Browsing by Author "Bimerew, Million S"

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    Analysing implementation of the integrated tuberculosis, HIV and AIDS policy in a rural sub-district, Western Cape
    (University of the Western Cape, 2015) Bimerew, Million S; Phetlhu, D. R
    Globally, tuberculosis (TB) and AIDS are the leading causes of morbidity and mortality of people, particularly in many developing countries. South Africa is among those countries with a high double burden of TB and HIV infections in the world. Although policy guidelines have been developed to mitigate the problems of TB and HIV coinfection, there are still challenges with their implementation. The aim of this study was to analyse the implementation of the integrated TB and HIV policy in a rural sub-district of the Western Cape. The study applied a descriptive survey method to collect data from 60 respondents selected using an all-inclusive sampling strategy. A self-reporting questionnaire was used, and data were analysed using the Statistical Package for Social Sciences (SPSS) program version 23. Descriptive statistics are presented with graphs and percentages. All ethical principles were adhered to. The results showed that 86% of the respondents were female nurses, 59% were registered nurses, and the rest were enrolled and assistant nurses. The general view of participants was that implementation of the integrated TB and HIV policy was poor, as only 25% (11) felt that they have sufficient knowledge and skills to implement it, while 50% (22) did not feel equipped to implement the integrated policy. These perceptions of inadequacy were justified by a lack of sufficient training, with only 32% of the respondents having attended training on integrated TB and HIV management. The nurses’ responses on actual practices ranged from poor to sufficient, and example being the management of HIV-positive TB patients with CD4 count of <100/μl, where 27.9% were unsure when to initiate antiretroviral therapy and 44.7% were unsure when isoniazid prophylaxis could not be given to HIVpositive patients. However, the findings indicated that TB and HIV policy guidelines were 86% and 85.7% accessible respectively. The study concluded that nurses do not implement the integrated TB and HIV policy guidelines sufficiently, mainly due to lack of adequate training which resulted in limited knowledge thus poor practice. It is recommended that a continuous staff capacity development programme, which includes suitable pre-service and in-service training in TB and HIV/AIDS management be developed and implemented as it has the potential to address the current knowledge and skills gaps which impact on implementation of the integrated TB and HIV policy.
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    Developing a framework for a district-based information management system for mental health care in the Western Cape
    (University of Western Cape, 2013) Bimerew, Million S; Adejumo, Oluyinka; Korpela, Mikko
    A review of the literature has shown that there is a lack of mental health information on which to base planning of mental health services and decisions concerning programme development for mental health services. Several studies have indicated that the use of an evidence-based health information system (HIS) reduces inappropriate clinical practices and promotes the quality of health care services. This study was aimed at developing a framework for a district-based mental health information management system, utilising the experiences of health care providers and caregivers about a district mental health information system (DMHIS). Activity Theory was used as the philosophical foundation of the information system for the study. A qualitative approach was employed using semi-structured individual interviews, Focus Group Discussions (FGDs), systematic review and document analysis. The intervention research design and development model of Rothman and Thomas (1994) was used to guide the study, which was conducted in the Cape Town Metropole area of the Western Cape. A purposive, convenient sampling method was employed to select study participants. Ethical clearance for the study was obtained from the University of the Western Cape, and permission to use the health facilities from the Department of Health. The data collection process involved 62 individual interview participants, from mental health nurses to district health managers, health information clerks, and patient caregivers/families and persons with stable mental conditions. Thirteen caregivers took part in the FGDs. Document review was conducted at three community mental health centres. The data were analysed manually using content analysis. Core findings of the interviews were lack of standardized information collection tools and contents for mental health, information infrastructure, capacity building, and resources. Information processing in terms of collection, compiling, analysing, feedback, access and sharing information were the major problems. Results from document analysis identified inconsistencies and inaccuracies of information recording and processing, which in turn affected the quality of information for decision making. Results from the systematic review identified five functional elements: organizational structure; information infrastructure; capacity building; inputs, process, output and feedback; and community and stakeholders’ participation in the design and implementation of a mental health information system (MHIS). The study has contributed a framework for a DMHIS based on the findings of the empirical and systematic review. It is recommended that there is a need to establish a HIS committee at district health facility level for effective implementation of the framework and quality information processing. There is a need to ensure that staffs have adequate knowledge and skills required for effective implementation of an information system. It is recommended that higher education institutions include a course on HISs in their curriculum. It is suggested that the South African Mental Health Policy be reviewed to include an MHIS and ensure involvement of the community and stakeholders in this system as well as adequate budget allocation.
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    Exploration of nurses' experiences of the assessment and management of patients at risk of absconding from an acute psychiatric ward in the Western Cape
    (University of the Western Cape, 2017) Malgas, Fikile Nelson; Bimerew, Million S
    Unlawful absence of patients from the acute psychiatric ward increases concern on the part of the professionals responsible for their care. Patients who abscond from psychiatric hospitals represent a risk of potential harm to patients or the general public. Consequences of absconding may include physical harm and prolonged treatment time, as well as considerable economic cost to the family and government. The aim of the study was to explore and describe the nurse's experiences of assessment and management for patients at risk of absconding from an acute psychiatric ward in the Western Cape. A qualitative approach using an exploratory descriptive design was applied to conduct this study. The target population was mental health nurses working in acute psychiatric wards where patients were at risk of absconding. A sample of ten (n=10) mental health nurses was purposively selected to participate in the study. Semistructured interviews were used to collect the data from participants. Data collection continued until data saturation was reached (until no further new information emerged). Data was analysed manually by coding, categorizing and identifying similar patterns. Trustworthiness of the study was ensured through addressing the confirmability, transferability; credibility and dependability. Ethics approval was obtained from the University Research Ethics Committee and Ethics Committee of the Department of Health and the selected psychiatric hospital. The ethical principles of the right to self-determination, withdrawal from the research study, privacy, autonomy and confidentiality, fair treatment, protection from discomfort and harm, and obtaining informed written consent were adhered to. Three themes emerged from the data: risk assessment, risk management, and increased observations. The results of the study was discussed with relevant recent literature evidence. The qualitative research is limited to few study sample size, and the results cannot be generalized to other similar population.
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    Factors associated with increased Neonatal deaths at a Regional hospital in Namibia
    (University of South Africa, 2020) Hatupopi, Saara K; Bimerew, Million S; Chipps, Jennifer
    The increased neonatal mortality rate in a regional hospital in Namibia is a concern. According to the 2013 records of the hospital, there were 333 neonatal deaths from 1 January to 31 December 2013. The aim of the study was to investigate the causes of the increased neonatal deaths at this regional hospital in Namibia. A retrospective descriptive survey design was employed to conduct the study.
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    An investigation of the knowledge and skills of health care providers on early infant diagnosis of HIV in Mzuzu, Malawi
    (University of the Western Cape, 2016) Mkuyamba, Veronica; Bimerew, Million S
    Early infant diagnosis (EID) programmes offer diagnosis of HIV, which facilitates provision of life-saving care to infants infected with HIV. Implementing programmes for EID and treatment has proved challenging in Malawi. Many infants access EID late or not at all. Previous studies have shown that lack of knowledge among health care providers (HCPs) is a challenge to effective EID. Little is known on the knowledge and skills of health care providers in Malawi. Aim: The aim of the study was to investigate the knowledge and skills of HCPs on EID of HIV in Mzuzu, Malawi. Objectives: (i) to examine the knowledge of HCPs on EID of HIV; and (ii) to determine the skills of HCPs on EID of HIV. Methods: A descriptive cross-sectional survey design with a quantitative approach was used. The study was conducted in three hospitals in Mzuzu, Malawi. The population was HCPs (doctors, nurses/midwives, clinical officers and medical assistants) working in maternity, paediatric wards and under-five clinics. A total of 68 HCPs participated in the study. A closed-ended self-administered questionnaire was used to collect data. Data were analysed using the Statistical Package for Social Science version 23. Descriptive statistics were used to present the frequency tables of observations. Ethical approval was sought from the University of the Western Cape Senate Research Committee and Malawi National Health Research Council. Results: The results on the knowledge of HCPs demonstrate that 38% of them had a score of <69% (poor), 25% scored within 70–79% (fair), and 37% scored >80% (good). Results on the skills showed that 69% of the HCPs scored <69% (poor), 15% scored within 70–79% (fair), and 16% scored >80% (good). The results also showed a correlation between the knowledge of HCPs and their level of education achievement (certificate, diploma and degree) as well as the skills of HCPs and their department of work. Conclusion: The study found that more than one-third of the HCPs lacked knowledge and skills on EID of HIV. These findings reflect the need to address the practical challenges of EID service delivery. Recommendations: There is a need to increase the efforts that are being put in place to train HCPs on EID of HIV in order to scale up EID. Training should assess the needs of HCPs regarding the knowledge and skills required in the delivery of EID services.