School of Nursing & Public Health

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A description of midwives’ perceived roles in health educating pregnant women at primary healthcare clinics in a Sub-District of eThekwini, KwaZulu-Natal, South Africa.
(2020) Ramnund , Sanveer.; Baloyi , Olivia Baorapetse.; Jarvis , Mary Ann.
Introduction and background Antenatal care (ANC), the care preceding birth, is described as a careful, systematic assessment and follow up of pregnant women through their pregnancy, culminating in the delivery of the foetus (Al-Ateeq and Al-Rusaiess, 2015). Health education has shown it can result in better pregnancy outcomes (Al-Ateeq et al., 2015). ANC health education is frequently conducted in PHC clinics by midwives (Phillips, 2014; Susuman, 2015), but with the advent of mHealth, it is not confined to the PHC setting (Skinner et al., 2018; Susuman, 2015). Aim/Purpose The aim of the study was to describe midwives’ perceived roles in maternal health education and their acceptance of mHealth in health educating pregnant women during and between antenatal visits at Primary Healthcare clinics in a sub-district of EThekwini, KwaZulu-Natal, South Africa. Methodology A quantitative approach was used, with an explorative and descriptive design, framed within a merged model of Donnabedian’s quality framework and the Unified Theory of User Acceptance of Technology (UTAUT) model. Purposive sampling selected a sub-district of eThekwini, and the participating midwives and unit managers. Data collection occurred over three and a half weeks, in February 2020, using a self-administered questionnaire with the midwives and a researcher-developed survey of the health education landscape with the unit managers. The four-part questionnaire included two validated scales to measure health education (Aldossary et al., 2013) and mhealth (Yakubu et al., 2019). Findings were grouped according to the sections of the questionnaire, namely Section A: Demographics, Section B: Roles and perception of health education, Section C: Acceptance of technology and mHealth in the PHC clinic and Section D: Actual health education conducted. Data was entered into IBM SPSS version 24, and descriptive and inferential statistics calculated. All ethical considerations were adhered to. Results Response rate was 88.5% (n= 92) for the completion of the self-administered questionnaire and 16 surveys of the health education landscape of the PHC clinics The mean age of the respondents was 39 years, with the majority of midwives being female (87%). Responsibility of midwives (m= 18.17/24 [CI95% 17.68-18.67]) was the highest of the subscales, emphasising the important role that midwives play in health education towards pregnant women. Performance Expectancy (m= 16.61/20 [CI95% 15.92 – 17.29]) was the highest of the mHealth subscales. Significant differences were found in the midwives >50 years of age for responsibilities of midwives, and in the male midwives for responsibilities of midwives and perceptions of patient’s responses to health education and midwives perceptions of their role in delivery of health education. During the survey of the health education landscape in the PHC clinics (n=16), the midwives mainly focused on ANC care with 730 sessions conducted in PHC clinics, but less mHealth registrations (n=22, 23.9%). Maternity health policies were available in all clinics (n=16), but just over half (n=10; 62.5%) were able to provide policies on mHealth. Conclusion The study identified both structure and process related information in its description of midwives’ perceived roles in maternal health education and their acceptance of mHealth in health educating pregnant women during and between antenatal visits. Structurally, mHealth polices need greater visibility in the clinics and increased facilitating conditions, such as support for the midwives for mHealth. In particular, midwives older than 50 years and male midwives could add further resistance to the seamless implementation of health education, when utilising both digital and face-to-face approaches. However, from the process perspective of quality care, the midwives showed positive perceptions towards both their roles and responsibility in health education, with high Performance Expectancies of a mHealth application to deliver maternal health education. The level of Performance Expectancy can be drawn on in the COVID-19 pandemic, to ensure continued maternal and neonatal health, despite constraints brought about by social distancing and thereby mitigate against increased maternal mortality rates. Recommendations Studies to identify mitigating circumstances and barriers towards mHealth applications as well as further investigation towards male midwives perceptions of their roles, and responsibilities towards maternal health education. Limitations The use of one district resulted in a small number of clinics and respondents. During this study the Chronbach α scores of the highest subscale ‘responsibilities of midwives’ was low (α= 0.37), thereby affecting the generalisability of that subscale to the population of studies.
Developing a brochure to be used by registered nurses working in the oncology settings to educate patients undergoing chemotherapy in public and private oncology settings in KwaZulu-Natal, South Africa: a mixed method study.
(2024) Mdletshe , Rachel Bonisiwe.; Wentzel , Dorien Lesley.; Gumede , Emelda Zandile.
Background The delivery of cancer care is facing unprecedented challenges, new technologies, shortage of human and other resources, increased number of patients with cancer and educational challenges. Registered nurses have to administer chemotherapy, function as guides to patients and their families as they make sense of their cancer experiences. Lack of knowledge hinders patients’ capacity to engage in effective interactions with care providers and can also lead to adverse medical outcomes, malpractice lawsuits, missed appointments and medication errors. Purpose The purpose of the study was to develop a brochure for registered nurses working in oncology settings to educate patients undergoing chemotherapy in public and private oncology settings in KwaZulu-Natal. Methodology The study employed a mixed methods approach embracing the sequential designs and pragmatic paradigm. The study was conducted in three oncology settings, one being a private outpatient and two public in/out-patient settings. A sample size of 85 participants was obtained through the use of Stata V15 sample size calculator with the assistance of a statistician and 64 gave consent to participate. Non-probability purposive sampling was used and all recruited participants were informed about the multi-staging processes in data collection (stages). All participants who volunteered to take part in the study gave their consent signed and their ethical issues/rights were explained in detail before the actual commencement of data collection. Mixed methods were employed to ensure that the quantitative aspect of the data was used to probe further or enrich the dialogue in the qualitative phase until data convergence. Using manifest content analysis, themes were identified which together with quantitative data guided the development of the brochure. The brochure was subsequently verified by experts. Findings Based on literature review and the findings of the study a brochure was developed, aimed at enhancing nurses’ support to their patients. The highlight was that nurses tend to focus more on managing patients’ physical side effects and neglect the emotional stages that patients go through chemotherapy. Patients need to know that registered nurses are available to support and guide them through the chemotherapy process. Conclusion When patients first receive the news that they have cancer, most of them feel scared and anxious and this can make them particularly vulnerable. Patients worry about their coping skills during this period and they need support from the healthcare providers. The current study described the knowledge, attitudes and competence of nurses working in oncology settings. Emanating from the quantitative and qualitative data obtained, a brochure was then developed and evaluated by experts. Registered nurses play an important role in educating patients. It is hoped that nurses working in oncology settings will use this brochure to empower patients as they provide valuable emotional support to patients undergoing chemotherapy. In turn, it is hoped that patients will feel emotionally resilient by being able to be aware of the various emotions that could be encountered as well as the knowledge to access support, whilst receiving chemotherapy.
Teaching and learning coping strategies adopted by teenage mothers during coronavirus disease lockdown in Makhado Municipality, Limpopo Province.
(2023) Moganedi, Shonisane Emily.; Mudau, Tshimangadzo Selina.
Background: The COVID-19 pandemic exposed inequalities in access to technology between rich and poor, rural, and urban, girls and boys and across and within countries. The other negative social and health related impacts that COVID-19 and related restrictions had on the poorest, most marginalized, and vulnerable sectors of society are likely to have been disproportionately affected by school closures due to COVID-19. Teenage mothers living in rural areas have fewer resources such as access to the internet, smartphones, and computers to adapt to and implement measures needed to continue with online learning during school closures. The aim of the study was to explore and describe teaching and learning coping strategies adopted by teenage mothers in the rural communities of Makhado Municipality during the coronavirus disease lockdown in Limpopo Province, South Africa. Design: The study adopted a qualitative critical participatory action research through the community engagement approach. Methods: Purposive and snowballing recruitment were employed in this study. Methods of generation of data included semi-structured face-to-face interviews which were audio-taped, transcribed verbatim, and participatory arts were also applied to generate data. Data was analysed using qualitative thematic analysis. Findings: Thematic analysis of data revealed that teenage mothers experienced challenges such as stigma and discrimination, stress, inability to cope with self-study, financial constraints in caring for and supporting their babies, lack of gadgets and the internet essential for home learning, and inconsistent support from parents and teachers. Recommendations: Policies need be reviewed to address the issue of stigmatization and discrimination in schools. Authorities in education need to be geared in enriching social change towards transformative learning and addressing the issue of the digital divide in rural communities. Conclusion: It was concluded that the COVID-19 pandemic has broadened a huge gap between the rich and the poor, urban and rural learners. It was concluded by the researcher that there was evidence of social segregation and social injustice for teenage mothers in teaching and learning.
Teaching and learning support received by teenage mothers during the coronavirus disease lockdown in Makhado Municipality, Vhembe district.
(2023) Makaleng, Kepse Christina.; Mudau , Tshimangadzo Selina.
Background: In the wake of the Coronavirus disease lockdown, schools, creches and higher education institutions worldwide closed their doors, disrupting teaching and learning. All learners, including teenage mothers were forced to study from home due to a shift from traditional classrooms to online learning platforms, increasing the probability of school dropouts. Home learning became overwhelming to teenage mothers as they had to balance motherhood and learning while studying from home. The sudden shift worsened education inequality, thus negatively impacting the achievement of the Sustainable Development Goal 3; namely, Good Health and Wellbeing since quality education promotes health. Learners from poor provinces such as Limpopo, specifically those living in rural areas such as the Makhado municipality, face obstacles such as poor connectivity and limited access to the internet. Purpose: The purpose of the study, therefore, is to explore and describe teaching and learning support received by teenage mothers during the COVID-19 lockdown in the Vhembe district, Makhado municipality, Limpopo province. Research methodology: The study employed qualitative, participatory action reseach (PAR) through community engagement since the latter is community driven, ensuring that teenage mothers and stakeholders are included in an enquiry that seeks to promote social justice. The participatory arts-based action research created a safe space for the teenage mothers to share their stories. Data were generated from 11 participants through unstructured individual and group interviews. Findings: The study revealed that teenage mothers were supported by families, community members and teachers during the coronavirus school closures and rotational classes. However, the support was not adequate and consistent to promote the continuity of teaching and learning. The teenage mothers were further supported emotionally thus promoting their self-concept. Remote learning has proven to be a challenge to most teenage mothers due to the inaccessibility of online resources. It was difficult for teenage mothers to balance motherhood and learning due to frequent interruptions such as taking care of the baby resulting in poor concentration. Conclusion: The teenage mothers were socially, emotionally and financially supported by their families and some teachers, however, the support provided was insufficient and inconsistent to promote continuity of teaching and learning, resulting in teenage mothers not having access to quality education. Due to the frequent interruptions by crying babies, teenage mothers had difficulty balancing motherhood and learning.

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