Exploring the Role of Healthcare Personnel in Designing Tuberculosis Infection Prevention and Control Measures in Healthcare Settings: A Scoping Review.

Background: Healthcare personnel (HCP) in high TB-burdened countries continue to be at high risk of occupational TB due to inadequate implementation of Tuberculosis Infection Prevention and Control (TB-IPC) measures and a lack of understanding of the context and relevance to local settings. Such transmission in the healthcare workplace has prompted the development and dissemination of numerous guidelines for strengthening TB-IPC for use in settings globally. However, a lack of involvement of healthcare personnel in the conceptualisation and development of guidelines and programmes seeking to improve TB-IPC in high-burden countries generally has been observed. Objectives: The aim of this review was to explore the inclusion of HCP in decision-making when designing the TB-IPC guidelines, in healthcare settings. Methods: A scoping review methodology was selected for this study to gain insight into the relevant research evidence, identifying and mapping key elements in the TB-IPC measures in relation to HCP as implementors. Results: Studies in this review refer to factors related to HCP's knowledge of TB-IPC, perception regarding occupational risks and behaviours, their role against a background of structural resource constraints, and guidelines' adherence. They report several challenges in TB-IPC implementation and adherence, particularly eliciting recommendations from HCP for improved TB-IPC practices. Conclusions: This review highlights a lack of participation in decision-making by the implementers of the policies and guidelines, yet adherence to TB-IPC measures is anticipated. Future research needs to focus more on consultations with users to understand the preferences from both within individual healthcare facilities and the communities. There is an urgent need for research on the participation of the implementers in the decision-making when developing TB-IPC policies and guidelines.

The importance of local language in healthcare: naming and defining dysmenorrhea.

INTRODUCTION: Using local language improves the quality of healthcare and patient safety but little has been done to understand and use local language in naming and defining conditions such as dysmenorrhea. Many indigenous African women value their language especially when communicating about women's health. METHOD: In this exploratory study, we wanted to understand the local language used to construct and conceptualize dysmenorrhea and highlight the importance of local language when healthcare practitioners engage with women experiencing dysmenorrhea guided by Africana Womanism Theory. Data were collected from 15 Black indigenous women using a Lekgotla discussion group and in-depth interviews. Data were thematically analyzed. RESULTS: Participants described how local language is important in naming and seeking healthcare. Drawing from their descriptions three themes emerged: (1) Self-naming and self-defining dysmenorrhea using a local language; (2) Types of local words, phrases, and terms used to name and define dysmenorrhea; (3) The importance of self-naming and self-defining dysmenorrhea in a local language. CONCLUSIONS: Communication between healthcare seekers and healthcare providers is at the heart of effective healthcare provision. Poor communication due to language barriers contributes to misunderstanding, misdiagnoses, poor or incomplete patient assessment, and delayed treatment. Therefore, communicating healthcare issues in a local language would promote culturally sensitive care.

A tool to define and measure maternal healthcare acceptability at a selected health sub-district in South Africa.

BACKGROUND: There are many factors during pregnancy and labor that influence women's acceptability of maternal healthcare. Nevertheless, the concept of acceptability of maternal healthcare has unfortunately not been clearly defined and remains difficult to assess, affecting its implications and approaches from maternal health perspectives. In this study, we proposed a practical definition of maternal healthcare acceptability and developed a tool to measure maternal healthcare acceptability from patients' perspective at a selected health sub-district in South Africa. METHODS: We applied known techniques to develop measurement tools in health settings. The concept development drew from the literature review leading to the proposed definition of maternal healthcare acceptability which was then refined and validated by experts through Delphi technique. Other techniques included specification of concept constructs; selection of indicators; formation of indices; measurement tool/scale construction; and testing of reliability and validity. Factor analysis and simple arithmetic equation were performed on secondary and primary datasets respectively. RESULTS: Experts in the field reached a consensual definition of maternal healthcare acceptability. Factor analysis revealed three factors retained to predict maternal healthcare acceptability indices, namely provider, healthcare and community. Structural equation model showed good fit (CFI = 0.97), with good reliability and validity. Hypothesis testing confirmed that items and their corresponding factors were related (p < 0.01). Simple arithmetic equation was recommended as alternative method to measure acceptability when factor analysis was not applicable. CONCLUSION: This study provides new insights into defining and measuring acceptability of maternal healthcare with significant contributions on existing theories and practices on this topic and practical applications not only for maternal health but also across diverse health disciplines.

Challenges Related to the Structure of the Choice on Termination of Pregnancy Services in Public Health Facilities in the Tshwane District of Gauteng.

In 1997 South Africa legalised termination of pregnancy services for all women living within the country. It is now more than a decade since Choice on Termination of Pregnancy (CTOP) services have been implemented however, the state of the infrastructure of CTOP services in public health facilities is a cause for concern. The assessment of the quality of CTOP services in public health facilities has been seriously neglected. The objectives of the study were to assess, determine and evaluate the challenges related to the quality of the infrastructure of CTOP services in public health facilities. A quantitative, non- experimental cross-sectional survey design was used. The population comprised of facility/quality managers, registered professional nurses and midwives. A universal sampling method was used. Data was collected from healthcare professionals who were involved in procuring CTOP services. The public health facilities were assessed in terms of space adequacy, provision of privacy, availability of ablution facilities, rest room as well as human and material resources using the Donabedian model. It was found that insufficient provision was made to the infrastructure of public health facilities to accommodate the high demand for CTOP services. Structural challenges remain a barrier in meeting the objectives of the CTOP services. There is evidence of significant differences between the facility/quality managers versus the professional nurses regarding their response to space provided for rendering CTOP services. The study recommends the revitalisation of the structure of CTOP services to improve the quality rendered.

The experiences of nurses in caring for circumcised initiates admitted to hospital with complications.

The circumcision of males is a ritual that is performed in the veld, out of the public eye. Traditionally, it has to be attended by circumcised men only; no one is allowed to see the initiates before they are officially released or discharged. In recent times, initiates have been admitted to hospitals following complications during the circumcision process. In the hospitals, they are cared for by nurses. Hospitalisation of initiates creates problems for the elders who accompany the initiates as well as the nurses who are expected to care for them. The purpose of the study was to explore and describe the experiences of nurses who care for initiates who have been admitted into hospital with medical and physical complications. A qualitative approach was adopted for this study, and the data was collected by means of unstructured interviews. A purposively selected sample of nurses of different categories from a rural hospital in the Nkangala district in Mpumalanga Province, South Africa, participated in the study. The data was analysed, and five major categories were developed. The major categories were: conflicting cultural practices, emotions, common complications, ethical issues and possible solutions. Based on the findings of the study, it is recommended that traditional circumcision should be regulated to avoid complications that lead to the admission of initiates into hospitals. Also, a collaborative partnership should be established between the health institutions and the traditional surgeons and healers in caring for initiates.