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.

An Inclusive Framework for Collaboration between Midwives and Traditional Birth Attendants and Optimising Maternal and Child Healthcare in Restricted Rural Communities in South Africa: Policy Considerations.

Collaboration between midwives and traditional birth attendants for maternal and child healthcare is a challenge in rural South African communities due to the absence of a guiding framework. To address this, this study sought to develop and validate an inclusive framework informed by the Donabedian structure-process-outcome (SPO) framework for collaboration between these healthcare professionals. METHOD: Key stakeholders were invited to participate in a co-creation workshop to develop the framework. Twenty (20) participants were purposively sampled based on their maternal and child healthcare expertise. A consensus design using the nominal group technique was followed. RESULTS: Participants identified the components needed in the framework, encompassing (i) objectives, (ii) structures, (iii) processes, and (iv) outcomes. CONCLUSION: This paper will contribute to the development of an inclusive healthcare framework, providing insights for stakeholders, policymakers, and practitioners seeking to improve maternal and child healthcare outcomes in resource-constrained, rural settings. Ultimately, the proposed framework will create a sustainable and culturally sensitive model that optimises the strengths of midwives and TBAs and fosters improved healthcare delivery to rural South African communities.

The training of midwives to perform obstetric ultrasound scan in Africa for task shifting and extension of scope of practice: a scoping review.

INTRODUCTION: Ultrasound scan is one of the essential assessments that is crucial in the early identification of health risks during antenatal care. Its accessibility to women in low-and middle-income countries remains a serious challenge because ultrasound scans are not within the scope of practice for midwives. However, task shifting and extension of scope of practice aim to train midwives to assess pregnant women through an ultrasound scan. This paper aims to report the findings of a scoping review on the training of midwives to perform obstetric ultrasound scans in Africa. METHODS: The 6-step iterative framework for scoping reviews by Arksey and O'Malley was used to determine the extent of qualitative and quantitative evidence available on the training of midwives on obstetric ultrasound scans, which includes specifying the research question, identifying relevant studies, selecting studies, extracting and charting data, collating, summarising, and synthesising and reporting findings. RESULTS: A total of 12 articles from eight African countries were included in this scoping review. Three main themes and 13 sub-themes emerged and they are: obstetric ultrasound scan training, challenges experienced by midwives from task shifting and extension of scope of practice regarding obstetric ultrasound scan, and the value of task shifting and extension of scope of practice regarding obstetric ultrasound scan to midwives. DISCUSSION: Despite the available evidence that the training of midwives on obstetric ultrasound scans is essential to ensure the accessibility of quality antenatal health services, the training of midwives on obstetric ultrasound scans in some African countries remains a serious challenge. It is evident from this scoping review results that there is a need for African countries to incorporate obstetric ultrasound scans as part of the scope of practice of midwives. Task shifting necessitates prioritising the training of midwives on the use of obstetric ultrasound scans as one of the steps towards the achievement of the United Nations Sustainable Development Goal number 3 targets by 2030.

Strategies to enhance sexual health education for prevention of teenage pregnancy in Vhembe District, Limpopo Province: different stakeholder's perspectives, a co-operative Inquiry qualitative protocol paper.

BACKGROUND: South Africa is reporting higher rates of adolescent pregnancy as compared to other countries. There are different types of interventions that are in place to address teenage pregnancy. However, these interventions were developed using top-down strategy without the inclusion of different stakeholders and adolescents which makes it hard to implement those interventions particularly in countries like South Africa. Hence, this study aimed to develop strategies to enhance sexual health education for prevention of teenage pregnancy in Vhembe District, Limpopo Province of South Africa. METHODS: The research design of this study will be Co-operative Inquiry.The study will take place in Vhembe District in Limpopo province of South Africa through collaborating with a Non-governmental Organisation (NGO). The study population will be the teenagers and all the different stakeholders caring for teenagers in their areas of specialization. Purposive sampling will be used to sample the targeted participants of the study. The data collection method will be done in phases and focus group discussions will be used to collect data. Content analysis will be used to analyse data. DISCUSSION: This study will add to the body of knowledge regarding the strategies that maybe used to enhance sexual health education for prevention of teenage pregnancy.

Psychometric properties of a clinical assessment tool in the postgraduate midwifery programme, Botswana.

BACKGROUND:  The psychometric properties of a clinical assessment tool used in the postgraduate midwifery programme in Botswana have not been evaluated. A lack of reliable and valid clinical assessment tools contributes to inconsistencies in clinical assessment in midwifery programmes. OBJECTIVES:  This study aimed to evaluate the internal consistency and content validity of a clinical assessment tool used in the postgraduate midwifery programme in Botswana. METHOD:  For internal consistency, we calculated the total-item correlation and Cronbach's alpha coefficient. For content validity, subject matter experts completed a checklist to evaluate the relevance and clarity of each competency in the clinical assessment tool. The checklist included questions with Likert-scale responses, indicating the level of agreement. RESULTS:  The clinical assessment tool had a good reliability, with a Cronbach's alpha of 0.837. The corrected item total correlation values ranged from -0.043 to 0.880 and the Cronbach's alpha (if item deleted) ranged from 0.079 to 0.865. Overall content validity ratio was 0.95, and content validity index was 0.97. Item content validity indices ranged from 0.8 to 1.0. The overall scale content validity index was 0.97 and the scale content validity index using universal agreement was 0.75. CONCLUSION:  The clinical assessment tool used in the postgraduate midwifery programme in Botswana has acceptable reliability. Most of the competencies included in the clinical assessment tool were relevant and clear. Certain competencies need to be reviewed to improve the reliability and validity of the clinical assessment tool.Contribution: The clinical assessment tool currently used in the postgraduate midwifery programme in Botswana had acceptable internal consistency reliability and validity.

Work-related support needs of registered nurses in a neonatal intensive care unit in the Tshwane District.

Background: Registered nurses in neonatal intensive care units (NICU) are working under stressful environment caused by the need and commitment to provide care for the critically ill neonates. Therefore, there is an imperative need to know and understand the work-related support strategies that can be adapted for registered nurses working in a NICU in the Tshwane District to enable them to provide quality care for the admitted neonates. Aim: To explore and describe the work-related support needs of registered nurses working in a specific NICU situated in the Tshwane District. Setting: The study was conducted in a selected NICU in Tshwane District. Method: A qualitative, exploratory, descriptive, and contextual design was used in this study. In-depth unstructured individual face-to-face interviews were conducted with nine registered nurses working at the selected NICU of an academic hospital. Thematic data analysis was conducted. Results: Three themes, namely teamwork between registered nurses and doctors, staff development in the form of peer seminars, workshops and in-service training, and availability of adequate resources within the workplace arose. Conclusion: This study revealed that the registered nurses working in the NICU in the Tshwane District are in need of work-related support, as it will improve their well-being. Contribution: The contribution of this study will be used by the hospital management to plan strategies that can be adapted for the betterment of the work environment for registered nurses in the NICU and the hospital in general.

Assessing HIV Pre-exposure Prophylaxis Uptake and Retention Amongst Young Females in Gauteng Province.

Although roll-out of HIV pre-exposure prophylaxis (PrEP) has been reported to have changed contexts of HIV risk in areas where it was well-implemented. The rate of its uptake and retention amongst young females has not been described in Gauteng Province. This paper aimed at assessing PrEP uptake and retention among young females in Gauteng Province. Total of young females who tested HIV across five clinics from 01/January/2017 to 31/December/2020 was 19,671 with 17,937 tested HIV negative. Of the HIV tested negative, PrEP was initiated to 1307 (7%). The analysis revealed that 27% of young females returned for their first follow up visit after PrEP initiation, while third month declined to 14%, fourth month to 11%, and fifth month to 3%, sixth month to 2% and seventh month at 1% and from the eighth month, the rate of follow up was 0%. Uptake and retention of PrEP was low among young females as measured against the total tested HIV negative.

Exploring the psychosocial challenges faced by pregnant teenagers in Ditsobotla subdistrict.

Background: Pregnant teenagers usually experience psychosocial challenges such as a great amount of stress when they have to deal with an unwanted pregnancy, unpreparedness for parenthood and a lack of income as well as labour and birth complications. These are further complicated by the stigma from their families, friends and community. Unaddressed psychosocial challenges during teenage pregnancy can adversely affect the health outcomes of both mother and the child. Aim: This study explores and describes the psychosocial challenges faced by pregnant teenagers in the Ditsobotla subdistrict. Setting: The study was conducted in three health centres in the Ditsobotla subdistrict. Methods: A qualitative-exploratory-descriptive and contextual research design was used. Non-probability purposive and convenience sampling techniques were used to select the participants. Semistructured individual interviews through WhatsApp video calls were used to collect data, which were analysed using conventional content analysis. Results: Three themes emerged from the findings of the study, namely psychological challenges, social challenges and suggestions to address psychosocial challenges faced by pregnant teenagers. Conclusion: The findings established that pregnant teenagers in the Ditsobotla subdistrict are faced with psychosocial challenges which negatively impact their psychological health and social life. Suggestions made in this study have the potential to improve the psychosocial well-being of pregnant teenagers in the Ditsobotla subdistrict if implemented. Contributions: The findings of this study provide important information that may be used to improve the psychosocial well-being of pregnant teenagers in the Ditsobotla subdistrict.

Factors that Master of Nursing students associate with study progress in higher education institutions in Gauteng province.

BACKGROUND: Globally, the unsatisfactory progress of postgraduate students registered for a master's degree is a cause for concern. It affects graduation numbers and completion time. AIM: This study aimed to determine the perceived supervisory-researcher community support, research writing, work-life balance, and research conceptions factors that Master of Nursing students associate with study progress. SETTING: The study was conducted in three selected higher education institutions (HEIs) in the Gauteng province. METHOD: A correlational cross-sectional research design was utilised. A self-administered questionnaire adapted from the Cross-Country Doctoral Experience Survey was e-mailed to a total sample of 136 Master of Nursing students who were at least in their second year of study, of which 122 (89.7%) responded. Descriptive statistics, factor analysis, the Mann-Whitney U test, and the Kruskal-Wallis test were used to analyse the responses. RESULTS: Most of the students' perception was greater regarding supervisory-researcher community support and research conceptions. Despite a high mean composite score of 4.134 (SD-1.452) on work-life balance, some respondents found it difficult to balance work and life. Respondents with a source of income perceived greater supervisory-researcher community support (p = 0.022) while those studying full-time had better research writing perceptions (p = 0.002). CONCLUSION: There is need for HEIs to develop or strengthen interventions targeting research writing and work-life balance factors that were perceived to result in less support. Funding remains a concern for Master of Nursing students. CONTRIBUTION: This study contributes to knowledge on factors that Master of Nursing students associated with study progress.

Conceptual Framework for Rape Survivors Diagnosed with PTSD in the North West Province of South Africa.

The lack of a conceptual framework that can be utilized to manage rape survivors diagnosed with Post-Traumatic Stress Disorders presents a challenge in the North-West province. The study aims to provide a conceptual framework for managing rape survivors with PTSD in the province of the North-West using Practice-Oriented Theory and Donabedian's Structure Process Outcome Model Features. The research was conducted using an explanatory, sequential and mixed-methods approach. Additionally, used was the descriptive and explorative programme evaluation design. The results of the study demonstrated the significance of PTSD assessment before management interventions for rape survivors. The study findings outlined and designed a framework to assess and manage PTSD among rape survivors consulting at Thuthuzela Care Centre and those referred to hospitals for further management. The Practice-Oriented theory by Dickoff, James and Wiedenbach, and the Structure Process Outcome model by Donabedian served as points of reference for the development of the conceptual framework. The study is limited to North-West provincial healthcare facilities and Thuthuzela care centres (TCCs), however, it highlights the lack of a conceptual framework pertaining to the psychological management of PTSD rape survivors in the province and South Africa.

The perspectives of nursing students regarding the incorporation of African traditional indigenous knowledge in the curriculum.

BACKGROUND: South Africa was caught off guard by the student unrest in 2015 and 2016. This unrest was named the #fees must fall campaign. During this campaign, students raised the issue of decolonisation of the curriculum, challenging the higher education fraternity and the academic community. This was based on the fact that the existing curriculum has inadequate content on African traditional indigenous knowledge (ATIK), and continues to use the Western approach to address the needs of a multicultural, multiracial and multi-ethnic societies. Institutions responded by initiating dialogues regarding decolonisation of the curriculum in senates, scholars and between different health professional bodies. AIM: This article aimed to explore and describe the perspectives of nursing students regarding incorporating ATIK into the curriculum. METHODS: Using a participatory transformative approach, researchers and participants worked collaboratively to inform social change. Participants comprised nursing students. The academics, traditional health practitioners, indigenous knowledge holders and primary health care nurses formed the panellists. Data were collected through one communal dialogue workshop, which lasted for 8 hours, tea and lunch included. Data were analysed thematically. RESULTS: Students' perspectives emerged strongly as four themes, namely, politics of identity, displacement and distortion, curriculum content and institutional resistance. Students expressed that the current education system results in an identity crisis. The existing curriculum does not adequately convey an understanding of ATIK; it is displaced and distorted. CONCLUSION: Nursing science has great potential to incorporate the wealth of ATIK into its curriculum. In spite of a vibrant and rich cultural heritage, the ATIK specific to nursing sciences still needs to be incorporated into the existing curriculum in a responsive and relevant manner.

The perspectives of nursing students regarding the incorporation of African traditional indigenous knowledge in the curriculum

Background: South Africa was caught off guard by the student unrest in 2015 and 2016. This unrest was named the #fees must fall campaign. During this campaign, students raised the issue of decolonisation of the curriculum, challenging the higher education fraternity and the academic community. This was based on the fact that the existing curriculum has inadequate content on African traditional indigenous knowledge (ATIK), and continues to use the Western approach to address the needs of a multicultural, multiracial and multi-ethnic societies. Institutions responded by initiating dialogues regarding decolonisation of the curriculum in senates, scholars and between different health professional bodies. Aim: This article aimed to explore and describe the perspectives of nursing students regarding incorporating ATIK into the curriculum. Methods: Using a participatory transformative approach, researchers and participants worked collaboratively to inform social change. Participants comprised nursing students. The academics, traditional health practitioners, indigenous knowledge holders and primary health care nurses formed the panellists. Data were collected through one communal dialogue workshop, which lasted for 8 hours, tea and lunch included. Data were analysed thematically. Results: Students' perspectives emerged strongly as four themes, namely, politics of identity, displacement and distortion, curriculum content and institutional resistance. Students expressed that the current education system results in an identity crisis. The existing curriculum does not adequately convey an understanding of ATIK; it is displaced and distorted. Conclusion: Nursing science has great potential to incorporate the wealth of ATIK into its curriculum. In spite of a vibrant and rich cultural heritage, the ATIK specific to nursing sciences still needs to be incorporated into the existing curriculum in a responsive and relevant manner