UWCScholar :: Browsing by Author "Hughes, Gail"

Browsing by Author "Hughes, Gail"

Now showing 1 - 10 of 10

Ability to manage diabetes – community health workers’ knowledge, attitudes and beliefs
(SEMDSA (Society for Endocrinology, Metabolism and Diabetes of SA), 2006) Hughes, Gail; Puoane, Thandi; Bradley, Hazel A.
BACKGROUND: Diabetes constitutes a significant health problem in South Africa. Early detection and good management can prevent or delay complications, with national guidelines for diabetes treatment now available to facilitate this. However, problems are being encountered with their implementation and there is evidence that preventive care is still inadequate in South Africa. Community health workers (CHWs) are lay personnel employed to serve as a link between professional health care staff and the community. They visit homes and can be a powerful force for diabetes prevention and adherence to treatment regimens, given appropriate knowledge. METHOD: We conducted a study to evaluate the knowledge, beliefs and attitudes of a group of CHWs serving a poor urban area, using focus groups and personal interviews. RESULTS: The CHWs did not have the requisite knowledge, attitudes and beliefs to make a positive impact on prevention and management of diabetes. For example, they cited eating sugar as a cause of diabetes. They advised folk remedies that purportedly diluted the blood sugar. Their patients took prescribed medication irregularly. Obesity was not considered an important risk factor. Poverty, however, was recognised as an obstacle to proper treatment. CONCLUSION: Training is clearly needed to empower the CHWs with skills to work within their communities to identify risk factors for diabetes and other non-communicable diseases, with emphasis on diet and physical activity.
Communication on sexual issues between migrant males and their partners: a study undertaken in rural South Africa
(University of the Western Cape, 2006) Hughes, Gail; Puoane, Thandi
INTRODUCTION: Women stay alone with their children in rural places while their husbands I partners work away from home for varying periods of time. Such fluctuating migration may cause difficulty in communications and may spread sexual transmittable infections (STI) and the human immunodeficiency virus (HIV). OBJECTIVE: This study explored ways in which black women in rural South Africa communicated with partners, who were migrant workers, on issues related to sexual matters. Method: This is a qualitative study where four focus groups were utilized to allow the women to describe their experiences, and to verbalize their feelings, beliefs, and perceptions in this area. PARTICIPANTS: Four focus groups consisting of six females between the ages of 16 - 48 who had partners that were employed as migrant labourers and do not live at home. Setting: A rural area in Hlabisa jurisdiction. DATA COLLECTION: An interview schedule with open questions were used to facilitate the focus group discussions Findings: The women, who saw their partners infrequently, were unlikely to communicate with them about sexual matters, including STI, HIV, and contraception to prevent unintended pregnancy. Poor communication severely constrained the possibility of reducing the risk of these outcomes. Raising the subject could be interpreted as a violation of the trust attached to the monogamous relationships of these Zulu women. The women felt they owed their returning husbands sexual intimacy and refusal was not an option because it was typically countered with force. CONCLUSION: The desire and need for sexual communication carried a price that was too high for women to pay. Control of their sexuality was mostly in the hands of their partners, upon whom they were economically and socially dependent. At this point in the HIV pandemic is it important to cultivate and identify the relevant social, cultural and behavioural norms that could reduce risk situations that tend to favour the spread of HIV.
Fear of sexually transmitted infections among women with male migrant partners – relationship to oscillatory migration pattern and risk-avoidance behaviour
(South African Medical Association, 2006) Hughes, Gail; Hoyo, Catherine; Puoane, Thandi
BACKGROUND: In South Africa, former apartheid laws encouraged rural males seeking employment to migrate to urban areas, moving weekly, monthly or annually between their rural families and urban workplaces. The combination of the migrant labour system and long family separations caused an explosion of serious health consequences, among others sexually transmitted infections (STIs) in the migrant population. OBJECTIVE: To describe some correlates of male migration patterns for the rural women left behind, especially the fear of STIs that this engendered in them and their risk-avoidance behaviour. Setting and subjects. In KwaZulu-Natal, 208 prenatal patients who were partners of oscillating male migrant workers were interviewed to determine their demographic and behavioural characteristics, and their fear of STIs. RESULTS: Thirty-six per cent of the rural women said that they were afraid of contracting STIs from their returning migrant partners. Women who saw their partners infrequently were more fearful of STI transmission, and were less able to have sexual communication. However, almost none of the women protected themselves, while only 8% used condoms, primarily for contraceptive purposes. CONCLUSIONS: These results reflect the gender-based power relationships of South African male migrants and their rural partners, the social and economic dependency of the women on their migrant partners, and the women’s social responsibility to bear children. The results point to the need to go beyond interventions that simply seek to modify behaviour without altering the forces that promote risk taking and discourage risk reduction, and the need to develop appropriate interventions to curb STIs and decrease HIV.
Health-seeking behaviours of older black women living with non-communicable diseases in an urban township in South Africa
(BioMed Central, 2016) Aboyade, Oluwaseyi; Beauclair, R.; Mbamalu, Oluchi; Puoane, Thandi; Hughes, Gail
BACKGROUND: Various studies have shown that non-communicable diseases (NCDs) especially diabetes and hypertension are prevalent among older women living in South African urban areas, placing a heavy burden on the healthcare system. This study aimed to understand the health-seeking behaviour, healthcare practices and prevalence of traditional herbal medicine (THM) use among older women self-reporting NCDs from the Prospective Urban Rural Epidemiology study (PURE). METHOD: A homogenous purposive sampling of PURE participants was used to recruit women who were 50 years or older (n = 250). Descriptive statistics were used to examine the number of NCDs reported by the study sample, health seeking behaviour and practices as well as THM use. Logistic regression was also employed to investigate possible associations between reported conditions and THM use or medical pluralism. RESULTS: Within the study sample, 72 % self-reported an NCD. Of those with self-reported NCDs, 46 % had one, and 54 % had two or more NCDs. Those with NCDs usually visited public clinics (80 %), relied on doctors (90 %) and nurses (85 %) for health information, and mostly used conventional medicine (CM) to manage high blood pressure (81 %). About 30 % of those with NCDs indicated using THM, of whom 29 (53 %) reported practicing medical pluralism. Participants with dental problems (OR: 3.24, 95 % CI: 1.30–8.20), headaches (OR: 2.42, 95 % CI: 1.24–4.94), heart burn (OR: 2.30, 95 % CI: 1.18–4.48) and severe tiredness (OR: 2.05, 95 % CI: 1.08–3.99) were more likely to use THM. Anxiety and allergies increased the likelihood to practise medical pluralism by five and 20 times, respectively. CONCLUSION: Self-reported NCD with co-morbidities was prevalent among the participants in the study. Most of the study participants utilized state-owned clinics and hospitals for the management of their chronic conditions. THM use was not very common. However, among those who used THM, medical pluralism was prevalent. Family history was the most common reason for THM use, with many THM patrons utilizing these for treatment of a health condition. Older black women with anxiety and allergies were more likely to practise medical pluralism.
Impact of the HIV/AIDS pandemic on non-communicable disease prevention
(South African Medical Association, 2005-04) Puoane, Thandi; Hughes, Gail
HIV/AIDS continues to ravage sub-Saharan Africa, and in South Africa accounts for 30% of all mortality, making it the leading cause of death. The epidemic has had other negative effects, which have not been fully realised. Among these is the fact that, paradoxically, the awareness programmes implemented to prevent major spread of HIV/AIDS have complicated the prevention of non-communicable diseases (NCDs).
Obesity among black South African women
(Kamla-Raj Enterprises, 2005) Puoane, Thandi; Hughes, Gail; Bradley, Hazel A.
Obesity and associated non-communicable diseases such as Type 2 diabetes, hypertension, and ischaemic heart disease were previously thought to be diseases of affluent countries, but they are becoming increasingly prevalent in developing nations. Accessibility to cheap unhealthy food, global trade and market development influence nutrition transition towards diets with high fat and sugar contents. A decrease in physical activity due to urbanisation and other environmental factors such as crime and violence are thought to lead to an increased risk of obesity. Positive beliefs about body weight among black African women, together with the idea of association of thinness with HIV/AIDS virus infection are believed to fuel the obesity epidemic amongst this population This paper describes some of the contributory factors which black South African women are faced with in making choices about healthy living. A multisectoral approach will be needed to fight the epidemic of obesity and associated diseases.
The prevalence of traditional herbal medicine use among hypertensives living in South African communities
(Biomedcentral, 2013) Hughes, Gail; Aboyade, Oluwaseyi; Clark, Bobby; Puoane, Thandi
BACKGROUND: In South Africa, over 6 million people are hypertensive and the burden of disease shows that cardiovascular diseases (CVDs) are the leading cause of death among adults. Although treatments exist, few people comply or adhere to recommended treatment due to side effects or costs of the drugs, hence the reliance on alternative forms of treatment. Traditional herbal medicines (THM) are used for the management of hypertension but the prevalence of its use among hypertensive patients living in South African communities is not sufficiently known. METHODS: This was a cross-sectional descriptive study to determine the prevalence of THM use for hypertension, among 135 purposefully selected South African participants of the Prospective Urban and Rural Epidemiological (PURE) study, who are THM users. Data on THM use were collected by way of face to face interviews using structured questionnaires administered by trained field workers. Standard descriptive measures were used to characterize the study sample and responses to the questionnaire. Chi-square test was used when making comparisons between groups. RESULTS: There were 135 THM users, 21% of whom used THM to treat hypertension. Majority (82.1%) of the hypertensive THM users were females, only 29% were married or co-habitating, virtually all (96%) were unemployed and 86% were Christians. More than half (56%) of the respondents were aged between 55 and 64 years. THM was occasionally used (51.9%) as a combination of tea and other mixtures (63%) and prescribed by family/ friends/selfadministered. There was a significant difference in the age, marital and employment status, as well as the form and frequency of THM use of hypertensive THM users compared to other THM users. CONCLUSIONS: The study gives an insight into the prevalence of THM use by hypertensive patients in selected South African communities. The practice of self-medication was also observed which raises concern regarding the safety of medications taken by the participants. Health care providers should however be more aware of THM use and counsel patients regarding the combination of prescribed treatment regimen and herbal medicines and the potential of herb-drug interactions.
Socio-cultural factors influencing food consumption patterns in the black African population in an urban township in South Africa
(Kamla-Raj Enterprises, 2006) Puoane, Thandi; Matwa, Princess; Hughes, Gail; Bradley, Hazel A.
The present study was undertaken to examine socio-cultural factors that influence food intake in different groups of people residing in a black township in Cape Town. Focus group discussions and in-depth interviews were used to explore these factors in men, and women of different age groups. Discussions were recorded, transcribed and analysed according to emerging themes. The main findings of the study indicated that in addition to nourishing the body, food is a sign of warmth, acceptance and friendship. Meat consumption on a daily basis is associated with a high socioeconomic status, while consumption of vegetables only is associated with a low socioeconomic status. Eating large portions of food is associated with affordability. Food is used for celebrations, rituals, and for welcoming guests. Food is also used during social occasions when people get together and meet socially. Sweets, ice cream and cakes are consumed on happy occasions. Fatty meat is a sign of generosity; lean meat and black tea is often used during mourning periods. Eating behaviours are learned during socialization, and carried over from generation to generation. There are socially accepted norms and values surrounding people’s understanding of what food is. This information needs to be used in a more constructive way to help people choose food wisely to prevent over nutrition and associated risks. In conclusion, this paper illustrates the impact of socio-cultural factors on eating patterns in this population and emphasizes the need to take these factors into consideration in development of interventions to promote healthy eating.
Sutherlandia frutescens: The meeting of science and traditional knowledge
(Mary Ann Liebert, 2013) Aboyade, Oluwaseyi; Styger, Gustav; Gibson, Diana; Hughes, Gail
Sutherlandia frutescens (L.) R.Br. (syn. Lessertia frutescens (L.) Goldblatt and J.C. Manning) is an indigenous medicinal plant extensively used in South Africa to treat a variety of health conditions. It is a fairly widespread, drought-resistant plant that grows in the Western, Eastern, and Northern Cape provinces and some areas of KwaZulu-Natal, varying in its chemical and genetic makeup across these geographic areas.1 Sutherlandia is widely used as a traditional medicine. Extensive scientific studies are being carried out on the safety, quality, and the efficacy of this medicinal plant to validate the traditional claims, elucidate the bioactive constituents, and conduct clinical trials. This has resulted in a unique situation in South Africa’s history, where traditional knowledge and science intersect to provide insight into this popular plant. This photoessay attempts to illustrate the interlinkage of science with the indigenous knowledge of traditional healers, the local knowledge of people who care for the sick, product development, and innovation agenda of the country as it relates to this plant.
Use of modified respondent driven sampling methodology to enhance identification and recruitment of most at risk persons into an HIV prevention trial in Kisumu, Western Kenya
(University of the Western Cape, 2016) Otieno, Fredrick Odhiambo; Hughes, Gail; Puoane, Thandi
This thesis presents research on the use of modified respondent driven sampling (mRDS) methodology to enhance identification and recruitment of key populations (KP) into an HIV prevention trial in Kisumu, western Kenya through a three phase mixed method study. The study was carried out in Kisumu, western Kenya within the Kenya Medical Research Institute (KEMRI) and the US Centers for Disease Control and Prevention (CDC) Research and Public Health Collaboration platform. The three phases included: 1. PHASE I: Identification and determination of categories of KPs and techniques of locating and motivating them to participate in HIV prevention trials.2. PHASE II: Design and Implementation of a mRDS methodology in recruiting Ks into HIV prevention trials.3. PHASE III: Evaluation of the mRDS in recruitment of KPs into an HIV incidence cohort study. Methods Phase I of the study included the conduct of in depth interviews which were used to identify different categories of persons considered to be KPs within Kisumu, identify strategies of locating the KPs and determine motivators and inhibitors of KPs participation in HIV prevention trials. Phase II on the other hand included the administration of a survey that had been refined in Phase I. The survey was used to design a mRDS methodology which was then implemented to recruit KPs into the survey. Phase III evaluated the success of the mRDS in recruiting KPs into an HIV prevention study by assessing the risk profiles for participants screened and enrolled into the Phase III study. Ethical approval for the study was sought from the ethics committee of the Kenya Medical Research Institute, the US CDC and the University of the Western Cape.The study recruited 53 individuals into phase I and was able to 8 identify different categories of people considered to be KPs and the 4 salient strategies that could be used to recruit them into HIV prevention studies. The phase also identified 8 potential motivators and 9 potential inhibitors to participation in HIV prevention research. These categories and salient strategies were used in phase II to develop and pilot a mRDS methodology in recruiting 203 individuals into a survey. The survey was used as a validation tool for the risk levels of persons recruited by the mRDS using the variables of inconsistent condom use and having multiple partners. The validated mRDS was then applied in the recruitment of 1,292 participants in phase III of thestudy. These study participants had characteristics similar to those seen in similar studies and elucidated from phases I and II of the study. HIV seropositivity was used as the variable for validating risk levels of participants in this study and this was found to be higher that that seen in general population and comparable to that seen in other KPs groups in the region. Results: Overall the study was able to identify different categories of people considered to be at high riskof HIV acquisition. The groups identified included people who frequent bars (e.g. bar workers, drunkards, sex workers, businessmen), people who work in transportation (e.g. truck drivers, matatu drivers, motorcycle drivers, taxi drivers, bicycle taxi drivers), fishermen/fishmongers, MSM and hair salon workers. The study also identified using personal contact, link persons, peer mobilisers and leaders as strategies of identifying and locating KPs. The study used the mRDS successfully in recruiting participants with evaluation of inconsistent condom use and multiple sexual partnerships showing the participants to be of high risk behaviour. Of all the females in the study, only 3.3% were pregnant. The prevalence of Chlamydia was 2.9%, gonorrhoea was 5.0%, syphilis was 0.4% and HSV-2 was 46.0%. Those who tested positive for HIV were 26.2% with 42.3% of the HIV positive participants having CD4 counts of between 250 – 500 cells/ml. Recommendations and Conclusion:The mRDS was successful in recruiting KPs in an HIV prevention trial. Majority of the participants reported inconsistent condom use and having multiple sex partners. In addition to MSM, SW and transport industry workers, fisherfolk, discordant couples, widowers, street youth, car washers and police also form part of KPs groups. The HIV prevalence was higher amongst these groups compared to general population with discordant couples having the highest HIV prevalence. The study recommends that mRDS should be used to identify and recruit KPs as it not only allows for faster recruitment of KPs, it also reduces the expense and complexity associated with coupon management in the standard RDS.

Browsing by Author "Hughes, Gail"

Results Per Page

Sort Options