Barriers to accessing and utilising under-five primary health care services in Vhembe District.

BACKGROUND:  Sub-Saharan Africa continues to be the region with the highest under-five mortality rate globally, with 74 deaths per 1000 live births. Even though under-five child primary health care (PHC) services are free in South Africa, accessing such services remains challenging. Children under 5 years reportedly die from common illnesses such as pneumonia, diarrhoea and malaria, which are treatable in PHC facilities. AIM:  The study explored the barriers to accessing and utilising under-five PHC services in the Vhembe District. SETTING:  The study was conducted in two PHC centres in Vhembe District among guardians accessing care for under-five child health services. METHODS:  An interpretative phenomenology design was followed using a semi-structured individual interview guide. Sixteen participants were purposively sampled for the study. Colaizzi's steps of data analysis were followed, and trustworthiness as well as ethical principles were ensured throughout the study. RESULTS:  Four themes emerged as health system barriers, health personnel-related behaviours, health facility infrastructure barriers and guardians-related barriers. Subthemes emerged as distance from the facility, lack of resources, long waiting times; poor time management, lack of commitment and work devotion, insufficient waiting space; challenges with water and sanitation, guardians' healthcare beliefs and the urgency of the illness. CONCLUSION:  It is imperative that an enabling professional and friendly environment is created to facilitate better access to PHC services for children under 5 years.Contribution: The study's findings brought insight into considering the context of the guardians in improving quality care for under 5 years.

The impediments of implementing infection prevention control in public hospitals: Nurses' perspectives.

Background: Infection prevention and control (IPC) programmes were introduced to combat healthcare-associated infections and antimicrobial resistance and to facilitate the implementation of IPC measures. The implementation of policies and guidelines results in effective service delivery. Aim: The purpose of the study was to explore nurses' experiences and perceptions regarding the impediments to implementing the IPC measures. Setting: The study was conducted in three public hospitals in Gauteng Province, South Africa. Methods: A qualitative exploratory design was used, and 49 nurses were purposively selected from three public hospitals to understand their experiences and perceptions regarding the impediments to implementing the IPC measures. Five focus group discussions were conducted using semi-structured interviews. Tesch's eight steps method was used to analyse data resulting in three main themes and seven sub-themes. Results: Three main themes emerged. Nurses experienced challenges regarding knowledge and attitudes towards IPC measures, inadequate hospital infrastructure and lack of management support. Conclusion: The lack of infection prevention control knowledge, infrastructure and management support impede the implementation of IPC measures. Consistent support in terms of training, resources and infrastructure is essential for implementing the measures. Contribution: The findings in this study will empower the nurses, doctors and managers with knowledge in implementing IPC measures to improve the infection prevention programme.

Healthcare providers' views of factors influencing family planning data quality in Tshwane District, South Africa.

BACKGROUND: The family planning service requires a routine health information system (RHIS) that can produce quality data that will be used for making decisions. However, the quality of data generated is not always of a good standard. Its usefulness in making data-driven decisions in family planning service is questionable. AIM: The study intended to assess the quality of family planning data and determine healthcare providers' (HCPs') views on factors influencing data quality in Tshwane district. SETTING: The study was carried out in 13 healthcare institutions in Tshwane district, Gauteng province, South Africa. METHODS: This paper reports on the quantitative strand of a mixed methods study. A sample of 111 HCPs was selected through a stratified random sampling technique, and six months of monthly reports from 13 institutions were reviewed for data quality. A self-administered questionnaire and a tick sheet were utilised to collect data from the HCPs and to review monthly reports for data quality, respectively. The Statistical Package for the Social Sciences (SPSS) programme for Windows version 24.0.0 was used to analyse the data. RESULTS: Data quality, mainly accuracy and timeliness, was a challenge. Many HCPs were not trained in the RHIS. They viewed several issues relating to organisational, behavioural and technical factors as barriers to data quality. CONCLUSION: The low quality of family planning data has a negative impact on policy development and decision-making.Contribution: There is a need for capacity building through training and supportive supervision, provision of adequate human and technical resources to enhance data quality and use of information for decision-making.

Nurse lecturers' experiences with online teaching during the pandemic at a public university in Gauteng, South Africa.

BACKGROUND:  Nurses' training has been mostly face-to-face in the South African context. This mode of delivery was linked to producing nurses who are critical thinkers, problem solvers and competent in practical skills. However, the emergence of coronavirus disease 2019 (COVID-19) accelerated the need for online teaching in nursing. Nurse lecturers were forced to teach online in order to save the academic project, despite concerns about the competencies and calibre of nurses produced through online teaching. OBJECTIVES:  This study aimed to explore and describe nurse lecturers' experiences with online teaching during the COVID-19 pandemic at a public university in Gauteng, South Africa. METHOD:  A qualitative, exploratory design was utilised. Six nurse lecturers - two males and four females - were purposefully selected to participate in this study. Data were collected through in-depth interviews to obtain rich, thick descriptions from the nurse lecturers who experienced online teaching. Content analysis was used to analyse the data. RESULTS:  Five themes emerged as, (1) challenges related to the learner management system; (2) challenges related to competency; (3) factors out of the span of control of the lecturer; (4) indirect benefits of online teaching; and (5) recommendations to facilitate the smooth delivery of online teaching. CONCLUSION:  The findings established that nurse lecturers experienced challenges when teaching online, which resulted in frustrations and discomfort for lecturers.Contribution: The study revealed the challenges nurse lecturers faced while teaching online. It highlights the need for nurse lecturers to be trained and supported to enhance online teaching and learning.

Organizational related challenges in antenatal care service delivery in semi-urban healthcare facilities in Gauteng, South Africa.

Antenatal care is vital in improving pregnancy outcomes. It is a vehicle for assisting in the reduction of maternal mortality. For this to be realized, there is a need for antenatal care that is effective, acceptable, and accessible to the users. However, South Africa is faced with challenges that impact the utilization of the service. A descriptive phenomenological design was used to explore the challenges of pregnant women attending antenatal care at selected facilities in Gauteng Province. Data were collected from 14 purposefully selected participants through in-depth individual telephonic interviews. Data analysis was guided by the Colaizzi steps. Credibility, dependability, confirmability, and transferability measures were applied to ensure trustworthiness. Ethical principles were adhered to throughout the study. Three themes emerged: resources and Covid-19-related challenges, overwhelming logistical processes, and suggested recommendations for ANC improvement. Management should provide sufficient resources and counselling services for staff and prioritize antenatal care services.