Barriers to accessing and utilising under-five primary health care services in Vhembe District.

BACKGROUND:  Sub-Saharan Africa continues to be the region with the highest under-five mortality rate globally, with 74 deaths per 1000 live births. Even though under-five child primary health care (PHC) services are free in South Africa, accessing such services remains challenging. Children under 5 years reportedly die from common illnesses such as pneumonia, diarrhoea and malaria, which are treatable in PHC facilities. AIM:  The study explored the barriers to accessing and utilising under-five PHC services in the Vhembe District. SETTING:  The study was conducted in two PHC centres in Vhembe District among guardians accessing care for under-five child health services. METHODS:  An interpretative phenomenology design was followed using a semi-structured individual interview guide. Sixteen participants were purposively sampled for the study. Colaizzi's steps of data analysis were followed, and trustworthiness as well as ethical principles were ensured throughout the study. RESULTS:  Four themes emerged as health system barriers, health personnel-related behaviours, health facility infrastructure barriers and guardians-related barriers. Subthemes emerged as distance from the facility, lack of resources, long waiting times; poor time management, lack of commitment and work devotion, insufficient waiting space; challenges with water and sanitation, guardians' healthcare beliefs and the urgency of the illness. CONCLUSION:  It is imperative that an enabling professional and friendly environment is created to facilitate better access to PHC services for children under 5 years.Contribution: The study's findings brought insight into considering the context of the guardians in improving quality care for under 5 years.

Conveying hypertension message: An investigation into the language and content used in primary health clinics in South Africa.

BACKGROUND: Hypertension is a global health burden affecting developed and developing countries, and South Africa is no exception. AIM: This article aims to highlight the language and content used in health education on hypertension in primary healthcare (PHC) by health promoters and in pamphlets. METHODS: The study design was quantitative descriptive. The population comprised a purposive selected sample of 12 health promoters in 12 PHC clinics and 50 pamphlets relating to health education on hypertension. An audio recorder was used to record health education provided by health promoters. Quantitative content analysis and frequency distribution was used to analyse the data. RESULTS: The health promoters used various South African languages mixed with English (code switching). Patients were taught about lifestyle modifications and encouraged to adhere to management therapy. The switching in language usage may affect the understanding of those who do not speak the local language and that may explain the reason for lack of hypertension-suited life modification required by health education. CONCLUSION: It is important that heath education on hypertension should be standardised so that the content of health education in clinic A is similar to that in clinic B. Information contained in pamphlets should be summarised and standardised to the content presented by health promoters.

Conveying hypertension message: An investigation into the language and content used in primary health clinics in South Africa

Background: Hypertension is a global health burden affecting developed and developing countries, and South Africa is no exception. Aim: This article aims to highlight the language and content used in health education on hypertension in primary healthcare (PHC) by health promoters and in pamphlets. Methods: The study design was quantitative descriptive. The population comprised a purposive selected sample of 12 health promoters in 12 PHC clinics and 50 pamphlets relating to health education on hypertension. An audio recorder was used to record health education provided by health promoters. Quantitative content analysis and frequency distribution was used to analyse the data. Results: The health promoters used various South African languages mixed with English (code switching). Patients were taught about lifestyle modifications and encouraged to adhere to management therapy. The switching in language usage may affect the understanding of those who do not speak the local language and that may explain the reason for lack of hypertension-suited life modification required by health education. Conclusion: It is important that heath education on hypertension should be standardised so that the content of health education in clinic A is similar to that in clinic B. Information contained in pamphlets should be summarised and standardised to the content presented by health promoters

Development of a Hypertension Health Literacy Assessment Tool for use in primary healthcare clinics in South Africa, Gauteng.

BACKGROUND: Hypertension is a universal risk factor for cardiovascular morbidity and mortality in both the ageing and obese populations and patients must be literate in hypertension health issues to participate actively in the management of their disease. Little research has been done to investigate hypertension health literacy levels among South Africans. AIM: To develop a Hypertension Heath Literacy Assessment Tool to establish patients' comprehension of the health education they receive in primary healthcare (PHC) clinics in Tshwane, Gauteng, South Africa. SETTING: PHC clinics in Tshwane, Gauteng, South Africa. METHODS: The design was quantitative, descriptive and contextual in nature. The study population comprised health promoters who were experts in the field of health, documents containing hypertension health education content and individuals with hypertension. Participants were conveniently and purposefully selected. A modified Delphi technique was used to develop and validate the Hypertension Health Literacy Assessment Tool (HHLAT). To ensure validity and reliability of the HHLAT, the tool was administered to 195 participants concurrently with the Learning Ability Battery (LAB). RESULTS: There was a strong positive (F = 76.0, p < 0.0001, R2 = 28.25%) correlation between the LAB and the HHLAT. The HHLAT indicated that only 37 (19%) of the patients with hypertension had poor hypertension health literacy levels. CONCLUSION: The HHLAT is a valid tool that can be used in busy PHC clinics as it takes less than two minutes to administer. This tool can inform the healthcare worker on the depth of hypertension health education to be given to the patient, empowering the patient and saving time in PHC facilities.

Comparison of parents of children and the elderly in a rural community.

A comparison of parents and the elderly on three variables--support, depression, and satisfaction are presented. The subjects were 201 elderly and 198 parents of children in a rural community. The findings support that the elderly who receive pensions are caring for young children.

Elderly citizen's perception of their health and care provided in a rural South African community.

A descriptive survey of 201 senior citizens, 55 years or older was conducted June 2001, using face-to-face interviews to establish a database. Structured tools were used to measure self appraisal of family stress, perceived social support, caregiver satisfaction and psychological health of family members and of themselves. Even though the senior citizens had survived past the estimated life expectancy, the quality of life has not improved significantly in the post-apartheid period.

Overview of health and development of children and their families: health and functional status of the elderly.

This paper provides an overview of two studies designed to establish data bases that would aid in describing the health and development of children and their families and the health and functioning of the elderly in a rural community in South Africa.

Health care and developmental status of children and their families.

A description of the health care and developmental status of children from a database created from a study done in a rural community of a province in South Africa. One hundred and ninety-eight parents/guardians responded to questions from structured interview guide. Findings suggest that most of the children are healthy. There appears to be evidence of some progress since the end of apartheid. There, however, still appears that much more is needed to meet the needs of the population living in this rural community.