An investigation into the level of empowerment of rural women in the Zululand district of KwaZulu-Natal province of South Africa.

The aim of the study was to evaluate the outcome of the empowerment of rural women in relation to gender issues, power, and communication within the Zululand District of KwaZulu-Natal in SouthAfrica after implementation of a four-year Primary Health Care project in partnership with the Provincial Department of Health, and two Schools of Nursing at the University of KwaZulu-Natal and McMaster University in Canada. This project is based on substantial evidence which reveals that rural women are being neglected to the extent that these women have missed out on opportunities for development. The reasons for this disempowerment of women, particularly rural women, are thought to be due to the feminisation of poverty, as well as female submission, educational deprivation, privacy of domestic violence, exploitation, domination by men and cultural oppression (patriarchy). A qualitative research approach was used. Focus group discussion was utilised as the data collection technique, and this was also applied during the collection of baseline data. An interview guide covered issues of concern in the communities and households, including what the women would, or had done about these, how they engaged in decision-making in their families, how they handled situations when there was a difference of opinion, and their awareness of, and ability to claim their rights, including control of their lives. The data was collected from six clinics, from groups of six to ten women in the predominantly rural Zululand District of KwaZulu-Natal. The project has revealed improvement in the women's realisation of their rights, albeit limited, in communication, self-confidence, and reliance, including partnerships between Primary Health Care Nurses and women's groups. The formation of women's groups facilitated community development and participation in their own health, socio-economic and emotional development. The project suggests that such groups be encouraged and allowed to network for support as they understand their own problems better, they merely require facilitation.

The impact of meaning in life and life goals on adherence to a tuberculosis medication regimen in South Africa.

SETTING: Out-patient tuberculosis (TB) clinics in Durban, South Africa. OBJECTIVE: Health care provider concerns about persons with active TB defaulting on medications led to a study of adherence among persons receiving anti-tuberculosis therapy and, specifically, the relationships between meaning in life, life goals, sense of coherence, social support, symptom presence and intensity, and adherence in individuals diagnosed with TB. DESIGN: A cross-sectional, descriptive design was used to gather self-reported data from TB-infected individuals who were enrolled in out-patient clinics. Data were collected from 159 Zulu and/or English-speaking persons who agreed to participate in the study. RESULTS: A significant relationship was found between higher life goals and adherence to TB treatment (P = 0.027). Analysis of variance revealed that higher meaning in life ratings were significantly associated with older age (P = 0.007). Having children and children living in the same household were significantly associated with low meaning in life ratings (P = 0.006 and P < or = 0.001, respectively), indicating that these individuals were more concerned about basic matters of home and sustenance. CONCLUSIONS: The results of this study indicate that meaning in life and life goals may be useful for identifying individuals who will require additional support in adhering to anti-tuberculosis treatment.

The use of PHC clinic-based women's groups for financial empowerment in a rural area.

The article is based on a four-year project during which Primary Health Care (PHC) nurses worked with women's groups in their areas. The aim of the study was to explore the involvement of PHC nurses in economic empowerment, both in terms of health promotion and in terms of the PHC approach. In particular the objectives were to establish whether nurses could lead economic empowerment groups, whether such groups could establish adequate external links and become financially viable. Eleven groups were used as case studies, and a cross-case analysis was done in terms of the three objectives. It was found that between the women and the nurses, adequate leadership existed for the groups to function well. Very limited external linkages were established, notwithstanding efforts in this regard. Nine out of 11 groups contributed to financial welfare of their members after 18 months, but a range of problems with regard to financial viability are identified.

The knowledge and attitudes of traditional birth attendants towards HIV/AIDS and their beliefs related to perinatal care: a study conducted in KwaZulu Natal.

Traditional birth attendants (TBAs) are still mainly being utilized in the rural areas even in the presence of the formal health care facilities. Studies reveal that the utilization of TBAs is beneficial in some other contexts with some support and supervision from the western health sector. In order to develop further training for TBAs the researchers deemed it necessary to assess their knowledge, attitudes and beliefs related to HIV/AIDS, prenatal care, delivery and postnatal care. This was a survey of an identified group of TBAs who had already received some training and were currently practicing in the catchment areas. Five Primary health care (PHC) clinics from Abaqulusi sub-district in Zululand Health District, Kwa-Zulu Natal Province, were selected as sites for the focus groups. A total of 57 TBAs participated in focus groups and completed a questionnaire. The HIV/AIDS knowledge questionnaire consisted of 16 questions about transmission, symptoms, course of the disease and its risk factors. An assessment tool was used to assess attitudes, beliefs and practice in relation to pregnancy, delivery and postnatal care. The results of this study demonstrated that the TBAs have a good knowledge of what they are doing.

Organ donation and transplantation within the Zulu culture.

Greater knowledge and technological advancement in the field of transplantation has increased the demand for organ donation beyond the supply of organs, especially among the black communities. This imbalance arises from the few sources of organs, limitations on the techniques of organ retrieval, disparities in the allocation of organs and socio-cultural factors. The aim of this study was to investigate the extent to which Zulu cultural norms and social structures influence an individual's decision to donate an organ or to undergo transplantation. A qualitative approach using an ethno-nursing method was selected. Semi-structured interviews were conducted with a transplant co-ordinator representing the professional sector, with traditional healers and religious leaders representing the folk sector, and with the general public representing the popular sector of the health care system. Both urban and rural settings were used. Conclusions arrived at showed that knowledge was lacking among Zulu speaking people about organ donation and transplantation and misconceptions about the topic were related to Zulu life patterns, beliefs about death, burial and life hereafter, and values and social structures. Recommendations with regard to the promotion of organ donation and transplantation among Zulu speaking people were made based on culture-sensitive and culture-congruent principles.

Exploring the critical care nurses' experiences regarding moonlighting.

While moonlighting is so prevalent amongst critical care nurses, there are no documented facts in this country about how it affects the nurses and the hospital management, considering the nature of their work that is both physically, mentally and emotionally strenuous. The aim of this study was to explore the critical care nurses' rationale and experiences regarding holding a second job (moonlighting). A non-experimental exploratory study was done using focus groups. Many positive and less positive experiences were revealed, for example, economical, educational, and psychosocial ones. Participatory control of moonlighting activity was suggested involving both management and staff at functional level.

Exploring the trauma care nurse's lived experiences of dealing with the violent death of their clients.

A phenomenological approach was used to explore the phenomenon, violent death, from the perspective of trauma care nurses working in Kwa-Zulu Natal. Three relatively unstructured interviews were undertaken on an individual basis with each lasting thirty to forty-five minutes long. The researchers applied the principle of theoretical saturation and a total of seven participants from three level-one trauma units were included in the study. All the interviews were tape recorded and transcribed, and manual analysis, as well as a qualitative software package--NUD*IST--was used to identify experiential themes within the data. The trauma care nurses conceptualized violent death as being sudden, unpredictable, senseless and not as dignified or peaceful as a non-violent death. A number of issues that made confronting violent death difficult were raised and the trauma care nurses described a number of emotional and physical reactions that they experienced due to exposure to these situations. A number of recommendations were suggested for the trauma care nurses, nursing management, nurse educators and for future research in an attempt to prevent the loss of these valuable nurses from the nursing profession.