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

Factors hindering midwives' utilisation of alternative birth positions during labour in a selected public hospital

Background: An evidence-based practice suggests that the birth position adopted by women during labour has a significant impact on the maternal and neonatal birth outcomes. The birth positions are endorsed by guidelines of maternity care in South Africa, which documented that women in labour should be allowed to select the birth position of their choice, preferably alternative birth positions (including upright, kneeling, squatting and lateral positions) during labour. Thus, the lithotomy birth position should be avoided. However, despite available literature, midwives routinely position women in the lithotomy position during normal vertex births, which causes several adverse maternal outcomes (namely prolonged labour, postpartum haemorrhage) and adverse neonatal outcomes (such as foetal asphyxia and respiratory compromise). Aim: The aim was to explore and describe factors hindering midwives' utilisation of alternative birth positions during labour in a selected public hospital. Setting: A public hospital in the Tshwane district, Pretoria were used in the study. Methods: This study used the qualitative, exploratory and descriptive research design. This design gathered quality information on factors hindering midwives' utilisation of alternative birth positions during labour in a selected public hospital. Results: The study revealed the following themes: (1) midwives' perceptions on alternative use of birth positions and (2) barriers to utilisation of alternative birth positions. The themes were discussed and validated through the use of a literature review. Conclusion: The lack of skills and training during the midwifery undergraduate and postgraduate programme contributes to the midwives being incompetent to utilise alternative birth positions during clinical practice

Perceptions of Female Teenagers in the Tshwane District on the Use of Contraceptives in South Africa

Background: Perceptions of female teenagers in the Tshwane District contribute to the nonuseand or discontinued use of contraceptives as evidenced by increased levels of unplanned pregnancies.Objective: The objective of this study was to explore and describe the perceptions of female teenagers in the Tshwane District on the use of contraceptives.Methods: A qualitative; explorative; descriptive approach was followed in this study. The population comprised of pregnant female teenagers who were purposively selected. Data were collected using unstructured individual interviews on a face-to-face encounter in a natural setting. Data were analysed using the discourse method of data analysis.Results: The following perceptions on the use of contraceptives emerged: Perceptions on the use of contraceptives; emotions; contraceptive effects; social pressure and education on contraceptives. Teenagers' perceptions were predominantly negative with unfounded fears. Though the teenagers were aware of the importance of the use of contraceptives; motivation to pursue contraception was lacking. Teenagers verbalised to be uncommitted as well. Conclusion: Various perceptions of female teenagers in the Tshwane District on the use of contraceptives were explored and described. It was noted that all the teenagers interviewed had great remorse and feelings of guilt regarding their behaviour of not using contraceptives.Their need for re-education was cited and seen as motivational enough to encourage the use of contraceptives at primary health care settings. Therefore; the study recommended that health education programmes should be restructured to effectively influence the female teenagers'perceptions positively and to promote the use of contraceptives

Healthcare Workers' Experiences of HIV Testing in Tshwane; South Africa

Background: In an era when antiretroviral (ARV) therapy has become part of the Human Immunodeficiency Virus (HIV) prevention strategy; early testing and introduction to ARVs iscritical for improving public health outcomes in general and; in particular; the lives of people living with HIV. South Africa has the highest number of people living with HIV as compared with the rest of the world. Initiated voluntary HIV counselling and testing and provider initiated counselling and testing (PICT) are required in order to increase the uptake of HIV testing.Objectives: To explore and describe the experiences of healthcare workers who are themselves in need of HIV testing.Method: A descriptive; exploratory design was used. In-depth interviews were conducted with the 26 healthcare workers who were involved in HIV testing in the Tshwane district of South Africa. The participants were sampled purposively from two healthcare settings. A thematic framework was used for data analysis.Results: There was a complication with regard to PICT as healthcare workers felt they could not initiate HIV testing for themselves and or their work colleagues without their confidentiality being compromised. This was complicated further by both the perceived and actual fear of stigmatisation and discrimination. It was difficult for qualified staff to support and encourage the uptake of HIV testing by students nurses as this was seen; albeit incorrectly; as targeting the students in a negative manner. Conclusion: There is a need for accessible HIV testing policies for healthcare workers in order to increase access to HIV testing and prevent the progression of the disease

Perceptions of Health Promoters about Health Promotion Programmes for Families with Adolescents Orphaned as a Result of AIDS in the Rural Hammanskraal Region in South Africa

South African communities are still greatly affected by the high rate of infection with HIV or who are living with AIDS; mirrored in the 2008 overall national HIV prevalence of 29.3(UNAIDS 2010:10). In addressing the challenge; the health system is dependent on community care level workers such as caregivers to render health promotion and education in the homes and communities. The caregivers based in the communities are the ones with first-hand information on what is needed for the success of health promotion programmes. This study; aimed at exploring the challenges faced by the health promoters; described their perceptions regarding a health promotion programme for families with adolescents orphaned as a result of AIDS. Data were collected on the purposively selected participants at the rural Hammanskraal region in South Africa and the research question: 'What is your perception regarding health promotion programmes for families with adolescents orphaned as a result of AIDS' was asked and discussed by participants in a focus group interview. Data were analysed using the adapted Tesch method to organize and isolate the main categories; sub-categories and themes. The following main categories were isolated: attitudes of adolescents; effectiveness of home visits; need for health education and limited resources. Based on the findings; it was therefore recommended that health care planners assist in the improvement of health promotion and education by using the community and national media; providing information material and providing access to the internet in order to allow more people; including young people; to access the information