UWCScholar :: Browsing by Author "Mathole, Thubelihle"

Browsing by Author "Mathole, Thubelihle"

Now showing 1 - 11 of 11

An evaluation of the effect of essential newborn care group motivational interviewing health education delivered in a maternity waiting home setting on the mothers' knowledge and practice and on early neonatal morbidity in rural eastern province of Zambia
(University of the Western Cape, 2018) Menda, Dhally Mutombo; Mathole, Thubelihle; Jackson, Debra
The study assesses the effect of the Essential Newborn Care family package health education messages delivered to pregnant mothers and their caregivers by the Safe Motherhood Action Groups members (SMAGs) in a Maternity Waiting Home (MWH) setting, using a client centered education methodology that uses the Group Motivational Interviewing philosophy, on the mothers' Essential Newborn Care (ENC) knowledge, mothers' ENC practice, and early neonatal morbidity. The study also explored the prevailing newborn care practices in the mothers' communities, and the mothers' level of satisfaction of the Essential Newborn Care Group Motivational Interviewing Health Education (ENCGMI HE) sessions.
Analysis of human resources for health strategies and policies in 5 countries in Sub-Saharan Africa, in response to GFATM AND Pepfar-funded HIV-activities
(BioMed Central -The Open Access Publisher, 2013) Cailhol, Johann; Craveiro, Isabel; Mathole, Thubelihle; Parsons, Ann Neo; Lehmann, Uta; Sanders, David; Madede, Tavares; Makoa, Elsie; Van Leemput, Luc; Biesma, Regien; Brugha, Ruairi; Chilundo, Baltazar; Dussault, Gilles; Van Damme, Wim
BACKGROUND: Global Health Initiatives (GHIs), aiming at reducing the impact of specific diseases such as Human Immunodeficiency Virus (HIV), have flourished since 2000. Amongst these, PEPFAR and GFATM have provided a substantial amount of funding to countries affected by HIV, predominantly for delivery of antiretroviral therapy (ARV) and prevention strategies. Since the need for additional human resources for health (HRH) was not initially considered by GHIs, countries, to allow ARV scale-up, implemented short-term HRH strategies, adapted to GHI-funding conditionality. Such strategies differed from one country to another and slowly evolved to long-term HRH policies. The processes and content of HRH policy shifts in 5 countries in Sub-Saharan Africa were examined. METHODS: A multi-country study was conducted from 2007 to 2011 in 5 countries (Angola, Burundi, Lesotho, Mozambique and South Africa), to assess the impact of GHIs on the health system, using a mixed methods design. This paper focuses on the impact of GFATM and PEPFAR on HRH policies. Qualitative data consisted of semi-structured interviews undertaken at national and sub-national levels and analysis of secondary data from national reports. Data were analysed in order to extract countries’ responses to HRH challenges posed by implementation of HIV-related activities. Common themes across the 5 countries were selected and compared in light of each country context. RESULTS: In all countries successful ARV roll-out was observed, despite HRH shortages. This was a result of mostly short-term emergency response by GHI-funded Non-Governmental Organizations (NGOs) and to a lesser extent by governments, consisting of using and increasing available HRH for HIV tasks. As challenges and limits of short-term HRH strategies were revealed and HIV became a chronic disease, the 5 countries slowly implemented mid to long-term HRH strategies, such as formalisation of pilot initiatives, increase in HRH production and mitigation of internal migration of HRH, sometimes in collaboration with GHIs. CONCLUSION: Sustainable HRH strengthening is a complex process, depending mostly on HRH production and retention factors, these factors being country-specific. GHIs could assist in these strategies, provided that they are flexible enough to incorporate country-specific needs in terms of funding, that they coordinate at global-level and minimise conditionality for countries.
Baseline assessment of the WHO/UNICEF/UNFPA maternal and newborn quality-of-care standards around childbirth: Results from an intermediate hospital, northeast Namibia
(Frontiers Media S.A., 2023) Siseho, Gloria Mutimbwa; Mathole, Thubelihle; Debra, Jackson
Background: Quality of care around childbirth can reduce above half of the stillbirths and newborn deaths. Northeast Namibia’s neonatal mortality is higher than the national level. Yet, no review exists on the quality of care provided around childbirth. This paper reports on baseline assessment for implementing WHO/UNICEF/UNFPA quality measures around childbirth. Methods: A mixed-methods research design was used to assess quality of care around childbirth. To obtain good saturation and adequate women opinions, we purposively sampled the only high-volume hospital in northeast Namibia; observed 53 women at admission, of which 19 progressed to deliver on the same day/hours of data collection; and interviewed 20 staff and 100 women who were discharged after delivery. The sampled hospital accounted for half of all deliveries in that region and had a high (27/1,000) neonatal mortality rate above the national (20/1,000) level. We systematically sampled every 22nd delivery until the 259 mother–baby pair was reached. Data were collected using the Every Mother Every Newborn assessment tool, entered, and analyzed using SPSS V.27. Descriptive statistics was used, and results were summarized into tables and graphs. Results: We reviewed 259 mother–baby pair records. Blood pressure, pulse, and temperature measurements were done in 98% of observed women and 90% of interviewed women at discharge. Above 80% of human and essential physical resources were adequately available. Gaps were identified within the WHO/UNICEF/UNFPA quality standard 1, a quality statement on routine postpartum and postnatal newborn care (1.1c), and also within standards 4, 5, and 6 on provider–client interactions (4.1), information sharing (5.3), and companionship (6.1). Only 45% of staff received in-service training/refresher on postnatal care and breastfeeding. Most mothers were not informed about breastfeeding (52%), postpartum care and hygiene (59%), and family planning (72%). On average, 49% of newborn postnatal care interventions (1.1c) were practiced. Few mothers (0–12%) could mention any newborn danger signs. Conclusion: This is the first study in Namibia to assess WHO/UNICEF/UNFPA quality-of-care measures around childbirth. Measurement of provider–client interactions and information sharing revealed significant deficiencies in this aspect of care that negatively affected the client’s experience of care. To achieve reductions in neonatal death, improved training in communication skills to educate clients is likely to have a major positive and relatively low-cost impact.
The effects of the devolution of HIV treatment programmes from external to local non-governmental organisations: A mixed-methods study in Kano, Northern Nigeria
(University of the Western Cape, 2021) Yahaya, Habibu Bala; Mathole, Thubelihle
The devolution of health programmes from external to local non-governmental organisations (NGOs) is a relatively new phenomenon in sub-Saharan Africa. The special characteristics of the devolution of complex programmes pose both managerial and employee challenges, which previous change management research has not adequately addressed. Furthermore, earlier research has mainly viewed organisations as isolated and independent entities, whereas programmes that aim at large-scale interventions, such as the President’s Emergency Plan for AIDS Relief (PEPFAR) projects, are embedded in their organisational context. Ineffective implementation of the PEPFAR antiretroviral therapy (ART) devolution process is a potential threat to programme sustainability in Nigeria.
Leadership and the functioning of maternal health services in two rural district hospitals in South Africa
(Oxford University Press, 2018) Lembani, M.; Jackson, D.; Zarowsky, C.; Bijlmakers, L.; Sanders, David; Mathole, Thubelihle
Maternal mortality remains high in Eastern Cape Province, South Africa, despite over 90% of pregnant women utilizing maternal health services. A recent survey showed wide variation in performance among districts in the province. Heterogeneity was also found at the district level, where maternal health outcomes varied considerably among district hospitals. In ongoing research, leadership emerged as one of the key health systems factors affecting the performance of maternal health services at facility level. This article reports on a subsequent case study undertaken to examine leadership practices and the functioning of maternal health services in two resource-limited hospitals with disparate maternal health outcomes. An exploratory mixed-methods case study was undertaken with the two rural district hospitals as the units of analysis. The hospitals were purposively selected based on their maternal health outcomes: one reported good maternal health outcomes (pseudonym: Chisomo) and the other had poor outcomes (pseudonym: Tinyade). Comparative data were collected through a facility survey, non-participant observation of management and perinatal meetings, record reviews and interviews with hospital leadership, staff and patients to elicit information about leadership practices including supervision, communication and teamwork. Descriptive and thematic data analysis was undertaken. The two hospitals had similar infrastructure and equipment. Hospital managers at Chisomo used their innovation and entrepreneurial skills to improve quality of care, and leadership style was described as supportive, friendly, approachable but ‘firm’. They also undertook frequent and supportive supervisory meetings. Each department at Chisomo developed its own action plan and used data to monitor their actions. Good performers were acknowledged in group meetings. Staff in this facility were motivated and patients were happy about the quality of services. The situation was different at Tinyade hospital. Participants described the leadership style of their senior managers as authoritarian. Managers were rarely available in the office and did not hold regular meetings, leading to poor communication across teams and poor coordination to address resource constraints. This demotivated the staff. The differences in leadership style, structures, processes and work culture affected teamwork, managerial supervision and support. The study demonstrates how leadership styles and practices influence maternal health care services in resource limited hospitals. Supportive leadership manifested itself in the form of focused efforts to build teamwork, enhance entrepreneurship and in management systems that are geared to improving maternal care.
Monitoring healthcare improvement for mothers and newborns: A quantitative review of WHO/UNICEF/UNFPA standards using every mother every mewborn assessment tools
(Frontiers Media, 2022) Siseho, Gloria Mutimbwa; Mathole, Thubelihle; Jackson, Debra
Assessment tools with the ability to capture WHO/UNICEF/UNFPA standard quality-of-care measures are needed. This study aimed to assess the ability of Every Mother Every Newborn (EMEN) tools to capture WHO/UNICEF/UNFPA maternal and newborn quality improvement standard indicators. A quantitative study using the EMEN quality assessment framework was applied. The six EMEN tools were compared with the WHO/UNICEF/UNFPA maternal and newborn quality improvement standards. Descriptive statistics analysis was carried out with summaries using tables and figures.
Perceptions of body size, obesity threat and the willingness to lose weight among black South African adults: a qualitative study
(BioMed Central, 2016) Okop, Kufre Joseph; Mukumbang, Ferdinand C.; Mathole, Thubelihle; Levitt, Naomi; Puoane, Thandi
BACKGROUND: The obesity epidemic is associated with rising rates of cardiovascular disease (CVD) among adults, particularly in countries undergoing rapid urbanisation and nutrition transition. This study explored the perceptions of body size, obesity risk awareness, and the willingness to lose weight among adults in a resource-limited urban community to inform appropriate community-based interventions for the prevention of obesity. METHOD: This is a descriptive qualitative study. Semi-structured focus group discussions were conducted with purposively selected black men and women aged 35–70 years living in an urban South African township. Weight and height measurements were taken, and the participants were classified into optimal weight, overweight and obese groups based on their body mass index (Kg/m2). Participants were asked to discuss on perceived obesity threat and risk of cardiovascular disease. Information on body image perceptions and the willingness to lose excess body weight were also discussed. Discussions were conducted in the local language (isiXhosa), transcribed and translated into English. Data was analysed using the thematic analysis approach. RESULTS: Participants generally believed that obesity could lead to health conditions such as heart attack, stroke, diabetes, and hypertension. However, severity of obesity was perceived differently in the groups. Men in all groups and women in the obese and optimal weight groups perceived obesity to be a serious threat to their health, whereas the overweight women did not. Obese participants who had experienced chronic disease conditions indicated strong perceptions of risk of obesity and cardiovascular disease. Obese participants, particularly men, expressed willingness to lose weight, compared to the men and women who were overweight. The belief that overweight is ‘normal’ and not a disease, subjective norms, and inaccessibility to physical activity facilities, negatively influenced participants’ readiness to lose weight. CONCLUSION: Low perception of threat of obesity to health particularly among overweight women in this community indicates a considerable challenge to obesity control. Community health education and promotion programmes that increase awareness about the risk associated with overweight, and improve the motivation for physical activity and maintenance of optimal body weight are needed.
PMTCT data management and reporting during the transition phase of implementing the rationalised Registers in Amathole District, Eastern Cape Province, South Africa
(International Journal of Environmental Research and Public Health, 2022) Oyebanji, Oyebola Gbenga; Mathole, Thubelihle; Jackson, Debra
Background: The National Department of Health, in March 2015, launched the implementation of Rationalisation of Register, aimed at reducing the amount of time invested in completing the registers and collecting data. Therefore, the number of registers used in the South African healthcare facilities was reduced from 56 to 6. Objectives: This study explored the effect of the rollout of Rationalisation of Register on the documentation and reporting of Prevention of Mother-to-Child Transmission (PMTCT) programme data with the existing source documents during the transitional period, especially with routine data collected and reported at various health care system levels.
Promoting awareness of the role of the district clinical specialist team in the Amathole District, South Africa: A valuable specialty in improving healthcare access and quality
(Tropical Medicine and Infectious Disease, 2022) Oyebanji, Oyebola G.; Mathole, Thubelihle; Jackson, Debra
Introduction: This study explored the understanding of healthcare professionals on the role of the District Clinical Specialist Team (DCST) and how the team works together with the district personnel at different management levels to improve and strengthen the Prevention of Motherto-Child Transmission of HIV (PMTCT) programme performance across four sub-districts in the Amathole district of the Eastern Cape Province, South Africa. Methods: An interpretive qualitative case study was used to understand the role played by the DCST in improving PMTCT programme performance in the district. We used a purposive sampling method to select eight participants involved in providing technical assistance to support the implementation of the quality improvement programme. We conducted in-depth interviews with all the participants; all were females in their mid-forties. Data were analysed thematically by identifying themes and reporting patterns within the data. Findings: Most interviewees were females in their mid-forties and had been at their respective facilities for at least five years. The findings were discussed based on three themes: capacity building, programme performance oversight and monitoring, and technical support. The DCST significantly enhances the staff’s clinical skills, knowledge, and work performance to care for and manage the mother and baby pair. In addition, the DCST plays a vital role in providing programme oversight and complements the technical support provided by the Department of Health (DoH) managers and the quality improvement programme support by the South to South (S2S) team aimed at improving and achieving the PMTCT programme’s desired outcomes. The DCST also provided additional support for data verification to identify gaps in the PMTCT programme. Conclusion: The role of DCST is essential in improving the quality and service provision of the PMTCT programme and is critical to assist the team at different levels in addressing challenges encountered and training and mentoring the needs of the staff. In addition, DCST’s responsibilities cannot be fully achieved without a good working relationship with the quality improvement and district health teams because they work better together to ensure that the programme is performing optimally. Take-home message: This study showed that the District Clinical Specialist Team is vital for improving the quality and service provision of the PMTCT programme and it is essential for addressing challenges encountered by healthcare facilities and the staff providing PMTCT services
Reasons for missed appointments linked to a public-sector intervention targeting patients with stable chronic conditions in South Africa: results from in-depth interviews and a retrospective review of medical records
(BioMed Central, 2017) Magadzire, Bvudzai P.; Mathole, Thubelihle; Ward, Kim
BACKGROUND Missed appointments serve as a key indicator for adherence to therapy and as such, identifying patient reasons for this inconsistency could assist in developing programmes to improve health outcomes. In this article, we explore the reasons for missed appointments linked to a centralised dispensing system in South Africa. This system dispenses pre-packed, patient-specific medication parcels for clinically stable patients to health facilities. However, at least 8%–12% of about 300,000 parcels are not collected each month. This article aims to establish whether missed appointments for collection of medicine parcels are indicative of loss-to-follow-up and also to characterise the patient and health system factors linked to missed appointments. METHODS We applied an exploratory mixed-methods design in two overlapping research phases. This involved in-depth interviews to yield healthcare practitioners’ and patients’ experiences and medical record reviews. Data collection was conducted during the period 2014–2015. Qualitative data were analysed through a hybrid process of inductive and deductive thematic analysis which integrated data-driven and theory-driven codes. Data from medical records (N = 89) were analysed in MS excel using both descriptive statistics and textual descriptions. RESULTS Review of medical records suggests that the majority of patients (67%) who missed original appointments later presented voluntarily to obtain medicines. This could indicate a temporal effect of some barriers. The remaining 33% revealed a range of CDU implementation issues resulting from, among others, erroneous classification of patients as defaulters. Interviews with patients revealed the following reasons for missed appointments: temporary migration, forgetting appointments, work commitments and temporary switch to private care. Most healthcare practitioners confirmed these barriers to collection but perceived that some were beyond the scope of health services. In addition, healthcare practitioners also identified a lack of patient responsibility, under-utilisation of medicines and use of plural healthcare sources (e.g. traditional healers) as contributing to missed appointments. COCLUSION We suggest developing a patient care model reflecting the local context, attention to improving CDU’s implementation processes and strengthening information systems in order to improve patient monitoring. This model presents lessons for other low-and-middle income countries with increasing need for dispensing of medicines for chronic illnesses.
Use of continuous quality improvement to improve prevention of mother to child transmission (pmtct) programme performance in Amathole district municipality of Eastern Cape province, South Africa
(University of the Western Cape, 2022) Oyebanji, Oyebola; Mathole, Thubelihle
Globally, new Human Immunodeficiency Virus (HIV) infections in children reduced by 54% due to implementation of Prevention of Mother to Child Transmission (PMTCT) of HIV since the peak in 1996, increase in Antiretroviral treatment (ART) coverage among children and increase in the proportion of pregnant women receiving ART. In South Africa, significant progress has been made regarding PMTCT programme geared towards the virtual elimination of new HIV infections in children, which has contributed to 40% reduction of new HIV infection in children.

Browsing by Author "Mathole, Thubelihle"

Results Per Page

Sort Options