and trauma. Stage 2 will be a qualitative study of trauma centre managers and personnel sampled from the contact record. IPA will analyze data. Phase 3 will conceptualize Phase 1 and the empirical phase into Donabedian's SPO framework for Phase 4. Phase 4 develops the intervention using Phase 3's conceptual framework and tests and validates it.

A systematic review of the effectiveness of epilepsy education programs on knowledge, attitudes, and skills among primary school learners.

Epilepsy is a common neurological condition affecting primary school learners, often leading to misconceptions, stigma, and limited social inclusion. These misconceptions transpire because of a lack of knowledge regarding the condition and may lead to high school dropouts. This systematic review aimed to evaluate the effectiveness of epilepsy education programs on epilepsy-related knowledge and understanding, values and attitudes, and skills among primary school learners. A thorough search of electronic databases was conducted to identify relevant studies published between January 2000 and September 2023. Studies that satisfied the eligibility criteria were chosen, and two reviewers conducted data extraction independently. A narrative synthesis approach was utilised to analyse the findings. The review included 10 studies that satisfied the inclusion requirements. The epilepsy education interventions varied in content, duration, and delivery method. Findings indicated that diverse delivery methods, such as classroom-based programs, hospital-based programs, and community-centred interventions, effectively enhanced epilepsy-related knowledge and understanding, values and attitudes, and skills among primary school learners. This systematic review provides evidence that epilepsy education programs can effectively enhance epilepsy-related knowledge, understanding, values, attitudes, and skills among primary school learners. These findings support developing and implementing comprehensive guidelines for teaching epilepsy in primary schools, suggesting various delivery methods and integrating cultural values to promote optimal learning outcomes and social inclusion for learners with epilepsy.

Registered nurses' experiences regarding operational factors influencing the implementation of HIV care services in the mobile health clinics of eThekwini Municipality in KwaZulu-Natal.

BACKGROUND: Registered nurses working in the mobile health clinics (MHCs) play an important role in enabling HIV care access to populations in remote areas through Nurse Initiated Antiretroviral Therapy program (NIMART). AIM: To explore and describe the nurses' experiences regarding operational factors influencing the implementation of HIV care services in the mobile health clinics (MHCs) of eThekwini Municipality in KwaZulu Natal. METHODS: Qualitative Exploratory Descriptive (QED) method was used after permission was granted from North-West University Human Research Ethics Committee provincial and local health authorities. Data saturation informed sample size of thirteen MHCs nurses were purposefully sampled to participate. Audio-recorded, semi-structured, online, one-on-one interviews guided by open-ended questions were done for data collection, and including demographic profile. The interview transcripts were analysed using Atlas-TI and SPSS descriptive statistics was used for demographics. RESULTS: Eleven subthemes emerged under patient-related, nurse-related, and organisational-related themes which influence the operational factors in the MHCs, namely: patient defaulting treatment, lack of privacy, unavailability of phones, stressful and demotivating MHCs, nurses feel unsafe, lack of support from management, lack of budget, unavailability of computers, shortage of medical equipment, shortage of nursing staff and absence of data capturers. CONCLUSION: Structured contextual coaching and support program for nurses is imperative to ensure effective and strengthened operations in MHCs, further supported by improvement in human resource for health allocation for MHCs in light of expanding health care programs CONTRIBUTIONS: Evaluation of health care programmes, and human resource for health quality improvement needs in the clinical practice of HIV care of MHCs nurses which advocate for specific policy formulations.

It Goes Beyond Anxiety: Experiences of Family Members and Caregivers of Epilepsy Care and Support.

Purpose: To investigate the knowledge of epilepsy care and the support given by professionals to assist family members and caregivers in providing good care to People Living with Epilepsy (PLWE). Patients and Methods: In this case study, fifteen participants participated. Of these, eleven were parents, and four were siblings. Twelve of the participants were primary caregivers, and three were secondary caregivers. Data were collected via in-person semi-structured interviews and analysed via thematic analysis. Results: From the study, two themes emerged: Participant experiences regarding epilepsy practices and knowledge regarding epilepsy. From these two themes, four subthemes emerged: Epileptic seizure practice and treatment, as well as epilepsy knowledge and counselling and support. Conclusion: This study revealed that although family members and caregivers are essential in patient care, they need more support and care from health providers. The much-needed care and support would assist in alleviating some pressures on epilepsy patient care and increase care standards and quality of life for families and PLWE.

'Hard-pressed on every side': Christian women's experiences of intimate partner violence in two provinces of South Africa.

Background: Women in South Africa are battling the scourge of intimate partner violence (IPV), and men are usually responsible. Despite this, no studies have been carried out to specifically explore and describe Christian women's IPV first-hand experiences in the Limpopo and Gauteng provinces. Aim: This study explored and described lived experiences with regard to IPV among women attending Pentecostal churches in Limpopo and Gauteng provinces. Setting: The study was conducted in the Makhado Local Municipality, City of Tshwane and Johannesburg metropolitan municipalities. Methods: The study utilised a qualitative research method, using interpretative phenomenological analysis. Sampling was purposeful. Semi-structured individual interviews were conducted to collect data among women attending Pentecostal churches in Limpopo and Gauteng provinces. Data saturation was achieved after 10 survivors were interviewed. Results: Two themes surfaced from the analysis: the experience of various forms of IPV by survivors and the hardships survivors encountered when seeking help after IPV. Conclusion: In spite of the salient role Christian belief played in survivors' lives, the expected support from family, pastors and law enforcement officers after disclosing IPV was non-existent. The survivors were stranded, frustrated and displayed symptoms of depression and anxiety. Contribution: This study revealed survivors' need for comprehensive, multidisciplinary, and transdisciplinary collaborative support by strengthening partnerships with church leaders to protect Christian women against IPV.

Childhood Trauma and Exposure to Violence Interventions: The Need for Effective and Feasible Evidence-Based Interventions.

Several crimes in South Africa cause physical, economic, and mental problems. Xenophobic attacks, mob justice, and other violent conduct directly traumatise children. Service delivery riots and physical and sexual abuse are examples. This evaluation evaluates childhood trauma and exposure to violence interventions. The review describes the therapeutic methods for traumatised children exposed to violence, the healthcare professionals administering them, and the strategies used to tailor the interventions. The researcher systematically searched PsycINFO, Google Scholar, PubMed, Science Direct, and EBSCOhost. Literature from 2011 to 31 July 2023 was searched, and 19 papers were chosen for further review after the systematic search. The authors conducted an eligibility evaluation according to PRISMA guidelines. A thorough review of article texts identified 19 papers that met eligibility standards. Only nineteen studies have validated trauma and violence therapies for children. An effective multi-phased intervention that is feasible and adaptable to varied socioeconomic backgrounds is needed. Further studies on the mental health benefits of brief trauma intervention treatment are needed.

HIV Care Profiling and Delivery Status in the Mobile Health Clinics of eThekwini District in KwaZulu Natal, South Africa: A Descriptive Evaluation Study.

Mobile health clinics (MHCs) serve as an alternative HIV care delivery method for the HIV-burdened eThekwini district. This study aimed to describe and profile the HIV care services provided by the MHCs through process evaluation. A descriptive cross-sectional quantitative evaluation study was performed on 137 MHCs using total population sampling. An online data collection method using a validated 50-item researcher-developed instrument was administered to professional nurses who are MHC team leaders, following ethical approval from the local university and departments of health. Descriptive statistics were used to analyze the data. The results described that HIV care services are offered in open spaces (43%), community buildings (37%), solid built buildings called health posts (15%), vehicles (9%), and tents (2%) with no electricity (77%), water (55%), and sanitation (64%). Adults (97%) are the main recipients of HIV care in MHCs (90%) offering antiretroviral therapy (95%). Staff, monitoring, and retaining care challenges were noted, with good linkage (91%) and referral pathways (n = 123.90%). In conclusion, the standardization and prioritization of HIV care with specific contextual practice guidelines are vital.

Exploring the perceptions and lived experiences of family members living with people diagnosed with COVID-19 in South Africa: a descriptive phenomenological study.

BACKGROUND: The incidence and prevalence of COVID-19 continues to escalate globally, with the consequence to quality of life, the economies of nations and various sectors of society. While there is substantial research on the impact and experiences of the COVID-19 pandemic, little remains known about the perceptions and lived experiences of families living with people diagnosed with COVID-19, particularly within the South African context. PURPOSE: To explore the perceptions and lived experiences of family members  living with people diagnosed with COVID-19 in South Africa. METHODS: A descriptive phenomenological design was used. Data were collected from 15 participants who were family members of people diagnosed with COVID-19 in South Africa. Purposive snowball sampling was used to identify and recruit participants, and data were collected at community level in KwaZulu-Natal, Western Cape and Gauteng, South Africa. Individual in-depth interviews were used to collect the data, and an audio tape was used to record all interviews. Data were transcribed verbatim and analysed using a phenomenological data analysis processes. Ethical approval to conduct the study was obtained from the University of KwaZulu-Natal Research Ethics Committee-reference number: BREC00003228/2021. RESULTS: Four super-ordinate themes emerged in relation to the perceptions and lived experiences of family members  living with people diagnosed with COVID-19 in South Africa. The superordinate themes were: (1) sources of information about COVID-19, (2) pandemic  perceptions and experiences, (3) impact of diagnosis and related burden and (4) aftermath of living with a family member diagnosed with COVID-19. DISCUSSION AND CONCLUSION: Family members' perceptions and lived experiences of COVID-19 are largely influenced by media, moreover, the impact of diagnosis has consequences for the physical, mental and emotional well-being of family members. Diagnosis disrupts family dynamics by depleting financial resources due to  the caregiver burden experienced. The findings thus imply that provision of psychosocial support is imperative for families living with persons diagnosed with COVID-19.

Experiences of life orientation among teachers teaching sexuality education in secondary schools in Vhembe and Mopani Districts Limpopo Province, South Africa.

Teachers' experiences regarding sexuality education are significant indicators of teaching sexuality in secondary schools. However, the importance of including sexuality education in the educational system is rising globally. This suggests that Life Orientation (LO) teachers have a unique and vital role to play, one for which they are not always ready, especially when sexuality education is a cross-curricular subject. This study examined teachers' experiences regarding teaching sexuality education in Limpopo Province. This study aimed to explore and describe the experiences of the Life Orientation (LO) teachers teaching sexuality education in secondary schools in Vhembe and Mopani districts Limpopo Province, South Africa. A qualitative, exploratory-descriptive phenomenological design was employed. In-depth face-to-face interviews were conducted with 14 LO teachers from four (4) sets of public secondary schools in Vhembe and Mopani districts. Interviews were audio recorded. Field notes were used to capture nonverbal communication from participants. Data saturation was reached on the seventh (7th) face to face interviews. A Qualitative thematic analysis was employed to analyses data. The results revealed four themes: Participant experiences of sexuality education; Communication concerns; Role shifting in imparting sexuality education and challenges experienced by LO teachers in the classes room. Ethical considerations and trustworthiness was ensured. The study concluded that participants experiences of sexuality education; communication concerns; role shifting in imparting sexuality education operate as barriers to comprehensive sexuality education. Recommendations: teachers need to be equipped with knowledge and skills and to teach various sexuality topics, including providing human and material resources.

A Model to Prevent Substance Use/Abuse by Student Nurses at Limpopo College of Nursing, South Africa.

BACKGROUND: Substance use/abuse is a global challenge that has detrimental effects on nations' health, wealth, and security. Substance users in Africa make up roughly 17% to 21% of global illicit drug users in Africa and cannabis abuse (63%) (UNODC, 2010). PURPOSE: We aimed to develop, describe, and evaluate a model that could be used as a framework of reference to prevent substance use/abuse by student nurses at Limpopo College of Nursing, South Africa. METHOD: A mixed-method study approach was used following a qualitative exploratory, descriptive, and contextual design to explore factors contributing to substance use/abuse by student nurses and quantitatively examine the impact of substance use/abuse on students' academic achievements in Limpopo Province. FINDINGS: The results of the first empirical phase reveal two themes and seven subthemes from the semi-structured interviews with lecturers, students, and support staff. The literature supported the results. In phase 2, we analyzed the concept of the "prevention" of substance use/abuse by student nurses following the process of a concept analysis by Walker and Avant (2016). The results were conceptualized within the six elements of practice theory: context, agent, recipient, dynamic, process and procedure, and outcome. CONCLUSIONS: The relational statements provided the basis for the model description. A reliable method was used to describe and evaluate the model.

Growth Monitoring and Promotion Index Development: A Novel Approach.

BACKGROUND: There are few growth monitoring and promotion indexes, and currently none of them include any metrics that measure caregiver behaviours. No index to date combines the metrics of both community health worker activeness and caregiver barriers and facilitators towards growth monitoring and promotion (GMP). This study developed a new growth monitoring and promotion index and validated it using the Delphi Technique. METHODS: The study began with phase 1, which was a scoping review of the literature on GMP indexes. Phase 2 involved a community health worker (CHW) survey which explored the process of GMP within the Umguza health system, and determined how knowledge of GMP by CHWs translated to frequency of activities. A barrier analysis was also conducted with caregivers of children under five to determine the barriers and facilitators towards GMP attendance by caregivers. Phase 3 was the construction of the index along with its validation, using the Delphi Technique where fifteen experts within the health and nutrition sector were consulted to analyse the constructs/variables of the index. RESULTS: A growth monitoring and promotion index was developed and validated by several technical experts in the health and nutrition sector in Zimbabwe. CONCLUSIONS: A new index has been developed to improve the quality of growth monitoring and promotion activities within the communities.

Challenges regarding sexual health communication with secondary school learners in Limpopo Province: Parents views.

BACKGROUND: A conversation about sexuality is most likely to encourage healthy and positive sexual practices while reducing risky sexual behaviour among adolescents. Traditionally, sexuality is discussed in hushed tones in proverbs and is reserved for adults. On the other hand, adolescents require to be well informed about their sexuality to assist them to make informed decisions about their sexual behaviour. AIM: The study determined parents' views regarding challenges of sexual health communication among secondary school learners in Limpopo Province. METHOD: A qualitative, exploratory-descriptive, and contextual approach was employed for the study. Fifty-six parents were purposively select, resulting in five focus group discussions that had 8-12 members. One central question was asked, and based on the participants' responses, probing questions asked followed. Data were analyzed using thematic analysis. Trustworthiness and ethical considerations were ensured. RESULTS: Three themes, that is communication concerns, role shifting in imparting sexuality education and poor parent-child relationships and eight sub-themes emerged from the data. CONCLUSION: Study identified that communication concerns influence parent-child dialogue on sexuality education. Therefore, there is a need to address factors hindering communication like cultural barriers, role shifting in imparting sexuality education, poor parent-child relationships. This study suggests that parents be empowered in dealing with children's sexuality.

A professional nurse's understanding of quality nursing care in Limpopo province, South Africa.

BACKGROUND:  Quality has increasingly become a critical part of life in every aspect. Patients are today continuously looking for good quality services from health professionals. Professional nurses are expected to render quality care to fulfil the patients' healthcare needs. Poor nursing care has led to several litigations and the loss of patients' lives. It is essential to explore professional nurses' viewpoints regarding quality nursing care. OBJECTIVES:  To explore and describe the understanding of professional nurses regarding quality care rendered to patients in the selected hospitals of Limpopo Province. METHOD:  This study utilised a qualitative, exploratory-descriptive design. Individual semi-structured interviews were conducted for data collection. Participants comprised 35 professional nurses who were purposely selected. Data collected were audio-recorded and transcribed verbatim. Data were analysed using Tech's eight-step data coding process, which led to the emergence of themes and sub-themes. Trustworthiness was ensured through credibility, confirmability, dependability, and transferability. RESULTS:  Three themes emerged: professional nurses' descriptions, meanings, and expectations of quality nursing care. The findings highlight that quality nursing care means meeting patients' needs through advocacy, empathy, fulfilment of patients' needs, good interpersonal relationships and teamwork. Challenges experienced included the lack of resources and staff shortage. CONCLUSION:  Hospital management needs to develop effective ways to support professional nurses in delivering quality nursing care. In discussion with the Department of Health (DoH), hospitals should be fully equipped with resources to render quality care to patients. Evaluation of service quality and patient satisfaction should be ongoing for improving the quality of patient care.Contribution: The study reveals that professional nurses perceive quality nursing care differently. Moreover, it emphasises the importance of maintaining and promoting quality nursing care as the cornerstone of healthcare.

Diagnosis of Epilepsy by Traditional Healers and Its Implications on Management in the Selected Rural Communities of Limpopo and Mpumalanga Provinces: A Qualitative Study.

Introduction: Epilepsy is a neurological disorder which causes seizures and may be accompanied by loss of unconsciousness and control of bowel or bladder function. However, other types of epilepsy are only characterised by rapid blinking or a few seconds of staring into space. Many people living with epilepsy in rural communities consult traditional healers as their first line of treatment for epilepsy. Second preference is given to medical practitioners which causes unnecessary delay in the early diagnosis and treatment of epilepsy. This study aimed to explore how traditional healers diagnose epilepsy and its implications on management in the selected rural communities of Limpopo and Mpumalanga Provinces. Methods: A qualitative approach using explorative, descriptive and contextual designs was adopted. Purposive sampling was used to sample six villages in Limpopo and Mpumalanga Provinces. Snowball sampling was used to sample twenty traditional healers. Data were collected through in-depth individual interviews at the participant's homes. Data were analysed using Tesch's eight steps of open coding data analysis. Results: This study found that traditional healers have varied beliefs and misconceptions regarding the causes and diagnosis of epilepsy, hence this greatly influencing the management. The misconceptions on the causes include a calling by ancestors, urine contents, snake in the stomach, contaminated digestive system and witchcraft. The management included using herbal plants, insects, foam excreted during seizures and urine of the person living with epilepsy. Recommendation: It is recommended that for effective management of epilepsy, there should be coordination between traditional healing and western medicine. Future research should look at the integration of traditional medicine and western medicine.

Knowledge and Attitudes towards Prostate Cancer and Screening among Males in Limpopo Province, South Africa.

Inadequate knowledge and poor attitudes about prostate cancer (PC) negatively affect early screening practices among males. The PC mortality rate is increasing due to late reporting, screening, and treatment. This study explored the awareness, attitudes, and PC screening behaviours among males in the Limpopo, Thulamela municipality. This descriptive cross-sectional study involved 245 males that were randomly selected. A structured questionnaire was used to collect data. Fisher's exact tests and logistic regression analysis were used to examine the association between sociodemographic variables, awareness, and attitudes towards PC. Our findings revealed that 64.1% demonstrated inadequate awareness about PC. The overall score (84.9%) showed a positive attitude towards PC. However, 87.4% had a negative attitude towards the effectiveness of treatment for PC. The majority (96.7%) of respondents had never undergone a PSA test, although 53.1% were willing to undergo a PSA test. There was a significant positive correlation between awareness of prostate cancer and attitudes toward prostate cancer (r = 0.280, p < 0.001). Health status predicted awareness about PC, while age and health status predicted attitudes towards PC among men. Rural community-based programmes and heightened awareness campaigns are needed to conscientize men about the risk factors, symptoms, diagnosis, and treatment of PC in rural areas of Limpopo.

Caregivers' and Family Members' Knowledge Attitudes and Practices (KAP) towards Epilepsy in Rural Limpopo and Mpumalanga, South Africa.

Epilepsy, a common neurological disease, has a significant impact on people living with epilepsy (PLWE), their caregivers, and their family members. Research has consistently shown that the quality of life of PLWE is low. To expand on this knowledge, a non-experimental quantitative survey study was conducted to explore the knowledge, attitudes, and practices (KAP) of caregivers and family members towards epilepsy and epilepsy-related seizures. The study sample consisted of 519 participants from two South African provinces (Limpopo and Mpumalanga), mostly aged 26-35 years. The study revealed that most respondents in Limpopo had no formal education, whereas in Mpumalanga, most had a secondary education. Most respondents (32.4%) reported always using a spoon to prevent tongue biting during seizures. However, 62.4% of respondents reported feeling unprepared to handle an epileptic seizure. Additionally, the majority (54.7%) showed a moderate level of knowledge about epilepsy. Many respondents had a negative attitude towards epilepsy, and there was uncertainty about proper practices during a seizure. In summary, the research highlights unsatisfactory knowledge and practices towards epilepsy and emphasizes the need for increased education and awareness among caregivers and family members. Significant educational investment is needed from medical services to improve epilepsy care, knowledge, and attitudes.

A Conceptual Model to Strengthen Integrated Management of HIV and NCDs among NIMART-Trained Nurses in Limpopo Province, South Africa.

Integrated management of human immune deficiency virus (HIV) and non-communicable diseases (NCDs) in primary health care facilities remains a challenge. Despite research that has been conducted in South Africa, it is evident that in Limpopo Province there are slits in the implementation thereof. There is a need to develop a conceptual model to guide in strengthening the clinical competence of nurse-initiated management of antiretroviral therapy (NIMART)-trained nurses to implement the integrated management of HIV and NCDs to improve clinical outcomes of patients with the dual burden of diseases in Limpopo Province, South Africa. This study aimed to develop a conceptual model to strengthen the implementation of integrated management of HIV and NCDs amongst NIMART nurses to improve clinical outcomes of patients with the dual burden of communicable and non-communicable diseases in Limpopo Province, South Africa. An explanatory, sequential, mixed-methods research design was followed. Data were collected from patient records and the skills audit of 25 Primary Health Care (PHC) facilities and from 28 NIMART trained nurses. Donabedian's structure process outcome model and Miller's pyramid of clinical competence provided a foundation in the development of the conceptual model. The study revealed a need to develop a conceptual model to strengthen the implementation of integrated HIV and NCDs implementation in PHC, as evidenced by differences in the management of HIV and NCDs. Conclusion: The study findings were conceptualised to describe and develop a model needed to strengthen the implementation of integrated management of HIV and NCDs amongst NIMART nurses working in PHC facilities. The study was limited to Limpopo Province; the model must be implemented in conjunction with the available frameworks to achieve better clinical outcomes.

Development of a growth monitoring and promotion index to improve child health in Zimbabwe.

In Zimbabwe, growth monitoring and promotion as conducted by community health workers are part of the nutritional surveillance system. This study seeks to develop a new index which will combine both caregiver behaviours, attitudes and CHW growth monitoring and promotion activities. An explanatory sequential mixed method design will be conducted in three phases. Phase one will comprise a scoping literature review. The second phase will comprise a needs analysis through quantitative data collection using two surveys of community health workers and caregivers of children under five years. Thereafter, qualitative data will be collected from caregivers of children under five years. The quantitative data will be analysed using SPSS while qualitative data will be collected and analysed using Atlas-ti. Phase three will be the development phase for the growth monitoring and promotion Index. The growth monitoring and promotion Index will be used to classify the GMP performance of districts through the DHIS2 thus strengthening the quality of growth monitoring and promotion. Recommendations on the findings and the adoption of the Index will be shared with the Ministry of Health and Child Care and key stakeholders implementing maternal, newborn and child health programmes in Zimbabwe for adoption and use in growth monitoring and promotion programming.