Using the Nominal Group Technique to Inform Approaches for Enhancing Men's Utilization of Sexual and Reproductive Health Services.

Sexual and reproductive health (SRH) services' underutilization by men remains a global public health challenge. SRH problems constitute major health challenges in that they form almost one-seventh of the disease burden and contribute to higher and earlier morbidity among men. We, therefore, invited subject matter experts to collaborate in co-creating intervention strategies to enhance men's utilization of SRH services. We employed the nominal group technique (NGT) for data collection. The NGT is a structured method that involves gathering a group of people to discuss a problem for the purpose of achieving a group consensus and planning actions for the selected problem. The participants who were purposively sampled included researchers, scientists, academics, clinicians, and policymakers. The participants suggested the need to improve men's knowledge, provide healthcare resources such as equipment, medical supplies, and SRH-trained male healthcare workers, deal with healthcare workers' negative attitudes through training and capacitation, and destigmatize socially constructed gender norms that deter men from seeking medical help. These important intervention strategies can be implemented to encourage men's use of SRH services. Men's current underutilization of SRH services requires the urgent implementation of evidence-based interventions. Collaborating with SRH experts in identifying appropriate intervention strategies can assist program managers and policymakers in designing SRH services tailored to men's sexual health needs.

Perceptions of healthcare workers on men's sexual and reproductive health services utilization in Kwazulu-Natal.

Healthcare workers have crafted and implemented several health policies and programs to attract men, but men still struggle to access SRH services. This study explored healthcare workers' perceptions and views about the determinants of men's sexual and reproductive health service utilization. This qualitative study employed a purposive sampling technique to select healthcare workers in urology clinics and those managing men diagnosed with SRH conditions outside urology clinics. Data were analyzed thematically. HCWs highlighted men's lack of awareness due to inadequate community education and health campaigns, staff shortage, the unavailability of medicines and medical supplies, health system incapacity, personal factors, and cultural norms and beliefs as hindrances in using SRH services. Health policymakers and relevant stakeholders need to pay attention to the SRH needs of men. The ongoing awareness campaigns about the importance of SRH service utilization, including additional male nurses, can encourage men to engage more with such services.

Les agents de santé ont élaboré et mis en œuvre plusieurs politiques et programmes de santé pour attirer les hommes, mais ceux-ci ont encore du mal à accéder aux services de SSR. Cette étude a exploré les perceptions et les points de vue des agents de santé sur les déterminants de l'utilisation des services de santé sexuelle et reproductive par les hommes. Cette étude qualitative a utilisé une technique d'échantillonnage raisonné pour sélectionner les agents de santé des cliniques d'urologie et ceux qui s'occupent des hommes diagnostiqués avec des problèmes de SSR en dehors des cliniques d'urologie. Les données ont été analysées thématiquement. Les agents de santé ont souligné le manque de sensibilisation des hommes en raison de campagnes d'éducation et de santé communautaires inadéquates, du manque de personnel, de l'indisponibilité des médicaments et des fournitures médicales, de l'incapacité du système de santé, des facteurs personnels et des normes et croyances culturelles comme obstacles à l'utilisation des services de SSR. Les décideurs politiques de la santé et les parties prenantes concernées doivent prêter attention aux besoins des hommes en matière de SSR. Les campagnes de sensibilisation en cours sur l'importance de l'utilisation des services de SSR, y compris l'embauche d'infirmiers supplémentaires, peuvent encourager les hommes à s'impliquer davantage dans ces services.

Evidence of community health workers' delivery of physical rehabilitation services in sub-Saharan Africa: a scoping review.

OBJECTIVES: To map the evidence and scope of physical rehabilitation services delivered by community health workers (CHWs) in sub-Saharan Africa (SSA). DESIGN: Scoping review DATA SOURCES: PubMed, Scopus, Cochrane Central and databases within the EBSCOhost platform. We also searched other literature sources including reference lists, conference presentations and organisational websites such as WHO, Ministries of Health and non-governmental organisations in SSA. ELIGIBILITY CRITERIA FOR SELECTION OF STUDIES: Articles presenting evidence on CHWs' delivery of physical rehabilitation services in SSA from September 1978 to June 2023. DATA EXTRACTION AND SYNTHESIS: Screening was conducted by two reviewers and was guided by the inclusion criteria. Thematic content analysis of data was employed. The results are presented according to the Preferred Reporting Items for Systematic Review and Meta-Analysis extension for scoping reviews. RESULTS: A total of 6996 articles were identified through various databases, with only 20 studies qualifying for data extraction. Evidence was presented by Eritrea, Ethiopia, Malawi, Mauritius, Namibia, South Africa and Uganda. Assessments, case management, health education, community liaison with support, health systems linkage and administration were the CHWs' scope of practice identified. The review identified home-based, community-based, community and facility-based, home and community-based and facility-based as modes of delivery. The barriers experienced are resources, societal and community attitudes, governance, geographical barriers and delivery capacity, while proximity to the community, positive job attitude and support with collaboration facilitated service delivery. CONCLUSION: Training and integrating CHWs in national health care systems, with careful selection of existing CHWs, would minimise the barriers faced.

Barriers and enablers for implementation of digital-linked diagnostics models at point-of-care in South Africa: stakeholder engagement.

The integration of digital technologies holds significant promise in enhancing accessibility to disease diagnosis and treatment at point-of-care (POC) settings. Effective implementation of such interventions necessitates comprehensive stakeholder engagements. This study presents the outcomes of a workshop conducted with key stakeholders, aiming to discern barriers and enablers in implementing digital-connected POC diagnostic models in South Africa. The workshop, a component of the 2022 REASSURED Diagnostics symposium, employed the nominal group technique (NGT) and comprised two phases: Phase 1 focused on identifying barriers, while Phase 2 centered on enablers for the implementation of digital-linked POC diagnostic models. Stakeholders identified limited connectivity, restricted offline functionality, and challenges related to load shedding or rolling electricity blackouts as primary barriers. Conversely, ease of use, subsidies provided by the National Health Insurance, and 24-h assistance emerged as crucial enablers for the implementation of digital-linked POC diagnostic models. The NGT workshop proved to be an effective platform for elucidating key barriers and enablers in implementing digital-linked POC diagnostic models. Subsequent research endeavors should concentrate on identifying optimal strategies for implementing these advanced diagnostic models in underserved populations.

Factors influencing men's decisions to utilize sexual reproductive health services in KwaZulu Natal, South Africa.

Sexual and Reproductive Health (SRH) service utilization remains a global public health concern. The SRH problems account for major health challenges and disease burdens for men. This descriptive cross-sectional study of 421 men aims to identify factors influencing men's decisions to utilize SRH services. The interviewer-administered questionnaire obtained data from conveniently selected men who met the inclusion criteria. Frequencies and percentages were used to summarize variables associated with SRH services utilization. Univariable logistic regression was conducted before conducting a multivariable logistic regression. Of the 421 participants, 307 (72.9%) reported having utilized SRH services at least more than once. Although participants reported barriers to SRH service utilization, most men utilize services despite encountering challenges. The final multivariate logistic regression model revealed that age, education level, medical aid, and perceived good quality of services were significantly associated with SRHS utilization (p-value <0.05). Study findings indicate that older men (age 45 and above) were more likely to utilize SRH services than younger men (ages 15 to 44). Barriers to SRH service utilization must be eliminated so that men can easily use the services. Identifying factors influencing men to utilize SRH services will help policymakers and program managers address the poor utilization of SRH services by men.

Men's utilisation of sexual and reproductive health services in low- and middle-income countries: A narrative review.

Background: Men have poor access to sexual and reproductive health (SRH) services globally, particularly in low- and middle-income countries (LMICs). Nevertheless, in LMIC and high-income countries (HICs), low SRH utilisation happens on account of several factors, such as individual, health system-related, and sociocultural factors. Identifying and addressing men's SRH service underutilisation remains essential to improving their sexual health and averting higher mortality and early morbidity associated with poor health seeking behaviour (HSB) among men. Aim: This narrative review identifies factors influencing whether men do or do not utilise SRH services in LMICs. Setting: We report on articles published in LMICs: Africa, Asia and South America. Method: In this narrative review, we searched for quantitative and qualitative articles published between 2004 and 2021 from international databases, including Google Scholar, ScienceDirect, EBSCOhost, Scopus, PubMed, Medline, and reference lists of retrieved published articles. Results: A total of 2219 articles were retrieved, from which 36 met the inclusion criteria. Factors contributing to poor uptake of SRH services by men included: a lack of access and availability of SRH services, poor health-seeking behaviour among men, and SRH facilities not being perceived as 'male-friendly spaces'. Furthermore, our review reveals that decreased use of SRH services is attributed to factors such as a lack of focus on men's SRH. Conclusion: The current underutilised state of SRH services calls for urgent implementation of evidence-based interventions. Identifying men's SRH service inhibitors and enablers will assist programme managers and policymakers in designing SRH services tailored to their sexual health needs. Contribution: Despite numerous global interventions to motivate men, the findings provide insight into the underutilisation of SRH services. The study also reveals the inadequate comprehensive investigation of men's SRH service utilisation, especially older men, to comprehend men's problems fully. Further research needs to be conducted on SRH issues, including vasectomy, mental health, and chronic conditions related to sexual and reproductive health. The analysis can assist SRH policymakers and program managers in strengthening the policies to motivate men to engage better with SRH services.

Global overview of pharmacy support personnel training programmes: a scoping review protocol.

INTRODUCTION: A global variation in the pharmacy support personnel training programmes has been observed. The objective of this scoping review is to map out global evidence available on the pharmacy support personnel training programme characteristics, and interface between knowledge, practice and regulatory requirements. METHODS AND ANALYSIS: The scoping review will be undertaken by two independent reviewers. Peer-reviewed journal articles of any study design and grey literature will be included with no publication time limit. All literature published in English focusing on pharmacy support personnel training programmes, entry-level certification requirements, ongoing professional development and apprenticeship will be included. We will search MEDLINE (EBSCOhost), PubMed, CINAHL (EBSCOhost), Web of Science, Academic Search Complete, (EBSCOhost) and Dissertation and Thesis (ProQuest), ProQuest Dissertation and Thesis Global and Google Scholar, and reference list of all included studies. We will also search grey literature from websites of international professional regulatory bodies and associations. All studies that meet the inclusion criteria will be imported into a reference management package (EndNote V.20) that facilitates study selection, screening and de-duplication. Data will be extracted by two independent reviewers using a jointly developed and piloted data charting form. Data items will include skills, knowledge, competencies, admission criteria, content, duration, qualification options, accreditation status, delivery models and approaches. Data extracted from the included studies will be collated, and quantitative results presented using descriptive statistics such as percentages, tables, charts and flow diagrams as appropriate. A narrative account of findings from the literature will be presented following qualitative content analysis of the extracted information using NVivo V.12. Quality appraisal of included studies will not be assessed as the purpose of the scoping review is to give a descriptive global overview of the pharmacy support personnel training programmes, and evidence will also be sourced from grey literature. ETHICS AND DISSEMINATION: No ethical approval is needed for this study as it does not include animals or human participants. The study findings will be disseminated electronically and in print with presentations done at relevant platforms, that is, in peer-reviewed journals, in print and in conferences. REGISTRATION: Open Science Framework (ofs.i0/r2cdn; registration DOI: https://doi.org/10.17605/OSF.IO/F95MH; internet archive link: https://archive.org/details/osf-registrations-f95mh-v1; registration type: OSF-Standard Pre-Data Collection Registration).

Mapping evidence of community health workers delivering physical rehabilitation services in sub-Saharan Africa: a scoping review protocol.

INTRODUCTION: Sub-Saharan Africa (SSA) is one of the low-income regions in the world which is affected by the critical shortage of human resources for health amid a high disease burden, including physical disability. Community health workers are viewed as the possible solution to increase population access to health services, including rehabilitation at the community level. The purpose of this scoping review is to map the evidence and scope of physical rehabilitation services delivered by community health workers in SSA. METHODS AND ANALYSIS: The framework by Arksey and O'Malley will be used to guide the scoping review protocol. Database searching will be conducted using PubMed, Scopus, Cochrane Central and databases within the EBSCOhost platform. Other sources of literature will include reference lists, conference presentations and publications on organisational websites such as WHO, Ministries of Health, and Non-governmental Organisations in SSA. The screening will be guided by the inclusion and exclusion criteria. Thematic content analysis aided by NVivo V.12 will be done to present the narrative account of the review. The Mixed Methods Appraisal Tool version 2018 will be used to evaluate the methodological quality of the studies. ETHICS AND DISSEMINATION: The review is part of a larger study that has received ethical clearance. The result will be disseminated using print and electronic media.

Utilisation of follow-up rehabilitation services for stroke survivors: a scoping review protocol.

INTRODUCTION: Stroke is a leading cause of death and disability and has been identified as a significant public health problem. Residual functional deficits negatively affect the stroke survivor's functional independence and quality of life. Rehabilitation is necessary for them to regain lost skills, relearn tasks and be independent again. METHODOLOGY AND ANALYSIS: A scoping review will be conducted to map available literature on factors influencing utilisation of follow-up rehabilitation services for stroke survivors. Databases including PubMed, LISTA(EBSCO), Web of Science (Clarivate), Google Scholar, Scopus and Science Direct will be searched using keyword searches for articles. The review will include studies presenting evidence on outpatient stroke rehabilitation services, studies undertaken and published in English, including grey literature. Title and abstract screening will be done simultaneously. Two reviewers will independently conduct the abstract and full-text article screening as well as pilot the data extraction form. Thematic analysis will be used to analyse the findings. ETHICS AND DISSEMINATION: This scoping review is part of a larger study approved by the University of KwaZulu Natal Biomedical Research Ethics Committee (Reference no. BREC/00000660/2019). The results will be disseminated through publication.

Knowledge, attitudes and practices of hospital-based staff regarding physical activity at a private hospital in Johannesburg.

BACKGROUND: Physical activity has been established as an important component to incorporate into a healthy lifestyle. Hospital-based staff are also threatened by the risks of sedentary lifestyles, despite their association with a healthcare environment. The aim of this study was to determine the knowledge, attitudes and practices of private hospital-based staff regarding physical activity in Johannesburg. METHODS: A cross-sectional study was conducted. Data were collected using a self-administered questionnaire. Data were analysed with a combination of descriptive and inferential statistics. A p-value less than 0.05 was deemed statistically significant. RESULTS: A total number of 217 participants responded to the questionnaire. The majority of participants (n = 179; 82.49%) displayed excellent knowledge of physical activity, had a good attitude towards physical activity (n = 157; 72.35%) and displayed satisfactory practices (n = 137; 63.13%). Participants with the highest level of education had better mean knowledge, attitude and practice scores as opposed to those with lower levels of education. There was a statistically significant difference amongst staff categories in terms of knowledge (p = 0.004) and practice scores (p = 0.031). In addition, there was a statistically significant difference amongst different levels of education in terms of knowledge (p = 0.000), attitude (p = 0.02) and practice scores (p = 0.004). CONCLUSION: Staff members who participated in the study displayed only satisfactory physical activity practices. The hospital's employee wellness programme should establish appropriate strategies to improve staff practices of physical activity in order to promote health.

Using poster presentation to assess large classes: a case study of a first-year undergraduate module at a South African university.

BACKGROUND: The massification of higher education is often associated with poor student engagement, poor development of their critical thinking, inadequate feedback and poor student throughput. These factors necessitate the need to devise novel, innovative methods to teach, assess and provide feedback to learners to counter the restrictions imposed due to the large class learning environments. This study was conducted to ascertain the perceptions of 1st year medical students and staff at the Nelson Mandela School of Medicine regarding the value of poster presentations as a strategy to enhance learning, assessment and feedback. METHODS: This was an exploratory observational, descriptive cross-sectional, case study. Data was collected through separate student and staff questionnaires that required participant responses on a five-point Likert scale. The data was extracted into Excel spreadsheets for quantitative analysis. RESULTS: Two-hundred- and-thirty (92%) student questionnaires were returned (N = 250). Most students indicated that the design and presentation of the poster had helped them to select important material (92%), understand and describe disadvantage (86%) and to make a difference in the community (92%). The students agreed that the poster assessment was an efficient (81%) and fair method (75%) that provided opportunities for meaningful feedback. Ten staff members responded to the questionnaire. Most staff members (90%) indicated that the poster presentation had allowed students to demonstrate their engagement in a meaningful and appropriate way around issues of disadvantage and HIV and agreed that the poster presentations allowed for immediate and effective feedback. CONCLUSION: Students' interactions in the tasks promoted active engagement with others and course material; the development of higher order thinking and skills which added to students' accounts of transformative learning experiences. They could describe and illustrate the difference that they had made in their chosen community. The poster presentations allowed for quick and efficient marking, immediate feedback and an opportunity to validate the students' participation. Poster presentations offered an innovative way to encourage deep meaningful engagement and learning amongst peers and facilitators. Poster presentations should be more widely considered as an innovative way of encouraging deeper engagement and learning in a large class setting.

Factors associated with physical activity in type 2 diabetes mellitus patients at a public clinic in Gaborone, Botswana, in 2017.

BACKGROUND: Physical activity plays a significant role in the managing of type 2 diabetes and is essential in reducing morbidity and mortality associated with diabetes mellitus. A number of factors influence non-adherence to physical activity: social, personal, environmental and economic factors. Diabetes research conducted in Botswana has focused on behavioural change, treatment adherence and nutrition. The physical activity levels of type 2 diabetes patients and associated factors are not known. AIM: The aim of this study was to assess the physical activity levels (PALs) and factors associated with physical activity in type 2 diabetes mellitusSetting: The study was conducted at a public clinic in Gaborone, Botswana, in 2017. METHODS: An observational cross-sectional study was conducted at a public clinic in Gaborone, Botswana. An interview-administered questionnaire was used to assess the PALs and factors associated with physical activity in type 2 diabetes mellitus patients. Data were captured on Excel and exported to SPSS software version 25 for analysis. Chi-square test, Fischer's exact test and Pearson's moment correlation examined the relationship between participants' characteristics and their engagement in regular exercise. RESULTS: The majority of the study participants had low PALs (54.7%). The results showed a non-significant negative correlation between age and PAL (r = -0.085) and between sitting time (sedentary time) and PAL (-0.098). CONCLUSION: Most type 2 diabetes mellitus patients had low PALs. Health-promoting activities are needed to promote physical activity and thus prevent complications associated with physical inactivity.

Factors associated with physical activity in type 2 diabetes mellitus patients at a public clinic in Gaborone, Botswana, in 2017

Background: Physical activity plays a significant role in the managing of type 2 diabetes and is essential in reducing morbidity and mortality associated with diabetes mellitus. A number of factors influence non-adherence to physical activity: social, personal, environmental and economic factors. Diabetes research conducted in Botswana has focused on behavioural change, treatment adherence and nutrition. The physical activity levels of type 2 diabetes patients and associated factors are not known. Aim: The aim of this study was to assess the physical activity levels (PALs) and factors associated with physical activity in type 2 diabetes mellitus. Setting: Thestudy was conducted at a public clinic in Gaborone, Botswana, in 2017. Methods: An observational cross-sectional study was conducted at a public clinic in Gaborone, Botswana. An interview-administered questionnaire was used to assess the PALs and factors associated with physical activity in type 2 diabetes mellitus patients. Data were captured on Excel and exported to SPSS software version 25 for analysis. Chi-square test, Fischer's exact test and Pearson's moment correlation examined the relationship between participants' characteristics and their engagement in regular exercise. Results: The majority of the study participants had low PALs (54.7%). The results showed a non-significant negative correlation between age and PAL (r = -0.085) and between sitting time (sedentary time) and PAL (-0.098). Conclusion: Most type 2 diabetes mellitus patients had low PALs. Health-promoting activities are needed to promote physical activity and thus prevent complications associated with physical inactivity

Prevalence and factors associated with low back pain among nurses at a regional hospital in KwaZulu-Natal, South Africa.

BACKGROUND: Low back pain (LBP) is a public health problem worldwide and is a common cause of work-related disorder among workers, especially in the nursing profession. Recruitment and retention of nurses is a challenge, and the nursing shortage has been exacerbated by the burden of occupational injuries such as LBP and related disabilities. The physiotherapy clinical records revealed that caseload of nurses presenting for the management of LBP was increasing. The prevalence and factors associated with LBP were unclear. METHODS: A cross-sectional study design with an analytic component was implemented. Data were collected utilising a self-administered questionnaire to determine the prevalence and factors associated with LBP among nurses at a regional hospital. Bivariate analyses were performed to determine the factors associated with LBP. RESULTS: The point prevalence of current LBP in nurses was 59%. The highest prevalence was recorded among enrolled nurses (54%), respondents aged 30-39 (46%), overweight respondents (58%) and those working in obstetrics and gynaecology (49%). Bending (p = 0.002), prolonged position (p = 0.03) and transferring patients (p = 0.004) were strongly associated with LBP. Nurses with more than 20 years in the profession reported a high prevalence of LBP. The prevalence of LBP was higher among the participants who were on six-month rotations (76%) compared with those on yearly rotation (16%). CONCLUSION: A high proportion of nurses reported to have LBP. Occupational factors are strongly associated with LBP. Education programmes on prevention and workplace interventions are required in order to reduce occupational injuries.

Master of Public Health programmes in South Africa: issues and challenges.

BACKGROUND: The demand for highly skilled public health personnel in low- and middle-income countries has been recognised globally. In South Africa, the need to train more public health professionals has been acknowledged. The Human Resource for Health (HRH) Strategy for South Africa includes the establishment of public health units at district and provincial levels. Programmes such as Master of Public Health (MPH) programmes are viewed as essential contributors in equipping health practitioners with adequate public health skills to meet the demands of the health care system. All MPH programmes have been instituted independently; there is no systematic information or comparison of programmes and requirements across institutions. This study aims to establish a baseline on MPH programmes in South Africa in terms of programme characteristics, curriculum, teaching workforce and graduate output. METHODS: A mixed method design was implemented. A document analysis and cross-sectional descriptive survey, comprising both quantitative and qualitative data collection, by means of questionnaires, of all MPH programmes active in 2014 was conducted. The MPH programme coordinators of the 10 active programmes were invited to participate in the study via email. Numeric data were summarized in frequency distribution tables. Non-numeric data was captured, collated into one file and thematically analysed. RESULTS: A total of eight MPH programmes responded to the questionnaire. Most programmes are affiliated to medical schools and provide a wide range of specialisations. The MPH programmes are run by individual universities and tend to have their own quality assurance, validation and assessment procedures with minimal external scrutiny. National core competencies for MPH programmes have not been determined. All programmes are battling to provide an appropriate supply of well-trained public health professionals as a result of drop-out, low throughput and delayed time to completion. CONCLUSION: The MPH programmes have consistently graduated MPH candidates, although the numbers differ by institution. The increasing number of enrolments coupled by insufficient teaching personnel and low graduate output are key challenges impacting on the production of public health professionals. Collaboration amongst the MPH programmes, standardization, quality assurance and benchmarking needs considerable attention.