Evaluating counselling skills of community health workers for pregnant adolescents in Limpopo province.

Background: Adolescent pregnancy carries significant global ramifications. Community health workers (CHWs) play a role in empowering adolescents through counselling skills, thereby promoting informed decision-making for better outcomes. Aim: The study aims to evaluate the counselling skills of CHWs in their efforts to support pregnant adolescents (PA) in Limpopo province. Setting: The research was carried out with CHWs in the Mopani and Vhembe districts of the Limpopo province. Methods: A quantitative descriptive approach was used to evaluate CHWs' counselling skills for PAs in Limpopo. A sample of 81 respondents was selected using simple random sampling. Ethical approval was obtained. Data were collected using a questionnaire guided by the Theory of Reasoned Action. Descriptive statistics were analysed using Statistical Package for Social Scientists version 24. The questionnaire's validity was assessed using Cronbach's alpha, resulting in a correlation coefficient of 0.710. Results: The study identified significant variations in counselling recommendations. Preparation: Using private space with fewer distractions showed considerable variability (standard deviation = 0.218). Introduction: High variability was observed in using the SOLER method (standard deviation = 0.316). Working phase: Suggesting rather than advising had notable variability (standard deviation = 0.396). Termination: Avoiding abrupt endings and informing clients about the session's conclusion demonstrated variability (standard deviation = 0.283). Additionally, the majority (64%) of the participants found record-keeping unnecessary, which demonstrated the highest variability (standard deviation = 0.482). Conclusion: The study revealed CHWs' proficiency in counselling techniques and emphasised the importance of following the counselling stages. Contribution: The research highlights the importance of evaluating the counselling skills of CHWs and identifying areas for improvement to develop targeted interventions and enhancing health outcomes for PAs.

Factors contributing to rise in teenage pregnancy in Sekhukhune district, Limpopo province.

BACKGROUND:  The Department of Health in South Africa has reported an alarming total of 90 037 teenage girls between the ages of 10 years and 19 years who gave birth from March 2021 to April 2022, across all provinces and districts. The rise in teenage pregnancy is of serious concern as adolescents girls are more likely to experience difficult pregnancies and deliveries which could lead to detrimental effects on their health. OBJECTIVES:  The study aimed to explore and describe factors contributing to the increase in teenage pregnancy in the Sekhukhune district of Limpopo. METHOD:  The study was conducted in the healthcare facilities of Sekhukhune area. A qualitative, exploratory design was followed. Participants were purposively selected, and data were gathered through face-to-face individual interviews. Data analysis employed Tesch's inductive, descriptive coding method. RESULTS:  Negligence, peer pressure, ambiguity, choice, lack of contraceptive use, and lack of family attachment were identified as exacerbating factors in the district's surge in teenage pregnancy. CONCLUSION:  To reduce teen pregnancy, it is crucial to promote contraception, enhance cooperation between schools and the government, involve families in sexual and reproductive health discussions, prioritise a supportive home environment, advocate for child support grants, revitalise school health services, and empower teenagers to make informed choices and resist peer pressure.Contribution: The study will provide guidance to policy makers and other stakeholders in developing appropriate programmes to address the problem and improve the health and socioeconomic status of adolescents in rural areas. This will reduce healthcare costs associated with complications and premature birth.

Perceptions of community health workers on teenage pregnancy in rural Limpopo: A qualitative study.

BACKGROUND:  Despite measures put in place to combat teenage pregnancy, the rate remains high. Community health workers (CHWs) are a cadre of health workers that can help put measures in place to reduce teenage pregnancy in the communities in which they live and work. AIM:  This article aims to gain a deeper understanding of CHWs' perceptions regarding teenage pregnancy in the rural districts of Limpopo province. METHODS:  An exploratory qualitative study approach was employed to collect data from CHWs in two rural districts of Limpopo. A non-probability purposive sampling approach was used to choose 81 CHWs. Eight focus group discussions (FGDs) were organised, and audio recorded to collect data from participants. The discussions were 2-3 h long and conducted in English, and data saturation was attained by the fifth FGDs. RESULTS:  An eight-step tech's content analysis approach was employed to deductively code, analyse and summarise data into themes. Three themes emerged: the prevalence of teenage pregnancy in rural villages, factors contributing to teenage pregnancy and challenges faced by CHWs when dealing with teenage pregnancy. CONCLUSION:  The study's findings revealed that CHWs face challenges in their communities when offering appropriate teen pregnancy services and CHWs believe that teen pregnancy numbers remain high. There is a significant barrier in combating teenage pregnancy; if contraceptives are not acceptable to the community, the only solution and option for combating teenage pregnancy is abstinence.Contribution: The CHWs presented their insights of teenage pregnancy in rural communities. The outcomes of this study could help clinical practise, schools, communities, youth-friendly services, policymakers and other non-governmental organisations reduce teenage pregnancy.

Perceptions of community health workers on teenage pregnancy in rural Limpopo: A qualitative study

Background: Despite measures put in place to combat teenage pregnancy, the rate remains high. Community health workers (CHWs) are a cadre of health workers that can help put measures in place to reduce teenage pregnancy in the communities in which they live and work. Aim: This article aims to gain a deeper understanding of CHWs' perceptions regarding teenage pregnancy in the rural districts of Limpopo province. Methods: An exploratory qualitative study approach was employed to collect data from CHWs in two rural districts of Limpopo. A non-probability purposive sampling approach was used to choose 81 CHWs. Eight focus group discussions (FGDs) were organised, and audio recorded to collect data from participants. The discussions were 2­3 h long and conducted in English, and data saturation was attained by the fifth FGDs. Results: An eight-step tech's content analysis approach was employed to deductively code, analyse and summarise data into themes. Three themes emerged: the prevalence of teenage pregnancy in rural villages, factors contributing to teenage pregnancy and challenges faced by CHWs when dealing with teenage pregnancy. Conclusion: The study's findings revealed that CHWs face challenges in their communities when offering appropriate teen pregnancy services and CHWs believe that teen pregnancy numbers remain high. There is a significant barrier in combating teenage pregnancy; if contraceptives are not acceptable to the community, the only solution and option for combating teenage pregnancy is abstinence. Contribution: The CHWs presented their insights of teenage pregnancy in rural communities. The outcomes of this study could help clinical practise, schools, communities, youth-friendly services, policymakers and other non-governmental organisations reduce teenage pregnancy

Factors contributing to rise in teenage pregnancy in Sekhukhune district, Limpopo province

Background: The Department of Health in South Africa has reported an alarming total of 90 037 teenage girls between the ages of 10 years and 19 years who gave birth from March 2021 to April 2022, across all provinces and districts. The rise in teenage pregnancy is of serious concern as adolescents girls are more likely to experience difficult pregnancies and deliveries which could lead to detrimental effects on their health. Objectives: The study aimed to explore and describe factors contributing to the increase in teenage pregnancy in the Sekhukhune district of Limpopo. Method: The study was conducted in the healthcare facilities of Sekhukhune area. A qualitative, exploratory design was followed. Participants were purposively selected, and data were gathered through face-to-face individual interviews. Data analysis employed Tesch's inductive, descriptive coding method. Results: Negligence, peer pressure, ambiguity, choice, lack of contraceptive use, and lack of family attachment were identified as exacerbating factors in the district's surge in teenage pregnancy. Conclusion: To reduce teen pregnancy, it is crucial to promote contraception, enhance cooperation between schools and the government, involve families in sexual and reproductive health discussions, prioritise a supportive home environment, advocate for child support grants, revitalise school health services, and empower teenagers to make informed choices and resist peer pressure. Contribution: The study will provide guidance to policy makers and other stakeholders in developing appropriate programmes to address the problem and improve the health and socioeconomic status of adolescents in rural areas. This will reduce healthcare costs associated with complications and premature birth. Keywords: factors; teenager; pregnancy; tee

A concept analysis: Support for lay healthcare workers in HIV services, Bojanala District, North West.

BACKGROUND:  Different lay healthcare workers play an important role in the retention of clients to human immunodeficiency virus (HIV) care. Retention to HIV care is crucial to promote treatment continuation, viral suppression and reduced risk of transmission. However, lay healthcare workers view and perceive support differently. OBJECTIVES:  The aim of the study was to investigate perceptions of healthcare workers regarding support provided to lay healthcare workers in HIV services. This article is a report of a concept analysis of healthcare workers' support provided to lay healthcare workers in HIV services, that was collected during the study. A concept analysis was done to explore the support attributes, clarify meaning and to understand its use within the lay healthcare workers' context in Bojanala District, situated in the North West province of South Africa. METHOD:  The initial phase was data collection from lay healthcare workers, their supervisors and clients on antiretroviral therapy. Thereafter, the eight concept analysis steps of Walker and Avant were followed. Peer-reviewed articles on the support concept were searched and guided by data saturation. RESULTS:  Responsiveness, provision, reciprocity and integration are key characteristics of support. CONCLUSION:  Despite support being an interpersonal process, it is perceived subjectively. Support is necessary to continuously promote growth or endurance during adverse times.Contribution: The concept analysis will provide common understanding of support and information that is responsive to the needs of different lay healthcare workers.

Cost of wound dressing: Implication for enrollment into the National Health Insurance scheme, Nigeria.

BACKGROUND:  Enrollment into the National Health Insurance scheme (NHIS) still poses a challenge in Nigeria despite the established Group, Individual and Family Social Health Insurance Programme (GIFSHIP) during the coronavirus disease 2019 (COVID-19) pandemic. OBJECTIVES:  This study examined the direct cost of wound dressing and enrollment into the health insurance scheme among hospitalised patients. METHOD:  A descriptive cross-sectional research design was utilised to investigate the cost of wound dressing and enrollment into health insurance scheme among hospitalised patients in three selected hospitals of South-West Nigeria. The study was conducted from March 2021 to June 2021, and 190 patients were recruited via an interviewer-administered questionnaire. Ethical approvals were obtained from the hospitals while COVID-19 preventive protocols and ethical principles of autonomy, confidentiality and non-maleficence were observed. RESULTS:  Majority of the respondents (91%) were not on any healthcare insurance scheme, only 4.2% were enrolled in NHIS while over 70% could not personally pay for their wound dressing. The minimum average cost of wound dressing materials per week and per acute care episode was ₦10 000.00 (Nigerian naira) and ₦50 000.00, respectively, while the minimum average cost for hospitalisation per week and per acute care episode was ₦18 000.00 and ₦130 000.00, respectively, ($1.00 equaled ₦600.00, June 2022). CONCLUSION:  A lack of health insurance coverage is a precursor of 'out of pocket' payment. A political will is required to scale up enrollment of the indigenous population into the NHIS in Nigeria.Contribution: Many hospitalised patients are not enrolled in the NHIS and they are at a higher risk of catastrophic healthcare expenditure.

Experiences of patients with chronic diseases during the COVID-19 pandemic in the North West province, South Africa.

BACKGROUND: Patients with chronic diseases (PWCDs) were severely affected by the coronavirus disease 2019 (COVID-19) pandemic, as they were prevented from making the necessary visits to health facilities for medical review and to collect their medication. The emergence of the health crisis and inadequate access to quality care affected chronic care management. The perspectives of PWCDs are not known, and therefore the research on which this paper is based sought to investigate the lived experiences of these patients during the COVID-19 pandemic. METHODS: A qualitative phenomenological design was used to obtain the lived experiences of PWCDs identified for participation in the study by means of purposive sampling. Patients' experiences were obtained during individual structured interviews, and a checklist was used to gather patient characteristics from their files. RESULTS: Three themes emerged from the study findings, namely poor healthcare services, the socio-economic impact of the COVID-19 pandemic, and the psychological impact of the COVID-19 pandemic. The COVID-19 pandemic had devastating effects on PWCDs, in that they experienced barriers to accessing quality chronic care services and suffered psychological and financial difficulties that affected their health, life, needs and expectations. CONCLUSION: Policymakers should consider PWCDs when responding to a public health concern in the future.Contribution: The study findings may have an impact on future policies regulating the management of chronic diseases during epidemics, in order to improve patient health outcomes and satisfaction with healthcare services and the chronic care model based on the experiences of PWCDs.

The support group impact on enhancing the self-worth of women who terminated a pregnancy in adolescence.

BACKGROUND:  Terminating a pregnancy can be a traumatic life event, resulting in negative emotions that can diminish women's self-worth. Support from different sources, including health support groups, could be beneficial in restoring a woman's self-worth. This article aimed to present findings on the impact of a support group intervention on the self-worth of women who terminated a pregnancy in adolescence. METHODS:  A qualitative, exploratory and descriptive approach, using in-depth, semi-structured interviews, was used to collect data. Thematic analysis guided the data analysis. RESULTS:  Five themes emerged from the data: reasons for joining the support group; enhanced emotional and physical wellbeing; self-forgiveness; spiritual growth and participants' voices. CONCLUSION:  Participants described why they needed to join the support group. It became clear that the intercession was effective in the short term as it enhanced participants' self-worth by encouraging them to accept themselves thereby altering their self-condemning emotions, replacing them with self-love.Contribution: The study recommends that a support group should be considered as a backup for women who terminated a pregnancy and have lost their self-worth.

Challenges of caregivers providing care to children with disabilities at non-governmental organisations in Tshwane townships, South Africa.

Background: Caregivers of children with disabilities are vital stakeholders when it comes to safeguarding the health, well-being and overall survival of the children that they care for. Caregivers, however, face many challenging conditions that make it difficult for them to optimally fulfil their caregiving role. Understanding these challenges is crucial for developing empowerment programmes for caregivers, which will ensure that children with disabilities receive comprehensive, optimal care and that caregivers experience a good quality of life. Objectives: The aim of this study was to explore and describe the experiences of caregivers providing care to children with disabilities at non-governmental organisations (NGOs) in townships of Tshwane, South Africa. Method: This study followed an exploratory, descriptive and contextual research design within a qualitative methodology. The population in this study included caregivers who care for children with disabilities at NGOs (n = 10). Participants for the study were selected using the purposive sampling technique. Data were collected by conducting semistructured interviews with caregivers. Data were analysed according to the six phases of thematic analysis proposed by. Results: The study revealed six themes that represent the challenges experienced by caregivers, namely (1) initial impressions, (2) rendering care, (3) stress, (4) lack of outside support, (5) coping and (6) poor community recognition. Conclusion: Support from the Departments of Health and Social Development and other institutions providing community rehabilitation services to townships should be provided to caregivers in order to empower them with skills and knowledge to effectively address the challenges they face so that they can render optimal care to the children they care for. Contribution: Results of this study could assist in ensuring improved recognition, resilience and supportive resources for caregivers in collaboration with community based rehabilitation stakeholders in the community that would ultimately lead to improved care for children with disabilities in townships within South Africa.

Challenges of caregivers providing care to children with disabilities at non-governmental organisations in Tshwane townships, South Africa

Caregivers of children with disabilities are vital stakeholders when it comes to safeguarding the health, well-being and overall survival of the children that they care for. Caregivers, however, face many challenging conditions that make it difficult for them to optimally fulfil their caregiving role. Understanding these challenges is crucial for developing empowerment programmes for caregivers, which will ensure that children with disabilities receive comprehensive, optimal care and that caregivers experience a good quality of life. Objectives: The aim of this study was to explore and describe the experiences of caregivers providing care to children with disabilities at non-governmental organisations (NGOs) in townships of Tshwane, South Africa. Method: This study followed an exploratory, descriptive and contextual research design within a qualitative methodology. The population in this study included caregivers who care for children with disabilities at NGOs (n = 10). Participants for the study were selected using the purposive sampling technique. Data were collected by conducting semi structured interviews with caregivers. Data were analysed according to the six phases of thematic analysis proposed by. Results: The study revealed six themes that represent the challenges experienced by caregivers, namely (1) initial impressions, (2) rendering care, (3) stress, (4) lack of outside support, (5) coping and (6) poor community recognition. Conclusion: Support from the Departments of Health and Social Development and other institutions providing community rehabilitation services to townships should be provided to caregivers in order to empower them with skills and knowledge to effectively address the challenges they face so that they can render optimal care to the children they care for. Contribution: Results of this study could assist in ensuring improved recognition, resilience and supportive resources for caregivers in collaboration with community-based rehabilitation stakeholders in the community that would ultimately lead to improved care for children with disabilities in townships within South Africa.

Community-based maternal and newborn care: A concept analysis.

BACKGROUND:  Community-based care can serve as a valuable programme in the provision of essential maternal and newborn care, specifically in communities in low-income countries. However, its application in maternal and newborn care is not clearly documented in relation to the rendering of services by skilled birth attendants. OBJECTIVES:  The purpose of the analysis was to clarify the meaning of the concept 'community-based maternal and newborn care and its relationship to maternal and newborn health'. METHOD:  Walker and Avant's and Rodgers and Knafl's as well as Chin and Kramer's approaches to concept analysis were followed to analyse community-based maternal and newborn care. RESULTS:  The attributes of community-based care in maternal and newborn health include (1) the provision of home- and/or community-level skilled care, (2) linkages of health services and (3) community participation and mobilisation. These attributes are influenced by antecedents as well as consequences. CONCLUSION:  The provision of good maternal and newborn care to all clients is a crucial aspect in provision of maternal and newborn services. In order for low-income countries to promote maternal and newborn health, community-based care services are the best option to follow.

HIV-positive patients' perceptions of care received at a selected antiretroviral therapy clinic in Vhembe district, South Africa.

BACKGROUND: Patients' experiences are a reflection of what has happened during the care process and, therefore, provide information about the performance of health care professional workers. They refer to the process of care provision at the antiretroviral therapy (ART) sites. AIM AND SETTING: This article explored the perceptions of HIV-positive patients of care received at the Gateway Clinic of the regional hospital that provides antiretroviral treatment in the Vhembe district. METHODS: A qualitative, explorative and descriptive design was used. A non-probability, convenient sampling method was used to select 20 HIV-positive patients who were above 18 years of age. In-depth individual interviews were used to collect data. Data were analysed through Tech's open coding method. RESULTS: One theme and two sub-themes emerged, namely positive experiences related to the environment and attitudes of health professionals, and negative experiences concerning the practices by health care providers. CONCLUSION: Patients' perceptions of quality of, and satisfaction with, health care may affect health outcomes. Recommendations are made to consider, practice and strengthen the protocols, the standard operating procedures and the principles of infection control in the health facilities.

Experiences of family members caring for tuberculosis patients at home at Vhembe district of the Limpopo Province.

Tuberculosis (TB) is a potentially serious infectious disease which enters the body by inhalation and usually affects the lungs. TB is ranked amongst the leading infectious diseases worldwide, and in South Africa (SA) it has become an epidemic, because of its high prevalence. There are multiple factors that were found to attribute to the existence and spread of this disease. The purpose of this study was to explore and describe experiences of family members caring for TB patients at home, in the Vhembe District of the Limpopo Province. The study was qualitative, explorative, descriptive, phenomenological and contextual in nature. The population group selected for the study all comprised of family members caring for tuberculosis patients at home in Tshifulanani village. A purposive sampling method was applied in the study. Data were collected through semi-structured interviews guided by three questions. Tech's eight steps of data analysis were followed. Measures to ensure trustworthiness and ethical issues were observed. The results of the study revealed that family members experienced difficulties when they care for TB patients at home. These difficulties included providing food, attending to hygiene needs, the lack of equipment, financial constraints as well as physical and psychological exhaustion. Recommendations were made concerning the provision food, attending to hygiene needs, assisting in the administration of medication, nursing practice and policy making.