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Browsing Articles by Author "Makhado, Lufuno"
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Item Open Access Conceptual framework to provide culturally congruent care to epilepsy patients in selected rural communities in South Africa(AOSIS, 2024) Nemathaga, Muofheni; Maputle, Maria S.; Makhado, Lufuno; Mashau, Ntsieni S.Background: Epilepsy is a neurological disorder affecting millions of people in Africa. Among other reported findings, many people living with epilepsy (PLWE) believe that the condition is caused by spiritual factors. Previous studies have revealed that majority of PLWE are not receiving adequate care and treatment because of diverse cultural beliefs associated with epilepsy. Consequently, they consult either faith-based healers or traditional healers. Others, however, acknowledge the medical causes of epilepsy and seek developed medical treatment. Aim: To develop a culturally congruent care conceptual framework to provide comprehensive and holistic epilepsy care. Setting: This study was conducted in the selected rural communities of Limpopo and Mpumalanga provinces. Methods: A qualitative multi-method research approach was employed and sub-divided into three phases. Phase 1: All 15 articles were reviewed and appraised using the Critical Appraisal Skills Programme (CASP) rating tool. Phase 2 involved two stages of empirical study in which an exploratory-descriptive study design was used. The study population comprised of 20 traditional healers, 15 faith-based healers, 20 professional nurses and 22 PLWE. Data were collected using in-depth individual interviews and analysed through eight Tesch’s steps of data analysis. Following data analysis, Phase 3 entailed synthesising the systematic and empirical findings into a conceptual framework. Results: Three themes that emerged from the findings were cultural epilepsy interventions, faith-based epilepsy intervention and medically developed epilepsy interventions. Conclusion: Incorporation of cultural beliefs, values and practices into the medically developed management of epilepsy is crucial for providing culturally congruent care that is preferred by majority of PLWE. Contribution: Healthcare providers may tailor care interventions that are culturally appropriate and acceptable hence promoting early diagnosis and treatment adherence leading to improved quality of life.Item Open Access Development and validation of an intervention for childhood trauma and exposure to violence in Vhembe District, South Africa(Elsevier, 2024) Tsheole, Pertunia; Makhado, Lufuno; Maphula, Angelina; Sepeng, Nombulelo VeronicaMost strategies are implemented; however, South Africa needs to evaluate and develop trauma interventions. The study aims to develop, test and validate childhood trauma exposure intervention in the Vhembe district, Limpopo province. Donabedian's structure-process-outcome model will guide the study. The study will employ multiphase mixed methods with five phases. Phase 1 will be a thorough systematic evaluation of literature on childhood trauma and exposure to violence interventions to describe existing interventions. Phase 2, stage 1: Will explore the experiences of children exposed to trauma and violence regarding their experiences of the treatment they received, using semi-structured qualitative interviews. Non-probability purposeful sampling techniques will be used to select participants. The Thoyondou Victim Empowerment's database will select participants. The researchers will conduct semi-structured and unstructured interviews with youngsters exposed to violence and trauma. Stage 2 will be a qualitative study of trauma centre managers and personnel sampled from the contact record. IPA will analyze data. Phase 3 will conceptualize Phase 1 and the empirical phase into Donabedian's SPO framework for Phase 4. Phase 4 develops the intervention using Phase 3′s conceptual framework and tests and validates it.Item Open Access Epilepsy in rural South Africa: Patient experiences andhealthcare challenges(Wiley, 2024) Makhado, Lufuno; Maphula, Angelina; Ngomba, Richard Teke; Musekwa, Ofhani Prudence; Makhado, Thendo Gertie; Nemathaga, Muofheni; Rammela, Mukovhe; Striano, PasqualeObjective: This study investigates the prevalent issues of healthcare access and the impact of antiseizure treatments among people with epilepsy (PWE) in rural Limpopo and Mpumalanga, South Africa, where healthcare facilities and affordable treatments are often inadequate. Methods: Using a cross-sectional survey, 162 PWE were selected using multistage sampling across the provinces. Data were collected via a structured questionnaire and analyzed descriptively using SPSS v27. Results: Most of the participants experienced seizures intermittently, with 70.6%in Limpopo and 53.3% in Mpumalanga reporting occasional episodes, whereas a significant minority in both regions—20.6% and 40%, respectively—suffered from frequent seizures. A notable portion of PWE also reported recurring side effects from antiseizure drugs, which led to consequential life disruptions, including educational dropout and unemployment. Significance: The findings underscore an urgent need for enhanced educational programs and increased awareness to improve the understanding and management of epilepsy in these underserved areas. Optimizing care for PWE requires a multifaceted approach, including evaluating healthcare accessibility, affordability, and societal beliefs influencing treatment adherence. The study advocates for government and policy interventions to mitigate the quality of life deterioration caused by epilepsy and its treatment in rural communities. Plain Language Summary: In Limpopo and Mpumalanga, many individuals with epilepsy experience seizures occasionally, while a significant minority have them frequently. Numerous people also suffer recurring side effects from antiseizure medications, impacting their lives severely by causing school dropouts and job losses. This underscores the urgent need for improved education and awareness programs to manage epilepsy in these provinces effectively. The study urges government action and policy reforms to enhance care and support for people with epilepsy in rural areas, aiming to improve their quality of life.Item Open Access Exploration of health care providers’ knowledge-based care and support given to family members and caregivers of people living with epilepsy(Frontiers, 2024) Musekwa, Ofhani Prudence; Makhado, Lufuno; Maphula AngelinaIntroduction: In South Africa, approximately half a million individuals live with epilepsy. This means that half a million families and caregivers are impacted by epilepsy, with a limited number of healthcare providers responsible for treating people living with the condition, as well as their families and caregivers. Methods: This study explored the knowledge-based care and support healthcare providers give families and caregivers. Fifteen participants were purposefully selected from Limpopo and Mpumalanga provinces to participate in the study. Data were collected via an open-ended interview guide divided into two sections: Section A comprised sociodemographic questions, and Section B had questions on epilepsy care and support. Four of the participants were male, and 11 were female, seven were community health workers, five were nurse practitioners, and three were auxiliary nurses. Seven had a grade 12 qualification or lower, and only six had a degree. The data collected was analyzed using thematic analysis, coded by the researcher and co-coded by an independent expert. Two themes emerged from the raw data: epilepsy knowledge and epilepsy support and counselling. From these two themes, three subthemes were identified: psychosocial impact of epilepsy, epilepsy-related training, and counselling and support. Results: The study revealed a gap in professional capacity building and highlighted the need for intentional knowledge sharing and equipping of healthcare providers. Discussion: The findings suggest that equipping community health workers, in particular, may be a better and more efficient way to increase the quality of life for families and caregivers and people living with epilepsy in South Africa.Item Open Access Living with epilepsy: patient knowledge and psychosocial impact(IRBS LCC, 2024) Musekwa, Ofhani Prudence; Makhado, LufunoBackground. People living with epilepsy (PLWE) often face psychological comorbidities and social challenges due to low levels of knowledge and awareness about epilepsy, as well as personal experiences with the condition. This can result in a low quality of life for PLWE. Objective: to investigate the psychosocial impact of epilepsy on patients residing in rural regions of South Africa (Limpopo and Mpumalanga Provinces). Material and methods. A non-experimental quantitative research was conducted, which involved 162 respondents living with epilepsy. Most were males, and the majority were between 18 and 35 years old in both provinces combined. The participants were offered a questionnaire divided into three sections comprising sociodemographic aspects, questions that assessed knowledge, and questions on the psychosocial impact of epilepsy. Results. I t was shown that while PLWE have a solid understanding of epilepsy as a medical condition, they may not fully comprehend its effects on daily life. For example, many respondents felt shameful after having a seizure and difficulties in forming relationships, and a significant proportion stated that they were never married because of epilepsy. The study highlights. The significant psychosocial impact of epilepsy on PLWE, including depression, difficulties in forming and maintaining social connections, and a lack of marital experience. Conclusion. To improve PLWE’s quality of life, the psychological help is recommended through healthcare facilities or local support groups.Item Open Access Managerial factors influencing the implementation of NIMART services in the mobile health clinics of eThekwini municipality in KwaZulu-Natal(Elsevier, 2024) Ngcobo, Silingene Joyce; Makhado, Lufuno; Sehlularo, Leepile AlfredBackground The mobile health clinics (MHCs) have been instrumental in rolling out Human Immunodeficiency Virus (HIV) care since they are an extension of Primary Health Care (PHC) services. The integration of HIV care into PHC services is reported as a structural facilitative factor for implementing nurse-initiated antiretroviral therapy (NIMART). The success of any health program relies heavily on management and support structure, hence managers’ perspectives on the implementation of NIMART services in MHCs are deemed crucial. Aim The study aimed to explore and describe the managerial factors influencing the implementation of NIMART services in the MHCs of eThekwini municipality in KwaZulu Natal. Methods A generic qualitative research approach was used applying Qualitative Exploratory Descriptive (QED) design, on twelve MHC managers who were purposefully selected and managing MHCs operated by local and provincial health authorities. The study was approved by the North-West University Human Research Ethics Committee (NWU 00934–19-A1), provincial (KZ_202002_017) and local health (30/1/1/6/3/1) authorities. Online semi-structured interviews were conducted to collect data and were transcribed. Atlas-TI was used for data analysis while demographic data was descriptively analysed. Results Three themes and twelve subthemes emerged from the study: theme 1: Challenges in implementing NIMART services in MHCs, theme 2: Positive factors influencing implementation of NIMART services in MHCs, and theme 3: Suggestions to strengthen implementation of NIMART services. Subthemes were shortage of staff, shortage of medical equipment for NIMART services, challenges with infrastructure, lack of budget for NIMART services, nurses are trained in NIMART, continuous meetings, Proper planning, more nurses should be trained on NIMART, employment of more nursing personnel, collaboration with relevant stakeholders, proper infrastructure for NIMART and need for allowances. Conclusion The involvement of managers is key to the successful implementation of NIMART services in the MHCs and improvement is more desirable.Item Open Access Professional nurses’ experiences of managing epilepsy at limited resource rural facilities in Limpopo and Mpumalanga Provinces, South Africa(Elsevier, 2024) Nemathaga, Muofheni; Maputle, Maria Sonto; Makhado, Lufuno; Mashau, Ntsieni StellaBackground Epilepsy is a neurological disorder affecting approximately 50 million individuals globally, contributing significantly to the global disease burden. Professional nurses play a crucial role in the care and treatment of people living with epilepsy, ensuring their safety and well-being. Professional nurses frequently encounter challenges, such as restricted access to drugs, specialised equipment, and epilepsy treatment training. Despite these obstacles, professional nurses are essential to providing high-quality care to patients with epilepsy in remote locations. Methods A qualitative design using explorative, descriptive, and contextual design was employed to achieve the objectives of the study. The sample comprised 20 professional nurses working in selected rural communities in Limpopo and Mpumalanga. Data was collected through in-depth individual interviews and analysed using Tesch's eight steps of data analysis. Results Four themes emerged from the data: experiences of professional nurses during management of epilepsy; inadequate training in management of epilepsy; insufficient supply of antiepileptic drugs and late presentation to local clinics. Conclusion The study found that professional nurses experienced several challenges hindering the effective management of epilepsy. Cultural beliefs in supernatural causes of epilepsy significantly influence treatment preferences, consequently delaying diagnosis and treatment. Despite limited resources and cultural barriers experienced by professional nurses, they strive to provide appropriate care to minimise seizures. Ongoing education and training on epilepsy management is vital to enable professional nurses to keep up-to-date with current methods and new developments.Item Open Access Professional Nurses’ Views and Experiences of Poor Health-Seeking Behavior Among Men in Limpopo Province, South Africa(MDPI, 2024) Chavalala, Lazarros; Lebese, Rachel Tsakani; Makhado, LufunoBackground/Objectives: The health-seeking behavior of men is a public health concern and is associated with poor health outcomes and lower life expectancy among men. Masculinity norms are among the factors contributing to men’s poor health-seeking behavior. This study explored the views and experiences of purposively selected nurses on men’s health-seeking behavior. Methods: Through qualitative descriptive design, individual semi-structured interviews were conducted with 14 professional nurses, and collected data were audio recorded and transcribed verbatim. Tech’s eight steps were used to analyze data and guide the development of the main themes and sub-themes. Trustworthiness was ensured through credibility, confirmability, dependability, and transferability. Ethical approval was granted by the University of Venda Research ethics committee with reference number FHS/21/PH/26/1215. Results: Self-medication, a lack of trust in Western medicine, and the use of traditional healers were identified as reasons men underutilize health care services. Men were viewed as people who consult heath care services when illness is severe, feel uncomfortable with female nurses, and value respect from clinicians. Conclusions: Cultural norms still remain a barrier among men in this study setting, as men did not feel comfortable with their private parts being physically examined by female clinicians. There is a need to take note of cultural norms impacting health care service usage by men.Item Open Access Registered nurses’ experiences regarding operational factors influencing the implementation of HIV care services in the mobile health clinics of eThekwini Municipality in KwaZulu-Natal(Springer Nature, 2024) Ngcobo, Silingene Joyce; Makhado, Lufuno; Sehularo, Leepile AlfredBackground Registered nurses working in the mobile health clinics (MHCs) play an important role in enabling HIV care access to populations in remote areas through Nurse Initiated Antiretroviral Therapy program (NIMART). Aim To explore and describe the nurses’ experiences regarding operational factors influencing the implementation of HIV care services in the mobile health clinics (MHCs) of eThekwini Municipality in KwaZulu Natal. Methods Qualitative Exploratory Descriptive (QED) method was used after permission was granted from North-West University Human Research Ethics Committee provincial and local health authorities. Data saturation informed sample size of thirteen MHCs nurses were purposefully sampled to participate. Audio-recorded, semi-structured, online, one-on-one interviews guided by open-ended questions were done for data collection, and including demographic profile. The interview transcripts were analysed using Atlas-TI and SPSS descriptive statistics was used for demographics. Results Eleven subthemes emerged under patient-related, nurse-related, and organisational-related themes which influence the operational factors in the MHCs, namely: patient defaulting treatment, lack of privacy, unavailability of phones, stressful and demotivating MHCs, nurses feel unsafe, lack of support from management, lack of budget, unavailability of computers, shortage of medical equipment, shortage of nursing staff and absence of data capturers. Conclusion Structured contextual coaching and support program for nurses is imperative to ensure effective and strengthened operations in MHCs, further supported by improvement in human resource for health allocation for MHCs in light of expanding health care programs Contributions Evaluation of health care programmes, and human resource for health quality improvement needs in the clinical practice of HIV care of MHCs nurses which advocate for specific policy formulations.Item Open Access The Effect of a Community-Based Complementary Feeding Education Program on the Nutritional Status of Infants in Polokwane Municipality, Limpopo Province, South Africa(MDPI, 2024) Makwela, Mashahataba Solomon; Mushaphi, Lindelani Fhumudzani; Makhado, LufunoBackground: Appropriate complimentary feeding (CF) has the potential to improve growth and development in infants from 6 months to 2 years of age. This study’s aim was to assess the effect of a CF education program on the nutritional status of infants aged 3–12 months in the Polokwane Municipality. Methods: A longitudinal (non-randomized), quasi-experimental intervention study was conducted among 187 caregivers. The caregiver-infant pairs (CIPs) in the intervention group (n = 95) received CF education and a six-month telephone follow-up support. The CIPs in the control group (n = 94) received no intervention. We collected data at baseline and end line using structured questionnaires. Intervention effectiveness was evaluated by comparing mean changes in anthropometric measurements between intervention and control groups using difference-in-difference analysis. Per protocol, analysis was run. Results: The results show that the children in the intervention group gained more weight after the intervention, were taller, and the mid-upper arm circumference (MUAC) increased more than in the control group. At baseline, the weight of infants was 7.37 ± 0.83 and 6.69 ± 0.13 kg in the intervention and control. At end line, significant weight and length gain were observed in the intervention group (difference-in-difference (DID) = 1.82 kg, p < 0.001) and (DID = 7.78 cm, p < 0.01), respectively. The intervention group showed significant gain in MUAC of 1.68 cm (p = 0.047), with no noticeable effect on the head circumference at end line; DID (0.16 cm; p = 0.950). Conclusions: Community-based nutrition intervention programs can effectively improve the anthropometric nutritional status of children aged 3–12 months.Item Open Access Unhealthy sexual practices among youth in Vhembe District, Limpopo province: A cross-sectional study(African Journals Online (AJOL), 2024) Khosa, N. Vinny; Mudau, A. Gladys; Makhado, LufunoAbstinence from sexual practice among youth not only prevents infections, HIV and AIDS, and unplanned pregnancies but also promotes healthy sexual practices and positive youth development. The study aims to explore and describe interventions to improve healthy sexual practices among youth in Vhembe district, Limpopo province. The study utilized a descriptive cross-sectional design with a sample size of 531 determined by the selected formular through probability, simple random technique. Using structured questionnaires for data collection from the participants. Validity was ensured and content and face validity. Reliability was ensured. Data was analysed using SPSS version 28.0. Ethical consideration was ensured during the study. The study results showed that 57.4% of the respondents indicated that they do not discuss their choice of contraceptive with their sexual partner, 80.6% of the respondents indicated that unplanned pregnancy can be prevented by supplying contraceptives programs at clinics and school while 83.2% of the respondents revealed that programs linked with contraceptive services can help prevent unplanned pregnancy. The study highlights the lack of contraceptive choice discussions among sexual partners, exposing them to risks of STIs, HIV and AIDS, and teen pregnancy, urging for improved healthcare access.