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Item Embargo Knowledge, attitudes, ans awareness of epilepsy amongst students at a selected higher education institution of learning in Limpopo, South Africa(2025-09-05) Ndou, Andani Edna; Makhado, L.; Netshisaulu, O. P.Background: Epilepsy, a neurological disorder that affects individuals of all ages, is often surrounded by stigma and misconceptions. Despite the prevalence of epilepsy, public knowledge and awareness about the condition are limited, particularly among university students. This study explored the perceptions, knowledge, and attitudes of students at the University of Venda regarding epilepsy to identify gaps in awareness and contribute to better educational strategies. Objectives: The purpose was to assess the level of knowledge, attitudes, and awareness regarding epilepsy among students at the selected university in Limpopo province. Methods: A cross-sectional study design was utilised following a quantitative research approach, survey-ing students from various faculties at the University of Venda. The study employed purposive sampling to select the institution, and Raosoft sample size calculator was utilized to determine the total sample size of 326 participants who participated in the study. Participants were asked to complete a structured question-naire covering demographic information, knowledge about epilepsy, attitudes towards people with epi-lepsy, and perceptions of public attention given to the condition. The survey included questions such as whether participants had heard about epilepsy, their understanding of its causes and management, and their views on the rights and abilities of people living with epilepsy. All submitted responses were first securely exported from Google Forms and screened for completeness. The data were coded and cleaned to ensure accuracy and consistency before analysis. Data were analyzed using IBM SPSS Statistics version 30.0. Descriptive statistics, including frequencies, percentages, means, and standard deviations, were employed to summarize participants’ demographic characteristics, levels of knowledge, attitudes, and awareness re-garding epilepsy. Results: The survey revealed that most students (approximately 92.9%) had heard of epilepsy, but signifi-cant misconceptions persisted. Many respondents believed epilepsy is untreatable or that people with epi-lepsy should not be allowed to engage in activities such as driving and should be supervised. Only a mi-nority of participants (18.7%) knew the correct management practices during a seizure. Notably, most stu-dents (67%) felt that insufficient attention was being given to epilepsy. At the same time, participation in the study spurred increased interest in learning more about the disorder, with over 92.9% expressing a desire for more information. Conclusion: The study highlights a critical need for enhanced education about epilepsy among university students, mainly to dispel myths and encourage informed and compassionate attitudes. Educational initia-tives focusing on seizure management, inclusivity, and the dispelling of stigma could significantly improve the knowledge base. These efforts could foster a more supportive environment for individuals with epilepsy within the University of Venda and broader society.Item Embargo The effect of COVID-19 lockdown regulations on art initiation among people living with HIV in Johannesburg, Gauteng Province, South Africa(2025-09-05) Nkadimeng, Naledi; Makhado, L.; Netshisaulu, O. P.Background: The COVID-19 pandemic has profoundly impacted healthcare delivery globally, disrupting services critical to managing chronic conditions like HIV. In South Africa, the burden of HIV, combined with the pandemic's restrictions, presented unique challenges for People Living with HIV (PLHIV). Lockdown regulations, designed to curb the virus's spread, inadvertently hindered access to healthcare services, including Antiretroviral Therapy (ART) initiation. ART is vital for reducing HIV-related morbidity and mortality and achieving global goals like the UNAIDS 90-90-90 targets. This study investigates the effects of lockdown regulations on ART initiation rates in Johannesburg, highlighting the pandemic's implications for HIV management in a resource-limited setting. Objectives: The study aimed to: • Assess ART initiation rates before, during, and after COVID-19 lockdown regulations in Johannesburg's Region D, Soweto. • Examine the barriers that hindered ART initiation during the lockdown period. • Provide recommendations for healthcare policy and planning to address service disruptions during pandemics or similar crises. Methods: This quantitative study utilized a retrospective chart review design to evaluate ART initiation trends across eight healthcare facilities in Region D, Soweto. Facilities were selected using simple random sampling to ensure representativeness. Data spanning 2019 (pre-lockdown), 2020–2021 (lockdown period), and 2022 (post-lockdown) were extracted from the Department of Health’s databases (DHIS and Tier.net). A self-designed checklist captured key metrics, including demographic data and ART initiation rates. Data analysis involved descriptive and inferential statistics using SPSS Version 29, with visual presentations in charts and tables. Ethical approvals were secured from the University of Venda and relevant health authorities. Results: The findings revealed a significant decline in ART initiation rates during the COVID-19 lockdown period. Community Health Centres (CHCs) reported a 40% decrease in ART initiation compared to a 20% reduction in primary healthcare clinics. Patient retention rates during the lockdown also varied, with CHCs achieving only 55% retention compared to 75% in clinics. Key barriers identified included restricted mobility due to stringent lockdown measures, fear of exposure to COVID-19, and the reallocation of healthcare resources to pandemic management. Despite these challenges, post-lockdown recovery efforts gradually improved ART initiation and retention. Conclusions: The COVID-19 pandemic disrupted ART initiation and highlighted systemic vulnerabilities in HIV service delivery. While necessary to contain the pandemic, lockdown regulations underscored the need for resilient healthcare systems capable of maintaining essential services during crises. This study recommends leveraging technology-based solutions such as telemedicine, scaling up community-based testing, and improving healthcare resource allocation to mitigate the impact of similar disruptions in the future. Ensuring accessibility and continuity of HIV care during pandemics is critical to maintaining progress toward global HIV eradication goals. Significance of the Study: The study provides critical insights into how lockdown regulations affected ART initiation in a high-HIV-burden setting. By addressing gaps in HIV service delivery during emergencies, the findings can inform public health strategies, strengthen resilience in healthcare systems, and safeguard the health of vulnerable populations during future pandemics. Recommendations: To enhance the response to healthcare crises, it is essential to strengthen policies that prioritize vital services, ensuring that the initiation of antiretroviral therapy (ART) and overall HIV care experience minimal disruption during emergencies. In this context, expanding telemedicine services can play a crucial role by facilitating remote consultations and effective management of ART. By incorporating telehealth, healthcare providers can continue supporting patients without requiring physical visits, which is particularly important during restrictive mobility. Additionally, increasing community-based testing and treatment outreach programs will help address the challenges of lockdowns and social distancing measures. These initiatives can ensure that individuals can still access essential services without travelling long distances. It is also vital to allocate adequate resources for HIV services during emergencies. This strategic planning will prevent interruptions in care that could jeopardize the health of those living with HIV. Finally, targeted public awareness campaigns should be implemented to reduce fear and stigma surrounding HIV, promoting a proactive approach to healthcare-seeking behaviour even during pandemics. By educating communities about their options and the importance of continued care, we can foster a supportive environment that encourages individuals to seek the help they need.Item Embargo Knowledge, attitudes and practices of caregivers towards measles and measles vaccine in a selected village in Vhembe District, Limpopo Province(2025-09-05) Mathenjwa, Happiness; Makhado, Lufuno; Olofinbiyi, O. B.Despite the widespread availability of an effective and free measles vaccine, the infection remains a global public health challenge. While barriers to childhood immunization have been extensively studied worldwide, including in South Africa, there is limited information regarding caregivers' specific knowledge, attitudes, and practices (KAP) concerning measles and its vaccination in the South African context. Given the ongoing measles outbreaks in 2022–2024, it is imperative to investigate whether caregivers know their children's vaccination status and the recommended timing for measles immunization. This study aimed to assess the KAP of caregivers toward measles and its vaccine in a selected village in Limpopo Province. The research was conducted alongside a scoping review to synthesize existing global literature on measles and vaccination and to inform the study's direction. The review incorporated keywords related to the study variables and sourced data from peer-reviewed journals, grey literature, and government reports. Subsequently, the study adopted a quantitative, cross-sectional, non-experimental descriptive design to gather data from caregivers of children aged six months to twelve years residing in the Vhembe District, Limpopo Province. Data were collected using a structured questionnaire designed to measure relevant variables. A simple random sampling method was employed to select 377 eligible respondents. The Statistical Package for the Social Sciences (SPSS, version 29.0) was utilized to analyze the data, presenting findings through tables, frequencies, and percentages, with Pearson correlation analysis used to explore associations. The scoping review identified themes indicating that caregivers possess adequate knowledge about measles; however, attitudes toward the measles vaccine varied, with the majority reporting positive rather than negative attitudes. Factors influencing caregivers' KAP included vaccine hesitancy, demographic characteristics such as the age and educational status of the caregiver, logistic constraints, the caregiver-physician relationship, and the impact of the COVID-19 pandemic. The quantitative analysis revealed that most caregivers demonstrated low (32.1%) to moderate (66.2%) knowledge levels, while only 6.8% exhibited high knowledge. Attitude scores indicated that most caregivers (89.3%) held positive attitudes toward measles and its vaccine. Practice scores highlighted that the majority (94.2%) demonstrated generally positive practices. The study found low knowledge could be attributed to limited exposure to measles infections and infrequent discussions with healthcare providers. The study recommends implementing targeted interventions that extend beyond mass community immunization campaigns. These should focus on educating caregivers about identifying measles cases and reinforcing the significance of vaccination, despite the limited exposure to the disease, to sustain community herd immunity.Item Embargo Knowledge and practices towards antibiotics use in Thulamela Municipality of Vhembe District Limpopo Province(2025-09-05) Makhari, Mpho; Maphula, A.; Tshitimbi, T. O.Antimicrobial resistance (AMR) is a health crisis that is found globally and it threatens the effective treatment of infectious diseases. It occurs when microorganisms develop resistance to the drugs that is used to treat them leaving the medication ineffective, microorganisms such as bacteria, fungi, viruses and parasite. The inappropriate use of antibiotics has been classified as major drivers of AMR, leading to multidrug-resistant strains of bacteria and reducing the effectiveness of existing treatment options. The World Health Organization (WHO) has recognized AMR as one of the biggest obstacles to public health in the 21st century not only is it increasing the morbidity and mortality rates associated with infectious diseases but also it leaves the economy in a hefty strain and negatively impacts the healthcare systems worldwide. This study aims to address the gap in knowledge by conducting a quantitative study to assess practices towards antibiotics and antimicrobial resistance among the communities. Simple random sampling was used to have 260 respondents who are males and females aged 18-65 residing in Thulamela Municipality. Data was collected using survey questionnaires, SPSS was used to analyse. Findings revealed adequate knowledge regarding antibiotics, The majority of respondents showed a good understanding of antibiotics, with 85% correctly identifying the difference between antibiotics and other medications. Ninety-four point six percent (94.6%) correctly identified that antibiotics are effective against bacteria, and 90.4% were aware that antibiotics can kill bacteria normally present on the skin and in the gut. The current study revealed that the community members are knowledgeable regarding antibiotics. However, some misconceptions were prevalent as evidence revealed that 50% believed that antibiotics speed up recovery from coughs and colds. The findings of this study provide valuable in-depth insights for the development of targeted interventions, campaigns, and policy measures to fight the AMR effectively. The findings highlight for the development of evidence-based strategies to fight against the AMR, promote responsible antibiotic use, and ensure safety of the public health on a global scale. Additionally, the study may serve as a benchmark for future research and policy development aimed at addressing this critical global health issue.Item Embargo Navigating the Gap: Unpacking the Unemployment Experiences of Higher Education Youth Graduates in Collins Chabane Municipality in the Limpopo Province(2025-09-05) Mthembi, Mpho; Maluleke, M.; Manganye, B. S.In the past few years, graduate unemployment has considerably increased in South Africa and around the world. The rising unemployment rates among unemployed youth graduates have impacted communities' quality of life. The main purpose of this study was to explore and describe the experiences of higher education graduates in Collins Chabane Municipality, in the Vhembe district of the Limpopo province. The study area for the proposed study was chosen to be a selected community in Collins Chabane municipality in Limpopo, which has a predominantly African population. The community was chosen because, like many communities in South Africa, it is struggling greatly with the unemployment of recent graduates. The researcher used a qualitative approach and a phenomenological case study research design to obtain an in-depth understanding of the research topic. The population is comprised of unemployed graduates between the ages of 21-35. A non-probability purposive and snowball sampling technique was utilized in the proposed study to select the participants. Semi-structured in-depth face-to-face individual interviews were used to collect data from the participants. The researcher intended to interview 15 participants, comprising both males and females; however, the sample size was determined by data saturation. A pre-test study was conducted to test the applicability of the research measures to ensure trustworthiness. Interpretative Phenomenological Analysis was applied to analyze data, and finally, ethical principles were maintained throughout the study. Recommendations were based on the findings of the study.Item Embargo Barriers to accessing Public Primary Health care among elderly people in Mpheni village, Limpopo Province.(2025-09-05) Netshakhuma, NdaedzoBackground As individuals age, their health demands increase compared to younger populations. When these demands are not adequately met by Primary Health Care (PHC) systems, it can lead to the progression of chronic diseases, increased comorbidities, and worsening health outcomes. This, in turn, reduces the overall quality of life for older adults. There is a gap between the ideal PHC policy framework and its practical implementation, especially in rural communities like Mpheni Village, Limpopo Province. Purpose of the Study This study aimed to explore and describe the barriers preventing the elderly population of the Mpheni community from accessing and benefiting from PHC services. Methods An exploratory qualitative research design was used. Participants were selected through non-probability convenience sampling, focusing on those aged 60 years and above, residing in Mpheni, and self-reporting challenges in accessing PHC services. Data were collected through semi-structured interviews with 10 participants and analysed using thematic content analysis. Ethical principles including informed consent, confidentiality, and trustworthiness were strictly observed. Results The study identified several barriers to PHC access, including long waiting times caused by staff shortages, transportation challenges due to poor infrastructure and high costs, and frequent medication shortages. These issues negatively impacted participants’ health, exacerbated chronic conditions, and led to psychological distress such as anxiety, depression, and feelings of neglect. While clinics were praised for their cleanliness and free services, participants expressed the need for specialised elderly care, improved communication about medication availability, and mobile clinic services. Recommendations To improve PHC service delivery for the elderly in rural areas, the study recommends the introduction of mobile clinics, training of PHC personnel in geriatric care, timely medication supply, and enhanced transport services. Policies must be tailored to ensure accessibility and responsiveness to the needs of the ageing population.Item Embargo Developing non-medical intervention strategies to reduce maternal and neonatal mortality associated with hypertension during pregnancy in Capricorn District, Limpopo Province, South Africa(2025-09-16) Madzaga, Thizwilondi; Malwela, T.; Mohlala, M.; Tshitangano, T. G.Hypertension is a global health concern, including in South Africa. It is one of the major risk factors of maternal and neonatal morbidity and mortality. The purpose of the study was to develop non-medical intervention strategies to reduce maternal and neonatal mortality, associated with hypertension during pregnancy in Capricorn District. A convergent parallel- mixed method was used in this study. The population of the study were all pregnant women aged 14 years to 49 years who were attending their antenatal services at the selected hospitals and clinics. In quantitative design anthropometric measurements and questionnaire were used to collect data. The chi-square test and logistic regression analysis were used to analyse the association of hypertension and its risk factors. In qualitative design a face-to- face unstructured interview was used to collect data and thematic analysis was used to analyse data. Ethical clearance was obtained from the University of Venda Ethics Committee. Permission to collect data was obtained from the Limpopo Department of Health manager and the Capricorn District Municipality manager. All ethical issues were observed, to ensure safety of the participants. The prevalence of hypertension was 126(21.50%) (CI 95%, 18.29% to 25.1%). The Chi-squire test showed that the prevalence of hypertension was significantly associated with age (P=0.00262), family history of hypertension (P=0.003), unemployment (P=0.04181), type of cooking oil (P=0.0436), salt intake (P=0.0111), obesity (P=1.664e-05), classification of BMI (P=5.765e-07), chronic hypertension (P=0.0000), gestational diabetes (P=0.0000) and a previous history of hypertension (P=2.2e-16). The multiple logistic regression showed that the prevalence of hypertension was significantly associated with a previous history of hypertension during pregnancy (P=1.93e-1), gestational diabetes (P=0.00317), chronic hypertension (P=0.01926) and salt intake (P=0.03355). Knowledge of hypertension among the pregnant women was found to be poor. Most of the participants indicated that they did not receive health education during antenatal care services. Good knowledge of hypertension was observed among those who were both employed and educated. The majority of the participants indicated that they had heard about hypertension, but only few of them bothered to find out more about it. Barriers to knowledge of hypertension were poor communication between patients and healthcare providers, education and ignorance of patients. Poor hypertension management was linked with preferred treatment, beliefs and poor knowledge about hypertension. In this study health information, social support and in-service training of staff are the proposed intervention strategies. Stakeholder were involved the development and validation of the program.Item Embargo Strategies to Improve Access to Healthcare Services for Refugees and Asylum Seekers in Gauteng Province, South Africa(2025-09-05) Manyuma, Duppy; Tshitangano, T. G.; Mudau, A. G.Introduction: South Africa currently hosts approximately 250,250 refugees and asylum seekers, the highest among the nine countries included in the UNHCR’s Multi-Country Office. The constitution of South Africa and the Refugee Act of South Africa grant refugee and asylum seekers the right to access healthcare services as South African citizens, despite the provisions in the legislation that grant refugees and asylum seekers similar rights as South African citizens in terms of access to health services, they still experience challenges in accessing these services in Gauteng Province. Aim: This study aimed to develop strategies to improve refugees' and asylum seekers' access to health care services in Gauteng Province, South Africa. Methods: The study was conducted in three phases. An exploratory sequential mixed methods design was employed in Phase 1 of the study, where the initial phase adopted a qualitative approach, and the subsequent phase adopted a quantitative approach. Phase 1 (a) of this study employed a qualitative approach in Gauteng Province among 16 conveniently sampled Health professionals and 20 purposively sampled refugees and asylum seekers. Unstructured interviews were used to collect data, which was analysed thematically. The results from Phase 1 (a) were then used to inform Phase 1 (b). Phase 1 (b) adopted a quantitative approach based on the findings from the initial qualitative approach to strengthen and ensure the generalisability of the qualitative phase to a broader population. Data was collected through structured self-administered questionnaires from n=353 health professionals and n=367 refugees and asylum seekers who were randomly sampled. Descriptive analysis was performed on the collected data. Ethical principles of informed consent, anonymity, privacy, confidentiality, and avoidance of harm were adhered to throughout the study. Results: The results from health professionals, refugees, and asylum seekers were reported separately. Nine themes emerged during data analysis. Four themes emerged from data collected from refugees and asylum seekers: Turnaround time, Hospital charges, Treatment by the hospital staff, and Practice in the hospital. Five themes emerged from data collected from health professionals: Communication challenges, corrupt activities by asylum seekers and refugees, hospital charges, attitude of asylum seekers, refugees and staff, and patients’ health-seeking behavior Phase 1 (c) focused on meta-inference and conceptualization. Where a conclusion was drawn based on the qualitative and quantitative data gathered. Phase 2 focused on developing strategies using analysis of Strengths, Weaknesses, Opportunities, and Threats and a Build, Overcome, Explore, and Minimize Model to guide the process. The developed strategies include the purpose, core values, and 17 strategic objectives with action plans. In Phase 3, the Delphi Technique was used to validate the developed strategies with 13 validators considered experts in healthcare, migration, and academics. Conclusion: There is a need to eliminate the language barriers between health professionals, refugees, and asylum seekers to ensure optimal access to services. Continuous provision of education in the refugee community will improve their understanding of the South African health system. Cultural competency training is needed to ensure acceptability between health professionals, refugees, and asylum seekers. There should be a collaboration between the community structures and local and international organizations with the Department of Health to address the existing challenges.Item Embargo Assessment of Sport Participation for People with Disabilities at Universities in Limpopo Province(2025-09-05) Mokwena, Tobias Johannes; Tshitangano, T. G.; Tshivhase, S. E.Background: Despite the notable progress that has been made in developing policies and putting structures in place to respond to the needs of people with disabilities in South Africa, people with disabilities are exposed to restrictive environments, discouraging them from participating in sports activities designed to promote a healthy lifestyle. These restrictive environments include architectural, societal, and personal barriers. The study aimed to assess, develop, and validate a sports participation program for people with disabilities at the rural universities in Limpopo Province. Methods: An exploratory sequential mixed methods design was conducted in three phases. Phase one of the study employed both qualitative and quantitative approaches. In Phase two, a meta-analysis was performed, along with the conceptualization and development of the intervention program using the health promotion model, BOEM, and SWOT analysis. Phase three employed the Delphi Technique to validate the developed intervention program. The study adopted purposive sampling and total population sampling techniques. Trustworthiness was ensured through measures of credibility, confirmability, transferability, and dependability. Qualitative data were collected through in-depth interviews with 16 students with disabilities, 10 disability unit staff, and 3 staff members from sports and recreation. Quantitative data were collected using structured self-administered questionnaires distributed to 164 participants, which included 150 students with disabilities, 10 disability staff, and 4 sports and recreation staff. The instrument’s reliability was established through a series of questions designed to assess sports participation guidelines for people with disabilities at selected rural-based universities in Limpopo Province. Ethical principles of informed consent, anonymity, privacy, confidentiality, and avoidance of harm were adhered to throughout the research process. Qualitative data were analysed through a thematic 6-step data analysis. Quantitative data were analysed using the Statistical Package for Social Sciences version 29.0. The study findings were conceptualised using the health promotion model and SWOT analysis. Results: The study findings were integrated, and the interpretation of the findings was discussed. Six themes emerged from the qualitative study findings: inclusion of students with disabilities to participate in sports activities; challenges discouraging students with disabilities from participating in sports activities; provision of conducive sports facilities; support from the rural-based universities in Limpopo Province; benefits of participating in sports, and strategies to encourage students with disabilities to participate in sports activities. These themes, developed from qualitative data analysis, were confirmed by the quantitative data findings. Specifically, 115 (76.7%) of the participants acknowledged the benefits of participating in sports activities. However, the study revealed that 111 (74%) participants experienced discrimination when attempting to participate in sports activities, and 92 (61.3%) experienced stigmatization when participating in sports activities. Additionally, the study indicated that sports facilities at the rural universities in Limpopo Province are not conducive for people with disabilities. A significant number of participants, 90 (60.0%), reported that there are no sports competitions for people with disabilities. Furthermore, 70.0% revealed that disability structures are not involved in planning adaptive sports activities. The study findings were presented to the disability support staff and the unit of Sports and Recreation staff at rural-based universities in Limpopo Province. The study findings informed the development of an intervention program, which consists of three components: personal factors, situational influences, and commitment to the plan of action. Stakeholders validated the designed intervention program, and the descriptive statistics were used to assess and summarize the data using tables, pie charts, and frequency distributions. The program is practical and can effectively address the challenges that discourage students with disabilities from participating in sports activities. Conclusion: People with disabilities experience several challenges that include architectural barriers, societal barriers, and personal barriers discouraging them from participating in sports activities designed to promote a healthy lifestyle. Recommendations: Universities should provide accessible and user-friendly sports facilities for students with disabilities and non-disabled students to promote a healthy lifestyle.Item Embargo Intervention strategies to promote health-seeking behaviour among men in rural villages of selected Districts in Limpopo Province, South Africa.(2025-09-05) Chavalala, Lazarros; Makhado, L.; Lebese, R. T.Background: In many societies, few men utilise the available health care service and those who seek care are likely to discontinue care before completing treatment. Men’s utilisation of health services remains low and tests for Human immunodeficiency virus (HIV) have even lower number, compared to women. They spend a long duration infected by untreated diseases such as STIs and have an increased chance of HIV infection, become severely ill, and die from the diseases. South Africa is among the countries where men utilise health care services at a lower number compared to women. Aim: This study sought to develop intervention strategies to promote health-seeking behaviour among men in rural villages of selected Districts in Limpopo Province, South Africa. The objectives were to: Describe Behavioural, socio-economic, cultural, and environmental factors that contribute to men’s poor health-seeking behaviour; Explore health system factors that contribute to low utilisation of health services and poor health-seeking behaviour; Describe the views of men on their health; Explore strategies that may encourage men to utilise health services; Assess knowledge of men on their health and determine their attitude towards public health care services; Validate the developed strategies. Methods: This study was conducted in multiphase. In the first phase, A systematic review was conducted. The second phase focused on convergent parallel mixed methods design comprising both qualitative and quantitative methods. The findings from both qualitative and quantitative were then merged side by side. Purposively selected participants for the qualitative strand were interviewed using both individual interviews and focus group discussions based on their categories. Randomly selected participants for the quantitative strand were given a self-administered questionnaire to complete to collect data from them. The qualitative data was analysed using Tesch’s eight steps, while the Statistical Package for Social Sciences (SPSS), version 29.0 was used to analyse quantitative data by employing descriptive and inferential statistics. Phase three focused on developing strategies and validating developed strategies. The Strengths, Weaknesses, Opportunities and Threats (SWOT) analysis, was applied to the findings from phase two. Build, Overcome, Explore and Minimise (BOEM) models, were then applied to the outcomes of the SWOT analysis and used to develop strategies. Chinn and Kramer's evaluation theory was used to validate developed strategies. Validity and reliability were ensured for quantitative findings, while the trustworthiness of qualitative findings was established through credibility, dependability, transferability, and conformability measures. Ethical considerations were observed. Results: The systematic review found that peer education, Men’s Sheds, HIV self-testing, and Telemedicine and digital platforms were among the strategies that have been used in other countries to improve men’s health-seeking behaviours. The qualitative inquiry identified factors that contribute to men’s poor health-seeking behaviours and experiences of men when visiting public health facilities. Through quantitative inquiry, men’s knowledge of their health was assessed and their attitudes towards public health services were determined. A total of 14 strategies were developed and this included the introduction of male-dedicated sections in existing health facilities: implementation of community outreach campaigns targeting males, providing male-dedicated health services through telemedicine, employing male nurses and community health workers (CWHs), regular staff training of health professionals serving males, and reducing the waiting period for males in the health facilities. Validation led to a few adjustments in the strategies suggested by experts. All Stakeholders agreed with the proposed strategies. Amendments to the strategies were made and presented based on the suggestions. Conclusion: Men are more likely to experience poor health outcomes due to poor health-seeking behaviour. There is a need to address men’s poor health-seeking behaviour in the Limpopo province. Implementing the proposed strategies could help improve men’s health-seeking behaviour in Limpopo province and improve health outcomes among men. The strategies should be implemented in the study setting, monitored, and evaluated to measure their impact. If the strategies lead to a positive impact on men’s health-seeking behaviour, they can then be extended to other settings.Item Embargo The impact of COVID-19 on HIV patients who are on ART in Vhembe district, Limpopo Province, South Africa(2025-09-05) Moyo, Ramasela Anna; Maphula, A.; Makhado, L.Background: People who had mental health conditions before, may be more susceptible to stressors related to Coronavirus disease-2019 (COVID-19). Understanding the impact, in particular psychosocial impact of the pandemic for people living with HIV (PLWH) is critical, as they are to an extent, already at a risk for common mental disorders such as depression and anxiety, due to the fact that poor mental health may precede negative human immunodeficiency virus (HIV) related outcomes. The study assesses the impact of COVID-19 on HIV patients who are on antiretroviral therapy (ART) at 2 health centres at local municipality in Vhembe district. Methods: The study incorporated a systematic review artle due to the article format of the submission but the main study was quantitative in nature, using a descriptive design that is cross-sectional in nature. Simple random sampling was used in this study to select the sample of respondents who were PLWH, who met the criteria of being on ART treatment from the Limpopo department of health. Data was collected using a questionnaire which incorporated the following scales: Self-Reported HIV Medication Adherence, Fear of COVID Scale and PROMIS 10. The questionnaire was presented and administered to PLWH who are 18 years old and above who are on ART and have been residing in selected local municipality for the previous 12 months. Ethical considerations were observed throughout the study, partcicipants gave full consent verbally and in writing prior data collection. Furthermore consent and approvals were obtained to ensure adherence to good ethical conduct. Results: The Statistical Package of Social Sciences was used to analyse data. The findings highlight a substantial 34,4% of respondents being afraid of COVID-19 and 14,1 also agreeing, implying the almost half of the respondents experiences anxiety. 47.1% reported being afraid to die COVID-19 and 35.2% struggling to sleep due to worrying about COVID-19. Although the PROMIS 10 scale reflect 64.4% and quality of life was reported to be high, the COPE scale highlight 2,8% used alcohol and durgs to cope, 3,5% used binge eating to cope. The majority reported more positive adaptive ways to cope such as eating healthy, taking break from social media, excircising and connecting with other people. The t-test result showed that there is no association between gender and the levels of anxiwty, irritability and depression, gender – females (M = 11.1869, SD = 8.6411) were not significantly different in level of irritability, anxiety and depression t(285) =0,527, P < .599 compared males (M = 10.7813, SD = 8.0366). The result implies that gender has no significant influence on anxiety, irritability and depression. Hypothesis three was rejected. The health system implementors in SA need to classify psychological treatment as essential to be as swiftly as general health response to improve the health and wellbeing for PLWH during COVID-19.MItem Embargo Perceptions and attitudes of adolescents towards contraceptive use at selected village in Thulamela Muicipality in Limpopo Province(2025-09-05) Mashila, Muano Mbofho; Mudau, A. G.; Rangwaneni, M. E.Contraceptives are methods endorsed by the World Health Organization to aid in family planning for everyone who is sexually active. While their primary function is to prevent unplanned and unwanted pregnancies. Some contraceptive methods, such as condoms, also play a vital role in preventing sexually transmitted diseases (STIs). Despite the availability of these methods, a significant number of adolescents globally continue to experience unintended pregnancies and STIs, largely due to limited contraceptive use. This study aimed to explore the perception and attitudes of adolescents towards contraceptive use in a selected village within Thulamela municipality, Limpopo Province. A qualitative research approach was employed, using an explorative design. The study population comprised 23 adolescents aged 15 to 19 years. A non-probability sampling method, specifically convenience sampling, was used to select participants. Data were collected through semi-structured interviews, which were audio-recorded and transcribed verbatim. The sample included 23 adolescents, of whom 9 were males and 14 were females. The analysis of the data was conducted using thematic methods. To ensure trustworthiness, the researcher placed a strong emphasis on credibility, confirmability, and authenticity. Ethical considerations were adhered to. The findings revealed that adolescents were generally aware of contraceptives and familiar with different types, of contraceptives, with condoms being the most recognised and commonly used method. However, several barriers to contraception use were identified. These included cultural and religious beliefs, stigma from health professionals, societal pressures, and general fears. The study highlights the urgent need for comprehensive health education on sexual and reproductive health. It also underscores the importance of educating communities to foster more supportive attitude towards adolescent contraceptive use. Furthermore, healthcare providers should enhance the accessibility of adolescent-friendly services including dedicated time slots for adolescents and appointment of youth champions within their facilities, to improve contraceptive uptake among adolescents.Item Embargo An Investigation of Patient Satisfaction on Service Delivery at the Selected Clinics in the Thulamela Municipality, Vhembe District(2025-09-05) Netshikweta, Thama; Manganye, B. S.Patient satisfaction is a critical indicator of the quality of healthcare services and plays a significant role in shaping health outcomes and patient loyalty. This study investigates patient satisfaction with service delivery at selected clinics in the Thulamela Municipality, Vhembe District, South Africa. The region, characterised by diverse healthcare needs and socio-economic challenges, provides a unique setting to evaluate healthcare delivery and identify areas for improvement. The purpose of the study was to investigate the level of patient satisfaction with service delivery at five selected clinics in Thulamela Local Municipality. The present study adopted a quantitative research approach, using structured questionnaires distributed to 441 patients across five clinics, with three hundred valid responses analysed using SPSS version 27. Findings revealed mixed levels of satisfaction, with factors such as clinic cleanliness and nurse competency receiving positive feedback, while long waiting times, limited availability of medication, and inadequate patient communication were highlighted as areas of concern. Gender and employment status influenced satisfaction levels, with women reporting higher satisfaction, likely due to greater healthcare engagement, whereas unemployed patients faced barriers in accessing quality care. This study underscores the need for targeted improvements in service efficiency, resource availability, and healthcare provider-patient interactions. Recommendations include employing quality assurance officers, conducting regular patient satisfaction surveys, and enhancing staff training in patient-centered care. Consequently, by addressing identified gaps, healthcare policymakers and administrators can improve patient experience, strengthen healthcare delivery, and promote equitable access to quality services.Item Embargo Impact of community sports programs on youth mental health in Vhembe District, Limpopo Province(2025-09-05) Ramalamula, Vhofanelwa; Manganye, B. S.; Mulibana, P. K.Community sports programs have been shown to bring better outcomes across the lifespans of youth regarding physical, mental, social, and emotional health. They also built social relationships, developed coping mechanisms, and promoted mental resilience, highlighting the collective benefits of sports engagement for youth's mental health. This study aimed to determine the impact of community sports programs on youth mental health in Vhembe District. The study used a quantitative research strategy and a descriptive cross-sectional design. The target population of this study included all youth between the ages of 15-34 who participated in community sports programs. A simple random sampling method was used to select respondents. The validity and reliability of the instrument were strengthened by adopting a standardized assessment tool from the International Olympic Committee of Sport Mental Health. The researcher requested permission to collect data from the royal council, coaches, and team managers. The data were collected using a selfadministered questionnaire with close-ended questions from 150 respondents. Collected data was analyzed using the Statistical Package for the Social Sciences (SPSS) V. 29.0. The collected data were analyzed using descriptive statistics such as Frequency, multinominal logistic regression, Wilcoxon Signed-Rank and Correlations. The level of significance was set at P<0.05. The researcher ensured that research ethics were considered, including informed consent, permission, confidentiality, beneficence, and privacy. Results, conclusions, and recommendations were based on the findings, community sports participation is strongly associated with improved mental well-being and social interactions, yet gaps remain in skill development and teamwork enhancement. While sports programs offer mental health support, additional interventions are needed to translate this support into observable improvements. The study’s findings have practical implications for program design and policy formulation, emphasizing the need for integrated mental health support within community sports initiatives. KeyItem Embargo Development of an integrated HIV, STI and Teenage pregnancy prevention programme in Vhembe District of Limpopo Province, South Africa(2025-09-05) Rammela, Mukovhe; Makhado, L.; Mudau, A. G.Background: In South Africa, there are several health care services provided at the primary level of health care dedicated to addressing adolescents' sexual and reproductive needs. These services often face challenges such as limited resources, lack of funding and insufficient training for healthcare providers, which hinder their ability to provide integrated care. Additionally, cultural stigma and lack of privacy are factors which deter adolescents from seeking help. Purpose: The study sought to develop an integrated Human Immunodeficiency Viruses (HIV), sexually transmitted infections (STI), and teenage pregnancy prevention programme among youth in the Vhembe district of Limpopo province. Methods: This study employed a comprehensive multiphase mixed-methods strategy structured across three interconnected phases to ensure a robust exploration of the subject matter. The journey began with Phase 1, where a comprehensive literature review was conducted. This foundational step laid the groundwork for the entire research by synthesizing existing knowledge and identifying gaps that warranted further investigation. Moving into Phase 2, the research adopted a concurrent triangulation mixed methods approach divided into two stages. This innovative phase was pivotal, culminating in the development of a conceptual framework interwoven with qualitative and quantitative findings. The study created a comprehensive understanding of the issues at hand by integrating, comparing, and interpreting data from diverse sources. In the Final Phase, the findings from Phase 2 were subjected to rigorous analyses, including a Political, Environmental, Social, and Technological (PEST) analysis and a Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis. The insights gleaned from these analyses served to inform the design of integrated programs geared toward preventing HIV, sexually transmitted infections (STIs), and teenage pregnancies. To ensure the efficacy of these proposed programs, a consultation was held with the Reduce the Risk (RTR) Coalition, which included a diverse group of stakeholders and experts. This collaborative effort aimed to validate the approach taken. Quantitative data were gathered through questionnaires distributed to 112 respondents at selected clinics in the Vhembe district, while qualitative insights were captured through simultaneous face-to-face interviews. As the data from Phase 2 were analyzed, qualitative findings underwent thematic analysis to identify key patterns and themes, while the quantitative data were processed using SPSS software. This detailed analytical process aimed to provide a nuanced understanding of the results, ultimately enriching the study's findings and contributing to more effective public health interventions. Results: AYFS has been evaluated in depth across eight WHO global standards for quality healthcare services for adolescents, with areas of success and areas for improvement identified. Provider competency reveals a disparity, with a majority (67.0%) of healthcare providers trained in effective communication with adolescents. In comparison, significantly fewer have received specific training in AYFS (16%) or on Pre-Exposure Prophylaxis (PrEP) (25.9%), underscoring the need for a more balanced approach to training focus. Ineffective implementation and monitoring of existing interventions were also identified as barriers. Several respondents cited insufficient resources for HIV PrEP implementation. Institutional barriers, such as staff shortages, also hinder HIV PrEP integration into family planning. A significant challenge is the lack of knowledge among healthcare workers regarding HIV PrEP and its benefits. Several facilitators were identified for successfully integrating HIV PrEP into family planning services, including community support, motivated staff, technical support and stakeholder collaboration. By effectively integrating these services, we can significantly diminish stigma and improve access to quality sexual health care in rural areas. This, in turn, is likely to result in better health outcomes, including reduced rates of HIV infection, as well as increased access to contraception. Conclusion: The findings of this study support the need for the integration of HIV, STIs, and pregnancy prevention services, given that all stakeholders demonstrated a readiness to participate in such a programme. The stakeholders agreed that such a programme would be an effective way of reducing HIV, STI transmission and teenage pregnancies while also providing reproductive health services. The stakeholders have expressed a desire to work collaboratively to ensure the success of the integrated programme. To implement the integrated programme, stakeholders could establish joint training sessions for healthcare providers to ensure consistent service delivery. They could also create a centralized platform for sharing resources and best practices. Additionally, regular community outreach events could be organized to raise awareness and encourage participation in the programme.Item Embargo A framework addressing barriers to utilization of Elimination of Mother- to -Child Transmission of HIV services among pregnant women and lactating mothers in Gauteng Province(2025-09-05) Nyamande, Ndivhuho; Tshitangano, T. G.; Tshivhase, S. E.Elimination of mother-to-child transmission of HIV (EMTCT) is a global health priority, ensuring that no child is born with HIV. Poor utilization of EMTCT services leads to burdensome consequences such as vertical transmission of HIV and an increase in maternal and neonatal mortality rates. Despite the progress made to reduce new HIV infections in children, barriers to the utilization of the Elimination of Mother-to-Child Transmission service remain the bottleneck that affects the program’s effectiveness. Pregnant and lactating women face many challenges that can contribute to loss of follow-up during their prenatal and postnatal care. This study developed a framework to enhance the utilization of the Elimination of Mother-to-Child Transmission of HIV services among pregnant women and lactating mothers in Gauteng province. A convergent parallel mixed methods design was used, where exploratory-descriptive qualitative approaches were concurrently run with the quantitative approach employing a cross-sectional descriptive design. A convenience sampling method was used to select these women based on accessibility and availability, ensuring the study's comprehensive coverage. A self-administered questionnaire was utilized to assess 681 pregnant and breastfeeding women. The data was analyzed using descriptive statistics using STATA 15.0. Validity and reliability issues were considered in the study to ensure the consistency of the work. For the qualitative approach, a convenience and purposive sampling method was used to select eligible pregnant and lactating women. A semi-structured interview guide was used to collect data until data saturation occurred after interviewing 25 participants. Qualitative data was analyzed thematically. Trustworthiness was ensured through Credibility, Confirmability, Transferability, and Dependability for the quantitative approach. Ethical principles were adhered to throughout the study. The findings were conceptualized using the health belief model. The results were interpreted and integrated. The combined qualitative and quantitative data gave a deeper understanding of the barriers to EMTCT utilization and perceived strategies to enhance its utilization. Strengths, Weaknesses, Opportunities, and Threats analysis were employed to guide the development of the framework using the BOEM model. Validation of the developed framework was done through stakeholder consultations and the Delphi technique. Experts and stakeholders participated in the process of validating and confirming the effectiveness of the developed framework to enhance the utilization of EMTCT services in Gauteng province. The framework can improve the utilization of EMTCT services among pregnant and lactating women with continued efforts to enhance the accessibility and utilization of EMTCT services, promoting the health and well-being of both mothers and their children. It is believed that the implementation of the developed framework will benefit all women of childbearing age throughout Gauteng province.Item Embargo Strategies to improve the effectiveness and efficiency of village health workers in service delivery in a seleceted district of Zimbabwe(2025-09-05) Munyai, Ofhani; Mudau, A. G.; Mashau, N. S.Background The advent of the Alma-Ata Conference has sparked a renewed global interest in community health programs to strengthen primary healthcare systems. The goal is to address inequities, respond to community health needs, and realise universal health coverage. Village Health Workers are vital for health systems to achieve universal health coverage by bringing primary healthcare services closer to the communities. They complement healthcare systems in low- and middle-income countries (LMICs), including Zimbabwe, that are affected by shortages of nurses. Their social connectedness fosters positive behaviour change and helps build trust in the healthcare system. Despite their importance, in Zimbabwe, these continue to face numerous challenges that impact their effectiveness and efficiency in service delivery, such as limited training and skills, poor remuneration, support and supervision, inadequate resource provision, and a lack of clear-cut implementation strategies, as evidenced by the 2017 Village Health Worker Strengthening Program, which was never operationalised. This necessitated the development and validation of strategies to enhance the effectiveness and efficiency of VHWs in service delivery. Aim The study aimed to develop and validate strategies to improve the effectiveness and efficiency of Village Health Workers in service delivery, leveraging the empirical findings and reviewing relevant literature. Setting Beitbridge district, Matabeleland South Province, Zimbabwe. Methods A review of the literature, using Rodgers’ Evolutionary Concept Analyses, identified the antecedents, attributes, and consequences of effective and efficient community health systems. An exploratory sequential mixed methods design was used to explore the roles of Village Health Workers in primary health care. . In-depth interviews in the first stage collected qualitative data from 45 purposely selected healthcare workers and Village Health Workers using interviews,and then they were thematically analysed with MAXQDA Software. The variables generated were validated by a cross-sectional survey, which collected quantitative data from 134 Village Health Workers and was analysed using SPSS. The strengths, weaknesses, opportunities, and threats enabled the identification of internal and external factors of the village health worker program. The program logic models were used to develop strategies, which were validated by a panel of experts using the Delphi technique and key stakeholders. Results Fifty-two articles and two reports were reviewed and analysed. Antecedents included an enabling work environment, community participation, motivation, incentives, community health integration into national health systems, and the use of information and communication technology. Attributes were ongoing training and skills development, mutual respect and trust, enhanced contact between Village Health Workers and communities, and supportive supervision. The consequences were equitable access and improved quality of primary healthcare services. The exploratory sequential mixed methods study revealed that health education, child growth monitoring, and referrals are the primary roles of Village Health Workers, who frequently face challenges with logistical supplies, allowances, knowledge, and skills. Eight strategies, developed and validated, included community engagement, ongoing training, role clarification, supportive supervision, optimal resourcing, mobile health technology, incentives, and the integration of VHWs into the mainstream healthcare system. Conclusion This paper clarifies the roles and strategies of Village Health Workers, providing valuable insights for program managers and stakeholders seeking to improve primary healthcare service delivery. Contribution Findings from the reviewed literature informed the development of a conceptual framework. Context-specific Village Health Worker service delivery strategies were developed through the novel application of strategic planning frameworks, models, and validation by a consensus of experts and key stakeholders.Item Embargo The Intervention strategies to reduce substance abuse among adolecents in low-resource communities of Tshwane District Municipality, Gauteng, South Africa(2025-09-05) Chauke, Ishmael Ntsako; Mashau, N.; Mudau, A.Substance abuse remains a critical major public health concern globally and is particularly alarming in the low-resource communities of Tshwane district municipality, Gauteng, South Africa where adolescent substance abuse continues to rise despite government interventions. This study aimed to develop effective intervention strategies to reduce substance abuse among adolescents in low-resource communities of Tshwane District Municipality. A pragmatic convergent parallel mixed-method design was employed. In Phase 1, a systematic review was conducted to extensively search for literature regarding intervention strategies to reduce substance abuse among adolescents. Phase 2 involved empirical data collection where 25 adolescents and 5 ward leaders were interviewed for the qualitative strand, while 397 adolescents participated in the quantitative strand. Phase 3 focused on strategy development, and Phase 4 used the Delphi technique for validation by experts with expertise in the field of substance abuse. Purposive sampling technique was applied for the selection of qualitative participants, and simple random sampling technique with Slovin’s formula was used for the quantitative respondents. Data was collected through interviews and self-administered questionnaires for qualitative and quantitative strands respectively. Qualitative data was thematically analysed using Tesch’s eight stages of data analysis, and the quantitative data was analysed through SPSS v25.0 and STATA and visualised through PowerBI. Validity, reliability and trustworthiness were ensured, and the Theory of Planned Behaviour (TPB) was used for conceptualisation. Key findings highlighted that adolescents whose parents abuse substances are more vulnerable to substance abuse and crime. Lack of recreational activities, parental guidance, and community-based prevention programs were also highlighted. Both strands confirmed six adolescent and four ward leader themes. These were validated by various experts and stakeholders including nurses, teachers, doctors, psychologists, ward leaders, traditional leaders, parents and adolescents. Intervention strategies included NGO establishment, strengthened immigration control, religious leader involvement, parentchild communication, health education, and community forums. A SWOT analysis helped identify strategic factors, and BOEM was applied to minimise threats. The developed strategies were validated using descriptive statistics. The study underscores the urgent need for youth-friendly, evidence-based intervention strategies. Recommendations were derived directly from the study findings to guide future policy and program development.Item Embargo Student's perceptions regarding the use of female condoms at the University of Venda, in Limpopo Province, South Africa(2025-05-16) Ramawa, Mulweli Cyril; Mashau, N. S.South Africa is a nation severely impacted by sexually transmitted diseases, HIV/AIDS, and unwanted pregnancy among youth. Even though the public sector has made female condom programmes that also help distribute female condoms, there is still mixed reaction between male and female students towards female condoms. This study aimed to describe cultural perceptions, identify personal perceptions, and determine social perceptions towards female condoms. This study utilised a quantitative, descriptive, cross-sectional survey approach. The study was conducted at the University of Venda in Limpopo province. A systematic sampling method was used to sample the respondents. The study's intended sampling size was 398 respondents, but only 386 students' questionnaires were included. This is the case as other respondents did not respond to some of the questions in the survey. The questionnaire instrument used had closed-ended questions. To ensure validity and reliability, the researcher presented the study proposal to the Department of Public Health, where suggestions were made, and the supervisor was involved in the study and questionnaire development. The researcher did a pretest first to ensure the data collected was adjusted so that the questions given to respondents were made clear and to ensure that the data was reliable and high-quality. The University of Venda Research Ethics Committee approved the study, and permission to conduct the study was obtained from the director of student affairs. The data was analysed using the Statistical Package of Social Science (SPSS) version 29.0.2.0. The data was presented in tables and histogram. The study findings revealed insufficient knowledge regarding the female condom, negative attitudes towards its discussion, gender inequality, misconceptions, and inadequate access to female condoms at tertiary institutions. The study suggested recommendations based on the findings and addressed the limitations of this study.Item Embargo Safe Food Handling Knowledge and Practices of Street Food Vendors at Louis Trichardt Makhado Local Municipality, South Africa(2025-05-16) Mudogwa, Ronewa; Tshivhase, S. E.; Mashau, N.Street-food vendors are an important component of the food supply chain; however, they have been implicated in the spreading of foodborne diseases. Street food often poses a risk to the health of consumers as they are prepared and sold in unhygienic conditions that bring about microbial and environmental contamination. This study aims to investigate safe-food handling knowledge and practices of street food vendors at Louis Trichardt, Makhado Local Municipality, Limpopo Province, South Africa. The researcher conducted the study using a quantitative approach with a cross-sectional descriptive survey design; a non-probability purposive sampling technique was utilized to sample 61 street-food vendors, and a self-administered questionnaire and a structured-observational checklist were used to collect data to determine the vendor’s food safety knowledge and practices. Pre-testing was conducted with 20 randomly selected street-food vendors to determine the validity of the measuring instruments and amended them, where necessary. The collected data was analyzed using SPSS statistical software version 19.0. The results showed that majority of the respondents 85.25% were females between the age range of 36-45 years with a high school education level with grade 10-12. About 68.85% of the street food vendors knew the correct way to wash hands, however, 52.46% were observed to not wash their hands before food preparation which may compromise the safety of street food. The majority of the vendors had moderate food safety knowledge (60.66%). This study concludes that street-food vendors practiced unsatisfactory hygiene and sanitary practices, during food preparation, Major infringements were- cross contamination from different food ingredients, lack of temperature control, lack of hand washing, inadequate infrastructure. This study recommends that food handlers are imparted with knowledge through targeted health education and promotion; such initiatives should be implemented periodically to ensure desired food-handling practices are implemented and sustained.