Recent studies in the Sub-Saharan countries in Africa have indicated gaps and challenges for voluntary medical male circumcision (VMMC) quality of service. Less has focused on the changes in quality ...of service after implementation of continuous quality improvement (CQI) action plans. This study aimed to evaluate the impact of coaching, provision of standard operating procedures (SOPS) and guidelines, mentoring and on-site in-service training in improving quality of VMMC services across four Right to Care (RTC) supported provinces in South Africa.
This was a pre- and post-interventional study on RTC supported VMMC sites from July 2018 to October 2019. All RTC-supported sites that were assessed at baseline and post-intervention were included in the study. Data for baseline CQI assessment and re-assessments was collected using a standardized National Department of Health (NDoH) CQI assessment tool for VMMC services from routine RTC facility level VMMC programme data. Quality improvement support was provided through a combination of coaching, provision of standard operating procedures and guidelines, mentoring and on-site in-service training on quality improvement planning and implementation. The main outcome measure was quality of service. A paired sample t-test was used to compare the difference in mean quality of service scores before and after CQI implementation by quality standard.
A total of 40 health facilities were assessed at both baseline and after CQI support visits. Results showed significant increases for the overall changes in quality of service after CQI support intervention of 12% for infection prevention (95%CI: 7-17; p<0.001) and 8% for male circumcision surgical procedure, (95%CI: 3-13; p<0.01). Similarly, individual counselling, and HIV testing increased by 14%, (95%CI: 7-20; p<0.001), group counselling, registration and communication by 8%, (95%CI: 3-14; p<0.001), and 35% for monitoring and evaluation, (95%CI: 28-42; p<0.001). In addition, there were significant increases for management systems of 29%, (95%CI: 22-35; p<0.001), leadership and planning 23%, (95%CI: 13-34; p<0.001%) and supplies, equipment, environment and emergency 5%, (95%CI: 1-9; p<0.01). The overall quality of service performance across provinces increased by 18% (95%CI: 14-21; p<0.001).
The overall quality of service performance across provinces was significantly improved after implementation of CQI support intervention program. Regular visits and intensive CQI support are required for sites that will be performing below quality standards.
Voluntary medical male circumcision (VMMC) remains an effective biomedical intervention for HIV prevention in high HIV prevalence countries. In South Africa, United States Agency for International ...Development VMMC partners provide technical assistance to the Department of Health, at national and provincial levels in support of the establishment of VMMC sites as well as in providing direct VMMC services at site level since April 2012. We describe the outcomes of the Right to Care (RTC) VMMC program implemented in South Africa from 2012 to 2017. This retrospective study was undertaken at RTC supported facilities across six provinces. Young males aged greater than or equal to10 years who presented at these facilities from 1 July 2012 to 31 September 2017 were included. Outcomes were VMMC uptake, HIV testing uptake and rate of adverse events (AEs). Using a de-identified observational database of these clients, summary statistics of the demographic characteristics and outcomes were calculated. There were a total 1,001,226 attendees of which 998,213 (99.7%) were offered VMMC and had a median age of 15 years (IQR = 12-23 years). Of those offered VMMC, 99.6% (994,293) consented, 96.7% (965,370) were circumcised and the majority (46.3%) were from Gauteng province. HIV testing uptake was 71% with a refusal rate of 15%. Of the newly diagnosed HIV positives, 64% (6,371 / 9,972) referrals were made. The rate of AEs, defined as bleeding, infection, and insufficient skin removal) declined from 3.26% in 2012 to 1.17% in 2017. There was a reduction in infection-related AEs from 2,448 of the 2,602 adverse events (94.08%) in 2012 to 129 of the 2,069 adverse events (6.23%) in 2017. There was a high VMMC uptake with a decline in AEs over time. Adolescent men contributed the most to the circumcised population, an indication that the young population accesses medical circumcision more. VMMC programs need to implement innovative demand creation strategies to encourage older males (20-34 years) at higher risk of HIV acquisition to get circumcised for immediate impact in reduction of HIV incidence. HIV prevalence in the total population increased with increasing age, notably in clients above 25 years.
Due to the Covid-19 pandemic, 2020 was one of the most difficult years in South Africa. Many institutions and organisations that had not yet adapted their operations to technological innovation were ...forced to do so in order to survive. This was the researcher's driving force behind the study, which was inspired by his experience teaching Grade 7 learners in Mathematics and Science online, while using a cell phone. A qualitative comparative case study was carried out to better understand how teachers in a township as well as an urban school use cell phones for online teaching in Grade 7. Field notes, document analysis, and semi-structured interviews with fifteen teachers from township and urban schools were used to collect the data. Atlas ti was used to perform the content analysis and coding of both the classroom documents and the interview responses.The results show that ICT can lead to a lot of uncertainty and that most teachers feel inefficient, even though they are open to new approaches and new technologies in online education. Teachers argue that their inadequacies in online teaching will be exposed if they are not properly trained in ICT. The study's conclusions demonstrate that teachers' technical proficiency and positive attitudes are key factors in whether digital technology is successful in teaching methods using cell phones.There is a need to provide online training for all teachers, including those in township schools, so that the curriculum can continue to be covered even when schools are closed for daily attendance.
BackgroundRecent studies in the Sub-Saharan countries in Africa have indicated gaps and challenges for voluntary medical male circumcision (VMMC) quality of service. Less has focused on the changes ...in quality of service after implementation of continuous quality improvement (CQI) action plans. This study aimed to evaluate the impact of coaching, provision of standard operating procedures (SOPS) and guidelines, mentoring and on-site in-service training in improving quality of VMMC services across four Right to Care (RTC) supported provinces in South Africa.MethodThis was a pre- and post-interventional study on RTC supported VMMC sites from July 2018 to October 2019. All RTC-supported sites that were assessed at baseline and post-intervention were included in the study. Data for baseline CQI assessment and re-assessments was collected using a standardized National Department of Health (NDoH) CQI assessment tool for VMMC services from routine RTC facility level VMMC programme data. Quality improvement support was provided through a combination of coaching, provision of standard operating procedures and guidelines, mentoring and on-site in-service training on quality improvement planning and implementation. The main outcome measure was quality of service. A paired sample t-test was used to compare the difference in mean quality of service scores before and after CQI implementation by quality standard.ResultsA total of 40 health facilities were assessed at both baseline and after CQI support visits. Results showed significant increases for the overall changes in quality of service after CQI support intervention of 12% for infection prevention (95%CI: 7-17; p<0.001) and 8% for male circumcision surgical procedure, (95%CI: 3-13; p<0.01). Similarly, individual counselling, and HIV testing increased by 14%, (95%CI: 7-20; p<0.001), group counselling, registration and communication by 8%, (95%CI: 3-14; p<0.001), and 35% for monitoring and evaluation, (95%CI: 28-42; p<0.001). In addition, there were significant increases for management systems of 29%, (95%CI: 22-35; p<0.001), leadership and planning 23%, (95%CI: 13-34; p<0.001%) and supplies, equipment, environment and emergency 5%, (95%CI: 1-9; p<0.01). The overall quality of service performance across provinces increased by 18% (95%CI: 14-21; p<0.001).ConclusionThe overall quality of service performance across provinces was significantly improved after implementation of CQI support intervention program. Regular visits and intensive CQI support are required for sites that will be performing below quality standards.
Voluntary medical male circumcision (VMMC) reduces HIV acquisition among heterosexual men by approximately 60%. VMMC is a surgical procedure and some adverse events (AEs) are expected. Swaziland's ...Ministry of Health established a toll-free hotline to provide general information about VMMC and to manage post-operative clinical AEs through telephone triage.
We retrospectively analyzed a dataset of telephone calls logged by the VMMC hotline during a VMMC campaign. The objectives were to determine reasons clients called the VMMC hotline and to ascertain the accuracy of telephone-based triage for VMMC AEs. We then analyzed VMMC service delivery data that included date of surgery, AE type and severity, as diagnosed by a VMMC clinician as part of routine post-operative follow-up. Both datasets were de-identified and did not contain any personal identifiers. Proportions of AEs were calculated from the call data and from VMMC service delivery data recorded by health facilities. Sensitivity analyses were performed to assess the accuracy of phone-based triage compared to clinically confirmed AEs.
A total of 17,059 calls were registered by the triage nurses from April to December 2011. Calls requesting VMMC education and counseling totaled 12,492 (73.2%) and were most common. Triage nurses diagnosed 384 clients with 420 (2.5%) AEs. According to the predefined clinical algorithms, all moderate and severe AEs (153) diagnosed through telephone-triage were referred for clinical management at a health facility. Clinicians at the VMMC sites diagnosed 341 (4.1%) total clients as having a mild (46.0%), moderate (47.8%), or severe (6.2%) AE. Eighty-nine (26%) of the 341 clients who were diagnosed with AEs by clinicians at a VMMC site had initially called the VMMC hotline. The telephone-based triage system had a sensitivity of 69%, a positive predictive value of 83%, and a negative predictive value of 48% for screening moderate or severe AEs of all the AEs.
The use of a telephone-based triage system may be an appropriate first step to identify life-threatening and urgent complications following VMMC surgery.
Abstracts in English, Sotho and Zulu
Waste generation is a global problem encountered by many nations. In recent years, population growth, booming urbanisation, an increase in economic activities and ...rise of communities’ living standards have significantly escalated household waste generation which has been a cause for concern. Waste production in households and schools imposes serious concern on the environment. To curb further depletion of environmental resources, sustainable consumption and household waste management practices and systems cannot be over emphasised. Therefore, the aim of the study was to explore the views of secondary school teachers’ views with regard to learners’ awareness of household waste management in Newcastle, South Africa.;
This study, following a qualitative approach, adopted a case study design to explore secondary teachers’ views on learners’ awareness on household waste management in the Newcastle municipality, in the Amajuba District, South Africa. By using semi- structured interviews, non-participatory observation and documents analysis, data were collected from three secondary schools and nine teachers, teaching Natural Sciences, Social Sciences and Life Orientation in Grade 8.;
The findings revealed that teachers understand the importance and benefits of household waste management although misconceptions of household waste management still prevailed. A challenge that emerged showed that teachers lack training to successfully integrate household waste management in their subjects. Their failure to identify household waste management themes in their CAPS subjects was sufficient evidence for the urgency of in-service training of teachers to assist them in integrating environmental education (EE) themes such as household waste management in their subjects. Although teachers experienced several challenges regarding implementing the theme of household waste management in their subjects, they considered the benefits outweighed the challenges.
Tlhahiso ya ditshila ke bothata bo aparetseng dinaha tse ngata. Dilemong tsa morao tjena, kgolo ya baahi, ho eketseha ha ditoropo, ho eketseha ha mesebetsi ya moruo, le ho phahama ha maemo a bophelo a baahi ho ekeditse tlhahiso ya ditshila tsa malapa ka mokgwa o bonahalang, e leng seo e leng sesosa sa ho tshwenyeha. Tlhahiso ya ditshila malapeng le dikolong e baka mathata a tebileng tikolohong. Ho thibela ho qepha ho eketsehileng ha mehlodi ya tikoloho, tshebediso e tsitsitseng le ditlwaelo tsa taolo ya ditshila tsa malapeng le ditsamaiso ho hloka ho elwa hloko ka tsela e kgethehileng. Kahoo, sepheo sa phuputso e ne e le ho hlahloba maikutlo a matitjhere a dikolo tse mahareng mabapi le tlhokomediso ya baithuti ka taolo ya ditshila tsa malapa Newcastle, Afrika Borwa.;
Phuputso, ka ho sebedisa mokgwa wa boleng, e amohetse moralo wa phuputso e ikgethileng ho hlahloba maikutlo a matitjhere a dikolo tse bohareng hodima tlhokomediso ya baithuti mabapi le taolo ya ditshila tsa malapa mmasepaleng wa Newcastle, Seterekeng sa Amajuba, Afrika Borwa. Ka ho sebedisa dipuisano tse hlophisitsweng hantle, tlhahlobo e sa kenyelletseng bonkakarolo le manollo ya ditokomane, datha e ile ya bokellwa ho tswa dikolong tse tharo tse bohareng le ho matitjhere a robong, a rutang Saense ya Tlhaho, Saense ya Phedisano le Thuto ya Bophelo bakeng sa baithuti ba Sehlopha sa 8.;
Diphetho di senotse hore matitjhere a utlwisisa bohlokwa le melemo ya taolo ya ditshila tsa malapa le hoja maikutlo a fosahetseng mabapi le taolo ya ditshila tsa malapa a ntse a atile. Phephetso e ileng ya hlaha e bontsha hore matitjhere a haellwa ke kwetliso ya ho kenyelletsa ka katleho taolo ya ditshila tsa malapa dithutong tsa bona. Ho hloleha ho kgetholla dihlooho tsa taolo ya ditshila tsa malapa dithutong tsa bona tsa CAPS e ne e le bopaki bo lekaneng ba ho potlaka ha kwetliso ya matitjhere a tshebetsong ho ba thusa ho kenyelletsa dihlooho tsa thuto ya tikoloho (EE) jwalo ka taolo ya ditshila tsa malapa dithutong tsa bona. Leha ele hore matitjhere a ile a ba le diphephetso mabapi le ho kenyelletsa dihlooho tsa taolo ya ditshila tsa malapa dithutong tsa bona, ba ile ba utlwa hore melemo e feta diphephetso.
Ukukhiqizeka kukadoti kuyinkinga ehlangabezana nezizwe eziningi emhlabeni. Eminyakeni esanda kudlula, ukukhula kwenani labantu, ukukhula kwamadolobha, ukukhula kwemisebenzi yamabhizinisi kanye nokukhuphuka kwezinga lempilo yabantu yikho okuye kwadala ukuthi imizi ikhiqize izinga eliphezulu likadoti/lenkukuma, okuyinkinga ebekade ivele isikhona. Ukukhiqizeka kukadoti emakhaya kanye nasezikoleni kudala izinkinga ezibi kakhulu endaweni. Ukuqeda ukumoshakala/ukuguga kwemithombo yezendawo okuqhubekela phambili, kusobala ukuthi kudingeka izindlela ezisimelele zokugaywa kukadothi kanye nezindlela zokulawula kukadothi kanti konke lokhu kuyiqiniso elingenakuphikiswa. Ngakho-ke, inhloso yocwaningo kwakuwukuphenya imibono yabafundisi bezikole zamabanga aphakeme mayelana nokuxwayisa uhlelo lokulawulwa kukadoti endaweni yase Newcastle, eNingizimu Afrika.;
Lolu cwaningo ngokulandela indlela yocwaningo eyencike kwingxoxo, luye lwalandela idizayini yocwaningo lotho ukuphenya imibono yabafundisi bamabanga aphakeme mayelana nokuxwayiswa kwabafundi ngokulawulwa kukadoti emakhaya ngaphansi kukamasipaladi waseNewcastle, ongaphansi kwesiFunda saseMajuba, eNingizimu Afrika. Idatha iye yaqoqwa ngokusebenzisa inhlolovo embaxambili, kwahlaziywa indlela yokuziphatha futhi kwahlaziywa imibhalo, kanti le datha iqoqwe ezikoleni zamabanga aphakeme ezintathu kanye nakubafundisi abayisishiyagalolunye, okungabafundisi abafundisa izifundo phecelezi Natural Sciences, Social Sciences kanye neLife Orientation yabafundi bakaGreyidi 8.;
Ulwazi olutholakele luveze ukuthi abafundisi bazwisisa ukubaluleka kanye nezinzuzo zohlelo lokulawulwa kukadoti, yize kusekhona ukudideka/ukungazwisisani mayelana nohlelo lokulawula ukuphatha kukadoti. Inselelo ebonakele, ikhombise ukuthi abafundisi baswela ukuqeqeshwa ukuze bakwazi ukuzwisisa kahle uhlelo lokulawulwa kukadoti kwizifundo zabo. Ukwehluleka kwabo ukwehlukanisa izindikimba zokulawulwa kukadoti emakhaya ezifundweni zabo zeCAPS kuye kwaba wubufakazi obanele besidingo esisheshayo sokuqeqeshwa kwabafundisi abasemsebenzini ukubanceda ukuba bakwazi ukuhlanganisa izindikimba zezifundo zezendawo environmental education (EE) ezinjengokulawulwa kukadoti ezifundweni zabo.Yize abafundisi behlangabezana nezinselele ezimbalwa mayelana nokusebenzisa indikimba yokulawulwa kukadoti ezifundweni zabo, baye babona ukuthi izinzuzo zalokhu zedlula izinselele.
Curriculum and Instructional Studies
M. Ed. (Environmental Education Curriculum)
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