Nomfuneko Sithole

Background Burnout-related symptoms among nurses are a growing concern globally and may affect workforce well-being, patient care, and health system performance. In resource-constrained rural stableettings, heavy workloads, staffing shortages, and limited organisational support may increase nurses’ vulnerability to burnout-related symptoms. Evidence from rural district hospitals in South Africa remains limited. Objective To examine burnout-related symptoms, workplace and organisational factors, and nursing workforce retention indicators among nurses at St Elizabeth Hospital in the Eastern Cape Province, South Africa. Methods A quantitative cross-sectional study was conducted among 210 nurses working in selected clinical departments at St Elizabeth Hospital. Participants were selected using stratified random sampling from an eligible population of 362 nurses. Data were collected using a structured self-administered questionnaire incorporating the Burnout Assessment Tool (BAT-12), selected Maslach Burnout Inventory personal accomplishment items, and workplace-related measures informed by the Job Demands–Resources (JD–R) model. In addition, aggregate nursing workforce and retention indicators were collected from Human Resources records using a structured data extraction tool. Descriptive statistical methods were used to summarise survey data, while Human Resources data were analysed separately. Results High frequencies of burnout-related symptoms were reported, particularly exhaustion. Mental exhaustion was reported often or always by 71.0% of participants, difficulty recovering energy after work by 71.9%, and physical exhaustion by 72.4%. Heavy workload (78.6%), inadequate staffing (68.6%), regular overtime (68.1%), inadequate equipment (67.1%), and limited access to wellness services (48.6%) were common workplace challenges. Human Resources records indicated a 12-month nursing workforce retention rate of 90,49% and a turnover rate of 9,51%. Conclusions Burnout-related symptoms were common among nurses in this rural Eastern Cape district hospital, driven by high workplace demands and limited resources. Organisational improvements, such as better staffing, stronger workplace support, and access to wellness services, could improve nurse well-being and workforce sustainability. The study also highlights the need for longitudinal research on burnout and staff retention while contributing context-specific evidence from an under-researched rural South African setting.

Background Illegal abortion remains a significant public health challenge globally, particularly among adolescent girls who often lack adequate reproductive health information, access to healthcare services, and social support. Despite South Africa’s progressive abortion legislation, teenage girls in rural communities like Lusikisiki still face barriers to accessing safe reproductive health services due to socio-cultural stigma, misinformation, and limited youth-friendly services, increasing the risk of unsafe abortion and related health complications. Objectives This study aims to assess the awareness of teenage girls in Lusikisiki regarding the health risks associated with illegal abortion, explore their sources of information, identify factors influencing their awareness, and propose strategies to reduce unsafe abortion. Methods A qualitative case study design guided by an interpretive paradigm was used to explore the perceptions and experiences of teenage girls. A purposive sample of 25 participants aged 13–19 years were recruited from Village Clinic, Bambisana Hospital, and St Elizabeth Regional Hospital. Data was collected through semi-structured interviews and analysed using thematic analysis supported by NVivo software. Results Data saturation was reached at the 11th interview when no new codes or themes emerged. Three main themes identified: Awareness of Abortion and Associated Health Risks, Sources of Information Regarding Abortion and Reproductive Health, Strategies and recommendations to reduce illegal abortion among teenage girls in Lusikisiki. Conclusion The study findings indicate that teenage girls in Lusikisiki mainly rely on informal sources such as friends, partners, social media, and community hearsay for information about abortion and its associated risks, while formal sources such as schools, families, and healthcare services remain limited or underutilised. Strengthening youth-friendly reproductive health education, improving parent-adolescent communication, ensuring confidential and non-judgemental healthcare services, and increasing access to contraception may help reduce illegal abortion and its negative effects on teenage girls’ health and well-being.

Background Chronic diseases place a substantial pressure on healthcare systems, particularly in resource-constrained rural settings. Community-based nursing interventions and effective discharge planning are recognised as key strategies for improving continuity of care and reducing avoidable hospital readmissions. The aim of this study was to explore community-based nursing interventions, discharge planning, continuity of care, and hospital readmissions among patients with chronic diseases in Nyandeni Local Municipality, Eastern Cape, South Africa. Methods An exploratory descriptive design was employed. Data were collected through semi-structured interviews of patients with chronic diseases, a focus group discussion with nurses involved in community-based care, and a retrospective review of patient records using a structured Patient Record Summary Analysis Checklist. Qualitative data were analysed using Braun and Clarke's thematic analysis, while document review data were analysed descriptively. Findings from the three data sources were integrated through methodological triangulation. Results Four integrated themes emerged: (1) community-based nursing interventions promote continuity of care and chronic disease management; (2) discharge planning and care coordination support continuity of care; (3) health system and socioeconomic barriers limit effective community nursing; and (4) collaborative partnerships facilitate successful community-based care. Community-based nursing interventions improved treatment adherence and continuity of care. However, inadequate discharge documentation, weak community referrals, and rural health system challenges limited their effectiveness, while family support and multidisciplinary collaboration enhanced patient care. Conclusion Community-based nursing interventions are fundamental to strengthening continuity of care for patients with chronic diseases in rural communities. Their effectiveness, however, depends on comprehensive discharge planning, coordinated referral systems, multidisciplinary collaboration, and strengthened rural health systems. Addressing documentation gaps, improving post-discharge care coordination, and investing in community-based primary healthcare services may reduce avoidable hospital readmissions and improve long-term outcomes for chronic diseases in resource-limited settings.

Illegal abortion remains a significant public health challenge globally, particularly among adolescent girls who often lack adequate reproductive health information, access to healthcare services, and social support. Despite South Africa’s progressive abortion legislation, teenage girls in rural communities like Lusikisiki still face barriers to accessing safe reproductive health services due to socio-cultural stigma, misinformation, and limited youth-friendly services, increasing the risk of unsafe abortion and related health complications. This paper outlines a protocol for a proposed qualitative case study that aims to assess the awareness of teenage girls in Lusikisiki regarding the health risks associated with illegal abortion, explore their sources of information, identify factors influencing their awareness, and propose strategies to reduce unsafe abortion. A qualitative case study design guided by an interpretive paradigm will be used to explore the perceptions and experiences of teenage girls. A purposive sample of 25 participants aged 13–19 years will be recruited from Village Clinic, Bambisana Hospital, and St Elizabeth Regional Hospital. Data will be collected through semi-structured interviews and analysed using thematic analysis supported by NVivo software. The anticipated findings are expected to provide context-specific insights to support improved reproductive health education and adolescent-friendly healthcare services in rural communities.

Background Burnout among nurses is a growing public health concern, particularly in resource-constrained healthcare systems across Africa. Nurses working in public hospitals are frequently exposed to high workloads, staffing shortages, and limited organisational support, all of which contribute to chronic occupational stress. Objectives This scoping review aimed to map and synthesise evidence on factors contributing to burnout among nurses working in public hospitals in Africa. Methods The review followed Arksey and O′Malley’s framework, enhanced by Levac et al., and was guided by PRISMA-ScR reporting standards. A comprehensive search of PubMed, CINAHL, Scopus, and Web of Science identified studies published between 2020 and 2026. Eligibility criteria were defined using the Population Concept Context (PCC) framework. A total of 990 English-language records were identified, and 11 studies were included after screening. Data were extracted and analysed thematically. Results Five key themes were identified: (1) excessive workload leading to emotional and physical exhaustion; (2) poor management support and communication gaps; (3) inadequate resources and infrastructure; (4) unfavourable work environments and staffing conditions; and (5) limited access to wellness and professional development programmes. These factors were consistently associated with reduced job satisfaction, increased turnover intention, and compromised patient care. Conclusion Burnout among nurses in African public hospitals is driven by interconnected organisational and systemic challenges. Addressing these factors requires a multifaceted approach, including improved staffing, stronger leadership, enhanced resource allocation, and implementation of wellness and support programmes. Contribution This review contributes to the literature by providing a comprehensive synthesis of evidence on nurse burnout in African public hospital settings, identifying key systemic drivers, and highlighting gaps to guide future research and policy development.

Introduction: The COVID-19 pandemic significantly disrupted the functioning of the health system, including nursing education, particularly within resource-constrained contexts such as in South Africa. This study explored the lived experiences of nursing students during the COVID-19 period at Lilitha College of Nursing, a public nursing college operating across multiple urban and rural campuses in the Eastern Cape Province of South Africa. Methodology: A qualitative phenomenological design was employed, guided by the Dimensions of Wellness Framework. Purposive sampling was used to recruit a diverse cohort of nursing students who were registered during the period 2020–2022. Semi-structured, one-on-one interviews were conducted with 20 participants between 1 and 31 October 2025, until data saturation was attained. Interviews were audio-recorded, transcribed, translated verbatim, and analysed manually using the six phases of thematic analysis. Results: The findings revealed that the COVID-19 pandemic severely affected nursing students’ academic progress, mental and physical health, clinical training, and overall well-being, revealing institutional unpreparedness and gaps in support during crisis conditions. Conclusions: The study highlights the need for fair, holistic, and crisis-ready support systems to protect nursing students’ well-being and learning during future emergencies.

Background: Cancer is a rising public health concern in South Africa, with varying incidence and prevalence trends between provinces. Objectives: This study aimed to investigate the approach to estimating and ranking common cancers in South Africa’s Eastern Cape and Mpumalanga provinces through a patient survey in three referral hospitals. Methods: A quantitative cross-sectional design was employed from 1 April 2022 to 31 July 2022. A total of 425 patients were recruited to participate in this study. Patients were purposively sampled. Pretests were conducted to determine the reliability and validity of the instruments. Data were coded in Microsoft Excel and Stata; version 18 was used for data analysis. Ethical principles were observed and ensured throughout the study. Results: The results show the highest prevalence as breast cancer with 37.65% representing 160 cases, followed by cervical cancer with 19.06% (81 cases), and prostate cancer with 12.00% (51 cases). Conclusions: This study provided valuable insights into the prevalence and distribution of common cancers in the Eastern Cape and Mpumalanga provinces of South Africa based on data collected from patients across three referral hospitals.

Background/Objectives: Prostate cancer is a major public health concern and a leading cause of cancer-related morbidity and mortality among men worldwide, with disproportionately high mortality rates in sub-Saharan Africa. Late diagnosis, limited access to screening services, low health-seeking behaviour, and sociocultural barriers contribute to poor outcomes, particularly in rural settings. However, evidence on effective and context-appropriate strategies for prostate cancer prevention and early detection in African countries remains fragmented. Objective: This scoping review protocol aims to map and synthesize existing evidence on strategies implemented to reduce the burden of prostate cancer in Africa, with a focus on prevention, screening, community engagement approaches, and their acceptability. Methods: This scoping review protocol will be conducted in accordance with established methodological frameworks and reported following the PRISMA-ScR guidelines. A comprehensive search will be undertaken in PubMed (MEDLINE), EBSCOhost, ScienceDirect, CINAHL, and ProQuest. Studies conducted in African countries and published in English, French, or Portuguese will be included. Study selection and data extraction will be managed using Covidence, and findings will be summarized descriptively and thematically. Expected Results: This review is expected to identify and categorize existing prostate cancer prevention and early detection strategies implemented across African settings. Gaps in evidence, differences in implementation, and reported levels of acceptability among men are anticipated to be highlighted. Conclusions: The completed scoping review is expected to provide a comprehensive overview of prostate cancer prevention and early detection strategies implemented in Africa and to identify gaps in evidence. The evidence will inform the development of culturally responsive and context-specific interventions, with particular relevance for rural South African settings. This manuscript presents a protocol for a scoping review; no review findings are reported.

Background: Inadequate access to healthcare in rural areas worsens the burden of disease, leading to increased morbidity and mortality rates. This study aims to explore the multifaceted barriers that hinder access to chronic disease management at selected rural facilities of the Eastern Cape Province. Methods: An exploratory descriptive qualitative design was used to collect data from a sample size of 32 participants (23 patients and 9 health professionals) between November and December 2024. A convenient sampling technique was used to select participants for the study. Semi-structured interviews were audio-recorded; transcribed; and analyzed using thematic analysis. The interview tool was piloted in one of the primary healthcare facilities in the Eastern Cape, which was not used in the actual study. Ethical principles were adhered to throughout the study. The study adhered to the Access to Healthcare conceptual framework. Results: The study identified three themes: barriers of access to healthcare services, experiences and perspectives, and existing strategies or interventions. Conclusions: Addressing systemic issues like workforce shortages, infrastructure deficits, and socioeconomic challenges in rural Eastern Cape requires a multifaceted approach, including strengthening community-based services and ensuring equitable resource distribution.