Sogo France Matlala

The Master of Public Health (MPH) degree is a key qualification for public health practice in low- and middle-income countries. Graduates entering practice should possess a range of competencies to address complex health issues in managerial, technical or research positions. As competencies of graduates exiting South African MPH programs are unknown, a consortium of academics from South African universities conducted an on-line survey of alumni exiting between 2012−2016, to determine their self-reported public health competencies and their recommendations for improving academic programs. Competencies were explored in 11 domains, through three lenses – their reported usefulness at work; perceptions whether they were obtained through MPH programs; and graduates’ confidence in their application. Over 80% of this cohort of 221 graduates, mostly in their mid-30’s, largely from South Africa and sub-Saharan Africa, needed the competencies in all 11 domains at work, which were felt to be largely obtained from the MPH, and most were confident using them. However, one fifth were not confident in crisis management and 13% were not confident in health promotion. On average 30% reported they did not obtain either crisis management or leadership skills from the MPH. Respondents recommended changes to course content and organization included more experiential learning, mentorship and faculty advocacy for graduate employment. In the absence of country-wide governance for public health education, the study is a first step towards developing core-competencies for South African programs. Findings can be factored into MPH program reviews with attention given to enhancing leadership, crisis management and monitoring and evaluation training into existing courses. Additionally, more experiential learning could fill identified gaps in problem-solving and project management skills. Producing a ‘fit for purpose’ public health workforce requires alignment of education objectives with health workforce systems in country contexts to ensure a seamless transition between learning and working.

Child health remains a critical global public health concern, with malnutrition, diarrhea and pneumonia consistently driving high morbidity and mortality rates among children under the age of five. The World Health Organization (WHO) estimates that malnutrition accounts for approximately 3.1 million child deaths annually. In South Africa, persistent challenges such as stunting, micronutrient deficiencies, and food insecurity remain prevalent, particularly in rural communities, despite the existing interventions. Fermented foods present a culturally acceptable, affordable, and sustainable strategy to address malnutrition and improve gut health, potentially reducing stunting and diarrheal diseases. This article presents a protocol for a future four-phase mixed-method study that will be conducted to develop and validate strategies to promote the integration of fermented foods into children’s daily diets. The researchers will employ an exploratory sequential mixed methods design in three phases for the purpose of the envisaged study: bibliometric analysis, qualitative inquiry through in-depth interviews with caregivers and nurses, and a quantitative survey developed from qualitative findings. By combining qualitative and quantitative data, the study seeks to generate evidence-based, context-specific strategies for policy and programmatic integration. The anticipated outcome is a framework to support the inclusion of fermented foods in child nutrition programs to ensure the improved child health and progress toward the United Nations Sustainable Development Goals (UN SDGs).

Background: Self-care is an important concept in public health. As there is no cure for COVID-19, symptomatic treatment is encouraged. South Africans have been practicing self-care using steam inhalation as an indigenous health practice to successfully treat respiratory infections. Older adults are vulnerable to COVID-19 but are also indigenous health knowledge holders. The study examines the use of steam inhalation as self-care practice during COVID-19 by older adults. Methods: This qualitative study used secondary qualitative data from 87 interviews with 26 older adults. Ten transcripts met the inclusion criteria and were analysed thematically. Results: Four themes and eight subthemes emerged revealing older adults of 61-75 years asserting their self-care practice of steaming with herbs, encouraging their families to steam, continuing with their chronic medications and getting relieve from respiratory symptoms. They shared their believes in steam inhalation as an acceptable self-care practice to promote health and well-being. Conclusions: Older adults are indigenous knowledge holders who use steam inhalation as self-care practice to promote health and well-being. Steaming is acceptable self-care practice which should promoted.

Despite several studies on learner-to-teacher workplace violence and harassment, the problem persists in some South African schools. Learner-to-teacher violence and harassment is a form of workplace violence and harassment, as schools are workplaces for teachers. Learner-to-teacher violence and harassment is therefore an important occupational health and safety issue for teachers. Employers are obliged to provide a safe working environment for teachers to enable quality teaching and learning in schools. The purpose of this interpretative phenomenological study was to explore and describe the lived experiences of high school teachers who have been targets of workplace violence and harassment perpetrated by learners at selected schools in Limpopo Province of South Africa. Many teachers were willing to share their lived experiences but, due to data saturation, only eleven participated after being selected through purposive sampling from seven high schools under a chosen sub-district. The research ethics of voluntary participation, informed consent, ethical clearance, and gatekeeper permission were observed. Data were collected through semi-structured interviews using an interview guide. The interviews were audio-taped, and field notes were also taken. Voice recordings were transcribed verbatim and analysed using interpretative phenomenological analysis into themes and sub-themes. The findings were confirmed by an independent coder to achieve trustworthiness. Teachers experienced physical workplace violence and harassment, verbal workplace violence and harassment, and nonverbal workplace violence and harassment from learners. Learner-to-teacher workplace violence and harassment affects teachers emotionally, and in turn, affects the quality of teaching and learning in schools. Some teachers propose the involvement of a community policing forum, the strengthening of schools’ governing bodies, and reducing overcrowding in classrooms as possible solutions to deal with learner-to-teacher workplace violence and harassment.

Background: A nursing care plan is a guideline developed for a patient's needs. A well-documented care plan provides holistic patient-centred care and includes assessing, evaluating, and administering a variety of interventions as well as teaching patients and families. There are existing tools to measure nurses' knowledge, attitude, and practices in writing nursing care plans in many countries. However, cultural differences and most of the tools do not cover region-specific aspects of diseases, making it challenging to be used between countries. Objective: Thisstudy aimed to develop and validate a tool for determining the knowledge, attitudes, and practices of nurses in writing nursing care plans at a teaching hospital in Gauteng province, South Africa. Methods: A cross-sectional study was conducted among 218 registered nurses in selected hospital wards. Reliability was examined using Cronbach alpha and item-total correlation, while validity was assessed using Exploratory Factor Analysis (EFA EFA) and convergent validity. SPSS for Windows (version 10.0; SPSS, Inc., Chicago, IL, USA) was used to analyze data. Results: Cronbach's alpha was 0.75 for knowledge, 0.74 for attitude, and 0.77 for practices. The item-total correlation values ranged from -0.203 to 0.742. Kaiser-Meyer-Olkin was 0.877, 0.793, and 0.797 for the three dimensions, respectively and the Bartlett test was significant (p< 0.0001). The EFA showed that all the items had loadings ≥0.5 except for item A1. Knowledge and practice had a good convergent validity. Implications for Nursing: Efforts to develop, validate and implement a new instrument to assess nursing knowledge, attitudes, and practice in writing nursing care plans improve communication between nursing staff, and involve patients more in their care, resulting in fewer medical errors and improving the quality of patient care. Conclusion: This study indicates that the tool has satisfactory reliability, and the use of EFA for the investigation of validity is adequate, but one item in the attitude dimension has a lower threshold value. Further confirmatory factor analysis studies with a larger sample size are needed to support construct validity.

Despite several studies on learner-to-teacher workplace violence and harassment, the problem persists in some South African schools. Learner-to-teacher violence and harassment is a form of workplace violence and harassment as schools are workplaces for teachers. Learner-to-teacher violence and harassment is therefore an important occupational health and safety issues for teachers. The employer is obliged to provide a safe working environment for the teachers to enable quality teaching and learning in the schools. The purpose of this interpretative phenomenological study was to explore and describe the lived experiences of high school teachers who have been targets of workplace violence and harassment perpetrated by learners at selected schools in Limpopo province of South Africa. Many teachers were willing to share their lived-experiences but due to data saturation, only eleven participated after being selected through purposive sampling from seven high schools under a particular circuit. Research ethics of voluntary participation, informed consent, ethical clearance and gatekeeper permission were observed. Data was collected through semi-structured interviews using an interview guide. Interviews were audio-taped, and field notes were also taken. Voice recordings were transcribed verbatim and analysed using interpretative phenomenological analysis into themes and sub-themes. Findings were confirmed by an independent coder to achieve trustworthiness. Teachers experienced physical workplace violence and harassment, verbal workplace violence and harassment as well as nonverbal workplace violence and harassment from learners. Learner-to-teacher workplace violence and harassment affects teachers emotionally and in turn affects quality teaching and learning in the schools. Some teachers propose involvement of community policing forum, strengthening of School Governing Bodies as well as reducing overcrowding in the classroom as possible solutions to deal with learner-to-teacher bullying.

Background. African countries with limited healthcare capacity are particularly vulnerable to the novel coronavirus. The pandemic has left health systems short on resources to safely manage patients and protect health care workers. South Africa is still battling the epidemic of HIV/AIDS and tuberculosis which have had their programme/services interrupted due to the effects of the pandemic. Lessons learned from the HIV/AIDS and TB programme have shown that South Africans delay seeking health services when a new disease presents itself. Objective. The study sought to investigate the risk factors for COVID-19 inpatients’ mortality within 24-hours of hospital admission in Public health facilities in Limpopo Province, South Africa. Methods. The study used retrospective secondary data obtained from the 1 067 clinical records of patients admitted between March 2020 and June 2021 by the Limpopo Department of Health (LDoH). A multivariable logistic regression model, both adjusted and unadjusted, was used to assess the risk factors associated with COVID-19 mortality within 24 hours of admission. Results. This study, which was conducted in Limpopo public hospitals, discovered that 411 (40%) of COVID-19 patients died within 24-hours of admission. The majority of the patients were 60 years or older, mostly of female gender and had co-morbidities. In terms of vital signs, most had body temperatures less than 38°C. Our study findings revealed that COVID-19 patients who present with fever and shortness of breath are 1.8 and 2.5 times more likely to die within 24-hours of admission to the hospital, than patients without fever and normal respiratory rate . Hypertension was independently associated with mortality in COVID-19 patients within 24-hours of admission, with a high odds ratio for hypertensive patients (OR = 1.451; 95% CI = 1.013; 2.078) compared to non-hypertensive patients. Conclusion. Assessing demographic and clinical risk factors for COVID-19 mortality within 24-hours of admission aids in understanding and prioritising patients with severe COVID-19 and hypertension. Finally, this will provide guidelines for planning and optimising the use of LDoH healthcare resources and also aid in public awareness endeavours.

Objectives: To investigate patient satisfaction regarding healthcare services at a district hospital. The research ques-tion was: what is the level of patient satisfaction regarding service delivery?Design: An observational cross-sectional descriptive study conducted in September 2019.Settings: A district hospital in Botswana serving a population of 90 000. Outpatients from the Eye clinic, Casualty and Outpatient Department, Sexual Reproductive Health clinic and Infectious Diseases Control Centre were selected for the studyParticipants: 240 stable outpatients over 17 years selected through consecutive sampling participated voluntarily after giving informed consent.Main outcome measures: The level of satisfaction was measured using 19 questions on five-point Likert scales rang-ing from strongly disagree 1, disagree 2, unsure 3, agree 4 to strongly agree 5. A binary outcome was created into satisfied and unsatisfied using the mean score as the cut-off point. Age, gender, employment, education and depart-ments were independent variables.Results: 65% (95% CI: 58-71%) were satisfied but unsatisfied with: doctor’s politeness (66.9%; 95% CI: 60-73%), explaining (67.8%; 95% CI: 61-73%), privacy (65.6%; 95% CI: 59-72%), skills (67.4%; 95% CI: 61-73%), confidence (67.4% 95% CI: 61-73%), compassion (66.5%; 95% CI: 60-72%) and waiting time (49.2%; 95% CI: 42-57%). De-partment visited predicted satisfaction (p=0.002); those from the Eye clinic and Sexual Reproductive Health clinic were satisfied compared to others.Conclusion: Satisfaction was generally high but lower regarding specified services and departments visited. There is a need for targeted interventions. Studies are needed to explore reasons for lower satisfaction in Casualty, Outpatient Department and Infectious Diseases Control Centre.

Objective: Exclusive breastfeeding for the first six months of an infant’s life is an internationally recognised practice that promotes maternal and child health. Mothers and their infants reap health and socioeconomic benefits from exclusive breastfeeding. Even with these benefits, exclusive breastfeeding is still a challenge for some mothers to practice. Many studies revealed numerous challenges and enablers, and proposed comprehensive solutions, but implementation of exclusive breastfeeding for six months remains a challenge although there is some improvement. This study therefore explored barriers and facilitators to practice exclusive breastfeeding for the first six months of the infant’s life among mothers attending a health centre in Limpopo Province of South Africa, to contribute to the ongoing measures to increase the practice. Materials and methods: Mothers were selected through purposive sampling and semi-structured interviews were held with those willing to participate until saturation of data was reached. Interviews were audio-recorded, transcribed verbatim and analysed using a thematic analysis approach. Ethical issues of consent, permission and confidentiality were respected as well as trustworthiness criteria. Results and Discussion: Nine mothers narrated their experiences as they navigated through the exclusive breastfeeding practice. Education on exclusive breastfeeding and social support to a breastfeeding mother emerged as both barriers and facilitators to practice exclusive breastfeeding for six months. Conclusion: The study recommends that vigorous education on exclusive breastfeeding for six months be given to mothers during antenatal care and be extended to include relatives to empower them to support a breastfeeding mother. Bangladesh Journal of Medical Science Vol. 21 No. 04 October’22 Page : 813-819

The coronavirus disease (COVID-19) pandemic has recently impacted and destabilised the global community. The healthcare systems of many countries have been reported to be partially or entirely interrupted. More than half of the countries surveyed (53%) have partially or completely disrupted hypertension treatment services. A population-based retrospective cohort study approach was used to determine the prevalence of hypertension and related risk factors for mortality in COVID-19 hospitalised patients in the Limpopo Province, South Africa. Hierarchical logistic regression was applied to determine the determinants of hypertension. Sixty-nine percent (69%) of mortality among individuals with laboratory-confirmed SARS-CoV-2 were elderly persons aged 60 years and above admitted to a person under investigation (PUI) ward (52%), and 66% had hypertension. Among the hospitalised COVID-19 patients who died, prominent risk factors for hypertension were advanced age, the presence of co-morbidities, such as diabetes and HIV/AIDS. There was no evidence to establish a link between hypertension and COVID-19 case severity. More cohort and systematic studies are needed to determine whether there is a link between hypertension and COVID-19 case severity.