Factors influencing the utilization of doctoral research findings at a university in KwaZulu-Natal, South Africa: Views of academic leaders.

BACKGROUND: Translation of health research findings into policy remains a challenge in sub-Saharan Africa. Factors influencing health research utilization are poorly described in literature. Therefore, identifying factors that influence the utilization of research findings for policy formulation is essential to facilitate implementation of evidence-based interventions. The purpose of this study was to explore the views of academic leaders as to why doctoral research is not adequately used in policymaking. METHODS: In-depth interviews were held with purposively selected key informants from the College of Health Sciences. An open-ended interview guide aimed at exploring college leadership views on factors influencing utilization of PhD generated knowledge into policy was used. Data was analysed thematically using NVivo 12 software. Thematic analysis was used to generate themes around the factors influencing utilization of doctoral research into policy. RESULTS: Factors such as inaccessibility of research results, lack of funding, poor quality of research, lack of continuity in translating research into policy, lack of timeliness of research results and lack of collaboration between researchers and policymakers hindered the utilization of PhD generated knowledge. Participants recommended engagement with the Department of Health/policymakers, collaboration with Department of Health/policymakers, increasing enrolment of South African citizens into PhD program, making final research products available to Department of Health/policymakers, and provision of funding for dissemination of research results. CONCLUSION: The study demonstrated that final doctoral research results are mainly disseminated through journal articles and theses. Participants cited inaccessibility of research findings, lack of funding and poor-quality research as the most common factors hindering utilization of doctoral research findings. The study also recommended availing adequate funding for dissemination of research results, collaboration between researchers and policymakers, facilitation of policymaker-researcher engagement to find best ways of using research findings to influence policy and making final research products accessible to policymakers. Further research to gain the perspective of policymakers as to why doctoral research is not adequately used in policy formulation is recommended.

Preconception Care Recommendations, Training, and Competency of Primary Healthcare Nurses in South Africa: A Quantitative Descriptive Study.

Introduction: There has been a growing interest in preconception care (PCC) as a primary means of tackling the high maternal and child mortality rates, as evidence has shown that the state of maternal health before conception can have a direct impact on the health of the mother and baby. Primary care nurses have been recognized as the highest providers of sexual and reproductive healthcare to the vulnerable population in resource-constrained settings. Objective: This study aimed to examine and describe the PCC recommendations, training, and competency of primary healthcare (PHC) nurses in South Africa. Methods: A cross-sectional descriptive study was conducted among 196 PHC nurses to examine the PCC recommendations, training, and competency. A self-administered survey tool was used for data collection. Results: The self-reported PCC recommendations, training, and competency of PHC nurses were 63.3%, 88.3%, and 94.9%, respectively, in each aspect. The PCC training among the respondents was mainly in-service training. The only training that was indicated to have been done primarily at a pre-service level was training about reproductive life plan screening and brief counseling. Over 20% of the respondents indicated that they did not receive any training on how to provide alcohol, drug, or tobacco cessation services and how to conduct preconception risk assessments. Conclusion: Although PHC nurses reported a high level of recommendation, training, and competency, their level of reported PCC practice is not equivalent to their provision, as they rendered PCC services to fewer women, and they also reported fewer women seeking PCC. A future longitudinal study is required to examine the reason for low PCC-seeking habits among those at high risk of adverse pregnancy outcomes and contextual factors influencing the provision of PCC services among healthcare workers.

Measuring perceived learning gains of undergraduate nursing students in ICT skills: One group pre-test and post-test design.

Purpose: This study aimed to measure learning gains during an ICT training intervention in first-year students completing a four-year undergraduate nursing degree.Methodology: This study adopted a quasi-experimental, one group pre-test and post-test design. The intervention effectiveness was measured using individual single-student normalised gains, g; class average normalised gain, 〈g〉; and average single-student normalised gain, g(ave).Results: In this study, the class average normalised gains, 〈g〉 ranged from 34.4% to 58.2%, and the average of single student normalised gains, g(ave) ranged from 32.4% to 50.7%. The overall class average normalised gain 〈g〉 was 44.8%, and the average of the single student normalised gain was 44.5%, with 68% of students having a normalised gain of 30% and above, indicating that the intervention was effective.Conclusion: Similar interventions and measurements are recommended to all health professional students during their first academic year to pave a foundation for ICT usage for academic purposes.

Integration of preconception care into the bachelor of nursing curriculum: An exploratory qualitative study.

Background: The significance of ensuring high quality of care has become apparent in nursing and midwifery education worldwide, especially in low- and middle-income countries. This has led to upgrades of the nursing curriculum to include several aspects of care that have been overlooked with recent evidence-based care. Objectives: To explore the integration of preconception care (PCC) into the Bachelor of nursing curriculum in South Africa. Design: An exploratory qualitative study. Setting and participants: This study was conducted in a higher education institution in South Africa that has recently revised its Bachelor of nursing curriculum. Data sources were Bachelor educators and program documents. Methods: Individual in-depth interviews were conducted among ten nurse educators. Interviews were complemented with an analysis of the curriculum documents for the Bachelor of nursing program using the BEKA (benchmarking, evidencing, knowing, and applying) model of curriculum analysis and evaluation. Findings: Benchmarking and evidencing of the Bachelor of nursing curriculum reveals a high level of compliance with the externally set standards. Both data sources pointed to some degree of incorporating the preconception care concept into the curriculum. The educators perceived that for full integration to occur, preconception care should be taught as a standalone topic. Lack of focus and poor perception was further reported as barriers to introducing the concept. Most preconception care components and services were taught to students throughout the four hundred levels of the nursing program, especially in the sexual and reproductive health module. Gaps were noted in female genital mutilation, mental health, environmental health, preconception vaccination, and other aspects where preconception care needs emphasis. Conclusions: There has been a high level of integration of preconception care competency in the Bachelor of nursing curriculum. Especially in the sexual and reproductive health module, most preconception care components are taught to students. However, there is a need to emphasise the preconception nursing management of women with certain conditions. To ensure nurses' role in providing health for all, safeguarding reproductive health, and maintaining the health continuum is enhanced.

Preconception care practices among primary health care nurses working in public health facilities in KwaZulu-Natal.

BACKGROUND: Preconception care (PCC) is necessary to identify and deal with all the risk factors before conception. Some aspects of PCC, like folic acid supplementation, would be relevant to people desiring a pregnancy. Alternatively, PCC could provide contraceptive support to those with no pregnancy intention. In South Africa, primary healthcare nurses provide a comprehensive package of essential services in public health facilities to about 90% of the population at no cost. Therefore, they are the key providers of promotive, preventive, and curative services, including PCC. OBJECTIVE: This study aimed to determine the level of PCC practice among primary healthcare nurses and identify determinants of effective practice. METHODS: This cross-sectional descriptive survey was conducted among 196 nurses undertaking a specialisation Primary HealthCare program in a selected higher education institution. A pretested questionnaire was used to collect data that were analysed with SPSS version 27 software. RESULTS: The overall practice of PCC was 87.8%. Older participants were significantly less likely to exhibit good PCC practice than their younger counterparts. Female participants were also less likely to have good PCC practices than their male counterparts. Married participants were significantly more likely to practice PCC than their unmarried counterparts. Participants practicing in rural areas were also less likely to have good PCC practices than their urban counterparts. CONCLUSION: The PCC practice of most primary healthcare nurses in the study is relatively high. The study also identified the determinants of good PCC practice that can enhance its practice. There is a need to revisit the PCC training of healthcare workers, as most indicated the need for further training.

"We Are Having a Huge Problem with Compliance": Exploring Preconception Care Utilization in South Africa.

BACKGROUND: Preconception care (PCC), a policy directive from the World Health Organisation (WHO), comprises all the health interventions offered to women and couples before conception and is intended to improve their overall health status and the pregnancy outcomes. Although PCC should be an essential part of maternal and child health services in most African countries, its provision and utilization are not widely documented. Hence, this study aimed to explore the factors influencing preconception care utilization among high-risk women in South Africa. METHODS: A descriptive qualitative study of 29 purposively selected women and healthcare workers was conducted through individual in-depth interviews using a semi-structured interview guide. The interviews were transcribed verbatim, and the analyses were performed using Nvivo version 12. The Social-Ecological Model (SEM) guided the data analysis. Four levels of factors (the individual, the interpersonal, the community and social, and the policy and institutional) were used to assess what can influence PCC utilization. FINDINGS: The availability of PCC services, the intrahospital referral of women, the referral practices of other healthcare workers, the underutilization of the PCC facility, and resources emerged at the institutional levels, while compliance with PCC appointments, socioeconomic factors, pregnancy planning, assumptions, and knowledge was at the individual levels. CONCLUSION: The utilization of the preconception care services was inadequate. The primary influencer of preconception care utilization was at the individual, policy, and institutional levels. The availability of preconception care services and the intrahospital referral of women at high risk of adverse pregnancy outcomes positively influenced the women's PCC utilization, while poor pregnancy planning, and unavailability of PCC policies and guidelines negatively influenced preconception care utilization. Therefore, interventions to improve PCC utilization should focus on the four SEM levels for effectiveness. There is a need to raise PCC awareness and develop policy and guidelines to ensure consistent, standardized practice among healthcare workers.

Perceptions and Practice of Preconception Care by Healthcare Workers and High-Risk Women in South Africa: A Qualitative Study.

Preconception care is biomedical, behavioural, and social health interventions provided to women and couples before conception. This service is sometimes prioritised for women at high risk for adverse pregnancy outcomes. Evidence revealed that only very few women in Africa with severe chronic conditions receive or seek preconception care advice and assessment for future pregnancy. Thus, this study aimed to explore the perceptions and practice of preconception care by healthcare workers and high-risk women in Kwa-Zulu-Natal, South Africa. This exploratory, descriptive qualitative study utilised individual in-depth interviews to collect data from 24 women at high risk of adverse pregnancy outcomes and five healthcare workers. Thematic analysis was conducted using Nvivo version 12. Five main themes that emerged from the study include participants' views, patients' access to information, practices, and perceived benefits of preconception care. The healthcare workers were well acquainted with the preconception care concept, but the women had inconsistent acquaintance. Both groups acknowledge the role preconception care can play in the reduction of maternal and child mortality. A recommendation is made for the healthcare workers to use the 'One key' reproductive life plan question as an entry point for the provision of preconception care.

Using Mobile Technologies Among Undergraduate Nursing Students for Academic Purposes in Tertiary Education: A Quantitative Survey.

Mobile devices are increasingly part of daily life, with the benefits of using the technology in nursing education widely recognized. This study explored the use of mobile devices among undergraduate nursing students for academic purposes in South Africa, using a quantitative survey. The majority of participants owned smartphones (87.6%), followed by laptops (76%) and tablets (47.1%). Mobile devices were used to perform academic tasks and communicate and collaborate with peers and teachers, as well as search and access electronic resources. Few of the first year nursing students owned laptops and tablets and used them less frequently than the students from other levels of the study. Equipping nursing students with mobile devices, such as laptops and tablets, particularly first year students, and ensuring that they have adequate skills to use them, is essential to training future nurses who are expected to work in a technology-mediated health environment.

Using Exploratory and Confirmatory Factor Analysis to understand the role of technology in nursing education.

AIM: The study aimed to establish the role played by technology in nursing education through Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA). METHODS: 150 student nurses participated, with data being collected using a structured questionnaire with 14 items on a 5-point Likert scale. Parallel Analysis (PA) and Exploratory Factor Analysis (EFA) were conducted to identify the factors for the role of technology in nursing education, Confirmatory Factor analysis (CFA) was used to ascertain the model fit. ANOVA, t-test and binary regression analysis were used to identify among the factors the differences within the level of the study, and perceived abilities to use the computer. RESULTS: The EFA identified five factors from 14 items, and through the CFA, the results indicated that the model was supported by the following indices: Comparative Fit Index (CFI) = 0.968 (>0.95); Incremental Fit Index (IFI) = 0.969 (>0.95); Tucker-Lewis Index (TLI) = 0.957 (>0.95); Root Mean Squared Error of Approximation (RMSEA) = 0.077 (<0.080); and SRMR = 0.0396 (<0.08). These results were within acceptable ranges, which indicated that the five factors obtained from EFA were validated. However, Chi-square goodness of fit statistics was not statistically significant (χ2 = 126.312, d.f = 67, p = .000). Overall, 89.3% (n = 134) nursing students had a positive perception of the role of technology in nursing education. Binary regression analysis indicated that 1st year nursing students positively perceived the role of technology 6.7 times more than other levels (OR = 6.710, 95% CI: 1.33-33.63, p = .021). Students with good ability to use the computers (92.9%) were 5.3 more likely to have a positive perception towards the role of technology in nursing than those with the poor ability (OR = 5.35, 95%CI = 1.76-16.26, p = .003). CONCLUSION: Using innovative teaching strategies and ensuring that nursing students are skilled is essential to the future of the nursing profession. The five-factor model would be a useful tool to assess the perception of students towards the role of technology in nursing education.

Transforming Nursing Education to Strengthen Health System in Malawi: An Exploratory Study.

BACKGROUND: Malawi made great strides to increase the number of nurses through the Emergency Human Resource for Health Program. However, quantity of health workforce alone is not adequate to strengthen the health system. Malawi still reports skill mix imbalance and geographical mal-distribution of the nursing workforce. Health systems must continuously adapt and evolve according to the health care needs and inform health professionals' education to accelerate gains in health outcomes. The Lancet Commission reported that health professionals' education has generally not lived up pace with health care demands. OBJECTIVES: The aim of this study was to describe the strategies being implemented in Malawi to improve nursing education. Specifically, the objectives of the study were to explore strategies being implemented, identify stakeholders and their targets in order to share practices with countries experiencing similar nursing education challenges. METHODS: This was a cross sectional descriptive study with a concurrent mixed method design. One hundred and sixty participants including nurse practitioners and educators responded to a questionnaire. Fifteen nurse practitioners and eight nurse educators were also engaged in one to one interview. RESULTS: Respondents showed varied opinion on how nursing education is being implemented. Six themes as regards strategies being implemented to improve nursing education emerged namely- capacity building, competency based curriculum, regulation, clinical learning environment, transformative teaching and infrastructure/ resources. CONCLUSION: Findings of this study show that the strategies being implemented to improve nursing education are relevant to closing the gap between health care needs and nursing education.

Issues and challenges of curriculum reform to competency-based curricula in Africa: A meta-synthesis.

Although in recent decades reforms to undergraduate nursing and midwifery education have increasingly been guided by the concept of competency-based curriculum in a drive to produce competent graduates in the African context, the topic remains poorly researched in-depth. The related issues and challenges need to be explored in the interest of evidence-based practice. This article stems from a systematic review of qualitative literature on the design and implementation of competency-based curriculum. Data was inductively analyzed using constant comparison. The two categories that emerged were: (i) the need for a paradigm shift to competency-based curriculum; and (ii) the associated issues and challenges, such as a shift from informative to transformative learning, lack or limited of involvement of key stakeholders in curriculum development, focus on hospital-oriented education, lack of preparation of educators, and inappropriate resources. While ongoing reform of nursing and midwifery education continues, much still needs to be done - in particular, extensive financial investment to increase the capacity of educators, mentors and infrastructure, and the development of collaborative frameworks between nursing and midwifery and higher educational councils.

A descriptive analysis of emergency department overcrowding in a selected hospital in Kigali, Rwanda

Introduction:Emergency Centre (EC) overcrowding is a global concern. It limits timeous access to emergency care; prolongs patient suffering; compromises quality of clinical care; increases staff frustration and chances of exposing staff to patient violence and is linked to unnecessary preventable fatalities. The literature shows that a better understanding of this phenomenon may contribute significantly in coming up with solutions; hence the need to conduct this study in Rwanda.Methods:A quantitative descriptive design; guided by the positivist paradigm; was adopted in this study. Self-administered questionnaires were distributed to 40 nurses working in the EC. Only 38 returned questionnaires; thus making the response rate 95.Results:The findings revealed that EC overcrowding in Rwanda is characterised by what is considered as reasonable waiting time for a patient to be seen by a physician; full occupancy of beds in the EC; time spent by patients placed in the hallways waiting; and time spent by patients in waiting room before they are attended. Triggers of EC overcrowding were classified into three areas: (a) those associated with community level services; (b) those associated with the emergency centre; (c) those associated with inpatient and emergency centre support services. Discussion:A number of recommendations were made; including the Ministry of Health in Rwanda adopting a collaborative approach in addressing EC overcrowding with emergency trained nurses and doctors playing an active role in coming up with resolutions to this phenomenon; conducting research that will lead to an African region definition of EC overcrowding and solutions best suited for the African context; and increasing the pool of nurses with emergency care training