https://ir.unisa.ac.za/handle/10500/14520 2026-05-05T13:55:49Z https://ir.unisa.ac.za/handle/10500/32324 Strategies to promote optimal utilisation of maternal healthcare services at primary healthcare centres in Pemba Island, Zanzibar Mwasha, Loveluck Kusirieli Maternal healthcare is healthcare services provided to women during pregnancy, childbirth, and postnatal period. Underutilisation of maternal healthcare services, specifically during delivery and postnatal period, is a deterrent to the efforts to reduce maternal mortality and morbidity globally. In middle and low-income countries, Tanzania among them, many women attend at least one antenatal care, but only a few make the recommended eight contacts due to health policy and population-related reasons. Additionally, some women do not deliver at health facilities and do not continue with postnatal services as they do not see the need. This study aimed to explore community perceptions of utilising facility-based maternal healthcare services in Wete Pemba Island and develop strategies to promote optimal utilisation. A qualitative explorative descriptive design was used to obtain data through individual interviews with women (n=16) and men (n=15), as well as four focus group discussions with nurse-midwives (NMs) (n=19). Data collection was done using a semi-structured interview guide and analysed thematically using MAXQDA2020. The emergent themes are categorised into perceived promoters and impeders of optimum utilisation of facility-based maternal healthcare services, and the third theme was the participants’ suggestions for enhancing facility-based maternal health service utilisation. The promoters include good maternal healthcare services, family and spouse support, comprehensive services under one roof, and good education, counselling, and advice. The impeders are cultural practices, family power relations and decision-making, religious beliefs, distance to health facilities, trust in traditional birth attendants (TBAs), fear of testing for HIV, health professionals’ attitudes, shortage of staff, unconducive physical infrastructure, inadequate medical equipment, and supplies, including medicines. The suggestions from the findings were: ensure the availability of medical supplies, medical equipment, and ambulance; staffing issues – shortage and attitude toward patients (Pts);emphasise health education/information to the community; and upgrade physical infrastructure. The study results were evaluated using the SWOT analysis to develop strategies for promoting optimal utilisation of facility-based maternal healthcare services. In conclusion, the findings indicate that the utilisation of facility-based maternal healthcare services within the community is generally appreciated. However, there is a need to reinforce the identified promoters and address impeders to achieve optimal utilisation. Hence, the proposed strategies will be presented later in the study.; Moedergesondheidsorg behels gesondheidsorgdienste wat verleen word aan vroue tydens swangerskap, bevalling en die nageboortetydperk. Onderbenutting van moedergesondheidsorgdienste, spesifiek tydens bevalling en die nageboortetydperk, werk pogings teë om moedersterftes en -morbiditeit wêreldwyd te verminder. In middel- en lae-inkomste lande, insluitend Tanzanië, woon baie vroue ten minste een voorgeboortesorgsessie by, maar vir gesondheidsbeleid- en bevolkingsverwante redes woon slegs ’n paar die aanbevole agt kontaktsessies by. Verder skenk sommige vroue nie by gesondheidsfasiliteite geboorte nie en gaan nie voort met nageboortedienste nie, aangesien hulle nie die behoefte sien om dit te doen nie. Die studie is uitgevoer om gemeenskappersepsies van die gebruik van fasiliteit-gebaseerde moedergesondheidsorgdienste in Wete Pemba-eiland te ondersoek en strategieë te ontwikkel om optimale benutting te bevorder. ’n Kwalitatiewe eksploratiewe beskrywende ontwerp is gebruik om data te bekom deur individuele onderhoude met vroue (n = 16) en mans (n = 15), asook deur vier fokusgroepbesprekings met verpleegster-vroedvroue (n = 19). Data-insameling is gedoen met behulp van ’n semi-gestruktureerde onderhoudsgids en data is tematies ontleed deur gebruik te maak van MAXQDA2020. Drie temas het na vore gekom, naamlik waargenome bevorderaars van optimale benutting van fasiliteit-gebaseerde moedergesondheidsorgdienste, waargenome belemmerings van die benutting van hierdie dienste, en deelnemers se voorstelle vir die verbetering van fasiliteit-gebaseerde moedergesondheidsdiensbenutting. Bevorderaars het goeie moedergesondheidsorgdienste, gesin- en eggenoot-ondersteuning, omvattende dienste onder een dak, en goeie opvoeding, berading en advies ingesluit. Die bevindinge het gewys dat belemmerings kulturele praktyke, gesinsmagsverhoudinge en -besluitneming, godsdienstige oortuigings, afstand na gesondheidsfasiliteite, vertroue in tradisionele geboorteverpleërs, vrees vir toetsing vir MIV, gesondheidswerkers se houdings,tekort aan personeel, onvoldoende fisiese infrastruktuur, en onvoldoende mediese toerusting, voorrade en medisyne insluit. Voorstelle is gemaak om die beskikbaarheid van mediese voorrade, mediese toerusting en ambulanse te verseker; personeelprobleme soos personeeltekorte en swak houding teenoor pasiënte op te los; gesondheidsopvoeding/inligting aan die gemeenskap te beklemtoon; en fisiese infrastruktuur op te gradeer. Die studieresultate is geëvalueer deur ’n SWOT-analise te gebruik om strategieë te ontwikkel vir die bevordering van optimale benutting van fasiliteit-gebaseerde moedergesondheidsorgdienste. Die bevindinge dui daarop dat fasiliteit-gebaseerde moedergesondheidsorgdienste oor die algemeen binne die gemeenskap gebruik word. Vir optimale benutting moet die geïdentifiseerde bevorderaars egter versterk word en die belemmerings oorkom word. Voorgestelde strategieë is aangebied.; Ukunakekelwa kwezempilo komama kuhlanganisa izinsizakalo zokunakekelwa kwezempilo ezidluliselwa kwabesifazane ngesikhathi sokukhulelwa, ukubeletha, kanye nesikhathi sangemva kokubeletha. Ukungasetshenziswa kancane kwezinsiza zokunakekelwa kwezempilo komama, ikakhulukazi ngesikhathi sokubeletha nangemva kokubeletha, kuphambene nemizamo yokunciphisa ukushona komama kanye nokugula emhlabeni jikelele. Emazweni anemali engenayo emaphakathi nephansi, okuhlanganisa neTanzania, abesifazane abaningi bahambela okungenani isikhathi esisodwa sokunakekelwa kwabakhulelwe, kodwa ngenxa yenqubomgomo yezempilo kanye nezizathu ezihlobene nenani labantu abambalwa kuphela abenza ukuxhumana okuphakanyisiwe okuyisishiyagalombili. Okunye futhi, abanye besifazane ababelethi ezikhungweni zezempilo futhi abaqhubeki nezinsiza ngemuva kokubeletha, ngoba abasiboni isidingo sokwenza lokho. Ucwaningo lwenzelwe ukuhlola imibono yomphakathi ngokusebenzisa izinsizakalo zokunakekelwa kwezempilo komama esikhungweni sase-Wete Pemba kanye nokusungula amasu okukhuthaza ukusetshenziswa ngendlela efanele. .Umklamo ochazayo osezingeni wasetshenziswa ukuze kutholwe imininingwane ngezingxoxiswano zabantu besifazane (n=16) namadoda (n=15), kanye nangezingxoxo ezine zamaqembu okugxilwe kuwo nabahlengikazi (n=19). Ukuqoqwa kwemininingwane kwenziwa kusetshenziswa inhlolokhono enesakhiwo esincane futhi imininingwane yahlaziywa ngokwengqikithi kusetshenziswa i-MAXQDA2020. Kwavela izindikimba ezintathu, okungabagqugquzeli bokusetshenziswa ngokugcwele kwezinsizakalo zokunakekelwa kwezempilo komama ezikhungweni, okucatshangwa ukuthi kubathiya ukusetshenziswa kwalezi zinsizakalo, kanye neziphakamiso zabahlanganyeli zokuthuthukisa ukusetshenziswa kwensizakalo yezempilo komama. Abagqugquzeli bahlanganisa nezinsizakalo ezinhle zokunakekelwa kwezempilo komama; ukwesekwa komndeni nomlingani; izinsizakalo ezibanzi ngaphansi kophahla olulodwa, kanye nemfundo enhle, ukwelulekwa, nezeluleko. Izithiyo kutholakale ukuthi imikhuba yamasiko, ubudlelwano bamandla omndeni nokuthathwa kwezinqumo, izinkolelo zezenkolo, ibanga lokuya ezikhungweni zezempilo, ukwethemba ababelethisi bendabuko, ukwesaba ukuhlolelwa igciwane lesandulela ngculazi, isimo sengqondo sochwepheshe bezempilo, ukushoda kwabasebenzi, ingqalasizinda engokomzimba eyanele, kanye nemishini yezokwelapha enganele kanye nokokusebenza, okuhlanganisa nemithi. Iziphakamiso bekuwukuthi: qinisekisa ukutholakala kwezinsiza zokwelapha, izinto zokwelashwa, nama-ambulensi; ukuxazulula izinkinga zabasebenzi njengokushoda kwabasebenzi kanye nesimo sengqondo esingesihle ngeziguli; gcizelela imfundo/ulwazi lwezempilo emphakathini; kanye nokuthuthukisa ingqalasizinda ebonakalayo. Imiphumela yocwaningo yahlolwa kusetshenziswa ukuhlaziya kwe-SWOT ukuze kwakhiwe amasu okukhuthaza ukusetshenziswa okuphelele kwezinsizakalo zokunakekelwa kwezempilo komama ezisekelwe esikhungweni. Imiphumela ikhomba ukuthi izinsizakalo zokunakekelwa kwezempilo komama ezisekelwe esikhungweni emphakathini zivame ukusetshenziswa. Kodwa-ke, ukuze kutholakale ukusetshenziswa okuphelele, abathuthukisi abahlonziwe badinga ukuqiniswa futhi kunqotshwe izithiyo. Amasu aphakanyisiwe ayethulwa. Abstracts in English, Afrikaans and Zulu 2024-01-01T00:00:00Z https://ir.unisa.ac.za/handle/10500/32290 Exploring nurses’ self-motivation with infection prevention and control practices at a selected hospital in Limpopo Province, South Africa Kanekgo, Madalane Hazel Healthcare-associated infections (HAIs) remain a major challenge in maternity units, where mothers and newborns are highly vulnerable. Infection Prevention and Control (IPC) practices are crucial for reducing maternal and neonatal morbidity and mortality; however, adherence among nurses is inconsistent. Understanding the factors that influence nurses’ self-motivation in following IPC guidelines is critical for improving compliance and patient safety. This study aimed to explore nurses’ perceptions and experiences of self-motivation and how these relate to their implementation of IPC practices in a maternity unit of a hospital in Limpopo Province, South Africa. Guided by Self-Determination Theory, the research examined intrinsic motivators, such as autonomy, competence, and relatedness, as well as extrinsic influences, including institutional oversight and the fear of blame. A qualitative, exploratory, descriptive, and contextual design was employed. Data were collected through twelve in-depth, semi-structured interviews with nurses se lected via purposive sampling. Reflexive thematic analysis was used to identify pat terns and themes. Findings revealed that while nurses demonstrate an intrinsic commitment to patient safety and professional integrity, systemic barriers, such as resource shortages, inadequate training, and poor policy dissemination, undermine their motivation. Six major themes emerged, highlighting intrinsic and extrinsic driv ers, institutional challenges, psychological impacts, and strategies for adherence. The study recommends contextually relevant interventions that strengthen both in ternal and external motivational ecosystems to enhance IPC compliance. Findings reveal that while nurses display an intrinsic commitment to protecting patients and upholding professional integrity, systemic challenges, including resource shortages, inadequate training, and limited policy awareness, undermine their motivation to do so. Thematic analysis identified six key themes: intrinsic and extrinsic drivers of motivation, institutional barriers, psychological impact, training needs in IPC, and strategic adherence behaviours. The study emphasises the necessity of nurturing both internal and external motiva tional ecosystems to sustain IPC compliance. It recommends that healthcare insti tutions adopt psychologically informed and contextually relevant interventions to en hance nurses’ adherence to IPC.; Mavabyi lama vangiwaka hi ku khathalela rihanyo (HAIs) ma ha ri ntlhontlho lowukulu eka tindzawulo ta vutswedyana, laha vamanana ni tincece va hlaselekaka hi ku olova. Ku sivela ni ku lawula vuvabyi (IPC) i swa nkoka eku hunguteni ka mavabyi ni ku fa ka vamanana ni tincece; kambe, ku landzeleriwa ka yona hi vaon gori a swi endliwi hi ku hetiseka. Ku twisisa swivangelo leswi susumetaka ku tiyimisela ka vaongori ku landzela swiletelo swa IPC i swa nkoka leswaku ku antswisiwa ku landzeleriwa ka swiletelo ni vuhlayiseki bya vavabyi. Nkambisiso lowu a wu ri ni xikongomelo xo kambisisa ndlela leyi vaongori va titwaka ha yona ni mintokoto ya vona malunghana ni ku va susumeteleka ku endla swo karhi ni ndlela leyi sweswo swi fambisanaka ha yona ni ku tirhisiwa ka tindlela ta IPC exibedlhele xa tincece xa le Xifundzheni xa Limpopo, eAfrika Dzonga. Hi ku kongomisiwa hi Self-Determination Theory, ndzavisiso lowu wu kambisise nhlonhlotelo wa le ndzeni, swo fana ni ku tilawula, vuswikoti ni vuxaka, swin'we ni minkucetelo leyi nga le handle, ku katsa ni vulanguteri bya minhlangano ni ku chava ku soriwa. Ku tirhisiwe endlelo ra nkoka, leri kambisisaka, leri hlamuselaka ni leri twisisekaka. Tinhlayo ti hlengeletiwe hi ku tirhisa mimbulavurisano leyi enteke ya 12 leyi hleri weke ya vaongori lava hlawuriweke hi ku tirhisa endlelo ra ku hlawula hi xikongom elo. Nkambisiso wa tinhloko-mhaka wu tirhisiwile ku kumisisa maendlelo na tin hloko-mhaka. Leswi kumiweke swi paluxe leswaku hambileswi vaongori va kombisaka ku tinyi ketela ka xiviri eka vuhlayiseki bya vavabyi ni ku tshembeka entirhweni, swihinga swa mafambiselo, swo fana ni ku kayivela ka switirhisiwa, ku nga leteriwi hi ndlela leyi faneleke ni ku hangalasiwa ka milawu hi ndlela leyi nga hoxeka, swi tsanisa nsusumeto wa vona. Tinhloko-mhaka ta tsevu letikulu ti humelerile, ti kandziyisa swivangelo swa le ndzeni ni swa le handle, mintlhontlho ya le xikolweni, mimbuyelo ya le mintlhavekweni ni maendlelo ya ku landzelela swiletelo. Ndzavisiso lowu wu bumabumela ku nghenelela loku fambisanaka ni xiyimo lexi, loku tiyisaka fambiselo ra le ndzeni ni ra le handle ra nsusumeto leswaku ku antswisiwa ku fambisana ni IPC. Leswi kumiweke swi kombisa leswaku hambileswi vaongori va tiyimiseleke ku sir helela vavabyi ni ku hlayisa vutshembeki entirhweni wa vona, swiphiqo leswi va langutanaka na swona, ku katsa ni ku kayivela ka switirhisiwa, ku nga leteriwi hi ndlela leyi faneleke ni ku ka va nga tivi milawu ya vutshunguri, swi va endla va nga ha swi koti ku endla ntirho lowu. Nkambisiso wa the-matic wu boxe tinhloko-mhaka ta tsevu ta nkoka: swivangelo swa le ndzeni ni swa le handle swa nsusumeto, swihinga swa mavandla, nkucetelo wa swa miehleketo, swilaveko swa vuleteri eka IPC, ni mahanyelo ya ku namarhela eka maendlelo. Ndzavisiso lowu wu tshikelela xilaveko xa ku kurisa mafambiselo ya le ndzeni ni ya le handle ya nsusumeto ku tiyisisa ku landzeleriwa ka IPC. Yi bumabumela leswaku mavandla ya swa rihanyo ma tirhisa tindlela leti sekeriweke eka ntivo-miehleketo ni leti fambisanaka ni swiyimo leswaku vaongori va ta landzelela swiletelo swa IPC.; Gesondheidsorg-geassosieerde infeksies (GSGI's) bly 'n groot uitdaging in kraam eenhede, waar moeders en pasgeborenes hoogs kwesbaar is. Infeksiebeheer- en voorkomingspraktyke (IBP) is noodsaaklik vir die vermindering van moeder en ne onatale morbiditeit en mortaliteit; die nakoming daarvan onder verpleegsters is eg ter inkonsekwent. Om die faktore te verstaan wat verpleegsters se selfmotivering beïnvloed om IBP-riglyne te volg, is van kritieke belang vir die verbetering van nakoming en pasiëntveiligheid. Hierdie studie het ten doel gehad om verpleegsters se persepsies en ervarings van selfmotivering te ondersoek en hoe dit verband hou met hul implementering van IBP-praktyke in 'n kraam-eenheid van 'n hospitaal in Limpopo Provinsie, Suid-Af rika. Die navorsing is gelei deur die Selfbeslissingsteorie en het intrinsieke mo tiveerders soos outonomie, bevoegdheid en verwantskap sowel as ekstrinsieke invloede, insluitend institusionele toesig en die vrees vir blaam, ondersoek. 'n Kwalitatiewe, eksploratiewe, beskrywende en kontekstuele ontwerp is gebruik. Data is ingesamel deur twaalf diepgaande, semi-gestruktureerde onderhoude met verpleegsters wat via doelgerigte steekproefneming gekies is. Refleksiewe temat iese analise is gebruik om patrone en temas te identifiseer. Bevindinge het getoon dat terwyl verpleegsters 'n intrinsieke verbintenis tot pasiëntveiligheid en professionele integriteit toon, sistemiese struikelblokke soos hulpbronne tekorte, onvoldoende opleiding en swak beleidsverspreiding hul mo tivering ondermyn. Ses hoof-temas het na vore gekom, wat intrinsieke en ekstrin sieke drywers, institusionele uitdagings, sielkundige impakte en strategieë vir nakoming beklemtoon. Die studie beveel kontekstueel relevante intervensies aan wat beide interne en eksterne motiverings-ekosisteme versterk om IBP-nakoming te verbeter. Summary and keywords in English, Tsonga and Afrikaans 2025-06-01T00:00:00Z https://ir.unisa.ac.za/handle/10500/32275 Exploring cervical cancer awareness, perceptions and screening uptake among rural women in Oshikoto region, Namibia Kamati, Maria Ndinelago Background:Cervical cancer is a worldwide public health concern; however, it is a preventable non-communicable disease that can be detected early through screening and treatment of pre-cancerous lesions and effective management. Whilst good progress has been seen in developed countries, this is not reflected in Sub-Saharan countries, including Namibia. Awareness of the disease, how screening is perceived by women, and its prevention remain essential for promoting early detection and treatment. Cervical cancer prevention efforts in low- and middle-income countries, especially in rural communities, are hampered by social and cultural barriers. The researcher’s observation is that in the Oshikoto region, among rural women, information regarding cervical cancer, awareness of it, the perception of it, and screening uptake is limited. The research was conducted to gain a deeper understanding of this public health issue among rural women, in support of early detection and timely prevention. Purpose: To explore rural women’s awareness of cervical cancer, their perceptions of it, and cervical cancer screening uptake. Setting: The study was conducted at Olukonda Clinic in the Oshikoto Region, Namibia. Methods: A qualitative exploratory design was used to examine cervical cancer awareness, perceptions, and screening uptake among rural women aged 18 to 55 and above in the Olukonda rural community. A convenient sample of 17 rural women, of diverse ages, educational backgrounds, and employment status, most of whom were mothers, participated in the study. Face-to-face semi-structured individual interviews were conducted to explore women’s awareness, perceptions, and uptake of cervical iii cancer screening. Data were collected between February and March 2024. The data were analysed using Tesch’s open coding method. Results: Despite the fact that women had limited knowledge regarding cervical cancer, it was evident that they had a high perception of the risk of developing cervical cancer, and some understood the importance of screening. Although women expressed interest in being screened, they were let down by the system, as community nurses were not always available to conduct screening in rural clinics. Conclusion: Women were challenged in terms of distance and finances to reach screening facilities. Also, information about the disease is shared sparingly. Patriarchy, religion and myths are barriers towards screening uptake in this rural setting. The Ministry of Health and Social Services of Namibia (MOHSS) must prioritise rural women’s health by developing culturally appropriate cervical cancer awareness programmes and advocating for accessible screening services to support the elimination of cervical cancer in rural communities. 2025-11-24T00:00:00Z https://ir.unisa.ac.za/handle/10500/32182 A conceptual model for the implementation of mobile electronic health records (mehr) system in Namibia George, Jomin The study aimed to develop a conceptual model for the implementation of mobile Elec-tronic Health Record (mEHR) systems in Namibia, aimed at enhancing health information management and ensuring continuity of care for healthcare providers and decision-mak-ers. An exploratory sequential mixed-methods design was employed, consisting of three phases. In Phase 1, an integrated literature review was conducted using the PRISMA-P guidelines. Data were extracted using a structured template and analysed qualitatively through thematic synthesis. Phase 2 involved a structured questionnaire targeting soft-ware developers, network providers, healthcare providers, and healthcare decision-mak-ers in Namibia. Data were analysed quantitatively through descriptive and inferential statistics which in-cluded multivariate logistic analysis and Chi-square tests analysis. The Statistical Package for the Social Sciences (SPSS) software version 26 was used. Data from both phases were integrated. In Phase 3, a conceptual model for the implementation of mEHR systems in Namibia was developed and validated by experts in nursing, healthcare providers, net-work providers and software developers using a modified Delphi technique. Findings showed that the adoption of mobile mEHR systems in Namibia presented an op-portunity for improving healthcare delivery through efficient communication, client data management and tracking, and precise data capturing. The study confirmed that there was an opportunity for mEHR adoption in Namibia as healthcare providers, software develop-ers, and network service providers showed positive attitudes and receptivity towards mHealth. The proposed model was grounded in the Technology Acceptance Model (TAM) and Innovation Diffusion Theory (IDT) and provided a practical framework for mEHR adop-tion in Namibia. Future research should evaluate this model in other Low and Middle-In-come Countries (LMICs) and examine its effect on policy integration and continuity of care. 2025-02-22T00:00:00Z