Practice In South Africa Research Articles

Strategies to facilitate upscaling midwifery practice in South African public maternity units

Background/Aims Various models have been proposed to reduce rates of maternal mortality, aimed at addressing the diverse range of causes. Many of these models focus on using midwifery practice to achieve these goals. The aim of this study was to develop strategies to facilitate upscaling midwifery practice in South African public maternity units. Methods A mixed-methods sequential exploratory research design was implemented using purposive sampling of midwives and postpartum women. Qualitative data were collected from 11 midwives and 11 postnatal women in the Eastern Cape province, while quantitative data were gathered from 314 midwives from across five South African provinces. Data were collected using semi-structured interviews and a self-developed questionnaire. Descriptive statistics were used to analyse quantitative data. Qualitative data were analysed thematically. Results The participants were committed to their work but barriers to practice were a cause of concern. Two strategies for woman-centered care were developed based on the challenges reported by midwives. To assist with up-scaling of midwifery clinical practice in South Africa, the strategies recommended providing an enabling work environment where midwives could be empowered to provide woman-centred care and women were empowered to receive this care and be educated in self-care practices. Conclusions The work environment for midwives in South African public maternity units is, at times, not of an acceptable standard because of concerns related to regulation and training. Recognition of midwifery practice as an autonomous profession will facilitate woman-centred practice.

Implications of the South African National Drug Policy on prescribing patterns: a case study of the Limpopo province

BackgroundThe South African National Drug Policy (SA-NDP) was introduced to promote rational medicine use (RMU). This study evaluates the quality of prescribing in the public healthcare sector in South Africa's Limpopo province following the World Health Organization's (WHO) rational prescribing standards. In addition, the prescribing practices in South Africa were compared to other African countries.MethodsA prospective cross-sectional survey of patients' prescriptions was conducted in Limpopo, South Africa, from October to December 2018. Findings were compared with the WHO reference values (WHO-RV), and the International Network of Rational Use of Drugs (IRDP) tool was used to measure the degree of rational prescribing. The optimal IRDP value was defined as 1. Study findings were compared with results from a previous study conducted in Limpopo and studies from Ethiopia and Eritrea.ResultsSix hundred prescriptions were reviewed. The mean (SD) age was 43.9 ± 24.4 years (females = 56.5%). The average number of drugs prescribed (4.3, IRDP = 0.47) was higher than the WHO-RV (< 2). Generic prescribing (43%, IRDP = 0.43) and medicines prescribed from the essential medicines list (EML) (90%, IRDP = 0.90) were less than the WHO-RV (100%, respectively). Antibiotics (28%, IRDP = 1) and the number of injections prescribed (8%, IRDP = 1) were below the WHO-RV (< 30% and < 20%, respectively). The number of medicines prescribed was higher compared to previous years (4.3 vs. 3.4). Antibiotic prescribing declined (28% vs. 63.4%). Generic prescribing (43% vs. 41.7%) and medicines prescribed from the EML (90% vs. 93.1%) did not improve. A higher number of medicines were prescribed in this study compared to Ethiopia (1.7) and Eritrea (1.8), and a lower number of antibiotics were prescribed compared to Ethiopia (58.2%) and Eritrea (54.5%). Generic prescribing was low compared to Ethiopia (95.6%) and Eritrea (94.9%). All studies showed reduced injection prescribing (6.6–15.9%) and similar prescribing from the EML (90–95%).ConclusionsThere is an increased potential for drug-drug and adverse reactions with the increased number of prescribed medicines; however, the patient's clinical needs may warrant using multiple medicines. There is a need for generic prescribing to reduce medicine expenditure.

Impact of ICT-Driven Teacher Professional Development for the Enhancement of Classroom Practices in South Africa: A Systematic Review of Literature

Education is critical to the development of any country. The quality of education depends on the quality of teachers in the education system. Studies affirm that the initial teacher education that teachers enter the teaching profession with, is not enough to sustain the education system. Hence, there is a need for continuing life-long learning for teachers to keep abreast of their profession. Seemingly, teachers play a significant role in the integration of ICT into teaching and learning. Therefore, adequate and regular professional development of teachers is paramount to the use of learning technologies in classrooms. This study employed a systematic review of the literature to explore the impact of teachers' exposure to ICT through professional development activities on teaching and learning success. The TPACK framework was adopted as an underpinning lens to understand the phenomenon. The study affirms that the professional development of teachers should be situated within ICT pedagogical and content-related content to capacitate teachers' ICT knowledge and skills. Hence, teachers' ICT knowledge enhances classroom instructional delivery, using various learning technologies in teaching and learning. The study recommends adequate and regular capacity building for teachers with ICT training, while teachers should be supported with ICT gadgets and resources. Follow-up should be designed to ensure teachers’ adoption and use of ICT for teaching and learning in South African schools, to familiarise their learners with various learning technologies, and to enhance their academic performances.&#x0D; &#x0D; Received: 17 April 2023 / Accepted: 29 July 2023 / Published: 5 September 2023

The Role of Technology in Sustainable Energy Management Policy and Policy Practices in South Africa

The Role of Technology in Sustainable Energy Management Policy and Policy Practices in South Africa

Experiences and perceptions of undergraduate optometry students towards public eye care services in South Africa

Background: Public eye care services in South Africa are relatively underdeveloped. This is, in part, due to optometry services historically being private sector-focussed, as well as a lack of ophthalmologists in the country. Optometry students who engage in service learning at public health facilities are well placed to share their perceptions of this service.Aim: To investigate the perceptions and experiences of optometry students regarding public eye care services in South Africa.Setting: Data were collected on the Phelophepa Health Care Train while it was stationed at Musina and Polokwane in 2019.Methods: A qualitative study was conducted using focus group interviews to collect data from South African optometry students. Two focus group sessions were held, with a total sample of 18 representing two different higher education institutions. Interview recordings were transcribed, and data were thematically analysed using interpretive content analysis.Results: Three main themes emerged, namely ‘inability to deliver quality services’, ‘negative perceptions about public eye care services’ and ‘potential to improve public eye care services’. Strengthening infrastructure and human resource capacity were seen as fundamental steps to improving public eye care services in South Africa.Conclusion: Strengthening public eye care services in South Africa is necessary in order to improve the experience-based perceptions of optometry students towards this sector. Addressing eye health system weaknesses through appropriate resourcing will likely contribute to attracting this potential future human resource to the sector, and assist in alleviating the shortage of human resources for eye health within South Africa’s public health service.Contribution: Optometry education and professional practice in South Africa is increasingly adopting a more public health approach. This shift towards strengthening public eye care services and improving human resources capacity for the same is both important and necessary to address unmet eye health needs in the country. However, current gaps and challenges within the public health system may deter new graduates in South Africa from choosing this practice path if the overall challenges of resourcing and capacity to deliver quality services are not addressed.

Religious Education as a Pedagogy of Care in the Context of Violence: Re-Imaging Working and Thinking Together

This qualitative paper couched with the decoloniality theory addresses the question of how religious education as a pedagogy of care can mitigate the ambivalent terrain of school violence. Despite various inventions within South African schools, the classroom remains violent and unsafe for both learners and educators igniting the adoption of religious education as a pedagogy of care. The author used the decoloniality theory since it calls for rehumanisation of people affected by school violence. The findings indicate that despite challenges associated with religious education, the subject can be conceptualised as a pedagogy of care to mitigate the challenges of school violence. The argument of the paper is that education authorities need to re-imagine religion as a pedagogy of care that has the impetus to evoke working and thinking together within the mainstream curriculum practices in South Africa. The paper contributes to knowledge in the sense that it locates arguments in decoloniality calling for equal representation of knowledge in the curriculum to address school violence. It sees religious education as the key to contributing to a peaceful existence in school and society. Keywords: Living and Working together, religion education, school violence, best practices.

Let the people know, and the country will be safe: FOI models in South Africa and Zimbabwe

PurposeDemocratic countries all over the world are embarking on initiatives to empower citizens through public participation. One of the tools used by countries to promote public participation is the enactment and implementation of freedom of information (FOI) legislation, as it is the case with South Africa and Zimbabwe. Despite having legislation reaffirming the need for people’s right to know, practices in South Africa and Zimbabwe indicate the opposite. The purpose of this study is to explore FOI models in South Africa and Zimbabwe, with a view to recommend ways in which people’s right to know can be promoted.Design/methodology/approachThis qualitative study used interviews to collect the data from 12 FOI experts in South Africa and Zimbabwe, who were selected through the snowball sampling technique. Data collected through interviews were supplemented by the data collected through document analysis.FindingsThe study concluded that the key role players need to make efforts to ensure that the right to know, which is associated with FOI, is being realised in both countries. FOI legislation, in both countries, is imprecise and needs to be revised to ensure effective implementation.Originality/valueThe study demonstrates that FOI is a necessary tool for people to be involved in decision-making in government. People’s rights to know can be achieved by successfully implementing FOI legislation.

Cochrane Corner: The use of anticoagulants in patients hospitalised with COVID-19.

In this Cochrane Corner, we highlight the main findings of a Cochrane Review by Flumignan et al. entitled 'Anticoagulants for people hospitalised with COVID-19' and discuss the implications of these findings for research and practice in South Africa. In particular, we underscore the need for additional, high-quality, randomised controlled trials comparing different intensities of anticoagulation in patients with COVID-19 illness. Individuals in the intensive care unit and those hospitalised with another illness who are incidentally found to be infected with SARS-CoV-2 should still only be treated with prophylactic-dose low-molecular-weight heparin. This Cochrane Corner summarises findings in a recent systematic review on the use of anticoagulation in people hospitalised with COVID-19, and provides insights on the implications of these findings for implementation by clinicians in South Africa. It highlights the need for clinicians to balance the benefits and harms of providing an anticoagulant, while considering the patients underlying risk for bleeding and thromboembolism.

Local Government Vertical Upward Accountability, Oversight, and the Intervention Mechanism in South Africa

Since democratisation, South Africa has struggled to create a stable system of local governance. There are constant municipal failures. Higher levels of government have to intervene in municipalities regularly. This study, therefore, set out to assess the effect of intervention mechanisms, including preventative measures, as part of the broader accountability and oversight setting. Based on a qualitative research approach, this paper argues that both prospective and retrospective accountability forms are weak. Post-factum interventions yield only limited results. Overall, these mechanisms are not able to form stable local governments and prevent municipal failures. Ultimately, this paper infers that strengthening prospective accountability and oversight mechanisms has the capacity to increase the stability of the local governance system. This finding has important implications for developing new accountability and oversight practices in South Africa and elsewhere.

Disposal of spectacles and contact lenses: Optometrist and lens wearer perspectives

Background: The increase in global waste generation has adverse impacts on the environment. Significant volumes of waste are generated in the lifecycle of spectacles, contact lenses (CLs) and associated products, and there is a lack of published data on their disposal practices.Aim: To determine optometrists’ recommendations to their patients, and lens wearers’ practices regarding the disposal of ophthalmic lenses and associated lens products.Setting: Optometrists and lens wearers in South Africa.Methods: Surveys were distributed via online platforms to optometrists and lens wearers and paper copies of the surveys were also available. Data from both surveys were analysed using IBM SPSS version 24.Results: Responses from 353 optometrists and 603 lens wearers were analysed. Optometrists were highly likely to recommend that patients should discard their old spectacle lenses (24%), and used CLs into wastewater systems (10%), or make no recommendations on either, respectively, (16%, 12%). Lens wearers were highly likely to retain their old spectacles upon new purchase (57%) and dispose used CLs into wastewater systems (37%). Less than 20% of optometrists and lens wearers were highly likely to recommend and engage in recycling of associated ophthalmic products.Conclusion: The disposal of CLs into wastewater systems, which contributes to microplastic pollution, must be highlighted and avoided. Optometrists should incorporate disposal instructions with all products sold to patients and promote recycling. Lens wearers should also be mindful of the environmental impact of their disposal practices.Contribution: This study provides previously unknown data on ophthalmic lens disposal practices in South Africa, and emphasises the need for environmental awareness.

Unani Tibb practitioners’ perceptions and attitudes towards spirituality and spiritual care in Unani Tibb practice in South Africa

BackgroundUnani Tibb is an Arabic term which means Greek medicine. It is an ancient holistic medical system based on the healing theories of Hippocrates, Galen and Ibn Sina (Avicenna). Despite this, spirituality and spiritual care practices are deficient in the clinical setting.MethodsThis cross-sectional descriptive study was used to describe Unani Tibb practitioners’ perceptions and attitudes regarding spirituality and spiritual care in South Africa. A demographic form, Spiritual Care-Giving Scale, Spiritual and Spiritual Care Rating Scale and Spirituality in Unani Tibb Scale were used to collect data.ResultsA response rate of 64.7% (n = 44 out of 68) was achieved. Positive perceptions and attitudes regarding spirituality and spiritual care were recorded for Unani Tibb practitioners. The spiritual needs of their patients were considered vital towards enhancing the Unani Tibb treatment approach. Spirituality and spiritual care were regarded as fundamental to Unani Tibb therapy. However, most practitioners agreed that adequate training in spirituality and spiritual care was lacking and future training initiatives were imperative for Unani Tibb clinical practice in South Africa.ConclusionThe findings of this study recommends further research in this field by means of qualitative and mixed methods approaches to provide a deeper understanding to this phenomenon. Clear guidelines on spirituality and spiritual care for Unani Tibb clinical practice are essential to ensure the integrity of the holistic approach required by the profession.

Hearing aid trial periods: Audiologists' thoughts and practices in South Africa.

Hearing aid trial periods: Audiologists' thoughts and practices in South Africa.

Practice schools as third spaces? Navigating the continuum between hierarchical models and collaborative partnerships in teaching practice in South Africa

Mentoring student teachers is a fundamental approach in teaching practice. Traditionally, teaching-practice models have been based on cognitive apprentice approaches and have been hierarchical in nature. Problems with finding suitable schools for teaching practice and mentoring experiences have been challenging, which has led to the implementation of collaborative partnership approaches. In South Africa, minimal research has been undertaken on the establishment of partnerships to strengthen teaching practice, with work in the third space almost non-existent. The research question under investigation in this paper is as follows: How do we move away from hierarchical models of teaching practice and establish collaborative partnerships between schools and universities? The paper is underpinned by both third space theory and border theory. The aim of the paper is, first, to explore the challenges encountered with the hierarchical models used in teaching practice. Second, we explore what collaborative educational partnerships entail and investigate the various models used internationally to establish partnerships between universities and schools to strengthen teaching practice. This non-empirical paper uses a secondary-source data design that draws on existing texts, research findings, and journal articles. A qualitative research approach has been employed as it allows a narrative description of the data collected. An interpretive approach is employed to interpret and to discuss the findings. The paper concludes by reviewing practice schools as a type of school that allows lecturers, teachers, and students to cross institutional borders and collaborate in the third space.

Paediatric procedural sedation and analgesia in a South African emergency centre: a single-centre, descriptive study

BackgroundProcedural sedation and analgesia are considered a core competency in emergency medicine as patients present to the emergency centre on an unscheduled basis, often with complex complaints that necessitate emergent management. Previous evidence has consistently shown that procedural sedation and analgesia in the emergency centre in the paediatric population, even the very young, are safe if appropriate monitoring is performed and appropriate medications are used. The aim of the study was to describe the indications for procedural sedation and analgesia, the fasting status of paediatric patients undergoing procedural sedation and analgesia and the complications observed during procedural sedation and analgesia in the paediatric population at a single emergency centre in Cape Town, South Africa.MethodsA retrospective, descriptive study was conducted at Mitchells Plain Hospital, a district-level hospital situated in Mitchells Plain, Cape Town. All paediatric patients younger than 13 years of age who presented to the emergency centre and received procedural sedation and analgesia during the study period (December 2020–April 2021) were included in the study. Data was extracted from a standardised form, and simple descriptive statistics were used.ResultsA total of 113 patients (69% male) were included: 13 infants (< 1 year of age), 47 young children (1–5 years of age) and 53 older children (5–13 years of age). There was only 1 (0.9%) complication documented, which was vomiting and did not require admission. The majority of patients received ketamine (96.5%). The standardised procedural sedation and analgesia form was completed in 49.1% of cases. Indications included burns debridement (11.5%), suturing (17.7%), fracture reduction (23.9%), lumbar punctures (31.9%) and others (15.0%). The indications for procedural sedation and analgesia varied between the different age groups. The majority of patients in this study did not have their fasting status documented (68.1%), and 18.6% were not appropriately fasted as per American Society of Anaesthesiology guidelines. Despite this, there was an extremely low rate of documented complications of 0.9%.ConclusionThe study findings are in accordance with previous international literature reporting low complication rates. Although fasting status was unknown in the majority of patients, there was an extremely low rate of documented complications and no interventions required. Safe, timely procedural sedation and analgesia with minimal pain and unnecessary suffering can become the norm in emergency medicine practice in South Africa.

Creating a shared vision by uniting local stakeholders to tackle plastic bag consumption

Single-use plastic bags contribute significantly to the plastic pollution in South Africa posing a serious environmental challenge. Hence, there is a need for comprehensive strategies to reduce plastic bag consumption. We report the results of an online workshop aimed to create a positive, shared future vision. The workshop was attended by 12 invited participants from diverse backgrounds and disciplines and utilized a collaborative approach to propose a framework for reducing plastic bag usage during grocery shopping in South Africa. The findings suggest that a combination of economic, structural and behavioral interventions is necessary to promote lasting behavior change, including financial incentives, a broad introduction of more environmentally friendly alternatives, and promoting bag reuse. Additionally, the vision underscored the importance of using social channels such as education and social norms. The invited stakeholders did not endorse conventional approaches such as increasing an already existing levy or implementing a complete ban on plastic bags. They also questioned the introduction of fully recycled plastic bags. Instead, the proposed vision encourages an integrated approach to reducing plastic bag usage involving individual behavior change and community engagement. The development of a creative product such as a video to showcase a future vision offers a powerful tool for communication with further stakeholders and political authorities, to engage with the community and broader population and for inspiring collective action. Overall, the findings have implications for policymakers, business leaders, environmental educators, and individuals committed to reducing plastic pollution and promoting sustainable practices in South Africa.

Nursing profession in Africa: A study on work engagement and talent management practices in South Africa

AbstractBackgroundThe global shortage of nurses, intensified by nurses migrating to richer countries, creates a health crisis in developing countries. This study investigates how strategic talent management practices can improve the work engagement of professional nurses in public hospitals in South Africa.MethodsA cross‐sectional, self‐administered survey was conducted among professional nurses employed in three large public hospitals in the Gauteng Province of South Africa. We measured: (1) management commitment, (2) talent review, (3) workforce planning, (4) staffing, (5) talent acquisition, (6) talent development, (7) talent commitment and (8) talent retention. The sub‐dimensions of work engagement that were measured included: (1) vigour, (2) absorption and (3) dedication. Descriptive and inferential (multiple regression) analyses were performed. The gap analysis calculated the difference between the current and desired status means talent management item.ResultsThe gap analysis revealed the biggest discrepancies between the value nurses attach to and the current status of management commitment and the talent review and staffing processes. Multiple regression analyses confirmed that current status‐rating talent acquisition impacts dedication and absorption combined (r = 0.112, p‐value = 0.012 &lt; 0.05) and management commitment impacts absorption and vigour combined (r = 0.26, p‐value = 0.026 &lt; 0.05). The importance‐rating revealed talent development and commitment combined influences dedication and absorption combined (r = 0.092, p‐value = 0.038 &lt; 0.05), and talent review and planning impacts absorption and vigour combined (r = 0.115, p‐value = 0.010 &lt; 0.05). Age and job status had a significant effect on absorption–vigour.ConclusionHospital managers can improve the engagement of nurses by demonstrating their commitment to talent development, offering a diverse variety of development opportunities and ensuring a pipeline of new nurses by improving the attractiveness of the profession. The study shows how strategic talent management practices can serve to improve work engagement in the healthcare sector.

Crisis Management Practices in South Africa: Hotel Industry Responses to the COVID-19 Crisis

The COVID-19 pandemic has not only had a significant impact on public health, but it has also severely affected the hotel industry. This study examines crisis management practices in the hotel industry in South Africa during the COVID-19 crisis. The time scope of the research concerns the second wave of the COVID-19 pandemic in the period from May 2021 to July 2021. The study employs the Importance-Performance Analysis framework to evaluate the use and importance that hoteliers assign to different crisis management practices. The analysis is based on a list of crisis management practices that belong to five categories: human resources, marketing, hotel maintenance, governmental assistance and innovation. Apart from seeking government support, the findings reveal that hotels have also embraced innovative strategies and cost-cutting activities to mitigate COVID impacts. However, considering the uniqueness of the COVID-19 crisis, these practices differ from other practices implemented during previous crises. Therefore, hotels should not rely on practices from other type of crises because crisis situations differ. Theoretical and practical implications are discussed.

Tackling Environmental and Epistemic Injustice: Decolonial Approaches for Pluriversal Peacebuilding in South Africa

The paper highlights environmental injustices in South Africa as well as the accompanying continuation of mega-extraction-based violence. In doing so, the paper examines how the history of environmental injustices has left its mark in various parts of this country, where industrialization practices and policies from the apartheid era lead to environmental degradation that disproportionately impacts black people. This exemplifies how epistemic injustice occurs when dominant structures in knowledge production eliminate and silence the epistemic integrity of the sufferers, as well as how their contributions to the environmental knowledge system have been undermined, misinterpreted, and curtailed in discursive practices. In this context, the paper explores how a decolonial ecological turn and practices in South Africa can integrate environmental and development policies for sustainability and pluriversal peacebuilding.

Touch as a feedback loop: exercising the leap from inertia to activation

This article critically reflects on the facilitation of embodied practice in virtual spaces of teaching, learning and creation, specifically looking at ways of facilitating touch within the broader context of decolonising dance and movement practices in South Africa. When working without the touch of another (human)being, I explore how the affordances of environment and surfaces can offer a feedback loop for the sounding body in motion. The article draws from experiences of facilitating movement and physical theatre courses at the University of Pretoria to suggest how touch may become an embodied technique that structures practice in spaces of isolation and inertia and in times where notions of continuity and discontinuity are ruptured. I explore how walls, surfaces and objects become secondary affordances that offer an external force onto the body through tactility. Reading discourses of embodiment and decoloniality through one another, I further argue that using touch to re-initiate motion offers political possibilities to exercise the leap from inertia to activation, and trouble the colonially formed category of human.

Transition from College to Professional Workplace: Lived Experiences of Mid-Level Emergency Care Graduates Working in a Provincial Department of Health in South Africa

This study aimed to obtain empirical data on the lived experiences of emergency care technicians (ECT) during their transition into the emergency medical service work environment. This qualitative (phenomenological) study used focus group discussions with 26 ECT graduates to obtain verbal statements describing their lived experiences when transiting from college to pre-hospital workplace environments. The three dominant emerging themes were workplace readiness and reception, professional confidence, and resistance in the workplace. The experiences reported regarding workplace readiness and reception were largely negative. The majority of the participants shared that the EMS station they were deployed to had not been ready to receive and optimally utilise their skills. In addition, participants stated that their integration into the workplace had been unpleasant, as they experienced a great deal of exclusion and resistance from colleagues. Furthermore, participants described how peer support, positive feedback from patients and co-workers, and the new skills and knowledge acquired during training enhanced their professional confidence. These findings suggest that more needs to be done by stakeholders in emergency care education and practice in South Africa to ensure that the transition of graduate paramedics to the workplace environment is a positive and less stressful experience. The recommendations made in this article could be beneficial in achieving this.